Plasma homocysteine concentration is increased in preeclampsia and is associated with evidence of endothelial activation

OBJECTIVE: We tested the hypothesis that the independent risk factor for at herosclerosis of increased plasma homocysteine concentration is associated with the pregnancy syndrome of preeclampsia. We further hypothesized that i ncreased plasma homocysteine concentration during pregnancy may advance end othelial dysfunction in preeclampsia by promoting oxidative stress. STUDY DESIGN: Antepartum blood samples were collected greater than or equal to 6 hours after the last meal from 33 women with normal, uncomplicated pr egnancies and from 21 women with preeclampsia. These plasma samples were an alyzed for concentrations of total homocysteine; folate; triglycerides; cre atinine; a marker of endothelial activation, cellular fibronectin; and a ma rker of oxidative stress, malondialdehyde. RESULTS: The mean Value of total plasma homocysteine in preeclampsia was si gnificantly higher than that observed in normal pregnancy (P<.04). Similarl y, plasma malondialdehyde (P<.001), triglyceride (P<.001), and cellular fib ronectin (P<.006) concentrations were also greater in women with preeclamps ia than in control subjects. However, no differences were observed between women with preeclampsia and control subjects in folate (P=.97) or creatinin e (P=.28) concentrations. Homocysteine concentration did not correlate with plasma creatinine (P =.61), malondialdehyde (P=.32), or triglyceride (P=.8 9) concentrations. However, cellular fibronectin concentration correlated p ositively with homocysteine concentration in both women with preeclampsia a nd control subjects (r= 0.87, P <.0001, and r= 0.50, P<.004, respectively), and folate concentrations were weakly but negatively correlated with homoc ysteine values (P=.03, r= 0.32). CONCLUSIONS: Total plasma homocysteine concentration is increased in preecl ampsia and is significantly correlated with cellular fibronectin concentrat ion, suggesting that homocysteine plays a role in promoting endothelial dys function in preeclampsia. Furthermore, despite the use of pregnancy multivi tamins and no indications of overt folate deficiency in this subject popula tion, homocysteine concentration weakly and negatively correlates with plas ma folate concentration.