The relationship between trace element imbalance, oxidative stress, and endothelial dysfunction in preeclampsia...

Preeclampsia is a complex and heterogeneous complication during pregnancy, with oxidative stress and endothelial dysfunction also playing a role in its pathogenesis. This prospective case-control study aimed to investigate the roles of trace and toxic element homeostasis, as well as oxidative stress and endothelial dysfunction markers, in the pathophysiology of preeclampsia.

The study included 100 third-trimester pregnant women (50 with preeclampsia and 50 matched normotensive controls). Trace-Zn, Se, Fe, Cu, V, Mn, Co-and toxic-As, Cd, Pb-elements were measured using inductively coupled plasma mass spectrometry (ICP-MS). To evaluate oxidative stress and endothelial dysfunction, malondialdehyde (MDA), superoxide dismutase (SOD) activity, and asymmetric dimethylarginine (ADMA) levels were measured by ELISA.

Fe, Mn, Zn, Co, Cu, Se, As, Cd, and V levels were significantly higher in the preeclampsia group than in controls (all p < 0.001), whereas Pb levels did not differ significantly (p = 0.669). SOD activity decreased (p = 0.027), while MDA (p = 0.005) and ADMA levels (p = 0.039) increased in the preeclampsia group. Compared with healthy controls, the element-correlation network was weaker in preeclampsia, and Cu/Zn, Fe/Zn, and MDA/SOD ratios were significantly altered (all p < 0.05). ROC analyses demonstrated high diagnostic performance for Fe (AUC = 0.891), Mn (AUC = 0.881), Zn (AUC = 0.876), and Se (AUC = 0.856). In binary logistic regression analyses, Zn (OR = 1.11, p < 0.001) and Fe (OR = 1.002, p = 0.004) were positively related to preeclampsia, whereas SOD activity showed an inverse relationship (OR = 0.99, p = 0.025).

These findings indicate that oxidative stress is increased and endothelial function is impaired in preeclampsia in parallel with disruption of elemental balance. The results provide a basis for further investigation into these parameters as supportive clinical assessments and potential biomarkers.