Association between serum paraoxonase and plasma nitric oxide in pre-eclampsia

Shilpa Suneja, Rahul Saxena, Raj Saxena, Dilutpal Sharma, Alok Milton Lal


Background: It is well accepted that oxidative stress plays a crucial role in the development of endothelial dysfunction leading to Pregnancy Induced Hypertension (PIH). However, studies related to altered levels of paraoxonase and nitric oxide in PIH subjects are still in obscure. In this context, the present study was undertaken to assess serum Paraoxonase (PON), Nitric Oxide (NO) levels along with other markers of oxidative stress i.e. erythrocyte Malondialdehyde (MDA), plasma ascorbic acid levels in the blood samples of PIH subjects and to determine their relation in etio-pathogenesis of  PIH complication.

Methods: Markers of oxidative stress (PON, MDA, and ascorbic acid) and endothelial dysfunction (serum NO) were estimated in 20 normotensive pregnant women (Group I) and 20 PIH women (Group II) by using standard methods. Data obtained from both the groups were statistically compared with age matched 20 healthy non pregnant women (Control group) by using student’s t-test.

Results: Serum PON and erythrocyte MDA levels were increased significantly whereas marked depletion in plasma NO and vitamin C levels (P <0.05, P <0.001) were observed in PIH subjects. In addition, PON levels were inversely correlated with endothelial dysfunction. However, only plasma NO levels were decreased significantly in group I subjects whereas other parameters were altered insignificantly (P <0.1) in group I subjects.

Conclusion: These findings reflects the importance of antioxidant rich diet in the prevention of PIH complication and emphasizes the early assessment of serum paraoxonase and NO levels as efficient diagnostic marker to predict future risk of PIH development. 


Ascorbic acid, Pre-eclampsia, Reactive oxygen species, Endothelial dysfunction

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Bowen RS, Moodley J, Dutton MF, Theron AJ. Oxidative stress in pre-eclampsia. Acta Obstet Gynecol Scand. 2001;80(8):719-25.

Saxena R, Jaiswal G. Selenium and its role in Health and Diseases. Kuwait Med J. 2007;39(1):10-8.

Bhattacharya I, Saxena R, Gupta, V. Efficacy of vitamin E in knee osteoarthritis management of North Indian Geriatric population. Therap Adv Musculo Dis. 2012;4(1):11-9.

Gupta V, Saxena R, Bhattacharya I, Thakur RK, Mishra M. Lipid peroxidation mediated electrolyte imbalance and altered antioxidant status in Hypertensive smokers. Saudi Germ Hosp Med J. 2011;5(1):7-17.

Gupta V, Saxena R, Bhattacharya I, Sunita. Assessment of Coronary heart disease risk in knee osteoarthritic North Indian elderly. J Indian Acad Geriat. 2012;8:64-71.

Zhang C, Williams MA, King IB, Dashow EE, Sorensen TK, Frederick IO et al. Vitamin C and the risk of preeclampsia--results from dietary questionnaire and plasma assay. Epidemiol. 2002;13(4):409-16.

Saxena R, Jaiswal G. Vitamin E, markers of oxidative stress and nitric oxide levels in senescence. J Indian Acad Geriat. 2010;6:71-7.

Gan KN, Smolen A, Eckerson HW, Bert NLD. Purification of human serum paraoxonase / arylesterase. Drug Metabol Disp. 1991;19:100-6.

Mc Cormick DB, Greene HL. Vitamin. In: Burtis and Ashwood, eds. Tietz Text Book of Clinical Chemistry. 3rd ed. USA: WB Saunders Company; 1998: 1025-1027.

Moshage H, Kok B, Huizenga JR, Jansen PL. Nitrite and nitrate determinations in plasma: a critical evaluation. Clin Chem. 1995;41:892-6.

Sinnhuber RO, Yu TC and Yu TC. Characterization of the red pigment formed in the thiobarbituric acid determination of oxidative rancidity. Food Res. 1958;23:626-30.

Adiga U , D'souza V, Kamath A, Mangalore N. Antioxidant activity and lipid peroxidation in preeclampsia. J Chin Med Assoc. 2007;70(10):435-8.

Yaghmaei M, Hashemi M, Azarian A, Moazeni-Roodi A, Mokhtari M, Naghavai A et al. Association of L55M and Q192R polymorphisms of paraoxonase-1 gene with preeclampsia. Arch Med Res. 2011;42(4):324-8.

Saxena R, and Jaiswal, G. Influence of vitamin E supplementation on plasma paraoxonase, antioxidants status and nitric oxide levels in hypertensive smokers. S As J Prev Cardiol. 2009;13(1):20-9.

Saxena R, Bhattacharya I, Saxena R. Susceptibility of knee osteoarthritic patients to develop cardiovascular disease. Asian J Med Sci. 2013;4(3):62-8.

Heitzer T, Just H and Munzel T. Antioxidant Vitamin C improves endothelial dysfunction in chronic smokers. Circulat. 1996;94:6-9.

Manson JF, Stampfer MJ and Willett WC. A prospective study of antioxidants vitamins and incidence of coronary artery disease in women. Circulat. 1991;84:2168-75.

Singh S, Saxena R, Lal AM. Influence of aging on plasma ascorbate level. Natl Acad Sci Lett. 2005;28(3 & 4):125-7.

Gupta S, Aziz N, Sekhon L, Agarwal R, Mansour G, Li J, Agarwal A. Lipid peroxidation and antioxidant status in preeclampsia: a systematic review. Obstet Gynecol Surv. 2009;4(11):750-9.

Podjarny E, Mandelbaum A, Bernheim J. Does nitric oxide play role in normal pregnancy and pregnancy-induced hypertension? Nephrol Dial Transplant. 1994;9:1527-40.

Sahu S, Daniel M, Abraham R, Vedavalli R, Senthilvel V. Study of uric acid and nitric oxide concentrations in preeclampsia and normal pregnancy. Int J Biol Med Res. 2011;2(1):390-3.

Ranta V, Viinikka L, Halmesmäki E, Ylikorkala O. Nitric oxide production with preeclampsia. Obstet Gynecol. 1999;93(3):442-5.