الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Preeclampsia (PE) is best described as a pregnancy-specific disorder of widespread vascular endothelial malfunction and vasospasm. It is a multisystem disorder that is characterized by a classical triad of hypertension, proteinuria, edema and various metabolic disturbances resembling those seen in the metabolic syndrome. PE occurs after 20 weeks of gestation.
Preeclampsia is mild in 75% of cases and severe in 25% of them. PE when remains untreated, it moves towards more serious condition known as eclampsia and HELLP syndrome.
Eclampsia is defined as tonic clonic seizures that cannot be attributed to other causes, in a woman with PE. It is a life-threatening acute complication that may appear before, during or after labor.
The pathogenesis of PE is due to alterations in placental anti-angiogenic factors and adipocyte-secreted factors such as adiponectin, leptin, tumour necrosis factor-α (TNF-α), chemerin and zinc-α 2-glycoprotein (ZAG). Alterations in these factors produce systemic endothelial dysfunction, resulting in hypertension, proteinuria and the other systemic manifestations of PE.
ZAG, a lipid mobilizing adipokine, is a 41 kDa soluble glycoprotein that its name is derived from its tendency to precipitate with zinc and from its electrophoretic migration in the region of α 2- globulins. It has been initially identified and purified in plasma and is expressed and synthesized in several human tissues, including subcutaneous and visceral adipocytes. It appears that renal filtration is an important route for eliminating ZAG. Thus, markers of renal function should be considered in studies on ZAG physiology.
ZAG participates in many important functions in the human body, including lipolysis, regulation of metabolism, cell proliferation and differentiation, regulation of melanin synthesis, cell adhesion as well as immunoregulation. Recently, it has been shown that it is also involved in tumor differentiation.
The aim of the present study was to measure serum zinc-α2-glycoprotein (ZAG) in pregnant Egyptian females with preeclampsia and eclampsia and to correlate its levels to clinical and biochemical measures of renal function, glucose and lipid metabolism.
The study was conducted on eighty pregnant females in the third trimester of pregnancy after exclusion of patients with diabetes mellitus, prior renal diseases, chronic hypertension, endocrine diseases or any chronic diseases. They were divided into four groups; twenty pregnant females with mild preeclampsia, twenty pregnant females with severe preeclampsia, twenty pregnant females with eclampsia and twenty gestational age-matched pregnant females without preeclampsia were included as controls.
All participants in the present study were subjected to detailed history taking and clinical examination. CBC, measurement of fasting glucose, serum cholesterol, serum triglycerides, serum creatinine, liver function tests were performed. Estimated glomerular filtration rate (eGFR), protein creatinine ratio and HOMA-IR were calculated. In addition, fasting insulin and serum ZAG concentrations were determined by a commercially available ELISA.
In our study, maternal serum ZAG levels were significantly higher in mild and severe preeclampsia patients when compared to healthy pregnant controls.
Furthermore, we found in our study a positive correlation between circulating ZAG on one hand and SBP, urinary protein, fasting serum insulin and HOMA-IR on the other hand in the patients group. The association remained significant after adjusting for other parameters that may affect ZAG level in patients