Abstract 19031: Amino Acid Pathways are Altered in Cardiovascular Complications of Pregnancy

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Background: Specific metabolites have been associated with cardiovascular complications of pregnancy, however studies in African American (AA) women are lacking. Objectives: The purpose of this study was to investigate metabolomics pathways in early gestation that associate with a later diagnosis of a cardiovascular complications of pregnancy, including gestational hypertension and preeclampsia, in AA women.

Methods: We conducted a retrospective analysis of pregnant AA women 18-40 years of age who had cardiovascular complications of pregnancy (preeclampsia - n=9; gestational hypertension (gHTN) - n=9) and who had uncomplicated, full-term pregnancies (n=86). Participants had serum samples collected between 8-14 weeks gestation and had medical chart abstraction following pregnancy to identify cardiovascular complications. High-resolution liquid chromatography mass spectrometry (LC-MS) was used to measure serum metabolites. Statistical tests of significance included t-tests with Benjamini-Hochberg correction for multiple corrections.

Results: Significant differences in several amino acid pathways were identified for women with and without preeclampsia or gHTN complications. Methionine and cysteine metabolism was common among both complications [preeclampsia - 8 significant metabolites, 4 upregulated, 4 downregulated; gHTN - 9 significant metabolites, 6 upregulated and 3 downregulated]. Two metabolites (m/z 139.026 and 171.007) were found in both and in the same direction. Other pathways different in preeclampsia included the metabolism of tryptophan [12 significant metabolites, 8 upregulated], a precursor of serotonin known to be involved in gut function, and tyrosine metabolism [15 metabolites, 8 upregulated], which is also related to neurotransmitters. Glutamate metabolism was altered in gHTN.

Conclusions: Findings suggest a contribution for specific metabolic pathways in the pathogenesis of cardiovascular complications of pregnancy. Larger scale studies investigating the value of metabolites in these pathways in predicting cardiovascular complications of pregnancy early in gestation are warranted.

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