PP049. Could the supplementation of L-arginine plus folic acid T improve reduced endothelial function seen in preeclampsia?

Introduction: Preeclampsia is characterized as an increase in vascular tone due to the disorder of endothelial cell function. It was found that action of nitric oxide (NO) derived from endothelial cell might be decreasing in preeclamptic women.

Objectives: In the present study, we investigated whether or not the supplementation of L-arginine (LARG, NO synthase substrate) and folic acid (FA) might improve the reduced action of NO seen in preeclampsia.

Methods: Change in brachial artery diameter by hyperemia (%FMD) was measured to evaluate the endothelial function using ultrasound. Twelve of 25 normal pregnant women seen with reduced %FMD (<110) at less than 16weeks of gestation were given the supplementation of FA 0.8mg+LARG1g/day throughout pregnancy. The concentrations of FA+LARG in erythrocyte, and cGMP (a second messenger of NO) in serum were measured. The informed consent was obtained from each patient. This investigation was approved by the Ethics Committee of Nagoya City East and West Medical Center.

Results: Reduced % FMD was seen in 25 pregnant women. One of 12 pregnant women in the supplementation group developed mild, late onset preeclampsia, while 8 of 13 pregnant women in no supplement group developed onset preeclampsia (4 cases were severe). Following the supplementation, %FMD had been increasing as well as the concentrations of FA and LARG in erythrocyte, while the concentration of cGMP in serum had not changed.

Conclusion: The supplementation of FA+LARG might prevent preeclampsia due to improvement of the reduced endothelial function in high risk pregnant women of preeclampsia.