effects of selenium supplementation on soluble fms-like tyrosine kinase-1 and glutathione peroxidase levels and the plasminogen activator inhibitor-1: plasminogen activator inhibitor-2 ratio in pregnant women

Background: preeclampsia is a hypertensive disorder of pregnancy, which is associated with increased maternal and prenatal morbidity and mortality. oxidative stress associated with preeclampsia may be a consequence of reduced antioxidant defense pathways that might involve inadequate glutathione peroxidase (gpx) levels, perhaps linked to reduced selenium availability. the soluble fms-like tyrosine kinase-1 (sflt-1) that contributes to endothelial dysfunction may be partially responsible for the clinical manifestation of preeclampsia. furthermore, elevated plasminogen activator inhibitor-1 (pai-1) and decreased plasminogen activator inhibitor-2 (pai-2) are found in preeclamptic women. hence, the pai1: pai2 ratio maybe a predictor of preeclampsia.objectives: the objective of this study was to evaluate the effects of selenium supplementation on sflt-1, gpx activity and pai1: pai2 ratio in pregnant women.materials and methods: a total of 125 high-risk pregnant women (with a familial history of hypertension, hyperlipidemia and other risk factors for preeclampsia) in the first trimesters of pregnancy were assigned to either selenium (n = 61) or placebo (n = 64) groups. the selenium group received 100 μg/day of selenium as a selenium-yeast tablet for six months. the placebo group received a placebo yeast tablet for the same period. at the beginning of the trial and at the end, blood samples were collected and the levels of sflt-1, pai-1, pai2 and gpx were measured in blood serum and plasma.results: serum selenium concentrations were raised in the selenium group (p < 0.001) from the first to the third trimester, but was unchanged in the placebo group (p = 0.85). the results showed that sflt-1 had significantly increased in both groups by the end of the gestation period, and selenium supplementation had no significant effect on the selenium group (p = 0.51). however, gpx activity was significantly increased in the selenium treatment group after supplementation compared to the control group (p < 0.001). the pai1: pai2 ratio was not significantly different between the two groups (p = 0.44).conclusions: selenium intake during the second and third trimester of pregnancy increased gpx activity but did not have a significant effect on serum sflt-1 levels or the ratio of pai1: pai2 in the serum.