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The Journal of Clinical Endocrinology & Metabolism Vol. 89, No. 9 4772-4773
Copyright © 2004 by The Endocrine Society

Letter to the Editor

Association of Glutathione Peroxidase Activity with Insulin Resistance and Dietary Fat Intake during Normal Pregnancy

Wayne Chris Hawkes

U. S. Department of Agriculture/Agricultural Research Service Western Human Nutrition Research Center, University of California at Davis (UCD) Department of Nutrition, National Center on Minority Health and Health Disparities Center of Excellence for Nutritional Genomics, UCD Medical Center Cancer Center, University of California at Davis, Davis, California 95616-8685

Address correspondence to: Wayne Chris Hawkes, Ph.D., University of California at Davis, 1 Shields Avenue, Davis, California 95616-8685. E-mail: chawkes{at}whnrd.usda.gov.

To the editor:

In a recent article, Chen et al. (1) reported a significant increase in erythrocyte glutathione peroxidase activity during pregnancy. The same article also reported higher glutathione peroxidase activity in Blacks and significant positive correlations with fasting insulin, C-peptide, and insulin resistance. Increased glutathione peroxidase activity during pregnancy is a very surprising finding in light of the many previous reports that selenium status declines significantly during normal pregnancy. This paper by Chen et al. (1) seems to be the first report of increased glutathione peroxidase (or any other parameter of selenium status) during pregnancy.

Lower blood selenium concentrations and glutathione peroxidase activities have been reported in pregnant women relative to prepregnancy levels (2, 3, 4, 5) and relative to nonpregnant control women (6, 7, 8, 9). Glutathione peroxidase activity in erythrocytes (5) and selenium concentration in hair (10) are lower in pregnant women, and amniotic fluid selenium concentrations decline throughout pregnancy (11), suggesting that a real decrease in selenium status occurs during pregnancy. The retention of stable isotopes of selenium is greater in pregnant women than in nonpregnant controls (12), suggesting that the decreased selenium status is driven by an increased requirement for selenium, presumably to support fetal growth.

It seems far more likely that the apparent increase in glutathione peroxidase activity was a result of their choice to express the activity relative to the hemoglobin concentration. It is well known that hemoglobin concentration declines during normal pregnancy (13); however, these authors did not report the hemoglobin data. The paper also does not mention what prenatal nutritional supplements were administered to, or used by, these pregnant women. If supplements were not given, then hemoglobin concentrations very likely declined (14, 15, 16) and would account for the apparent increase in glutathione peroxidase activity. If supplements were given and they contained selenium and/or vitamin E (which may improve selenium utilization) (17), then the supplements may have been the source of a real increase in glutathione peroxidase activity, as has been observed before (18). The apparent racial differences can also be explained by noting that hemoglobin is lower in African-American women than in Caucasian women (19) and anemia is more prevalent in Black women (20, 21, 22), which would cause the ratio of glutathione peroxidase to hemoglobin to appear higher in African-Americans relative to Caucasians.

The authors could have reported the glutathione peroxidase activity as a simple concentration to show that the effect was independent of a change in hemoglobin, or they could have reported the hemoglobin data to show that it did not change. Alternatively, they could have included hemoglobin concentration as a covariate in the statistical analysis of the glutathione peroxidase/hemoglobin ratios. Because these data were not reported and none of these issues were raised in the article, it would seem appropriate to address them now by publishing this letter and the authors’ response.

Received February 18, 2004.

References

  1. Chen X, Scholl TO, Leskiw MJ, Donaldson MR, Stein TP 2003 Association of glutathione peroxidase activity with insulin resistance and dietary fat intake during normal pregnancy. J Clin Endocrinol Metab 88:5963–5968[Abstract/Free Full Text]
  2. McGlashan ND, Cook SJ, Melrose W, Martin PL, Chelkowska E, von Witt RJ 1996 Maternal selenium levels and sudden infant death syndrome (SIDS). Aust N Z J Med 26:677–682[Medline]
  3. Butler JA, Whanger PD, Tripp MJ 1982 Blood selenium and glutathione peroxidase activity in pregnant women comparative assays in primates and other animals. Am J Clin Nutr 36:15–23[Abstract/Free Full Text]
  4. Hinks LJ, Ogilvy SA, Hambidge KM, Walker V 1989 Maternal zinc and selenium status in pregnancies with a neural tube defect or elevated plasma alpha fetoprotein. Br J Obstet Gynaecol 96:61–66[Medline]
  5. Zachara BA, Wardak C, Didkowski W, Maciag A, Marchaluk E 1993 Changes in blood selenium and glutathione concentrations and glutathione peroxidase activity in human pregnancy. Gynecol Obstet Invest 35:12–17[Medline]
  6. Ferrer E, Alegria A, Barbera R, Farre R, Lagarda MJ, Monleon J 1999 Whole blood selenium content in pregnant women. Sci Total Environ 227:139–143[CrossRef][Medline]
  7. Navarro M, Lopez H, Perez V, Lopez MC 1996 Serum selenium levels during normal pregnancy in healthy Spanish women. Sci Total Environ 186:237–242[CrossRef][Medline]
  8. Wasowicz W, Wolkanin P, Bednarski M, Gromadzinska J, Sklodowska M, Grzybowska K 1993 Plasma trace element (Se, Zn, Cu) concentrations in maternal and umbilical cord blood in Poland—relation with birth weight, gestational age, and parity. Biol Trace Elem Res 38:205–215[Medline]
  9. Gromadzinska J, Wasowicz W, Krasomski G, Broniarczyk D, Andrijewski M, Rydzynski K, Wolkanin P 1998 Selenium levels, thiobarbituric acid-reactive substance concentrations and glutathione peroxidase activity in the blood of women with gestosis and imminent premature labour. Analyst 123:35–40[CrossRef][Medline]
  10. Guvenc H, Karatas F, Guvenc M, Kunc S, Aygun AD, Bektas S 1995 Low levels of selenium in mothers and their newborns in pregnancies with a neural tube defect. Pediatrics 95:879–882[Abstract/Free Full Text]
  11. Karunanithy R, Roy AC, Ratnam SS 1989 Selenium status in pregnancy studies in amniotic fluid from normal pregnant women. Gynecol Obstet Invest 27:148–150[CrossRef][Medline]
  12. Swanson CA, Reamer DC, Veillon C, King JC, Levander OA 1983 Quantitative and qualitative aspects of selenium utilization in pregnant and nonpregnant women: an application of stable isotope methodology. Am J Clin Nutr 38:169–180[Abstract/Free Full Text]
  13. Bashiri A, Burstein E, Sheiner E, Mazor M 2003 Anemia during pregnancy and treatment with intravenous iron: review of the literature. Eur J Obstet Gynecol Reprod Biol 110:2–7[CrossRef][Medline]
  14. Mahomed K 2000 Iron and folate supplementation in pregnancy. Cochrane Database Syst Rev:CD001135
  15. Sloan NL, Jordan E, Winikoff B 2002 Effects of iron supplementation on maternal hematologic status in pregnancy. Am J Public Health 92:288–293[Abstract/Free Full Text]
  16. Dawson EB, McGanity WJ 1987 Protection of maternal iron stores in pregnancy. J Reprod Med 32:478–487[Medline]
  17. Combs Jr GF, Combs SB 1986 The role of selenium in nutrition. San Diego: Academic Press
  18. Hawkes WC, Alkan FZ, Oehler L 2003 Absorption, distribution and excretion of selenium from beef and rice in healthy North American men. J Nutr 133:3434–3442[Abstract/Free Full Text]
  19. Hunter GR, Weinsier RL, McCarthy JP, Enette Larson-Meyer D, Newcomer BR 2001 Hemoglobin, muscle oxidative capacity, and VO2max in African-American and Caucasian women. Med Sci Sports Exerc 33:1739–1743[Medline]
  20. Semba RD, Shah N, Klein RS, Mayer KH, Schuman P, Vlahov D 2002 Prevalence and cumulative incidence of and risk factors for anemia in a multicenter cohort study of human immunodeficiency virus-infected and -uninfected women. Clin Infect Dis 34:260–266[CrossRef][Medline]
  21. Bodnar LM, Scanlon KS, Freedman DS, Siega-Riz AM, Cogswell ME 2001 High prevalence of postpartum anemia among low-income women in the United States. Am J Obstet Gynecol 185:438–443[CrossRef][Medline]
  22. Leshan L, Gottlieb M, Mark D 1995 Anemia is prevalent in an urban, African-American adolescent population. Arch Fam Med 4:433–437[Abstract/Free Full Text]



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