| Autor: |
de Knegt VE; Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark.; Department of Paediatrics, University Hospital Slagelse, 4200 Slagelse, Denmark., Hedley PL; Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark.; Brazen Bio, Los Angeles, CA 90014, USA., Eltvedt AK; Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark., Placing S; Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark., Wøjdemann K; Department of Gynecology and Obstetrics, Bornholm Hospital, 3700 Rønne, Denmark., Shalmi AC; Department of Obstetrics, Hillerød Hospital, 3400 Hillerød, Denmark., Rode L; Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, 2600 Glostrup, Denmark., Kanters JK; Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark., Sundberg K; Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark., Tabor A; Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark., Lausten-Thomsen U; Department of Neonatology, University Hospital Rigshospitalet, 2100 Copenhagen, Denmark., Christiansen M; Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark.; Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark. |
| Abstrakt: |
The serum adiponectin/leptin ratio (A/L ratio) is a surrogate marker of insulin sensitivity. Pre-eclampsia (PE) is associated with maternal metabolic syndrome and occasionally impaired fetal growth. We assessed whether the A/L ratio in first-trimester maternal serum was associated with PE and/or birth weight. Adiponectin and leptin were quantitated in first-trimester blood samples (gestational week 10+3−13+6) from 126 women who later developed PE with proteinuria (98 mild PE; 21 severe PE; 7 HELLP syndrome), and 297 controls, recruited from the Copenhagen First-Trimester Screening Study. The A/L ratio was reduced in PE pregnancies, median 0.17 (IQR: 0.12−0.27) compared with controls, median 0.32 (IQR: 0.19−0.62) (p < 0.001). A multiple logistic regression showed that PE was negatively associated with log A/L ratio independent of maternal BMI (odds ratio = 0.315, 95% CI = 0.191 to 0.519). Adiponectin (AUC = 0.632) and PAPP-A (AUC = 0.605) were negatively associated with PE, and leptin (AUC = 0.712) was positively associated with PE. However, the A/L ratio was a better predictor of PE (AUC = 0.737), albeit not clinically relevant as a single marker. No significant association was found between A/L ratio and clinical severity of pre-eclampsia or preterm birth. PE was associated with a significantly lower relative birth weight (p < 0.001). A significant negative correlation was found between relative birth weight and A/L ratio in controls (β = −0.165, p < 0.05) but not in PE pregnancies), independent of maternal BMI. After correction for maternal BMI, leptin was significantly associated with relative birth weight (β = 2.98, p < 0.05), while adiponectin was not significantly associated. Our findings suggest that an impairment of the A/L ratio (as seen in metabolic syndrome) in the first trimester is characteristic of PE, while aberrant fetal growth in PE is not dependent on insulin sensitivity, but rather on leptin-associated pathways. |
