Abstract

Resistin might be involved with general inflammation and endothelial dysfunction observed in preeclampsia. We aimed to investigate longitudinal changes in resistin concentrations during high-risk pregnancies and evaluate their significance in preeclampsia development. Ninety-one patients were recruited at 11–14 weeks of gestation. They were followed towards the end of each trimester and before their deliveries. Of the 91 pregnant women, 21 developed preeclampsia, while 70 women did not develop preeclampsia despite being at risk. Compared to the 1^st trimester, resistin concentration significantly increased during the 2^nd trimester (p<.001). When women were divided into groups of those who developed preeclampsia and those who did not develop preeclampsia, we noticed a significant difference only in women who did not develop preeclampsia (p<.001). Moreover, resistin concentration in the 1^st trimester was statistically higher in women who developed preeclampsia when compared to those who did not develop preeclampsia (p<.001). The analysis of the Receiver Operating Characteristics (ROC) curves indicated that inclusion of triglycerides (TG), high-sensitivity C-reactive protein (CRP), and resistin (AUC = 0.870) improved diagnostic accuracy of the basic model including demographic and clinical parameters (AUC = 0.777) for preeclampsia prediction (p<.05). If the concentration of resistin is high in the 1^st trimester, such pregnancy at risk is likely to develop preeclampsia as a complication, indicating that resistin concentration in the 1^st trimester might contribute to existing predictive and prognostic models for preeclampsia. A multi-marker model, possibly including also resistin and other clinical, metabolic, and inflammatory parameters, seems to be the best approach in late-onset preeclampsia prediction.

摘要

抵抗素可能与先兆子痫中观察到的一般炎症和内皮功能障碍有关。我们旨在调查高危妊娠期间抵抗素浓度的纵向变化，并评估其在先兆子痫发展中的意义。在妊娠 11-14 周时招募了 91 名患者。他们在每个学期末和分娩前被跟踪。在 91 名孕妇中，有 21 名出现先兆子痫，而 70 名妇女尽管处于危险之中，但并未出现先兆子痫。与第 1^{孕期相比，第 2孕期}抵抗素浓度显着增加（p<.001)。当将女性分为发生先兆子痫和未发生先兆子痫的组时，我们注意到只有未发生先兆子痫的女性存在显着差异（p <.001）。此外，与未发生先兆子痫的女性相比，发生先兆子痫的女性在妊娠前三个月的抵抗素浓度在^{统计学上较高（} p <.001）。接受者操作特征 (ROC) 曲线的分析表明，包含甘油三酯 (TG)、高敏 C 反应蛋白 (CRP) 和抵抗素 (AUC = 0.870) 提高了基本模型的诊断准确性，包括人口统计学和临床​​参数(AUC = 0.777) 用于先兆子痫预测 ( p<.05)。^{如果抵抗素在妊娠}早期的浓度很高，这种有风险的妊娠可能会发展为先兆子痫，这表明妊娠早期抵抗素的浓度可能有助于现有的先兆子痫预测和预后模型^。多标志物模型，可能还包括抵抗素和其他临床、代谢和炎症参数，似乎是迟发性先兆子痫预测的最佳方法。