Serum sFlt1:PlGF ratio, PlGF, and soluble endoglin levels in gestational proteinuria

Akihide Ohkuchi, Chikako Hirashima, Shigeki Matsubara, Hirotada Suzuki, Kayo Takahashi, Rie Usui, Mitsuaki Suzuki
Hypertension in Pregnancy 2009, 28 (1): 95-108

OBJECTIVE: It was recently reported that both a high soluble fms-like tyrosine kinase 1 (sFlt1): placental growth factor (PlGF) ratio (sFlt1:PlGF ratio) and high soluble endoglin (sEng) levels are related to the later occurrence of preeclampsia. We compared the serum sFlt1:PlGF ratio, PlGF and sEng levels in women with gestational proteinuria (GP) to those in women with preeclampsia.

METHODS: Seven women with GP and 34 women with preeclampsia were recruited in this study. The 95(th) percentile values in the reference curves of sFlt1, sFlt1:PlGF ratio and sEng, and the 5(th) percentile values in the reference curve of PlGF were respectively set as the cutoff values.

RESULTS: The incidence rates of a high sFlt1:PlGF ratio, low PlGF and high sEng in women with GP were 57%, 29% and 86%, respectively, whereas those in women with preeclampsia were 94%, 77%, and 88%, respectively (p=0.028, p=0.024, and p=1.000, respectively). The incidence rates of a both high sFlt1:PlGF ratio and high sEng in women with GP and preeclampsia were 57% and 88%, respectively (p=0.082).

CONCLUSION: The majority of women with GP showed both increases of the sFlt1:PlGF ratio and sEng, thus suggesting some women with GP may represent subclinical preeclampsia. In addition, women with GP showed a significantly lower sFlt1:PlGF ratio and higher PlGF level than those with preeclampsia, suggesting that the PlGF level is a key regulator for developing hypertension in some pregnant women, even with increases of both sFlt1:PlGF ratio and sEng levels.

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