Abstract：
Preeclampsia is characterized by impaired angiogenesis and assessment of angiogenic factors can play a crucial role in the early diagnosis of preeclampsia. The current study reports the levels of angiogenic factors longitudinally from early pregnancy in women with preeclampsia and in the subtypes of preeclampsia, to identify their role in early prediction of preeclampsia. A total of 1154 women with singleton pregnancies were recruited in early pregnancy from 2 hospitals. Blood samples were collected, plasma samples were separated and stored at four time points across gestation: V1 = 11-14 weeks, V2 = 18-22 weeks, V3 = 26-28 weeks, and V4 = at delivery. The current study includes a total of 108 women developed preeclampsia (PE), and 216 matched controls. Angiogenic factors were estimated using commercially available ELISA kits. Receiver operating characteristic (ROC) curves were used to evaluate the potential diagnostic value in the prediction of PE. Lower levels of VEGF, PlGF, and higher levels of sEng and sEng/PlGF ratio (p < 0.05 for all) predate clinical diagnosis in women with preeclampsia. sEng levels and sEng/PlGF ratio showed significant correlation with odds of preeclampsia at all the timepoints. This study identifies a cut off of 33.5 for sFlt-1/PlGF and 25.9 for sEng/PlGF for prediction of early onset preeclampsia. This study reports various angiogenic factors serially across gestation in a general population to identify women at risk of developing preeclampsia and its subtypes. The study also reports a potential biomarker and a pragmatic window for estimation of angiogenic markers to identify women at risk.
摘要：
先兆子痫的特征是血管生成受损，血管生成因子的评估在先兆子痫的早期诊断中起着至关重要的作用。目前的研究报告了先兆子痫妇女和先兆子痫亚型妊娠早期血管生成因子的纵向水平。确定它们在先兆子痫早期预测中的作用。从2家医院招募了1154名单胎妊娠妇女。采集血样,在整个妊娠的四个时间点分离并储存血浆样品：V1=11-14周，V2=18-22周，V3=26-28周，V4=交货时。目前的研究包括总共108名患有先兆子痫（PE）的妇女，和216个匹配的控件。使用市售ELISA试剂盒估计血管生成因子。受试者工作特征（ROC）曲线用于评估预测PE的潜在诊断价值。VEGF水平较低，PlGF,更高水平的sEng和sEng/PlGF比率(全部p<0.05)早于先兆子痫妇女的临床诊断。在所有时间点,sEng水平和sEng/PlGF比率显示与先兆子痫的几率显著相关。这项研究确定了sFlt-1/PlGF的临界值为33.5，sEng/PlGF的临界值为25.9，用于预测早发型先兆子痫。这项研究报告了在一般人群中在整个妊娠期间连续的各种血管生成因子，以确定有患先兆子痫及其亚型风险的女性。该研究还报道了一种潜在的生物标志物和用于评估血管生成标志物以识别处于危险中的女性的实用窗口。
