학술논문

Automated measurement of sFltl, PIGF and sFItl/PIGF ratio in differential diagnosis of hypertensive pregnancy disorders.
Document Type
Article
Source
Hypertension in Pregnancy. Nov2013, Vol. 32 Issue 4, p459-473. 15p.
Subject
*PREGNANCY complications
*DIFFERENTIAL diagnosis
*HYPERTENSION in pregnancy
*BIOMARKERS
*GESTATIONAL age
*SERUM
*CLINICAL trials
*DIAGNOSIS
Language
ISSN
1064-1955
Abstract
Objectives: The utility of angiogenic and antiangiogenic biomarkers as diagnostic tools in preeclampsia (PE) has been shown in previous studies. Our study's aim was to evaluate the use of automated measurement of sFltl, PIGF and their ratio (sFltl/PlGF) in differential diagnosis of hypertensive pregnancy disorders. Patients /Methods: Sixty-four patients with PE/HELLP, 18 with pregnancy-induced hypertension (PIH), 22 with gestational proteinuria (GP) and 232 controls were investigated. The PE/HELLP group was divided into mild PE (mPE, « = 31), severe PE (sevPE, n = 20), superimposed PE (supPE, n = 7) and HELLP syndrome (n = Q). sFltl and PIGF were measured in serum samples on an automated platform. Statistical analysis was performed using parametric and non-parametric methods, ROC analysis and logistic regression method. Results: PE patients showed higher sFltl and ratio and lower PIGF than controls (median ± SEM in pg/mL; 10 888 ±878 versus 2456 ±116; 268 ±39 versus 16 ±2 and 68 ±6 versus 439 ±37, each p< 0.001), subgroups showed similar differences in ratios (median ± SEM; supPE: 202 ±110; mPE: 137 ±27; sevPE: 497 ±91; HELLP syndrome: 254 ± 72 versus controls 16 ±2, each p<0.001). ROC analysis showed best performance for sFltl/PlGF (AUC all PE: ratio 96.4%, sFltl 92.8%, PIGF 92.4%, supPE: ratio 93.6%, mPE: ratio 94.8%, sevPE: ratio 99.4%, HELLP: ratio 98.6%, each versus controls). Patients with PIH and GP showed significant differences compared to controls (p≤0.01, respectively), mPE (p≤0.007), sevPE (p<0.001) and HELLP syndrome (p ≤ 0.003). Conclusion: The automated measurement of sFltl/PlGF is a reliable diagnostic tool in differential diagnosis of hypertensive pregnancy disorders and gives additional valuable information for clinical management. [ABSTRACT FROM AUTHOR]