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Predictive value of maternal serum podocalyxin in the diagnosis of preeclampsia: a prospective case-control study
- Department of Obstetrics and Gynecology, Health Sciences University Derince Training And Research Hospital, Kocaeli, Turkey
- Department of Biochemistry, Doctor Lufti Kirdar Kartal Training and Research Hospital, Istanbul, Turkey
open access
Abstract
Objectives: There is a need for markers to facilitate the diagnosis of preeclampsia, one of the most chief causes of maternal and infant mortality. Preeclampsia causes damage to the glomeruli and vascular endothelium in pregnant women. Podocalyxin is a sialoglycoprotein found in both glomeruli and vascular endothelium. In this study, we investigated the levels of podocalyxin in preeclampsia, and studied its potential to predict preeclampsia.
Material and methods: Women admitted to the Health Sciences University Derince Training and Research Hospital, Department of Obstetrics and Gynecology between February–November 2018 due to high direct blood and diagnosed with preeclampsia according to the 2013 American College of Obstetricians and Gynecologists criteria were included in the study. The control group consisted of healthy volunteers having similar demographic features (gestational week, gravida, parity, and age) with the preeclampsia group. The main outcome variable was serum podocalyxin levels.
Results: The mean (± SD) podocalyxin levels of the study and control groups were 124.15 ± 39.63 ng/mL and 71.47 ± 16.86 ng/mL, respectively (t = 7.845, p < 0.001). Using a cut-off of 91.7123, podocalyxin could predict preeclampsia with 90% sensitivity and 98% specificity. Furthermore, podocalyxin levels were significantly higher than the normotensive participants in both early (143.81 ± 51.96 ng/mL vs. 75.35 ± 19.36 ng/mL) and late-onset (110.22 ± 19.11 ng/mL vs 68.26 ± 14.13 ng/mL) preeclampsia (p < 0.001).
Conclusions: Serum podocalyxin levels increase in preeclampsia. We conclude that podocalyxin is a candidate for predicting preeclampsia.
Abstract
Objectives: There is a need for markers to facilitate the diagnosis of preeclampsia, one of the most chief causes of maternal and infant mortality. Preeclampsia causes damage to the glomeruli and vascular endothelium in pregnant women. Podocalyxin is a sialoglycoprotein found in both glomeruli and vascular endothelium. In this study, we investigated the levels of podocalyxin in preeclampsia, and studied its potential to predict preeclampsia.
Material and methods: Women admitted to the Health Sciences University Derince Training and Research Hospital, Department of Obstetrics and Gynecology between February–November 2018 due to high direct blood and diagnosed with preeclampsia according to the 2013 American College of Obstetricians and Gynecologists criteria were included in the study. The control group consisted of healthy volunteers having similar demographic features (gestational week, gravida, parity, and age) with the preeclampsia group. The main outcome variable was serum podocalyxin levels.
Results: The mean (± SD) podocalyxin levels of the study and control groups were 124.15 ± 39.63 ng/mL and 71.47 ± 16.86 ng/mL, respectively (t = 7.845, p < 0.001). Using a cut-off of 91.7123, podocalyxin could predict preeclampsia with 90% sensitivity and 98% specificity. Furthermore, podocalyxin levels were significantly higher than the normotensive participants in both early (143.81 ± 51.96 ng/mL vs. 75.35 ± 19.36 ng/mL) and late-onset (110.22 ± 19.11 ng/mL vs 68.26 ± 14.13 ng/mL) preeclampsia (p < 0.001).
Conclusions: Serum podocalyxin levels increase in preeclampsia. We conclude that podocalyxin is a candidate for predicting preeclampsia.
Keywords
early diagnosis; maternal serum; podocalyxin; preeclampsia
Title
Predictive value of maternal serum podocalyxin in the diagnosis of preeclampsia: a prospective case-control study
Journal
Issue
Article type
Research paper
Pages
229-234
Published online
2021-05-06
Page views
5414
Article views/downloads
760
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(3):229-234.
Keywords
early diagnosis
maternal serum
podocalyxin
preeclampsia
Authors
Navdar Dogus Uzun
Bahar Sarııbrahım Astepe
Fulya Uzun
Ebru Kale
- Bramham K, Parnell B, Nelson-Piercy C, et al. Chronic hypertension and pregnancy outcomes: systematic review and meta-analysis. BMJ. 2014; 348: g2301.
- Köse MR, Bora Başara B, Güler C. Health Statistics Yearly 2016 News Bulletin.Bora Başara B, Güler C, Soytutan Çağlar I. ed. Sağlık Araştırmaları Genel Müdürlüğü, Ankara 2017.
- Merdad L, Ali MM. Timing of maternal death: Levels, trends, and ecological correlates using sibling data from 34 sub-Saharan African countries. PLoS One. 2018; 13(1): e0189416.
- Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2011; 25(4): 391–403.
- Turbeville HR, Taylor EB, Garrett MR, et al. Superimposed Preeclampsia Exacerbates Postpartum Renal Injury Despite Lack of Long-Term Blood Pressure Difference in the Dahl Salt-Sensitive Rat. Hypertension. 2019; 73(3): 650–658.
- Turner RJ, Bloemenkamp KWM, Penning ME, et al. From Glomerular Endothelium to Podocyte Pathobiology in Preeclampsia: a Paradigm Shift. Curr Hypertens Rep. 2015; 17(7): 54.
- Chen Qi, Wang Y, Li Y, et al. Serum podocalyxin is significantly increased in early-onset preeclampsia and may represent a novel marker of maternal endothelial cell dysfunction. J Hypertens. 2017; 35(11): 2287–2294.
- Panek-Laszczyńska K, Konieczny A, Milewska E, et al. Podocyturia as an early diagnostic marker of preeclampsia: a literature review. Biomarkers. 2018; 23(3): 207–212.
- Jim B, Mehta S, Qipo A, et al. A comparison of podocyturia, albuminuria and nephrinuria in predicting the development of preeclampsia: a prospective study. PLoS One. 2014; 9(7): e101445.
- Kelder TP, Penning ME, Uh HW, et al. Quantitative polymerase chain reaction-based analysis of podocyturia is a feasible diagnostic tool in preeclampsia. Hypertension. 2012; 60(6): 1538–1544.
- von Elm E, Altman DG, Egger M, et al. STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61(4): 344–349.
- Hernández-Díaz S, Toh S, Cnattingius S. Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study. BMJ. 2009; 338: b2255.
- Craici IM, Wagner SJ, Bailey KR, et al. Podocyturia predates proteinuria and clinical features of preeclampsia: longitudinal prospective study. Hypertension. 2013; 61(6): 1289–1296.
- Montesano R, Matsumoto K, Nakamura T, et al. Identification of a fibroblast-derived epithelial morphogen as hepatocyte growth factor. Cell. 1991; 67(5): 901–908.
- Monte S. Biochemical markers for prediction of preclampsia: review of the literature. J Prenat Med. 2011; 5(3): 69–77.
- Conde-Agudelo A, Villar J, Lindheimer M. World Health Organization systematic review of screening tests for preeclampsia. Obstet Gynecol. 2004; 104(6): 1367–1391.
- Thangaratinam S, Coomarasamy A, Sharp S, et al. Tests for predicting complications of pre-eclampsia: a protocol for systematic reviews. BMC Pregnancy Childbirth. 2008; 8: 38.
- Cnossen JS, van der Post JAM, Mol BWJ, et al. Prediction of pre-eclampsia: a protocol for systematic reviews of test accuracy. BMC Pregnancy Childbirth. 2006; 6: 29.
- Wang D, Cummins C, Bayliss S, et al. Immunoprophylaxis against respiratory syncytial virus (RSV) with palivizumab in children: a systematic review and economic evaluation. Health Technol Assess. 2008; 12(36): iii, ix–x, 1.
- Giguère Y, Charland M, Bujold E, et al. Combining biochemical and ultrasonographic markers in predicting preeclampsia: a systematic review. Clin Chem. 2010; 56(3): 361–375.
- El-Sayed AAF. Preeclampsia: A review of the pathogenesis and possible management strategies based on its pathophysiological derangements. Taiwan J Obstet Gynecol. 2017; 56(5): 593–598.
- Sibai BM, Taslimi MM, el-Nazer A, et al. Maternal-perinatal outcome associated with the syndrome of hemolysis, elevated liver enzymes, and low platelets in severe preeclampsia-eclampsia. Am J Obstet Gynecol. 1986; 155(3): 501–509.
- Makuyana D, Mahomed K, Shukusho FD, et al. Liver and kidney function tests in normal and pre-eclamptic gestation--a comparison with non-gestational reference values. Cent Afr J Med. 2002; 48(5–6): 55–59.
- Büyükbaş S, İnal A. Changes in Serum Lactate Dehydrogenase Isoenzymes in Moderate Drinkers]. Van Med J. 2006; 13(3): 85–89.
- Taşın C, Yıldız Y, Ünlü Bekir S, et al. Evaluation of Maternal and Perinatal Findings in Mild and Severe Preeclampsia Cases]. Kocatepe Tıp Derg Kocatepe Med J. 2014; 15(1): 7–12.
- Augoff K, Grabowski K. [Significance of lactate dehydrogenase measurements in diagnosis of malignancies]. Pol Merkur Lekarski. 2004; 17(102): 644–647.
- Doyonnas R, Nielsen JS, Chelliah S, et al. Podocalyxin is a CD34-related marker of murine hematopoietic stem cells and embryonic erythroid cells. Blood. 2005; 105(11): 4170–4178.