Abstract P423: INCREASED LEVELS OF URINARY ANGIOGENIC FACTORS AND MARINOBUFAGENIN IN PREECLAMPSIA PATEINT
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Background: Preeclampsia (preE) is a syndrome which occurs in 3-10% of pregnancies and is a leading cause of maternal and fetal morbidity and mortality. The precise etiology (etiologies) of this syndrome remain(s) unknown. There is no single biomarker for detection of the syndrome. Objective: To measure angiogenic, antiangiogenic factors, and MBG in urine of pregnant patients with and without preE. Methods: A prospective cohort of patients with normal pregnancies and of those with preE were recruited. sFlt-1, soluble endoglin (sEng), PlGF, TGF--1, VEGF, and MBG were assayed using ELISA and results corrected to units per mg creatinine. Patient characteristics were compared using Chi-square tests for proportions, Students t test for parametric data, and Mann-Whitney U test for nonparametric data. P < 0.05 was taken as significant. Variation associated with gestational age was examined using correlations and when appropriate linear regression equations were obtained. Receiver operator curves (ROC) were examined to establish criteria levels for those factors that varied with preeclampsia. Results: In total, 40 patients with normal pregnancies were sampled between 22 and 39 weeks gestation and 30 patients with preE were sampled between 28 and 39 weeks gestation. As expected, groups differed (p < 0.02) for blood pressure, gestational age at delivery, and age. They did not differ for weight (p = 0.28), height (p = 0.38), and creatinine levels (p = 0.29). Groups differed in sEng (p = 0.016), PlGF (p = 0.018), sFlt-1 (p = 0.00066), and MBG (p < 0.0001). The PlGF levels were less in preE while sEng, sFlt-1 and MBG levels were increased. TGF--1 and VEGF did not differ between groups (p > 0.14). Only urinary MBG was found to vary with gestational age in preE (p = 0.0009). MBG, sFlt-1, PlGF, and sFlt-1/PlGF ratio had significant ROC area under the curve measures (p < 0.02) with criteria for preeclampsia that provided sensitivities between 65 and 88% and specificities between 74 and 96%. Conclusions: Urinary levels of angiogenic and antiangiogenic factors and MBG as measured in urine demonstrated differences in patients with clinical diagnosis of preE. Urine specimen procurement and assay are less invasive and potentially more acceptable for assessment of preE.
