Assessment of the diagnostic value of a urinary adipsin rapid strip test for pre-eclampsia: A prospective multicenter study

Pregnancy urine biomarkers for effectively preeclampsia prediction: a systematic review and meta-analysis

Preeclampsia (PE) is a common multi-organ disorder in pregnancy. Urine as a source for test samples is noninvasive and easy to obtain. This study followed the Priority Reporting Project for Systematic Evaluation and Meta-Analysis protocol. We searched PubMed and Web of Science databases for studies relating to urine biomarker analysis for PE from inception to the 28th of February 2023. The Chi-squared test was utilized to evaluate the statistical heterogeneity of the results. The combined sensitivity, combined specificity, combined positive likelihood ratio, combined negative likelihood ratio, combined diagnostic odds ratio for urine analysis in the context of PE were calculated. Sixty-five studies were eventually included in the final analysis. In only hypertensive disorders of pregnancy (HDP) pregnant women, the the area under the summary receiver operating characteristic curve (AUC) of urine analysis to predict PE was 0.93 (0.91-0.95). The results show that spot random urine analysis or shortened-hour urinary analysis for the diagnosis of PE is a credible alternative method when 24-h urine collection is difficult to complete. The protein/creatinine ratio from spot random urine analysis may be an effective biomarker of the further progression of HDP into PE.

Serum peptidomic screening identified circulating peptide biomarkers predictive for preeclampsia

Background

Reliable biomarkers are needed to improve preeclampsia (PE) prediction accuracy. With the investigational tool of peptidomics, we aimed to identify and validate potential serum peptide biomarkers in cohorts suspected for PE development in middle or late pregnancy.

Methods

Totally 195 serum samples were prospectively collected from pregnant women with PE-related syndromes who were followed up for PE development until delivery. Serum peptidomic analysis was performed in the discovery cohort of 115 samples using matrix-assisted laser desorption ionization-time of flight coupled with Linear Trap Quadropole Orbitrap mass spectrometry. The candidate biomarkers were further validated using an in-house developed liquid chromatography tandem mass spectrometry (LC-MS/MS) method in an independent validation cohort of 80 serum samples.

Results

We identified 8 peptides that were differentially expressed and originated from fibrinogen alpha chain (FGA), inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4) and complement component 3. In the subsequent LC-MS/MS quantitation analysis, the levels of the three peptides (FGA-1033.4, ITIH4-2026.9, ITIH4-2051.1) exhibited a significant difference between the PE-positive and PE-negative groups. Further, the three-peptide panel yielded an area under the ROC curve (AUC) of 0.985 [95% confidence interval (CI) 0.965-1.000] and 0.923 (95% CI 0.845-1.000) in the discovery and validation cohorts respectively, with negative predictive values of 98.1-98.8% and positive predictive values of 73.1-85.3% that were much improved when compared with that of soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio.

Conclusions

We have discovered and validated a novel three-peptide biomarker panel predictive for the occurrence PE in pregnant women.

Identification of Novel Biomarker for Early Detection of Diabetic Nephropathy

Diabetic nephropathy (DN) is one of the most common complications of diabetes mellitus. After development of DN, patients will progress to end-stage renal disease, which is associated with high morbidity and mortality. Here, we developed early-stage diagnostic biomarkers to detect DN as a strategy for DN intervention. For the DN model, Zucker diabetic fatty rats were used for DN phenotyping. The results revealed that DN rats showed significantly increased blood glucose, blood urea nitrogen (BUN), and serum creatinine levels, accompanied by severe kidney injury, fibrosis and microstructural changes. In addition, DN rats showed significantly increased urinary excretion of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL). Transcriptome analysis revealed that new DN biomarkers, such as complementary component 4b (C4b), complementary factor D (CFD), C-X-C motif chemokine receptor 6 (CXCR6), and leukemia inhibitory factor (LIF) were identified. Furthermore, they were found in the urine of patients with DN. Since these biomarkers were detected in the urine and kidney of DN rats and urine of diabetic patients, the selected markers could be used as early diagnosis biomarkers for chronic diabetic nephropathy.

Long-term effects of prior diets, dietary transition and pregnancy on adipose gene expression in dairy heifers

Adipose tissue is highly involved in whole-body metabolism and is the main site for lipid synthesis, storage and mobilization in ruminants. Therefore, knowledge about adipose tissue responses to different diets is important, especially in growing heifers as the feeding regimes of replacement heifers affect their future success as dairy cows. However, at gene expression level such knowledge is limited. As part of a larger feed trial, adipose tissue biopsies from 24 Norwegian Red heifers were collected at 12 months of age (12MO) and at month seven of gestation (PREG) and analyzed by next-generation mRNA sequencing. Between these two sampling points, all heifers had gone through a successful conception and a feed change from four dietary treatments of high or low energy (HE/LE) and protein (HP/LP) content (treatments LPHE, HPHE, LPLE and HPLE) to a low-energy, low-protein pregnancy feed given to all animals. Gene expression differences between different feed treatments at 12MO are described in an earlier publication from our group. The main objectives of this study were to investigate the long-term effects of diets differing in protein and energy density level on gene expression in adipose tissue of growing replacement dairy heifers. To achieve this, we examined the post-treatment effects between the treatment groups at month seven of gestation; 6 months after the termination of experimental feeding, and the long-term gene expression changes occurring in the adipose tissue between 12MO and PREG. Post-treatment group comparisons showed evidence of long-term effects of dietary treatment on adipose gene expression. Differences between protein treatments were smaller than between energy treatments. Adipose gene expression changes from 12MO to PREG were much larger for the HE than the LE treatments and seemed to mostly be explained by the characteristics of the diet change. 97 genes displayed a unidirectional expression change for all groups from 12MO to PREG, and are considered to be treatment-independent, possibly caused by pregnancy or increased age. This study provides candidate genes and key regulators for further studies on pregnancy preservation (TGFB1, CFD) and metabolic regulation and efficiency (PI3K, RICTOR, MAP4K4,) in dairy cattle.

Predictive value of soluble fms-like tyrosine kinase-1 against placental growth factor for preeclampsia in a Chinese pregnant women population

Objective

The purpose of the present study was to explore the predictive effects of soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) for preeclampsia.

Methods

A total of 1580 singleton pregnant women aged 18‐45 years were included in this study. Serum samples were collected and stored frozen during their regular obstetric examinations. A total of 48 women who were eventually diagnosed with preeclampsia among them were defined as the preeclampsia group, other 134 women who were matched with age and sample collecting gestational weeks and finally diagnosed without preeclampsia were selected as control. The concentration of sFlt‐1 and PlGF in prestored serum samples was examined. The optimal cut‐off of sFlt‐1, PlGF, and sFlt‐1/PlGF ratio in predicting preeclampsia was determined by establishing the receiver operating characteristic curve (ROC).

Results

Serum PlGF levels in patients with preeclampsia were significantly lower than those in normal pregnancy (P < 0.05), On the contrary, sflt‐1 levels and sflt‐1/PlGF ratios were significantly higher than those in the normal pregnant women (P < 0.05). The ROC curve study showed that using the sFlt‐1/PlGF ratio to predict preeclampsia was better than using PlGF alone but no difference with sFlt‐1. When the cut‐off of the sFlt‐1/PlGF ratio was 26.6, the area under the ROC curve was 0.918, and high sensitivity (85.42%) and specificity (96.27%) for predicting preeclampsia were obtained.

Conclusion

The cut‐off of sflt‐1/PlGF ratio determined by ROC curve has a good predictive value for the occurrence of preeclampsia.