Correlation Between Serum Levels Of Adropin And Preptin And Preeclampsia

Background:Preeclampsia is a special disease in pregnancy.The incidence is 2?8%.Preeclampsia is characterized by the development of hypertension and proteinuria after 20 weeks of gestation.It can lead to serious perinatal maternal and fetus complications and seriously affect maternal and fetus health.The pathogenesis of preeclampsia is not very clear.Etiology is generally recognized to have trophoblast ischemia,immune theory,vasoactive substances imbalance,insulin resistance,genetic theory,coagulation system and fibrinolytic system disorder,and abnormal regulation of apoptosis.The classical theory suggests that the uterine spiral arterioles do not recast sufficiently,resulting in a narrowing of the lumen of the placental vasculature,decreasing villus mass,lessening placental flow and hypoperfusion,causing placental ischemia,hypoxia,and metabolic disorders,then releasing various placental factors into the maternal blood circulation,giving rise to systemic inflammation and immune response and vascular endothelial damage,and resulting in preeclampsia and multiple organ dysfunction.So the ischemia of uterus-placental trophoblast is considered the basic pathophysiological of preeclampsia and its related complications.It is generally accepted that preeclampsia is a complex pathological process involving multiple organs and multiple systems.More and more studies have found that insulin resistance is an important cause of preeclampsia and directly or indirectly involved in the occurrence.There is a tight relationship between insulin resistance and abnormal lipid metabolism,endothelial dysfunction and vascular inflammatory reaction,which also have closely relationship with preeclampsia.Thus it can be seen insulin resistance plays a major role in preeclampsia.But the molecular mechanisms behind insulin resistance remain largely unknown.Adropin and preptin are recently identified cytokines that regulate carbohydrate,lipid,and protein metabolism.It can not only regulate energy metabolism balance but also play an important role in improving insulin resistance,regulating endothelial cell function and protecting blood vessel.Studies have found that serum adropin levels are low in metabolic related diseases such as gestational diabetes mellitus,primary hypertension,and childhood obesity.Suggesting that adropin is associated with insulin resistance and hypertension.Preptin,another energy regulator factor,can not only promote the proliferation of osteoblas and regulate the anabolism of bone but also boost insulin secretion which is mediated by glucose and is involved in metabolic diseases such as obesity,polycystic ovary syndrome,gestational diabetes mellitus,and type 2 diabetes mellitus.Although adropin and preptin have been shown to maintain energy stability,improve insulin resistance,regulate endothelial cell function,protect vessels,regulate blood pressure and so on.But,there is relatively few studies on adropin and preptin in preeclampsia.In view of this,We hypothesized that adropin and preptin had a change in preeclampsia,had a different expression between different subgroups of preeclampsia and had a certain value in predicting the severity of preeclampsia.We determined serum levels of adropin and preptin in normal pregnant and preeclampsia in order to confirm this hypothesis.Objective:To clarify the changes of serum adropin and preptin levels in preeclampsia.To determine the changes of serum adropin and preptin levels in different subtypes of preeclampsia.To investigate the role of adropin and preptin in preeclampsia.Methods:32 women with preeclampsia were selected as the observation group,of which 8 women were mild preeclampsia and 24 women were severe preeclampsia.While 29 women with nomal pregnancy served as control.Normal pregnancy and mild preeclampsia were due to "planned labor" or "expectant" admission and severe preeclampsia were due to "severe" admission.All subjects were fasting at 20 o'clock on admission,then fasting peripheral blood were collected on the following morning and delivered within 2-3 days of admission.Blood samples were collected timely to isolate serum and then saved in-80 ?.The serum adropin and preptin levels were determined by enzyme-linked immunosorbent assay after all the samples were gathered.Results:The serum levels of adropin in preeclampsia were significantly higher than that in normal pregnancy.The difference was statistically significant(Z=-2.542,P<0.05).The levels of serum adropin in severe preeclampsia were significantly higher than that in normal pregnancy.The difference was statistically significant(Z=-2.394,P<0.05).There was no significant difference in serum adropin levels between severe preeclampsia and mild preeclampsia(Z=-0.440,P>0.05).The serum levels of adropin in early onset preeclampsia were significantly higher than that in normal pregnancy.The difference was statistically significant(Z=-2.499,P<0.05).The difference of serum adropin levels between early onset preeclampsia and late onset preeclampsia was not statistically significant(Z=-0.813,P>0.05).There was no significant difference in serum preptin levels between normal pregnancy and preeclampsia as well as its different subgroups(P>0.05).Conclusion:1.The serum adropin levels in preeclampsia were significantly higher than that in normal pregnancy.The serum adropin levels in severe preeclampsia and early onset preeclampsia were significantly higher than that in normal pregnancy.It is suggested that elevated serum adropin level is an important pathological change in preeclampsia,and is related to the severity of preeclampsia.Adropin may be involved in the occurrence and development of preeclampsia.2.There is no significant difference between the serum levels of preptin in preeclampsia and normal pregnancy.It is speculated that preptin may not play an important role in insulin resistance in preeclampsia.