LEVELS OF THE ADIPOKINE CHEMERIN HELP TO PREDICT PREECLAMPSIA AND ITS COMPLICATIONS

Abstract

Objective: The adipokine chemerin is increased in preeclampsia (PE). Here, we evaluated its potential as a biomarker to predict PE or fetal complications. Design and method: We measured chemerin in 523 women with suspected or confirmed PE, as a secondary analysis of a prospective cohort study that evaluated the use of the sFlt-1 (soluble Fms-like tyrosine kinase-1)/PlGF (placental growth factor) ratio. The concordance (c)-statistic was used to evaluate the predictive value of chemerin or the sFlt-1/PlGF ratio on top of the traditional clinical risk factors (TCF) model involving gestational age, parity, proteinuria, and mean arterial pressure (MAP). Results: At the time of biomarker measurement, women had a median gestational age of 35.6 weeks (range 31.7-38.0). Serum chemerin was elevated (P<0.001) in women with confirmed PE (n = 152) or gestational hypertension (n = 95) vs. women without hypertensive disease of pregnancy (n = 276; 252±129 and 236±113 vs. 198±83 ng/mL). Moreover, serum chemerin levels were higher (P<0.001) in pregnancies with fetal growth restriction or fetal death (n = 78) vs. those without fetal complications (n = 361; 289±172 vs. 210±95 ng/mL). To predict PE, the TCF model yielded a C-index of 0.90, while adding chemerin or the sFlt-1/PlGF ratio to the model raised this to 0.95, with no further increase occurring when adding both at the same time. To predict fetal complications, the C-index was 0.76 for the TCF model only. This increased to 0.78 and 0.80 when adding chemerin and the ratio, respectively, and to 0.82 when adding both. Conclusions: Chemerin levels are elevated in women with PE and gestational hypertension, and chemerin levels might be used to predict PE and fetal complications.