First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal Growth
The serum adiponectin/leptin ratio (A/L ratio) is a surrogate marker of insulin sensitivity. Pre-eclampsia (PE) is associated with maternal metabolic syndrome and occasionally impaired fetal growth. We assessed whether the A/L ratio in first-trimester maternal serum was associated with PE and/or bir...
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MDPI AG
2023-01-01
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| author | Victoria E. de Knegt Paula L. Hedley Anna K. Eltvedt Sophie Placing Karen Wøjdemann Anne-Cathrine Shalmi Line Rode Jørgen K. Kanters Karin Sundberg Ann Tabor Ulrik Lausten-Thomsen Michael Christiansen |
| author_facet | Victoria E. de Knegt Paula L. Hedley Anna K. Eltvedt Sophie Placing Karen Wøjdemann Anne-Cathrine Shalmi Line Rode Jørgen K. Kanters Karin Sundberg Ann Tabor Ulrik Lausten-Thomsen Michael Christiansen |
| author_sort | Victoria E. de Knegt |
| collection | DOAJ |
| description | The serum adiponectin/leptin ratio (A/L ratio) is a surrogate marker of insulin sensitivity. Pre-eclampsia (PE) is associated with maternal metabolic syndrome and occasionally impaired fetal growth. We assessed whether the A/L ratio in first-trimester maternal serum was associated with PE and/or birth weight. Adiponectin and leptin were quantitated in first-trimester blood samples (gestational week 10<sup>+3</sup>–13<sup>+6</sup>) from 126 women who later developed PE with proteinuria (98 mild PE; 21 severe PE; 7 HELLP syndrome), and 297 controls, recruited from the Copenhagen First-Trimester Screening Study. The A/L ratio was reduced in PE pregnancies, median 0.17 (IQR: 0.12–0.27) compared with controls, median 0.32 (IQR: 0.19–0.62) (<i>p</i> < 0.001). A multiple logistic regression showed that PE was negatively associated with log A/L ratio independent of maternal BMI (odds ratio = 0.315, 95% CI = 0.191 to 0.519). Adiponectin (AUC = 0.632) and PAPP-A (AUC = 0.605) were negatively associated with PE, and leptin (AUC = 0.712) was positively associated with PE. However, the A/L ratio was a better predictor of PE (AUC = 0.737), albeit not clinically relevant as a single marker. No significant association was found between A/L ratio and clinical severity of pre-eclampsia or preterm birth. PE was associated with a significantly lower relative birth weight (<i>p</i> < 0.001). A significant negative correlation was found between relative birth weight and A/L ratio in controls (<i>β</i> = −0.165, <i>p</i> < 0.05) but not in PE pregnancies), independent of maternal BMI. After correction for maternal BMI, leptin was significantly associated with relative birth weight (<i>β</i> = 2.98, <i>p</i> < 0.05), while adiponectin was not significantly associated. Our findings suggest that an impairment of the A/L ratio (as seen in metabolic syndrome) in the first trimester is characteristic of PE, while aberrant fetal growth in PE is not dependent on insulin sensitivity, but rather on leptin-associated pathways. |
| first_indexed | 2024-03-09T11:56:35Z |
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| spelling | doaj.art-66b0c530b0494d4c9d6c17b5262058522023-11-30T23:08:26ZengMDPI AGLife2075-17292023-01-0113113010.3390/life13010130First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal GrowthVictoria E. de Knegt0Paula L. Hedley1Anna K. Eltvedt2Sophie Placing3Karen Wøjdemann4Anne-Cathrine Shalmi5Line Rode6Jørgen K. Kanters7Karin Sundberg8Ann Tabor9Ulrik Lausten-Thomsen10Michael Christiansen11Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, DenmarkDepartment for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, DenmarkDepartment for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, DenmarkDepartment for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, DenmarkDepartment of Gynecology and Obstetrics, Bornholm Hospital, 3700 Rønne, DenmarkDepartment of Obstetrics, Hillerød Hospital, 3400 Hillerød, DenmarkDepartment of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, 2600 Glostrup, DenmarkDepartment of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, DenmarkCenter of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, DenmarkCenter of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Neonatology, University Hospital Rigshospitalet, 2100 Copenhagen, DenmarkDepartment for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, DenmarkThe serum adiponectin/leptin ratio (A/L ratio) is a surrogate marker of insulin sensitivity. Pre-eclampsia (PE) is associated with maternal metabolic syndrome and occasionally impaired fetal growth. We assessed whether the A/L ratio in first-trimester maternal serum was associated with PE and/or birth weight. Adiponectin and leptin were quantitated in first-trimester blood samples (gestational week 10<sup>+3</sup>–13<sup>+6</sup>) from 126 women who later developed PE with proteinuria (98 mild PE; 21 severe PE; 7 HELLP syndrome), and 297 controls, recruited from the Copenhagen First-Trimester Screening Study. The A/L ratio was reduced in PE pregnancies, median 0.17 (IQR: 0.12–0.27) compared with controls, median 0.32 (IQR: 0.19–0.62) (<i>p</i> < 0.001). A multiple logistic regression showed that PE was negatively associated with log A/L ratio independent of maternal BMI (odds ratio = 0.315, 95% CI = 0.191 to 0.519). Adiponectin (AUC = 0.632) and PAPP-A (AUC = 0.605) were negatively associated with PE, and leptin (AUC = 0.712) was positively associated with PE. However, the A/L ratio was a better predictor of PE (AUC = 0.737), albeit not clinically relevant as a single marker. No significant association was found between A/L ratio and clinical severity of pre-eclampsia or preterm birth. PE was associated with a significantly lower relative birth weight (<i>p</i> < 0.001). A significant negative correlation was found between relative birth weight and A/L ratio in controls (<i>β</i> = −0.165, <i>p</i> < 0.05) but not in PE pregnancies), independent of maternal BMI. After correction for maternal BMI, leptin was significantly associated with relative birth weight (<i>β</i> = 2.98, <i>p</i> < 0.05), while adiponectin was not significantly associated. Our findings suggest that an impairment of the A/L ratio (as seen in metabolic syndrome) in the first trimester is characteristic of PE, while aberrant fetal growth in PE is not dependent on insulin sensitivity, but rather on leptin-associated pathways.https://www.mdpi.com/2075-1729/13/1/130adipocytokineadiponectinA/L ratiobirth weightleptinmetabolic syndrome |
| spellingShingle | Victoria E. de Knegt Paula L. Hedley Anna K. Eltvedt Sophie Placing Karen Wøjdemann Anne-Cathrine Shalmi Line Rode Jørgen K. Kanters Karin Sundberg Ann Tabor Ulrik Lausten-Thomsen Michael Christiansen First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal Growth Life adipocytokine adiponectin A/L ratio birth weight leptin metabolic syndrome |
| title | First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal Growth |
| title_full | First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal Growth |
| title_fullStr | First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal Growth |
| title_full_unstemmed | First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal Growth |
| title_short | First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal Growth |
| title_sort | first trimester maternal serum adiponectin leptin ratio in pre eclampsia and fetal growth |
| topic | adipocytokine adiponectin A/L ratio birth weight leptin metabolic syndrome |
| url | https://www.mdpi.com/2075-1729/13/1/130 |
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