First-Trimester Maternal Serum Adiponectin/Leptin Ratio in Pre-Eclampsia and Fetal Growth

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*

*Corresponding author af dette arbejde

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Abstract

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+3–13+6) 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) (p < 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 (p < 0.001). A significant negative correlation was found between relative birth weight and A/L ratio in controls (β = −0.165, p < 0.05) but not in PE pregnancies), independent of maternal BMI. After correction for maternal BMI, leptin was significantly associated with relative birth weight (β = 2.98, p < 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.

OriginalsprogEngelsk
Artikelnummer130
TidsskriftLife
Vol/bind13
Udgave nummer1
Antal sider13
ISSN2075-1729
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
We gratefully acknowledge the expert technical assistance of Pia Lind and Pernilla Rasmussen. We also gratefully acknowledge the financial support to the Copenhagen First-Trimester Study from the Danish Medical Research Council, Copenhagen University, The John and Birthe Meyer Foundation, The Ivan Nielsen Foundation, The Else and Mogens Wedell-Wedellsborg Foundation, The Dagmar Marshall Foundation, The Egmont Foundation, The Fetal Medicine Foundation, The Augustinus Foundation, The Gangsted Foundation, The A.P. Møller Foundation, The Mads Clausens Foundation, The Copenhagen Hospital Corporation, and SAFE Network of Excellence. This research has been conducted using the Danish National Biobank resource, funded by the Novo Nordisk Foundation.

Publisher Copyright:
© 2023 by the authors.

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