Relevance of placental protein 13 in combination with xanthine oxidase activity and asymmetric dimethylarginine in early prediction of preeclampsia with an evidence of lgals13 gene promoter variant

Abstract

Introduction and Aim: Preeclampsia is a pregnancy specific hypertensive disorder and its complications are associated with maternal morbidity and mortality. The intention of the study is to determine early placental and endothelial dysfunction markers in first and second trimesters of pregnancy for the prediction of preeclampsia. Materials and Methods: Study design was prospective which enrolled 268 pregnant women during their first ante-natal visit. Blood samples were analysed for Placental protein13 (PP13), Asymmetric dimethyl arginine (ADMA) by ELISA and Xanthine oxidase (XO) activity by colorimetric assay. On follow-up, 22 subjects developed preeclampsia, 12 had spontaneous abortions and the rest remained normotensive till delivery. PP13 gene, LGALS13 was sequenced in preeclampsia cases to know if any polymorphism was present. Results: Results were analysed by Wilcoxon Signed Ranks test know the level of statistical significance, correlation analysis by Spearman’s correlation and diagnostic performance of the measured parameters was assessed by receivers operating characteristic (ROC) curve. Pregnant women who developed Preeclampsia had low PP13 levels in first trimester and elevated ADMA in second trimester (p<0.001). Gene sequencing of LGALS13 in preeclampsia showed-98C/A SNP at promoter region. ROC curve showed AUC for first trimester PP13 (0.932), second trimester PP13 (0.955) second trimester XO activity (0.967) and second trimester ADMA (1.000). Conclusion: The results suggest that oxidative stress, placental and endothelial dysfunction biomarkers would be helpful for early prediction of preeclampsia.