J Korean Med Sci.  2007 Oct;22(5):873-877. 10.3346/jkms.2007.22.5.873.

Increased sFlt-1 to PlGF Ratio in Women Who Subsequently Develop Preeclampsia

• Kim SY
• Ryu HM
• Yang JH
• Kim MY
• Han JY
• Kim JO
• Chung JH
• Park SY
• Lee MH
• Kim DJ

• KMID: 1713296
• DOI: http://doi.org/10.3346/jkms.2007.22.5.873

Abstract

The purpose of this study was to determine whether the levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and placenta growth factor (PlGF) are altered during the second trimester in the plasma of women who subsequently develop preeclampsia. We performed a case-control study to compare the levels of sFlt-1 and PlGF in the preeclamptic (n=46) and normal pregnant women (n=100). The maternal plasma levels of sFlt-1 and PlGF were measured by enzyme-linked immunosorbent assay. The sFlt-1 levels were significantly higher in the preeclamptic women than in normal controls (p<0.001), while the PlGF levels were significantly lower (p<0.001). In normal controls, sFlt-1 levels were positively correlated (r=0.27, p=0.008), whereas, in the preeclamptic women, those were negatively correlated with the PlGF levels (r=-0.423, p=0.005). Furthermore, the log[sFlt-1/PlGF] ratio was significantly higher in the preeclamptic women than in normal controls (p<0.001). The receiver operating characteristic curve revealed a specificity of 78% with a diagnostic sensitivity of 80.4%; the optimal cut-off value of the log[sFlt-1/PlGF] ratio was 1.4 (95% CI 0.756-0.910, p<0.001). Preeclampsia showed a strong association with increased levels of sFlt-1 and decreased levels of PlGF in the second trimester maternal plasma. Accordingly, the sFlt-1/PlGF ratio may provide early prediction of subsequent development of preeclampsia.

Keyword

Pre-Eclampsia; Fms-like Tyrosine Kinase 1; Placental Growth Factor; Biological Markers

MeSH Terms

Adult
Biological Markers/metabolism
Case-Control Studies
Female
Humans
Immunoassay
Middle Aged
Placenta/metabolism
Pre-Eclampsia/*diagnosis/*metabolism
Pregnancy
Pregnancy Proteins/*biosynthesis
Pregnancy Trimester, Second
ROC Curve
Sensitivity and Specificity
Vascular Endothelial Growth Factor Receptor-1/*biosynthesis

Figure

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  Fig. 1 Box plots indicating levels of sFlt-1 (A) and PlGF (B) in maternal plasma between normal controls and preeclamptic women. Boxes denote the interquartile range with the upper and lower horizontal edges representing the 75th and 25th percentiles, respectively. The central horizontal lines represent the medians. The vertical whiskers above and below the boxes represent the range of outlying data points up to 1.5 times the interquartile range, and the circles beyond the whiskers represent severe outliers. *Statistically significant, p<0.05.

• 

  Fig. 2 Correlation between sFlt-1 and PlGF levels in maternal plasma of the preeclamptic women (●) and normal controls (○). The solid and dashed lines indicate the regression lines for the preeclamptic women and normal controls, respectively.

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  Fig. 3 Box plots indicating ratios of the log[sFlt-1/PlGF] in maternal plasma between normal controls and preeclamptic women. Boxes denote the interquartile range with the upper and lower horizontal edges representing the 75th and 25th percentiles, respectively. The central horizontal lines represent the medians. The vertical whiskers above and below the boxes represent the range of outlying data points up to 1.5 times the interquartile range, and the circles beyond the whiskers represent severe outliers. *Statistically significant, p<0.05.

• 

  Fig. 4 Receiver operating characteristic curve (ROC) showing the ability of the maternal plasma log[sFlt-1/PlGF] to differentiate preeclampsia from normal pregnancies. AUC, area under the curve.

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