Biological markers and its significance in preeclamptic patients

Lee, J K; Lee, H K; Kim, Y W; Jung, K Y; Yi, C S; Kim, S J; Rha, J G; Kim, S P

Abstract

Background and Puropse: The pathophysiologic features of preeclampsia are poorly understood. The diagnosis of preeclampsia is based not on the pathophysiology, but on the clinical symptoms. The endothelial dysfunction and the intravascular coagulopathy secondary to it, might be pivotal in the pathophysiology of preeclampsia. The purpose of this study is to investigate the significance of the potential biomarkers based on pathophysiology in preeclampsia.
METHODS
The vascular cell adhesion molecule-1 (VCAM-1), platelet-derived growth factor (PDGF-AB), antithrombin-III (AT-III) and D-dimer were measured in the plasma of the normotensive pregnant(control group) and preeclamptic women(study group). On the basis of the mean +/-2SD or mean +/-1SD cut-off value of biomarkers in control group, the sensitivity, specificity, positive predictive value and negative pred ctive value of each marker were calculated.
RESULTS
There were significant differences in VCAM-1, AT-III and D-dimer between control and study group. But the levels of PDGF were not significantly different from each other. With the mean+/-2SD cut-off value, the sensitivities of VCAM-1, AT-III and D-dimer were 38%, 34% and 40%, respectively. The specificities of VCAM-1, AT-III and D-dimer were 100%, 87% and 100%, respectively. Their positive predictive values were 100%, 86% and 100%, respectively. Their negative predictive values were 57%, 36% and 42%, respectively. With the mean +/-1SD cut-off value, the sensitivities of VCAM-1, AT-III and D-dimer were 43% 51% and 60%,respectively Their specificities are 80%, 87% and 80%, respectively. Their positive predictive values were 64%, 90% and 88%, respectively. Their negative predictive values were 50%, 43% and 46%, respectively.
CONCLUSION
The combination of these biomarkers such as VCAM-1, AT-III and D-dimer may be more useful as a biomarker in preeclampsia.