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Serum sFlt-1, cystatin C and cathepsin B are potential severity markers in preeclampsia: a pilot study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Preeclampsia is associated with abnormal invasion of the trophoblast through decidua and subsequently altered remodeling of the maternal spiral arteries and endothelial dysfunction. This phenomenon is explained by the dysregulation of various kinds of vascular factors and proteases. The purpose of this study was to compare the circulating levels of sFlt-1, cathepsin B, and cystatin C in preeclamptic and normotensive pregnancies.

Study design

Sixty-two pregnant women were enrolled in this prospective study. Twenty women were preeclamptic and 42 were normotensive. Serum levels of sFlt-1, cathepsin B, and cystatin C were measured using an enzyme-linked immunosorbent assay kit.

Results

Circulating levels of sFlt-1, cathepsin B, and cystatin C were significantly higher in preeclamptic than in normotensive pregnant women (p < 0.001; p = 0.017; p = 0.003). Preeclamptic women with severe features demonstrated significantly higher levels of cathepsin B (p = 0.05). Serum sFlt-1 and cystatin C levels were positively correlated with elevated systolic and diastolic blood pressure. The levels of cathepsin B were positively correlated with alanine and aspartate aminotransferase. The amount of 24 h proteinuria was positively, but non-significantly correlated with sFlt-1 and cystatin C.

Conclusions

In addition to sFlt-1 levels, the serum levels of cathepsin B and cystatin C significantly change when preeclampsia develops. These markers are associated with severity markers of elevated blood pressure and liver injury in preeclampsia.

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Abbreviations

sFlt-1:

Soluble fms-like tyrosine kinase

PlGF:

Placental growth factor

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

BMI:

Body mass index

SGA:

Small for gestational age

AGA:

Appropriate for gestational age

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

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Funding

This study was supported by a Korea University Ansan Hospital Grant (O1801301).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Republic of Korea

    Ye Sul Park, Yezi Kim, Ho Yeon Kim, Ki-Hoon Ahn, Geum Joon Cho, Soon-Cheol Hong, Min-Jeong Oh & Hai-Joong Kim

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  1. Ye Sul Park
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  2. Yezi Kim
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  3. Ho Yeon Kim
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  4. Ki-Hoon Ahn
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  5. Geum Joon Cho
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  7. Min-Jeong Oh
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  8. Hai-Joong Kim
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Contributions

YSP: Protocol development, Manuscript writing, Data collection. YK: Data collection, Manuscript writing. HYK: Project development, Data analysis, Manuscript editing. KHA: Data management, Manuscript editing. GJC: Data analysis, Manuscript editing. SCH: Manuscript supervision. MJO: Manuscript supervision. HJK: Data collection, Manuscript editing.

Corresponding author

Correspondence to Ho Yeon Kim.

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Conflict of interest

All authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Park, Y.S., Kim, Y., Kim, H.Y. et al. Serum sFlt-1, cystatin C and cathepsin B are potential severity markers in preeclampsia: a pilot study. Arch Gynecol Obstet 301, 955–962 (2020). https://doi.org/10.1007/s00404-020-05478-6

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  • DOI: https://doi.org/10.1007/s00404-020-05478-6

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