Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis

Abstract Objective: Recent observations support the hypothesis that an imbalance between angiogenic factors has a fundamental role in the pathogenesis of pre-eclampsia and is responsible for the clinical manifestations of the disease. The goal of the present study was to evaluate the sensitivity, specificity, and the best accuracy level of Soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio in maternal serum and protein/creatinine ratio in urine sample to define the best cutoff point of these tests to discriminate between the patients with gestational hypertension and the patients with pre-eclampsia, to evaluate the possibility of using them as diagnostic methods. Methods: A prospective longitudinal study was performed, and blood samples were collected from 95 pregnant patients with hypertension to measure serum concentrations of biomarkers sFlt-1 and PlGF. Urine samples were collected for protein screening. Significance was set as p < 0.05. Results: The sFlt-1/PlGF ratio demonstrated a sensitivity of 57.5% and a specificity of 60% using 50.4 as a cutoff point. The test that showed the best accuracy in the diagnosis of pre-eclampsia was protein/creatinine ratio, with a sensitivity of 78.9% and a specificity of 70% using 0.4 as a cutoff point and showing an area under the receiver operating characteristic curve of 0.80 (p < 0.001). Conclusion: No studied laboratory test proved to be fairly accurate for the diagnosis of pre-eclampsia, except for the protein/creatinine ratio. The evidence is insufficient to recommend biomarkers sFlt-1 and PlGF to be used for the diagnosis of pre-eclampsia.

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Main Authors: Sá,Catherine Primo Nogueira de, Jiménez,Mirela Foresti, Rosa,Marcos Wengrover, Arlindo,Ellen Machado, Ayub,Antonio Celso Koehler, Cardoso,Rodrigo Bernardes, Kreitchmann,Régis, Beitune,Patrícia El
Format: Digital revista
Language:English
Published: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 2020
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001100697
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spelling oai:scielo:S0100-720320200011006972020-12-18Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia DiagnosisSá,Catherine Primo Nogueira deJiménez,Mirela ForestiRosa,Marcos WengroverArlindo,Ellen MachadoAyub,Antonio Celso KoehlerCardoso,Rodrigo BernardesKreitchmann,RégisBeitune,Patrícia El angiogenic factors pre-eclampsia PlGF protein creatinine ratio sFlt-1 Abstract Objective: Recent observations support the hypothesis that an imbalance between angiogenic factors has a fundamental role in the pathogenesis of pre-eclampsia and is responsible for the clinical manifestations of the disease. The goal of the present study was to evaluate the sensitivity, specificity, and the best accuracy level of Soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio in maternal serum and protein/creatinine ratio in urine sample to define the best cutoff point of these tests to discriminate between the patients with gestational hypertension and the patients with pre-eclampsia, to evaluate the possibility of using them as diagnostic methods. Methods: A prospective longitudinal study was performed, and blood samples were collected from 95 pregnant patients with hypertension to measure serum concentrations of biomarkers sFlt-1 and PlGF. Urine samples were collected for protein screening. Significance was set as p < 0.05. Results: The sFlt-1/PlGF ratio demonstrated a sensitivity of 57.5% and a specificity of 60% using 50.4 as a cutoff point. The test that showed the best accuracy in the diagnosis of pre-eclampsia was protein/creatinine ratio, with a sensitivity of 78.9% and a specificity of 70% using 0.4 as a cutoff point and showing an area under the receiver operating characteristic curve of 0.80 (p < 0.001). Conclusion: No studied laboratory test proved to be fairly accurate for the diagnosis of pre-eclampsia, except for the protein/creatinine ratio. The evidence is insufficient to recommend biomarkers sFlt-1 and PlGF to be used for the diagnosis of pre-eclampsia.info:eu-repo/semantics/openAccessFederação Brasileira das Sociedades de Ginecologia e ObstetríciaRevista Brasileira de Ginecologia e Obstetrícia v.42 n.11 20202020-11-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001100697en10.1055/s-0040-1713916
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language English
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author Sá,Catherine Primo Nogueira de
Jiménez,Mirela Foresti
Rosa,Marcos Wengrover
Arlindo,Ellen Machado
Ayub,Antonio Celso Koehler
Cardoso,Rodrigo Bernardes
Kreitchmann,Régis
Beitune,Patrícia El
spellingShingle Sá,Catherine Primo Nogueira de
Jiménez,Mirela Foresti
Rosa,Marcos Wengrover
Arlindo,Ellen Machado
Ayub,Antonio Celso Koehler
Cardoso,Rodrigo Bernardes
Kreitchmann,Régis
Beitune,Patrícia El
Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
author_facet Sá,Catherine Primo Nogueira de
Jiménez,Mirela Foresti
Rosa,Marcos Wengrover
Arlindo,Ellen Machado
Ayub,Antonio Celso Koehler
Cardoso,Rodrigo Bernardes
Kreitchmann,Régis
Beitune,Patrícia El
author_sort Sá,Catherine Primo Nogueira de
title Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
title_short Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
title_full Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
title_fullStr Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
title_full_unstemmed Evaluation of Angiogenic Factors (PlGF and sFlt-1) in Pre-eclampsia Diagnosis
title_sort evaluation of angiogenic factors (plgf and sflt-1) in pre-eclampsia diagnosis
description Abstract Objective: Recent observations support the hypothesis that an imbalance between angiogenic factors has a fundamental role in the pathogenesis of pre-eclampsia and is responsible for the clinical manifestations of the disease. The goal of the present study was to evaluate the sensitivity, specificity, and the best accuracy level of Soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio in maternal serum and protein/creatinine ratio in urine sample to define the best cutoff point of these tests to discriminate between the patients with gestational hypertension and the patients with pre-eclampsia, to evaluate the possibility of using them as diagnostic methods. Methods: A prospective longitudinal study was performed, and blood samples were collected from 95 pregnant patients with hypertension to measure serum concentrations of biomarkers sFlt-1 and PlGF. Urine samples were collected for protein screening. Significance was set as p < 0.05. Results: The sFlt-1/PlGF ratio demonstrated a sensitivity of 57.5% and a specificity of 60% using 50.4 as a cutoff point. The test that showed the best accuracy in the diagnosis of pre-eclampsia was protein/creatinine ratio, with a sensitivity of 78.9% and a specificity of 70% using 0.4 as a cutoff point and showing an area under the receiver operating characteristic curve of 0.80 (p < 0.001). Conclusion: No studied laboratory test proved to be fairly accurate for the diagnosis of pre-eclampsia, except for the protein/creatinine ratio. The evidence is insufficient to recommend biomarkers sFlt-1 and PlGF to be used for the diagnosis of pre-eclampsia.
publisher Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
publishDate 2020
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-72032020001100697
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