Evaluation of the angiogenic factors sFlt‐1, PlGF, and the sFlt‐1/PlGF ratio in preeclampsia and associated features

Abstract

AbstractProblemSoluble Fms‐like tyrosine kinase‐1 (sFLT‐1) and placental growth factor (PlGF) were previously reported to play a key role in the pathogenesis of preeclampsia (PE). We tested the link between altered PlGF and sFLT‐1 levels, and their ratio (sFlt‐1/PlGF) with PE and PE‐associated featured in Tunisian PE cases and age‐ and BMI‐matched normotensive women.Method of StudyPeripheral blood specimens from 88 women with PE, and 60 control women were tested for PlGF and sFLT by commercially available ELISA.ResultsSignificant increases in sFlt‐1 levels and in the sFlt‐1/PlGF ratio, more than changes in PlGF levels were noted in PE subjects when compared to control women. Elevation in sFlt‐1 and sFlt‐1/PlGF ratio was observed at different percentile values in PE cases. The receiver operating characteristic (ROC) area under the curve (AUC) for sFlt‐1, PlGF, and sFlt‐1/PlGF ratio were 0.869 ± 0.031, 0.463 ± 0.048, and 0.759 ± 0.039, respectively. A systematic shift in sFlt‐1, but not in PlGF, distributions for higher values occurred in PE subjects. A progressive increase in the adjusted OR paralleled increased sFlt‐1 and the sFlt‐1/PlGF ratio percentile values; no similar trend was noted for the PlGF percentiles. Increased sFlt‐1 levels and sFlt‐1/PlGF ratio were significantly correlated with dysmenorrhea, hypertension, baby weight, and C‐section. In contrast, no correlation was found between PlGF and the PE‐associated features tested.ConclusionsIncreased sFlt‐1 levels and corresponding sFlt‐1/PlGF ratio, but not circulating PlGF levels, constitute an independent risk factor for PE.