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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Abstract WP131: Effects Of EDAS Surgery On The Circulating Angiogenic Factors Of Patients With Moyamoya And Intracranial Atherosclerosis.

Stroke ◽

10.1161/str.47.suppl_1.wp131 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Nestor R Gonzalez ◽

Juan F Toscano ◽

Raymond Liou ◽

Neal Rao ◽

Jason D Hinman ◽

...

Keyword(s):

Mixed Models ◽

Angiogenic Factors ◽

Intracranial Atherosclerosis ◽

Control Groups ◽

Prospective Longitudinal Study ◽

Cranial Surgery ◽

Tumor Pathology ◽

Vessel Maturation ◽

And Control ◽

Prospective Longitudinal

Objective: To evaluate the levels of circulating angiogenic factors in patients with moyamoya disease (MMD), intracranial atherosclerosis (ICAS), and controls, and the effects of EDAS in their levels. Methods: Prospective longitudinal study of angiogenic factors in 22 patients with MMD, ICAS, and controls. Patients with MMD and ICAS underwent EDAS surgery. Control cases had cranial surgery for non-vascular or tumor pathology. Angiogenic factors were measured at baseline and 7 days after surgery. Log-corrected levels were compared between groups. Multivariate analysis of variance (MANOVA) was used to examine differences within pairs and between groups. Regression mixed models were built to account for intrasubject correlation and evaluate the association of angiogenic levels with group and treatment. Results: Mean age was 41 ± 11 in MMD, 65 ± 16 in ICAS, and 51 ± 19 in controls. There were 83% females in the MMD group, 44% in ICAS, and 43% in controls. Patients with MMD had significantly higher levels of PDGFAA (568.8 pg/ml), vs ICAS (165.9pg/mL), and controls (38.4 pg/mL) p=0.007; PDGFBB (1449.7 pg/mL), vs. ICAS (141.2 pg/mL), and controls (65.2 pg/mL) p=0.03; TGFB1 (24.5 ng/mL), vs. ICAS (13.8 ng/mL), and controls (6.2 ng/mL) p=0.006; TSP1 (128.5 ng/mL), vs. ICAS (91.7 ng/mL), and controls (9 ng/mL) p=0.0007. After surgery (EDAS for MMD and ICAS vs. cranial surgery for controls) levels of PDGFAA, PDGFBB, and TGFB1 increased on the ICAS and control groups eliminating the baseline differences. EDAS, independently from etiology, affected the levels of pro-angiogenic TGFB2 (EDAS: 290 pg/mL, controls: 161 pg/mL), and BMP2 (EDAS: 153 pg/mL, controls: 109 pg/mL) p<0.02. EDAS also increased the levels of the anti-angiogenic TSP2 (EDAS: 54.5 ng/mL, controls: 29 ng/mL) p=0.02. Conclusion: Patients with MMD have baseline higher levels of pro-angiogenic factors PDGFAA, PDGFBB, and TGFB1, involved in vessel maturation. EDAS, independent from etiology, affected the levels of TGFB2, BMP2 and TSP2, cytokines involved in vessel maturation, increased vascular permeability, and modulation of cell migration, respectively.

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Predictive Value of Plasma Thrombomodulin in Preeclampsia and Gestational Hypertension

Thrombosis and Haemostasis ◽

10.1055/s-0037-1615021 ◽

1998 ◽

Vol 79 (06) ◽

pp. 1092-1095 ◽

Cited By ~ 36

Author(s):

Luca Valsecchi ◽

Alfonso Fausto ◽

Danielle Gozin ◽

Silvana Vigano’ D’Angelo ◽

Omid Safa ◽

...

Keyword(s):

At Risk ◽

Longitudinal Study ◽

Predictive Value ◽

Gestational Hypertension ◽

Pharmacological Intervention ◽

Prospective Longitudinal Study ◽

Mild Preeclampsia ◽

Prospective Longitudinal

SummaryIn a prospective longitudinal study, 130 primigravidae at risk for preeclampsia were examined and plasma sampling performed in 45 of them. Plasma thrombomodulin (pTM) was sequentially measured at weeks 12, 24 and 32 of gestation and after delivery in 20 primigravidae who developed either mild preeclampsia (n = 8) or gestational hyper-tension (n = 12) between weeks 32 and 39 of gestation and in 25 (age-matched) primigravidae who had uneventful pregnancies. pTM elevations were not observed until week 32 in uneventful pregnancies, but were present by week 24 (p = 0.002) in patients who later developed hypertensive complications. A net individual pTM increase ≥4.2 ng/ml between weeks 12 and 24 (more than 8 times that of normotensive primigravidae) and/or pTM level ≥47.5 ng/ml at week 32 predicted the development of hypertensive complications with 80% accuracy. Serial pTM determinations can be useful to select pregnancies who may benefit from early pharmacological intervention.

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The clinical value of the delta finger to palm distance in systemic sclerosis

Reumatismo ◽

10.4081/reumatismo.2020.1233 ◽

2020 ◽

Vol 72 (1) ◽

pp. 44-51

Author(s):

A. Javinani ◽

S. Mostafaei ◽

F. Gharibdoost ◽

A.R. Jamshidi ◽

R. Atef Yekta ◽

...

Keyword(s):

Systemic Sclerosis ◽

Clinical Manifestations ◽

Digital Ulcers ◽

Clinical Value ◽

Prospective Longitudinal Study ◽

Linear Effect ◽

One Year ◽

The One ◽

Prospective Longitudinal

Systemic sclerosis (SSc) is a collagen-vascular disorder characterized by fibrosis and vasculopathy. Delta finger to palm distance (delta FTP) is an index measuring the distance between the tip of the third finger to the distal palmar crease in the flexed and extended position. The present study aimed to evaluate the clinical value of delta FTP and to assess the correlation of delta FTP with modified Rodnan skin score (mRSS) and forced vital capacity (FVC) over the 12-month follow-up. This prospective longitudinal study began with 50 participants who were followed for twelve months. Lowess smoothing and linear regression were applied to detect and assess the relationship between delta FTP and mRSS. p-values were adjusted by the Benjamini-Hochberg method (BHM) as a control for false discovery rate. Delta FTP was lower among patients with higher disease duration (p-valueadj: 0.008), diffuse cutaneous SSc (p-valueadj: 0.006), digital ulcers (p-valueadj: 0.003), telangiectasia (p-valueadj: 0.006) and dysphagia (p-valueadj: 0.036). The mRSS has a significant negative linear effect on the delta FTP at the baseline and the end of the follow-up (r: -0.31 and -0.40, respectively). Moreover, changes of mRSS and delta FTP showed a negative linear association over time (r: -0.22). These linear effects remained significant after regrouping the patients based on their SSc subtype. Delta FTP and FVC were not correlated either at the baseline or at the end. It seems that the delta FTP can be a valuable clinical index, supported by its correlated changes with mRSS and other SSc clinical manifestations over the one-year follow-up.

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Plasma N-glycome shows continuous deterioration as the diagnosis of insulin resistance approaches

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2021-002263 ◽

2021 ◽

Vol 9 (1) ◽

pp. e002263

Author(s):

Ana Cvetko ◽

Massimo Mangino ◽

Marko Tijardović ◽

Domagoj Kifer ◽

Mario Falchi ◽

...

Keyword(s):

Insulin Resistance ◽

Plasma Protein ◽

Multiple Testing ◽

Characteristic Curve ◽

Predictive Biomarker ◽

Ultra Performance Liquid Chromatography ◽

Discriminative Performance ◽

Prospective Longitudinal Study ◽

Diagnostic Potential ◽

Prospective Longitudinal

IntroductionPrediction of type 2 diabetes mellitus (T2DM) and its preceding factors, such as insulin resistance (IR), is of great importance as it may allow delay or prevention of onset of the disease. Plasma protein N-glycome has emerged as a promising predictive biomarker. In a prospective longitudinal study, we included patients with a first diagnosis of impaired glucose metabolism (IR or T2DM) to investigate the N-glycosylation’s predictive value years before diabetes development.Research design and methodsPlasma protein N-glycome was profiled by hydrophilic interaction ultra-performance liquid chromatography in 534 TwinsUK participants free from disease at baseline. This included 89 participants with incident diagnosis of IR or T2DM during the follow-up period (7.14±3.04 years) whose last sample prior to diagnosis was compared using general linear regression with 445 age-matched unrelated controls. Findings were replicated in an independent cohort. Changes in N-glycome have also been presented in connection with time to diagnosis.ResultsEight groups of plasma N-glycans were different between incident IR or T2DM cases and controls (p<0.05) after adjusting for multiple testing using Benjamini-Hochberg correction. These differences were noticeable up to 10 years prior to diagnosis and are changing continuously as becoming more expressed toward the diagnosis. The prediction model was built using significant glycan traits, displaying a discriminative performance with an area under the receiver operating characteristic curve of 0.77.ConclusionsIn addition to previous studies, we showed the diagnostic potential of plasma N-glycome in the prediction of both IR and T2DM development years before the clinical manifestation and indicated the continuous deterioration of N-glycome toward the diagnosis.

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Incidence of pregnancy-induced hypertension in block Hazratbal of district Srinagar, Jammu and Kashmir: a prospective longitudinal study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20172819 ◽

2017 ◽

Vol 4 (7) ◽

pp. 2333

Author(s):

Rouf Hussain Rather ◽

S. Mohammad Salim Khan ◽

Shahnaaz Taing

Keyword(s):

Longitudinal Study ◽

Gestational Hypertension ◽

Post Partum ◽

Antenatal Clinic ◽

Pregnancy Induced Hypertension ◽

Jammu And Kashmir ◽

Prospective Longitudinal Study ◽

Pregnant Females ◽

Induced Hypertension ◽

Prospective Longitudinal

Background: The term pregnancy induced hypertension (PIH) suggests a disorder of blood pressure that arises because of the pregnancy. PIH is defined as new onset hypertension with or without significant proteinuria emerging after 20 weeks of gestation, during labour, or in first 48 hours post-partum. It is classified as gestational hypertension (without proteinuria), preeclampsia (with proteinuria), and eclampsia (associated with convulsions). Incidence of PIH varies from country to country and has been reported to occur as low as 0.51% to as high as 38.4%. The objectives of the study were to estimate the incidence of PIH in block Hazratbal, Srinagar and to see the extent of progression of gestational hypertension into preeclampsia and eclampsia.Methods: A community based longitudinal study was conducted in block Hazratbal (district Srinagar) for a period of 18 months. All the pregnant females attending the antenatal clinic at the sub-centers and PHCs were included in the study and assessed for eligibility (less than 20 weeks and normotensive), till the desired number of 385 eligible pregnant females was reached. The pregnant women enrolled in the study were examined again around 30 weeks, 37 weeks and once in postnatal period.Results: The incidence of PIH was 20%. Majority of them (14.5%) had Gestational Hypertension and about one-fourth (5.5%) progressed to pre-eclampsia, while no one developed eclampsia.Conclusions: PIH is common among Kashmiri females, 20 out of 100 pregnant females develop PIH. PIH is a major cause of perinatal mortality, preterm delivery, IUGR, and maternal morbidity and mortality.

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Hypovitaminosis Din Postherpetic Neuralgia—High Prevalence and Inverse Association with Pain: A Retrospective Study

Nutrients ◽

10.3390/nu11112787 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2787 ◽

Cited By ~ 3

Author(s):

Jen-Yin Chen ◽

Yao-Tsung Lin ◽

Li-Kai Wang ◽

Kuo-Chuan Hung ◽

Kuo-Mao Lan ◽

...

Keyword(s):

Postherpetic Neuralgia ◽

Characteristic Curve ◽

Hypovitaminosis D ◽

Pain Clinic ◽

Spontaneous Pain ◽

Inverse Association ◽

Cross Sectional ◽

Prospective Longitudinal Study ◽

First Pain ◽

Prospective Longitudinal

Hypovitaminosis D (25-hydroxyvitamin D (25(OH)D) <75 nmol/L) is associated with neuropathic pain and varicella-zoster virus (VZV) immunity. A two-part retrospective hospital-based study was conducted. Part I (a case-control study): To investigate the prevalence and risk of hypovitaminosis D in postherpetic neuralgia (PHN) patients compared to those in gender/index-month/age-auto matched controls who underwent health examinations. Patients aged ≥50 years were automatically selected by ICD-9 codes for shingle/PHN. Charts were reviewed. Part II (a cross-sectional study): To determine associations between 25(OH)D, VZV IgG/M, pain and items in the DN4 questionnaire at the first pain clinic visit of patients. Independent predictors of PHN were presented as adjusted odds ratios(AOR) and 95% confidence intervals (CI). Prevalence (73.9%) of hypovitaminosis D in 88 patients was high. In conditional logistic regressions, independent predictors for PHN were hypovitaminosis D (AOR3.12, 95% CI1.73–5.61), malignancy (AOR3.21, 95% CI 1.38–7.48) and Helicobacter pylori-related peptic ulcer disease (AOR3.47, 95% CI 1.71–7.03). 25(OH)D was inversely correlated to spontaneous/brush-evoked pain. Spontaneous pain was positively correlated to VZV IgM. Based on the receiver operator characteristic curve, cutoffs for 25(OH)D to predict spontaneous and brush-evoked pain were 67.0 and 169.0 nmol/L, respectively. A prospective, longitudinal study is needed to elucidate the findings.

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