Amer Ali Eham, Nori Wassan, Salman Alea Farhan, Al-Rawi Taghreed S Saeed, Hameed Ban H, Al-Ani Raid M
Department of Chemistry and Biochemistry, Mustansiriyah University, Baghdad 10052, Iraq.
Department of Obstetrics and Gynecology, Mustansiriyah University, Baghdad 10052, Iraq.
World J Clin Cases. 2023 Jun 16;11(17):3993-4002. doi: 10.12998/wjcc.v11.i17.3993.
Preeclampsia (PE) is a multisystemic metabolic disease with an undetermined etiology. PE is a worldwide cause of maternal and perinatal morbidity, subdivided into early (EoPE) and late-onset (LoPE) according to 34 wk of gestation as a divider. Many researchers investigated biomarkers for predicting PE to halt its consequences on the feto-maternal outcome. Elabela (Ela) is a newly discovered peptide hormone that was implicated in PE pathogenesis. Earlier rodent studies discussed Ela's role in controlling blood pressure. Moreover, Ela deficiency was associated with PE development.
To test whether plasma Ela could serve as a reliable marker for predicting PE based on the time of onset (EoPE LoPE) compared to age and body mass matched healthy controls since no definitive treatment exists for PE but to terminate a pregnancy.
This case-control study recruited ( = 90) pregnant who fulfilled inclusion criteria; they were allocated into three groups: EoPE (30/90) (< 34 wk of gestation); LoPE (30/90) (≥ 34 wk of gestation); and healthy pregnant (30/90). Demographic criteria; biochemical, hematological, and maternal plasma Ela levels were recorded for comparison.
Serum Ela was significantly reduced in EoPE compared to LoPE and healthy controls ( = 0.0023). The correlation confirmed a strong inverse relationship with mean atrial blood pressure ( = -0.7, < 0.001), while gestational age and platelets count showed a moderate correlation with ( = 0.4 with < 0.0001). No correlation was confirmed between the body mass index (BMI) and urine albumin. The predictive ability of 25 centile serum Ela had an Odds ratio of 5.21, 95% confidence interval (1.28, 21.24), = 0.02 for predicting EoPE. The receiver operator characteristic curve defined the Ela cutoff value at > 9.156 with 96.7% and 93.3% sensitivity and specificity, < 0.0001 in predicting EoPE.
A strong correlation of serum Ela with PE parameters with excellent sensitivity and specificity in distinguishing EoPE independent of the BMI, age, and blood pressure which makes Ela a recommendable marker in screening. Further research is warranted to explore prognostic and therapeutic applications for Ela in PE.
子痫前期（PE）是一种病因不明的多系统代谢性疾病。PE是全球孕产妇和围产儿发病的原因，根据妊娠34周作为分界点分为早发型（EoPE）和晚发型（LoPE）。许多研究人员研究了用于预测PE以阻止其对母婴结局产生影响的生物标志物。艾拉贝拉（Ela）是一种新发现的肽激素，与PE发病机制有关。早期的啮齿动物研究讨论了Ela在控制血压中的作用。此外，Ela缺乏与PE的发生有关。
由于PE除了终止妊娠外没有确切的治疗方法，因此测试与年龄和体重匹配的健康对照相比，血浆Ela是否可以根据发病时间（EoPE与LoPE）作为预测PE的可靠标志物。
本病例对照研究招募了符合纳入标准的90名孕妇；她们被分为三组：EoPE组（30/90）（妊娠<34周）；LoPE组（30/90）（妊娠≥34周）；以及健康孕妇组（30/90）。记录人口统计学标准、生化、血液学和母体血浆Ela水平以进行比较。
与LoPE组和健康对照组相比，EoPE组血清Ela显著降低（P = 0.0023）。相关性证实与平均心房血压呈强负相关（r = -0.7，P < 0.001），而孕周和血小板计数与Ela呈中度相关（r = 0.4，P < 0.0001）。体重指数（BMI）与尿白蛋白之间未证实有相关性。第25百分位数血清Ela预测EoPE的比值比为5.21，95%置信区间（1.28，21.24），P = 0.02。受试者工作特征曲线确定Ela的截断值>9.156，预测EoPE的敏感性和特异性分别为96.7%和93.3%，P < 0.0001。
血清Ela与PE参数密切相关，在区分EoPE方面具有出色的敏感性和特异性，且独立于BMI、年龄和血压，这使得Ela成为筛查中值得推荐的标志物。有必要进一步研究探索Ela在PE中的预后和治疗应用。
