Profili biohemijskih i inflamatornih biomarkera u serumu u teškoj preeklampsiji i njihova klinička prediktivna vrednost
Biohemijski i inflamatorni markeri u preeklampsiji
Sažetak
Background: Preeclampsia is a pregnancy-specific hypertensive disorder characterized by systemic endothelial dysfunction, metabolic disturbances, and inflammatory activation. However, comprehensive biochemical and inflammatory biomarker profiles associated with disease severity, particularly severe preeclampsia, remain insufficiently defined. This study aimed to investigate serum biochemical and inflammatory markers in preeclampsia and to evaluate their clinical predictive value for severe disease.
Methods: In this retrospective case–control study, pregnant women were classified into severe preeclampsia (n=30), mild preeclampsia (n=30), and normal pregnancy control groups (n=30). Serum biochemical parameters, including alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase (LDH), uric acid, creatinine, albumin, total bilirubin, triglycerides, and total cholesterol, were measured. Inflammatory markers, including C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8, tumor necrosis factor-α, procalcitonin, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio, were analyzed. Group comparisons, Spearman correlation analyses, multivariable logistic regression, and receiver operating characteristic (ROC) curve analyses were performed.
Results: Both biochemical and inflammatory markers showed significant stepwise alterations across the three groups, with the most pronounced abnormalities observed in severe preeclampsia (P < 0.05). LDH, uric acid, CRP, IL-6, and albumin were significantly associated with disease severity. Multivariable logistic regression identified elevated LDH, uric acid, CRP, IL-6, and reduced albumin as independent predictors of severe preeclampsia. ROC analysis demonstrated that the combined biomarker model achieved good discriminative performance, with an area under the curve of 0.89 (95% CI: 0.81–0.96).
Conclusions: Severe preeclampsia is characterized by distinct serum biochemical and inflammatory biomarker profiles. An integrated biomarker-based model may serve as a practical tool for early identification and risk stratification of severe preeclampsia.
Reference
2. Brownfoot F, Rolnik DL. Prevention of preeclampsia. Best Practice & Research. Clinical Obstetrics & Gynaecology 2024; 93: 102481.
3. Roberts JM. Preeclampsia epidemiology(ies) and pathophysiology(ies). Best Practice & Research. Clinical Obstetrics & Gynaecology 2024; 94: 102480.
4. Melchiorre K, Giorgione V, Thilaganathan B. The placenta and preeclampsia: villain or victim? Am J Obstet Gynecol 2022; 226(2S): S954-62.
5. Nirupama R, Divyashree S, Janhavi P, Muthukumar SP, Ravindra PV. Preeclampsia: Pathophysiology and management. J Gynecol Obstet Hum 2021; 50(2): 101975.
6. Rosenberg EA, Seely EW. Update on Preeclampsia and Hypertensive Disorders of Pregnancy. Endocrin Metab Clin 2024; 53(3): 377-89.
7. Deer E, Herrock O, Campbell N, Cornelius D, Fitzgerald S, Amaral LM, et al. The role of immune cells and mediators in preeclampsia. Nature Reviews. Nephrology 2023; 19(4): 257-70.
8. Chandra N, Kimble TD, Heim KR, Anderson SM, Wong AP, Thurman AR, et al. Inflammatory mediators and the RAGE pathway in placental tissues of pregnancies complicated by severe preeclampsia. Frontiers in Reproductive Health 2025; 7: 1587699.
9. Burwick RM, Rodriguez MH. Angiogenic Biomarkers in Preeclampsia. Obstet Gynecol 2024; 143(4): 515-23.
10. MacDonald TM, Walker SP, Hannan NJ, Tong S, Kaitu'U-Lino TJ. Clinical tools and biomarkers to predict preeclampsia. Ebiomedicine 2022; 75: 103780.
11. Tomkiewicz J, Darmochwał-Kolarz DA. Biomarkers for Early Prediction and Management of Preeclampsia: A Comprehensive Review. Med Sci Monitor 2024; 30: e944104.
12. Adil M, Kolarova TR, Doebley A, Chen LA, Tobey CL, Galipeau P, et al. Preeclampsia risk prediction from prenatal cell-free DNA screening. Nat Med 2025; 31(4): 1312-8.
13. Nan MN, Garrido-Giménez C, Garcia-Osuna Á, Garcia Manau P, Ullmo J, Mora J, et al. N-terminal pro B-type natriuretic peptide as biomarker to predict pre-eclampsia and maternal-fetal complications. Ultrasound in Obstetrics & Gynecology : The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology 2025; 65(4): 447-55.
14. Zeng L, Liao C. Multivariate logistic regression analysis of preeclampsia in patients with pregnancy induced hypertension and the risk predictive value of monitoring platelet, coagulation function and thyroid hormone in pregnant women. Am J Transl Res 2022; 14(9): 6805-13.
15. Kametas NA, Nzelu D, Nicolaides KH. Chronic hypertension and superimposed preeclampsia: screening and diagnosis. Am J Obstet Gynecol 2022; 226(2S): S1182-95.
16. Nemeth Z, Granger JP, Ryan MJ, Drummond HA. Is there a role of proinflammatory cytokines on degenerin-mediated cerebrovascular function in preeclampsia? Physiol Rep 2022; 10(13): e15376.
17. Vilotić A, Nacka-Aleksić M, Pirković A, Bojić-Trbojević Ž, Dekanski D, Jovanović Krivokuća M. IL-6 and IL-8: An Overview of Their Roles in Healthy and Pathological Pregnancies. International Journal of Molecular Sciences 2022; 23(23): 14574.
18. Solt I, Cohen SM, Admati I, Beharier O, Dominsky O, Yagel S. Placenta at single-cell resolution in early and late preeclampsia: insights and clinical implications. Am J Obstet Gynecol 2025; 232(4S): S176-89.
19. Chiang Y, Seow K, Chen K. The Pathophysiological, Genetic, and Hormonal Changes in Preeclampsia: A Systematic Review of the Molecular Mechanisms. International Journal of Molecular Sciences 2024; 25(8): 4532.
20. Bovee EM, Gulati M, Maas AH. Novel Cardiovascular Biomarkers Associated with Increased Cardiovascular Risk in Women With Prior Preeclampsia/HELLP Syndrome: A Narrative Review. European Cardiology 2021; 16: e36.
Sva prava zadržana (c) 2026 Fan Yang, Yanping Liu, Yanyan Liu
Ovaj rad je pod Creative Commons Autorstvo 4.0 međunarodnom licencom.
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.