Serum sFlt1:PlGF ratio, PlGF, and soluble endoglin levels in gestational proteinuria

It was recently reported that both a high soluble fms-like tyrosine kinase 1 (sFlt1): placental growth factor (PlGF) ratio (sFlt1:PlGF ratio) and high soluble endoglin (sEng) levels are related to the later occurrence of preeclampsia. We compared the serum sFlt1:PlGF ratio, PlGF and sEng levels in women with gestational proteinuria (GP) to those in women with preeclampsia.

Seven women with GP and 34 women with preeclampsia were recruited in this study. The 95(th) percentile values in the reference curves of sFlt1, sFlt1:PlGF ratio and sEng, and the 5(th) percentile values in the reference curve of PlGF were respectively set as the cutoff values.

The incidence rates of a high sFlt1:PlGF ratio, low PlGF and high sEng in women with GP were 57%, 29% and 86%, respectively, whereas those in women with preeclampsia were 94%, 77%, and 88%, respectively (p=0.028, p=0.024, and p=1.000, respectively). The incidence rates of a both high sFlt1:PlGF ratio and high sEng in women with GP and preeclampsia were 57% and 88%, respectively (p=0.082).

The majority of women with GP showed both increases of the sFlt1:PlGF ratio and sEng, thus suggesting some women with GP may represent subclinical preeclampsia. In addition, women with GP showed a significantly lower sFlt1:PlGF ratio and higher PlGF level than those with preeclampsia, suggesting that the PlGF level is a key regulator for developing hypertension in some pregnant women, even with increases of both sFlt1:PlGF ratio and sEng levels.