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Maternal serum fatty acid binding protein 4 (FABP4) and the development of preeclampsia
Christina M Scifres1, Janet M Catov, Hyagriv Simhan
1Magee-Womens Research Institute, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, Pennsylvania 15213, USA. scifresc@mail.magee.edu
Insights
Elevated serum fatty acid binding protein 4 (FABP4) levels in early pregnancy are linked to preeclampsia development. This finding was independent of maternal body mass index, suggesting FABP4 as a potential early biomarker for preeclampsia.
Area of Science:
- Reproductive biology
- Metabolic syndrome research
- Biomarker discovery
Background:
- Serum fatty acid binding protein 4 (FABP4) is linked to metabolic syndrome components like dyslipidemia and insulin resistance in nonpregnant individuals.
- Preeclampsia shares features with metabolic syndrome, but the association between early pregnancy FABP4 and preeclampsia risk was previously unknown.
Purpose of the Study:
- To investigate if elevated serum FABP4 levels precede the clinical onset of preeclampsia.
- To test the hypothesis that FABP4 is a potential early indicator for preeclampsia development.
Main Methods:
- A nested case-control study was conducted within a prospective cohort of healthy pregnant women.
- Maternal serum FABP4 was measured in 22 women who developed preeclampsia and 72 controls at two time points: <13 weeks gestation and 24-28 weeks gestation.
- Preeclampsia was defined as new-onset gestational hypertension and proteinuria after 20 weeks gestation.
Main Results:
- Women who developed preeclampsia had significantly higher serum FABP4 concentrations at both early (<13 wk) and mid-pregnancy (24-28 wk) compared to controls.
- Elevated FABP4 levels were independently associated with an increased risk of developing preeclampsia, even after adjusting for body mass index, blood pressure, and nulliparity.
- The adjusted odds ratio for preeclampsia associated with FABP4 was 1.2 (95% CI, 1.1-1.3; P<0.01).
Conclusions:
- Maternal serum FABP4 levels are elevated before the clinical manifestation of preeclampsia.
- The observed increase in FABP4 is independent of maternal body mass index, highlighting its potential as a specific biomarker.
- These findings suggest FABP4 could serve as an early predictive marker for preeclampsia.
Context:
Serum fatty acid binding protein 4 (FABP4) is associated with components of the metabolic syndrome in nonpregnant individuals, including dyslipidemia and insulin resistance. Preeclampsia shares many features with the metabolic syndrome, but the relationship between early pregnancy serum FABP4 levels and the development of preeclampsia is unknown.
Objective:
The aim of the study was to test the hypothesis that FABP4 is elevated in women who develop preeclampsia before the onset of disease.
Study Design:
This was a nested case-control study within a larger prospective cohort of healthy women with singleton gestations. Cases included 22 women who developed preeclampsia, and a random sample of 72 unmatched controls delivered without preeclampsia was identified. Maternal serum FABP4 was measured at less than 13 wk gestation and 24-28 wk gestation, which was before the onset of preeclampsia in all patients.
Main Outcome Measures:
The main outcome measure was preeclampsia (new-onset gestational hypertension and proteinuria for the first time after 20 wk gestation).
Results:
Maternal serum FABP4 concentrations were higher in women who ultimately developed preeclampsia both at 8-13 wk (20.4±12.3 vs. 10.1±4.7 ng/ml; P<0.01) and at 24-28 wk (20.7±11.7 vs. 9.9±4.5 ng/ml; P<0.01). After controlling for first trimester body mass index, systolic blood pressure, and nulliparity, FABP4 was associated with the development of preeclampsia (adjusted odds ratio, 1.2; 95% confidence interval, 1.1-1.3; P<0.01).
Conclusion:
Maternal serum FABP4 levels are elevated before the clinical onset of preeclampsia, and this increase occurs independently of maternal body mass index.
