Diagnostic performance of urinary adipsin as a screening biomarker for pre-eclampsia

This study evaluated the diagnostic performance of urinary adipsin as a potential biomarker for pre-eclampsia screening in a low-resource setting.

A case-control study was conducted involving 150 pregnant women classified into three groups: 50 healthy pregnancies, 50 high-risk pregnancies without pre-eclampsia, and 50 pregnant women clinically diagnosed with pre-eclampsia. Urinary adipsin concentration was measured with a commercial sandwich ELISA kit. Linear regression was conducted to examine the relationship between urinary adipsin levels and pre-eclampsia risk, while receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of urinary adipsin.

Urinary adipsin levels were significantly higher in pre-eclamptic women compared to healthy controls and the high-risk group (1258.70 ± 342.88 ng/mg Cr vs. 284.16 ± 24.04 ng/mg Cr and 305.15 ± 36.10 ng/mg Cr; P < 0.001). At a cutoff value of 750 ng/mg Cr, urinary adipsin demonstrated a good diagnostic performance, with a sensitivity of 83.6% and a specificity of 88.9%. Combining urinary adipsin with blood pressure measurements significantly improved the predictive performance (P < 0.001), with 96.7% sensitivity, 91.0% specificity, and an area under the curve (AUC) of 0.930. The combination of urinary adipsin, urine protein-to-creatinine ratio (uPCR), and blood pressure measurement further enhanced specificity (99.7%) with a sensitivity of 90.5% (AUC = 0.909).

Urinary adipsin showed high sensitivity, specificity, and predictive value in diagnosing pre-eclampsia. This highlights its potential as a non-invasive biomarker for pre-eclampsia screening in low-resource settings. Routine urinary adipsin assay and blood pressure monitoring could enhance early detection strategies and improve maternal and perinatal outcomes.