First-trimester adipocytokine levels as predictive biomarkers for preeclampsia: a prospective case-control study

This study investigated whether first-trimester serum levels of adiponectin, leptin, resistin, and visfatin can predict the development of preeclampsia in pregnant women.

A prospective case-enriched case-control study was conducted with 199 pregnant women recruited during their first trimester (11-13 weeks of gestation). Participants were followed longitudinally, and recruitment was continued until a sufficient number of women who subsequently developed preeclampsia were identified. Thus, the final analytic cohort was intentionally enriched for PE outcomes and does not reflect population-based disease prevalence.

Early-pregnancy adiposity indices, including ultrasound-derived visceral and subcutaneous fat thickness, were also assessed given their emerging role as metabolic and inflammatory risk factors for preeclampsia. Adiponectin was lower in the PE group (9.57 ± 2.88 vs. 10.13 ± 3.16 ng/mL, p = 0.031). In unadjusted comparisons, mean leptin was marginally lower among women who developed PE (19.52 ± 4.11 vs. 20.29 ± 5.01 ng/mL, p = 0.013). However, in multivariate logistic regression controlling for age, BMI, and parity, leptin was positively associated with PE (OR = 1.18, 95% CI 1.04-1.34, p = 0.012), indicating that after adjusting for covariates, higher leptin levels predicted an increased PE risk. Resistin and visfatin did not show large unadjusted mean differences, though resistin was significant in adjusted models (OR = 1.35, p = 0.004).

First-trimester adipocytokines demonstrate significant predictive capability for the development of preeclampsia, with resistin showing superior diagnostic performance. The combination of multiple biomarkers enhances predictive accuracy beyond individual markers. These findings support the potential integration of adipocytokine assessment into early pregnancy screening protocols, pending validation in diverse populations.