Maternal serum SPARCL-1 levels in preeclampsia: Diagnostic performance by onset subtype

Secreted protein acidic and rich in cysteine-like 1 (SPARCL-1) is an extracellular matrix-associated matricellular protein involved in endothelial stability and vascular homeostasis. Given the central role of endothelial dysfunction in preeclampsia, we hypothesized that circulating SPARCL-1 levels would differ between early- and late-onset preeclampsia. Accordingly, this study aimed to evaluate maternal serum SPARCL-1 levels in women with early- and late-onset preeclampsia and to assess its diagnostic performance by disease onset.

This prospective cross-sectional study included 48 women with preeclampsia (24 early-onset <34 weeks, 24 late-onset ≥34 weeks) and 41 gestational age-matched normotensive controls. Maternal serum SPARCL-1 concentrations were measured using enzyme-linked immunosorbent assay. Demographic, clinical, and laboratory data were recorded. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed.

Serum SPARCL-1 levels were significantly lower in women with preeclampsia compared with controls (p < 0.001). Both early- and late-onset preeclampsia subgroups showed lower SPARCL-1 levels relative to controls (p < 0.001 for both), with significantly lower levels in early-onset cases compared to late-onset cases (p < 0.001). Lower SPARCL-1 levels remained independently associated with preeclampsia in multivariable analysis. ROC analysis demonstrated good discriminative ability of SPARCL-1 for both early- and late-onset disease.

Maternal serum SPARCL-1 levels are significantly lower in preeclampsia, with lower levels observed in early-onset disease. SPARCL-1 reflects a key component of endothelial structural integrity and may serve as a novel, accessible biomarker for the evaluation of disease onset subtypes.