The relationship between serum cytokeratin 18-M30, 8-iso-prostaglandin F2α, apelin-13 and the severity of early-onset preeclampsia and their impact on perinatal outcomes
10.3760/cma.j.cn115455-20241227-01180
- VernacularTitle:血清角蛋白18-M30、8-异前列腺素F2α和爱帕琳肽-13与早发型子痫前期患者病情的关系及对围生期结局的影响
- Author:
Wenting GUO
1
;
Yan JIA
1
Author Information
1. 西安国际医学中心医院产二科，西安 710000
- Publication Type:Journal Article
- Keywords:
Eclampsia;
Pregnancy outcome;
Keratin-18;
Isoprostanes;
Apelin-13
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(7):590-596
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between serum cytokeratin 18 (CK18)-M30, 8-iso-prostaglandin F2α (8-iso-PGF2α), apelin-13 and the severity of early-onset preeclampsia, as well as their impact on perinatal outcomes.Methods:A prospective study method was adopted. A total of 125 patients with early-onset preeclampsia (early-onset preeclampsia group) and 125 healthy pregnant women (healthy control group) from April 2022 to June 2024 in Xi′an International Medical Center Hospital were selected. Enzyme-linked immunosorbent assay was used to detect serum levels of CK18-M30, 8-iso-PGF2α and apelin-13. All subjects of both groups were followed up until delivery, and the perinatal outcomes were recorded, including the delivery gestational week, fetal asphyxia, fetal growth restriction, fetal death and small for gestational age infant. Point-biserial correlation analysis was used for correlation analysis. Multivariate Logistic regression analysis was used to analyze the effects of serum CK18-M30, 8-iso-PGF2α and apelin-13 on the illness severity in patients with early-onset preeclampsia.Results:The serum CK18-M30 and 8-iso-PGF2α in early-onset preeclampsia group were significantly higher than those in healthy control group: (282.55 ± 37.07) U/L vs. (117.18 ± 18.76) U/L and (478.79 ± 51.24) ng/L vs. (246.05 ± 33.73) ng/L, the serum apelin-13 was significantly lower than that in healthy control group: (337.29 ± 42.42) ng/L vs. (810.86 ± 91.47) ng/L, and there were statistical differences ( P<0.01). Among the 125 patients with early-onset preeclampsia, 68 cases were mild and 57 cases were severe. The serum CK18-M30 and 8-iso-PGF2α in severe patients were significantly higher than those in mild patients: (316.95 ± 40.22) U/L vs. (253.72 ± 31.08) U/L and (527.22 ± 56.44) ng/L vs. (438.19 ± 49.27) ng/L, the serum apelin-13 was significantly lower than that in mild patients: (291.72 ± 36.41) ng/L vs. (375.49 ± 47.08) ng/L, and there were statistical differences ( P<0.01). The point-biserial correlation analysis results showed that the serum CK18-M30 and 8-iso-PGF2α were positively correlated with the illness severity in patients with early-onset preeclampsia ( r = 0.536 and 0.521, P<0.01), the serum apelin-13 was negatively correlated with the illness severity ( r = - 0.540, P<0.01). Multivariate Logistic regression analysis result showed that high CK18-M30, high 8-iso-PGF2α and low apelin-13 were the independent risk factors of disease progression in patients with early-onset preeclampsia ( OR = 2.984, 2.855 and 0.873; 95% CI 1.670 to 5.330, 1.561 to 5.221 and 0.781 to 0.976; P<0.01 or <0.05). Taking the mean values of serum CK18-M30, 8-iso-PGF2α and apelin-13 in patients with early-onset preeclampsia (282.55 U/L, 478.79 ng/L and 337.29 ng/L) as the cut-off values, the patients were divided into high (≥mean value) and low (
