Copeptin and mid‐regional pro‐atrial natriuretic peptide in women with suspected or confirmed pre‐eclampsia: comparison with sFlt‐1/PlGF ratio
ABSTRACT Objectives Arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) may contribute to the pathogenesis of pre‐eclampsia (PE), but their role remains to be elucidated. Our aims were to evaluate the surrogates of AVP and ANP, C‐terminal pro‐AVP (copeptin) and mid‐regional pro‐ANP (MR‐p...
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| Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2020-12, Vol.56 (6), p.872-878 |
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| creator | Neuman, R. I. Meer, M. M. Alblas Saleh, L. Berg, S. A. A. Meiracker, A. H. Danser, A. H. J. Visser, W. |
| description | ABSTRACT
Objectives
Arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) may contribute to the pathogenesis of pre‐eclampsia (PE), but their role remains to be elucidated. Our aims were to evaluate the surrogates of AVP and ANP, C‐terminal pro‐AVP (copeptin) and mid‐regional pro‐ANP (MR‐proANP), as biomarkers for the prediction of PE‐related pregnancy complications and whether they are associated with angiogenic markers and/or clinical manifestations of PE.
Methods
This was a retrospective analysis of a prospective cohort study that enrolled pregnant women with suspected or confirmed PE, between December 2013 and April 2016. From each patient, a blood sample was obtained at study entry and serum levels of copeptin, MR‐proANP, soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) were measured. We evaluated the ability of sFlt‐1, PlGF, sFlt‐1/PlGF ratio, copeptin and MR‐proANP, assessed either alone or combined with traditional predictors (gestational age, parity, diastolic blood pressure and proteinuria), to predict maternal complications and fetal/neonatal complications. Models were compared using concordance statistic (C‐index).
Results
A total of 526 women were evaluated in the study. Women with confirmed PE displayed elevated serum copeptin and MR‐proANP levels in comparison to those with suspected PE but no hypertensive disease of pregnancy. When combined with traditional predictors, the sFlt‐1/PlGF ratio displayed a higher C‐index than copeptin and MR‐proANP (0.76, 0.63 and 0.67, respectively, vs 0.60 for the traditional predictors alone) for the prediction of maternal complications. Similarly, for the prediction of fetal/neonatal complications, the sFlt‐1/PlGF ratio displayed a higher C‐index than copeptin and MR‐proANP when added to the traditional model (0.83, 0.79 and 0.80, respectively, vs 0.79 for the traditional predictors alone). When subdividing women according to sFlt‐1/PlGF ratio (≥ 85 vs |
| doi_str_mv | 10.1002/uog.21979 |
| format | Article |
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Objectives
Arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) may contribute to the pathogenesis of pre‐eclampsia (PE), but their role remains to be elucidated. Our aims were to evaluate the surrogates of AVP and ANP, C‐terminal pro‐AVP (copeptin) and mid‐regional pro‐ANP (MR‐proANP), as biomarkers for the prediction of PE‐related pregnancy complications and whether they are associated with angiogenic markers and/or clinical manifestations of PE.
Methods
This was a retrospective analysis of a prospective cohort study that enrolled pregnant women with suspected or confirmed PE, between December 2013 and April 2016. From each patient, a blood sample was obtained at study entry and serum levels of copeptin, MR‐proANP, soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) were measured. We evaluated the ability of sFlt‐1, PlGF, sFlt‐1/PlGF ratio, copeptin and MR‐proANP, assessed either alone or combined with traditional predictors (gestational age, parity, diastolic blood pressure and proteinuria), to predict maternal complications and fetal/neonatal complications. Models were compared using concordance statistic (C‐index).
Results
A total of 526 women were evaluated in the study. Women with confirmed PE displayed elevated serum copeptin and MR‐proANP levels in comparison to those with suspected PE but no hypertensive disease of pregnancy. When combined with traditional predictors, the sFlt‐1/PlGF ratio displayed a higher C‐index than copeptin and MR‐proANP (0.76, 0.63 and 0.67, respectively, vs 0.60 for the traditional predictors alone) for the prediction of maternal complications. Similarly, for the prediction of fetal/neonatal complications, the sFlt‐1/PlGF ratio displayed a higher C‐index than copeptin and MR‐proANP when added to the traditional model (0.83, 0.79 and 0.80, respectively, vs 0.79 for the traditional predictors alone). When subdividing women according to sFlt‐1/PlGF ratio (≥ 85 vs < 85), no differences in copeptin levels were observed, while MR‐proANP level was elevated in women with sFlt‐1/PlGF ratio ≥ 85. Multiple regression analysis revealed that copeptin and MR‐proANP were independent determinants of proteinuria.
Conclusions
Copeptin and MR‐proANP have limited value in predicting PE‐related complications when compared with the sFlt‐1/PlGF ratio. However, both copeptin and MR‐proANP were associated with proteinuria, with copeptin exerting this effect independently of the sFlt‐1/PlGF ratio. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.21979</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Angiogenesis ; Argipressin ; Atrial natriuretic peptide ; Biomarkers ; Blood pressure ; Complications ; copeptin ; Eclampsia ; Evaluation ; Fetuses ; Gestational age ; Growth factors ; Kinases ; Multiple regression analysis ; Neonates ; Pathogenesis ; Peptides ; Placenta ; PlGF ; prediction ; Predictions ; Preeclampsia ; Pregnancy ; Pregnancy complications ; pre‐eclampsia ; Protein-tyrosine kinase ; Proteinuria ; Serum levels ; sFlt‐1 ; Statistical analysis ; Tyrosine ; Vasopressin ; Womens health</subject><ispartof>Ultrasound in obstetrics & gynecology, 2020-12, Vol.56 (6), p.872-878</ispartof><rights>Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3659-f46c1df2373dceca81cef52791be81eed8f4b7e2f927f5ed615fba6c5506c2e33</citedby><cites>FETCH-LOGICAL-c3659-f46c1df2373dceca81cef52791be81eed8f4b7e2f927f5ed615fba6c5506c2e33</cites><orcidid>0000-0001-6219-3109</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fuog.21979$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fuog.21979$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids></links><search><creatorcontrib>Neuman, R. I.</creatorcontrib><creatorcontrib>Meer, M. M. Alblas</creatorcontrib><creatorcontrib>Saleh, L.</creatorcontrib><creatorcontrib>Berg, S. A. A.</creatorcontrib><creatorcontrib>Meiracker, A. H.</creatorcontrib><creatorcontrib>Danser, A. H. J.</creatorcontrib><creatorcontrib>Visser, W.</creatorcontrib><title>Copeptin and mid‐regional pro‐atrial natriuretic peptide in women with suspected or confirmed pre‐eclampsia: comparison with sFlt‐1/PlGF ratio</title><title>Ultrasound in obstetrics & gynecology</title><description>ABSTRACT
Objectives
Arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) may contribute to the pathogenesis of pre‐eclampsia (PE), but their role remains to be elucidated. Our aims were to evaluate the surrogates of AVP and ANP, C‐terminal pro‐AVP (copeptin) and mid‐regional pro‐ANP (MR‐proANP), as biomarkers for the prediction of PE‐related pregnancy complications and whether they are associated with angiogenic markers and/or clinical manifestations of PE.
Methods
This was a retrospective analysis of a prospective cohort study that enrolled pregnant women with suspected or confirmed PE, between December 2013 and April 2016. From each patient, a blood sample was obtained at study entry and serum levels of copeptin, MR‐proANP, soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) were measured. We evaluated the ability of sFlt‐1, PlGF, sFlt‐1/PlGF ratio, copeptin and MR‐proANP, assessed either alone or combined with traditional predictors (gestational age, parity, diastolic blood pressure and proteinuria), to predict maternal complications and fetal/neonatal complications. Models were compared using concordance statistic (C‐index).
Results
A total of 526 women were evaluated in the study. Women with confirmed PE displayed elevated serum copeptin and MR‐proANP levels in comparison to those with suspected PE but no hypertensive disease of pregnancy. When combined with traditional predictors, the sFlt‐1/PlGF ratio displayed a higher C‐index than copeptin and MR‐proANP (0.76, 0.63 and 0.67, respectively, vs 0.60 for the traditional predictors alone) for the prediction of maternal complications. Similarly, for the prediction of fetal/neonatal complications, the sFlt‐1/PlGF ratio displayed a higher C‐index than copeptin and MR‐proANP when added to the traditional model (0.83, 0.79 and 0.80, respectively, vs 0.79 for the traditional predictors alone). When subdividing women according to sFlt‐1/PlGF ratio (≥ 85 vs < 85), no differences in copeptin levels were observed, while MR‐proANP level was elevated in women with sFlt‐1/PlGF ratio ≥ 85. Multiple regression analysis revealed that copeptin and MR‐proANP were independent determinants of proteinuria.
Conclusions
Copeptin and MR‐proANP have limited value in predicting PE‐related complications when compared with the sFlt‐1/PlGF ratio. However, both copeptin and MR‐proANP were associated with proteinuria, with copeptin exerting this effect independently of the sFlt‐1/PlGF ratio. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.</description><subject>Angiogenesis</subject><subject>Argipressin</subject><subject>Atrial natriuretic peptide</subject><subject>Biomarkers</subject><subject>Blood pressure</subject><subject>Complications</subject><subject>copeptin</subject><subject>Eclampsia</subject><subject>Evaluation</subject><subject>Fetuses</subject><subject>Gestational age</subject><subject>Growth factors</subject><subject>Kinases</subject><subject>Multiple regression analysis</subject><subject>Neonates</subject><subject>Pathogenesis</subject><subject>Peptides</subject><subject>Placenta</subject><subject>PlGF</subject><subject>prediction</subject><subject>Predictions</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy complications</subject><subject>pre‐eclampsia</subject><subject>Protein-tyrosine kinase</subject><subject>Proteinuria</subject><subject>Serum levels</subject><subject>sFlt‐1</subject><subject>Statistical analysis</subject><subject>Tyrosine</subject><subject>Vasopressin</subject><subject>Womens health</subject><issn>0960-7692</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kb9OwzAQxi0EEuXPwBtYYoEhre0kdsyGKlqQKsEAc-Q6ZzBK4mAnqrrxCEw8IE-C28KCxHKnT_f7Trr7EDqjZEwJYZPBPY8ZlULuoRHNuEyIIPk-GhHJSSK4ZIfoKIRXQgjPUj5Cn1PXQdfbFqu2wo2tvt4_PDxb16oad95FqXpvo2g3ffDQW423lgpwtK1cA7Ha_gWHIXSge6iw81i71ljfRNF5iFtA16rpglVXcdR0ytvgfn2zuo8EnTzU8xn2qrfuBB0YVQc4_enH6Gl28zi9TRb387vp9SLRKc9lYjKuaWVYKtJKg1YF1WByJiRdQkEBqsJkSwHMSCZMDhWnuVkqrvOccM0gTY_RxW5vPPVtgNCXjQ0a6lq14IZQsjTLGJdFISJ6_gd9dYOPb4pUxnNBJSlopC53lPYuBA-m7LxtlF-XlJSbhMqYULlNKLKTHbuyNaz_B8un-_nO8Q1eypnE</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Neuman, R. I.</creator><creator>Meer, M. M. Alblas</creator><creator>Saleh, L.</creator><creator>Berg, S. A. A.</creator><creator>Meiracker, A. H.</creator><creator>Danser, A. H. J.</creator><creator>Visser, W.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6219-3109</orcidid></search><sort><creationdate>202012</creationdate><title>Copeptin and mid‐regional pro‐atrial natriuretic peptide in women with suspected or confirmed pre‐eclampsia: comparison with sFlt‐1/PlGF ratio</title><author>Neuman, R. I. ; Meer, M. M. Alblas ; Saleh, L. ; Berg, S. A. A. ; Meiracker, A. H. ; Danser, A. H. J. ; Visser, W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3659-f46c1df2373dceca81cef52791be81eed8f4b7e2f927f5ed615fba6c5506c2e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Angiogenesis</topic><topic>Argipressin</topic><topic>Atrial natriuretic peptide</topic><topic>Biomarkers</topic><topic>Blood pressure</topic><topic>Complications</topic><topic>copeptin</topic><topic>Eclampsia</topic><topic>Evaluation</topic><topic>Fetuses</topic><topic>Gestational age</topic><topic>Growth factors</topic><topic>Kinases</topic><topic>Multiple regression analysis</topic><topic>Neonates</topic><topic>Pathogenesis</topic><topic>Peptides</topic><topic>Placenta</topic><topic>PlGF</topic><topic>prediction</topic><topic>Predictions</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy complications</topic><topic>pre‐eclampsia</topic><topic>Protein-tyrosine kinase</topic><topic>Proteinuria</topic><topic>Serum levels</topic><topic>sFlt‐1</topic><topic>Statistical analysis</topic><topic>Tyrosine</topic><topic>Vasopressin</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Neuman, R. I.</creatorcontrib><creatorcontrib>Meer, M. M. Alblas</creatorcontrib><creatorcontrib>Saleh, L.</creatorcontrib><creatorcontrib>Berg, S. A. A.</creatorcontrib><creatorcontrib>Meiracker, A. H.</creatorcontrib><creatorcontrib>Danser, A. H. J.</creatorcontrib><creatorcontrib>Visser, W.</creatorcontrib><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neuman, R. I.</au><au>Meer, M. M. Alblas</au><au>Saleh, L.</au><au>Berg, S. A. A.</au><au>Meiracker, A. H.</au><au>Danser, A. H. J.</au><au>Visser, W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Copeptin and mid‐regional pro‐atrial natriuretic peptide in women with suspected or confirmed pre‐eclampsia: comparison with sFlt‐1/PlGF ratio</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><date>2020-12</date><risdate>2020</risdate><volume>56</volume><issue>6</issue><spage>872</spage><epage>878</epage><pages>872-878</pages><issn>0960-7692</issn><eissn>1469-0705</eissn><abstract>ABSTRACT
Objectives
Arginine vasopressin (AVP) and atrial natriuretic peptide (ANP) may contribute to the pathogenesis of pre‐eclampsia (PE), but their role remains to be elucidated. Our aims were to evaluate the surrogates of AVP and ANP, C‐terminal pro‐AVP (copeptin) and mid‐regional pro‐ANP (MR‐proANP), as biomarkers for the prediction of PE‐related pregnancy complications and whether they are associated with angiogenic markers and/or clinical manifestations of PE.
Methods
This was a retrospective analysis of a prospective cohort study that enrolled pregnant women with suspected or confirmed PE, between December 2013 and April 2016. From each patient, a blood sample was obtained at study entry and serum levels of copeptin, MR‐proANP, soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) were measured. We evaluated the ability of sFlt‐1, PlGF, sFlt‐1/PlGF ratio, copeptin and MR‐proANP, assessed either alone or combined with traditional predictors (gestational age, parity, diastolic blood pressure and proteinuria), to predict maternal complications and fetal/neonatal complications. Models were compared using concordance statistic (C‐index).
Results
A total of 526 women were evaluated in the study. Women with confirmed PE displayed elevated serum copeptin and MR‐proANP levels in comparison to those with suspected PE but no hypertensive disease of pregnancy. When combined with traditional predictors, the sFlt‐1/PlGF ratio displayed a higher C‐index than copeptin and MR‐proANP (0.76, 0.63 and 0.67, respectively, vs 0.60 for the traditional predictors alone) for the prediction of maternal complications. Similarly, for the prediction of fetal/neonatal complications, the sFlt‐1/PlGF ratio displayed a higher C‐index than copeptin and MR‐proANP when added to the traditional model (0.83, 0.79 and 0.80, respectively, vs 0.79 for the traditional predictors alone). When subdividing women according to sFlt‐1/PlGF ratio (≥ 85 vs < 85), no differences in copeptin levels were observed, while MR‐proANP level was elevated in women with sFlt‐1/PlGF ratio ≥ 85. Multiple regression analysis revealed that copeptin and MR‐proANP were independent determinants of proteinuria.
Conclusions
Copeptin and MR‐proANP have limited value in predicting PE‐related complications when compared with the sFlt‐1/PlGF ratio. However, both copeptin and MR‐proANP were associated with proteinuria, with copeptin exerting this effect independently of the sFlt‐1/PlGF ratio. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><doi>10.1002/uog.21979</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-6219-3109</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley-Blackwell Free Backfiles(OpenAccess); Wiley Online Library Journals【Remote access available】; Free E-Journal (出版社公開部分のみ） |
| subjects | Angiogenesis Argipressin Atrial natriuretic peptide Biomarkers Blood pressure Complications copeptin Eclampsia Evaluation Fetuses Gestational age Growth factors Kinases Multiple regression analysis Neonates Pathogenesis Peptides Placenta PlGF prediction Predictions Preeclampsia Pregnancy Pregnancy complications pre‐eclampsia Protein-tyrosine kinase Proteinuria Serum levels sFlt‐1 Statistical analysis Tyrosine Vasopressin Womens health |
| title | Copeptin and mid‐regional pro‐atrial natriuretic peptide in women with suspected or confirmed pre‐eclampsia: comparison with sFlt‐1/PlGF ratio |
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