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Daskalakis G, Bellos I, Nikolakea M, Pergialiotis V, Papapanagiotou A, Loutradis D. The role of serum adipokine levels in preeclampsia: A systematic review. Metabolism 2020; 106:154172. [PMID: 32027908 DOI: 10.1016/j.metabol.2020.154172] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/27/2020] [Accepted: 02/02/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Preeclampsia represents a major pregnancy complication, associated with high rates of perinatal morbidity. The aim of this systematic review is to accumulate current literature evidence in order to examine the pattern of serum adipokine levels among preeclamptic women and asses their potential efficacy in the prediction of the disease. METHODS Medline, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar databases were systematically searched from inception. All observational studies reporting serum adipokine values among preeclamptic and healthy pregnant women were held eligible. RESULTS A total of 163 studies were included, comprising 23,482 women. Leptin was evaluated in 91 studies and its values were found to be significantly elevated in preeclamptic women during all pregnancy trimester, independently of disease onset and severity. Preeclampsia was also associated with increased serum fatty acid binding protein-4 and chemerin levels, when measured both during the 1st and 3rd trimester. Data concerning the rest adipokines were either conflicting or limited to reach firm conclusions. Quality of evidence was evaluated to be high for leptin, moderate for serum fatty acid binding protein-4 and chemerin and low for the other adipokines. CONCLUSIONS The existing evidence suggests that preeclampsia is linked to increased levels of leptin, chemerin and fatty acid binding protein-4 in all pregnancy trimesters and forms of the disease. Inconsistent data currently exists concerning the role of the other adipokines. Large-scale prospective studies should longitudinally evaluate the serum concentration of novel adipokines and define the optimal threshold and timing of measurement to be widely applied in clinical practice.
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Affiliation(s)
- Georgios Daskalakis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Bellos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece.
| | - Melina Nikolakea
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece
| | - Vasilios Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece
| | - Angeliki Papapanagiotou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Loutradis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Adipokines and Endothelium Dysfunction Markers in Pregnant Women with Gestational Hypertension. Int J Hypertens 2019; 2019:7541846. [PMID: 31737362 PMCID: PMC6815564 DOI: 10.1155/2019/7541846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 08/07/2019] [Accepted: 09/13/2019] [Indexed: 12/17/2022] Open
Abstract
Objective The aim of the study was to evaluate the levels of adipokines such as adiponectin and leptin as well as soluble intercellular adhesion molecule-1 (sICAM-1) and endogenous NOS inhibitor-asymmetric dimethylarginine (ADMA), as the endothelium dysfunction markers in pregnant women with gestational hypertension (GH). Patients and Methods Adiponectin, leptin, sICAM-1, and ADMA concentrations were measured in a group of 34 patients with GH and in 32 healthy pregnant women between the 24th and 34th week of gestation with ELISA tests. Results The patients with GH compared with healthy ones were characterized by significantly higher BMI (28.09 ± 7.90 vs. 22.34 ± 4.21 kg/m2, p=0.016) and higher concentrations of leptin (45.89 ± 35.91 vs. 24.09 ± 24.40 ng/mL, p=0.006). sICAM-1 levels were also higher in the GH group but without the statistical significance (264.51 ± 50.99 vs. 232.56 ± 43.3 ng/ml, p=0.057). There were no significant differences between groups in adiponectin (8.79 ± 8.67 vs. 7.90 ± 3.71 μg/mL, p=0.46, NS) and ADMA (0.57 ± 0.26 vs. 0.60 ± 0.24 μmol/L, p=0.68, NS) levels. The significant correlation between leptin levels and BMI value was observed only in patients with GH (R = 0.56, p=0.02). Conclusions The higher levels of leptin in pregnant women with gestational hypertension may be suggestive of the role of leptin in GH development. As the patients in the GH group had higher BMI, hyperleptinemia may link obesity with gestational hypertension. The significance of leptin as the predictive marker of GH development could be implied. It could be postulated that the higher levels of sICAM-1 in the GH patients, although not statistically significant, could reflect some impairment of the endothelium function occurring in GH regardless of BMI. The comparable adiponectin levels in GH and healthy pregnant patients and the lack of its correlation with BMI may indicate the occurrence of a protective mechanism in pregnancy maintaining its concentration and preserving from the consequences of the decrease in its levels in overweight and obese patients. Since ADMA levels were similar in GH and healthy pregnant women, ADMA seems not to be involved in GH pathogenesis, suggesting that NO synthesis is not impaired in this pregnancy complication. As the data on the gestational hypertension pathogenesis and its correlations with adipokines and markers of the endothelium dysfunction are limited, further studies on this issue are warranted.
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Barbe A, Bongrani A, Mellouk N, Estienne A, Kurowska P, Grandhaye J, Elfassy Y, Levy R, Rak A, Froment P, Dupont J. Mechanisms of Adiponectin Action in Fertility: An Overview from Gametogenesis to Gestation in Humans and Animal Models in Normal and Pathological Conditions. Int J Mol Sci 2019; 20:ijms20071526. [PMID: 30934676 PMCID: PMC6479753 DOI: 10.3390/ijms20071526] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/20/2019] [Accepted: 03/22/2019] [Indexed: 02/06/2023] Open
Abstract
Adiponectin is the most abundant plasma adipokine. It mainly derives from white adipose tissue and plays a key role in the control of energy metabolism thanks to its insulin-sensitising, anti-inflammatory, and antiatherogenic properties. In vitro and in vivo evidence shows that adiponectin could also be one of the hormones controlling the interaction between energy balance and fertility in several species, including humans. Indeed, its two receptors—AdipoR1 and AdipoR2—are expressed in hypothalamic–pituitary–gonadal axis and their activation regulates Kiss, GnRH and gonadotropin expression and/or secretion. In male gonads, adiponectin modulates several functions of both somatic and germ cells, such as steroidogenesis, proliferation, apoptosis, and oxidative stress. In females, it controls steroidogenesis of ovarian granulosa and theca cells, oocyte maturation, and embryo development. Adiponectin receptors were also found in placental and endometrial cells, suggesting that this adipokine might play a crucial role in embryo implantation, trophoblast invasion and foetal growth. The aim of this review is to characterise adiponectin expression and its mechanism of action in male and female reproductive tract. Further, since features of metabolic syndrome are associated with some reproductive diseases, such as polycystic ovary syndrome, gestational diabetes mellitus, preeclampsia, endometriosis, foetal growth restriction and ovarian and endometrial cancers, evidence regarding the emerging role of adiponectin in these disorders is also discussed.
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Affiliation(s)
- Alix Barbe
- INRA UMR85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- Université François Rabelais de Tours, F-37041 Tours, France.
| | - Alice Bongrani
- INRA UMR85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- Université François Rabelais de Tours, F-37041 Tours, France.
| | - Namya Mellouk
- INRA UMR85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- Université François Rabelais de Tours, F-37041 Tours, France.
| | - Anthony Estienne
- INRA UMR85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- Université François Rabelais de Tours, F-37041 Tours, France.
| | - Patrycja Kurowska
- Department of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University, 31-007 Krakow, Poland.
| | - Jérémy Grandhaye
- INRA UMR85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- Université François Rabelais de Tours, F-37041 Tours, France.
| | - Yaelle Elfassy
- Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Service de Biologie de la Reproduction, F-75020 Paris, France.
- Université Pierre et Marie Curie Paris 6, F-75005 Paris, France.
- INSERM UMRS_938, Centre de Recherche Saint-Antoine, F-75571 Paris, France.
| | - Rachel Levy
- Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Service de Biologie de la Reproduction, F-75020 Paris, France.
- Université Pierre et Marie Curie Paris 6, F-75005 Paris, France.
- INSERM UMRS_938, Centre de Recherche Saint-Antoine, F-75571 Paris, France.
| | - Agnieszka Rak
- CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
| | - Pascal Froment
- INRA UMR85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- Université François Rabelais de Tours, F-37041 Tours, France.
| | - Joëlle Dupont
- INRA UMR85 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- CNRS UMR7247 Physiologie de la Reproduction et des Comportements, F-37380 Nouzilly, France.
- Université François Rabelais de Tours, F-37041 Tours, France.
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Herrera TT, Garcia JL, Britton GB. Blood-based biomarkers of adverse perinatal outcomes in maternal obesity. J Matern Fetal Neonatal Med 2017; 30:2991-2997. [PMID: 27936994 DOI: 10.1080/14767058.2016.1271406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Increasing maternal weight has been shown to predict adverse perinatal outcome, including increases in the relative risk of fetal death, stillbirth, neonatal death, perinatal death and infant death. In order to better understand the pathophysiological factors associated with obesity during pregnancy, the role of biomarkers associated with adverse outcomes in obese pregnant women is under investigation. The purpose of this review study was to examine potential biomarkers that could serve as effective screening strategies in obese pregnant women to reduce fetal and neonatal morbidity, as well as maternal morbidity. METHODS Electronic databases (Pubmed, Embase) were searched for previously published research studies that investigated biomarkers associated with perinatal outcomes in obese pregnant women and the putative mechanisms underlying biomarker effects on pregnancy outcomes. RESULTS It is evident that while several biomarkers predict perinatal complications in obese pregnant women, none fulfilled the criteria to be considered clinically useful. CONCLUSION There is a critical need for reliable blood-based biomarkers associated with an increased risk of adverse perinatal outcomes in obese pregnant women.
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Affiliation(s)
- Tania T Herrera
- a Department of Obstetrics and Gynecology, Maternal Fetal Medicine Center , Hospital Punta Pacifica, Affiliate of John Hopkins Medicine International , Calle Darién , Panamá
| | - Jillian L Garcia
- b University of Illinois College of Medicine , Chicago , IL , USA
| | - Gabrielle B Britton
- c Centro de Neurociencias y Unidad de Investigación Clínica , Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP) , Clayton , Panamá
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Sharp AN, Alfirevic Z. First trimester screening can predict adverse pregnancy outcomes. Prenat Diagn 2014; 34:660-7. [PMID: 24810468 DOI: 10.1002/pd.4406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 05/04/2014] [Accepted: 05/05/2014] [Indexed: 11/09/2022]
Abstract
There has been an increasing drive over the last two decades to push the detection of women at risk of adverse pregnancy outcomes into the first trimester. This has led to a plethora of techniques, risk assessments and biomarkers, both fascinating and bewildering in its breadth. Despite the vast amount of knowledge available, it is often difficult to determine what is practicable and valuable for clinical practice. This is especially true as earlier diagnosis does not necessarily equate to improved outcomes for mother and child. We suggest that, at least for preeclampsia, fetal growth restriction, spontaneous preterm birth and gestational diabetes, there are effective first trimester tests available to identify the women at risk of subsequently developing complications. Unfortunately, there are no currently reliable first trimester tests available for identifying women at risk of stillbirth. It is likely that this field will continue to develop over time, and we hope that new and better strategies will continue to emerge to target these clinically important pathologies.
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Affiliation(s)
- Andrew N Sharp
- Department of Women and Children's Health Research, University Department, Liverpool Women's Hospital, Liverpool, UK
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Abstract
Pregnancy-associated plasma protein A (PAPP-A) is a key regulator of insulin-like growth factor bioavailability essential for normal fetal development. In maternal blood, this protein increases with gestational age and then rapidly decreases after delivery. It is routinely used for Down syndrome screening in the first trimester of pregnancy, and its decrease compared to a normal pregnancy indicates an increased risk for both chromosomal anomalies and adverse pregnancy outcomes. It belongs to a group of biomarkers that predict later preeclampsia development, primarily early onset preeclampsia; however, it should be combined with a Doppler ultrasonography of the uterine artery (pulsatile index) and other biochemical and maternal factors to achieve a higher detection rate with an acceptable false positivity rate. Some studies have demonstrated an even more pronounced decrease of PAPP-A in the early second trimester of pregnancy in women who subsequently develop preeclampsia compared with women who do not develop preeclampsia. Conversely, during the last trimester of pregnancy, its concentration increases even more in patients with preeclampsia than in patients without. It is also detectable at very low levels in nonpregnant individuals, and a higher concentration indicates an adverse effect in patients with acute coronary syndromes or stable atherosclerotic disease and in patients with end-stage renal disease who are being treated with hemodialysis.
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Abstract
Ischemic placental disease is characterized by one or more of the clinical manifestations of preeclampsia, fetal growth restriction, and/or placental abruption, resulting in indicated preterm delivery. Since over half of the indicated preterm deliveries are due to ischemic placental disease, accurate early prediction of the disease is of paramount importance in developing prevention strategies. This review article focuses on studies that have used the first trimester aneuploidy screening timing window to predict those patients who later develop ischemic placental disease. Emphasis was given to studies originating from the Fetal Medicine Foundation because of their uniformity in definitions and expertise of the personnel who performed the ultrasound screening exams.
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Affiliation(s)
- Anthony M Vintzileos
- Department of Obstetrics and Gynecology, Winthrop-University Hospital, Mineola, NY 11501.
| | - Cande V Ananth
- Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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ADIPOKINES AND PATHOPHYSIOLOGY OF PREGNANCY COMPLICATIONS – THE ROLE OF LEPTIN AND ADIPONECTIN. ACTA ACUST UNITED AC 2014. [DOI: 10.1017/s0965539514000011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Angelidis G, Dafopoulos K, Messini CI, Valotassiou V, Tsikouras P, Vrachnis N, Psimadas D, Georgoulias P, Messinis IE. The Emerging Roles of Adiponectin in Female Reproductive System-Associated Disorders and Pregnancy. Reprod Sci 2012; 20:872-81. [DOI: 10.1177/1933719112468954] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- George Angelidis
- Department of Nuclear Medicine, Medical School, University of Thessalia, Larissa, Greece
| | - Konstantinos Dafopoulos
- Department of Obstetrics and Gynecology, Medical School, University of Thessalia, Larissa, Greece
| | - Christina I. Messini
- Department of Obstetrics and Gynecology, Medical School, University of Thessalia, Larissa, Greece
| | - Varvara Valotassiou
- Department of Nuclear Medicine, Medical School, University of Thessalia, Larissa, Greece
| | - Panagiotis Tsikouras
- Department of Obstetrics and Gynecology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Vrachnis
- Department of Obstetrics and Gynecology, Medical School, National and Kapodestrian University of Athens, Athens, Greece
| | - Dimitrios Psimadas
- Department of Nuclear Medicine, Medical School, University of Thessalia, Larissa, Greece
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, Medical School, University of Thessalia, Larissa, Greece
| | - Ioannis E. Messinis
- Department of Obstetrics and Gynecology, Medical School, University of Thessalia, Larissa, Greece
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Mikat B, Gellhaus A, Wagner N, Birdir C, Kimmig R, Köninger A. Early detection of maternal risk for preeclampsia. ISRN OBSTETRICS AND GYNECOLOGY 2012; 2012:172808. [PMID: 22852092 PMCID: PMC3407628 DOI: 10.5402/2012/172808] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Accepted: 06/19/2012] [Indexed: 01/19/2023]
Abstract
Preeclampsia is one of the leading causes of maternal and fetal morbidity and mortality. New molecular insights offer new possibilities of early diagnosis of elevated maternal risk. Maternal risk factors, biophysical parameters like Doppler examination of the uterine arteries and biochemical parameters allow early risk calculation. Preventive and effective therapeutic agents like acetylsalicylacid can be started in the early second trimester. This article reviews the diagnostic possibilities of early risk calculation to detect women having high risk for preeclampsia and the potential benefits for them, the offspring and health care systems. We provide risk calculation for preeclampsia as an important and sensible part of first trimester screening.
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Affiliation(s)
- B Mikat
- Department of Obstetrics and Gynecology, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany
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Nanda S, Poon LCY, Muhaisen M, Acosta IC, Nicolaides KH. Maternal serum resistin at 11 to 13 weeks' gestation in normal and pathological pregnancies. Metabolism 2012; 61:699-705. [PMID: 22146093 DOI: 10.1016/j.metabol.2011.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 10/09/2011] [Accepted: 10/10/2011] [Indexed: 11/24/2022]
Abstract
The objective was to examine maternal serum levels of resistin at 11 to 13 weeks' gestation in normal and pathological pregnancies. Serum resistin, pregnancy-associated plasma protein A (PAPP-A), and uterine artery pulsatility index (PI) at 11 to 13 weeks were measured in 480 singleton pregnancies, including 240 with normal outcome, 60 that subsequently developed preeclampsia (PE), 60 that developed gestational diabetes mellitus (GDM), 60 that delivered large for gestational age (LGA) neonates, and 60 that delivered small for gestational age (SGA) neonates. Each value in both the normal and pathological outcome groups was expressed as a multiple of the expected normal median (MoM), and the median MoM values in the outcome groups were compared. In the PE group, compared with the controls, there were an increase in median resistin (1.22 MoM, P = .003) and uterine artery PI (1.25 MoM, P < .0001) and a decrease in serum PAPP-A (0.72, P < .0001). There was no significant association between serum resistin with either uterine artery PI (P = .415) or serum PAPP-A (P = .290). In the SGA, LGA, and GDM groups, serum resistin MoM was not significantly different from that of the controls (P = .415, P = .702, and P = .549, respectively). In pregnancies that develop PE, maternal serum resistin concentration at 11 to 13 weeks is increased in a manner not related to altered placental perfusion or function. In pregnancies complicated by the development of GDM or delivery of SGA or LGA neonates, serum resistin is not significantly altered.
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Affiliation(s)
- Surabhi Nanda
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Miehle K, Stepan H, Fasshauer M. Leptin, adiponectin and other adipokines in gestational diabetes mellitus and pre-eclampsia. Clin Endocrinol (Oxf) 2012; 76:2-11. [PMID: 21951069 DOI: 10.1111/j.1365-2265.2011.04234.x] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Proteins secreted from adipocytes - so-called adipokines - influence metabolic and vascular function. Recent data suggest that various adipokines are dysregulated in gestational diabetes mellitus (GDM) and pre-eclampsia (PE) and might be of pathophysiological and prognostic significance in these complications of pregnancy. This review gives an overview on the regulation and pathophysiology of leptin and adiponectin in GDM and PE. Furthermore, data on novel adipokines including resistin, visfatin, retinol-binding protein 4 and vaspin are summarized.
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Affiliation(s)
- Konstanze Miehle
- Department of Internal Medicine (Endocrinology and Nephrology), University of Leipzig, Germany
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