Plasma adiponectin concentration in early pregnancy and subsequent risk of hypertensive disorders.
OBJECTIVE
Adiponectin is an exclusively adipose tissue-derived protein. Low plasma adiponectin levels have been found in hypertensive men. Our objective was to evaluate whether low first-trimester plasma adiponectin values were predictive of hypertensive disorders later in pregnancy.


METHODS
A nested case-control study was carried out on a cohort of 1,842 pregnant women who participated in the first-trimester Down syndrome screening program; 34 developed preeclampsia and 48 gestational hypertension. A control group of 82 nonhypertensive uneventful pregnancies was selected. Plasma adiponectin was determined using an enzyme-linked immunosorbent assay (ELISA).


RESULTS
Adiponectin median concentrations in the group which subsequently became hypertensive were significantly lower than those in the control group (7.6 versus 13.0 microg/mL) (P < .001). When the 2 hypertensive subgroups were considered, the plasma adiponectin median value in the preeclampsia group was significantly lower than that in the gestational hypertension group (6.6 versus 9.3 microg/mL) (P = .01). Regression analysis showed an inverse correlation between plasma adiponectin concentrations and maternal age, gestational age, body mass index, systolic blood pressure, and proteinuria. Approximately 34% of hypertensive pregnancies, compared with 7% of controls (P < .001), had plasma adiponectin concentrations less than 6.4 microg/mL (mean value of lower quartile of distribution among control patients). After adjusting for maternal age, all these women experienced a 6.6-fold (95% confidence interval 2.5-17.8) increased risk of pregnancy hypertension, compared with those women who had higher concentrations.


CONCLUSIONS
Our findings suggest a strong association between hypoadiponectinemia and the risk of hypertensive disorders in pregnancy, especially with preeclampsia.
D'Anna
Rosario
R
Department of Obstetrics and Gynecology, University of Messina, Messina, Italy. rosariodanna@tin.it
Baviera
Giovanni
G
Corrado
Francesco
F
Giordano
Domenico
D
Di Benedetto
Antonino
A
Jasonni
Valerio M
VM
D052242:Adiponectin; D000328:Adult; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology*; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D011225:Pre-Eclampsia / Q000209:etiology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First
D052242:Adiponectin; D036341:Intercellular Signaling Peptides and Proteins