title: Retinol binding protein 4--a novel association with early-onset preeclampsia.
abstract: Dysregulation of maternal circulating adipokines has been implicated in several "great obstetrical syndromes" including preeclampsia (PE), small-for-gestational age (SGA) neonate and fetal death (FD). It has been suggested that adipokines provide a molecular link between metabolic derangements and inflammatory response in complicated pregnancies. Retinol binding protein 4 (RBP4), a novel adipokine, plays a role in obesity-related disorders, as well as in the regulation of the immune response. The aim of this study was to determine whether there are changes in maternal plasma concentrations of RBP4 in patients with PE and in those with an SGA neonate or FD.
  
  
  
  This cross-sectional study included patients in the following groups: 1) normal pregnancy (n=134); 2) PE (n=104); 3) SGA neonate (n=28); and 4) FD (n=37). Maternal plasma RBP4 concentrations were determined by ELISA. Non-parametric statistics were used for analysis.
  
  
  
  1) The median maternal plasma RBP4 concentration was higher among patients with PE than in those with a normal pregnancy (P=0.03); 2) The median maternal plasma RBP4 concentrations of patients with preterm PE (<37 weeks) was higher than that of those with term PE (P=0.017) and than that of those with a normal pregnancy (P=0.002); 3) The median maternal plasma RBP4 concentration did not differ significantly between patients with a normal pregnancy and those with an SGA neonate or with an FD; 4) Among normal pregnant women, the maternal plasma RBP4 concentrations did not correlate with pre-pregnancy body mass index, gestational age at blood sampling and neonatal birthweight.
  
  
  
  1) Preeclampsia, but not pregnancy with an SGA neonate or an FD, is associated with a higher median maternal plasma concentration of RBP4 than normal pregnancy; 2) Preterm PE, and specifically early-onset PE, is associated with higher median RBP4 concentrations in maternal plasma compared to term PE. These findings suggest a role for RBP4 in the pathogenesis of preterm PE, but not in SGA and FD.
authors.affiliation: Intramural Division, Perinatology Research Branch, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, MD, USA.
authors.forename: Edi
authors.initials: E
authors.lastname: Vaisbuch
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaki-Tovi
authors.forename: Offer
authors.initials: O
authors.lastname: Erez
authors.forename: Sun Kwon
authors.initials: SK
authors.lastname: Kim
authors.forename: Tinnakorn
authors.initials: T
authors.lastname: Chaiworapongsa
authors.forename: Francesca
authors.initials: F
authors.lastname: Gotsch
authors.forename: Nandor Gabor
authors.initials: NG
authors.lastname: Than
authors.forename: Zhong
authors.initials: Z
authors.lastname: Dong
authors.forename: Percy
authors.initials: P
authors.lastname: Pacora
authors.forename: Ronald
authors.initials: R
authors.lastname: Lamont
authors.forename: Lami
authors.initials: L
authors.lastname: Yeo
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005313:Fetal Death / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma