Maternal plasma retinol binding protein 4 in acute pyelonephritis during pregnancy.
Adipokines have been implicated in metabolic regulation and the immune response thus providing a molecular mechanism for the interaction between these two systems. Retinol binding protein 4 (RBP4) is a novel adipokine that plays a role in the pathophysiology of obesity-induced insulin resistance, as well as in the modulation of inflammation. The aim of this study was to determine whether there are changes in maternal plasma concentrations of RBP4 in pregnant women with acute pyelonephritis.



This cross-sectional study included pregnant women in the following groups: 1) normal pregnancy (n=80); 2) pyelonephritis (n=39). Maternal plasma RBP4 concentrations were determined by enzyme-linked immunoassays. Non-parametric statistics were used for analyses.



1) The median maternal plasma RBP4 concentration was lower in patients with acute pyelonephritis than in those with a normal pregnancy (3709.6 ng/mL, interquartile range (IQR) 2917.7-5484.2 vs. 9167.6 ng/mL, IQR 7496.1- 10,384.1, P<0.001; 2) the median maternal plasma RBP4 concentration did not differ significantly between patients with acute pyelonephritis who had a positive blood culture and those with a negative culture (3285.3 ng/mL, IQR 2274.1-4741.1 vs. 3922.6 ng/mL, IQR 3126.8-5547.1, respectively, P=0.2); and 3) lower maternal plasma RBP4 concentrations were independently associated with pyelonephritis after adjustment for confounding factors.



In contrast to what has been reported in preeclampsia, acute pyelonephritis during pregnancy is associated with lower maternal plasma RBP4 concentrations than in normal pregnancy. This finding suggests that the acute maternal inflammatory process associated with pyelonephritis is fundamentally different from that of the chronic systemic inflammatory process suggested in preeclampsia, in which RBP4 concentrations were found to be elevated.
Vaisbuch
Edi
E
Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, MD, and Detroit, MI, USA.
Romero
Roberto
R
Mazaki-Tovi
Shali
S
Kusanovic
Juan Pedro
JP
Chaiworapongsa
Tinnakorn
T
Dong
Zhong
Z
Kim
Sun Kwon
SK
Ogge
Giovanna
G
Gervasi
Maria Teresa
MT
Hassan
Sonia S
SS
D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood*; D011704:Pyelonephritis / Q000097:blood* / Q000150:complications*; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism*; D012189:Retrospective Studies; D055815:Young Adult
D018836:Inflammation Mediators; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma