Increased urinary orosomucoid excretion predicts preeclampsia in pregnant women with pregestational type 1 diabetes.
OBJECTIVE
We evaluated the urinary orosomucoid excretion (UOE) as a biomarker of preeclampsia and preterm delivery in pregnant women with type 1 diabetes.


METHODS
Singleton pregnant women with pregestational type 1 diabetes were included provided one urine sample had been collected before 17 gestational weeks. Serum and urinary orosomucoid were analysed by immunoturbidimetry. Primary outcome measurements were development of preeclampsia (blood pressure>140/90mmHg and proteinuria) and preterm delivery before 37 weeks.


RESULTS
In total 173 women were included. The UOE increased during pregnancy. Preeclampsia developed in 20 women and 65 women delivered preterm. Using logistic regression analysis we found that UOE>1.37mg/l (OR: 6.85 (95% CI: 1.97-23.88; p<0.003)), nulliparity (3.88 (1.10-13.72); p<0.04), systolic blood pressure>120mmHg (4.12 (1.35-12.59); p<0.02) and duration of diabetes>20 years (3.69 (1.18-11.52); p<0.03) independently predicted the development of preeclampsia. Independent predictors of preterm delivery were duration of diabetes and HbA1c>7%. The remaining covariates included in the regression models were BMI, serum creatinine, smoking and microalbuminuria.


CONCLUSIONS
Increased UOE early in pregnancy predicted preeclampsia in women with pregestational type 1 diabetes independently of albuminuria and other known risk factors. No association to preterm delivery was found.
Christiansen
M S
MS
Department of Clinical Biochemistry and Department of Medicine, Amager Hospital, Italiensvej 1, Copenhagen S, Denmark. skovdal@dadlnet.dk
Hesse
D
D
Ekbom
P
P
Hesse
U
U
Damm
P
P
Hommel
E
E
Feldt-Rasmussen
B
B
Mathiesen
E
E
D000328:Adult; D000419:Albuminuria / Q000453:epidemiology / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine*; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000652:urine*; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000652:urine*; D005260:Female; D006801:Humans; D009961:Orosomucoid / Q000652:urine*; D017063:Outcome Assessment, Health Care; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000652:urine; D047928:Premature Birth / Q000175:diagnosis / Q000453:epidemiology / Q000652:urine; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
D015415:Biomarkers; D009961:Orosomucoid; D003404:Creatinine