title: Evaluation of kisspeptin levels in obese pregnancy as a biomarker for pre-eclampsia.
abstract: OBJECTIVE
  Circulating concentrations of the peptide kisspeptin have been proposed as a novel biomarker for early detection of pre-eclampsia. Our aims were to assess analytical and clinical performance characteristics of a commercial kisspeptin assay and to determine sensitivity and specificity of the test for pre-eclampsia.
  
  
  METHODS
  Prospective, longitudinal study in a United Kingdom tertiary referral Antenatal Metabolic Clinic.
  
  
  METHODS
  Severely obese (body mass index, BMI > 40 kg/m(2), n = 194) and lean (BMI < 25 kg/m(2), n = 78) pregnant women.
  
  
  METHODS
  A commercial kisspeptin ELISA (Phoenix Pharmaceuticals) was assessed for analytical sensitivity, specificity, precision, linearity, recovery and stability in maternal plasma samples at 16, 28 and 36 weeks gestation. Pre-eclampsia, defined using International Society for the Study of Hypertension in Pregnancy guidelines; blood pressure; delivery gestation; birthweight.
  
  
  RESULTS
  Kisspeptin concentrations were lower in early pregnancy in obese women (P < 0.001), and in women who later developed pre-eclampsia (P < 0.05), compared with women with uncomplicated pregnancies. For 16-week plasma kisspeptin in prediction of pre-eclampsia, area under the receiver-operator characteristic curve was 0.80 (P < 0.01), positive and negative likelihood ratios were 3.0 and 0.2, and test sensitivity and specificity were 85.7 and 71.4%, respectively. In regression analyses, kisspeptin (16 weeks) associated positively with delivery gestation (P < 0.05) and birthweight (P < 0.0001), and negatively with 28- and 36-week blood pressure (P < 0.0001).
  
  
  CONCLUSIONS
  Kisspeptin concentration in early pregnancy is a promising biomarker for pre-eclampsia and low birthweight but cannot be recommended, in isolation, for universal screening because of inadequate test sensitivity and specificity. Large-scale studies are required to assess its potential in a panel of biomarkers.
authors.affiliation: Clinical Biochemistry, Wishaw General Hospital, Wishaw, Lanarkshire, UK.
authors.forename: James J
authors.initials: JJ
authors.lastname: Logie
authors.forename: Fiona C
authors.initials: FC
authors.lastname: Denison
authors.forename: Simon C
authors.initials: SC
authors.lastname: Riley
authors.forename: Thayalini
authors.initials: T
authors.lastname: Ramaesh
authors.forename: Shareen
authors.initials: S
authors.lastname: Forbes
authors.forename: Jane E
authors.initials: JE
authors.lastname: Norman
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Reynolds
mesh_terms: D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D059648:Kisspeptins / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000150:complications; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D059648:Kisspeptins