title: Systolic blood pressure and fatty acid-binding protein 4 predict pregnancy-induced hypertension in overweight nulliparous women.
abstract: BACKGROUND
  The insulin-sensitivity regulator adipocyte fatty acid-binding protein 4 (FABP4) integrates metabolic and inflammatory responses. We hypothesize that there is relationship between FABP4 and factors related to metabolic syndrome in pregnancy-induced hypertension (PIH).
  
  
  METHODS
  In this prospective observational study, among the 72 relatively overweight (BMI ≥24 kg/m2) nulliparous women, 14 developed non-proteinuric PIH and 12 developed proteinuric PIH (preeclampsia), whereas 46 had normotensive pregnancies. Insulin sensitivity was assessed via the whole-body insulin sensitivity index (ISI) and the homeostatic model of assessment - insulin resistance (HOMA-IR) at 24 weeks of gestation. Maternal serum levels of FABP4, high-sensitive C-reactive protein (hs-CRP), total testosterone, and non-protein-bound calculated free testosterone (cfT) were determined at 24 and 32 weeks.
  
  
  RESULTS
  Measures of ISI, HOMA-IR, hs-CRP, testosterone and lipids did not differ at 24 and/or at 32 weeks in women who were subsequently hypertensive. SBP was higher at all time points and FABP4 levels tended to be higher at 24 and 32 weeks in patients compared to controls. In logistic regression analysis, baseline FABP4 (OR [95% CI] 1.069 [1.020-1.121], P = 0.006) and SBP after 10 min standing (OR [95% CI] 1.087 [1.029-1.149], P = 0.003) were associated with the development of PIH. FABP4 levels at 24 weeks did not correlate with insulin sensitivity. Neither was correlation seen between FABP4 levels at 24 and 32 weeks, vs. those of hs-CRP and testosterone.
  
  
  CONCLUSIONS
  Serum FABP4 concentration and SBP after 10 min standing in an orthostatic test at 24 weeks are associated with subsequent development of PIH.
authors.affiliation: Department of Obstetrics and Gynecology, Hospital District of Helsinki and Uusimaa, FIN-00029 Helsinki, Finland. Electronic address: anna.tuuri@hus.fi.
authors.forename: A L
authors.initials: AL
authors.lastname: Tuuri
authors.affiliation: National Institute for Health and Welfare, PL 30, 00271 Helsinki, Finland. Electronic address: matti.jauhiainen@thl.fi.
authors.forename: M S
authors.initials: MS
authors.lastname: Jauhiainen
authors.affiliation: Heart and Lung Center, Helsinki University Central Hospital and Folkhälsan Research Center, Biomedicum Helsinki, Haartmansgatan 8 (PB 63), 00014, Helsingfors universitet, Finland. Electronic address: Matti.J.Tikkanen@helsinki.fi.
authors.forename: M J
authors.initials: MJ
authors.lastname: Tikkanen
authors.affiliation: Turku University/Satakunta Central Hospital, 28500 Pori, Finland. Electronic address: risto.kaaja@utu.fi.
authors.forename: R J
authors.initials: RJ
authors.lastname: Kaaja
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D050177:Overweight / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: C493410:FABP4 protein, human; D050556:Fatty Acid-Binding Proteins; D002097:C-Reactive Protein
keywords: Angiopoietin-like protein 6; Insulin sensitivity; Preeclampsia; Pregnancy-induced hypertension; Serum fatty acid-binding protein 4