title: Maternal plasma TIMP-4 levels combined with clinical risk factors for the early prediction of pregnancy-induced hypertension.
abstract: OBJECTIVE
  The objective of this study was to create a model for early predicting pregnancy-induced hypertension (PIH) using plasma markers and clinical risk factors.
  
  
  METHODS
  A nested case-control study was performed at the Laboratory Department of Guangzhou Women and Children's Medical Center. From a prospective cohort of tens of thousands of unselected women with singleton pregnancies at 8-20 weeks gestation, maternal plasma samples were obtained from 73 women who subsequently developed PIH (PIH group) and 146 gestational age- and maternal age-matched women with normotensive pregnancies (control group). Proteins extracted from the plasma samples were screened by microchip and verified by ELISA. Clinical risk factor data were analyzed retrospectively.
  
  
  RESULTS
  Compared to the control group, high concentrations of tissue inhibitor of metalloproteinase-4 (TIMP-4) were found in women with PIH (P = 0.000). Univariate risk factor analysis identified three variables with significant differences between the groups: family history of PIH (P = 0.031), body mass index (BMI; P < 0.001), and non-glucose-6-phosphate dehydrogenase deficiency-induced anemia (P < 0.027). Multiple regression analyses revealed a significant relationship of PIH with TIMP-4 levels, BMI, and family history (combined area under the receiver operating characteristic curve = 0.820).
  
  
  CONCLUSIONS
  Upregulation of plasma TIMP-4 might contribute to PIH processes. Potential risk factors of this disease may include a family history of PIH and BMI. The combination of TIMP-4 levels and these risk factors may have some predictive values for PIH. Future multicenter studies including greater numbers of samples, analyzed proteins, and risk factors are needed to obtain a higher predictive value of the model for the clinical diagnosis of PIH.
authors.affiliation: Laboratory Department, Guangzhou Women and Children Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Laboratory Department, Guangzhou Women and Children Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Qinling
authors.initials: Q
authors.lastname: Ma
authors.affiliation: Laboratory Department, Guangzhou Women and Children Medical Center, Guangzhou Medical University, Guangzhou, China. hlyang62@sina.com.
authors.forename: Hongling
authors.initials: H
authors.lastname: Yang
authors.affiliation: Laboratory Department, Guangzhou Women and Children Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Long
authors.affiliation: Laboratory Department, The 324th Hospital of Third Military Medical University, Chongqing, China.
authors.forename: Xingxing
authors.initials: X
authors.lastname: Liu
authors.affiliation: Laboratory Department, Guangzhou Women and Children Medical Center, Guangzhou Medical University, Guangzhou, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Zhou
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000175:diagnosis*; D008423:Maternal Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D019714:Tissue Inhibitor of Metalloproteinases / Q000097:blood* / Q000378:metabolism; D000097792:Tissue Inhibitor of Metalloproteinase-4
chemical_list: D015415:Biomarkers; D019714:Tissue Inhibitor of Metalloproteinases; D000097792:Tissue Inhibitor of Metalloproteinase-4
keywords: Plasma biomarker; Pregnancy-induced hypertension; Risk model; TIMP-4