Increased levels of serum clusterin is associated with intrauterine growth restriction and adverse pregnancy outcomes in preeclampsia.
OBJECTIVE
Our aim was to investigate serum clusterin levels in preeclampsia and to determine whether any changes in clusterin levels are useful in distinguishing the presence of concomitant intrauterine growth restriction (IUGR) and in predicting adverse pregnancy outcomes.


METHODS
A prospective case-control study was carried out which included 86 pregnant women (47 patients with preeclampsia and 39 healthy controls). Maternal serum samples obtained from all participants and clusterin levels were determined by enzyme-linked immunosorbent assay (ELISA).


RESULTS
Compared with controls, women with preeclampsia had significantly higher clusterin levels (mean 83.8±23.6 vs. 119.2±40.5, P<0.01). Further analysis revealed the highest clusterin levels were in patients with preeclampsia and IUGR (P<0.001). According to the receiver operating characteristic (ROC) analysis performed for the predictive value of clusterin levels for adverse maternal outcomes, the area under the curve (AUC) was 0.738 (95% CI: 0.616-0.859). The best clusterin cut-off value in predicting adverse maternal outcomes was 102.6 pg/mL with 75% sensitivity and 66% specifity. Multivariable logistic regression analysis revealed serum clusterin levels of >102.6 pg/mL was independently associated with preeclampsia (OR: 6.18, 95% CI: 2.41-15.9) and maternal adverse outcomes (OR: 5.13, 95% CI: 2.01-13.1) and also clusterin levels higher than 117.4 pg/mL were associated with adverse neonatal outcomes (OR: 5.02, 95% CI: 1.04-24.3).


CONCLUSIONS
The current study suggests that increased levels of clusterin is associated with IUGR and probably predictive for adverse pregnancy outcomes in preeclampsia.
Efser
E
Oztas
Sibel
S
Ozler
Ali Ozgur
http://orcid.org/0000-0003-1137-7017
AO
Ersoy
Can Tekin
http://orcid.org/0000-0003-1376-5734
CT
Iskender
Ayhan
A
Sucak
Merve
M
Ergin
Dilek
D
Uygur
Nuri
N
Danisman
D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D051152:Clusterin / Q000097:blood*; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D011225:Pre-Eclampsia / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D055815:Young Adult
D015415:Biomarkers; C495242:CLU protein, human; D051152:Clusterin