title: An analysis on the roles of angiogenesis-related factors including serum vitamin D, soluble endoglin (sEng), soluble fms-like tyrosine kinase 1 (sFlt1), and vascular endothelial growth factor (VEGF) in the diagnosis and severity of late-onset preeclampsia.
abstract: OBJECTIVE
  The aim of this study was to evaluate the roles of proangiogenic factors including serum vitamin D and vascular endothelial growth factor (VEGF) and anti-angiogenic factors including soluble endoglin (sEng) and soluble fms-like tyrosine kinase 1 (sFlt1) in the diagnosis and severity of late-onset preeclampsia.
  
  
  METHODS
  The study was conducted at Yuzuncu Yil University Research and Education Hospital Department of Gynecology and Obstetrics. The study included a patient group of 40 women with late-onset preeclampsia who were pregnant at ≥32 weeks of gestation according to the last menstrual period (LMP) or ultrasonographic fetal biometric measurement and a control group of 40 healthy pregnant women who presented to our clinic for routine pregnancy examination and were at the same age and gestational period with those in the patient group. The two groups were compared in terms of maternal age, gravida, parity, week of gestation, systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, white blood cell (WBC), hemoglobin (Hgb), platelet count, urea, creatinine, liver function tests (AST, ALT, LDH), vitamin D3, 25(OH) vitamin D3, 1,25(OH) vitamin D3, sEng, sFlt1, and VEGF levels, mode of delivery, the infant APGAR score at 1 and 5 min after delivery, and infant weight at delivery.
  
  
  RESULTS
  The groups were similar in terms of age, gravida, parity, week of gestation, serum vitamin D3, 25(OH) vitamin D3, 1,25(OH)2vitamin D3and VEGF levels, and infant weight at delivery (p > 0.05). Systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, WBC, Hgb, serum urea, creatine, AST, ALT, and LDH were significantly higher in the preeclamptic group compared to the healthy group (p < 0.05). However, thrombocyte level and the APGAR score at 1 and 5 min after delivery were significantly lower in the preeclamptic group compared to the healthy group (p < 0.05). No significant correlation was found between serum sEng, sFlt1, VEGF, vitamin D3, 25(OH) vitamin D3, and 1,25(OH)2vitamin D3levels. The sEng level was higher in the women with severe preeclampsia compared to the women with mild preeclampsia (p < 0.05) and no significant difference was observed in serum sFlt1, VEGF, vitamin D3, 25(OH) vitamin D3, and 1,25(OH)2vitamin D3levels between the subgroups of preeclampsia (p > 0.05).
  
  
  CONCLUSIONS
  Both sEng and sFlt1 levels are remarkably high in patients with late-onset preeclampsia; however, only sEng may be a useful tool in the determination of the severity of preeclampsia.
authors.affiliation: a Deparment of Obstetrics and Gynecology, Faculty of Medicine , Yuzuncu Yil University , Van , Turkey.
authors.forename: Numan
authors.initials: N
authors.lastname: Cim
authors.affiliation: b Deparment of Obstetrics and Gynecology, Faculty of Medicine , Gazi University , Ankara , Turkey.
authors.forename: Mertihan
authors.initials: M
authors.lastname: Kurdoglu
authors.affiliation: c Deparment of Obstetrics and Gynaecology , Republic of Turkey Ministry of Health, Diyarbakir Gazi Yasargil Education and Research Hospital , Diyarbakir , Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Ege
authors.affiliation: d Department of Chemistry, Faculty of Science and Arts , Yuzuncu Yil University , Van , Turkey , and.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yoruk
authors.affiliation: e Deparment of Medical Microbiology, Faculty of Medicine , Maltepe University , Istanbul , Turkey.
authors.forename: Gorkem
authors.initials: G
authors.lastname: Yaman
authors.affiliation: a Deparment of Obstetrics and Gynecology, Faculty of Medicine , Yuzuncu Yil University , Van , Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Yildizhan
mesh_terms: D000328:Adult; D043925:Angiogenesis Inducing Agents / Q000097:blood* / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D000071063:Endoglin / Q000097:blood* / Q000378:metabolism; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011247:Pregnancy; D011505:Protein-Tyrosine Kinases / Q000097:blood* / Q000378:metabolism; D011507:Proteinuria; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016216:Ultrasonography, Prenatal; D042461:Vascular Endothelial Growth Factor A / Q000097:blood* / Q000378:metabolism; D014807:Vitamin D / Q000097:blood*
chemical_list: D043925:Angiogenesis Inducing Agents; D015415:Biomarkers; D000071063:Endoglin; D042461:Vascular Endothelial Growth Factor A; D014807:Vitamin D; D011505:Protein-Tyrosine Kinases
keywords: Preeclampsia; angiogenesis; soluble endoglin; soluble fms-like tyrosine kinase 1; vascular endothelial growth factor; vitamin D