Expression And Significance Of Soluble VEGF Receptor-1(sFlt-1)、Placenta Growth Factor(PLGF) In Placenta, Serum In Preeclampsia

ObjiectiveThe purpose of this research was to investigate the change of vascularendothelial growth factor receptor-1（sFlt-1）,placenta growth factor（PLGF） inmaternal serum and sFlt-1、PLGF mRNA placental expression in patients withpreeclampsia(PE), in order to find out its association with PE pathogenesis, analyzethe relationship between PE with serum lipid and insulin resistance, discuss their rolesin the pathogenesis of PE,and the relationship with metabolic syndrome and IR.MethodsA total of60women with PE and60normal pregnant women control wereparticipated in this study. All were admitted to Fujian Maternity and Children HealthHospital for delivery from October2009to June2011.The levels of sFlt-1,PLGF,fasting insulin(FINS),fasting serum glucose in serum were detected by enzyme-linkedimmunosorbent assay (ELISA),the levels of lipid and glucose were detected withbiochemistry. Patients with PE were divided into early-onset group(presented at≤34weeks of gestation,n=30) and late-onset group (presented at>34weeks ofgestation,n=30), with normal pregnant women as early control group (≤34weeks ofgestation,n=30) and late control group (>34weeks of gestation,n=30).Real-time fluorescent quantitative reverse transcription PCR was used to detectplacental sFlt-1, PLGF mRNA expression in the early-onset, late-onset severe PEgroups and controls.Result1. The levels of serum sFlt-1in the early-onset and late-onset severe PE groupswere significantly elevated as compared to controls groups(P＜0.05). 2. The levels of serum PLGF in the early-onset and late-onset severe PE groups weresignificantly lower as compared to controls groups(P＜0.05).3. The levels of serum total cholesterol(TC), triglyeride(TG), fasting insulin(FINS),and homeostatic model assessment insulin of resistance index(HOMA-IR) weresignificantly elevated in the early-onset PE group and late-onset PE group ascompared to control groups,respectively.4. The serum levels of sFlt-1were positively correlated with serum TG、TC、SP、DP、MAP、BMI、IRI、FINS and UA(P＜0.05), The serum levels of PLGF werenegatively correlated with serum TG、SP、DP、MAP、BMI、IRI、FINS and UA(P＜0.05). The serum levels of sFlt-1were negatively correlated with serumPLGF.5. The levels of placenta tissue sFlt-1mRNA expression were significantly elevatedin the early-onset PE group and late-on set PE group as compared to late controlgroup(P＜0.05).6. The levels of placenta tissue PLGF mRNA expression were significantly lower inthe early-onset and late-onset severe PE groups as compared to late controlgroup(P＜0.05).7. The serum levels of sFlt-1correlated positively with placental sFlt-1mRNAexpression(P＜0.05). The serum levels of PLGF correlated positively withplacental PLGF mRNA expression(P＜0.05).Conclusions1、Increased sFlt-1expression in serum and placenta tissue may be involved in thepathogenesis of PE.2、Decreased PLGF expression in serum and placenta tissue may be involved in thepathogenesis of PE.3、Increased expression of sFlt-1mRNA in placental contributes to high serum sFlt-1level in women with PE..4、Decreased expression of PLGF mRNA in placental contributes to low serumPLGF level in women with PE. 5、Dyslipidemia and insulin resistance may be associated with decreased PLGF andincreased sFlt-1expression in patients with PE,and may be associated withPI3K-Akt pathway,led to development of PE.