Correlation Of Serum DKK1,Ratio Of Urine Microalbumin And Creatinine With Preeclampsia

Objective:To compare the expression of serum Dikkopf-related protein 1(DKK1)and the ratio of Urine Microalbumin and Creatinine(ACR)in pregnant women with preeclampsia(PE)and normal pregnancy,and to investigate the correlation between serum DKK1 and ACR.And to investigate the correlation with pre-eclampsia.Methods:From January 2022 to December 2022,30 patients diagnosed with preeclampsia were selected as the experimental group from pregnant women who had regular obstetric examinations and delivered in the obstetrics department of Qingdao Municipal Hospital,and 34 pregnant women with normal pregnancies in the same period were included in the control group.The experiment was reviewed and approved by our ethics committee and all consent was obtained from the study participants.All included cases met the diagnostic criteria of preeclampsia in the 9th edition of the Human Health Obstetrics and Gynecology,and all study participants had to be free of all other pregnancy complications and free of comorbidities such as diabetes mellitus,infectious diseases,acute and chronic liver and kidney diseases,and tumours.(1)Collection of general clinical information and biochemical parameters of the two study groups for comparison;(2)Application of an enzyme-linked immunosorbent assay(ELISA)to determine serum DKK1 protein expression in all study participants and analysis of the differences between the two groups;(3)Detection of microprotein in urine by immunoturbidimetric method and creatinine in urine by picric acid method and calculation of ACR values in two groups for comparison;(4)Analysis of correlation between DKK1,ACR and biochemical parameters;(5)Analysis of correlation between DKK1 and ACR and analysis of diagnostic value of both parameters in predicting onset of PE.All the above analyses were performed using SPSS 25.0 software to investigate the correlation between DKK1,ACR and onset and severity of PE using t-test,non-parametric test,Spearman correlation analysis and ROC curve.Results:1.There was no statistical difference in age and height between the experimental and control groups(P > 0.05);however,weight,systolic blood pressure and diastolic blood pressure were higher in the experimental group than in the control group,and the difference was statistically significant(P < 0.05),and gestational week in the experimental group was less than in the control group,and the difference was statistically significant(P < 0.05).2.There were statistical differences between the experimental and control groups in albumin(ALB),uric acid(UA),urea nitrogen(BUN),creatinine(CREA)and24-hour urine protein quantification(UTP)levels(P < 0.05).Notably,ALB levels were lower in the experimental group than in the control group;UA,BUN,CREA and UTP levels were significantly higher in the experimental group than in the control group.There was no statistical difference between the experimental and control groups in ALT and AST levels(P > 0.05).3.The serum DKK1 protein expression was 90.97±19.97(ng/m L)in the experimental group and 69.72±16.60(ng/m L)in the control group,which were conspicuous different between the two groups(P <0.05).4.The ACR values in the experimental group were significantly higher than those in the control group,with statistically significant results between the two groups(p <0.05).5.The correlation between DKK1 and statistically different measures of liver and kidney function in the two groups was compared,and the results showed that DKK1 was negatively correlated with ALB and positively correlated with UA(P < 0.05);there was no statistically significant difference between DKK1 and BUN and CREA(P >0.05).6.Spearman correlation analysis showed that the association between ACR and statistically different measures of liver and kidney function and protein quantification in24-hour urine in the two groups showed a positive correlation between ACR and UA,BUN,CREA and UTP and a negative correlation between ACR and ALB(P < 0.05).7.Spearman correlation coefficient was done between the ACR values and DKK1 expression levels in the experimental and control groups,and the results suggested a moderate positive correlation(P <0.001,r =0.509).8.DKK1,ACR have predict value in the development of PE.ROC curves were constructed using DKK1,ACR and their combined predictive values as test variables,and the results showed that the AUC of DKK1 and ACR for diagnosis of onset of PE was 0.789 and 0.957,with cut-off values of 72.32 and 44.14,sensitivity 0.867 and 0.933 and specificity 0.588 and 0.882.The AUC for the combination of the two was 0.954,with a cut-off value of 0.402,sensitivity 0.900 and specificity 0.941.Conclusions:1.Urine microalbumin and creatinine ratio can be used as a monitoring indicator for preeclampsia kidney injury.2.Serum DKK1 is involved in the development of preeclampsia.3.Serum DKK1 and the ratio of urine microalbumin and creatinine correlated with the onset of PE,and the combination of ACR and DKK1 has some clinical value in the diagnosis of PE in pregnant women.