Diagnostic Value Of Urinary Misfolded Protein In Preeclampsia

Objective The diagnostic value of urinary misfolded protein in pregnant women with preeclampsia was investigated by comparing the expression of misfolded protein in the urine of pregnant women with preeclampsia and normal pregnancy,and also analyzing the correlation between urinary misfolded protein and 24-hour urine protein quantification in pregnant women with preeclampsia.Methods1.General data,urinary misfolded protein results,and 24-hour urinary protein quantification results of the case group were collected from October 2021 to December2022 in 45 cases(pre-eclampsia group)and 45 controls(normal expectant group)who were examined at Chaohu Hospital,Anhui Medical University.The general data of the case and control groups were collected:age,pre-pregnancy weight,height,pre-pregnancy BMI,sampling gestational week,gestation,and delivery,and an Excel sheet was created.Urinary misfolded protein was measured in the case and control groups by the spot diffusion method.24-hour urine was collected from pregnant women in the case group,and the concentration of microalbumin was measured using the immunoturbidimetric method,and the concentration of albumin was measured by the Lienbeck’s triplet red method.The urine volume was counted.The amount of 24-hour urine protein was calculated.The results of the two groups of urinary misfolded protein and the 24-hour urine protein quantification in the case group were recorded and entered into an Excel sheet.2.The general data and urinary misfolded protein test results of the two groups of pregnant women were compared and analyzed.The independent samples t-test was used for the comparison between the case group and the control group for quantitative data,and the Chi-square test was used for the comparison between the groups for qualitative data.The correlation analysis between urinary misfolded protein and 24-hour urine protein quantification in the case group was performed by Point-biserial correlation.Mc Nemar’s test and Kappa consistency test were used to detect the diagnostic efficacy of urinary misfolded protein in preeclampsia.Results1.General data of the case and control groups were compared,and there was no statistically significant difference between the two groups in terms of age,pregnancy,delivery,height and sampling gestational week(P>0.05),and the difference in pre-pregnancy BMI and pre-pregnancy weight between the two groups was statistically significant(P<0.05).2.There were 26 positive and 19 negative results for urinary misfolded protein detected in the case group,accounting for 57.78%and 42.22%,respectively;there was 1 positive and 44 negative results for urinary misfolded protein detected in pregnant women in the control group,accounting for 2.22%and 97.78%,respectively.The rate of positive results for urinary misfolded protein detected in the case group(57.78%)was significantly higher than that in the control group(2.22%),and the difference was statistically significant(χ~2=20.829,P<0.001).3.Correlation analysis between urinary misfolded protein and 24-hour urine protein quantification in pregnant women with pre-eclampsia in the case group showed a significant positive correlation(r=0.526,P<0.001).4.Compared with the gold standard,the results of urinary misfolded protein detection were basically consistent with the gold standard(Kappa=0.556,P<0.001),and the accuracy of urinary misfolded protein detection was lower(P<0.001).In the diagnosis of severe preeclampsia,the results of urinary misfolded protein were consistent with the gold standard(P>0.05),and there was moderate consistency between the two(Kappa=0.525,P<0.001).Diagnostic efficacy for mild preeclampsia:urinary misfolded protein diagnosis was consistent with the gold standard(P>0.05),but the consistency between the two was poor(Kappa=0.171,P>0.05).5.The sensitivity of urinary misfolded protein for the diagnosis of preeclampsia was poor(57.78%),but the specificity(97.78%)and positive predictive value(96.30%)were higher,the negative predictive value was 69.84%,and its false positive rate was low,only 2.22%.ConclusionThere was a significant positive correlation between urinary misfolded protein and24-hour urine protein quantification in pregnant women with preeclampsia.The diagnostic value of urinary misfolded protein was higher for severe preeclampsia compared with that for mild preeclampsia.The sensitivity of urinary misfolded protein for the diagnosis of preeclampsia is low,but its specificity is high,with high positive predictive value and low false-positive rate.It will be more effective as a diagnostic indicator in combination with other tests,and can be used for rapid initial screening of preeclampsia.