Expression And Significance Of Adipocyte Fatty Acid Binding Protein In Placenta, Serum And Cord Blood In Preeclampsia

ObjiectiveTo investigate the expression and alteration of the adipocyte fatty acid binding protein (FABP4/AFABP/aP2) in placenta tissue and serum in severe preeclampsia (PE) in order to find out its association with the pathogenesis of PE, analyze the relationship between PE with serum lipid and insulin resistance, discuss their roles in the pathogenesis of PE. And to determine the cord blood levels of FABP4 and their relationship with serum FABP4 levels, placenta FABP4 mRNA levels and neonatal body weight.MethodsThe serum levels of FABP4, insulin, and adiponectin were detected by enzyme-linked immunosorbent assay (ELISA), and the levels of lipid, glucose and renal function were detected with biochemistry analyzer in normal third-trimester pregnant women(controls:including pregnant week≤34 weeks group and pregnant week>34 weeks group) and in case of women with severe PE, which were divides into early-onset group (presented at≤34 weeks of gestation) and late-onset group (presented at>34 weeks of gestation).The expression of FABP4 mRNA levels in placenta tissue of women with severe PE and normal third-trimester pregnant women, were determined by real-time fluorescent quantitative reverse transcription PCR.Result1.The levels of serum FABP4 in the early-onset and late-onset severe PE groups were significantly higher than that of their controls(P<0.05). The differences were still significant after correction for haematocrit(P<0.05).2.1n early-onset and late-onset severe PE groups, the levels of serum total cholesterol(TC), triglyeride(TG), low density lipoprotein cholesterol(LDL), apolipo- protein B(ApoB), fasting insulin(FINS), and homeostatic model assessment insulin of resistance index(HOMA-IR) were higher than that of their controls, while high density lipoprotein cholesterol(HDL), apolipoprotein Al(ApoAl) and adiponectin were lower than that of their controls(P<0.05).3. In early-onset and late-onset severe PE groups, the levels of serum creatinine (Cr) and uric acid(UA) were higher than that of their controls, while glomerular filtration rate (GFR) was lower than that of their controls(P<0.05). The levels of 24-hour proteinuria in the early-onset group were higher than in the late-onset group(P<0.05).4.The levels of placenta tissue FABP4 mRNA expression in the early-onset and late-onset severe PE groups were significantly higher than control group(P<0.05).5.The levels of cord blood FABP4 in the early-onset and late-onset severe PE groups were significantly lower than control group, and the levels in the early-onset group was lower than in the late-onset group(P<0.05).6.The serum levels of FABP4 in early-onset and late-onset severe PE groups were positively correlated with serum TG, HOMA-IR, Cr and UA(P<0.05), while negatively correlated with serum HDL, adiponectin and GFR(P<0.05).7.The serum levels of FABP4 in early-onset and late-onset severe PE groups were positively correlated with the FABP4 mRNA expression in placenta tissue(P<0.05).8.The cord blood levels of FABP4 in early-onset and late-onset severe PE groups were positively correlated with neonatal body weight, while negatively correlated with the maternal serum levels of FABP4 and the placenta tissue FABP4 mRNA levels(P<0.05). The cord blood levels of FABP4 in control group were positively correlated with neonatal body weight(P<0.05).Conclusion1.Increased FABP4 expression in serum and placenta tissue may be involved in the pathogenesis of PE.2.The serum levels of FABP4 in PE groups were positively correlated with the FABP4 mRNA expression in placenta tissue. Increased expression of FABP4 mRNA in placenta tissue may contribute to high serum FABP4 levels of PE. 3.Dyslipidemia, low serum adiponectin levels and insulin resistance may be associated with increased FABP4 expression in patients with PE, and may be involved in the pathophysiology of high serum FABP4 levels led to development of PE.4.The cord blood levels of FABP4 in PE groups were negatively correlated with the maternal serum levels of FABP4 and the placenta tissue FABP4 mRNA levels. Decreased cord blood FABP4 levels in PE groups may contribute to the low birthweight.