Melatonin,IL-6,and SFlt-1/PLGF Ratios Changes In Late Onset Sever Preeclampsia

Purpose This study was designed to detect Melatonin(MT),interleukin-6(IL-6),soluble fms-like tyrosine kinase-1(sFlt-1)and Placental growth factor(PLGF)and the level of melatonin in saliva were analyzed.To elucidate the correlation between MT,IL-6 and sFlt-1/PLGF ratio and body mass index(BMI),so as to further explore the prediction of late onset severe preeclampsia by changing MT,IL-6 and sFlt-1/PLGF ratio.Methods Based on the criteria for inclusion and exclusion,pregnant women hospitalized in the obstetrics department of Gansu Provincial People’s Hospital from September 2021 to August 2022 were selected.Case group(L-s PE group)diagnosed with late onset severe preeclampsia: 47 cases in total;Healthy pregnant women with normal antenatal examination were taken as the control group(NC group): 48 cases in total.All subjects’ peripheral blood and saliva of patients with late onset severe preeclampsia were collected,and the contents of MT,IL-6,sFlt-1,PLGF in peripheral blood and MT in saliva were measured by ELISA.The expression characteristics and differences among different groups were analyzed and compared.In addition,the ROC of the subjects was used to analyze the predictive diagnostic value of MT,IL-6,sFlt-1/PLGF ratio and the combination of the three indicators for late onset severe preeclampsia,and the correlation between the three indicators and BMI was analyzed to explore the pathogenesis of late onset severe preeclampsia.Results 1.There was no significant difference in general information such as age,BMI and gestational week of delivery between the L-s PE group and NC group(P>0.05).The systolic blood pressure and diastolic blood pressure in the case group were higher than those in the normal control group(both P<0.05).2.MT levels in peripheral blood and saliva of subjects in case group and control group during the daytime and at night The results of Mann-Whitney U test showed that MT levels in peripheral blood and saliva in case group during the daytime or at night.There was a significant difference between the two groups and a statistically significant difference.(P<0.05).3.The Mann-Whitney U test results of IL-6 in peripheral blood between the case group and the control group showed that the level of IL-6 in the case group was significantly higher than that in the control group and the difference was statistically significant(P<0.05).4.The Mann-Whitney U test of sFlt-1/PLGF ratio in peripheral blood between the case group and the control group showed that the sFlt-1/PLGF ratio in the case group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).5.The areas under the curve of MT in peripheral blood and MT in saliva for the diagnosis of late onset severe preeclampsia are 0.823 and 0.796,respectively,with the corresponding P values less than 0.05.There was no significant statistical difference between the two in the prediction value of the disease(P<0.05).6.The area under the curve predicted by salivary MT,IL-6,sFlt-1/PLGF ratio and the combination of the three indicators in late onset severe preeclampsia was 0.796,0.899,0.957 and 0.984,respectively,and the corresponding P values were all less than 0.05.7.The correlation between BMI and daytime saliva MT,night saliva MT,daytime peripheral blood MT,night peripheral blood MT,peripheral blood IL-6,sFlt-1/PLGF ratio in patients with late onset severe preeclampsia The results of Spearman correlation analysis showed that there was a significant negative correlation between BMI and daytime saliva MT,night saliva MT,daytime peripheral blood MT,night peripheral blood MT(R<0,P<0.05);There was a significant positive correlation with IL-6 and the ratio of sFlt-1/PLGF(r>0,P<0.05).Conclusion 1.The change of melatonin level can be used to predict late-onset severe preeclampsia,and the effect of saliva MT in predicting this disease is as good as that of peripheral blood MT,which means that non-invasive saliva can be used as a predictor.2.IL-6,sFlt-1 and PLGF may be involved in the occurrence and development of late-onset severe preeclampsia.3.The combined prediction effect of salivary MT,peripheral blood IL-6 and sFlt-1/PLGF ratio is obviously better than any one of them alone.4.MT,IL-6,sFlt-1/PLGF ratio are all correlated with BMI,and the mechanism of melatonin participating in the occurrence and development of diseases may be related to inflammation-mediated endothelial injury.