Predictive Value of Plasma Total Carnitine, Arginine, Asymmetric Dimethylarginine and Ischemia-modified Albumin Levels and Their Combined Use in the Early Detection of Preeclampsia

Abstract

Purpose: Aim of the study was to investigate serum levels of total carnitine, arginine, asymmetric dimethylarginine (ADMA) and ischemia-modified albumin (IMA) and their combined use for the early detection of preeclampsia. Materials and Methods: The study group, which included normal pregnancies, consisted of a total of 44 singleton pregnant women (gestational age: between 6 and 12 weeks), divided into a preeclampsia group (n = 22) and a control group (n = 22). Results: When the serum levels of both groups in the 6th and 12th week of gestation were compared with levels between the 21st and 35th week of gestation, total carnitine, ADMA, IMA levels were increased; L-arginine levels were decreased in the preeclampsia group. Using a total carnitine level of ≤ 3.62 nmol/ml as a cut-off value, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 68, 64, 65 and 64 %; using an ADMA level of ≤ 518.70 ng/ml as a cut-off value, the sensitivity, specificity, PPV and NPV were 82, 32, 55 and 64 %; using an L-arginine level of ≤ 161.23 nmol/ml as a cut-off value, the sensitivity, specificity, PPV and NPV were 45, 73, 62, 57 %; using an IMA level of > 0.82 as a cut-off value, the sensitivity, specificity, PPV and NPV were 45, 77, 64 and 57 %, respectively. When all parameters were taken together to predict preeclampsia, the sensitivity, specificity, PPV and NPV were 9, 100, 100 and 52 %, respectively. Conclusion: Although the sensitivity of ADMA levels was found to be higher in individual measurements, there is still no independent placental ischemia factor which can predict preeclampsia.

Zusammenfassung

Fragestellung: Ziel der Studie war es, die Serumkonzentrationen von Plasma-Carnitin, Arginin, asymmetrischem Dimethylarginin (ADMA) und Ischämie-modifiziertem Albumin (IMA) zu untersuchen sowie die Kombination dieser Werte als potenzielle Indikatoren zur Früherkennung von Präeklampsie. Material und Methoden: Es wurden 44 schwangere Frauen (Einlingsschwangerschaften, Gestationsalter zwischen 6 und 12 Wochen) untersucht: Präeklampsiegruppe (n = 22), Kontrollgruppe (n = 22). Ergebnisse: Serumkonzentrationen in der 6. und 12. Gestationswoche wurden mit Serumkonzentrationen in der 21. und 35. Gestationswoche in beiden Gruppen verglichen. Carnitin-, ADMA-, und IMA-Konzentrationen waren erhöht; L-Arginin-Konzentrationen in der Präeklampsiegruppe waren verringert. Bei einem Carnitin-Wert von ≤ 3,62 nmol/ml als Cut-off-Wert war die Sensitivität, Spezifität, PPV und NPV 68, 64, 65 und 64 %, bei einem ADMA-Wert von ≤ 518,70 ng/ml als Cut-off-Wert betrugen die Sensitivität, Spezifität, PPV und NPV 82, 32, 55 und 64 %, bei einem L-Arginin-Wert von ≤ 161,23 als Cut-off-Wert betrugen die Sensitivität, Spezifität, PPV und NPV 45, 73, 62 und 57 %, bei einem IMA-Wert von > 0,82 als Cut-off-Wert lagen die Sensitivität, Spezifität, PPV und NPV bei 45, 77, 64 und 57 %. Wurden alle Parameter zusammen betrachtet, betrugen die Sensitivität, Spezifität, PPV und NPV 9, 100, 100 und 52 %. Schlussfolgerung: Obwohl die Sensitivität der ADMA-Konzentration höher war, gibt es dennoch keinen unabhängigen Ischämiefaktor, der als Indikator zur Vorhersage von Präeklampsie dienen könnte.

Key words

pregnancy - preeclampsia - total carnitine - asymmetric dimethylarginine - arginine - ischemia‐modified albumin

Schlüsselwörter

Schwangerschaft - Präeklampsie - Carnitin - asymmetrisches Dimethylarginin - Arginin - Ischämie‐modifiziertes Albumin

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