Evaluation of Adiponectin and Resistin in Early Diagnosis and Prediction of Pre-eclampsia

Hassan  H. Al-Saeed

doi:10.51699/cajmns.v7i3.3287

Authors

Hassan H. Al-Saeed Department of Chemistry and Biochemistry, Collage of Medicine, Al-Nahrain University, Iraq.

DOI:

https://doi.org/10.51699/cajmns.v7i3.3287

Keywords:

Preeclampsia, Adiponectin, Resistin, Uric acid, Traditional renal markers

Abstract

Background: Inflammation, organ damage, and endothelial dysfunction characterize preeclampsia, a pregnancy-specific multisystem hypertension disease. Adipokines, particularly resistin and adiponectin, have been identified as possible participants in the metabolic and inflammatory pathways that may be involved in the development of disease. Objective: The purpose of this research was to examine the relationship between preeclampsia serum adiponectin and resistin levels and their function as early diagnostic and disease severity predictive markers. Methods: There were 88 pregnant women in this case-control research; 30 were healthy controls, 29 had mild preeclampsia, and 29 had severe preeclampsia. The guidelines set out by the American College of Obstetricians and Gynecologists were used to define preeclampsia. An ELISA was used to ascertain the amounts of resistin and serum adiponectin. On automated analyzers, routine parameters related to renal and hepatic biochemistry were measured. For group comparisons, either Kruskal-Wallis or ANOVA tests were utilized. The use of Spearman coefficients allowed for the evaluation of correlations. In order to find independent factors that could predict the presence and severity of the disease, logistic regression models were developed. In order to evaluate the efficacy of the diagnostic, ROC curve analysis was performed. Results: The levels of resistin and adiponectin were found to be significantly higher in the mild and severe preeclampsia groups compared to the control group (p < 0.001). Strong associations were seen with systolic blood pressure (r = 0•816, p <0•0001), uric acid (r = 0•49, p = 0•0001), and gestational age (r =.477, p= 0•0002), and resistin had a clear progressive rise (8.55 ± 1.43 vs 10.98 ± 1.06 vs 14.16 ± 1.04 mg/L). Even while adiponectin increased (5.05 ± 1.19 vs 10.93 ± 2.43 vs 16.83 ± 4.19 mg/L), it was not as effective in differentiating between the groups. As compared to adiponectin, resistin performed better in ROC analysis for severe preeclampsia (AUC = 0.980 vs. 0.866). Resistin was found to be a significant predictor of both preeclampsia and the severity of the condition, according to logistic regression (OR = 4.93, 95% CI: 2.31-10.54, p < 0.001). Conclusions: Serum resistin outperforms adiponectin in both diagnostic and prognostic tests, and its rise is linked to the severity of preeclampsia. For the purpose of risk stratification and severity evaluation in preeclampsia, resistin could be a clinically valuable supplementary biomarker.

References

S. Rana, E. Lemoine, J. P. Granger, and S. A. Karumanchi, “Preeclampsia: Pathophysiology, challenges, and perspectives,” Circulation Research, vol. 124, no. 7, pp. 1094–1112, 2019, doi: 10.1161/CIRCRESAHA.118.313276.

K. S. Khan, D. Wojdyla, L. Say, A. M. Gülmezoglu, and P. F. Van Look, “WHO analysis of causes of maternal death,” The Lancet, vol. 367, no. 9516, pp. 1066–1074, 2021, doi: 10.1016/S0140-6736(06)68397-9.

B. W. J. Mol, C. T. Roberts, S. Thangaratinam, L. A. Magee, C. J. M. de Groot, and G. J. Hofmeyr, “Pre-eclampsia,” The Lancet, vol. 387, no. 10022, pp. 999–1011, 2016, doi: 10.1016/S0140-6736(15)00070-7.

C. W. G. Redman and A. C. Staff, “Preeclampsia, biomarkers, syncytiotrophoblast stress, and placental capacity,” American Journal of Obstetrics & Gynecology, vol. 213, no. 4 Suppl., pp. S9.e1–S9-11, 2015, doi: 10.1016/j.ajog.2015.08.003.

C. Martini, Z. Saeed, P. Simeone, et al., “Preeclampsia: Insights into pathophysiological mechanisms and preventive strategies,” American Journal of Preventive Cardiology, vol. 23, Art. no. 101054, 2025, doi: 10.1016/j.ajpc.2025.101054.

S. M. Timpanakos, N. Hryshko, J. J. Grigsby, and S. Goulopoulou, “Endothelial dysfunction in preeclampsia: Focus on the uteroplacental circulation,” Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 46, no. 6, 2026, doi: 10.1161/ATVBAHA.125.321668.

S. A. Karumanchi and J. P. Granger, “Preeclampsia and angiogenic imbalance,” Hypertension, vol. 79, no. 6, pp. 1235–1245, 2022, doi: 10.1161/HYPERTENSIONAHA.121.18281.

R. A. H. Abdalla, N. Parveen, N. Iqbal, A. A. Abdelrahman Mohamed, S. M. Shahid, and G. E. Elhussein, “Adipokines in preeclampsia: Disrupted signaling pathways and therapeutic strategies,” European Journal of Medical Research, vol. 30, p. 702, 2025, doi: 10.1186/s40001-025-02972-y.

N. K. N. Kansu, M. Beinder, H. Schleussner, M. Schiessl, T. Ebert, A. Tönjes, and S. Stumvoll, “Adipokines in pregnancy: A systematic review of clinical data,” Biomedicines, vol. 11, no. 5, p. 1419, 2023, doi: 10.3390/biomedicines11051419.

G. Banjac, D. Ardalic, M. Mihajlovic, and T. Antonic, “The role of resistin in early preeclampsia prediction,” Scandinavian Journal of Clinical and Laboratory Investigation, vol. 81, no. 1, pp. 1–6, 2021, doi: 10.1080/00365513.2021.1938205.

X. Xu, Y. Du, and N. Wang, “Association between circulating resistin level and preeclampsia: A meta-analysis,” Hormone and Metabolic Research, vol. 55, no. 12, pp. 835–845, 2023, doi: 10.1055/a-2167-0179.

Y. Ling, B. Han, T. Gu, and X. Jiang, “Resistin in cardiac diseases: From molecular mechanisms to clinical implications,” Frontiers in Endocrinology, vol. 16, Art. no. 1708332, 2025, doi: 10.3389/fendo.2025.1708332.

I. Carrilho, M. Mariana, and E. Cairrao, “Adiponectin as a biomarker of preeclampsia,” Reproductive Medicine, vol. 6, no. 4, p. 29, 2025, doi: 10.3390/reprodmed6040029.

S. Rao, A. Kumari, M. Sharma, and B. C. Kabi, “Predicting maternal serum adiponectin and leptin level as biomarkers of pre-eclampsia: A prospective study,” Journal of Obstetrics and Gynaecology of India, vol. 71, no. 1, pp. 58–65, 2021, doi: 10.1007/s13224-020-01378-6.

A. D. Nugrahani, M. A. Aziz, D. P. J. Santoso, A. Siddiq, A. Y. Pramatirta, S. Irianti, A. Pribadi, A. D. Anwar, and M. R. A. A. Syamsunarno, “Adiponectin and leptin profiles among obese pregnant women with preeclampsia vs. non-preeclampsia: A systematic review and meta-analysis,” European Review for Medical and Pharmacological Sciences, vol. 28, no. 13, pp. 3922–3933, 2024, doi: 10.26355/eurrev_202407_36524.

A. Froń, P. Tomecka, and M. Orczyk-Pawiłowicz, “Impact of maternal obesity on adipokines,” International Journal of Molecular Sciences, vol. 26, no. 19, p. 9757, 2025, doi: 10.3390/ijms26199757.

S. Sharma, J. Skog, S. Timpka, and C. Ignell, “Preeclampsia and high blood pressure in early pregnancy as risk factors of severe maternal cardiovascular disease during 50-years of follow-up,” Pregnancy Hypertension, vol. 26, pp. 79–85, 2021, doi: 10.1016/j.preghy.2021.09.005.

B. M. Sibai, “Diagnosis and management of gestational hypertension and preeclampsia,” Obstetrics & Gynecology, vol. 102, no. 1, pp. 181–192, 2003, doi: 10.1016/S0029-7844(03)00475-7.

H. Stepan, M. Hund, and T. Andraczek, “Combining biomarkers to predict pregnancy complications and redefine preeclampsia: The angiogenic-placental syndrome,” Hypertension, vol. 75, no. 4, pp. 918–926, 2020, doi: 10.1161/HYPERTENSIONAHA.119.13763.

S. Rolnik, S. Rahman, A. Syngelaki, E. M. D. Akolekar, J. Bakalis, N. O’Gorman, and T. H. Nicolaides, “Preterm preeclampsia screening and prevention: A comprehensive approach to implementation in a real-world setting,” BMC Pregnancy and Childbirth, vol. 25, no. 32, 2025, doi: 10.1186/s12884-025-07154-6.

S. Verlohren and L. A. Dröge, “The diagnostic value of angiogenic and antiangiogenic factors in differential diagnosis of preeclampsia,” American Journal of Obstetrics & Gynecology, vol. 226, no. 2 Suppl., pp. S1048–S1058, 2022, doi: 10.1016/j.ajog.2020.09.046.

N. Parveen, N. Iqbal, A. A. Abdelrahman, M. Abdelrahman, S. M. A. Shahid, R. A. H. Abdalla, G. E. M. Osman, M. Saleem, A. A. Choudhry, and M. S. Khan, “First-trimester adipocytokine levels as predictive biomarkers for preeclampsia: A prospective case-control study,” European Journal of Medical Research, vol. 31, no. 1, p. 325, 2026, doi: 10.1186/s40001-026-03959-z.

N. Parveen, N. Iqbal, A. A. A. Mohamed, S. M. Alam Shahid, R. A. H. Abdalla, G. M. Elhussein, A. A. Choudhry, and M. S. Khan, “First-trimester adipocytokines as predictive biomarkers,” European Journal of Medical Research, vol. 31, p. 325, 2026, doi: 10.1186/s40001-026-03959-z.

“ACOG Practice Bulletin No. 222: Gestational hypertension and preeclampsia,” Obstetrics & Gynecology, vol. 135, no. 6, pp. e237–e260, 2020, doi: 10.1097/AOG.0000000000003891.

S. Sharmin, S. Chy, D. Alam, N. Banu, F. Rashid, and S. Kabir, “Association of serum C-reactive protein in preeclampsia and its effect on fetal birth weight – A case control study,” Bangladesh Journal of Obstetrics & Gynaecology, vol. 31, no. 2, pp. 75–80, 2016, doi: 10.3329/bjog.v31i2.34214.

W. John and W. Abraham, “The comparison of creatinine and cystatin C value in preeclampsia severity and neonatal outcome,” Majalah Obstetri & Ginekologi, vol. 24, no. 3, pp. 84–89, 2018, doi: 10.20473/mog.V24I32016.84-89.

A. N. Mirković, V. Cvitković, A. Nikolić, D. Mandić, S. Bogavac, G. Milovanović, M. Rakić, and Z. Stanojević, “Cystatin C in pre-eclampsia,” Journal of Maternal-Fetal and Neonatal Medicine, vol. 25, no. 7, pp. 961–965, 2012, doi: 10.3109/14767058.2011.601366.

M. C. E. Hooijschuur, C. Ghossein-Doha, A. A. Kroon, P. W. de Leeuw, A. A. M. Zandbergen, S. M. J. van Kuijk, and M. E. A. Spaanderman, “Metabolic syndrome and pre-eclampsia,” Ultrasound in Obstetrics & Gynecology, vol. 54, no. 1, pp. 64–71, 2019, doi: 10.1002/uog.20126.

E. Phipps et al., “Preeclampsia: Updates in pathogenesis, definitions, and guidelines,” Clinical Journal of the American Society of Nephrology, vol. 11, no. 6, pp. 1102–1113, 2016, doi: 10.2215/CJN.12081115.