Analysis of serological risk factors for preeclampsia and the predictive role of high homocysteine levels

Abstract

Objectives: To investigate the serological risk factors for preeclampsia, focusing on homocysteine level and its predictive role in the condition.

Methods: A retrospective analysis was conducted on 242 pregnant women (121 preeclampsia cases and 121 healthy controls) admitted from January 2022 to June 2023. Serological markers, including homocysteine, fasting blood glucose (FBG), triglycerides (TG), and inflammatory indicators, were compared between the two groups. Statistical analyses, including multivariate logistic regression and receiver operating characteristic (ROC) analysis, were performed to identify significant predictors.

Results: Elevated homocysteine levels were strongly associated with preeclampsia, showing a high area under the curve (AUC) of 0.978 in ROC analysis, with a sensitivity of 93.4% and a specificity of 95.0% at a 9.230 μmol/L threshold. TG and FBG were also associated with increased preeclampsia risk, though the latter's significance diminished in multivariate analysis. In terms of inflammatory markers, Interleukin-6 (IL-6) levels were elevated, whereas C-reactive protein (CRP) levels were unexpectedly lower in preeclampsia cases. Lower Vitamin C level was correlated with the presence of preeclampsia.

Conclusion: Elevated homocysteine level was a significant predictor of preeclampsia, alongside dyslipidemia and altered inflammatory responses.

Keywords: Preeclampsia; biomarkers; homocysteine; hypertension; inflammation; pregnancy.

Figure 1

Comparison of serum proteins, blood glucose, and lipids between the preeclampsia and non-preeclampsia groups. A: Hb (g/L); B: Albumin (g/L); C: FBG (mmol/L); D: TG (mmol/L); E: TC (mmol/L). Hb: Hemoglobin; FBG: Fasting Blood Glucose; TG: Triglycerides; TC: Total Cholesterol. Ns: P > 0.05; *: P < 0.05; **: P < 0.01.

Figure 2

Comparison of maternal and fetal health monitoring indicators between the preeclampsia and non-preeclampsia groups. A: PAPP-A (MOM); B: sFlt-1/PLGF ratio; C: Hcy (μmol/L). PAPP-A: Pregnancy-associated Plasma Protein A; MOM: Multiple of the Median; sFlt1: Soluble Fms-like Tyrosine Kinase 1; PLGF: Placental Growth Factor; Hcy: Homocysteine. Ns: **: P < 0.01; ***: P < 0.001.

Figure 3

Comparison of vitamin levels between the preeclampsia and non-preeclampsia groups. A: Vitamin C (μmol/L); B: Vitamin A (mg/L); C: Vitamin E (mg/L); D: 25 hydroxyvitamins D (ng/mL). Ns: P > 0.05; *: P < 0.05.