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| Analysis of the correlation between the levels of the serum matrix metalloproteinase-9, endothelin-1 and soluble fms-like tyrosine kinase-1 of pregnant women with hypertensive disorder complicating pregnancy (HDP) and their perinatal outcomes |
| Nanchong Central Hospital, Nanchong, Sichuan Province, 637000 |
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Abstract To observe the correlation between the levels of the serum matrix metalloproteinase-9 (MMP-9), endothelin-1 (ET-1) and soluble fms-like tyrosine kinase-1(sFlt-1) of pregnant women with hypertensive disorder complicating pregnancy(HDP). Methods: A total of 80 pregnant women with HDP from January 2020 to October 2023 were selected in study group retrospectively, and 80 healthy pregnant women during the same period were selected in control group. The levels of serum MMP-9, ET-1 and sFlt-1 of the women were compared between the two groups, and the correlation between which of the women and the disease severity of their HDP was analyzed. According to the perinatal outcomes, the women in the study group were divided into group A (women with normal pregnancy outcomes) and group B (women with adverse pregnancy outcomes). The predictive values of the serum MMP-9, ET-1 and sFlt-1 levels of the women with HDP for their perinatal outcomes were analyzed by receiver operating characteristic (ROC) curve. Results: The serum MMP-9 level(0.37±0.05ng/ml) of the women in the study group was significantly lower than that (0.66±0.15ng/ml) of the women in the control group. The levels of ET-1(30.63±4.17ng/ml) and sFlt-1 (4459.74±62.25ng/L) of the women in the study group were significantly higher than those (19.67±2.28ng/ml and 2371.16±48.52ng/L) of the women in the control group. In the study group, the MMP-9 level of the women with mild HDP was significantly higher than that of the women with moderate or severe HDP, and the levels of ET-1 and sFlt-1 of the women with mild HDP were significantly lower than those of the women with moderate or severe HDP (all P<0.05). Spesrman correlation analysis showed that the severity of HDP of the women with HDP was negatively correlated with their level of MMP-9 (r=-0.496), and was positively correlated with their ET-1 level (r=0.472) and their sFlt-1 level (r=0.508) (P<0.05). In 80 women with HDP, there were 19 women with adverse perinatal outcomes. The serum MMP-9 level of the women in group B was significantly lower than that of the women in group A, and the serum ET-1 and sFlt-1 levels of the women in group B were significantly higher than those of the women in group A (all P<0.05). ROC analysis showed that the best cut-off values of the MMP-9 level, the ET-1 level and the sFlt-1 level of the women with HDP for predicting their adverse perinatal outcomes were 0.365 ng/ml, 29.425 ng/ml and 4495.65 ng/L, respectively. The area under the curve and the specificity of the combined levels of the MMP-9, ET-1 and sFlt-1 of the women with HDP for predicting their adverse perinatal outcomes were 0.906 and 91.8%, and which were significantly higher than those of the MMP-9 level, the ET-1 level or the sFlt-1 level alone (all P<0.05). Conclusion: The serum levels of MMP-9, ET-1 and sFlt-1 of the pregnant women with HDP are closely related to their disease severity and perinatal outcomes. The combined detection of the MMP-9, ET-1 and sFlt-1 levels of the pregnant women with HDP has higher predictive value for their adverse perinatal outcomes.
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