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sFlt-1/PlGF ratio combined with endocan-1 serum levels improves the predictive values for the occurrence and prognosis of preeclampsia in a single centre study

Journal of Human Hypertension volume 39, pages 348–354 (2025)Cite this article

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Abstract

This retrospective study evaluated diagnostic and prognostic values of sFlt-1/PlGF ratio combined with serum endocan-1 for preeclampsia (PE). This study included 105 patients with PE admitted at Xiamen University Affiliated Xiang’an Hospital from January 2020 to September 2023, with 90 healthy pregnant women receiving routine check-ups during the same period as controls. sFlt-1, PlGF, and endocan-1 levels were measured, and sFlt-1/PlGF ratio was calculated. The correlation of sFlt-1/PlGF ratio with serum endocan-1 levels was analysed, and influencing factors for poor prognosis of PE patients were screened. Diagnostic and prognostic values of sFlt-1/PlGF ratio combined with serum endocan-1 were assessed. Results showed an increase in sFlt-1/PlGF ratio and serum endocan-1 levels in PE patients and a positive correlation between them. For assisting in the diagnosis of PE, the AUC of the sFlt-1/PlGF ratio combined with serum endocan-1 was 0.874 (95%CI: 0.819 − 0.917; sensitivity, 75.24%; specificity, 100.00%), which was superior over that of sFlt-1/PlGF ratio (P = 0.025) and endocan-1 (P = 0.047) alone. Elevated sFlt-1/PlGF ratio and serum endocan-1 levels were independent risk factors for poor prognosis of PE patients. For assisting in predicting poor prognosis of PE, the AUC of sFlt-1/PlGF ratio with serum endocan-1 was 0.955 (95%CI: 0.896 − 0.986; sensitivity, 82.61%; specificity, 100.00%), which was higher than that of sFlt-1/PlGF ratio (P = 0.023) or serum endocan-1 (P = 0.010) alone. Altogether, sFlt-1/PlGF ratio combined with serum endocan-1 is advantageous over sFlt-1/PlGF ratio and serum endocan-1 alone for predicting PE occurrence and prognosis.

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Fig. 1: Comparison of sFlt-1/PlGF ratios and serum endocan-1 levels between the PE and control groups and their correlation analysis.
Fig. 2: ROC curve analysis of the sFlt-1/PlGF ratio and/or serum endocan-1 levels in predicting the occurrence of PE.
Fig. 3: sFlt-1/PlGF ratio and serum endocan-1 levels in PE patients with poor and good prognosis.
Fig. 4: ROC curve analysis of sFlt-1/PlGF ratio and/or serum endocan-1 levels for predicting the poor prognosis of PE patients.

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All data generated or analysed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Acknowledgements

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No funding was received for this study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Xiamen University Affiliated Xiang’an Hospital, No.2000 Xiang’an East Road, Xiang’an District, Xiamen City, 361000, China

    Shanshan Tian, Ahuang Pan, Lina Zhang & Jielin Wang

  2. Chiropractic Room, Xiamen University Affiliated Xiang’an Hospital, No.2000 Xiang’an East Road, Xiang’an District, Xiamen City, 361000, China

    Libin He

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Contributions

SST, JLW are the guarantors of integrity of the entire study and contributed to the study concepts, study design, definition of intellectual content, manuscript review and editing; SST, JLW, LBH contributed to the the clinical studies, literature research; SST, LBH, LNZ contributed to the data acquisition; SST, JLW, LBH, AHP, LNZ contributed to the data analysis, statistical analysis, manuscript preparation, read and approved the final manuscript.

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Correspondence to Jielin Wang.

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The ethics committee of Xiamen University Affiliated Xiang’an Hospital approved this study, which was performed in strict accordance with the Declaration of Helsinki.

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Tian, S., He, L., Pan, A. et al. sFlt-1/PlGF ratio combined with endocan-1 serum levels improves the predictive values for the occurrence and prognosis of preeclampsia in a single centre study. J Hum Hypertens 39, 348–354 (2025). https://doi.org/10.1038/s41371-025-01009-5

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