# Diagnostic performance of urinary adipsin as a screening biomarker for pre‐eclampsia

## TL;DR

This study shows that measuring urinary adipsin can help detect pre-eclampsia, a dangerous pregnancy condition, with high accuracy in low-resource settings.

## Contribution

The study demonstrates urinary adipsin's potential as a non-invasive, high-performance biomarker for pre-eclampsia screening.

## Key findings

- Urinary adipsin levels were significantly higher in pre-eclamptic women compared to healthy and high-risk groups.
- Combining urinary adipsin with blood pressure measurements improved diagnostic performance with 96.7% sensitivity and 91.0% specificity.
- Adding urine protein-to-creatinine ratio further enhanced diagnostic specificity to 99.7%.

## Abstract

This study evaluated the diagnostic performance of urinary adipsin as a potential biomarker for pre‐eclampsia screening in a low‐resource setting.

A case–control study was conducted involving 150 pregnant women classified into three groups: 50 healthy pregnancies, 50 high‐risk pregnancies without pre‐eclampsia, and 50 pregnant women clinically diagnosed with pre‐eclampsia. Urinary adipsin concentration was measured with a commercial sandwich ELISA kit. Linear regression was conducted to examine the relationship between urinary adipsin levels and pre‐eclampsia risk, while receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic performance of urinary adipsin.

Urinary adipsin levels were significantly higher in pre‐eclamptic women compared to healthy controls and the high‐risk group (1258.70 ± 342.88 ng/mg Cr vs. 284.16 ± 24.04 ng/mg Cr and 305.15 ± 36.10 ng/mg Cr; P < 0.001). At a cutoff value of 750 ng/mg Cr, urinary adipsin demonstrated a good diagnostic performance, with a sensitivity of 83.6% and a specificity of 88.9%. Combining urinary adipsin with blood pressure measurements significantly improved the predictive performance (P < 0.001), with 96.7% sensitivity, 91.0% specificity, and an area under the curve (AUC) of 0.930. The combination of urinary adipsin, urine protein‐to‐creatinine ratio (uPCR), and blood pressure measurement further enhanced specificity (99.7%) with a sensitivity of 90.5% (AUC = 0.909).

Urinary adipsin showed high sensitivity, specificity, and predictive value in diagnosing pre‐eclampsia. This highlights its potential as a non‐invasive biomarker for pre‐eclampsia screening in low‐resource settings. Routine urinary adipsin assay and blood pressure monitoring could enhance early detection strategies and improve maternal and perinatal outcomes.