Urine albumin is a superior predictor of preeclampsia compared to urine plasminogen in type I diabetes patients

摘要

Abstract Pregnant women with type I diabetes mellitus (T1DM) are at increased risk of developing preeclampsia (PE). Plasminogen is aberrantly filtrated from plasma into tubular fluid in PE patients and activated to plasmin. Plasmin activates the epithelial?sodium channel in the collecting ducts potentially causing impaired sodium excretion, suppression of the renin-angiotensin-aldosterone system, and hypertension in PE. The objective of the study was to test whether urinary total plasmin(ogen)/creatinine ratio and plasma concentration of aldosterone were better predictors of PE in pregnant women with T1DM compared with urine albumin and haemoglobin A 1C . The design was a longitudinal observational study of 88 pregnant T1DM patients at 2 Danish centers. Spot urine- and blood samples were collected at gestational weeks 12, 20, 28, 32, and 36. U-plasmin(ogen)/creatinine ratio increased during pregnancy. In gestational week 36, the ratio was significantly increased in the T1DM patients developing PE ( P ? P ? Highlights ? U-plasmin(ogen)/creatinine ratio increased during pregnancy in pregnant type I diabetes mellitus patients from gestational week 12 to?36. ? There was a positive association between u-total plasmin(ogen) and the development of preeclampsia (PE) late in pregnancy. ? Creatinine Ratio and Association With Development of /creatinine ratio was significantly increased and associated with the development of PE at all tested gestational ages. ? Creatinine Ratio and Association With Development of /creatinine ratio had a stronger association with the development of PE compared with u-total plasmin(ogen)/creatinine ratio and p-aldosterone.