{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T20:32:05Z","timestamp":1783629125879,"version":"3.55.0"},"reference-count":70,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T00:00:00Z","timestamp":1672704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The serum adiponectin\/leptin ratio (A\/L ratio) is a surrogate marker of insulin sensitivity. Pre-eclampsia (PE) is associated with maternal metabolic syndrome and occasionally impaired fetal growth. We assessed whether the A\/L ratio in first-trimester maternal serum was associated with PE and\/or birth weight. Adiponectin and leptin were quantitated in first-trimester blood samples (gestational week 10+3\u201313+6) from 126 women who later developed PE with proteinuria (98 mild PE; 21 severe PE; 7 HELLP syndrome), and 297 controls, recruited from the Copenhagen First-Trimester Screening Study. The A\/L ratio was reduced in PE pregnancies, median 0.17 (IQR: 0.12\u20130.27) compared with controls, median 0.32 (IQR: 0.19\u20130.62) (p &lt; 0.001). A multiple logistic regression showed that PE was negatively associated with log A\/L ratio independent of maternal BMI (odds ratio = 0.315, 95% CI = 0.191 to 0.519). Adiponectin (AUC = 0.632) and PAPP-A (AUC = 0.605) were negatively associated with PE, and leptin (AUC = 0.712) was positively associated with PE. However, the A\/L ratio was a better predictor of PE (AUC = 0.737), albeit not clinically relevant as a single marker. No significant association was found between A\/L ratio and clinical severity of pre-eclampsia or preterm birth. PE was associated with a significantly lower relative birth weight (p &lt; 0.001). A significant negative correlation was found between relative birth weight and A\/L ratio in controls (\u03b2 = \u22120.165, p &lt; 0.05) but not in PE pregnancies), independent of maternal BMI. After correction for maternal BMI, leptin was significantly associated with relative birth weight (\u03b2 = 2.98, p &lt; 0.05), while adiponectin was not significantly associated. Our findings suggest that an impairment of the A\/L ratio (as seen in metabolic syndrome) in the first trimester is characteristic of PE, while aberrant fetal growth in PE is not dependent on insulin sensitivity, but rather on leptin-associated pathways.<\/jats:p>","DOI":"10.3390\/life13010130","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T02:51:39Z","timestamp":1672714299000},"page":"130","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["First-Trimester Maternal Serum Adiponectin\/Leptin Ratio in Pre-Eclampsia and Fetal Growth"],"prefix":"10.3390","volume":"13","author":[{"given":"Victoria E.","family":"de Knegt","sequence":"first","affiliation":[{"name":"Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark"},{"name":"Department of Paediatrics, University Hospital Slagelse, 4200 Slagelse, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5801-960X","authenticated-orcid":false,"given":"Paula L.","family":"Hedley","sequence":"additional","affiliation":[{"name":"Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark"},{"name":"Brazen Bio, Los Angeles, CA 90014, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna K.","family":"Eltvedt","sequence":"additional","affiliation":[{"name":"Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Placing","sequence":"additional","affiliation":[{"name":"Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"W\u00f8jdemann","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Bornholm Hospital, 3700 R\u00f8nne, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Cathrine","family":"Shalmi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Hiller\u00f8d Hospital, 3400 Hiller\u00f8d, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9080-3389","authenticated-orcid":false,"given":"Line","family":"Rode","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, 2600 Glostrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3267-4910","authenticated-orcid":false,"given":"J\u00f8rgen K.","family":"Kanters","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Sundberg","sequence":"additional","affiliation":[{"name":"Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Tabor","sequence":"additional","affiliation":[{"name":"Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, 2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrik","family":"Lausten-Thomsen","sequence":"additional","affiliation":[{"name":"Department of Neonatology, University Hospital Rigshospitalet, 2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4713-755X","authenticated-orcid":false,"given":"Michael","family":"Christiansen","sequence":"additional","affiliation":[{"name":"Department for Congenital Disorders, Statens Serum Institut, 2300 Copenhagen, Denmark"},{"name":"Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1016\/S0140-6736(15)00070-7","article-title":"Pre-eclampsia","volume":"387","author":"Mol","year":"2016","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1056\/NEJMra2109523","article-title":"Preeclampsia","volume":"386","author":"Magee","year":"2022","journal-title":"N. 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