The imbalance of circulating angiogenic/antiangiogenic factors is mild or absent in obese women destined to develop preeclampsia

Abstract

We thank Dr Rana et al. () for their interesting study clarifying the clinical profile of preeclamptic patients with normal angiogenic profile. In their study, the patients with non-angiogenic preeclampsia were more obese, although with large overlapping of body mass index (BMI) between the groups [BMI: 35.2 (31.6, 38.7) versus 31.1 (28.0, 39.0), p = 0.04]. We performed a case-control study assessing the predictive value of sFlt-1 and PlGF for preeclampsia in a population with high-obesity prevalence (). Both BMI and circulating mean concentrations of sFlt-1 were significantly higher in the preeclampsia group. However, a two-variable model associating sFlt-1 and PlGF dosages was not better than the model including only age and BMI in the prediction of preeclampsia. In line with these findings, Suwaki et al. () reported that overweight patients with pre-eclampsia had lower levels of sFlt1 and higher levels of PlGF than women with pre-eclampsia who were of normal weight. All these data support the fact that in obese pregnant women who will develop preeclampsia, the imbalance of circulating angiogenic/antiangiogenic factors is mild or absent, suggesting that in these patients the extra benefit of the dosages of angiogenic factors appears to be of limited value.