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Assessment of plasma cell-free DNA and ST2 as parameters in gestational hypertension and preeclampsia


The objective of this study was to evaluate the differences and predictive efficacy of circulating cell-free DNA (cfDNA) and human suppression of tumorigenesis 2 (ST2) among women with uncomplicated pregnancies and patients with gestational hypertension (GH) or preeclampsia (PE). This study included patients with GH (n = 41), patients with PE (n = 62), and women with uncomplicated pregnancies (n = 148). The cfDNA concentration was determined by qPCR, and the ST2 levels were measured by ELISA. A receiver operating characteristic curve was employed to measure the diagnostic performance of cfDNA and ST2. Our results showed that ST2 but not cfDNA was increased in the middle and third trimesters of normal pregnancy; ST2 and cfDNA were increased in GH and PE patients compared to women with uncomplicated pregnancies. More importantly, plasma cfDNA and ST2 served as diagnostic biomarkers for GH and PE, and the AUCs were 0.883 and 0.734 for GH and 0.838 and 0.816 for PE, respectively. Moreover, their combination significantly elevated the diagnostic efficiency for GH and PE, with AUCs of 0.906 and 0.916, respectively. Plasma cfDNA and ST2 could be used as parameters for GH and PE.

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This study was supported by grants from the National Key R&D Program of China (2017YFC1001403 and 2019YFA0802600) and NSFC (31871512 and 31671199) to CZ. Support was also obtained from the Ji’nan Clinical Medical Science Technology Innovation Program (201704080) and the Shanghai Commission of Science and Technology (17DZ2271100).

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Correspondence to Cong Zhang.

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Liu, L., Li, H., Wang, N. et al. Assessment of plasma cell-free DNA and ST2 as parameters in gestational hypertension and preeclampsia. Hypertens Res (2021).

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  • Circulating cell-free DNA (cfDNA)
  • Human suppression of tumorigenesis 2 (ST2)
  • Gestational hypertension
  • Preeclampsia


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