Serum ELA,MALAT1 levels in patients with gestational hypertension and their relationship with disease severity and pregnancy outcomes

Duan Juan; Chen Xuerong; Shen Ran; Li Ruihua; Meng Haiyun

doi:10.3969/j.issn.1671-6450.2025.03.014

Abstract：Objective To investigate the expression of serum ELABELA(ELA),long non coding RNA lung ade-nocarcinoma transcript 1(MALAT1)in patients with gestational hypertension(HDCP),and their relationship with the severi-ty of the disease and pregnancy outcomes.Methods One hundred and two patients with HDCP treated in our hospital from February 2021 to February 2023 were selected and divided into three subgroups based on the severity of their condi-tion:gestational hypertension subgroup(34 cases),mild preeclampsia subgroup(35 cases),and severe preeclampsia sub-group(33 cases);Based on pregnancy outcomes,they were grouped by a good prognosis subgroup(66 cases)and a poor prognosis subgroup(36 cases),with 60 healthy pregnant women in the same period as the control group.Enzyme linked im-munosorbent assay and qPCR were conducted to detect serum ELA and MALAT1 levels,respectively.The evaluation value of serum ELA and MALATl for adverse pregnancy outcomes in HDCP were analyzed by logistic regression model and re-ceiver operating characteristic curve.Results The serum ELA and MALAT1 levels in the HDCP group were lower than those in the control group(t/P=17.101/＜0.001,15.035/＜0.001).The serum ELA and MALAT1 levels in the gestational hy-pertension subgroup,mild PE subgroup,and severe PE subgroup decreased sequentially(F/P=115.480/＜0.001,40.421/＜0.001).Compared with the good prognosis subgroup,the poor prognosis subgroup of HDCP patients had higher systolic blood pressure,lower serum MALAT1,and ELA(t/P=7.347/＜0.001,8.898/＜0.001,11.100/＜0.001).Systolic blood pressure is a risk factor for adverse pregnancy outcomes in HDCP patients[OR(95％CI)=1.556(1.230-1.968)],while serum MAL-AT1 and ELA were protective factors[OR(95％CI)=0.680(0.548-0.843),0.754(0.617-0.920)].The area under the curve(95％CI)of the combined use of serum ELA and MALAT1 for prognostic evaluation of adverse pregnancy outcomes in HDCP was 0.912(0.881-0.940),which was superior to serum ELA and MALAT1 alone at 0.838(0.790-0.869)and 0.829(0.783-0.856)(Z/P=4.613/＜0.001,4.820/＜0.001).Conclusion The decreased levels of serum ELA and MALAT1 in pa-tients with HDCP are related to the severity of the disease and adverse pregnancy outcomes.The combination of the two has high predictive value for clinical evaluation of adverse pregnancy outcomes in HDCP.