Changes in serum levels of HMGB1 and ApoB/ApoA1 in patients with pregnancy induced hypertension and their di-agnostic value for early renal damage

Duan Xiaoxia; Feng Sisi; Zhou Zhuo; Wang Shan; Deng Tian

doi:10.3969/j.issn.1671-6450.2025.07.013

Abstract：Objective To investigate the changes in serum levels of high mobility protein B1(HMGB1)and apoli-poprotein B/apolipoprotein A1(ApoB/ApoA1)in patients with pregnancy induced hypertension,and to analyze their diagnostic value for early renal damage in patients.Methods One hundred and eighteen cases of gestational hypertension ad-mitted to the Department of Obstetrics and Gynecology of the First Hospital of Northwestern University from July 2020 to Ju-ly 2023 were selected as the gestational hypertension group,and the patients were categorized into the subgroups of gestational hypertension(43 cases),mild preeclampsia(38 cases),and severe preeclampsia(37 cases)according to the degree of hyperten-sion,while 118 cases of women with normal pregnancies during the same period were selected as the normal pregnancy group.The hyperemesis gravidarum group was divided into a renal impairment subgroup(32 cases)and a non-renal impairment sub-group(86 cases)based on the occurrence of renal impairment.Serum HMGB1 levels were measured by enzyme-linked immu-nosorbent assay(ELISA),and ApoB and ApoA1 levels were measured by fully automated biochemical analyzer.Comparison of serum HMGB1 and ApoB/ApoA1 levels in patients with different severity of disease.Comparison of patient data and serum HMGB1 and ApoB/ApoA1 levels in the renal impairment subgroup and the non-renal impairment subgroup.Multifactorial lo-gistic regression analysis of the factors influencing the occurrence of early kidney damage in patients with hyperemesis gravi-darum.Diagnostic value of serum HMGB1 and ApoB/ApoA1 levels in early renal damage in patients with hyperemesis gravi-darum analyzed by using subject operating characteristic(ROC)curves.Results Serum HMGB1 and ApoB/ApoA1 levels were higher in patients in the hyperemesis gravidarum group than in the normal pregnancy group(t/P=29.806/＜0.001,22.378/＜0.001).Serum HMGB1 and ApoB/ApoA1 levels were higher in patients with hyperemesis gravidarum the more severe the condition(t/P=51.726/＜0.001,143.231/＜0.001).Serum HMGB1 and ApoB/ApoA1 levels were higher in patients in the renal damage subgroup than in the non-renal damage subgroup(t/P=8.346/＜0.001,8.582/＜0.001).High serum HMGB1 and ApoB/Apo A1 levels are influential factors in the development of early renal damage in patients with hyperemesis gravidarum[OR(95％CI)=6.887(3.309-14.335),8.887(3.766-20.970)].The AUCs of serum HMGB1,ApoB/ApoA and the combination of the two for predicting early kidney damage in patients with hyperemesis gravidarum were 0.840,0.836,and 0.938,respec-tively,and the combination of the two was superior to the efficacy of their respective individual predictions(Z=3.321,3.481,P=0.001,＜0.001).Conclusion Serum levels of HMGB1 and ApoB/ApoA1 are elevated in patients with preeclampsia,and have high diagnostic value in diagnosing early renal damage.