Hyperresistinemia - a novel feature in systemic infection during human pregnancy

Problem: Resistin, originally described as an adipokine, has emerged as a potent pro-inflammatory protein associated with both acute and chronic inflammation. Moreover, resistin has been proposed as a powerful marker of sepsis severity, as well as a predictor of survival of critically ill non-pregnant patients. The aim of this study was to determine whether pyelonephritis during pregnancy is associated with changes in maternal plasma resistin concentrations. Methods of study: This cross-sectional study included the following groups: (i) normal pregnant women (. n = 85) and (ii) pregnant women with pyelonephritis (. n = 40). Maternal plasma resistin concentrations were determined by ELISA. Non-parametric statistics was used for analyses. Results: (i) The median maternal plasma resistin concentration was higher in patients with pyelonephritis than in those with a normal pregnancy (. P < 0.001); (ii) among patients with pyelonephritis, the median maternal resistin concentration did not differ significantly between those with and without a positive blood culture (. P = 0.3); (iii) among patients with pyelonephritis who were diagnosed with systemic inflammatory response syndrome (SIRS), those who fulfilled ≥3 criteria for SIRS had a significantly higher median maternal plasma resistin concentration than those who met only two criteria; and (iv) maternal WBC count positively correlated with circulating resistin concentration (. r = 0.47, P = 0.02). Conclusion: Hyperresistinemia is a feature of acute pyelonephritis during pregnancy. The results of this study support the role of resistin as an acute-phase protein in the presence of bacterial infection during pregnancy.