Adipokines in preeclampsia: Pathophysiological insights and biomarker potential

Preeclampsia is a multifactorial hypertensive disorder of pregnancy with major clinical consequences. Adipokines—bioactive peptides secreted by adipose tissue—may contribute to its pathogenesis through mechanisms involving inflammation, angiogenesis, and endothelial dysfunction. This review summarizes findings from various clinical and experimental studies evaluating serum levels of adipokines such as leptin, adiponectin, resistin, visfatin, chemerin, and apelin in preeclamptic versus normotensive pregnancies. Findings across studies are heterogeneous for most adipokines. While the majority of studies report elevated leptin and chemerin levels in preeclampsia, conflicting data exist, including reports of no significant difference or even inverse associations, particularly in obese populations and across different preeclampsia phenotypes. Adiponectin, resistin, visfatin, and apelin show even more variable trends, with studies reporting elevation, reduction, or no change depending on gestational age, body mass index, and disease severity. These molecules may hold potential as early indicators of disease, though further research is needed to clarify their diagnostic value and clinical applicability.