The pathophysiology of preeclampsia in obese women is not fully understood, and various mechanisms have been suggested.24 Adipose tissue is abundant in inflammatory mediators and complement proteins, which may contribute to altered placental angiogenesis and development of preeclampsia.25 In addition, maternal obesity is characterized by decreased angiogenic regulators and an increase in oxidative stress markers.25,26 This environment may impact endothelial integrity and lower the threshold for development of endothelial dysfunction and arterial stiffness. Here, VTN is linked to endothelial dysfunction.