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血浆总半胱氨酸、妊娠并发症及不良妊娠结局:霍达兰同型半胱氨酸研究

Plasma total cysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine Study.

作者信息

El-Khairy Lina, Vollset Stein E, Refsum Helga, Ueland Per M

机构信息

LOCUS for Homocysteine and Related Vitamins and the Department of Pharmacology, University of Bergen, Norway.

出版信息

Am J Clin Nutr. 2003 Feb;77(2):467-72. doi: 10.1093/ajcn/77.2.467.

Abstract

BACKGROUND

Total homocysteine (tHcy) is associated with pregnancy complications and adverse pregnancy outcomes. The associations of plasma total cysteine (tCys) with such outcomes have not been investigated in large populations.

OBJECTIVE

We investigated the association between plasma tCys and pregnancy complications, congenital malformations, and other adverse pregnancy outcomes.

DESIGN

The plasma tCys concentrations of 5883 women aged 40-42 y that were measured in 1992-1993 during a cardiovascular health screening were compared with the outcomes and complications of 14492 pregnancies in the same women that were registered in the Medical Birth Registry of Norway from 1967 to 1996.

RESULTS

After adjustment for parity, mother's age, tHcy, total cholesterol, body mass index, smoking, and coffee drinking, high plasma tCys concentrations (above the 95th percentile) were associated with significantly higher risks of preeclampsia [n = 342; odds ratio (OR): 1.6; 95% CI: 1.1, 2.4; P = 0.03], premature delivery (n = 774; OR: 1.8; 95% CI: 1.3, 2.5; P = 0.001), and very low birth weight (n = 175; OR: 2.0; 95% CI: 1.1, 3.9; P = 0.03) than were lower plasma tCys concentrations. tCys was not associated with the risk of placental abruption. High tCys concentrations showed a weak association with congenital malformations and stillbirths with birth weight <1500 g. The associations were independent of the tHcy concentrations.

CONCLUSION

High tCys concentrations were associated with risks of preeclampsia, premature delivery, and low birth weight.

摘要

背景

总同型半胱氨酸(tHcy)与妊娠并发症及不良妊娠结局相关。血浆总半胱氨酸(tCys)与这些结局之间的关联尚未在大规模人群中进行研究。

目的

我们研究了血浆tCys与妊娠并发症、先天性畸形及其他不良妊娠结局之间的关联。

设计

将1992年至1993年心血管健康筛查期间测量的5883名40至42岁女性的血浆tCys浓度,与这些女性在1967年至1996年期间在挪威医疗出生登记处登记的14492次妊娠的结局和并发症进行比较。

结果

在调整了产次、母亲年龄、tHcy、总胆固醇、体重指数、吸烟和咖啡饮用情况后,血浆tCys浓度高(高于第95百分位数)与子痫前期(n = 342;比值比(OR):1.6;95%置信区间:1.1,2.4;P = 0.03)、早产(n = 774;OR:1.8;95%置信区间:1.3,2.5;P = 0.001)和极低出生体重(n = 175;OR:2.0;95%置信区间:1.1,3.9;P = 0.03)的风险显著升高相关,而血浆tCys浓度较低时则不然。tCys与胎盘早剥风险无关。高tCys浓度与先天性畸形和出生体重<1500 g的死产存在弱关联。这些关联独立于tHcy浓度。

结论

高tCys浓度与子痫前期、早产和低出生体重风险相关。

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