Salomon Laurent J, Benattar Clarisse, Audibert François, Fernandez Hervé, Duyme Michel, Taieb Joëlle, Frydman René
Service de Gynécologie Obstétrique, Hôpital Antoine Béclère (Assistance Publique-Hopitaux de Paris), 157 rue de la Porte-de-Trivaux, 92140 Clamart, France.
Am J Obstet Gynecol. 2003 Dec;189(6):1517-22. doi: 10.1016/s0002-9378(03)00902-5.
The purpose of this study was to determine whether maternal serum inhibin A and leptin concentrations changed in the first trimester of pregnancy in patients in whom severe preeclampsia subsequently developed.
Blood samples were collected prospectively from patients during the first trimester of prenatal care. Patients in whom severe preeclampsia with no evidence of glucose intolerance or gestational diabetes mellitus subsequently developed were identified (study group, 30 patients) and matched with control subjects in a 1:2 ratio (control group, 60 patients). Inhibin A and leptin concentrations were determined in these first-trimester serum samples for both the study and control groups.
Leptin levels were correlated highly with body mass index in both groups but were not correlated with the subsequent onset of preeclampsia. Serum inhibin A concentrations were significantly higher in women in whom preeclampsia subsequently developed than in women in whom it did not. With a specific cutoff value, the estimated odds for severe preeclampsia were almost five times higher in women with high inhibin A concentrations than in women with normal levels (odds ratio, 4.93; 95% CI, 1.83, 13.28).
High serum inhibin A levels in the first trimester of pregnancy could be used as an early risk marker for preeclampsia.
本研究旨在确定随后发生重度子痫前期的患者在妊娠早期母血清抑制素A和瘦素浓度是否发生变化。
在产前检查的孕早期前瞻性地收集患者的血样。确定随后发生无糖耐量异常或妊娠糖尿病证据的重度子痫前期患者(研究组,30例患者),并按1:2的比例与对照组(60例患者)进行匹配。测定研究组和对照组这些孕早期血清样本中的抑制素A和瘦素浓度。
两组中瘦素水平均与体重指数高度相关,但与随后子痫前期的发病无关。随后发生子痫前期的女性血清抑制素A浓度显著高于未发生子痫前期的女性。采用特定的临界值,抑制素A浓度高的女性发生重度子痫前期的估计几率几乎是正常水平女性的五倍(比值比,4.93;95%可信区间,1.83, 13.28)。
妊娠早期血清抑制素A水平升高可作为子痫前期的早期风险标志物。