Wiwanitkit Viroj
Department of Laboratory Medicine, Faculty of Medicine, Chulalongkorn University, 10330, Bangkok, Thailand.
Arch Gynecol Obstet. 2006 Mar;273(6):322-4. doi: 10.1007/s00404-005-0117-8. Epub 2006 Jan 28.
Plasminogen activator inhibitor-1 (PAI-1) is an important inhibitor of the fibrinolytic system, so it is biologically plausible that elevated levels could suppress fibrinolysis and result in an increased risk of thrombosis. There is considerable controversy regarding the clinical role of PAI-1 4G/5G polymorphism as a risk factor of pre-eclampsia. Here, the author performs a summative analysis on the recent previous reports on the PAI-1 4G/5G and its correlation to pre-eclampsia.
The metanalysis was performed in order to assess the correlation between the pattern of PAI-1 4G/5G polymorphism and pre-eclampsia. From the available six case-control studies, 880 patients and 810 controls are evaluated.
The overall frequencies of 4G allele for the patients and controls are 49.9 and 44.4, respectively. According to this study, 54.9% of subjects with 4G allele have pre-eclampsia while 43.1% of subjects without 4G allele have pre-eclampsia. From overall risk estimation, the subjects with 4G alleles have 1.27 times higher risk to pre-eclampsia.
According to this analysis, the author proposes that the pattern of PAI-1 4G/5G polymorphism might represent a useful marker of increased risk for pre-eclampsia. In addition, the lack of association between pattern of PAI-1 4G/5G and ethnicity of the patients can be demonstrated in this study.
纤溶酶原激活物抑制剂-1（PAI-1）是纤维蛋白溶解系统的一种重要抑制剂，因此，PAI-1水平升高会抑制纤维蛋白溶解并导致血栓形成风险增加，这在生物学上是合理的。关于PAI-1 4G/5G多态性作为子痫前期危险因素的临床作用存在相当大的争议。在此，作者对先前关于PAI-1 4G/5G及其与子痫前期相关性的近期报道进行了汇总分析。
进行荟萃分析以评估PAI-1 4G/5G多态性模式与子痫前期之间的相关性。从现有的六项病例对照研究中，评估了880例患者和810例对照。
患者和对照中4G等位基因的总体频率分别为49.9和44.4。根据这项研究，携带4G等位基因的受试者中有54.9%患有子痫前期，而没有4G等位基因的受试者中有43.1%患有子痫前期。从总体风险估计来看，携带4G等位基因的受试者患子痫前期的风险高1.27倍。
根据该分析，作者提出PAI-1 4G/5G多态性模式可能是子痫前期风险增加的一个有用标志物。此外，本研究可以证明PAI-1 4G/5G模式与患者种族之间缺乏关联。
