Zammiti Walid, Mtiraoui Nabil, Kallel Choumous, Mercier Eric, Almawi Wassim Y, Mahjoub Touhami
Laboratory of Hematology, Faculty of Pharmacy, University of Monastir, Tunisia.
Reproduction. 2006 Apr;131(4):817-22. doi: 10.1530/rep.1.01060.
Whereas antiphospholipid antibodies (aPL) are associated with thrombotic events and recurrent spontaneous abortion (RSA), the contribution of anti-beta2 glycoprotein 1 (beta2GP1) and anti-annexin V antibodies as risk factors for RSA remain poorly understood. We investigated anti-beta2-GPI and anti-annexin V IgM and IgG antibodies as potential risk factors for RSA in 200 women with more than three consecutive idiopathic RSA, and 200 age-matched, healthy, parous women. Pearson's chi squared test analysis showed that while anti-beta2-GPI IgG (P = 0.416) and IgM (P = 0.72) were comparable between patients and controls, elevated anti-annexin V IgG (P = 0.006), but not IgM (P = 0.084), was more pronounced in patients. Higher frequencies of elevated IgG-only (P = 0.005), but not IgM-only (P = 1.000; OR = 6.66), anti-annexin V antibodies were noted among patients. Multinomial regression analysis showed that body-mass index (overweight and obesity; P = 0.008), education status (P < 0.001) and anti-beta2-GPI IgM (P = 0.033), but not IgG (P = 0.723), were associated with early abortion, while anti-beta2-GPI IgG (P = 0.030) and anti-annexin V IgG (P = 0.004) were associated with late RSA. For combined early-late RSA, the only variable selected was education status (P < 0.001), and neither anti-annexin V nor anti-beta2-GPI IgM and IgG was associated with early-late RSA. Accordingly, anti-annexin V and anti-beta2-GPI should be regarded as independent risk markers of RSA.
抗磷脂抗体(aPL)与血栓形成事件及复发性自然流产(RSA)相关,而抗β2糖蛋白1(β2GP1)抗体和抗膜联蛋白V抗体作为RSA的危险因素,其作用仍知之甚少。我们调查了200名有三次以上连续特发性RSA的女性以及200名年龄匹配、健康且已生育的女性体内抗β2-GPI和抗膜联蛋白V的IgM和IgG抗体,将其作为RSA的潜在危险因素。Pearson卡方检验分析显示,虽然患者和对照组之间抗β2-GPI IgG(P = 0.416)和IgM(P = 0.72)水平相当,但患者体内抗膜联蛋白V IgG水平升高(P = 0.006),而IgM水平升高不明显(P = 0.084)。在患者中,仅IgG水平升高的抗膜联蛋白V抗体频率较高(P = 0.005),而仅IgM水平升高的抗体频率无明显差异(P = 1.000;OR = 6.66)。多项回归分析表明,体重指数(超重和肥胖;P = 0.008)、教育程度(P < 0.001)和抗β2-GPI IgM(P = 0.033)与早期流产相关,而抗β2-GPI IgG(P = 0.030)和抗膜联蛋白V IgG(P = 0.004)与晚期RSA相关。对于早期和晚期RSA合并症,唯一入选的变量是教育程度(P < 0.001),抗膜联蛋白V以及抗β2-GPI的IgM和IgG均与早期和晚期RSA无关。因此,抗膜联蛋白V和抗β2-GPI应被视为RSA的独立风险标志物。