Department of Clinical Biochemistry and Immunology, Statens Serum Institut, Copenhagen, Denmark.
Prenat Diagn. 2010 Feb;30(2):103-9. doi: 10.1002/pd.2337.
Prophylaxis with low-dose aspirin may reduce the risk of pre-eclampsia (PE) if introduced in first trimester. The performance of first trimester maternal serum screening for PE using free leptin index (fLI) and PAPP-A, where fLI = leptin/leptin soluble receptor was studied.
First trimester serum samples from 126 PE pregnancies and 289 control pregnancies were studied. fLI and PAPP-A were converted into gestational age and maternal weight independent log MoM values of PAPP-A and fLI. The screening performance of markers was studied by receiver-operator-characteristics curves. The performance of population screening was estimated by Monte Carlo simulation.
fLI was significantly (p < 0.001) elevated [mean log MoM 0.2165 (SD: 0.2604)] compared to controls [mean log MoM -0.0368 (SD: 0.3132)] and PAPP-A was significantly (p < 0.001) reduced [mean log MoM -0.0133 (SD: 0.2661)] compared to controls [mean log MoM 0.0474 (SD: 0.2521)] in PE pregnancies. There was no correlation between fLI and PAPP-A in control or PE pregnancies. Combined fLI and PAPP-A screening for PE had estimated population detection rates of 22% and 35% for false positives rates of 6% and 12%, respectively.
Combining PAPP-A and fLI improves screening performance for PE compared to single marker screening.
如果在孕早期使用小剂量阿司匹林进行预防，可能会降低子痫前期（PE）的风险。本研究旨在探讨使用游离瘦素指数（fLI）和 PAPP-A 进行孕早期子痫前期母血清筛查的性能，其中 fLI=瘦素/瘦素可溶性受体。
研究了 126 例 PE 妊娠和 289 例对照妊娠的孕早期血清样本。将 fLI 和 PAPP-A 转换为与妊娠年龄和母体体重无关的 log MoM 值 PAPP-A 和 fLI。通过接收者操作特性曲线研究标记物的筛查性能。通过蒙特卡罗模拟估计人群筛查的性能。
与对照组相比，fLI 显著升高（p < 0.001）[平均 log MoM 0.2165（SD：0.2604）]，而 PAPP-A 显著降低（p < 0.001）[平均 log MoM -0.0133（SD：0.2661）]在 PE 妊娠中。在对照组或 PE 妊娠中，fLI 和 PAPP-A 之间没有相关性。fLI 和 PAPP-A 联合筛查 PE 的估计人群检出率分别为 22%和 35%，假阳性率分别为 6%和 12%。
与单一标志物筛查相比，联合使用 PAPP-A 和 fLI 可提高子痫前期筛查性能。
