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早发型和晚发型子痫前期患者循环血管生成因子和脂肪细胞因子谱的差异。

Different profiles of circulating angiogenic factors and adipocytokines between early- and late-onset pre-eclampsia.

机构信息

Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

出版信息

BJOG. 2010 Feb;117(3):314-20. doi: 10.1111/j.1471-0528.2009.02453.x. Epub 2009 Dec 10.

Abstract

OBJECTIVE

Circulating angiogenic factors have been shown to be important in the pathophysiology of pre-eclampsia. Blood levels of adipocytokines differ in pre-eclampsia relative to controls and may also play an important role in disease pathogenesis. Differences in the circulating levels of these molecules were compared between matched normotensive controls and women with pre-eclampsia with onset before or at/after 32 weeks, and according to whether the women were of normal weight (18.5 < body mass index < 25) or overweight.

DESIGN

A cross-sectional study of 110 pregnant Japanese women who visited the Department of Obstetrics and Gynecology, Okayama University Hospital, Okayama, Japan.

SETTING

Tertiary referral centre serving 2000 births.

METHODS

Serum concentrations of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), soluble endoglin (sEng), adiponectin and leptin were measured in women with pre-eclampsia and in normotensive controls matched for age, gestational week, parity and body mass index. Main outcome measures Serum levels of sFlt-1, PlGF, the sFlt-1/PlGF ratio, sEng, adiponectin and leptin.

RESULTS

The sFlt-1/PlGF ratio in early-onset pre-eclampsia was significantly higher than that in late-onset pre-eclampsia (112.0 +/- 30.2 versus 45.4 +/- 43.8, P = 0.037). There was a significant elevation of leptin in both subtypes relative to controls (early: 58.6 +/- 18.3 ng/ml versus 26.0 +/- 6.7 ng/ml, P = 0.001; late: 39.5 +/- 9.2 ng/ml versus 22.0 +/- 4.3 ng/ml, P = 0.005), but adiponectin was increased only in late-onset pre-eclampsia (36.5 +/- 13.4 microg/ml versus 12.0 +/- 4.3 microg/ml, P = 0.003). Significant differences in angiogenic factors and adiponectin were found between normal and overweight women only in late-onset pre-eclampsia.

CONCLUSIONS

These data suggest that there are different profiles of angiogenic factors and adipocytokines between women who develop early- and late-onset pre-eclampsia.

摘要

目的

循环血管生成因子在子痫前期的病理生理学中起着重要作用。与对照组相比,子痫前期患者的脂肪细胞因子血水平存在差异,并且这些因子在疾病发病机制中也可能发挥重要作用。比较了在正常血压对照者和发病时间早于或等于 32 周的子痫前期患者以及根据体重指数(18.5<体重指数<25)是否正常或超重之间这些分子的循环水平的差异。

设计

一项对 110 名在日本冈山大学医院妇产科就诊的日本孕妇的横断面研究。

设置

为 2000 名分娩者提供服务的三级转诊中心。

方法

测量子痫前期患者和年龄、孕周、产次和体重指数相匹配的正常血压对照者的可溶性 fms 样酪氨酸激酶 1(sFlt-1)、胎盘生长因子(PlGF)、可溶性内皮糖蛋白(sEng)、脂联素和瘦素的血清浓度。主要观察指标 sFlt-1、PlGF、sFlt-1/PlGF 比值、sEng、脂联素和瘦素的血清水平。

结果

早发型子痫前期的 sFlt-1/PlGF 比值明显高于晚发型子痫前期(112.0+/-30.2 与 45.4+/-43.8,P=0.037)。与对照组相比,两种亚型的瘦素水平均升高(早发型:58.6+/-18.3ng/ml 与 26.0+/-6.7ng/ml,P=0.001;晚发型:39.5+/-9.2ng/ml 与 22.0+/-4.3ng/ml,P=0.005),但仅在晚发型子痫前期中脂联素升高(36.5+/-13.4μg/ml 与 12.0+/-4.3μg/ml,P=0.003)。仅在晚发型子痫前期中,正常体重和超重妇女之间的血管生成因子和脂联素存在显著差异。

结论

这些数据表明,早发型和晚发型子痫前期患者的血管生成因子和脂肪细胞因子谱存在差异。

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