Srinivas Sindhu K, Larkin Jacob, Sammel Mary D, Appleby Dina, Bastek Jamie, Andrela Christina M, Ofori Ella, Elovitz Michal A
Department of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, PA 19104, USA.
J Matern Fetal Neonatal Med. 2010 Nov;23(11):1294-300. doi: 10.3109/14767051003677988.
We sought to evaluate the association between soluble fms-like tyrosine kinase 1 (sFlt1) and endoglin (ENG) and preeclampsia in an urban population, to develop a discriminatory model, and evaluate the association of these biomarkers with small for gestational age (SGA).
Cases are prospectively identified with preeclampsia. Controls are term patients without preeclampsia. Commercially available ELISAs were used to measure levels of sFlt1, ENG, and placental growth factor (PlGF). Log-transformed levels were compared and multivariable logistic regression analyses were performed to control for confounders. Receiver operating characteristic curves were developed.
In cases (n=86) compared to controls (n=288), sFlt1 (p=0.24) levels were no different. However, ENG levels were higher (p<0.001), and PlGF levels were lower (p<0.001). Further, levels of sFlt1 had poor discriminatory ability between cases and controls [AUC=0.56, (0.48–0.63)]. The best model to discriminate between groups included clinical risk factors, ENG, and PlGF [AUC=0.89, (0.85–0.92)].
Unlike recent reports, this study suggests that sFlt1 may have limited diagnostic utility in predicting preeclampsia, especially term disease.
我们试图评估可溶性fms样酪氨酸激酶1（sFlt1）和内皮糖蛋白（ENG）与城市人群先兆子痫之间的关联，建立一个判别模型，并评估这些生物标志物与小于胎龄儿（SGA）的关联。
前瞻性地确定先兆子痫病例。对照组为无先兆子痫的足月患者。使用市售酶联免疫吸附测定法（ELISA）测量sFlt1、ENG和胎盘生长因子（PlGF）的水平。比较对数转换后的水平，并进行多变量逻辑回归分析以控制混杂因素。绘制受试者工作特征曲线。
与对照组（n = 288）相比，病例组（n = 86）的sFlt1水平无差异（p = 0.24）。然而，ENG水平较高（p < 0.001），PlGF水平较低（p < 0.001）。此外，sFlt1水平在病例组和对照组之间的判别能力较差 [曲线下面积（AUC）= 0.56，（0.48 - 0.63）]。区分两组的最佳模型包括临床危险因素、ENG和PlGF [AUC = 0.89，（0.85 - 0.92）]。
与近期报告不同，本研究表明sFlt1在预测先兆子痫，尤其是足月疾病方面的诊断效用可能有限。
