正常血压孕妇的母体血管生成谱。
Maternal angiogenic profile in pregnancies that remain normotensive.
机构信息
Cancer Prevention Fellowship Program, Center for Cancer Training, National Cancer Institute, Rockville, MD USA.
出版信息
Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):189-93. doi: 10.1016/j.ejogrb.2011.05.001.
OBJECTIVE
We sought to determine if maternal characteristics are associated with angiogenic profile in the first and second trimester of normotensive pregnancies.
STUDY DESIGN
Circulating levels of maternal placental like growth factor (PlGF), soluble fms-like tyrosine kinase receptor (sFlt1), and soluble endoglin (sEng) were measured in serum samples collected during the first (median 11.3 weeks) and second trimester (median 17.1 weeks) of 182 normotensive pregnancies. Diastolic blood pressure (DBP), systolic blood pressure (SBP), and mean arterial pressure (MAP) were measured at the same visits when samples were collected to measure angiogenic factors. Linear regression analysis was used to examine associations of the angiogenic measures with maternal characteristics. The association between blood pressure measures and concentrations of angiogenic factors was evaluated using Spearman correlation and linear regression analysis.
RESULTS
In adjusted analyses, nulliparous women had higher sFlt1 concentrations in both first (p=0.06) and second (p=0.001) trimester. Higher BMI was associated with greater sFlt1 concentrations in both the first (p=0.004) and second trimester (p=0.008), but significantly lower sEng concentrations in both trimesters (p=0.002 for first trimester and p=0.0009 for second). Nulliparity and higher BMI also were associated with higher sFlt1/PLGF anti-angiogenic ratios in both first (p=0.05 and p=0.007, respectively) and second trimesters (p=0.003 and p=0.02, respectively). First trimester sFlt1 levels were weakly correlated with first trimester SBP (r(s)=0.18, p=0.03) and MAP (r(s)=0.16, p=0.04). Second trimester sEng levels were inversely associated with second trimester MAP (r(s)=-0.17, p=0.05). Including blood pressure measures in the linear regression models did not change the reported associations of angiogenic factors with maternal characteristics.
CONCLUSIONS
These results demonstrate that even early in normotensive pregnancies maternal characteristics are associated with variations in angiogenic profile across this population.
目的
我们旨在探究孕妇的母体特征是否与正常血压妊娠的前、中孕期血管生成谱相关。
研究设计
在 182 例正常血压妊娠中，于妊娠 11.3 周（中位数）和 17.1 周（中位数）收集血清样本，检测母体胎盘样生长因子（PlGF）、可溶性 fms 样酪氨酸激酶受体（sFlt1）和可溶性内皮糖蛋白（sEng）的循环水平。在采集血管生成因子样本的同时，测量舒张压（DBP）、收缩压（SBP）和平均动脉压（MAP）。采用线性回归分析来检测血管生成指标与母体特征之间的关联。采用 Spearman 相关和线性回归分析评估血压测量值与血管生成因子浓度之间的关系。
结果
在调整分析中，初产妇在前、中孕期的 sFlt1 浓度均较高（p=0.06 和 p=0.001）。较高的 BMI 与前、中孕期 sFlt1 浓度均呈正相关（p=0.004 和 p=0.008），但与前、中孕期 sEng 浓度均呈负相关（p=0.002 和 p=0.0009）。初产妇和较高的 BMI 在前、中孕期的 sFlt1/PLGF 抗血管生成比值也较高（p=0.05 和 p=0.007，分别；p=0.003 和 p=0.02，分别）。前孕期 sFlt1 水平与前孕期 SBP（r(s)=0.18，p=0.03）和 MAP（r(s)=0.16，p=0.04）呈弱相关。中孕期 sEng 水平与中孕期 MAP 呈负相关（r(s)=-0.17，p=0.05）。在线性回归模型中纳入血压测量值并未改变血管生成因子与母体特征之间的关联。
结论
这些结果表明，即使在正常血压妊娠的早期，母体特征与该人群的血管生成谱的变化有关。
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