Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Ultrasound, Washington University in St. Louis, St. Louis, MO 63110, USA.
Prenat Diagn. 2011 Oct;31(10):990-4. doi: 10.1002/pd.2822. Epub 2011 Jul 11.
We tested the hypothesis that first-trimester metabolic biomarkers offered a unique profile in women with preeclampsia (PE) in the second half of pregnancy, compared with controls.
We conducted a nested case-control study within a prospective cohort of pregnant women followed from the first-trimester to delivery. Cases were those who developed PE at any gestational age, and these were compared with a control group without adverse pregnancy outcome, matched for gestational age within 3 days. We analyzed maternal blood obtained at 11-14 weeks' gestation for 40 acylcarnitine species (C2-C18 saturated, unsaturated, and hydroxylated) and 32 amino acids by liquid chromatography tandem mass spectrometry. Logistic regression modeling estimated the association of each metabolite with development of PE.
We compared 41 cases with PE with 41 controls and found four metabolites (hydroxyhexanoylcarnitine, alanine, phenylalanine, and glutamate) that were significantly higher in the cases with PE. The area under the curve (AUC) using these metabolites individually to predict PE varied from 0.77 to 0.80, and when combined, the AUC improved to 0.82 [95% confidence interval (95% CI): 0.80-0.85] for all cases of PE and 0.85 (95% CI: 0.76-0.91) for early onset PE.
Our findings suggest a potential role for first-trimester metabolomics in screening for PE.
我们检验了这样一个假设，即在妊娠中期后半期，与对照组相比，子痫前期（PE）患者的早期代谢生物标志物具有独特的特征。
我们在一项前瞻性队列研究中进行了嵌套病例对照研究，该研究对从孕早期到分娩的孕妇进行了随访。病例是指在任何孕龄发生 PE 的患者，这些病例与无不良妊娠结局的对照组进行了比较，对照组在 3 天内按孕龄匹配。我们通过液相色谱串联质谱法分析了 11-14 周妊娠时获得的 40 种酰基肉碱（C2-C18 饱和、不饱和和羟化）和 32 种氨基酸。逻辑回归模型估计了每种代谢物与 PE 发生发展的相关性。
我们将 41 例 PE 病例与 41 例对照组进行了比较，发现 4 种代谢物（羟基己酰肉碱、丙氨酸、苯丙氨酸和谷氨酸）在 PE 病例中显著升高。这些代谢物单独用于预测 PE 的曲线下面积（AUC）从 0.77 到 0.80 不等，而联合使用时，AUC 提高到 0.82 [95%置信区间（95%CI）：0.80-0.85]，用于所有 PE 病例，0.85（95%CI：0.76-0.91）用于早发性 PE。
我们的研究结果表明，早期代谢组学在子痫前期的筛查中具有潜在的作用。
