Zhou Yuheng, Niu Jianmin, Duan Dongmei, Lei Qiong, Wen Jiying, Lin Xiaohong, Lv Lijuan, Chen Longding
Guangdong Women and Children Hospital, 13 Guang Yuan Xi Road, Guangzhou, Guangdong province, 510010, People's Republic of China.
Heart Vessels. 2015 Jul;30(4):503-9. doi: 10.1007/s00380-014-0514-7. Epub 2014 Apr 23.
Both hypertension and preeclampsia (PE) are considered as inflammatory diseases. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory marker associated with lipid metabolism. We aimed to study the correlation and predictive value of Lp-PLA2 in postpartum hypertension after PE. A group of 160 PE patients (PE group) and a separate group of 160 normal pregnant women (control group) were recruited from January 2010 to October 2011. The average age in the PE group was 28.4 ± 4.5 years and the average gestational age was 34.7 ± 1.1 weeks. The average age in the control group was 27.8 ± 4.5 years and the average gestational age was 35.5 ± 1.2 weeks. General information (including age, gestational age, parity, history of metabolic disease, family history of high blood pressure, height, body weight before childbirth, and blood pressure) and blood samples were collected for measuring Lp-PLA2 and lipid parameters. From February to April in 2013, 153 cases in the PE group and 132 in the control group were re-called. We assessed their postpartum health, pregnancy, height, weight, and blood pressure. Serum mass of Lp-PLA2 in the PE group (210.67 ± 17.98 ng/mL) was significantly higher compared with that in the control group (174.72 ± 30.26 ng/mL) (P < 0.01). The pro-gestation BMI, systolic blood pressure (SBP), diastolic blood pressure, total cholesterol, triglyceride, and low-density lipoprotein-cholesterol (LDL-C) were also significantly higher. Correlation analysis showed that the level of Lp-PLA2 and SBP (r = 0.31), LDL-C (r = 0.37) were positively correlated. The incidence of postpartum hypertension in the PE group was higher than that in the normal control group. Logistic regression analysis showed that prenatal Lp-PLA2 mass was an independent risk factor for PE postpartum hypertension (OR 1.134,95 % CI 1.086-1.185). ROC curve analysis showed that the sensitivity of predicting postpartum hypertension was 73.2% and the specific degree was 86.6%, with Lp-PLA2 level of 217.75 ng/mL for boundary value. The onset of postpartum hypertension in PE patients may contribute to vascular inflammation, which is associated with antepartum lipid metabolism.
高血压和先兆子痫（PE）均被视为炎症性疾病。脂蛋白相关磷脂酶A2（Lp-PLA2）是一种与脂质代谢相关的炎症标志物。我们旨在研究Lp-PLA2在PE后产后高血压中的相关性及预测价值。2010年1月至2011年10月招募了一组160例PE患者（PE组）和另一组160例正常孕妇（对照组）。PE组的平均年龄为28.4±4.5岁，平均孕周为34.7±1.1周。对照组的平均年龄为27.8±4.5岁，平均孕周为35.5±1.2周。收集一般信息（包括年龄、孕周、产次、代谢疾病史、高血压家族史、身高、产前体重和血压）及血样以检测Lp-PLA2和脂质参数。2013年2月至4月，对PE组的153例患者和对照组的132例患者进行了回访。我们评估了他们的产后健康状况、妊娠情况、身高、体重和血压。PE组的Lp-PLA2血清质量（210.67±17.98 ng/mL）显著高于对照组（174.72±30.26 ng/mL）（P<0.01）。孕前BMI、收缩压（SBP）、舒张压、总胆固醇、甘油三酯和低密度脂蛋白胆固醇（LDL-C）也显著更高。相关性分析显示，Lp-PLA2水平与SBP（r=0.31）、LDL-C（r=0.37）呈正相关。PE组产后高血压的发生率高于正常对照组。Logistic回归分析显示，产前Lp-PLA2质量是PE产后高血压的独立危险因素（OR 1.134，95%CI 1.086-1.185）。ROC曲线分析显示，以Lp-PLA2水平217.75 ng/mL为界值，预测产后高血压的敏感性为73.2%，特异性为86.6%。PE患者产后高血压的发病可能与血管炎症有关，而血管炎症与产前脂质代谢相关。
