Melekoglu Rauf, Ciftci Osman, Eraslan Sevil, Basak Nese, Celik Ebru
Department of Obstetrics and Gynecology, University of Inonu, Faculty of Medicine, Malatya, Turkey.
Gynecol Obstet Invest. 2018;83(1):70-75. doi: 10.1159/000455192. Epub 2017 Jan 20.
The aim of this study was to determine the effects of obesity on amniotic fluid (AF) inflammatory markers in second-trimester AF, testing the hypothesis that there is a relationship between maternal body mass index (BMI) and fetal inflammatory exposure.
AF was obtained from 84 singleton pregnant women undergoing elective amniocentesis for karyotype analysis at 16-24 weeks of gestation between April 2014 and May 2016. The cell-free AF was used to analyze interleukin (IL)-1β and IL-6, and matrix metalloproteinase (MMP)-1, MMP-6, and MMP-13.
IL-1β levels were significantly higher in class II-III obese patients than in class I obese, overweight, and normal weight patients (14.68 ± 1.37 vs. 13.34 ± 1.86 vs. 13.00 ± 2.22 vs. 10.78 ± 1.92, respectively; p < 0.05). IL-6 levels were lowest in the normal weight group and highest in class II-III obese patients. MMP-1, MMP-6, and MMP-13 levels were also significantly higher in class II-III obese patients than in the other groups.
This study demonstrated that the fetuses of class II-III obese women are exposed in utero to higher cytokine and MMP levels than fetuses of lean women. Modification of current cutoff levels of intra-amniotic cytokines and MMPs according to the BMI could improve the accuracy of the prenatal diagnosis of intra-amniotic infection and inflammation.
本研究旨在确定肥胖对孕中期羊水（AF）炎症标志物的影响，检验母体体重指数（BMI）与胎儿炎症暴露之间存在关联这一假设。
2014年4月至2016年5月期间，从84名单胎孕妇获取羊水，这些孕妇在妊娠16 - 24周时接受了用于核型分析的选择性羊膜穿刺术。使用无细胞羊水分析白细胞介素（IL）-1β、IL-6以及基质金属蛋白酶（MMP）-1、MMP-6和MMP-13。
II - III级肥胖患者的IL-1β水平显著高于I级肥胖、超重和正常体重患者（分别为14.68±1.37 vs. 13.34±1.86 vs. 13.00±2.22 vs. 10.78±1.92；p < 0.05）。IL-6水平在正常体重组最低，在II - III级肥胖患者中最高。II - III级肥胖患者的MMP-1、MMP-6和MMP-13水平也显著高于其他组。
本研究表明，II - III级肥胖女性的胎儿在子宫内比瘦女性的胎儿暴露于更高的细胞因子和MMP水平。根据BMI修改目前羊水中细胞因子和MMPs的临界值水平，可提高羊膜腔内感染和炎症产前诊断的准确性。
