孕早期甲状腺素转运蛋白-视黄醇结合蛋白4-纯合性片段及血管生成因子对小于胎龄儿结局的预测作用
First trimester TTR-RBP4-ROH complex and angiogenic factors in the prediction of small for gestational age infant's outcome.
作者信息
Fruscalzo Arrigo, Frommer Julia, Londero Ambrogio P, Henze Andrea, Schweigert Florian J, Nofer Jerzy-Roch, Steinhard Johannes, Klockenbusch Walter, Schmitz Ralf, Raila Jens
机构信息
Obstetrics and Gynecology, St. Franziskus-Hospital of Ahlen, Robert-Koch-Straße 55, 59227, Ahlen, Germany.
Obstetrics and Gynecology, University Hospital of Münster, Münster, Germany.
出版信息
Arch Gynecol Obstet. 2017 May;295(5):1157-1165. doi: 10.1007/s00404-017-4338-4. Epub 2017 Mar 23.
PURPOSE
To study the role of the TTR-RBP4-ROH complex components (transthyretin, serum retinol binding protein, retinol) and of angiogenic factors PlGF (placental growth factor) and sFlt-1 (soluble fms-like tyrosine kinase-1) in pregnancies complicated by small for gestational age infants (SGA).
METHODS
Case control study conducted on maternal serum collected between 11 + 0 to 13 + 6 weeks of gestation. TTR, RBP4, ROH, PlGF and sFlt-1 were measured in SGA patients (birth weight <10%) who delivered at term (n = 37) and before 37 weeks of gestation (n = 17) and in a matched control group with uneventful pregnancies (n = 37).
RESULTS
We found decreased RBP4 in SGA patients that delivered fetuses <3% and in fetuses delivered after the 37 weeks of gestation compared to controls [1.50 (95% CI 1.40-1.75) vs 1.62 (95% CI 1.47-1.98), p < 0.05]. Further, we found lower PlGF and sFlt-1 concentrations in SGA that delivered before 37 weeks of gestation compared to controls (respectively, PIGF and sFlt-1: 39.7 pg/ml (95% CI 32.3-66.3) vs 62.9 pg/ml (95% CI 45.2-78.4) and 906 pg/ml (95% CI 727-1626) vs 1610 pg/ml (95% CI 1088-212), p < 0.05).
CONCLUSIONS
First trimester maternal serum RBP4 and angiogenic factors PlGF and sFlt-1 can differently predict the timing of delivery of pregnancies complicated by SGA fetuses.
目的
研究甲状腺素转运蛋白-视黄醇结合蛋白4-视黄醇（TTR-RBP4-ROH）复合物成分（甲状腺素转运蛋白、血清视黄醇结合蛋白、视黄醇）以及血管生成因子胎盘生长因子（PlGF）和可溶性fms样酪氨酸激酶-1（sFlt-1）在妊娠合并小于胎龄儿（SGA）中的作用。
方法
对妊娠11⁺⁰至13⁺⁶周期间采集的母血进行病例对照研究。检测足月分娩（n = 37）和妊娠37周前分娩（n = 17）的SGA患者（出生体重<第10百分位数）以及妊娠过程顺利的匹配对照组（n = 37）中的TTR、RBP4、ROH、PlGF和sFlt-1。
结果
我们发现，与对照组相比，分娩胎儿体重<第3百分位数的SGA患者以及妊娠37周后分娩的胎儿的母血RBP4降低[1.50（95%CI 1.40 - 1.75）vs 1.62（95%CI 1.47 - 1.98），p<0.05]。此外，我们发现与对照组相比，妊娠37周前分娩的SGA患者的PlGF和sFlt-1浓度较低（分别为，PlGF和sFlt-1：39.7 pg/ml（95%CI 32.3 - 66.3）vs 62.9 pg/ml（95%CI 45.2 - 78.4）以及906 pg/ml（95%CI 727 - 1626）vs 1610 pg/ml（95%CI 1088 - 212），p<0.05）。
结论
孕早期母血RBP4以及血管生成因子PlGF和sFlt-1能够不同程度地预测合并SGA胎儿的妊娠分娩时间。
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