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异位妊娠中母体血清缺血修饰白蛋白和总抗氧化状态的评估

Evaluation of maternal serum ischemia modified albumin and total antioxidant status in ectopic pregnancy.

作者信息

Bozkaya Giray, Karaca Ibrahim, Fenercioglu Ozge, Yildirim Karaca Suna, Bilgili Sibel, Uzuncan Nuriye

机构信息

a Department of Medical Biochemistry , Health Sciences University, Bozyaka Training and Research Hospital , Izmir , Turkey.

b Department of Gynecology , Health Sciences University, Bakırköy Dr. Sadi Konuk Research and Training Hospital , Istanbul , Turkey.

出版信息

J Matern Fetal Neonatal Med. 2019 Jun;32(12):2003-2008. doi: 10.1080/14767058.2017.1422718. Epub 2018 Jan 8.

Abstract

BACKGROUND

Ectopic pregnancies constitute about 2% of all pregnancies which are the leading cause of pregnancy-related deaths and a considerable cause of maternal morbidity. Oxidative stress can lead to a number of pregnancy related diseases including miscarriage, eclampsia and preterm labor. Ischemia modified albumin (IMA) which reflects the oxidative stress may be used as a marker for ectopic pregnancy. Our aim was to compare the levels of IMA and total antioxidant status (TAS) in ectopic and normal pregnancies and to understand if IMA can be used as a marker to diagnose ectopic pregnancy.

MATERIALS AND METHODS

Our case-control study consisted of 38 women with ectopic and 42 women with normal pregnancy. IMA and TAS levels were determined in serum samples with an albumin-cobalt binding test and by commercially available kits, respectively. IMA levels were adjusted according to serum albumin levels. Index of oxidation (IOS) was calculated by dividing adjusted IMA (A-IMA) levels with TAS. A receiver operating characteristics (ROC) curve analysis was made and cut-off values for the biomarkers were investigated in SPSS 21.0 program (SPSS, Chicago, IL). Data were presented as mean ± standard deviation and a p value < .05 was accepted as statistically significant.

RESULTS

There was a statistically significant difference in IMA, A-IMA, and IOS levels between ectopic and normal pregnancies. Although TAS level was not different statistically, it was lower in ectopic pregnancy. According to ROC curve analysis, IOS had the largest area under curve. A cut-off value of 0.545 for IOS had 81.6% sensitivity and 59.5% specificity.

CONCLUSIONS

According to our study, oxidative stress plays an important role in ectopic pregnancy and either A-IMA or IOS can be evaluated as a marker of ectopic pregnancy after further studies.

摘要

背景

异位妊娠约占所有妊娠的2%,是妊娠相关死亡的主要原因,也是孕产妇发病的重要原因。氧化应激可导致多种妊娠相关疾病,包括流产、子痫和早产。反映氧化应激的缺血修饰白蛋白(IMA)可作为异位妊娠的标志物。我们的目的是比较异位妊娠和正常妊娠中IMA和总抗氧化状态(TAS)的水平,并了解IMA是否可作为诊断异位妊娠的标志物。

材料与方法

我们的病例对照研究包括38例异位妊娠妇女和42例正常妊娠妇女。分别采用白蛋白-钴结合试验和市售试剂盒测定血清样本中的IMA和TAS水平。根据血清白蛋白水平调整IMA水平。氧化指数(IOS)通过将调整后的IMA(A-IMA)水平除以TAS来计算。绘制受试者工作特征(ROC)曲线,并在SPSS 21.0程序(SPSS,芝加哥,伊利诺伊州)中研究生物标志物的截断值。数据以均值±标准差表示,p值<0.05被认为具有统计学意义。

结果

异位妊娠和正常妊娠之间的IMA、A-IMA和IOS水平存在统计学显著差异。虽然TAS水平在统计学上没有差异,但在异位妊娠中较低。根据ROC曲线分析,IOS的曲线下面积最大。IOS的截断值为0.545时,灵敏度为81.6%,特异性为59.5%。

结论

根据我们的研究,氧化应激在异位妊娠中起重要作用,经过进一步研究,A-IMA或IOS均可作为异位妊娠的标志物进行评估。

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