Garg Priyanka, Jaryal Ashok Kumar, Kachhawa Garima, Deepak Kishore Kumar, Kriplani Alka
Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India.
Pregnancy Hypertens. 2018 Oct;14:245-251. doi: 10.1016/j.preghy.2018.03.005. Epub 2018 Mar 10.
To evaluate the sequential trend of asymmetric dimethylarginine (ADMA), placental growth factor (PLGF) and pentraxin 3 (PTX 3) in pregnancies developing preeclampsia (PE) as compared to healthy pregnancy (HP) and to estimate their predictive value for development of PE later in pregnancy.
Nested case control design, sampling was done in 13 women with PE and 21 age matched healthy pregnant women at 11-13 weeks, 20-22 weeks and 30-32 weeks of gestation.
PLGF, ADMA, and PTX 3 were estimated temporally.
Serum ADMA and PTX 3 levels were higher in PE than HP even at 11-13 weeks and remained elevated throughout the gestation. PTX 3 concentration increased in both the groups with advancing gestation however significant rise was observed only in HP group. PLGF levels also increased with advancing gestation in HP group while in PE, there was a rise till 20-22 weeks of gestation followed by fall at 30-32 weeks. PLGF levels were lower in PE at 30-32 weeks than healthy pregnancy. Area under curve (AUC) for ADMA and PTX 3 were: at 11-13 weeks; 95.95% and 83.33% and 20-22 weeks; 89.88% and 90.06% respectively. At 30-32 weeks, PLGF and ADMA demonstrated an AUC of 86.51% and 86.51% respectively.
Abnormally elevated ADMA and PTX 3 levels precede the manifestation of PE and suggest endothelial dysfunction with exaggerated inflammatory response in PE. Both ADMA and PTX 3 can be used to segregate high risk women for development of PE than others in early pregnancy.
评估与健康妊娠（HP）相比，子痫前期（PE）孕妇中不对称二甲基精氨酸（ADMA）、胎盘生长因子（PLGF）和五聚体3（PTX 3）的连续变化趋势，并估计它们对后期妊娠发生PE的预测价值。
巢式病例对照设计，在13例PE孕妇和21例年龄匹配的健康孕妇妊娠11 - 13周、20 - 22周和30 - 32周时进行采样。
随时间推移对PLGF、ADMA和PTX 3进行评估。
即使在妊娠11 - 13周时，PE孕妇血清ADMA和PTX 3水平也高于HP孕妇，且在整个妊娠期均持续升高。两组中PTX 3浓度均随妊娠进展而增加，但仅在HP组观察到显著升高。HP组中PLGF水平也随妊娠进展而升高，而在PE组中，妊娠至20 - 22周时升高，随后在30 - 32周时下降。PE组在30 - 32周时的PLGF水平低于健康妊娠组。ADMA和PTX 3的曲线下面积（AUC）分别为：在11 - 13周时，分别为95.95%和83.33%；在20 - 22周时，分别为89.88%和90.06%。在30 - 32周时，PLGF和ADMA的AUC分别为86.51%和86.51%。
ADMA和PTX 3水平异常升高先于PE的表现，提示PE存在内皮功能障碍和过度的炎症反应。ADMA和PTX 3均可用于在妊娠早期将发生PE的高危女性与其他女性区分开来。
