Department of Public Health Medicine, Medical School, University of Pécs, Szigeti str. 12. H-7624, Pécs, Hungary.
Department of Public Health Medicine, Medical School, University of Pécs, Szigeti str. 12. H-7624, Pécs, Hungary.
Placenta. 2018 Sep;69:57-63. doi: 10.1016/j.placenta.2018.07.010. Epub 2018 Jul 19.
Preeclampsia (PE) is the leading cause of maternal and perinatal mortality around the world. The impaired function of fetal-placental vasculature is a key factor in PE. Several studies have investigated the connection between PE and endothelial dysfunction. Also, many authors have examined the changes in asymmetric dimethylarginine (ADMA) as a prominent marker of endothelial dysfunction. Our study aim is to review and analyse the connections between PE and ADMA levels.
To obtain data we performed a comprehensive literature search in Pubmed, Embase and Web of Science. Standardized mean differences were used to estimate the differences in ADMA levels.
The quantitative analysis included 10 studies reporting a total number of 631 PE and 498 healthy pregnant individuals. We found significantly higher ADMA levels in PE patients compared to controls, when comparing the ADMA levels of the patients to the ADMA levels of the controls (z = 5.93, p < 0.001). This difference was present regardless of the measurement method. Regarding the onset of PE, we found significantly higher ADMA levels in patients suffering from early-onset PE when comparing the ADMA levels of the early-onset PE patients to that of the controls (z = 2.82, p = 0.005). However, we did not find such difference when we compared late-onset PE patients' ADMA levels to controls.
ADMA is significantly higher in PE patients than in the controls. Elevated ADMA levels can play a major role in the development of PE, but more research is needed to clarify the connection between the two.
子痫前期 (PE) 是全球孕产妇和围产期死亡的主要原因。胎儿-胎盘血管功能障碍是 PE 的一个关键因素。一些研究已经探讨了 PE 与血管内皮功能障碍之间的联系。此外，许多作者已经研究了不对称二甲基精氨酸 (ADMA) 作为内皮功能障碍的显著标志物的变化。我们的研究目的是回顾和分析 PE 与 ADMA 水平之间的关系。
为了获取数据，我们在 Pubmed、Embase 和 Web of Science 中进行了全面的文献检索。使用标准化均数差来估计 ADMA 水平的差异。
定量分析包括 10 项研究，共报告了 631 例 PE 患者和 498 例健康孕妇。与对照组相比，PE 患者的 ADMA 水平显著升高，当将患者的 ADMA 水平与对照组的 ADMA 水平进行比较时（z=5.93，p<0.001）。这种差异在无论使用何种测量方法。关于 PE 的发病，与对照组相比，早发型 PE 患者的 ADMA 水平显著升高（z=2.82，p=0.005）。然而，当我们比较晚发型 PE 患者的 ADMA 水平与对照组时，我们没有发现这种差异。
PE 患者的 ADMA 水平明显高于对照组。ADMA 水平升高可能在 PE 的发展中起重要作用，但需要进一步研究来阐明两者之间的关系。
