Colmenares-Mejía Claudia C, Quintero-Lesmes Doris C, Bautista-Niño Paula K, Guio Mahecha Elizabeth, Beltrán Avendaño Mónica, Díaz Martínez Luis Alfonso, Ortiz Serrano Ricardo, Páez Leal María Carolina, Monterrosa Castro Álvaro, Mesa Restrepo Clara Maria, Monsalve Germán, Sanín-Blair Enrique, Saldarriaga Wilmar, Luna María Lucrecia, Casas Juan P, Serrano Díaz Norma
Fundación Universitaria Sanitas, Bogotá, Colombia.
Research Centre, Fundacion Cardiovascular de Colombia (FCV), Bucaramanga, Colombia.
Hypertens Res. 2020 Sep;43(9):884-891. doi: 10.1038/s41440-020-0434-0. Epub 2020 Apr 13.
Pentraxin-3 has been reported as a promising biomarker of pre-eclampsia and its severity; however, available studies have small sample sizes, and analyses are not always adjusted for confounders. The aim of this study is to establish the strength of the association between maternal Pentraxin-3 level and pre-eclampsia or HELLP syndrome. It was a case-control study. Women with pre-eclampsia or HELLP syndrome were defined as cases, and women with healthy pregnancies at term (>37 weeks) were classified as controls. Plasma concentrations of Pentraxin-3 were determined at the time of delivery by quantitative enzyme immunoassay. Associations between Pentraxin-3 and pre-eclampsia and HELLP syndrome were assessed by multinomial logistic regression. Subsidiary analysis for the time of disease onset was also carried out. Odds ratios and 95% confidence intervals are reported. A total of 1024 pregnant women were included (461 controls, 368 pre-eclampsia, 195 HELLP). A positive log-linear relationship was found between the top pentraxin-3 quintile and HELLP syndrome. After adjustment for confounders (maternal age, ethnicity, socioeconomic position, date and place of recruitment, family history of pre-eclampsia, smoking, body mass index at beginning of pregnancy, gestational age and multiple pregnancy), the strength of the association was higher for HELLP syndrome [OR 1.13 (95% CI 1.08; 1.18)] than for pre-eclampsia [OR 1.03 (95% CI 1.03; 1.10)]. No difference according to time of onset or pentraxin-3 level was found. In summary, pentraxin-3 level was associated with pre-eclampsia, but it was more strongly associated with HELLP syndrome. Longitudinal studies with a lower probability of residual confounding are necessary to improve our knowledge about the role of pentraxin-3 in pre-eclampsia.
已有报道称，妊娠相关血浆蛋白-3是先兆子痫及其严重程度的一个有前景的生物标志物；然而，现有研究样本量较小，且分析并不总是针对混杂因素进行校正。本研究的目的是确定母体妊娠相关血浆蛋白-3水平与先兆子痫或HELLP综合征之间关联的强度。这是一项病例对照研究。患有先兆子痫或HELLP综合征的女性被定义为病例组，足月（>37周）健康妊娠的女性被归类为对照组。在分娩时通过定量酶免疫测定法测定妊娠相关血浆蛋白-3的血浆浓度。通过多项逻辑回归评估妊娠相关血浆蛋白-3与先兆子痫和HELLP综合征之间的关联。还对疾病发作时间进行了辅助分析。报告了比值比和95%置信区间。总共纳入了1024名孕妇（461名对照组、368名先兆子痫患者、195名HELLP综合征患者）。在妊娠相关血浆蛋白-3最高五分位数与HELLP综合征之间发现了正对数线性关系。在对混杂因素（产妇年龄、种族、社会经济地位、招募日期和地点、先兆子痫家族史、吸烟、妊娠开始时的体重指数、孕周和多胎妊娠）进行校正后，HELLP综合征的关联强度[比值比1.13（95%置信区间1.08；1.18）]高于先兆子痫[比值比1.03（95%置信区间1.03；1.10）]。未发现根据发作时间或妊娠相关血浆蛋白-3水平存在差异。总之，妊娠相关血浆蛋白-3水平与先兆子痫有关，但与HELLP综合征的关联更强。有必要进行残留混杂可能性较低的纵向研究，以增进我们对妊娠相关血浆蛋白-3在先兆子痫中作用的认识。
