Kucukbas Gokce Naz, Kara Ozgur, Yüce Deniz, Uygur Dilek
Department of Perinatology, Zekai Tahir Burak Women's Research and Tertiary Hospital, Ankara, Turkey.
Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
J Matern Fetal Neonatal Med. 2022 Apr;35(7):1295-1300. doi: 10.1080/14767058.2020.1749591. Epub 2020 Apr 14.
Intrauterine growth restriction (IUGR) is diagnosed when the estimated fetal weight remains below the 10th percentile of gestational age based on pathological restriction of growth and/or accompanying Doppler abnormalities. Endothelial dysfunction is a common pathogenetic pathway underlying IUGR etiology. Endocan (ESM-1) is a novel marker of endothelial dysfunction and inflammation found in the maternal circulation. This study was designed to compare plasma endocan levels between pregnancies complicated with IUGR and a control group.
Forty-four pregnancies complicated with IUGR and 47 healthy pregnancies were included. Maternal plasma endocan levels were detected by ELISA. Parametric data was studied by Student's -test. Mann-Whitney -test was used in analyzing non-parametric data. Categorical variables underwent chi-square test. ROC analysis was performed to define the cutoff value of endocan in detecting IUGR. Spearman correlation test was performed.
Maternal plasma endocan level varied significantly between IUGR and healthy pregnancies and was 1.8 fold higher in the IUGR group (793.0 (IQR:544.4-1896.0) ng/L vs. 441.8 (IQR: 408.3-512.4) ng/L, < .001). There was a weak negative correlation between endocan level and 5th and 10th minute APGAR Scores ( = -0.256; = .015 and = -0.215; = .042, respectively), a weak positive correlation with umbilical artery pulsatility index, and a moderate negative correlation with cerebroplacental ratio ( = 0.394; < .001 and = -0.459; < .001, respectively).
There was a significant difference between endocan levels of IUGR and healthy pregnancies. Further studies might be designed to investigate the performance of endocan in predicting neonatal outcomes for pregnancies complicated with IUGR.
当基于生长的病理限制和/或伴随的多普勒异常,估计胎儿体重低于胎龄的第10百分位数时,即可诊断为宫内生长受限(IUGR)。内皮功能障碍是IUGR病因的常见发病机制。内皮糖蛋白(Endocan,ESM-1)是在母体循环中发现的内皮功能障碍和炎症的新型标志物。本研究旨在比较合并IUGR的妊娠与对照组之间的血浆内皮糖蛋白水平。
纳入44例合并IUGR的妊娠和47例健康妊娠。采用酶联免疫吸附测定法(ELISA)检测母体血浆内皮糖蛋白水平。参数数据采用学生t检验进行研究。非参数数据采用曼-惠特尼U检验进行分析。分类变量采用卡方检验。进行ROC分析以确定内皮糖蛋白检测IUGR的临界值。进行Spearman相关性检验。
IUGR妊娠与健康妊娠的母体血浆内皮糖蛋白水平差异显著,IUGR组高出1.8倍(793.0(四分位间距:544.4 - 1896.0)ng/L vs. 441.8(四分位间距:408.3 - 512.4)ng/L,P <.001)。内皮糖蛋白水平与第5分钟和第10分钟阿氏评分之间存在弱负相关(r分别为 -0.256,P = 0.015和r = -0.215,P = 0.042),与脐动脉搏动指数呈弱正相关,与脑胎盘比值呈中度负相关(r分别为0.394,P <.001和r = -0.459,P <.001)。
IUGR妊娠与健康妊娠的内皮糖蛋白水平存在显著差异。可能需要进一步研究来调查内皮糖蛋白在预测合并IUGR妊娠的新生儿结局中的表现。