妊娠中期和分娩时母体血浆三甲胺 N-氧化物与子痫前期风险的关联。
Association between risk of preeclampsia and maternal plasma trimethylamine-N-oxide in second trimester and at the time of delivery.
机构信息
Department of Epidemiology, Hunan Normal University School of Medicine, 371 Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, Province, China.
Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China.
出版信息
BMC Pregnancy Childbirth. 2020 May 19;20(1):302. doi: 10.1186/s12884-020-02997-7.
BACKGROUND
The data on the association between the microbiota-dependent metabolite trimethylamine-N-oxide (TMAO) during pregnancy and risk of preeclampsia (PE) is limited.
METHODS
We, therefore, conducted a prospective nested case control study during Sep 2017 to Dec 2018 to examine the association between plasma TMAO measured during pregnancy and the risk of PE. Total of 17 patients diagnosed with early onset PE (EOPE), 49 with late onset PE (LOPE) and 198 healthy controls were enrolled. Blood samples were collected at 15-23 weeks gestation and time at delivery. The Logistic regression model was used to assess the odds ratio (OR) and 95% confidence interval (CI) for TMAO and risk of PE, EOPE, LOPE, mild PE, and severe PE.
RESULTS
We found that the mean TMAO levels of overall subjects in the second trimester (T2) and at the time of delivery (TD) were 90.39 μg/m (standard deviation (SD) =45.91) and 175.01 μg/m (SD = 160.97), respectively. No significant spearman correlation was found between the TMAO in those two periods (p > 0.05). T2 TMAO was not significantly associated with risk of PE or risk of any PE subtypes (p > 0.05). However, TD TMAO was significant associated with risk of PE, EOPE and severe PE (adjusted OR and 95%CI were 1.24(1.09, 1.40), 1.62(1.29, 2.03), and 1.41(1.17, 1.70)) per 50 μg/m increment, respectively).
CONCLUSION
Our study found that plasma TMAO level would alter over the course of pregnancy. The major role of TMAO in PE development might be in the accelerating process not in the initiation.
背景
关于孕期微生物依赖代谢产物三甲胺氮氧化物（TMAO）与子痫前期（PE）风险之间的关联，目前数据有限。
方法
因此，我们于 2017 年 9 月至 2018 年 12 月期间进行了一项前瞻性嵌套病例对照研究，以检验孕期 TMAO 水平与 PE 风险之间的相关性。共纳入 17 例早发型 PE（EOPE）患者、49 例晚发型 PE（LOPE）患者和 198 例健康对照者。在妊娠 15-23 周和分娩时采集血样。采用 Logistic 回归模型评估 TMAO 与 PE、EOPE、LOPE、轻度 PE 和重度 PE 风险的比值比（OR）和 95%置信区间（CI）。
结果
我们发现，在中期（T2）和分娩时（TD），总体受试者的 TMAO 平均值分别为 90.39μg/ml（标准差（SD）=45.91）和 175.01μg/ml（SD=160.97）。两个时期的 TMAO 之间未发现显著的斯皮尔曼相关性（p＞0.05）。T2 TMAO 与 PE 风险或任何 PE 亚型风险均无显著相关性（p＞0.05）。然而，TD TMAO 与 PE、EOPE 和重度 PE 风险显著相关（校正后的 OR 和 95%CI 分别为 1.24（1.09，1.40）、1.62（1.29，2.03）和 1.41（1.17，1.70））。
结论
我们的研究发现，血浆 TMAO 水平在妊娠期间会发生变化。TMAO 在 PE 发展中的主要作用可能在于加速过程，而不是启动过程。
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