Department of Obstetrics and Gynecology, Kahramanmaraş Sütçü İmam University Hospital, Kahramanmaras, Turkey.
Department of Biochemistry, Kahramanmaraş Sütçü İmam University Hospital, Kahramanmaras, Turkey.
Biol Trace Elem Res. 2021 Jun;199(6):2096-2103. doi: 10.1007/s12011-020-02327-0. Epub 2020 Aug 16.
It was aimed to evaluate serum zinc and copper levels and oxidative stress parameters in ectopic pregnancy cases, healthy pregnant women, and healthy non-pregnant women. In this cross-sectional case-control study, 30 patients diagnosed with tubal ectopic pregnancy in the gynecology clinic of a tertiary hospital constituted the study group. A healthy pregnant control group (n = 30) was formed of age, body mass index (BMI), and gestational week-matched subjects, and a healthy non-pregnant control group (n = 30) was formed of age and BMI-matched women. The groups were compared in terms of demographic characteristics and laboratory parameters including serum zinc (Zn) level, serum copper (Cu) level, serum malondialdehyde (MDA) level, serum catalase (CAT) activity, serum glutathione peroxidase (GPX) activity, and serum superoxide dismutase (SOD) activity. The groups were similar in respect of demographic characteristics. In the ectopic pregnancy group, serum GPX activity and Cu level were significantly lower, and serum SOD and CAT activity and Zn and MDA levels were higher compared with those of the healthy pregnant and healthy non-pregnant groups. The Cu/Zn ratio showed a significant, positive correlation with the serum GPX activity and serum progesterone level and a negative correlation with serum SOD and CAT activity. When 1.14 was taken as the cutoff value, sensitivity and specificity of the Cu/Zn ratio to determine ectopic pregnancy were 73.3% and 80.0%, respectively. Comparing the area under curve (AUC) in the ROC (receiver operating characteristic) curve analysis, the Cu/Zn ratio was determined to be more valuable than the Cu or Zn values alone in predicting ectopic pregnancy. In correlation analysis, serum beta hCG level showed a negative correlation with SOD and CAT activities and Zn levels. Serum progesterone level showed a negative correlation with serum CAT and SOD activities and MDA and zinc levels and a positive correlation with serum GPX activity and serum copper level (p < 0.05 for all). The current study can be considered of value as the first study in literature to show a significantly lower serum Zn level and higher serum Cu level in ectopic pregnancy cases compared with healthy pregnant control cases. This is also the first study to have revealed an association between the serum Cu/Zn ratio, oxidative status, and ectopic pregnancy. Furthermore, the serum Cu/Zn ratio was found to be useful in the diagnosis of ectopic pregnancy cases.
本研究旨在评估异位妊娠患者、健康孕妇和健康非孕妇的血清锌和铜水平及氧化应激参数。在这项横断面病例对照研究中，30 名在三级医院妇科诊所诊断为输卵管异位妊娠的患者为研究组。健康孕妇对照组（n=30）由年龄、体重指数（BMI）和孕周匹配的受试者组成，健康非孕妇对照组（n=30）由年龄和 BMI 匹配的女性组成。比较了三组的人口统计学特征和实验室参数，包括血清锌（Zn）水平、血清铜（Cu）水平、血清丙二醛（MDA）水平、血清过氧化氢酶（CAT）活性、血清谷胱甘肽过氧化物酶（GPX）活性和血清超氧化物歧化酶（SOD）活性。三组在人口统计学特征方面相似。在异位妊娠组中，血清 GPX 活性和 Cu 水平明显降低，血清 SOD 和 CAT 活性以及 Zn 和 MDA 水平升高，与健康孕妇和健康非孕妇组相比差异有统计学意义。Cu/Zn 比值与血清 GPX 活性和血清孕酮水平呈显著正相关，与血清 SOD 和 CAT 活性呈负相关。当 1.14 作为截断值时，Cu/Zn 比值对异位妊娠的敏感性和特异性分别为 73.3%和 80.0%。ROC 曲线分析中曲线下面积（AUC）的比较表明，Cu/Zn 比值在预测异位妊娠方面比 Cu 或 Zn 值单独更有价值。在相关性分析中，血清β-hCG 水平与 SOD 和 CAT 活性及 Zn 水平呈负相关，血清孕酮水平与血清 CAT 和 SOD 活性及 MDA 和 Zn 水平呈负相关，与血清 GPX 活性及血清 Cu 水平呈正相关（p<0.05）。本研究首次在文献中表明，与健康孕妇对照组相比，异位妊娠患者血清 Zn 水平显著降低，血清 Cu 水平升高。这也是首次揭示血清 Cu/Zn 比值、氧化状态与异位妊娠之间的关系。此外，发现血清 Cu/Zn 比值在诊断异位妊娠患者方面具有一定的价值。
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