Belmar Vega Lara, Fernández Fresnedo Gema, Irure Ventura Juan, Orallo Toural Victoria, Vicario Milagros Heras, San Millán Juan Carlos Ruiz, Rodrigo Emilio, Hoyos Marcos López
Nephrology Service, University Hospital Marqués de Valdecilla, 39008 Santander, Spain.
Immunology Service, University Hospital Marqués de Valdecilla, 39008 Santander, Spain.
Life (Basel). 2020 Oct 14;10(10):241. doi: 10.3390/life10100241.
The association between unconventional antiphospholipid antibodies and pre-eclampsia in patients without thrombotic manifestations and its relationship with endothelial dysfunction after delivery has been studied poorly. We included 157 pregnant women, 122 of them having developed pre-eclampsia (56 non-severe and 66 severe). The determination of classical and unconventional, as well as pulse wave velocity and ankle-brachial index were performed at three months after delivery. The prevalence of unconventional antiphospholipid antibodies was 22.9% and 54.9% in patients included in control and pre-eclampsia groups, respectively ( = 0.001). The most frequent antiphospholipid antibody was IgM anti-phosphatidylserine/prothrombin in both cohorts. The presence of IgM anti-phosphatidylserine/prothrombin showed an association with the development of pre-eclampsia (OR = 5.4; CI 95% (2.0-14.9), = 0.001) with an AUC of 0.744 ( < 0.001). Likewise, IgM anti-phosphatidylserine/prothrombin exhibited a positive linear correlation with pulse wave velocity values (rho = 0.830; < 0.001) and an association with the presence of pulse wave velocity altered values (OR = 1.33; CI95% (1.10-1.59), = 0.002). With regard to ankle braquial index values, the presence of IgM anti-phosphatidylserine/prothrombin displayed a weak negative correlation (rho = -0.466; < 0.001) and an association with altered ankle braquial index values (OR = 1.08; CI 95% (1.04-1.13), < 0.001). In patients who developed preeclampsia, the presence of IgM anti-phosphatidylserine/prothrombin could be associated with endothelial dysfunction, causing alteration of cardiovascular parameters.
在无血栓形成表现的患者中,非传统抗磷脂抗体与子痫前期之间的关联及其与产后内皮功能障碍的关系研究较少。我们纳入了157名孕妇,其中122名发生了子痫前期(56例非重度和66例重度)。在产后三个月进行经典和非传统抗磷脂抗体的检测,以及脉搏波速度和踝臂指数的测定。对照组和子痫前期组患者中非传统抗磷脂抗体的患病率分别为22.9%和54.9%(P = 0.001)。两组中最常见的抗磷脂抗体均为IgM抗磷脂酰丝氨酸/凝血酶原。IgM抗磷脂酰丝氨酸/凝血酶原的存在与子痫前期的发生相关(OR = 5.4;95%CI(2.0 - 14.9),P = 0.001),曲线下面积为0.744(P < 0.001)。同样,IgM抗磷脂酰丝氨酸/凝血酶原与脉搏波速度值呈正线性相关(rho = 0.830;P < 0.001),并与脉搏波速度改变值的存在相关(OR = 1.33;95%CI(1.10 - 1.59),P = 0.002)。关于踝臂指数值,IgM抗磷脂酰丝氨酸/凝血酶原的存在呈弱负相关(rho = -0.466;P < 0.001),并与踝臂指数改变值相关(OR = 1.08;95%CI(1.04 - 1.13),P < 0.001)。在发生子痫前期的患者中,IgM抗磷脂酰丝氨酸/凝血酶原的存在可能与内皮功能障碍有关,导致心血管参数改变。