Fukushima Regional Center for the Japan Environment and Children's Study, Fukushima, Japan
Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, Fukushima, Japan.
BMJ Open. 2021 Dec 2;11(12):e054156. doi: 10.1136/bmjopen-2021-054156.
To evaluate the association between the urinary 8-hydroxy-2'-deoxyguanosine (U8-OHdG) levels and the incidence of small-for-gestational age (SGA) infants and to assess the utility of U8-OHdG as a biomarker to predict the incidence of SGA infants.
Prospective cohort study.
The Japan Environment and Children's Study.
Data of participants enrolled in the Japan Environment and Children's Study, a nationwide birth cohort study, between 2011 and 2014 were analysed; 104 062 fetal records were analysed. Data of women with singleton pregnancies ≥22 weeks of gestation were analysed.
U8-OHdG levels were assessed using liquid chromatography-tandem mass spectrometry. Participants were categorised into the following three groups according to the quartile of the distribution of U8-OHdG: low U8-OHdG (<1.95 ng/mgCre), moderate U8-OHdG (the combined second and third quartiles; 1.95-2.95 ng/mgCre) and high U8-OHdG (>2.95 ng/mgCre) groups. Additionally, participants in the 90th percentile for U8-OHdG levels were analysed. Odds ratios (ORs) for SGA infants (<-1.5 and <-2.0 SD) were calculated using a logistic regression model while adjusting for confounding factors; the moderate U8-OHdG group was used as a reference. The cut-off value of U8-OHdG to predict the incidence of SGA infants was calculated using a receiver operating characteristic (ROC) curve analysis.
Data of 80 212 participants were analysed. The adjusted ORs for SGA infants (<-1.5 and<-2.0 SD) in the high U8-OHdG group were 1.16 (95% CI 1.07 to 1.25) and 1.22 (95% CI 1.07 to 1.38). The cut-off value of U8-OHdG (3.26 ng/mgCre) showed a poor ability to predict SGA infants (sensitivity, 21.9%; specificity, 83.6%; area under the ROC curve, 0.530).
Elevated U8-OHdG levels were associated with an increased incidence of SGA infants. However, this parameter would not be a useful screening tool for predicting SGA infants owing to its low sensitivity and specificity.
评估尿 8-羟基-2'-脱氧鸟苷（U8-OHdG）水平与小于胎龄儿（SGA）发生率之间的关联，并评估 U8-OHdG 作为预测 SGA 婴儿发生率的生物标志物的效用。
前瞻性队列研究。
日本环境与儿童研究。
分析了 2011 年至 2014 年间参加日本环境与儿童研究的参与者的数据，这是一项全国性的出生队列研究；分析了 104062 例胎儿记录。对孕 22 周以上单胎妊娠的女性数据进行了分析。
采用液相色谱-串联质谱法评估 U8-OHdG 水平。根据 U8-OHdG 分布的四分位区间，参与者被分为以下三组：低 U8-OHdG（<1.95ng/mgCre）、中 U8-OHdG（第二和第三四分位数的组合；1.95-2.95ng/mgCre）和高 U8-OHdG（>2.95ng/mgCre）组。此外，还分析了 U8-OHdG 水平处于第 90 百分位数的参与者。使用逻辑回归模型在调整混杂因素后计算 SGA 婴儿（<-1.5 和<-2.0SD）的优势比（OR）；以中 U8-OHdG 组为参照。使用接收者操作特征（ROC）曲线分析计算 U8-OHdG 预测 SGA 婴儿发生率的截断值。
分析了 80212 名参与者的数据。高 U8-OHdG 组 SGA 婴儿（<-1.5 和<-2.0SD）的调整后 OR 为 1.16（95%CI 1.07 至 1.25）和 1.22（95%CI 1.07 至 1.38）。U8-OHdG（3.26ng/mgCre）的截断值预测 SGA 婴儿的能力较差（灵敏度，21.9%；特异性，83.6%；ROC 曲线下面积，0.530）。
U8-OHdG 水平升高与 SGA 婴儿的发生率增加有关。然而，由于其灵敏度和特异性较低，U8-OHdG 不太可能成为预测 SGA 婴儿的有用筛查工具。
