Shahid Ruqaiya, Bari Muhammad F, Hussain Mehwish
Department of Pathology, DOW International Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Department of Pathology, Dr. Ishrat-u-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Pakistan.
J Taibah Univ Med Sci. 2021 Aug 11;17(1):14-27. doi: 10.1016/j.jtumed.2021.07.003. eCollection 2022 Feb.
Preeclampsia is a major risk factor for maternal and foetal mortality and morbidity. There have been tremendous efforts to identify serum biomarkers which can reliably predict the occurrence of preeclampsia. The study aims to assess the biomarkers that have the greatest utility in the diagnosis of preeclampsia.
A systematic search was performed on the PubMed literature database, and chain references were retrieved. Original research articles composed of case controls, cohorts, randomised control trials, and cross-sectional studies were included. The recorded variables included each study's design, type, year, and location; the value (mean ± standard deviation) of the markers in the patients and the pregnant controls; and the -value, unit of measurement, and the sample size of each study. The results were interpreted based on the standardised mean difference (SMD) values.
A total of 398 studies were retrieved from the PubMed database. After further analysis, 89 studies were selected for this review. An additional 47 studies were included based on chain referencing. Later, 136 full-text articles were reviewed in detail and their data were entered. Finally, 25 studies, in which 13 serum biomarkers were assessed, were selected for this meta-analysis. The levels of the angiogenic markers fms-like tyrosine kinase (sFlt), sFlt/placental growth factor (PlGF), and endoglin were significantly higher in patients with preeclampsia than in the pregnant controls. The levels of PlGF and the lipid biomarkers high density lipoprotein (HDL) and adiponectin were significantly lower, while the levels of triglycerides, apolipoprotein B (APO-B), and leptin were elevated in the preeclamptic patients compared to the pregnant controls ( < 0.05).
In our study, the values of the serum biomarkers sFlt, PlGF, sFlt/PlGF, HDL, adiponectin, leptin, triglycerides, and APO-B differed significantly between preeclampsia patients and the pregnant controls. These findings demand advanced evaluation of biomarkers to enhance diagnostic screening for preeclampsia.
子痫前期是孕产妇和胎儿死亡及发病的主要危险因素。人们一直在努力寻找能够可靠预测子痫前期发生的血清生物标志物。本研究旨在评估在子痫前期诊断中最具效用的生物标志物。
对PubMed文献数据库进行系统检索，并检索连锁参考文献。纳入由病例对照、队列、随机对照试验和横断面研究组成的原始研究文章。记录的变量包括每项研究的设计、类型、年份和地点；患者和妊娠对照组中标志物的值（均值±标准差）；以及每项研究的P值、测量单位和样本量。根据标准化均值差（SMD）值对结果进行解释。
从PubMed数据库中检索到398项研究。经过进一步分析，选择了89项研究进行本综述。基于连锁引用又纳入了47项研究。随后，对136篇全文文章进行了详细审查并录入其数据。最后，选择了25项评估13种血清生物标志物的研究进行这项荟萃分析。子痫前期患者中血管生成标志物可溶性fms样酪氨酸激酶（sFlt）、sFlt/胎盘生长因子（PlGF）和内皮糖蛋白的水平显著高于妊娠对照组。与妊娠对照组相比，子痫前期患者中PlGF以及脂质生物标志物高密度脂蛋白（HDL）和脂联素的水平显著降低，而甘油三酯、载脂蛋白B（APO-B）和瘦素的水平升高（P<0.05）。
在我们的研究中，子痫前期患者和妊娠对照组之间血清生物标志物sFlt、PlGF、sFlt/PlGF、HDL、脂联素、瘦素、甘油三酯和APO-B的值存在显著差异。这些发现需要对生物标志物进行进一步评估，以加强对子痫前期的诊断筛查。
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