Fuentes-Carrasco Marta, Ruíz-Román Rebeca, Savirón-Cornudella Ricardo, Pérez-Roncero Gonzalo, López-Baena María T, Pérez-López Faustino R
Department of Obstetrics and Gynecology, Facultad de Medicina, Hospital Clínico San Carlos, Universidad Complutense, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Aragón Health Research Institute, Zaragoza, Spain.
Gynecol Endocrinol. 2022 Nov;38(11):918-927. doi: 10.1080/09513590.2022.2122433. Epub 2022 Sep 12.
To investigate maternal circulating apelin levels in pregnancies with and without preeclampsia. Systematic review and meta-analysis of observational studies reporting circulating apelin in women who develop preeclampsia. We searched databases for appropriate studies published through December 2021, without language restriction. The quality of studies was evaluated using the Newcastle-Ottawa-Scale. Data were pooled as mean difference (MDs) or standardized MDs (SMDs) and 95% confidence interval (95% CI). A random-effects model enabled reporting of differences between groups, minimizing the effects of uncertainty associated with inter-study variability on the effects of different endpoints. We identified a total of 122 studies, and ten of them reported circulating apelin in women with and without preeclampsia. Maternal apelin did not show a difference in preeclamptic compared to normotensive women (SMD: -0.38, 95%CI -0.91 to 0.15), although there was high heterogeneity between the included studies ( = 95%). Participants with preeclampsia had higher body mass index, lower gestational age at delivery, and birth weight. Preeclamptic pregnant women with higher BMI showed significantly lower apelin levels in the subgroup analysis. There was no significant apelin difference in the preeclampsia severity sub-analysis. There was no significant difference in apelin levels in pregnant women with and without preeclampsia.
研究子痫前期和非子痫前期孕妇母体循环中Apelin水平。对报告子痫前期女性循环中Apelin的观察性研究进行系统评价和荟萃分析。我们检索了截至2021年12月发表的相关研究数据库,无语言限制。使用纽卡斯尔-渥太华量表评估研究质量。数据合并为平均差(MDs)或标准化平均差(SMDs)以及95%置信区间(95%CI)。随机效应模型用于报告组间差异,将与研究间变异性相关的不确定性对不同终点效应的影响降至最低。我们共识别出122项研究,其中10项报告了子痫前期和非子痫前期女性的循环Apelin。与血压正常的女性相比,子痫前期患者的母体Apelin无差异(SMD:-0.38,95%CI -0.91至0.15),尽管纳入研究间存在高度异质性(I² = 95%)。子痫前期患者的体重指数较高,分娩时的孕周和出生体重较低。在亚组分析中,体重指数较高的子痫前期孕妇的Apelin水平显著较低。子痫前期严重程度亚分析中Apelin无显著差异。子痫前期和非子痫前期孕妇的Apelin水平无显著差异。