IGFBP-2 在预测 20 周前子痫前期中的诊断价值：一项前瞻性巢式病例对照研究。
Diagnostic Value of IGFBP-2 in Predicting Preeclampsia before 20 Weeks of Pregnancy: A Prospective Nested Case-Control Study.
机构信息
The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China.
Laboratory Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
出版信息
Comput Math Methods Med. 2022 Sep 28;2022:5075569. doi: 10.1155/2022/5075569. eCollection 2022.
PURPOSE
To identify novel biomarker insulin-like growth factor binding protein-2 (IGFBP-2) associated with preeclampsia (PE) before 20 weeks of gestation and to explore the predictive value of plasma IGFBP-2 in PE.
METHODS
A prospective nested case-control investigation involving 122 PE patients and 122 normal controls (NC) that were matched 1 : 1 in terms of age and week of pregnancy was carried out in Guangzhou Women and Children's Medical Center (Guangzhou, China, 2018030306) from April 2016 to December 2019. At 8 to 20 weeks, blood samples from the mother were taken. To calculate the correlations, univariate conditional logistic regression was employed.
RESULTS
Herein, 12 clinical indices were significantly different between the PE and NC groups (uric acid (UA), cystatin C (Cys C), aspartate aminotransferase (AST), glutamyl transpeptidase (-GT), total bilirubin (TB), prothrombin time (PT), red blood cell (RBC), hematocrit (HCT), red cell distribution width (RDW), platelets (PLT), mean platelet volume (MPV), and thrombocytocrit (PCT)). Compared with the NC group (36.79 ± 19.91 pg/mL), the expression level of IGFBP2 in the PE group (19.76 ± 19.40 pg/mL) before 20 weeks of pregnancy was significantly decreased ( < 0.01). Two high-risk factors were found to be significantly associated with PE independently of confounders: anemia 4.35 (2.20-8.45) ( < 0.01) and cesarean section history 8.25 (2.67-26.67) ( < 0.01). As a result of the univariate logistic regression analysis, the following three variables were included in the final logistic regression model.: = -18.841 - 0.085 × (IGFBP-2) + 0.630 × (RDW) + 0.165 × (AST) + 0.863 × (MPV). In comparison to IGFBP-2 alone as an independent predictor of PE (AUC = 0.897, 95% CI 0.830-0.964), the model's discriminatory power was considerably higher (AUC = 0.953, 95% CI 0.911-0.995).
CONCLUSION
Plasma IGFBP-2 before 20 weeks of pregnancy combined with high-risk factors and routine blood indexes has a high early predictive value for PE.
目的
鉴定与 20 周前子痫前期（PE）相关的新型生物标志物胰岛素样生长因子结合蛋白-2（IGFBP-2），并探讨血浆 IGFBP-2 在 PE 中的预测价值。
方法
本研究采用前瞻性巢式病例对照研究，纳入 2016 年 4 月至 2019 年 12 月在广州妇女儿童医疗中心（广州，中国，2018030306）的 122 例 PE 患者和 122 例正常对照（NC），按年龄和妊娠周数 1:1 匹配。在 8 至 20 周时采集母亲的血样。采用单变量条件逻辑回归计算相关性。
结果
PE 组和 NC 组有 12 项临床指标差异有统计学意义（尿酸（UA）、胱抑素 C（Cys C）、天门冬氨酸氨基转移酶（AST）、谷氨酰转肽酶（-GT）、总胆红素（TB）、凝血酶原时间（PT）、红细胞（RBC）、血细胞比容（HCT）、红细胞分布宽度（RDW）、血小板（PLT）、平均血小板体积（MPV）和血小板压积（PCT））。与 NC 组（36.79 ± 19.91 pg/mL）相比，PE 组（19.76 ± 19.40 pg/mL）在 20 周前妊娠时 IGFBP2 的表达水平显著降低（<0.01）。两个高危因素被发现与 PE 独立相关，不受混杂因素影响：贫血 4.35（2.20-8.45）（<0.01）和剖宫产史 8.25（2.67-26.67）（<0.01）。单因素逻辑回归分析结果显示，以下三个变量纳入最终逻辑回归模型：= -18.841-0.085×（IGFBP-2）+0.630×（RDW）+0.165×（AST）+0.863×（MPV）。与单独使用 IGFBP-2 作为 PE 的独立预测因子（AUC=0.897，95%CI 0.830-0.964）相比，该模型的判别能力明显更高（AUC=0.953，95%CI 0.911-0.995）。
结论
20 周前妊娠时的血浆 IGFBP-2 结合高危因素和常规血液指标对 PE 具有较高的早期预测价值。
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