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补体因子 B 和 H 对有子痫前期风险的妊娠期糖尿病女性的预测价值。

Predictive value of the complement factors B and H for women with gestational diabetes mellitus who are at risk of preeclampsia.

机构信息

Department of Laboratory Medicine, Peking University Third Hospital, Beijing 100191, China.

Department of Blood Transfusion, Peking University Third Hospital, Beijing 100191, China.

出版信息

Pregnancy Hypertens. 2022 Dec;30:210-214. doi: 10.1016/j.preghy.2022.10.010. Epub 2022 Oct 21.

Abstract

OBJECTIVES

We aimed to define the relationships between the serum concentrations of complement factors B and H in mid-pregnancy and the risk of preeclampsia (PE) in patients with gestational diabetes mellitus (GDM).

STUDY DESIGN

We performed a prospective nested case-control study of 503 patients with GDM who attended Peking University Third Hospital between March 2018 and December 2018. 456 patients were followed until delivery and blood samples were collected between gestational weeks 24 and 28. Thirty patients developed PE, 12 developed gestational hypertension (GH), and 42 matched cases were selected as a control group.

RESULTS

The incidence of PE was 5.96 %. The serum concentrations of triacylglycerol (TG), FB, and FH of women with GDM who developed PE (GDM-PE group) in mid-pregnancy were significantly higher than those of the GDM group [TG: 3.60 (2.94-4.63) vs 2.54 (2.14-3.01) mmol/L, p < 0.001; FB: 346 (314-378) vs 284 (263-323) mg/L, p < 0.001; FH: 417 ± 45 vs 379 ± 47 mg/L, p = 0.003]. Multivariate regression analysis showed that high serum concentrations of TG and FB in mid-pregnancy were related to the risk of patients with GDM developing PE [TG: odds ratio (OR) 2.035 (95 % confidence interval (CI) 1.032-4.013); FB: OR 1.018 (95 % CI 1.001-1.035)]. The area under the curve (AUC) of FB for the prediction of PE was 0.821 (95 % CI 0.722-0.921) and that for a combination of TG, FB, and FH was 0.857 (95 % CI 0.770-0.944).

CONCLUSIONS

High serum FB concentration during mid-pregnancy is a potential predictor of the risk of PE in patients with GDM, and the combination of FB, FH, and TG increased this predictive value.

摘要

目的

本研究旨在探讨中孕期血清补体因子 B 和 H 浓度与妊娠期糖尿病(GDM)患者子痫前期(PE)风险之间的关系。

研究设计

我们进行了一项前瞻性巢式病例对照研究,纳入了 2018 年 3 月至 12 月在北京大学第三医院就诊的 503 例 GDM 患者。456 例患者随访至分娩,并在孕 24-28 周采集血样。30 例患者发生 PE,12 例发生妊娠期高血压(GH),选择 42 例匹配病例作为对照组。

结果

PE 的发生率为 5.96%。中孕期发生 PE 的 GDM 患者(GDM-PE 组)血清三酰甘油(TG)、FB 和 FH 浓度明显高于 GDM 组[TG:3.60(2.94-4.63)比 2.54(2.14-3.01)mmol/L,p<0.001;FB:346(314-378)比 284(263-323)mg/L,p<0.001;FH:417±45 比 379±47 mg/L,p=0.003]。多因素回归分析显示,中孕期血清 TG 和 FB 浓度升高与 GDM 患者发生 PE 的风险相关[TG:比值比(OR)2.035(95%置信区间(CI)1.032-4.013);FB:OR 1.018(95%CI 1.001-1.035)]。FB 预测 PE 的曲线下面积(AUC)为 0.821(95%CI 0.722-0.921),TG、FB 和 FH 联合预测的 AUC 为 0.857(95%CI 0.770-0.944)。

结论

中孕期血清 FB 浓度升高是 GDM 患者发生 PE 的潜在预测因素,FB、FH 和 TG 联合可提高预测价值。

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