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孕中期早期羊水钙卫蛋白和甲状旁腺激素的测定及其对生长障碍胎儿的影响:其水平与氧化应激有关吗?

Measurement of Calprotectin and PTH in the Amniotic Fluid of Early Second Trimester Pregnancies and Their Impact on Fetuses with Growth Disorders: Are Their Levels Related to Oxidative Stress?

作者信息

Maroudias George, Vrachnis Dionysios, Fotiou Alexandros, Loukas Nikolaos, Mantzou Aimilia, Pergialiotis Vasileiοs, Valsamakis George, Machairiotis Nikolaos, Stavros Sofoklis, Panagopoulos Periklis, Vakas Panagiotis, Kanaka-Gantenbein Christina, Drakakis Petros, Vrachnis Nikolaos

机构信息

Department of Obstetrics and Gynecology, Tzaneio General Hospital, 18536 Athens, Greece.

Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.

出版信息

J Clin Med. 2024 Feb 1;13(3):855. doi: 10.3390/jcm13030855.

Abstract

: During the early stages of human fetal development, the fetal skeleton system is chiefly made up of cartilage, which is gradually replaced by bone. Fetal bone development is mainly regulated by the parathyroid hormone parathormone (PTH) and PTH-related protein, with specific calprotectin playing a substantial role in cell adhesion and chemotaxis while exhibiting antimicrobial activity during the inflammatory osteogenesis process. The aim of our study was to measure the levels of PTH and calprotectin in early second trimester amniotic fluid and to carry out a comparison between the levels observed among normal full-term pregnancies (control group) and those of the groups of embryos exhibiting impaired or enhanced growth. For the present prospective study, we collected amniotic fluid samples from pregnancies that underwent amniocentesis at 15 to 22 weeks of gestational age during the period 2021-2023. Subsequently, we followed up on all pregnancies closely until delivery. Having recorded fetal birthweights, we then divided the neonates into three groups: small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). In total, 64 pregnancies, including 14 SGA, 10 LGA, and 40 AGA fetuses, were included in our study. Both substances were detected in early second trimester amniotic fluid in both groups. Concentrations of calprotectin differed significantly among the three groups ( = 0.033). AGA fetuses had a lower mean value of 4.195 (2.415-6.425) IU/mL, whereas LGA fetuses had a higher mean value of 6.055 (4.887-13.950) IU/mL, while SGA fetuses had a mean value of 5.475 (3.400-9.177) IU/mL. Further analysis revealed that only LGA fetuses had significantly higher calprotectin concentrations compared to AGA fetuses ( = 0.018). PTH concentration was similar between the groups, with LGA fetuses having a mean value of 13.18 (9.51-15.52) IU/mL, while SGA fetuses had a mean value of 14.18 (9.02-16.00) IU/mL, and AGA fetuses had similar concentrations of 13.35 (9.05-15.81) IU/mL. The differences in PTH concentration among the three groups were not statistically significant ( = 0.513). Calprotectin values in the amniotic fluid in the early second trimester were higher in LGA fetuses compared to those in the SGA and AGA categories. LGA fetuses can possibly be in a state of low-grade chronic inflammation due to excessive fat deposition, causing oxidative stress in LGA fetuses and, eventually, the release of calprotectin. Moreover, PTH concentrations in the amniotic fluid of early second trimester pregnancies were not found to be statistically correlated with fetal growth abnormalities in either LGA or SGA fetuses. However, the early time of collection and the small number of patients in our study should be taken into account.

摘要

在人类胎儿发育的早期阶段,胎儿骨骼系统主要由软骨组成,随后逐渐被骨骼替代。胎儿骨骼发育主要受甲状旁腺激素(PTH)和甲状旁腺激素相关蛋白调节,特定的钙卫蛋白在细胞黏附和趋化作用中发挥重要作用,同时在炎症性骨生成过程中表现出抗菌活性。本研究旨在测量孕中期羊水甲状旁腺激素(PTH)和钙卫蛋白水平,并比较正常足月妊娠组(对照组)与生长受损或生长加速胚胎组之间的水平差异。在本前瞻性研究中,我们收集了2021年至2023年期间孕15至22周接受羊膜穿刺术的孕妇羊水样本。随后,我们对所有妊娠进行密切随访直至分娩。记录胎儿出生体重后,我们将新生儿分为三组:小于胎龄儿(SGA)、适于胎龄儿(AGA)和大于胎龄儿(LGA)。本研究共纳入64例妊娠,包括14例SGA胎儿、10例LGA胎儿和40例AGA胎儿。两组孕中期羊水均检测到这两种物质。三组钙卫蛋白浓度差异有统计学意义(P = 0.033)。AGA胎儿的平均浓度较低,为4.195(2.415 - 6.425)IU/mL,而LGA胎儿的平均浓度较高,为6.055(4.887 - 13.950)IU/mL,SGA胎儿的平均浓度为5.475(3.400 - 9.177)IU/mL。进一步分析显示,只有LGA胎儿的钙卫蛋白浓度显著高于AGA胎儿(P = = 0.018)。各组间PTH浓度相似,LGA胎儿的平均浓度为13.18(9.51 - 15.52)IU/mL,SGA胎儿的平均浓度为14.18(9.02 - 16.00)IU/mL,AGA胎儿的浓度与之相似,为13.35(9.05 - 15.81)IU/mL。三组间PTH浓度差异无统计学意义(P = 0.513)。与SGA和AGA胎儿相比,孕中期羊水钙卫蛋白水平在LGA胎儿中更高。LGA胎儿可能因脂肪过度沉积而处于低度慢性炎症状态,导致LGA胎儿发生氧化应激,最终释放钙卫蛋白。此外,孕中期妊娠羊水中PTH浓度与LGA或SGA胎儿的胎儿生长异常无统计学相关性。然而,应考虑到本研究的早期收集时间和较少的患者数量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2732/10856459/da58963028dd/jcm-13-00855-g001.jpg

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