The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use.
The sFlt-1 to PlGF Ratio in Pregnant Women with Rheumatoid Arthritis: Impact of Disease Activity and Sulfasalazine Use.
复制标题
患有类风湿性关节炎的孕妇中 sFlt-1 与 PlGF 的比率：疾病活动性和柳氮磺吡啶使用的影响。
作者：
R. Neuman;H. Smeele;A. J. Jan Danser;R. Dolhain;W. Visser
目标
SFlt-1/PlGF-比值升高已被证实为先兆子痫的重要预测因子，但尚未在类风湿关节炎(RA)女性中得到证实。我们探讨了sFlt-1/PlGF-1比值是否会因RA的疾病活动而改变，并可应用于该人群预测先兆子痫。由于柳氮磺吡啶被认为可以改善先兆子痫患者的血管生成失衡，我们还旨在研究柳氮磺吡啶是否会影响sFlt-1或PlGF水平。
方法
采用全国性、观察性、前瞻性队列研究方法，对妊娠晚期类风湿性关节炎孕妇进行sFlt-1和PlGF检测。共有221名年龄在21-42 之间的女性被纳入研究，她们的平均孕周为30 + 3 周。
结果
高、中、低疾病活动度组间sFlt-1和PlGF水平差异无统计学意义(p=0.07和p=0.41)，而sFlt-1和PlGF水平与DAS28-CRP评分无相关性(r=-0.01和r=-0.05)。4名(2%)sFlt-1/plf-≤比率为38的妇女发展为先兆子痫，而 >； 比率为38的妇女中有3人(43%)患先兆子痫，其阴性预测值为98.1%。柳氮磺吡啶使用者(n = 57)与非柳氮磺胺吡啶使用者(n = 164，p=0.91和p=0.11)相比，sFlt-1和PlGf水平没有变化。
结论
我们的研究表明，在患有RA的孕妇中，sFlt-1/plgf-1的比率不会因疾病活动而改变，≤38可以用于排除先兆子痫。此外，柳氮磺吡啶的使用不影响该人群中sFlt-1或PlGF的水平。
OBJECTIVES
An elevated sFlt-1/PlGF-ratio has been validated as a significant predictor of preeclampsia, but has not been established in women with rheumatoid arthritis (RA). We explored whether the sFlt-1/PlGF-ratio could be altered due to disease activity in RA, and could be applied in this population to predict preeclampsia. Since sulfasalazine has been suggested to improve the angiogenic imbalance in preeclampsia, we also aimed to examine whether sulfasalazine could affect sFlt-1 or PlGF levels.
METHODS
Making use of a nationwide, observational, prospective cohort study on pregnant women with RA, sFlt-1 and PlGF were measured in the third trimester. A total of 221 women, aged 21-42 years, were included, with a median gestational age of 30 + 3 weeks.
RESULTS
No differences in sFlt-1 or PlGF were observed between women with high, intermediate or low disease activity (p= 0.07 and p= 0.41), whereas sFlt-1 and PlGF did not correlate with DAS28-CRP score (r=-0.01 and r=-0.05, respectively). Four (2%) women with a sFlt-1/PlGF-ratio ≤38 developed preeclampsia in comparison to three (43%) women with a ratio > 38, corresponding to a negative predictive value of 98.1%. Sulfasalazine users (n = 57) did not show altered levels of sFlt-1 or PlGF in comparison to non-sulfasalazine users (n = 164, p= 0.91 and p= 0.11).
CONCLUSION
Our study shows that in pregnant women with RA, the sFlt-1/PlGF-ratio is not altered due to disease activity and a cut-off ≤38 can be used to exclude preeclampsia. Additionally, sulfasalazine use did not affect sFlt-1 or PlGF levels in this population.
影响因子：
158.5
作者：
Zeisler, Harald;Llurba, Elisa;Verlohren, Stefan
通讯作者：
Verlohren, Stefan