Combination of lipids and uric acid in mid-second trimester can be used to predict adverse pregnancy outcomes
Combination of lipids and uric acid in mid-second trimester can be used to predict adverse pregnancy outcomes
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妊娠中期血脂和尿酸的组合可用于预测不良妊娠结局
DOI：
10.3109/14767058.2012.704447
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发表时间：
2012-12-01
影响因子：
1.8
通讯作者：
Hu, Yali
中科院分区：
文献类型：
--
作者：
Zhou, Jianjun;Zhao, Xia;Hu, Yali
目的：本研究的目的是评估妊娠中期血脂和尿酸对不良妊娠结局的预测价值。方法：对1000例妊娠20周的健康初产妇进行血脂和尿酸测定。随访妊娠结局。采用非条件Logistic回归分析，校正母亲年龄和体重指数（BMI），估计比值比（OR）和95%CI。结果如下：妊娠中期甘油三酯（TG）升高的妇女发生先兆子痫的风险为2.91倍（95%CI 1.58-5.34），发生妊娠糖尿病（GDM）的风险为2.03倍（95%CI 1.29-3.19）。高尿酸血症女性的风险是男性的1.99倍。（95% CI 1.16-3.40），风险为2.34倍（95%CI 1.44-3.83），而高密度脂蛋白胆固醇（HDLc）降低的女性发生GDM的风险为2.32倍。（95%CI 1.18-4.58），GDM的风险为2.11倍（95%CI 1.37-3.25），分娩巨大儿的风险为1.63倍（95%CI 1.02-2.60）。这些效应具有浓度依赖性，因为风险随TG四分位数增加和HDLc四分位数降低而增加。ROC曲线分析结果显示，单一指标的敏感性和特异性均较低。而将TG、HDLc、尿酸、年龄、BMI等指标联合应用时，ROC曲线下面积增加到0.71-0.77，敏感性和特异性分别增加到80-92%和50- 53%。结论：联合检测妊娠中期代谢指标可预测不良妊娠结局。
Objective: The objective of this study was to evaluate the predictive values of lipids and uric acid in mid-second trimester for adverse pregnancy outcome. Methods: Lipids and uric acid concentrations were measured in 1000 healthy nulliparous women at 20 weeks of gestation. Pregnancy outcomes were followed-up. The odds ratios (OR) and 95% CI were estimated with unconditional logistic regression adjusting for maternal age and body mass index (BMI). Results: Women who had elevated triglyceride (TG) in the mid-second trimester experienced a 2.91-fold risk (95% CI 1.58-5.34) for preeclampsia and a 2.03-fold risk (95% CI 1.29-3.19) for gestation diabetes mellitus (GDM). Hyperuricemic women experienced a 1.99-fold risk (95% CI 1.16-3.40) for preeclampsia and a 2.34-fold risk (95% CI 1.44-3.83) for GDM, while women who had decreased high-density lipoprotein cholesterol (HDLc) experienced a 2.32-fold risk (95% CI 1.18-4.58) for preeclampsia, a 2.11-fold risk (95% CI 1.37-3.25) for GDM, and a 1.63-fold risk (95% CI 1.02-2.60) for delivering macrosomic newborns. These effects were concentration dependent, as risks increased with increasing TG quartiles and with decreasing HDLc quartiles. The result of the ROC analysis revealed that the sensitivity and specificity values for one marker alone was relatively low. But when combined TG, HDLc, uric acid, age and BMI together, the area under ROC curve increased to 0.71-0.77, sensitivity and specificity increased to 80-92% and 50-53%. Conclusion: The combination of these metabolic markers in mid-second trimester can be used to predict adverse pregnancy outcomes.