Endoglin, PlGF and sFlt-1 as markers for predicting pre-eclampsia
Endoglin, PlGF and sFlt-1 as markers for predicting pre-eclampsia
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DOI：
10.1080/00016340802253759
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发表时间：
2008-01-01
影响因子：
4.3
通讯作者：
D'Anna, Rosario
中科院分区：
文献类型：
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作者：
De Vivo, Antonio;Baviera, Giovanni;D'Anna, Rosario
目标。为了评估内源性激素的能力，在妊娠24-28周时测量胎盘生长因子（PlGF）和血管内皮生长因子受体（sFlt-1）的可溶性形式来预测先兆子痫。设计。观察性、前瞻性研究。设置。墨西拿大学妇产科和生殖医学系。样本。52名先兆子痫和52名健康孕妇方法。孕24 ~ 28周，将母体血清冷冻保存，进行1 h 50 g葡萄糖激发试验。子痫前期组和对照组在入院准备分娩时分别在发病时和入院准备分娩时采集第二份母体血清样本。测定储存血清中内啡肽、sFlt-1和PlGF的水平。子痫前期受试者也被分为早发性（37周）和晚发性子痫前期（37周）。结果。内啡肽水平、sFlt-1水平和sFlt-1:PlGF比值在两个妊娠期子痫前期组均较高。早发性和晚发性子痫前期没有差异。将受试者工作特征曲线应用于妊娠中期标记值，显示sFlt-1的最佳诊断特征：PlGF（曲线下面积，AUC=0.92），其次是内啡肽（AUC=0.88）， sFlt-1 （AUC=0.87）和PlGF （AUC=0.83）。贝叶斯分析证实了这一发现，该分析强调了sFlt-1:PlGF的特异性、敏感性、诊断准确性、阳性预测值和阴性预测值为88.5%，截止值为38.47。结论。内啡肽、PlGF和sFlt-1可能作为预测子痫前期的标志物，但sFlt-1:PlGF似乎更准确。
Objective. To evaluate the ability of endoglin, placental growth factor (PlGF) and the soluble form of vascular endothelial growth factor receptor (sFlt-1) measurements in gestational weeks 24-28 were used to predict pre-eclampsia. Design. Observational, prospective study. Setting. Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina. Sample. Fifty-two pre-eclamptic and 52 healthy pregnant women. Methods. A maternal serum sample was frozen and stored at 1-h 50-g glucose challenge test between 24 and 28 weeks' gestation. A second maternal serum sample was collected at admission for the onset of the disease in the pre-eclamptic group and at admission for delivery in the control group. Levels of endoglin, sFlt-1 and the PlGF were measured in the stored serum. Pre-eclamptic subjects were also divided into women with early-onset (37 weeks) and women with late-onset pre-eclampsia (37 weeks). Results. Levels of endoglin, sFlt-1, and sFlt-1:PlGF ratio were found to be higher in the pre-eclamptic group in both trimesters. No differences were found between early- and late-onset pre-eclamptic. The Receiver Operating Characteristics curve, applied to the second trimester marker values, showed the best diagnostic profile for sFlt-1:PlGF (area under the curve, AUC=0.92) followed by endoglin (AUC=0.88), sFlt-1 (AUC=0.87) and PlGF (AUC=0.83). This finding was confirmed by Bayesian analysis which highlighted a specificity, a sensitivity, a diagnostic accuracy, a positive predictive value and a negative predictive value of 88.5% for sFlt-1:PlGF using a cut-off of 38.47. Conclusions. Endoglin, PlGF and sFlt-1 might be used as markers for predicting pre-eclampsia, but sFlt-1:PlGF seems to be more accurate.