Effective prediction of preeclampsia by a combined ratio of angiogenesis-related factors
Effective prediction of preeclampsia by a combined ratio of angiogenesis-related factors
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DOI：
10.1097/aog.0b013e3181719b7a
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发表时间：
2008-06-01
影响因子：
7.2
通讯作者：
Ryu, Hyun Mee
中科院分区：
文献类型：
--
作者：
Lim, Ji Hyae;Kim, Shin Young;Ryu, Hyun Mee
目的：血管生成相关因子的失衡与子痫前期的发生发展密切相关。目的是评估血管生成相关因子（包括可溶性fms样酪氨酸激酶1（sFlt-1）、可溶性内皮糖蛋白、胎盘生长因子（PlGF）和转化生长因子β 1）的水平和比率中最有效和准确的预测生物标志物。（TGF-β 1），在妇女谁随后发展先兆子痫。进行巢式队列研究以估计sFlt-1、可溶性内皮糖蛋白、PIGF、和TGF-从40名随后发展为先兆子痫的妇女和100名同期血压正常的妇女中收集的妊娠中期血浆中的β 1结果：子痫前期妇女sFlt-1和可溶性内皮素水平显著高于正常血压妇女，而PIGF和TGF-β 1水平较低（P <0.001）。在患有先兆子痫的妇女中，sFlt-1/PIGF、可溶性内皮糖蛋白/TGF-β 1和（sFlt-1+可溶性内皮糖蛋白）/（PIGF+ TGF-β 1）的组合比率显著高于血压正常的妇女（P <0.001），并且与轻度先兆子痫伴足月分娩相比，重度先兆子痫伴早产的妇女甚至更高（P <0.05）。在同等灵敏度（85%）下，sFlt-1的假阳性率为45%，可溶性内皮糖蛋白为41%，sFlt-1/PIGF为33%，可溶性内皮糖蛋白/TGF-β 1为21%，联合比值为10%。在调整潜在的混杂因素后，发生先兆子痫的风险如下：sFIt-1水平的优势比（OR）为6.9 [95%置信区间2.3-20.7]，可溶性内皮糖蛋白水平为7.1 [2.3-21.71]，sFIt-1/PIGF为6.8 [2.4-19.41]，可溶性内皮糖蛋白/TGF-β 1为38.8 [9.8-154.3]，结论：血管生成相关因素的联合比值预测子痫前期的假阳性率最低，OR值最高，提示联合比值可更有效地预测子痫前期的发生。
OBJECTIVE: Imbalance between angiogenesis-related factors is closely related to the development of preeclampsia. The objective was to estimate the most effective and accurate predictive biomarker among levels and ratios of angiogenesis-related factors, including soluble fms-like tyrosine kinase 1 (sFlt-1), soluble endoglin, placental growth factor (PIGF), and transforming growth factor-beta 1 (TGF-beta 1), in women who subsequently developed preeclampsia.METHODS: A nested cohort study was conducted to estimate the levels of sFlt-1, soluble endoglin, PIGF, and TGF-beta 1 in plasma collected in the second trimester from 40 women who subsequently developed preeclampsia and 100 contemporaneous normotensive women.RESULTS: Levels of sFlt-1 and soluble endoglin were significantly higher in women with preeclampsia than in normotensive women, whereas levels of PIGF and TGF-beta 1 were lower (P < .001). In women with preeclampsia, sFlt-1/PIGF, soluble endoglin/TGF-beta 1, and the combined ratio of (sFlt-1+soluble endoglin)/(PIGF+TGF-beta 1) were significantly higher than in normotensive women (P < .001) and even greater in severe preeclampsia with preterm delivery compared with mild preeclampsia with term delivery (P < .05). At equivalent sensitivity (85%), the false-positive rate was 45% for sFlt-1, 41% for soluble endoglin, 33% for sFIt-1/PIGF, 21% for soluble encloglin/TGF-beta 1, and 10% for the combined ratio. After adjusting for potential confounding factors, the risks for developing preeclampsia were as follows: odds ratio (OR) 6.9 [95% confidence interval 2.3-20.7] for sFIt-1 level, 7.1 [2.3-21.71 for soluble endoglin level, 6.8 [2.4-19.41 for sFIt-1/PIGF, 38.8 [9.8-154.3] for soluble endoglin/TGF-beta 1, and 74.8 [17.6-316.7] for the combined ratio.CONCLUSION: The combined ratio of angiogenesisrelated factors showed the lowest false-positive rate and the highest OR for prediction of preeclampsia, indicating that it may provide more effective prediction of development of preeclampsia.