Identifying metabolite markers for preterm birth in cervicovaginal fluid by magnetic resonance spectroscopy.
Identifying metabolite markers for preterm birth in cervicovaginal fluid by magnetic resonance spectroscopy.
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DOI：
10.1007/s11306-016-0985-x
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发表时间：
2016
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影响因子：
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通讯作者：
Anumba DO
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作者：
Amabebe E;Reynolds S;Stern VL;Parker JL;Stafford GP;Paley MN;Anumba DO
早产（PTB）可能发生在阴道菌群和代谢物谱的变化之前。我们试图通过1H NMR谱来描述孕妇宫颈阴道液（CVF）的代谢物谱，并评估其对PTB的预测价值。从无临床感染证据的孕妇中获得一对高阴道拭子，并将其分组如下：无症状低风险（ALR）妇女，既往无PTB病史，在20-22妊娠周评估，g.w, n = 83；既往有肺结核病史的无症状高风险（AHR）妇女，评估为20-22 g.w, n = 71，和26-28 g.w, n = 58；和有早产症状（PTL） （SYM）的妇女，在24-36 g.w.评估，n = 65。阴道分泌物溶解于磷酸盐缓冲盐水中，用9.4 T核磁共振波谱仪扫描。分析了六种代谢物（乳酸、丙氨酸、乙酸、谷氨酰胺/谷氨酸、琥珀酸和葡萄糖）。在所有研究队列中，阴道pH值与乳酸积分相关（r = - 0.62, p < 0.0001）。与AHR （20-22 g.w）的女性相比，ALR的乳酸积分更高（p = 0.003）。在AHR中，早产儿的醋酸积分高于足月妇女（20-22 g.w）。（p = 0.048）和SYM组（p = 0.003）；并且在SYM妇女中预测PTB < 37 g.w (AUC 0.78; 95% CI 0.61-0.95)，以及在指数评估后2周内分娩（AUC 0.84; 95% CI 0.64-1），而其他代谢物则没有。有PTL症状的妇女的高CVF醋酸积分似乎预示着早产，以及出现后2周内分娩。本文的在线版本（doi:10.1007/s11306-016-0985-x）包含补充材料，授权用户可以使用。
Preterm birth (PTB) may be preceded by changes in the vaginal microflora and metabolite profiles. We sought to characterise the metabolite profile of cervicovaginal fluid (CVF) of pregnant women by 1H NMR spectroscopy, and assess their predictive value for PTB. A pair of high-vaginal swabs was obtained from pregnant women with no evidence of clinical infection and grouped as follows: asymptomatic low risk (ALR) women with no previous history of PTB, assessed at 20–22 gestational weeks, g.w., n = 83; asymptomatic high risk (AHR) women with a previous history of PTB, assessed at both 20–22 g.w., n = 71, and 26–28 g.w., n = 58; and women presenting with symptoms of preterm labor (PTL) (SYM), assessed at 24–36 g.w., n = 65. Vaginal secretions were dissolved in phosphate buffered saline and scanned with a 9.4 T NMR spectrometer. Six metabolites (lactate, alanine, acetate, glutamine/glutamate, succinate and glucose) were analysed. In all study cohorts vaginal pH correlated with lactate integral (r = −0.62, p < 0.0001). Lactate integrals were higher in the term ALR compared to the AHR (20–22 g.w.) women (p = 0.003). Acetate integrals were higher in the preterm versus term women for the AHR (20–22 g.w.) (p = 0.048) and SYM (p = 0.003) groups; and was predictive of PTB < 37 g.w. (AUC 0.78; 95 % CI 0.61–0.95), and delivery within 2 weeks of the index assessment (AUC 0.84; 95 % CI 0.64–1) in the SYM women, whilst other metabolites were not. High CVF acetate integral of women with symptoms of PTL appears predictive of preterm delivery, as well as delivery within 2 weeks of presentation. The online version of this article (doi:10.1007/s11306-016-0985-x) contains supplementary material, which is available to authorized users.