摘要
目的探讨血清补体C1q肿瘤坏死因子相关蛋白(CTRP)-3、亲环素A(CyPA)与子痫前期(PE)患者脂代谢异常的相关性。方法选取2017年1月至2018年6月,青海大学附属医院产科收治的98例PE患者为研究对象。根据PE严重程度,将其分为重度PE组(n=48)与轻度PE组(n=50)。同时采用随机数字表法,选取同期于本院进行定期产前检查的50例健康孕妇作为对照,纳入对照组。采用酶联免疫吸附法,检测3组受试者的血清CTRP-3、CyPA水平。采用全自动生化分析仪,检测3组受试者的血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)与低密度脂蛋白胆固醇(LDL-C)水平。采用单因素方差分析,对3组受试者的人体质量指数(BMI)、收缩压、舒张压及血清TG、TC、LDL-C、HDL-C、CTRP-3、CyPA水平进行总体比较;然后,再采用最小显著性差异(LSD)法,进一步两两比较。PE患者血清CTRP-3、CyPA水平与其血清TG、TC、LDL-C、HDL-C水平的相关性,采用Pearson相关性分析。PE患者血清CTRP-3、CyPA水平与其脂代谢指标的多因素分析,采用多重线性回归法。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。3组受试者年龄、孕龄分别比较,差异均无统计学意义(P>0.05)。结果①3组受试者BMI、收缩压、舒张压及血清TG、TC、LDL-C、HDL-C、CTRP-3、CyPA水平分别总体比较,差异均有统计学意义(F=5.138、6.742、7.012、7.436、6.538、6.715、7.213、27.659、7.704,P<0.05)。对其进一步进行两两比较的结果显示,重度PE组和轻度PE组受试者BMI、收缩压、舒张压及血清TG、TC、LDL-C、CyPA水平,均分别显著高于对照组,并且差异均有统计学意义(重度PE组vs对照组:LSD-t=7.156、13.864、8.664、14.264、6.837、13.875、28.185,P<0.001;轻度PE组vs对照组:LSD-t=5.875、11.673、7.148、10.643、4.184、11.684、23.686,P<0.001);而血清HDL-C、CTRP-3水平,则均分别显著低于对照组,并且差异亦均有统计学意义(重度PE组vs对照组:LSD-t=12.864、44.378,P<0.001;轻度PE组vs对照组:LSD-t=9.547、31.684,P<0.001)。重度PE组受试者的BMI、收缩压、舒张压及血清TG、TC、LDL-C、CyPA水平,均显著高于轻度PE组,并且差异均有统计学意义(LSD-t=4.738、P<0.001,LSD-t=9.814、P<0.001,LSD-t=4.864、P<0.001,LSD-t=2.326、P=0.042,LSD-t=2.563、P=0.028,LSD-t=2.713、P=0.022,LSD-t=6.145、P<0.001);而血清HDL-C、CTRP-3水平,则均显著低于轻度PE组,差异亦均有统计学意义(LSD-t=6.258、16.386,P<0.001)。②PE患者的血清CTRP-3水平与其血清TG、TC、LDL-C水平,均分别呈负相关关系(r=-0.546、-0.573、-0.601,P<0.001),而其血清CTRP-3水平与血清HDL-C水平,则呈正相关关系(r=0.531,P<0.001)。PE患者的血清CyPA水平与其血清TG、TC、LDL-C水平,均分别呈正相关关系(r=0.612、0.637、0.552,P<0.001),而其血清CyPA水平与血清HDL-C水平,则呈负相关关系(r=-0.514,P<0.001)。③血清TG、TC、LDL-C、HDL-C水平,均分别为PE患者血清CTRP-3、CyPA水平的独立影响因素(血清CTRP-3水平:t=4.427、P<0.001,t=3.675、P<0.001,t=2.328、P=0.020,t=4.576、P<0.001;血清CyPA水平:t=2.788、P=0.005,t=3.332、P=0.001,t=2.429、P=0.015,t=2.140、P=0.032)。结论PE患者血清CTRP-3水平较正常值降低、CyPA水平较正常值升高。CTRP-3、CyPA水平与其脂代谢异常具有相关关系,可能参与PE的发生、发展过程。
Objective To investigate the correlation between serum complement C1q tumor necrosis factor related protein(CTRP)-3,cyclophilin A(CyPA)and abnormal metabolism of lipid in patients with preeclampsia(PE).Methods A total of 98 cases of PE patients who admitted to Department of Obstetrics,Qinghai University Affiliated Hospital from January 2017 to June 2018 were selected as study subjects.According to the severity of PE,they were divided into severe PE group(n=48)and mild PE group(n=50).At the same time,another 50 cases of healthy pregnant women who received regular prenatal examination in our hospital during the same period were included in the control group.The serum levels of CTRP-3 and CyPA of three groups were measured by enzyme linked immunosorbent assay.The serum levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)of three groups were measured by automatic biochemical analyzer.The body mass index(BMI),systolic blood pressure,diastolic blood pressure,and serum levels of TG,TC,LDL-C,HDL-C,CTRP-3 and CyPA in three groups were compared by one-way ANOVA,and the least-significant difference(LSD)method was used for further multiple comparisons.The correlations between serum levels of CTRP-3,CyPA and serum levels of TG,TC,LDL-C and HDL-C in PE patients were analyzed by Pearson correlation analysis.And multiple linear regression analysis was used for multivariate analysis for serum levels of CTRP-3,CyPA and lipid metabolism index in PE patients.The procedures followed in this study met the requirements of World Medical Association Declaration of Helsinki revised in 2013.There were no significant differences among three groups in age and gestational age(P>0.05).Results①The BMI,systolic blood pressure,diastolic blood pressure and serum levels of TG,TC,LDL-C,HDL-C,CTRP-3 and CyPA were compared among three groups,and all the differences were statistically significant(F=5.138,6.742,7.012,7.436,6.538,6.715,7.213,27.659,7.704,P<0.05).Further comparisons showed that BMI,systolic blood pressure,diastolic blood pressure and serum levels of TG,TC,LDL-C and CyPA in severe PE group and mild PE group were significantly higher than those in control group,and all the differences were statistically significant(severe PE group vs control group:LSD-t=7.156,13.864,8.664,14.264,6.837,13.875,28.185,P<0.001;mild PE group vs control group:LSD-t=5.875,11.673,7.148,10.643,4.184,11.684,23.686,P<0.001),while serum levels of HDL-C and CTRP-3 were significantly lower than those in control group,and all the differences also were statistically significant(severe PE group vs control group:LSD-t=12.864,44.378,P<0.001;mild PE group vs control group:LSD-t=9.547,31.684,P<0.001).The BMI,systolic blood pressure,diastolic blood pressure and serum levels of TG,TC,LDL-C and CyPA in severe PE group were significantly higher than those in mild PE group,and all the differences were statistically significant(LSD-t=4.738,P<0.001,LSD-t=9.814,P<0.001,LSD-t=4.864,P<0.001,LSD-t=2.326,P=0.042,LSD-t=2.563,P=0.028,LSD-t=2.713,P=0.022,LSD-t=6.145,P<0.001),while serum levels of HDL-C and CTRP-3 were significantly lower than those in mild PE group,and all the differences also were statistically significant(LSD-t=6.258,16.386,P<0.001).②Pearson correlation analysis results showed that serum CTRP-3 level was negatively correlated with serum levels of TG,TC and LDL-C in PE patients(r=-0.546,-0.573,-0.601,P<0.001),while positively correlated with serum HDL-C level in PE patients(r=0.531,P<0.001).Serum CyPA level was positively correlated with serum levels of TG,TC and LDL-C in PE patients(r=0.612,0.637,0.552,P<0.001),while negatively correlated with serum HDL-C level in PE patients(r=-0.514,P<0.001).③Multiple linear regression analysis results showed that serum levels of TG,TC,LDL-C and HDL-C were independent influencing factors of serum CTRP-3 and CyPA levels in PE patients(serum CTRP-3 level:t=4.427,P<0.001,t=3.675,P<0.001,t=2.328,P=0.020,t=4.576,P<0.001;serum CyPA level:t=2.788,P=0.005,t=3.332,P=0.001,t=2.429,P=0.015,t=2.140,P=0.032).Conclusions Serum CTRP-3 level in PE patient is lower than normal value,and serum CyPA level is higher than normal value.CTRP-3 and CyPA levels are closely related to the abnormal metabolism of lipid in patients with PE,and may be involved in the occurrence and development process of PE.
作者
周巧莲
李琴
Zhou Qiaolian;Li Qin(Department of Obstetrics,Qinghai University Affiliated Hospital,Xining 810001,Qinghai Province,China)
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2019年第4期382-388,共7页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
青海省卫生计生委一般指导性课题(2018-wjzdx-117)~~
