Circulation:胎盘生长因子能否预测女性妊娠后心血管风险?

2019-02-23 国际循环编辑部 国际循环

妊娠期间血管生成胎盘生长因子(PlGF)浓度上升,在妊娠中期结束时达到峰值。妊娠期间低PlGF浓度与妊娠并发症相关,并具有公认的晚年心血管风险。Circulation发表的一项研究假设低PlGF浓度,特别是在妊娠中期,不仅可识别具有妊娠并发症风险的女性子集,而且还可诊断妊娠后心血管危险因素负担较大的女性,无论妊娠结局如何。

妊娠期间血管生成胎盘生长因子(PlGF)浓度上升,在妊娠中期结束时达到峰值。妊娠期间低PlGF浓度与妊娠并发症相关,并具有公认的晚年血管风险。Circulation发表的一项研究假设低PlGF浓度,特别是在妊娠中期,不仅可识别具有妊娠并发症风险的女性子集,而且还可诊断妊娠后心血管危险因素负担较大的女性,无论妊娠结局如何。

该前瞻性队列研究纳入5529名女性,计算早孕和妊娠中期PlGF浓度。从医院登记处获得有关妊娠并发症(先兆子痫,小于胎龄和自发性早产)的信息。妊娠6年后,研究者测量母亲的收缩压和舒张压(SBP和DBP),心脏结构[主动脉根部直径(AOD),左心房直径(LAD),左心室质量(LV质量)和缩短分数],颈动脉-股动脉脉搏波速度和中央视网膜小动脉和小静脉口径,并测量了妊娠9年后的血压情况。

结果显示:女性在怀孕期间平均年龄为29.8岁(SD 5.2),大多数为欧洲人(55.2%),14.8%患有妊娠并发症。四分位数分析显示,尤其是PlGF处于最低四分位数(低PlGF子集)的妊娠中期女性AOD(0.40 mm,95%CI:0.08~0.73),LAD(0.34 mm,95%CI:-0.09~0.78),妊娠6年后,LV质量(4.6 g,95%CI:1.1~8.1)和SBP(2.3 mm Hg,95%CI:0.93~3.6)比PlGF最高的女性较大。线性回归分析显示,较高的孕中期PlGF浓度与较小的AOD(-0.24 mm,95%CI:-0.39~-0.10)、LAD(-0.75 mm,95%CI:-0.95~-0.56),较低的LV质量(-3.9 g,95%CI:-5.5~-2.3)和SBP(-1.1 mm Hg,95%CI:-1.7~-0.46)。排除复杂的妊娠女性后,上述差异仍存在。

研究表明,与PlGF较高的女性(包括无并发症女性)相比,妊娠中期PlGF低的女性AOD,LAD和LV质量较高,妊娠后6年和9年SBP较高。妊娠中期较低PlGF浓度的病理生理学意义可为识别导致更大心血管危险因素负担的方法提供新见解。

原始出处
Laura Benschop,Sarah Schalekamp-Timmermans, Zoe A. Broere-Brown, et al. Placental Growth Factor as an Indicator of Maternal Cardiovascular Risk After Pregnancy. Circulation. Feb 2019.

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    2019-03-06 1254a331m32暂无昵称

    谢谢分享,辛苦了!

    0

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    2019-03-03 boc_111

    生长因子的作用谢谢分享!胎盘细胞因子还有很多

    0

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