子痫前期患者血清ANGPTL4、LPL表达与胎儿生长受限

The relationship between the expression levels of serum angiopoietin-like protein 4 and lipoprotein lipase in women with preeclampsia and their fetal growth restriction

目的:探究子痫前期(PE)患者血清血管生成素样蛋白4(ANGPTL4)、脂蛋白脂肪酶(LPL)表达与胎儿生长受限(FGR)关系。方法:回顾性收集2018年1月-2020年6月在本院收治并分娩的PE患者164例临床资料,根据新生儿是否合并FGR分为FGR组73例和正常组91例,比较两组患者基本资料及新生儿结局。酶联免疫吸附法检测患者分娩前血清ANGPTL4、LPL水平,Pearson法分析血清ANGPTL4、LPL水平与新生儿身长、体重关系;利用受试者工作特征曲线(ROC)评价PE患者血清ANGPTL4、LPL水平对FGR的诊断价值。结果:FGR组PE患者血清ANGPTL4(22.64±4.17 ng/ml)水平高于正常组(16.37±2.53 ng/ml),LPL(1.82±0.36μg/L)水平低于正常组(2.30±0.42μg/L)(P<0.05);FGR组新生儿出生身长、体重低于正常组,住院时间长于正常组(P<0.05);PE患者血清ANGPTL4与新生儿体重呈负相关(r=-0.317,P<0.05),LPL与新生儿体重呈正相关(r=0.347,P<0.05),ANGPTL4、LPL呈负相关(r=-0.652,P<0.05)但与新生儿身长均无相关性(P>0.05);PE患者血清ANGPTL4、LPL评估FGR的曲线下面积分别为0.913(95%CI:0.859~0.951)、0.856(95%CI:0.792~0.906),敏感性分别为86.3%、84.9%,特异性分别为84.6%、79.1%;二者联合评估FGR的曲线下面积为0.960(95%CI:0.918~0.985),敏感性和特异性分别为87.7%,92.3%。结论:PE合并FGR患者血清ANGPTL4水平升高、LPL水平降低,二者可能通过调节脂代谢对新生儿结局产生不良影响,且对FGR有一定诊断价值。

Objective:To explore the relationship between the expression levels of the serum angiopoietin-like protein 4(ANGPTL4)and lipoprotein lipase(LPL)of pregnant women with preeclampsia(PE)and their fetal growth restriction(FGR).Methods:The clinical data of 164 pregnant women with PE from January 2018 to June 2020 were collected retrospectively.These women were divided into group A(73 women with FGR)and group B(91 women without FGR).The basic data and neonatal outcomes of the women were compared between the two groups.Enzyme-linked immunosorbent assay was used to detect the levels of serum ANGPTL4 and LPL of the women.Pearson method was used to analyze the relationship between the levels of serum ANGPTL4 and LPL of the women and the length and weight of their newborn.The receiver operating characteristic curve(ROC)was used to evaluate the value of serum ANGPTL4 and LPL levels of the women for diagnosing FGR.Results:The serum ANGPTL4 level(22.64±4.17 ng/ml)of the women in group A was significant higher than that(16.37±2.53 ng/ml)of the women in group B,but the LPL level(1.82±0.36μg/L)of the women in group A was significant lower than that(2.30±0.42μg/L)of the women in group B(P<0.05).The birth length and weight of newborns of the women in group A was significant lower than those of the women in group B,but the time of hospital stay of the women in group A was significant longer than that of the women in group B(P<0.05).The serum ANGPTL4 level of the women was negatively correlated with their newborn weight(r=-0.317,P<0.05),but the LPL level of the women was positively correlated with their newborn weight(r=0.347,P<0.05).There was negative correlation between the ANGPTL4 level and the LPL level(r=-0.652,P<0.05),but the levels of ANGPTL4 and LPL of the women had no correlated with their newborn body length(P>0.05).The area under the curve,the sensitivity,and the specificity of the serum ANGPTL4 level of the women for assessing FGR were 0.913(95%CI:0.859-0.951),86.3%,and 84.9%,respectively.The area under the curve,the sensitivity,and the specificity of the serum LPL level of the women for assessing FGR were 0.856(95%CI:0.792-0.906),84.6%,and 79.1%,respectively.The area under the curve,the sensitivity,and the specificity of the combinational serum ANGPTL4 and LPL levels of the women for assessing FGR were 0.960(95%CI:0.918-0.985),87.7%,and 92.3%,respectively.Conclusion:The serum ANGPTL4 level of the women with PE and FGR increases,while their LPL level decreases,and both of which may cause poor neonatal outcomes by regulating lipid metabolism,so they have certain diagnostic value for FGR.