孕妇血清8-羟基脱氧鸟苷水平与妊娠期高血压疾病的关联

The association between serum 8-hydroxy-2′-deoxyguanosine exposure and hypertensive disorders of pregnancy

目的本研究旨在探讨孕妇孕期血清8-羟基脱氧鸟苷(8-OHdG)水平与妊娠期高血压疾病(HDP)发病的关联。方法本巢式病例对照研究基于北京市海淀区妇幼保健院开展的孕产妇队列,最终纳入150名HDP病例及490名健康对照。此队列于2017年10月至2018年10月募集孕妇,在基线产检期间通过结构性问卷面对面收集孕妇的一般人口学特征和生活方式等信息,产检期间保留检验科的剩余血样。使用ELISA试剂盒检测孕妇血清的8-OHdG浓度,HDP的诊断标准为妊娠20周后首次出现高血压。采用Logistic回归分析孕妇血清8-OHdG水平与HDP发生风险间的关联,计算比值比(OR)及95%置信区间(CI),进一步探索血清8-OHdG与HDP间的剂量-效应关系及孕前体质指数(BMI)与血清8-OHdG对HDP发病的潜在交互作用。结果本研究中孕妇血清8-OHdG的检出率为93.59%,中位数浓度为28.98 ng/mL。Logistic回归结果显示,血清8-OHdG高暴露对HDP具有显著的保护作用。将血清8-OHdG按照其四分位数浓度进行四分类计算时,8-OHdG高暴露组(Q4)HDP的发生风险是低暴露组(Q1)的0.42倍(95%CI:0.22,0.78),且二者存在显著的剂量-效应关系(线性趋势检验P=0.001)。仅在孕前BMI≥24 kg/m 2的孕妇中8-OHdG高暴露可显著降低HDP的发生风险,孕前BMI与血清8-OHdG对HDP发病存在显著的交互作用(P=0.012)。结论孕妇孕期血清8-OHdG暴露可降低HDP发病风险,孕前BMI可修饰二者的关联。

Objective This study aims to investigate the association between 8-hydroxydeoxyguanosine(8-OHdG)in serum and the incidence of hypertensive disorders of pregnancy(HDP).Methods This nested case-control study was based on a cohort of pregnant women at the Haidian Maternal and Child Health Hospital in Beijing.The cohort recruited pregnant women from October 2017 to October 2018.The study ultimately included 150 HDP cases and 490 healthy controls.General demographic characteristics and lifestyle information were collected through structured face-to-face questionnaires during baseline prenatal visits,and leftover blood samples were retained from laboratory tests.The concentration of 8-OHdG in the serum of pregnant women was measured using an ELISA kit.HDP was diagnosed based on the first occurrence of hypertension after 20 weeks of pregnancy.Logistic regression was used to analyze the association between serum 8-OHdG and the risk of HDP,calculating the odds ratio(OR)and 95%confidence interval(CI).Further exploration of the dose-response relationship between serum 8-OHdG and HDP,as well as the potential interaction between pre-pregnancy body mass index(BMI)and serum 8-OHdG on the incidence of HDP,was conducted.Results In this study,the detection rate of serum 8-OHdG in pregnant women was 93.59%,with a median concentration of 28.98 ng/mL.Logistic regression results showed that high exposure to serum 8-OHdG had a significant protective effect against HDP.When serum 8-OHdG was divided into quartiles,the risk of HDP in the high exposure group(Q4)was 0.42 times that of the low exposure group(Q1)(95%CI:0.22,0.78),and there was a significant dose-response relationship(linear trend test P=0.001).High exposure to 8-OHdG significantly reduced the risk of HDP only in pregnant women with a pre-pregnancy BMI≥24 kg/m 2,and there was a significant interaction between pre-pregnancy BMI and serum 8-OHdG on the incidence of HDP(P=0.012).Conclusion Exposure to serum 8-OHdG during pregnancy can reduce the risk of HDP,and pre-pregnancy BMI can modify this association.