International Journal of Reproductive BioMedicine
International Journal of Reproductive BioMedicine
IJRM
Medical Sciences
http://ijrm.ir
1
admin
2476-4108
2476-3772
10.29252/ijrm
en
jalali
1398
4
1
gregorian
2019
7
1
17
7
online
1
fulltext
en
سطح fetuin-A پلاسمای مادر در محدودیت رشد جنین (FGR): یک مطالعه مورد شاهدی
Maternal plasma fetuin-A levels in fetal growth
restriction: A case-control study
Original Article
Original Article
<strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">مقدمه: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">غلظت بالای </span></span><span style="font-size:10.0pt;">(</span><span dir="LTR"><span style="font-size:10.0pt;">Fetuin-A (FA</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> معمولا با چاقی همراه بوده و بین </span></span><span dir="LTR"><span style="font-size:10.0pt;">FA</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">مادر و نتایج بارداری ارتباط وجود دارد.</span></span><br>
<strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> هدف:</span></span></strong> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">هدف ما از انجام این مطالعه، بررسی ارتباط سطح </span></span><span dir="LTR"><span style="font-size:10.0pt;">FA</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">پلاسمای مادر با محدودیت رشد جنین </span></span><span style="font-size:10.0pt;">(</span><span dir="LTR"><span style="font-size:10.0pt;">FGR</span></span><span style="font-size:10.0pt;">)</span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> بود.</span></span><strong><span dir="LTR"><span style="font-size:11.0pt;"></span></span></strong><br>
<strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">موارد و روش­ها: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">41 زن باردار مبتلا به محدودیت رشد جنین و 40 زن باردار سالم به عنوان کنترل در این مطالعه مورد- شاهدی از جولای تا نوامبر 2015 انتخاب شدند. برای تشخیص محدودیت رشد جنین، نمونه خون وریدی </span></span><span style="font-size:11.0pt;">(</span><span dir="LTR"><span style="font-size:10.0pt;">CC</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 10</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) برای تجزیه و تحلیل </span></span><span dir="LTR"><span style="font-size:10.0pt;">FA</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">گرفته شد.</span></span><strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;"></span></span></strong><br>
<strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">سطح </span></span><span dir="LTR"><span style="font-size:10.0pt;">FA</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">پلاسمای مادر در زنان باردار مبتلا به محدودیت رشد جنین در مقایسه با گروه شاهد (001/0 </span></span><span style="font-size:10.0pt;">=</span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">،</span></span><span dir="LTR"><span style="font-size:10.0pt;">ng/ml</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">0/3</span></span><span style="font-size:11.0pt;">±</span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">3/19 در مقابل</span></span><span dir="LTR"><span style="font-size:10.0pt;">ng/ml</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 8/6</span></span><span style="font-size:11.0pt;">±</span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">9/25) به طور قابل توجهی بالاتر بود. سطح زیر منحنی مشخصه عملکرد سیستم </span></span><span dir="LTR"><span style="font-size:10.0pt;">FA</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">در زنان باردار مبتلا به محدودیت رشد جنین 815/0 بود (001/0</span></span><span style="font-size:10.0pt;">></span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">، </span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">95%، 718/0-912/0: </span></span><span dir="LTR"><span style="font-size:10.0pt;">CI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">). سطح </span></span><span dir="LTR"><span style="font-size:10.0pt;">FA</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">مادران با مقادیر بیش از</span></span> <span dir="LTR"><span style="font-size:10.0pt;">ng/ml</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 22/5</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> به ترتیب دارای حساسیت حدود 17/73% (95%، 25/85-79/56 :</span></span><span dir="LTR"><span style="font-size:10.0pt;">CI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">)، ویژگی حدود 5/82% (</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">95%، </span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">11/92-64/66 :</span></span><span dir="LTR"><span style="font-size:10.0pt;">CI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) با مقادیر پیش­بینی مثبت و منفی حدود 08/81% (95%، 45/91-29/64 :</span></span><span dir="LTR"><span style="font-size:10.0pt;">CI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) و 75% (95%، 30/86-35/59 :</span></span><span dir="LTR"><span style="font-size:10.0pt;">CI</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) بود. بنابراین، دقت تشخیصی در حدود 78/77% بدست آمده است.</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"></span></span><br>
<strong><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتیجه ­گیری:</span></span></span></strong> <span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج این مطالعه سطح بالاتری از </span></span></span><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">FA</span></span> <span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">در زنان باردار مبتلا به محدودیت رشد جنین را نشان داد. به منظور نشان دادن اثرات طولانی مدت </span></span></span><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">FA</span></span> <span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">در حاملگی</span></span></span><span style="font-family:times new roman,serif;"><span style="font-size:11.0pt;">­</span></span><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">های پیچیده در زنان باردار مبتلا به محدودیت رشد جنین و پیش</span></span></span><span style="font-family:times new roman,serif;"><span style="font-size:11.0pt;">­</span></span><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">بینی اولیه محدودیت رشد جنین مطالعات بیشتری مورد نیاز است.</span></span></span>
<strong>Background: </strong>Higher Fetuin-A (FA) concentrations were found to be associated with obesity and there is an interest to the relation between maternal FA and pregnancy outcomes.<br>
<strong>Objective:</strong> In this study, our aim was to evaluate the association of maternal plasma levels of FA with fetal growth restriction (FGR).<br>
<strong>Materials and Methods:</strong> 41 pregnant women with FGR and 40 controls were recruited in this case-control study between July and November 2015. At the diagnosis of FGR, venous blood samples (10 cc) were obtained for FA analysis.<br>
<strong>Results: </strong>Maternal plasma FA levels were significantly higher in fetal growth-restricted pregnant women compared with controls (19.3 ± 3.0 ng/ml vs 25.9 ± 6.8 ng/ml, p = 0.001). Area under receiver operating characteristic curve analysis of FA in FGR was 0.815 (95% confidence interval (CI): 0.718-0.912, p < 0.001). The maternal FA levels with values more than 22.5 ng/ml had a sensitivity of about 73.17% (95% CI: 56.79- 85.25) and a specificity of about 82.5% (95% CI: 66.64-92.11) with positive and negative predictive values of about 81.08% (95% CI: 64.29-91.45) and 75% (95% CI: 59.35-86.30), respectively. Therefore, the diagnostic accuracy was obtained about 77.78%.<br>
<strong>Conclusion:</strong> The results of this study show higher maternal plasma levels of FA in FGR. Further studies are needed in order to demonstrate the long-term effects of FA in pregnancies complicated with FGR and early prediction of FFGR.
محدودیت رشد جنین, Fetuin-A, بارداری.
Fetal growth restriction, Fetuin-A, Pregnancy
487
492
http://ijrm.ir/browse.php?a_code=A-10-1-639&slc_lang=en&sid=1
Mujde Can
Ibanoglu