Wallenstein Matthew B, Jelliffe-Pawlowski Laura L, Yang Wei, Carmichael Suzan L, Stevenson David K, Ryckman Kelli K, Shaw Gary M
a Division of Neonatal and Developmental Medicine , Department of Pediatrics, Stanford University School of Medicine , Palo Alto , CA , USA .
b Department of Epidemiology & Biostatistics , UCSF Preterm Birth Initiative, University of California San Francisco School of Medicine , San Francisco , CA , USA , and.
J Matern Fetal Neonatal Med. 2016 Oct;29(20):3317-22. doi: 10.3109/14767058.2015.1124083. Epub 2015 Dec 23.
To identify associations between second-trimester serum inflammatory biomarkers and preterm birth among obese women.
In this nested case-control study, we compared 65 serum inflammatory biomarkers in obese women whose pregnancies resulted in early spontaneous preterm birth (<32 weeks gestation, n = 34) to obese women whose pregnancies resulted in term birth (n = 34). These women were selected from a larger population-based California cohort. Random forest and classification and regression tree techniques were employed to identify biomarkers of importance, and adjusted odds ratios (aORs) and 95% confidence intervals (CI) were estimated using logistic regression.
Random forest and classification and regression tree techniques found that soluble vascular endothelial growth factor receptor-3 (sVEGFR3), soluble interleukin-2 receptor alpha-chain (sIL-2RA) and soluble tumor necrosis factor receptor-1 (sTNFR1) were related to preterm birth. Using multivariable logistic regression to compare preterm cases and term controls, decreased serum levels of sVEGFR3 and increased serum levels of sIL-2RA and sTNFR1 were associated with increased risk of preterm birth among obese women, aOR = 3.2 (95% CI: 1.0-9.9), aOR = 2.8 (95% CI: 0.9-9.0), and aOR = 4.1 (95% CI: 1.2-14.1), respectively.
In this pilot study, we identified three serum biomarkers indicative of inflammation to be associated with spontaneous preterm birth among obese women: sVEGFR3, sIL-2RA and sTNFR1.
确定肥胖女性孕中期血清炎症生物标志物与早产之间的关联。
在这项巢式病例对照研究中,我们比较了妊娠导致早期自然早产(妊娠<32周,n = 34)的肥胖女性与妊娠足月分娩的肥胖女性(n = 34)的65种血清炎症生物标志物。这些女性选自加利福尼亚州一个更大的基于人群的队列。采用随机森林以及分类与回归树技术来确定重要的生物标志物,并使用逻辑回归估计调整后的优势比(aOR)和95%置信区间(CI)。
随机森林以及分类与回归树技术发现,可溶性血管内皮生长因子受体-3(sVEGFR3)、可溶性白细胞介素-2受体α链(sIL-2RA)和可溶性肿瘤坏死因子受体-1(sTNFR1)与早产有关。使用多变量逻辑回归比较早产病例和足月对照,肥胖女性中sVEGFR3血清水平降低以及sIL-2RA和sTNFR1血清水平升高与早产风险增加相关,aOR分别为3.2(95%CI:1.0 - 9.9)、aOR为2.8(95%CI:0.9 - 9.0)以及aOR为4.1(95%CI:1.2 - 14.1)。
在这项初步研究中,我们确定了三种指示炎症的血清生物标志物与肥胖女性自然早产有关:sVEGFR3、sIL-2RA和sTNFR1。