-
摘要:
目的 了解孕妇血铜(copper, Cu)水平及其与子痫前期的关系，探讨孕妇血Cu对子痫前期的影响。 方法 以山西医科大学第一医院产科分娩的427例子痫前期孕妇为病例组，按成组匹配的方法随机选取427例非妊娠期高血压疾病孕妇作为对照组。采用面对面调查和病历查阅的方式收集孕妇人口学特征、生育史、妊娠及健康状况、行为生活方式、高血压家族史和新生儿出生情况等资料，采用电感耦合等离子体质谱法(inductively coupled plasma mass spectrometry, ICP-MS)测定血Cu水平。 结果 子痫前期组和对照组血Cu中位数和四分位数分别为1.31(1.07，1.60)mg/L和1.31(1.06，1.56)mg/L(Z=0.41，P=0.685)。早发子痫前期与晚发子痫前期孕妇血Cu中位数和四分位数分别为1.25(1.04，1.56)mg/L和1.34(1.08，1.61)mg/L(Z=1.78，P=0.075)，子痫前期组与对照组及不同临床亚型子痫前期组孕妇血Cu水平差异均无统计学意义(均有P＞0.05)。Logistic回归分析模型分析结果显示，控制了文化程度、经济收入、孕前体重指数(body mass index, BMI)、孕期增重、产次、妊娠期糖尿病、高血压家族史和其他元素等后，未发现孕妇血Cu与子痫前期、早发子痫前期和晚发子痫前期的发生有关。 结论 尚不能认为孕妇血Cu水平与子痫前期及其亚型的发生有关。 Abstract:Objective To investigate the level of copper (Cu) in pregnant women with preeclampsia and normotensive pregnant women, and their relationship with risk of preeclampsia. Methods A frequency matching case-control study was performed among the pregnant women who gave birth between March 2012 and September 2016 in the First Hospital of Shanxi Medical University. A total of 427 pregnant women with preeclampsia were as cases. 427 normotensive pregnant women matched for date of conception, residence, and age were randomly selected as controls. Demographic characteristics, childbearing history, pregnancy and health condition, behavior and lifestyle, family history of hypertension, and newborn birth condition were collected by face to face investigation and medical records review. Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine levels of copper, manganese, zinc, and selenium in the maternal blood. Results The distribution of maternal blood copper was skewed, and the median and inter-quartile range of copper concentration in the preeclampsia and control group were 1.31(1.07, 1.60) mg/L and 1.31(1.06, 1.56) mg/L (Z=0.41, P=0.685). The median and quartile values of blood Cu in pregnant women with early and late preeclampsia were 1.25 (1.04, 1.56) mg/L and 1.34 (1.08, 1.61) mg/L (Z=1.78, P=0.075), respectively. There were no significant differences in blood Cu levels between the preeclampsia group, the control group and the pre-eclampsia group with different clinical subtypes (all P > 0.05). The results of Logistic regression analysis model showed that after the control of the level of education, income, pre-pegant body mass index, pregnancy weight gain, parity, gestational diabetes, family history of high blood pressure, and other elements, such as pregnant women were not found in the blood Cu with preeclampsia, early onset preeclampsia, and later in the pathogenesis of preeclampsia. Conclusions It can not be considered that maternal blood copper is related with preeclampsia and its subtypes. -
Key words:
- Preeclampsia /
- Copper /
- Pregnant women /
- Case-control study
-
表 1 子痫前期与非妊娠期高血压疾病孕妇一般情况比较[n(%)]
Table 1. Characteristics comparison between preeclampsia and normotensive pregnant women [n(%)]
变量 合计(n=854) 子痫前期(n=427) 对照(n=427) χ2值 P值 孕妇年龄(岁) 0.01 0.995 ＜25 147(17.21) 74(17.33) 73(17.09) 25~ 327(38.29) 163(38.17) 164(38.41) 30~ 380(44.50) 190(44.50) 190(44.50) 居住地 0.04 0.837 太原本地 469(54.92) 233 (54.57) 236(55.27) 外地 385(45.08) 194 (45.43) 191(44.73) 文化程度 18.29 ＜0.001 初中及以下 278(32.55) 159 (37.24) 119(27.87) 高中/大中专 308(36.07) 162 (37.94) 146(34.19) 大学及以上 268(31.38) 106 (24.82) 162(37.94) 家庭人均月收入(元) 4.27 0.118 ＜2000 206(24.12) 113(26.46) 93(21.78) 2 000~ 493(57.73) 246 (57.61) 247(57.85) 4 000~ 155(18.15) 68 (15.93) 87(20.37) 孕前BMI(kg/m2) 48.25 ＜0.001 ＜18.5 110(12.88) 37 (8.66) 73(17.09) 18.5~ 524(61.36) 238 (55.74) 286(66.98) 24~ 220(25.76) 152 (35.60) 68(15.93) 孕期增重 28.68 ＜0.001 不足 148(16.59) 56(12.56) 92(20.63) 适宜 321(35.99) 136(30.49) 185(41.48) 过多 423(47.42) 254(56.95) 169(37.89) 孕期被动吸烟 0.55 0.457 否 716(83.84) 354 (82.91) 362(84.78) 是 138(16.16) 73 (17.09) 65(15.22) 体育活动(小时/周) 3.84 0.146 ＜7 298(34.90) 150 (35.13) 148(34.66) 7~ 288(33.72) 155 (36.30) 133(31.15) 10~ 268(31.38) 122 (28.57) 146(34.19) 产次 2.21 0.137 初产 594(69.56) 307 (71.90) 287(67.21) 经产 260(30.44) 120 (28.10) 140(32.79) 妊娠期糖尿病 11.53 ＜0.001 无 738(86.42) 352 (82.44) 386(90.40) 有 116(13.58) 75 (17.56) 41(9.60) 高血压家族史 12.55 ＜0.001 无 698(81.73) 329 (77.05) 369(86.42) 有 156(18.27) 98 (22.95) 58(13.58) 怀孕月份(月) 4.27 0.234 3~5 166(19.44) 92 (21.55) 74(17.33) 6~8 227(26.58) 103 (24.12) 124 (29.04) 9~11 252(29.51) 130 (30.44) 122(28.57) 12~2 209(24.47) 102 (23.89) 107(25.06) 孕周(周) 134.92 ＜0.001 ≥37 636(74.47) 244(57.14) 392(91.80) ＜37 218(25.53) 183(42.86) 35(8.20) 胎儿性别 0.23 0.631 女 397(46.49) 202 (47.31) 195(45.67) 男 457(53.51) 225 (52.69) 232(54.33) 
下载: 导出CSV
表 2 痫前期孕妇与对照组孕妇血Cu水平(mg/L)
Table 2. Maternal blood Cu level in preeclampsia and normotensive pregnant women (mg/L)
分组 例数(n) 血Cu水平(mg/L) Z值a P值 对照组 427 1.31(1.06，1.56) 0.41 0.685 子痫前期组 427 1.31(1.07，1.60) 发病时间分组 早发子痫前期 183 1.25(1.04，1.56) 1.78 0.075 晚发子痫前期 244 1.34(1.08，1.61) 合计 854 1.31(1.06，1.58) 注：a表示采用秩和检验。
下载: 导出CSV
表 3 孕妇血Cu与子痫前期及其亚型发生风险的Logistic回归分析模型分析结果
Table 3. Analysis results between maternal blood Cu level and preeclampsia, early-onset preeclampsia, and late-onset preeclampsia in Logistic regression analysis models
分组 对照[n(%)] 病例[n(%)] OR (95% CI)值a OR (95% CI)值b OR (95% CI)值c 子痫前期 Ln-Cu 427 427 1.02(0.67, 1.55) 0.90(0.57, 1.42) 0.97(0.57, 1.63) T1(＜1.148) 142(33.26) 141(33.02) 1.00 1.00 1.00 T2(1.148~) 143(33.48) 139(32.55) 0.98(0.70, 1.36) 0.93(0.65, 1.32) 0.91(0.63, 1.30) T3(≥1.486) 142(33.26) 147(34.43) 1.04(0.75, 1.45) 0.93(0.65, 1.32) 0.91(0.63, 1.33) 发病时间分组 早发子痫前期 Ln-Cu 427 183 0.72(0.42, 1.23) 0.65(0.36, 1.16) 0.55(0.28, 1.08) T1(＜1.148) 142(33.26) 67(36.61) 1.00 1.00 1.00 T2(1.148~) 143(33.48) 57(31.15) 0.85(0.55, 1.29) 0.80(0.51, 1.26) 0.76(0.47, 1.21) T3(≥1.486) 142(33.26) 59(32.24) 0.88(0.58, 1.34) 0.78(0.49, 1.23) 0.72(0.44, 1.16) 晚发子痫前期 Ln-Cu 427 244 1.35(0.81, 2.27) 1.19(0.68, 2.09) 1.44(0.77, 2.72) T1(＜1.148) 142(33.26) 74(30.33) 1.00 1.00 1.00 T2(1.148~) 143(33.48) 82(33.61) 1.10(0.75, 1.63) 1.00(0.66, 1.52) 0.97(0.63, 1.49) T3(≥1.486) 142(33.26) 88(36.06) 1.19(0.81, 1.75) 1.08(0.71, 1.64) 1.08(0.69, 1.68) 注：a表示未控制混杂因素；b控制了文化程度、经济收入、孕前BMI、被动吸烟、体育锻炼、孕期增重、产次、妊娠期糖尿病、高血压家族史；c控制了文化程度、经济收入、孕前BMI、被动吸烟、体育锻炼、孕期增重、产次、妊娠期糖尿病、高血压家族史和血硒、锰、锌。
下载: 导出CSV
-
[1] Mol BWJ, Roberts CT, Thangaratinam S, et al. Pre-eclampsia[J]. Lancet, 2016, 387(10022): 999-1011. DOI: 10.1016/S0140-6736(15)00070-7. [2] Brown MA, Magee LA, Kenny LC, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice[J]. Hypertension, 2018, 72(1):24-43. DOI: 10.1161/HYPERTENSIONAHA.117.10803. [3] Phipps E, Prasanna D, Brima W, et al. Preeclampsia: updates in pathogenesis, definitions, and guidelines[J]. Clin J Am Soc Nephrol, 2016, 11(6):1102-1113. DOI: 10.2215/CJN.12081115. [4] 孙长颢.营养与食品卫生学[M].第8版.北京:人民卫生出版社, 2017:78-79.Sun JH. Nutrition and Food Hygiene[M]. Edition 8. Beijing: People's Medical Publishing House, 2017:78-79. [5] Hellman NE, Gitlin JD. Ceruloplasmin metabolism and function[J]. Annu Rev Nutr, 2002, 22:439-458. DOI: 10.1146/annurev.nutr.22.012502.114457. [6] Song X, Li B, Li Z, et al. High serum copper level is associated with an increased risk of preeclampsia in Asians: a meta-analysis[J]. Nutr Res, 2017, 39:14-24. DOI: 10.1016/j.nutres.2017.01.004. [7] Keshavarz P, Nobakht M, Mirhafez SR, et al. Alterations in lipid profile, zinc and copper levels and superoxide dismutase activities in normal pregnancy and preeclampsia[J]. Am J Med Sci, 2017, 353(6):552-558. DOI: 10.1016/j.amjms.2017.03.022. [8] Elmugabil A, Hamdan HZ, Elsheikh AE, et al. Serum calcium, magnesium, zinc and copper levels in sudanese women with preeclampsia[J]. PLoS One, 2016, 11(12):e0167495. DOI: 10.1371/journal.pone.0167495. [9] 彭婷婷, 岳福娟, 王芳, 等.孕前体重指数及孕期增重与小于胎龄儿的关系[J].中华流行病学杂志, 2015, 36(6):644-648. DOI: 10.3760/cma.j.issn.0254-6450.2015.06.023.Peng TT, Yue FJ, Wang F, et al. Relationship between pre-pregnant body mass index, maternal weight gain and small for gestational age[J]. Chin J Epidemiol, 2015, 36(6): 644-648. DOI: 10.3760/cma.j.issn.0254-6450.2015.06.023. [10] Mistry HD, Gill CA, Kurlak LO, et al. Association between maternal micronutrient status, oxidative stress, and common genetic variants in antioxidant enzymes at 15 weeks gestation in nulliparous women who subsequently develop preeclampsia[J]. Free Radic Biol Med, 2015, 78:147-155. DOI: 10.1016/j.freeradbiomed.2014.10.580. [11] 梁春梅.孕妇血清和脐血清中铜、硒水平对0~24月龄婴幼儿BMI发育水平影响的出生队列研究[D].合肥: 安徽医科大学, 2018.Liang CM. The effects of maternal and umbilical cord serum copper and selenium levels on the BMI developmental levels among infants with 0 month to 24 months old: a birth cohort study[D]. Hefei: Anhui Medical University, 2018. [12] Liu X, Piao J, Zhang Y, et al. Serum copper status in school-age children and pregnant women in china nutrition and health survey 2010-2012[J]. Biol Trace Elem Res, 2016, 173(2): 268-274. DOI: 10.1007/s12011-016-0639-x. [13] Fan Y, Kang Y, Zhang M. A meta-analysis of copper level and risk of preeclampsia: evidence from 12 publications[J]. Biosci Rep, 2016, 36(4): e00370. DOI: 10.1042/BSR20160197. [14] Sak S, Barut M, Celik H, et al. Copper and ceruloplasmin levels are closely related to the severity of preeclampsia[J]. J Matern Fetal Neonatal Med, 2020, 33 (1):96-102. DOI: 10.1080/14767058.2018.1487934. [15] Maduray K, Moodley J, Soobramoney C, et al. Elemental analysis of serum and hair from pre-eclamptic south African women[J]. J Trace Elem Med Biol, 2017, 43:180-186. DOI: 10.1016/j.jtemb.2017.03.004. [16] Sarwar MS, Ahmed S, Ullah MS, et al. Comparative study of serum zinc, copper, manganese, and iron in preeclamptic pregnant women[J]. Biol Trace Elem Res, 2013, 154(1): 14-20. DOI: 10.1007/s12011-013-9721-9. [17] 冯晶瑾, 王玉贤.血清微量元素在早发型重度子痫前期中的测定及临床意义[J].中国优生与遗传杂志, 2013, 21(5): 82-84. DOI: 10.13404/j.cnki.cjbhh.2013.05.044.Feng JJ, Wang YX. The measurement and clinical significance of serum trace elements in early-onset severe preeclampsia[J]. Chinese Journal of Birth Health & Heredity, 2013, 21(5): 82-84. DOI: 10.13404/j.cnki.cjbhh.2013.05.044. [18] Choi R, Sun J, Yoo H, et al. A prospective study of serum trace elements in healthy korean pregnant women[J]. Nutrients, 2016, 8(11):749. DOI: 10.3390/nu8110749. [19] Kashanian M, Hadizadeh H, Faghankhani M, et al. Evaluating the effects of copper supplement during pregnancy on premature rupture of membranes and pregnancy outcome[J]. J Matern Fetal Neonatal Med, 2018, 31(1): 39-46. DOI: 10.1080/14767058.2016.1274299. -
- 中国精品科技期刊
- 《中文核心期刊要目总览》收录期刊
- RCCSE 中国核心期刊(5/114,A+)
- Scopus收录期刊
- 美国《化学文摘》(CA)收录期刊
- WHO 西太平洋地区医学索引(WPRIM)收录期刊
- 《中国科学引文数据库(CSCD)》核心库期刊 (C)
- 中国科技核心期刊
- 中国科技论文统计源期刊
- 《日本科学技术振兴机构数据库(中国)》(JSTChina)收录期刊
- 美国《乌利希期刊指南》(UIrichsweb)收录期刊
- 中华预防医学会系列杂志优秀期刊(2019年)
留言板
尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!
| 姓名 | |
|---|---|
| 邮箱 | |
| 手机号码 | |
| 标题 | |
| |
