患有阻塞性睡眠呼吸暂停的高风险孕妇中的内甲素-1系统
Samantha Shirk1, Melissa L Kozakiewicz1, Kristin N Sheehan2
1Maternal Fetal Medicine Division, Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.
在肥胖的孕妇患者中,阻塞性睡眠呼吸暂停 (OSA) 与显著升高的内甲蛋白-1的更高率有关. 较低的妊娠前BMI与增加的内甲素-1水平有关,这表明了复杂的相互作用.
科学领域:
- 产科和妇科 产科和妇科
- 睡眠医学 睡眠医学
- 心血管生理学心血管生理学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与妊娠期高血压有关.
- 升高的内甲素-1 (ET-1) 与妊娠性高血压的发病有关.
- 怀孕期间ET-1和OSA之间的关系尚不清楚.
研究的目的:
- 在肥胖的孕妇患者中调查阻塞性睡眠呼吸暂停和内甲素-1水平之间的关联.
- 探索ET-1在OSA并发症怀孕中的作用.
主要方法:
- 60名肥胖孕妇的前性队列研究.
- 对30名患有OSA和30名没有OSA的患者进行比较.
- 使用西部斑块,qPCR,免疫组织化学和ELISA测量血和胎盘ET-1.
- 多变量分析调整身体质量指数 (BMI).
主要成果:
- 在OSA和非OSA组之间,整体ET-1蛋白或mRNA表达没有显著差异.
- 在OSA组显著升高ET-1 (>第90百分位) 的比率增加了6倍 (aOR 5.9).
- 较低的怀孕前BMI (<32 kg/m2) 与ET-1升高相关;3类肥胖症对ET-1升高产生保护作用.
结论:
- 阻塞性睡眠呼吸暂停与高风险孕妇显著增加内甲素-1血水平的风险增加有关.
- 在肥胖的孕妇患者中,较低的妊娠前BMI与更高的ET-1水平有关.
- 目前的OSA查可能低估了这一群体的风险.
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