1.Establishment of median for the antepartum screening biomarkers in normal pregnant women
Shaohua TANG ; Yijian MAO ; Shengyong PAN ; Bingle XIE ; Xuemei YANG ; Xuna SHEN ; Xiangyang XU ; Xueping YE
Chinese Journal of Laboratory Medicine 2009;32(3):309-314
Objective To evaluate the differences of α-fetoprotein (AFP), ffeeβ-human chorionic gnnadotropin (HCG) indexes in 3 foreign median databases for antepartum risk screening, and establish the median databases of normal pregnant women in Wenzhou for antepartum screening of AFP, free-β-HCG indexes through the suitable median computational models. Methods The levels of AFP and free β-HCG of 20054 normal pregnant women in Wenzhou were detected by time-resolved fluorometry. The data in this paper were compared with the data of 2T-risk ( 2T), Lifecycle-2. 2 (LC2.2 ) and Lifecycle -3.0 (LC3.0) by double-factor ANOVA. The differences between the data in the paper and the data from Shenyang and Ningbo were analyzed. The median database of Wenzhou pregnant women was established by the suitable regression model, with the stability of nonlinear regression models of the 3 software assessed by model correcting fitting, distribution mean of model fitting logarithmic and standard deviation. Results The levels of AFP and freeβ- hCG reported here were 10% and 16% higher than the data of 2T-risk, 15% and 20% higher than that of LC 2. 2, 6% and 17% higher than that of LC 3.0 respectively. The differences were statistically significant. ( FAFP = 161. 757 ,P < 0. 01 ; Ffree-β-HCG = 58. 261, P < 0.01 ). The levels of AFP and free β- hCG in Wenzhou were 2% higher and 3% lower than that of Shenyang, 1% and 2% higher than that of Ningbo. There was no statistical difference of AFP levels among Wenzhou , Shenyang and Ningbo( FAFP = 0. 174 ,P =0. 840) while the differences of free-β-hCG were statistically significant( F<,free-β-HCG> = 13.303 ,P < 0. 01 ). The differences of quadratic equation regression model, exponent quadratic function regression model and exponent quadru-function regression model of 2T, LC-2. 2 and LC-3.0 were not remarkable. The exponent quadru-function regression model was the best. Conclusions There are significant differences between the data from Wenzhou, Shenyang and Ningbo and the data of T-2 risk, LC-2. 2, LC -3.0. The discrepancy is due to the ethnic and different parameters of regression models. So the model parameters and the median databases are urgently required in China. The differences of large sample size of AFP from Wenzhow, Shengyang and Ningbo are not significant, while the differences of free-β- hCG from Wenzhow, Shengyang and Ningbo is remained because of its instability. The levels from Wenzhow and Ningbo are near. It is suggested that the laboratories with small sample size can establish their own laboratory parameters using the reference obtained from large sample size under the same experimental conditions. There are no significant differences of stability among regression computational models in the 3 software. The exponent quadru-function regression model can be used to establish the median databases for the screening with the similar data distribution in the paper.
2.Association of vitamin D level and vitamin D receptor gene FokI polymorphisms in pregnant women with fetal growth restriction
Zhihui WANG ; Xinxiao CHEN ; Xuna SHEN ; Qinjian YU ; Wenjing BAI ; Huanzheng LI ; Zejiao FENG
Chinese Journal of General Practitioners 2019;18(7):672-675
Serum vitamin D level and vitamin D receptor (VDR) gene FokI polymorphisms were detected in 200 single full-term pregnant women who gave birth in our hospital during 2016 to 2018. The newborns with birth weight<2500 g were diagnosed as fetal growth restriction (FGR), there were 100 cases in FGR group and 100 cases in control group. The average level of vitamin D in pregnant women in FGR group was significantly lower than that of the control group [(30.1±10.9) vs. (36.1±15.8) nmol/L, P<0.05]. In the FGR group, the birth weight of infants in mother carrying ff genotype was significantly lower than that in mother carrying Ff and FF genotypes [(2073±90) g vs. (2242±122) g and (2349±96) g, P<0.05]. Pregnant women carrying Ff and FF genotypes had lower risk of FGR than those of carrying ff genotype (ORFf=0.31, 95% CI: 0.17-0.76; ORFF=0.28, 95%CI: 0.11-0.46). The pregnant women with serum 25(OH)D level>30 nmol/L carrying F allele (FF+Ff) were set as reference, the risk of FGR in pregnant women with serum 25 (OH)D level ≤ 30 nmol/L carrying ff genotype was increased (OR=6.14, 95%CI: 2.13-13.23). The polymorphism of VDR gene FokI may be associated with the occurrence of FGR. In the case of vitamin D deficiency, the influence of ff genotype on FGR is more tangible.
3.Correlation between preeclampsia and abnormal thyroid function in pregnancy
Wenshu CHEN ; Jieli WU ; Sisi ZHAN ; Xuna SHEN
Chinese Journal of Endocrine Surgery 2021;15(3):269-272
Objective:To investigate the correlation between preeclampsia and thyroid dysfunction in pregnancy.Methods:107 early pregnant women with preeclampsia admitted to our hospital from Jan. 2017 to Jan. 2020 were all enrolled (observation group) . The observation group were in 6-34 gestational weeks, with an average parity of (1.67±0.35) times. In addition, 100 cases of normal pregnant women in the same period were selected as the control group. The control group were in 6-34 gestational weeks, with an average parity of (1.61±0.31) times. The two groups were compared at early, mid and late pregnancy in terms of thyroid function, and the correlation of preeclampsia and abnormal thyroid function was analyzed.Results:1. TSH levels in the observation group were (1.92±1.24) , (2.07±0.82) , and (2.30±1.23) mU/L in the first trimester, second trimester and third trimester, respectively, showing an upward trend. The difference between the two groups was statistically significant ( P=0.024) . FT4 levels of the observation group in the first trimester, second trimester and third trimester were (0.80±0.26) , (0.60±0.34) and (0.59±0.32) pmol/L, respectively, showing a decreased trend and the difference was statistically significant compared with those of the control group ( P=0.012) . 2. The incidence of hypothyroidism, TPOAb positive and reduced free tetraiodothyronine in the observation group was significantly higher than that in the control group ( P=0.001, 0.023, 0.005) . There was no significant difference in the incidence of hyperthyroidism or subclinical hypothyroidism between the two groups ( P=0.169, 0.846) . 3. Correlation analysis showed that preeclampsia was related to hypothyroidism, normal thyroid function with TPOAb positive and reduced free tetraiodothyronine ( P=0.000, 0.000, 0.000) . Conclusions:There are changes in thyroid function in pregnant women with preeclampsia. Hypothyroidism, positive TPOAb and reduced free tetraiodothyronine are closely related to the onset of preeclampsia.