JCEM：妊娠相关血浆蛋白A(PAPP-A)预测妊娠期糖尿病(GDM)

2015-04-08 Mechront 译 MedSci原创

孕早期进行B超下胎儿NT值测量时，还会检测孕妇妊娠相关血浆蛋白A(PAPP-A)水平，一同评估胎儿染色体异常的风险。但是妊娠相关血浆蛋白A(PAPP-A)可以预测妊娠期糖尿病(GDM)吗？可以预测2型糖尿病(T2D)吗？可以预测大于胎龄儿(LGA)吗？Wells G 等人进行了一项研究探究该问题。

孕早期进行B超下胎儿NT值测量时，还会检测孕妇妊娠相关血浆蛋白A(PAPP-A)水平，一同评估胎儿染色体异常的风险。但是妊娠相关血浆蛋白A(PAPP-A)可以预测妊娠期糖尿病(GDM)吗？可以预测2型糖尿病(T2D)吗？可以预测大于胎龄儿(LGA)吗？Wells G 等人进行了一项研究探究该问题。

该研究纳入了1664名孕妇，均在10-14周孕当其进行超声下胎儿NT值测量时，检测孕妇妊娠相关血浆蛋白A(PAPP-A)水平。孕妇糖尿病分类为：2型糖尿病(T2D)、＜22周孕时诊断的妊娠期糖尿病(early GDM)、≥22周孕才诊断的妊娠期糖尿病(late GDM)。通过多元回归模型寻找妊娠相关血浆蛋白A(PAPP-A)中位数倍数(MoM)、孕妇糖尿病和大于胎龄儿(LGA)间的联系。

研究结果显示，2型糖尿病(T2D)孕妇组其PAPP-A-MoM明显降低。妊娠期糖尿病(GDM)孕妇中PAPP-A-MoM水平也较没有糖尿病的孕妇低。数据表明，PAPP-A-MoM在T2D组低41.3%，在early GDM组低22.6%，在late GDM组低8.6%。孕妇PAPP-A-MoM位于最低四分位数，较最高四分位数，有2.7倍发展为early GDM的风险(OR 2.74，95%CI 1.2, 6.1)。同时研究结果显示，出生体重与PAPP-A-MoM呈线性正相关。孕妇PAPP-A-MoM位于最高四分位数比最低四分位数有2倍发展为大于胎龄儿(LGA)风险(OR 2.2，95%CI 1.39, 3.46) p=0.0007)。

研究结果表明，孕早期妊娠相关血浆蛋白A(PAPP-A)的常规检测可以作为孕妇糖尿病及大于胎龄儿(LGA)的新奇标志物。孕妇PAPP-A处于低水平，提示孕妇糖尿病风险增加，但是两者之间不具有因果关系。PAPP-A水平低提示妊娠期糖尿病(GDM)风险高，高水平PAPP-A或许可以帮助识别大于胎龄儿(LGA)风险。

原始出处：

Wells G1, Bleicher K, Han X, McShane M, Fun Chan Y, Bartlett A, White C, Mei Lau S.Maternal Diabetes, Large for Gestational Age Births and First Trimester Pregnancy Associated Plasma Protein-A.J Clin Endocrinol Metab. 2015 Mar 31:jc20144103. [Epub ahead of print]

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2015-12-21 cathymary

#PAPP-A#

64 0
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2015-05-14 zhaohui6731

#血浆蛋白#

58 0
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2016-03-10 ms1467340776200723

#PAP#

60 0
[GetPortalCommentsPageByObjectIdResponse(id=1786089, encodeId=55c71e86089a0, content=<a href='/topic/show?id=2edb13e32f4' target=_blank style='color:#2F92EE;'>#PAPP-A#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13732, encryptionId=2edb13e32f4, topicName=PAPP-A)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=226a143, createdName=cathymary, createdTime=Mon Dec 21 02:42:00 CST 2015, time=2015-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1926496, encodeId=4cb2192649696, content=<a href='/topic/show?id=891089221dc' target=_blank style='color:#2F92EE;'>#血浆蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89221, encryptionId=891089221dc, topicName=血浆蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Thu May 14 11:42:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030145, encodeId=dfe22030145df, content=<a href='/topic/show?id=d88913e2636' target=_blank style='color:#2F92EE;'>#PAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13726, encryptionId=d88913e2636, topicName=PAP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=82ba2500166, createdName=ms1467340776200723, createdTime=Thu Mar 10 08:42:00 CST 2016, time=2016-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33116, encodeId=d20c3311688, content=开拓了思路, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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href='/topic/show?id=9d5d44888a9' target=_blank style='color:#2F92EE;'>#妊娠期糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44888, encryptionId=9d5d44888a9, topicName=妊娠期糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=)]
2015-07-19 1dd911abm58(暂无匿称)

开拓了思路

149 0
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topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Mon Jul 06 08:42:00 CST 2015, time=2015-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062890, encodeId=f5c1206289067, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sat Aug 01 23:42:00 CST 2015, time=2015-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20310, encodeId=c86b2031083, content=AKI对心衰临床治疗意义重大，但依然需要研究检验其适用性, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sat Apr 11 22:37:00 CST 2015, time=2015-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250952, encodeId=531c12509524d, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253576, encodeId=3f2312535e681, content=<a 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2015-06-11 ljjj1053

好好学习一下

147 0
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topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Mon Jul 06 08:42:00 CST 2015, time=2015-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062890, encodeId=f5c1206289067, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sat Aug 01 23:42:00 CST 2015, time=2015-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20310, encodeId=c86b2031083, content=AKI对心衰临床治疗意义重大，但依然需要研究检验其适用性, beContent=null, objectType=article, 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href='/topic/show?id=9d5d44888a9' target=_blank style='color:#2F92EE;'>#妊娠期糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44888, encryptionId=9d5d44888a9, topicName=妊娠期糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=)]
2015-07-06 smallant2015

#JCEM#

44 0
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href='/topic/show?id=9d5d44888a9' target=_blank style='color:#2F92EE;'>#妊娠期糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44888, encryptionId=9d5d44888a9, topicName=妊娠期糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=)]
2015-08-01 achengzhao

#JCE#

50 0
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topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Mon Jul 06 08:42:00 CST 2015, time=2015-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062890, encodeId=f5c1206289067, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sat Aug 01 23:42:00 CST 2015, time=2015-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20310, encodeId=c86b2031083, content=AKI对心衰临床治疗意义重大，但依然需要研究检验其适用性, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sat Apr 11 22:37:00 CST 2015, time=2015-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250952, encodeId=531c12509524d, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253576, encodeId=3f2312535e681, content=<a href='/topic/show?id=9d5d44888a9' target=_blank style='color:#2F92EE;'>#妊娠期糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44888, encryptionId=9d5d44888a9, topicName=妊娠期糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=)]
2015-04-11 x35042875

AKI对心衰临床治疗意义重大，但依然需要研究检验其适用性

105 0
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createdName=zhaohui6731, createdTime=Thu May 14 11:42:00 CST 2015, time=2015-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030145, encodeId=dfe22030145df, content=<a href='/topic/show?id=d88913e2636' target=_blank style='color:#2F92EE;'>#PAP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13726, encryptionId=d88913e2636, topicName=PAP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=82ba2500166, createdName=ms1467340776200723, createdTime=Thu Mar 10 08:42:00 CST 2016, time=2016-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33116, encodeId=d20c3311688, content=开拓了思路, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Mon Jul 06 08:42:00 CST 2015, time=2015-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2062890, encodeId=f5c1206289067, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Sat Aug 01 23:42:00 CST 2015, time=2015-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20310, encodeId=c86b2031083, content=AKI对心衰临床治疗意义重大，但依然需要研究检验其适用性, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sat Apr 11 22:37:00 CST 2015, time=2015-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250952, encodeId=531c12509524d, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253576, encodeId=3f2312535e681, content=<a href='/topic/show?id=9d5d44888a9' target=_blank style='color:#2F92EE;'>#妊娠期糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44888, encryptionId=9d5d44888a9, topicName=妊娠期糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=)]
2015-04-10 wjcjjian

#妊娠期#

54 0
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channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sat Apr 11 22:37:00 CST 2015, time=2015-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250952, encodeId=531c12509524d, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253576, encodeId=3f2312535e681, content=<a href='/topic/show?id=9d5d44888a9' target=_blank style='color:#2F92EE;'>#妊娠期糖尿病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44888, encryptionId=9d5d44888a9, topicName=妊娠期糖尿病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Fri Apr 10 12:42:00 CST 2015, time=2015-04-10, status=1, ipAttribution=)]
2015-04-10 shenxlcyp

#妊娠期糖尿病#

60 0

内科

外科

专科科室

热点

按科室浏览

临床工具

科研工具

其他工具

科研数智化

真实世界研究解决方案

数字化学术传播解决方案

其它

内分泌科

JCEM：妊娠相关血浆蛋白A(PAPP-A)预测妊娠期糖尿病(GDM)

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