Predictive value of ultrasonic combined with serum levels of TXNIP and Sirt1 for intrauterine hypoxia in fetuses of pregnant women with gestational hypertension
Objective To investigate the predictive value of ultrasound combined with serum thioredoxin-interacting protein(TXNIP)and silent information regulator 1(Sirt1)expression levels in fetuses of pregnant women with hypertensive disorders of pregnancy(HDP)for intrauterine hypoxia.Methods 169 pregnant women with HDP who received treatment in Pinggu District Hospital in Beijing from May 2021 to June 2023 were included in the study.Among them,34 patients with intrauterine hypoxia constituted the intrauterine hypoxia group and the other 125 patients constituted the normal group.The correlation between the expression levels of TXNIP and Sirt1 in serum and resistance index(RI),pulsatility index(PI)and the ratio of systolic peak velocity to end-diastolic velocity(S/D)was evaluated by Pearson correlation analysis.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of ultrasound combined with serum TXNIP and Sirt1 expression levels for intrauterine hypoxia in fetuses of pregnant women with HDP.Results The Apgar score in intrauterine hypoxia group was lower than that in normal group(t=8.961,P<0.001).The values of RI,PI and S/D in intrauterine hypoxia group were significantly higher than those in normal group(t=5.694.6.525 and 7.678,respectively,P<0.001).Significant differences were observed in the expression levels of TXNIP and Sirt1 in serum between the two groups(t=6.061 and 8.161,respectively,P<0.001).The serum TXNIP expression level was positively correlated with RI,PI and S/D values(r=0.553,0.671 and 0.609,respectively,P<0.001),while the serum Sirt1 expression level was negatively correlated with RI,PI and S/D values(r=-0.546,-0.591 and-0.761,respectively,P<0.001).The independent predictive values,as indicated by the area under the curve(AUC),for RI,PI,S/D,and serum TXNIP and Sirt1 in predicting intrauterine hypoxia in fetuses of pregnant women with HDP were 0.790,0.750,0.836,0.768 and 0.873,respectively,and the AUC of combined prediction was 0.964.The combined prediction of ultrasound with serum TXNIP and Sirt1 was better than their individual predictions(Z combination-RI=3.610,Z combination-PI=3.434,Z combination-TXNIP=4.608,P<0.001;Z combination-S/D=2.528,Zcombination-Sirt1=2.514,P=0.011 and 0.012,respectively).Conclusion Ultrasound combined with serum TXNIP and Sirt1 expression has good predictive value for intrauterine hypoxia in fetuses of pregnant women with HDP.
ultrasoundthioredoxin-interacting proteinsilent information regulatory factor 1hypertensive disorders of pregnancyfetal intrauterine hypoxia