目的 探讨微小RNA-370-3p(miR-370-3p)和低密度脂蛋白受体相关蛋白6(LRP6)对胎儿生长受限(FGR)孕妇的临床诊断价值.方法 选取2020年6月-2022年6月期间产检并确诊为FGR的孕妇96例为观察组,另选取同期产检的健康孕妇96例作为对照组,记录两组分娩孕周、1 min Apgar评分、5 min Apgar评分、新生儿体重、胎盘质量,依据美国妇产科学院(ACOG)标准将观察组划分为FGR组、严重FGR组.qRT-PCR法检测血清miR-370-3p和LRP6 mRNA表达水平;血清miR-370-3p和LRP6 mRNA水平与分娩孕周、1 min Apgar评分、5 min Apgar评分、新生儿体重、胎盘质量的相关性采用Pearson法分析;miR-370-3p和LRP6 mRNA对FGR的诊断价值采用ROC曲线评估.结果 两组孕妇年龄、分娩孕周、是否初产的比例差异有统计学意义(P＜0.05);观察组miR-370-3p显著高于对照组,LRP6显著低于对照组(P＜0.05);严重FGR组miR-370-3p显著高于FGR组,LRP6显著低于FGR组(P＜0.05);对照组与观察组新生儿体重、1 min Apgar评分、5 min Apgar评分及胎盘质量之间差异有统计学意义(P＜0.05);miR-370-3p 与 LRP6 之间呈负相关(r=-0.692,P＜0.05),miR-370-3p 与分娩孕周、新生儿体重、1 min Apgar评分、5 min Apgar 评分、胎盘质量均呈负相关(r=-0.401、-0.382、-0.425、-0.484、-0.504,均 P＜0.05),LRP6 与分娩孕周、新生儿体重、1 min Apgar评分、5 min Apgar评分、胎盘质量均呈正相关(r=0.306、0.412、0.512、0.612、0.419,均 P＜0.05);ROC 曲线显示,miR-370-3p 对 FGR 诊断的 AUC 为 0.877(95％CI:0.821～0.919),截断值为1.40,其敏感度、特异性分别为 67.71％、93.75％;LRP6 对 FGR 诊断的 AUC 为 0.838(95％CI:0.778～0.887),截断值为0.83,其敏感度、特异性分别为84.37％、71.87％;二者联合对FGR诊断的AUC为0.923(95％CI:0.875～0.956),明显高于二者单独诊断(Z联合vs miR-370-3P=2.811、P=0.005;Z联合vs LRP6=3.372、P=0.001),其敏感度、特异性分别为85.42％、87.50％.结论 FGR患者血清miR-370-3p高表达、LRP6低表达,二者联合对FGR具有一定诊断价值.
Clinical diagnostic value of miR-370-3p and LRP6 in pregnant women with fetal growth restriction
Objective To explore the clinical diagnostic value of microRNA-370-3p(miR-370-3p)and low density lipo-protein receptor-related protein 6(LRP6)in pregnant women with fetal growth restriction(FGR).Methods From June 2020 to June 2022,96 pregnant women who were diagnosed as FGR in our hospital were selected as observation group,and 96 healthy pregnant women examined in our hospital were selected as control group.And then,the gestational weeks of deliv-ery,1 min Apgar score,5 min Apgar score,newborn weight and placental quality of the two groups were recorded.Accord-ing to the standards of the American College of Obstetrics and Gynecology(ACOG),the observation group were divided into FGR group and severe FGR group.The expression levels of serum miR-370-3p and LRP6 mRNA were detected by qRT-PCR;the correlation between serum miR-370-3p and LRP6 mRNA levels and gestational weeks of delivery,1 min Apgar score,5 min Apgar score,newborn weight and placental quality was analyzed by Pearson method;and the diagnostic value of miR-370-3p and LRP6 mRNA for FGR was evaluated by ROC curve.Results There was statistically significant difference in the proportion of age,gestational weeks of delivery,and whether or not the first delivery between the two groups(P＜0.05);the miR-370-3p of the observation group was obviously higher than that of the control group,and LRP6 was obvious-ly lower than that of the control group(P＜0.05);the miR-370-3p of the severe FGR group was obviously higher than that of the FGR group,and the LRP6 was obviously lower than that of the FGR group(P＜0.05);there was statistically significant difference in terms of newborn weight,1 minute Apgar score,5 minute Apgar score,and placental quality between the con-trol group and the observation group(P＜0.05);there was negative correlation between miR-370-3p and LRP6(r=-0.692,P＜0.05),the miR-370-3p was negatively associated with gestational weeks of delivery,newborn weight,1 min Apgar score,5 min Apgar score,and placental quality(r=-0.401,-0.382,-0.425,-0.484,-0.504,all P＜0.05),the LRP 6 was positively correlated with gestational weeks of delivery,neonatal weight,1 min Apgar score,5 min Apgar score,and placen-tal quality(r=0.306,0.412,0.512,0.612,and 0.419,allP＜0.05);the ROC curve showed that the AUC of miR-370-3p for FGR diagnosis was 0.877(95％CI:0.821-0.919)with a cutoff value of 1.40,and its sensitivity and specificity were 67.71％and 93.75％,respectively;the AUC of LRP6 for FGR diagnosis was 0.838(95％CI:0.778-0.887),with a cutoff value of 0.83,and its sensitivity and specificity were 84.37％and 71.87％,respectively;and the AUC of FGR di-agnosis by the combination of the two was 0.923(95％CI:0.875-0.956),which was obviously higher than that diagnosis by each of the two alone(Zcombination vs miR-370-3P=2.811,P=0.005;Zcombination vs LRP6=3.372,P=0.001),and its sensitivity and specificity were 85.42％and 87.50％,respectively.Conclusion Serum miR-370-3p is highly expressed and LRP6 is lowly expressed in FGR patients,the combination of the two has certain diagnostic value for FGR.
microRNA-370-3plow density lipoprotein receptor-related protein 6(LRP6)fetal growth restrictiondiagnosis
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