A Study on the Correlation between Preeclampsia and Carbon Metabolism in Dichorionic Diamniotic Twin Pregnancy / 实用妇产科杂志

ABSTRACT

Objective:To explore the correlation between choline,betaine,dimethylglycine,methionine and tri-methylamine oxide,metabolites related to the methionine cycle in carbon metabolism,and preeclampsia(PE)in di-chorionic diamniotic(DCDA)twin pregnancy.Methods:175 pregnant women with twin pregnancies who under-went regular prenatal examinations were registered in Peking University Third Hospital from July 2017 to April 2019 were included as the study subjects.According to whether PE had occurred,they were divided into non-PE group(138 cases)and PE group(37 cases).The fasting peripheral blood of pregnant women during the second trimester of pregnancy was collected,and the metabolites were quantitatively analyzed by ultra-high performance liquid chromatogrey-triple quadrupole tandem mass spectrometry(UHPLC-QqQ MS).The basic characteristics and plasma metabolite concentrations were compared between PE group and non-PE group.Poisson regression was used for plasma metabolite-related PE relative risk(RR)analysis,and receiver operating characteristic(ROC)curve was used to evaluate the accuracy of PE model prediction.Results:①Compared with the non-PE group,the rate of elderly pregnant women was higher,the concentration of betaine was lower,and the concentra-tion of choline was higher in PE group.The differences were statistically significant(P＜0.05).②Poisson regres-sion analysis showed that in the model adjusted for all confounding factors,there was a positive correlation be-tween maternal choline levels and PE risk(RR＞1,P＜0.05).The risk of PE occurrence increased as the in-crease of choline levels(Ptrend＜0.05).Betaine levels were negatively associated with PE risk(RR＜1,P＜0.05).The risk of PE occurrence decreased as the increase of betaine level(Ptrend＜0.05).There was no corre-lation between plasma levels of dimethylglycine,methionine and trimethylamine oxide and the risk of PE.③Pois-son regression analysis showed that the relative risk of PE was lowest when the plasma betaine/choline ratio was highest(RR0.32,95％Cl 0.14-0.75).When the dimethylglycine/betaine ratio was in the thirdpercentile,the risk of PE was increased in pregnant women(RR 2.53,95％Cl 1.01-6.32).(4)ln terms of PE prediction,the AUC combined with general risk factors and methionine metabolites was 0.80.Conclusions:Maternal choline and be-taine levels in the second trimester are related to the occurrence of PE in DCDA twin pregnancy,and provide a new idea for early prediction and intervention of PE.It is still necessary to expand the sample size to further verify and explore the mechanism.