| BackgroundPreeclampsia(PE)is a common complication occurring in the middle and third trimester of pregnancy and also one of the main causes of increasing maternal and perinatal mortality,posing a great threat to the life and health of mothers and infants.In recent years,more and more scholars at home and abroad believe that PE is a kind of excessive inflammatory response that causes extensive vascular endothelial cell injury.Body mass index(BMI)is a common index used by The World Health Organization to measure the degree of obesity and health status of the body.The pathological changes such as glucose and lipid metabolism disorder,insulin resistance and inflammatory response caused by the excessive BMI are also the pathological changes that promote the occurrence and development of PE.A large number of studies have confirmed that high pre-pregnancy BMI and excessive increase of gestational weight gain are risk factors for PE.Tumor necrosis factor-α(TNF-α)mainly involves in the body’s immune inflammatory response process,and it is an important inflammatory mediator and imunomodulatory factor,and also is a common biochemical indicator to measure the inflammatory state of the body.Studies have confirmed that TNF-α is one of the marker factors to measure the excessive inflammatory injury of PE vascular endothelial cells,and highly expressed in serum of PE patients.As a newly discovered adipocytokine closely related to metabolic syndrome,chemerin involves the regulation of adipose tissue differentiation,insulin resistance and inflammatory response,and is closely related to metabolic diseases,such as hypertension,obesity and diabetes.Studies have found that chemerin stimulates chemokines,promotes the release of TNF-α dominated inflammatory factors,and aggravates the inflammatory response,and the inflammatory factor TNF-α can also promotes the gene expression and protein secretion of chemerin in fat cells,the positive feedback effect between them magnifies the inflammation response and aggravats the inflammatory damage of body.Adipose tissue has a strong endocrine function,which can secrete multiple adipose factors to regulates the whole tissue and organs.BMI can be used to measure the body fat content to some extent,the higher the BMI,the more fat content,and the secretion of adipokine significantly increases.Most of PE patients had a high pre-pregnancy weight,and the increase of the fat tissue is mostly obviouse during pregnancy.Therefore,it can be speculated that chemerin may be involved in the inflammatory injury process of vascular endothelium of PE,and the secretion of chemerin and TNF-α may be related to the pre-pregnancy BMI and gestational weight gain.ObjectiveThe purpose of this study was to investigate the expression of chemerin and TNF-α in serum of PE patients with different BMI and analyze their significances.Materials and methods1.Research object selection and their inclusion criteriaThe selection time was from January 2018 to December 2018,and the selection place was all obstetrics departments of The Third Affiliated Hospital of Zhengzhou University.The control group was:70 healthy pregnant women.The experimental group was:the normal prenatal examination of 70 pregnant women diagnosed with preeclampsia(Pregnant women with severe PE were included),and according to the severity of the patient’s condition,the pregnant women in the experimental group were divided into the PE group and the SPE group.To study the relationship between pre-pregnancy BMI and PE,pregnant women in the experimental group were divided into the pre-pregnancy overweight/obese group(pre-pregnancy BMI>25Kg/m2)and the pre-pregnancy normal body mass index group(18<pre-pregnancy BMI≤25Kg/m2).To study the relationship between gestational weight gain and PE,the pregnant women in the experimental group were divided into three group:gestational weight gain≤4Kg/m2 group,4<gestational weight gain≤6 Kg/m2 group and gestational weight gain>6Kg/m2 group.Inclusion criteria:Two groups of pregnant women were no labor Chinese and singleton pregnancies,no with other pregnancy complications,no with other acute or chronic disease.2.experimental method2.1 Enzyme-linked immunosorbent assay(ELISA)was used to detect the protein of chemerin and TNF-α in serum of pregnant women in the experimental group and the normal group.2.2 Calculating pre-pregnancy BMI and gestational weight gain.[BMI=weight(kg)/height(m2)]Results1.The expression levels chemerin and TNF-α in the SPE group and the PE group all were significantly higher than those in the control group,all with statistically significant differences(P<0.05).And the expression levels of chemerin and TNF-α in the SPE group all were significantly higher than those in the PE group,all with statistically significant difference(P<0.05).2.Pre-pregnancy BMI and gestational weight gain in the SPE group and the PE group all were significantly higher than those in the control group,all with statistically significant differences(P<0.05).And pre-pregnancy BMI and gestational weight gain in the SPE group all were significantly higher than those in the PE group,all with statistically significant differences(P<0.05).3.In the experimental group,the expression levels of chemerin,TNF-α in the Pre-pregnancy overweight/obese group were higher than those in the Pre-pregnancy normal BMI group,all with statistically significant differences(P<0.05).4.In the experimental group,the expression levels of chemerin,TNF-α in the gestational weight gain>6 Kg/m2 group all were higher than those in the gestational weight gain≤4Kg/m2 group and 4<gestational weight gain≤6Kg/m2 group,all with statistically significant differences(P<0.05).However,it is no statistically significant differences between the expression levels of chemerin and TNF-α in the 4<gestational weight gain≤6 Kg/m2 group and gestational weight gain≤4Kg/m2 group(P>0.05).5.In the experimental group,the expression levels of chemerin were positively correlated with the systolic pressure(SBP)and the diastolic pressure(DBP),all with statistically significant differences(P<0.05).6.In the experimental group,the expression levels of chemerin was positively correlated with the expression levels of TNF-α,with statistically significant differences(P<0.05).7.In the experimental group,the expression levels of chemerin and TNF-α were positively correlated with pre-pregnancy BMI,with statistically significant differences(P<0.05).Conclusion1.Chemerin may be involved in the inflammatory injury process of PE vascular endothelium and is closely related to the severity of the disease.2.High pre-pregnancy BMI may induce inflammatory reaction in the body by causing the high expression of chemerin and TNF-α,which leads to the occurrence and development of PE,so the combined detection of chemerin and TNF-α may contribute to the early diagnosis of PE.3.Measures such as the control of pre-pregnancy weight have certain clinical guiding signignificance for the occurrence of PE. |
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