Biomedical subjects

R Chen

Publications and source records attributed to R Chen.

At least 73 records · Page 4Linked to original sources

PubMed2003

HLA-DRB1, DQB1 and DPB1 polymorphism in the Naxi ethnic group of South-western China.

Polymorphism of HLA-DRB1, DQB1 and DPB1 was revealed with a sequencing-based typing (SBT) method in unrelated healthy volunteers from the Naxi ethnic group. Among the 43 DRB1 alleles detected, the most common allele was DRB1*12021 with a frequency of 17%, followed by DRB1*08032, DRB1*09012 and DRB1*1404 with frequencies of 8.5%, 7.4% and 7.4%, respectively. Among 23 DQB1 alleles detected, the most frequent DQB1 allele was DQB1*03011/0309 (21.9%), followed by DQB1*0502 (16.4%) and DQB1*05031 (9.6%). For the DPB1 locus, the most common alleles were DPB1*0501 (25.5%), DPB1*0402 (14.6%) and DPB1*02012 (12.0%). The most common DRB1-DQB1-DPB1 haplotype was DRB1*1404-DQB1*05031-DPB1*0402 with a frequency of 5.26%, followed by the DRB1*08032-DQB1*06011-DPB1*1301 (3.51%). The distribution characteristics of the HLA class II alleles revealed that the Naxi ethnic group belonged to the Southern group of Chinese.

Alleles↗

PubMed2003

Endpoint quantitative PCR assays for Bacteroides forsythus, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans.

BACKGROUND: Conventional polymerase chain reaction (PCR) assays for periodontal pathogens are so sensitive that they detect infections of no clinical significance. Quantitative PCR (qPCR) may provide a solution to this problem. However, most qPCR systems require expensive real-time thermal cyclers. OBJECTIVE: Our goal was to develop qPCR assays which would allow endpoint quantification. MATERIALS AND METHODS: 16S rRNA primers for Bacteroides forsythus, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans were adapted to the Amplifluor qPCR system, which incorporates fluorescein into the PCR product so that endpoint fluorescence is proportional to the original amount of template. DNA dilutions representing known numbers of cells were used as standard curves. Pooled subgingival plaques from the four deepest pockets of 21 severe adult periodontitis patients were assayed. Buccal molar supragingival plaque from 35 dental students provided healthy controls. Endpoint fluorescence was measured with a microplate reader. RESULTS: Optimized standard curves were linear in log-log or semilog fits over a range of 100-10(6) cells. Countable B. forsythus was present in all patients, with counts (as logs) from 2.4 to 7.3 (mean = 5.0), and 11 controls with counts from 2.1 to 4.5 (mean = 3.0). P. gingivalis was present in 11 patients and no controls, with counts from 2.2 to 4.7 (mean = 3.2). A. actinomycetemcomitans was present in two patients, with counts of 1.5 and 3.5. CONCLUSIONS: Amplifluor qPCR assays discriminated between plaque samples differing by one log or more, allowing major infections to be distinguished from minor ones. This approach allows high-throughput qPCR of plaque samples, using equipment available to many laboratories.

Adult↗

PubMed2003

A model for the analysis of nonviral gene therapy.

Further understanding of the mechanisms involved in cellular and intracellular delivery of transgene is needed to produce clinical applications of gene therapy. The compartmental and computational model designed in this work is integrated with data from previous experiments to quantitatively estimate rate constants of plasmid translocation across cellular barriers in transgene delivery in vitro. The experimental conditions between two cellular studies were held constant, varying only the cell type, to investigate how the rates differed between cell lines. Two rate constants were estimated per barrier for active transport and passive diffusion. Translocation rates of intact plasmid across the cytoplasmic and nuclear barriers varied between cell lines. CV1 cells were defined by slower rates (0.23 h(-1) cytoplasmic, 0.08 h(-1) nuclear) than those of the HeLa cells (1.87 h(-1) cytoplasmic, 0.45 h(-1) nuclear). The nuclear envelope was identified as a rate-limiting barrier by comparing the rate of intact plasmid translocation at each barrier. Slower intact plasmid translocation in CV1 cells was correlated with a reduced absolute capacity for transgene efficiency in comparison with HeLa cells. HeLa cells were three times more efficient than CV1 cells at producing green fluorescent protein per intact plasmid delivered to the nucleus. Mathematical modeling coordinated with experimental studies can provide detailed, quantitative understanding of nonviral gene therapy.

Cell Line↗

PubMed2003

Trends and social factors in blood pressure control in Scottish MONICA surveys 1986-1995: the rule of halves revisited.

Time trends and social factors in detection, treatment and control of hypertension in the community were examined in four independent Scottish MONICA cross-sectional surveys in 1986, 1989, 1992 and 1995. Residents aged 25-64 years were recruited randomly from general practice lists in north Glasgow, Scotland with stratification by sex and 10-year age groups. A total of 1262 participated in the first survey, 1397 in the second, 1516 in the third and 1836 in the fourth. Differences and trends in proportions of hypertension undetected, detected but untreated, treated but uncontrolled and controlled across the four surveys were tested by chi(2), and the associations of the poor control of hypertension with social factors were estimated by multivariate logistic regression model to derive odds ratios. Using the cut point of >/=160/95 mmHg, proportion of hypertension undetected across the four surveys was 56.3, 44.6, 32.0 and 38.2%, and of treated controlled hypertension was 15.2, 26.4, 32.0 and 32.8% (both trends P<0.001). Multivariate analysis showed that poor control of hypertension was not related to social deprivation, but significantly related to being male, young, of low body mass index and heavy alcohol drinking. Undetected hypertension was significantly related to full-time employment, and untreated hypertension to high social class and possibly education level. These findings suggest that in this part of Scotland the management of hypertension has improved, so the 'rule of halves' no longer applies. Control of blood pressure is not positively associated with social deprivation, but people at a high risk of poor control of hypertension should be targeted.

Adult↗

PubMed2003

Continuous glucose monitoring for treatment adjustment in diabetic pregnancies--a pilot study.

AIMS: To examine the efficacy of a continuous glucose monitoring (CGM) system for treatment adjustment in patients with diabetic pregnancy treated with insulin. METHODS: The study sample consisted of eight women with diabetic pregnancy, six with pre-pregnancy Type 1 diabetes mellitus and two with gestational diabetes (GDM), all being treated with multiple daily insulin injections. Gestational age ranged from 24 to 32 weeks. Data derived from the Continuous Glucose Monitoring System (MiniMed) for 72 h were compared with fingerstick glucose measurements (six to eight times a day), and treatment was adjusted on the basis of the findings. Two to four weeks later, the patients were re-evaluated with CGM. RESULTS: In the first part of the study, an average of 744+/-33 glucose measurements was recorded for each patient with CGM. The mean total time of hyperglycaemia (glucose level >7.7 mmol/l) undetected by the fingerstick method was 152+/-33 min/day. Nocturnal hypoglycaemic events (glucose level <2.7 mmol/l) were recorded in seven patients. Based on the additional information obtained by continuous monitoring, the insulin regimen was changed in all patients. CGM re-evaluation after treatment adjustment showed a reduction in undetected hyperglycaemia to 89+/-17 min/day and in nocturnal hypoglycaemic events, which were recorded in only one patient. CONCLUSIONS: Continuous glucose monitoring may diagnose high blood glucose levels and nocturnal hypoglycaemic events that are unrecognized by intermittent blood glucose monitoring and could serve as a useful tool for the long-term management of diabetic pregnancies. A large prospective study is needed to determine the clinical implications of this new monitoring technique.

Adult↗

PubMed2003

Induction of labor with vaginal prostaglandin E2.

OBJECTIVE: To determine the effects of labor induction with vaginal prostaglandin E2 (PGE2) on mode of delivery in post-term pregnancies and to identify possible predictors of successful vaginal delivery. METHODS: The study group consisted of 211 women with post-term pregnancy (gestational age more than a full 41 weeks) admitted for induction of labor with vaginal applications of PGE2. Findings were compared with women with spontaneous onset of labor (group 2, n = 510). Women with previous Cesarean section were excluded from both study and control groups. RESULTS: The rate of Cesarean section was significantly higher in the study group (19.4%) than in the control group (9%). A logistic regression model was used to control for maternal and gestational age, gravidity, parity, nulliparity rate, number of used PGE2 tablets, oligohydramnios and delivery weight as possible predictors of Cesarean section (R2 = 0.56, p < 0.001). On stepwise analysis, nulliparity (OR 45.2, 95% CI 2.93-695.5), number of PGE2 applications (OR 2.79, 95% CI 1.04-7.52) and maternal age (OR 1.23, 95% CI 1.01-1.50) were independently and significantly associated with increased risk of Cesarean section. PGE2 induction was a significant independent predictor of Cesarean section (OR 2.3, 95% CI 1.3-3.9). CONCLUSION: PGE2 induction of labor was successful in approximately 80% of patients with post-term pregnancy, with apparently no serious maternal or fetal complications. Risk factors intrinsic to the patient, and labor induction itself, were the reasons for excess Cesarean deliveries in women with prolonged pregnancies.

Administration, Intravaginal↗

PubMed2003

Continuous glucose monitoring for the evaluation and improved control of gestational diabetes mellitus.

OBJECTIVES: To compare the daily glycemic profile reflected by continuous versus self-monitoring of blood glucose in women with gestational diabetes mellitus (GDM), and to evaluate possible differences in treatment strategy based on the two monitoring methods. MATERIALS AND METHODS: The study sample consisted of 57 women with gestational diabetes, 47 in Israel and ten in California. Gestational age ranged from 24 to 32 weeks in the Israeli women, and 32 to 36 weeks in the American women. Data derived from the Continuous Glucose Monitoring (CGM) System (MiniMed) for 72 h were compared to fingerstick glucose measurements (6-8 times a day). During continuous monitoring, patients documented the timing of food intake, insulin injections and hypoglycemic events. RESULTS: In the Israeli group, 23 women were treated by diet alone, and 24 by diet plus insulin. An average of 763 +/- 62 glucose measurements was recorded for each patient with continuous glucose monitoring. The mean total time of hyperglycemia (glucose level > 140 mg/dl) undetected by the fingerstick method was 132 +/- 31 min/day in the insulin-treated group and 94 +/- 23 min/day in the diet-treated group. Nocturnal hypoglycemic events (glucose levels < 50 mg/dl) were recorded in 14 patients, all insulin-treated. On the basis of the additional information provided by continuous monitoring, the therapeutic regimen (insulin therapy, diet adjustment, or both) was changed in 36 of the 47 patients. All ten American women were treated with insulin. The mean time of undetected hyperglycemia for a total group monitoring time of 30 days was 78 +/- 13 min/day. Eight women had nocturnal hypoglycemia on at least one of the three nights of monitoring for a total of 12 nights. A change in insulin dosage was made in all women on the basis of the data provided by continuous glucose monitoring. CONCLUSION: Continuous glucose monitoring is helpful for monitoring women with GDM and for adjusting diabetes therapy. It can accurately detect high postprandial blood glucose levels and nocturnal hypoglycemic events that may go unrecognized by intermittent blood glucose monitoring. A large prospective study on maternal and neonatal outcome is needed to determine the clinical implications of this new monitoring technique.

Adult↗

PubMed2002

Novel thalidomide analogues display anti-angiogenic activity independently of immunomodulatory effects.

The anti-tumour effects of thalidomide have been associated with its anti-angiogenic properties. Second generation thalidomide analogues are distinct compounds with enhanced therapeutic potential. Although these compounds are beginning to enter trials for the treatment of cancer there is very little information regarding the anti-angiogenic activity of these clinically relevant compounds. Furthermore, it is not known how the various immunomodulatory activities of these compounds relate to anti-angiogenic activity. In this study we assessed the anti-angiogenic activity of compounds from both IMiD and SelCID classes of analogues using a novel in vitro multicellular human assay system and the established rat aorta assay. Our results show that both the IMiDs and SelCIDs tested are significantly more potent than thalidomide. The anti-angiogenic potency of the analogues was not related to inhibition of endothelial cell proliferation, nor their TNF-alpha/PDE type 4 inhibitory properties. However, anti-migratory effects in vitro and inhibition of tumour growth in vivo was observed with the analogue IMiD-1 (clinically known as REVIMID). Our results show that anti-angiogenic activity spans both currently defined classes of thalidomide analogue and is not related to their previously described immunomodulatory properties. Identification of the differential effects of these compounds will enable targeting of such compounds into the appropriate clinical setting.

3',5'-Cyclic-AMP Phosphodiesterases↗

PubMed2002

Transcranial magnetic stimulation for the treatment of seizures: a controlled study.

OBJECTIVE: To perform a controlled trial of transcranial magnetic stimulation (TMS). METHODS: Twenty-four patients with localization-related epilepsy were randomized to blinded active or placebo stimulation. Weekly seizure frequency was compared for 8 weeks before and after 1 week of 1-Hz TMS for 15 minutes twice daily. RESULTS: When the 8-week baseline and post-stimulation periods were compared, active patients had a mean seizure frequency reduction of 0.045 +/- 0.13 and sham-stimulated control subjects -0.004 +/- 0.20. Over 2 weeks, actively treated patients had a mean reduction in weekly seizure frequency of 0.16 +/- 0.18 and sham-stimulated control subjects 0.01 +/- 0.24. Neither difference was significant. CONCLUSION: The effect of TMS on seizure frequency was mild and short lived.

Adult↗

PubMed2002

Effects of subthalamic nucleus stimulation on motor cortex excitability in Parkinson's disease.

BACKGROUND: Transcranial magnetic stimulation (TMS) studies have found abnormalities in several excitatory and inhibitory circuits in the motor cortex in PD. These include motor evoked potential (MEP) recruitment curve, silent period duration (SP), short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), and long-interval intracortical inhibition (LICI). METHODS: The authors studied the effects of subthalamic nucleus (STN) deep brain stimulation (DBS) on these circuits in 12 patients with PD treated with STN DBS. Data from nine patients who completed the study were analyzed. Patients remained on their usual medications. The stimulators were set at the optimal parameters (ON), half the optimal amplitude (HALF), and switched off (OFF) in random order. RESULTS: The Unified PD Rating Scale motor scores were significantly lower in the ON compared to the HALF and OFF conditions. Resting SICI, studied with paired-pulse TMS at interstimulus interval of 2 ms, was reduced in the OFF and HALF conditions compared to normal subjects. STN stimulation restored SICI to normal levels. STN stimulation had no effect on motor threshold, MEP recruitment curve, SP, active SICI, ICF, and LICI. CONCLUSIONS: Although restoration of short-interval intracortical inhibition by STN stimulation is similar to the effects of dopaminergic drugs, it has no effect on silent period duration and long-interval intracortical inhibition, which are also influenced by dopaminergic drugs. A previous study found that internal globus pallidus (GPi) stimulation reduced SP but did not change SICI. Thus, GPi and STN stimulation may affect different circuits in the motor cortex.

Adult↗

PubMed2002

Changing attitudes toward mode of delivery and external cephalic version in breech presentations.

OBJECTIVES: To compare the attitude of gravid women in breech presentation towards external cephalic version (ECV) and mode of delivery between 1995 and 2001. METHODS: A questionnaire on ECV and mode of delivery was distributed to women in the third trimester of pregnancy with breech presentation, attending our departmental clinic for a routine check-up once in 1995 and again in 2001 in order to analyze changing attitudes. RESULTS: One hundred fifty-four women completed the questionnaire in 1995 and 127 in 2001. There were no statistically significant differences between the groups in age, gestational age, gravidity, parity, or level of education. In 1995, more than half the women (52.7%) had heard of ECV and 53.8% were willing to consider it, whereas in 2001, 73.2% had heard of it but only 23.9% were willing to consider it. In both groups, the women who were familiar with ECV were more likely to work outside of the home, have a higher level of educated than the women who were not. The women who were willing to try ECV were more likely not to work outside of the home, to consider their pregnancy low risk, and to opt for vaginal delivery (vs. cesarean section) if ECV did not succeed. The percentage of women who would choose planned cesarean section if the presentation remained breech was significantly higher in 2001 (97%) than in 1995 (64.7%). CONCLUSIONS: Attitudes toward breech delivery have changed since 1995. More women are aware of the option of ECV but are less inclined to consider it. Planned cesarean section for breech presentation is the overwhelming choice of women in general, with a significant increase in 2001 compared with 1995.

Adult↗

PubMed2002

Nervous system reorganization following injury.

Contrary to the classical view of a pre-determined wiring pattern, there is considerable evidence that cortical representation of body parts is continuously modulated in response to activity, behavior and skill acquisition. Both animal and human studies showed that following injury of the peripheral nervous system such as nerve injury or amputation, the somatosensory cortex that responded to the deafferented body parts become responsive to neighboring body parts. Similarly, there is expansion of the motor representation of the stump area following amputation. Reorganization of the sensory and motor systems following peripheral injury occurs in multiple levels including the spinal cord, brainstem, thalamus and cortex. In early-blind subjects, the occipital cortex plays an important role in Braille reading, suggesting that there is cross-modal plasticity. Functional recovery frequently occurs following a CNS injury such as stroke. Motor recovery from stroke may be associated with the adjacent cortical areas taking over the function of the damaged areas or utilization of alternative motor pathways. The ipsilateral motor pathway may mediate motor recovery in patients who undergo hemispherectomy early in life and in children with hemiplegic cerebral palsy, but it remains to be determined if it plays a significant role in the recovery of adult stroke. One of the challenges in stroke recovery is to identify which of the many neuroimaging and neurophysiological changes demonstrated are important in mediating recovery. The mechanism of plasticity probably differs depending on the time frame. Rapid changes in motor representations within minutes are likely due to unmasking of latent synapses involving modulation of GABAergic inhibition. Changes over a longer time likely involve other additional mechanisms such as long-term potentiation, axonal regeneration and sprouting. While cross-modal plasticity appears to be useful in enhancing the perceptions of compensatory sensory modalities, the functional significance of motor reorganization following peripheral injury remains unclear and some forms of sensory reorganization may even be associated with deleterious consequences like phantom pain. An understanding of the mechanism of plasticity will help to develop treatment programs to improve functional outcome.

Aging↗

PubMed2002

Relationship between plasma glucose concentrations and Native Hawaiian Ancestry: The Native Hawaiian Health Research Project.

OBJECTIVE: To investigate the relationship between fasting glucose and 2 h glucose with percentage of Hawaiian ancestry and ethnic admixture. DESIGN: Cross-sectional epidemiological study of type 2 diabetes and heart disease risk factor prevalence among Native Hawaiians. SUBJECTS: A total of 578 Native Hawaiians residing in two rural communities were examined between 1993 and 1996. Sample sizes in statistical analyses varied due to missing data and selection criteria based on ethnic ancestry. MEASUREMENTS: Percentage of Hawaiian ancestry and non-Hawaiian ethnic admixture, assessed by self-report. Fasting and 2 h post glucose challenge plasma glucose levels. Anthropometric measures (height, weight, waist and hip circumferences). Self-report of diet and physical activity. Medical history. RESULTS: Increased Hawaiian blood quantum was significantly associated with increased fasting glucose (P=0.0047), increased body mass index (BMI; P<0.0001), waist-to-hip ratio (WHR; P=0.0103), and age (P<0.0001), but not with leisure time physical activity and total dietary caloric intake. This association was attenuated after adjusting for BMI and WHR, but not by age-adjustment alone. However, when the effects of descent from other ethnic groups was examined in a subset of participants, full-Hawaiians had significantly higher fasting glucose concentrations (7.28 mmol/l) than part-Hawaiians after adjustments for age, gender, BMI and WHR. In contrast, part-Hawaiians of predominantly Asian ancestry had the highest 2 h glucose concentrations (7.62 mmol/l). CONCLUSION: These results suggest that ethnic admixture may be an important, but extremely complex, factor concerning the high prevalence of type 2 diabetes observed among this population. The complexity of this relationship may have obscured the relationship between ancestry and glucose tolerance in earlier observations of this population.

Adult↗

PubMed2002

Measurement of passive smoking in adults: self-reported questionnaire or serum cotinine?

BACKGROUND: Low to moderate agreement between self-reported exposure to environmental tobacco smoke (ETS) and serum cotinine levels in non-smokers questions the accuracy of the measurement of ETS exposure. We examined the relationship of serum cotinine to different self-reported ETS questionnaires in a large community-based study. METHODS: Subjects were derived from four Scottish MONICA surveys. Agreement between self-reported ETS (yes/no) and serum cotinine levels (> 0, 0) in non-smokers was tested by K, and the difference in cotinine levels among self-reported ETS exposure by ANOVA and the relationship by linear regression. RESULTS: None of the values for K was > 0.24 for any ETS questionnaire. In non-smokers with serum cotinine > 0, cotinine levels increased with increasing ETS exposures. In the first and second surveys with the questionnaire of ETS exposure in the last 3 days, standardised coefficients were 0.28-0.39, while in the third and fourth surveys with the questionnaire of a total exposure to ETS at work, at home and in other places the standardised coefficients were 0.19-0.36, with the questionnaire of ETS daily exposure hours, 0.23-0.36. The relationship between self-reported ETS and cotinine levels varied with the questionnaires, and with the time of day of the blood sample collection. In current smokers, cotinine levels were significantly related to both the number of cigarettes smoked daily (the coefficients were 0.13-0.41) and time elapsed since the last cigarette (-0.24 to -0.40). CONCLUSION: The findings raise the question of whether it is ideal to take only serum cotinine as an index of ETS exposure in adults, because of time delays between ETS exposure and blood collection, and suggest the combined use of appropriately worded self-reported questionnaires and cotinine levels to estimate ETS exposure.

Adult↗

PubMed2002

Luminescence of CsGd2F7 crystals.

Optical and dosimetric properties of nominally pure CsGd2F7 crystals and of CsGd2F7 crystals doped with various concentrations of Pr3+ ions were investigated. Effects of X, beta and UV irradiation on these crystals were studied. Methods of optical absorption, X and UV excited luminescence, thermoluminescence (TL), phototransferred thermoluminescence and optically stimulated luminescence were used in these investigations. The dependence of the TL efficiency on the radiation dose was found to be linear up to 6 kGy for the 3 at.% Pr3+ doped samples. The crystals containing from 0.3 at.% to 1.0 at.% of Pr3+ ions were found to have the best TL sensitivity and the intensity of the main TL peak in these samples was more than two orders of magnitude higher than that of the pure crystals. The TL sensitivity of the CsGd,F7:Pr3+ crystals was also compared with that of other commonly used TLD materials.

Beta Particles↗

PubMed2002

The role of retrapping in dose dependence of pulsed optically stimulated luminescence.

Superlinear behaviour has been observed in dose dependence measurements of optically stimulated luminescence (OSL). Previous theoretical work has shown that superlinearity of the integral under the OSL decay curve may occur, resulting from competition with either radiationless luminescence centres or disconnected trapping states. Also, it has recently been shown that if OSL is measured during a relatively short pulse of stimulating light, quadratic dose dependence may take place even when only one trapping state and one kind of recombination centre take part. Here, the conditions for superlinear dose dependence, quadratic and more, to occur are considered. Also, the dose dependence of 'pulsed OSL' is discussed. In this procedure, the luminescence is only detected after the end of the stimulating light pulse, it is shown that when retrapping is relatively strong and initially the traps and centres are empty, superlinear dose dependence is expected.

Dose-Response Relationship, Radiation↗

PubMed2002

Root gravitropism: an experimental tool to investigate basic cellular and molecular processes underlying mechanosensing and signal transmission in plants.

The ability of plant organs to use gravity as a guide for growth, named gravitropism, has been recognized for over two centuries. This growth response to the environment contributes significantly to the upward growth of shoots and the downward growth of roots commonly observed throughout the plant kingdom. Root gravitropism has received a great deal of attention because there is a physical separation between the primary site for gravity sensing, located in the root cap, and the site of differential growth response, located in the elongation zones (EZs). Hence, this system allows identification and characterization of different phases of gravitropism, including gravity perception, signal transduction, signal transmission, and curvature response. Recent studies support some aspects of an old model for gravity sensing, which postulates that root-cap columellar amyloplasts constitute the susceptors for gravity perception. Such studies have also allowed the identification of several molecules that appear to function as second messengers in gravity signal transduction and of potential signal transducers. Auxin has been implicated as a probable component of the signal that carries the gravitropic information between the gravity-sensing cap and the gravity-responding EZs. This has allowed the identification and characterization of important molecular processes underlying auxin transport and response in plants. New molecular models can be elaborated to explain how the gravity signal transduction pathway might regulate the polarity of auxin transport in roots. Further studies are required to test these models, as well as to study the molecular mechanisms underlying a poorly characterized phase of gravitropism that is independent of an auxin gradient.

Biological Transport↗

PubMed2002

Beta2-microglobulin and hypertensive complications in pregnant women at risk.

BACKGROUND AND AIM: Beta2-microglobulin (beta2-m) is a polypeptide, which is freely filtered through the glomerular basement membrane and absorbed almost entirely by the proximal tubular cells. Preeclampsia, a common complication of pregnancy, is characterized by pathological renal changes, mainly glomerular lesions. The aim of the present study was to investigate whether serum beta2-m measured in the early stages of pregnancy could be used as a marker to predict hypertensive complications in women at increased risk. PATIENTS AND METHODS: Serum beta2-m concentrations were prospectively measured in 75 pregnant women with history of chronic hypertension, chronic renal disease, chronic vascular disease or preeclampsia and compared with those in 16 healthy pregnant women. RESULTS: Of the 75 women in the study group, 10 (13%) developed preeclampsia and 20 (26%) had other complications, such as intrauterine growth restriction (n = 8), fetal or neonatal loss (n = 9) and delivery before 30 weeks of gestation (n = 8). Gestational age at delivery, birth weight and cesarean section rate were significantly worse in the patients with complications than in those without and in the healthy controls. No significant difference was detected in early serum beta2-m concentrations between the women who later developed preeclampsia or other complications and those who did not. There was a significant positive correlation of beta2-m concentrations with serum creatinine level (R2 = 0.394, p < 0.001), but not with gestational week at blood collection. CONCLUSION: Serum beta2-m concentrations are not predictive of the development of preeclampsia or other complications in woman at risk.

Adult↗