摘要
Abstract
Objective To investigate changes in serum homocysteine(Hcy)and C-reactive protein(CRP)in patients with hypertensive disorders of pregnancy(HDP)complicated by obesity and their relationship with disease severity grading.Methods A total of 148 patients with HDP admitted to People's Hospital ofYindu District from January 2020 to May 2023 were enrolled.Based on body mass index(BMI),they were divided into an obese HDP group(n=77,BMI ≥ 25 kg/m2)and a non-obese HDP group(n=71,BMI＜25 kg/m2).An additional 70 healthy pregnant women during the same period served as a control group.Hcy and CRP levels were measured in all participants.According to hypertension severity,the obese HDP group was further divided into three subgroups:group A(gestational hypertension,n=26),group B(mild preeclampsia,n=28),and group C(severe preeclampsia,n=23).Changes in Hcy and CRP across severity levels were compared.Spearman correlation analysis was used to assess the associations of Hcy and CRP with the severity of obesity-complicated HDP.Univariate and multivariate logistic regression analyses were performed to identify factors influencing the occurrence of HDP.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of Hcy and CRP for the occurrence of HDP.Results BMI,Hcy,and CRP levels in the obese HDP group were higher than those in the non-obese HDP group and the control group(P＜0.05),and the non-obese HDP group showed higher values than the control group(P＜0.05).Hcy and CRP levels in group C were higher than those in groups B and A,and levels in group B were higher than those in group A(P＜0.05).Serum Hcy and CRP levels were positively correlated with the severity of obesity-complicated HDP(r=0.786 and 0.714,P＜0.05).Logistic regression analysis showed that higher Hcy and CRP levels were risk factors for the occurrence of HDP(P＜0.05).ROC analysis showed that,for Hcy,the cut-off value corresponding to the maximum Youden index(0.709)was 11.48 μmol/L,with an area under the curve of 0.871,sensitivity of 83.78％,and specificity of 87.14％;for CRP,the cut-off value corresponding to the maximum Youden index(0.573)was 6.76 mg/L,with an area under the curve of 0.812,sensitivity of 84.46％,and specificity of 72.86％.Conclusion Serum Hcy and CRP are positively correlated with the severity of obesity-complicated HDP and have high predictive value for the occurrence of HDP.Pregnant women with elevated Hcy and CRP should receive focused attention and timely intervention to reduce the occurrence of HDP.关键词
肥胖/妊娠期高血压/同型半胱氨酸/C反应蛋白Key words
obesity/hypertensive disorders of pregnancy/homocysteine/C-reactive protein分类
医药卫生
