A Nomogram Model Containing Genetic Polymorphisms to Predict Risk of Pulmonary Embolism in Pregnant Women.

IF 2.5 4区医学 Q2 OBSTETRICS & GYNECOLOGY

International Journal of Women's Health Pub Date : 2024-09-17 eCollection Date: 2024-01-01 DOI:10.2147/IJWH.S470644

Huiqin Sun, Lu Zhou, Yihan Lu, Yingchuan Li, Yan Huo, Weifeng Huang

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引用次数: 0

Abstract

Introduction: Pulmonary embolism (PE), the most serious presentation of venous thromboembolism (VTE), is associated with a high rate of mortality and expense. Clinical studies on pregnant women with PE are scarce. The aim of this study was to analyze the clinical impact of fibrinolytic enzyme activation inhibitor-1 (PAI-1) 4G/5G genetic polymorphisms, methylenetetrahydrofolate reductase (MTHFR) rs1801131 (A1298C) and rs1801133 (C677T) genetic polymorphisms, and establish a predictive model for pregnant women.

Material and methods: Between September 2022 and August 2023, 53 pregnant women with PE were enrolled. Using the propensity score matching method, 106 consecutive pregnant women without VTE were 1:2 matched. The relevant patient data were collected, and the susceptibility genes for PE were detected to determine genetic polymorphisms, and PE susceptibility in pregnant women, as well as to develop predictive models.

Results: Our study showed that 4G/4G homozygous mutations increased the risk of pregnant PE fourfold (OR = 4.46, 95% CI = 1.59-12.50, P = 0.004), whereas the 4G allele mutation increased the risk twofold (OR = 2.33, 95% CI = 1.35-4.04, P = 0.002). A nomogram was established to predict the risk of pregnant women with PE by four predictive features including PAI-1 genetic polymorphisms, international normalized ratio (INR), antithrombin-III (AT-III) activity, and platelet count (PLT). The area under the curve (AUC) of the nomogram was 0.821 (0.744-0.898). The AUC of the internal validation group was 0.822 (0.674-0.971). Decision curve analysis revealed that the nomogram has a higher net benefit in the following threshold: probability interval of ≥15%.

Conclusion: The PAI-1 4G/4G genotype is an independent risk factor for pregnant women with PE; furthermore, the presence of the 4G allele can increase the risk of PE. The study established a nomogram to predict the risk of PE in pregnant women.

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预测孕妇肺栓塞风险的包含基因多态性的提名图模型。

导言：肺栓塞（PE）是静脉血栓栓塞症（VTE）最严重的表现形式，死亡率高、花费大。针对患有 PE 的孕妇的临床研究很少。本研究旨在分析纤溶酶活化抑制剂-1（PAI-1）4G/5G基因多态性、亚甲基四氢叶酸还原酶（MTHFR）rs1801131（A1298C）和rs1801133（C677T）基因多态性的临床影响，并建立孕妇的预测模型：在 2022 年 9 月至 2023 年 8 月期间，共纳入 53 名患有 PE 的孕妇。采用倾向得分匹配法，对 106 名无 VTE 的连续孕妇进行 1:2 匹配。收集患者相关数据，检测 PE 易感基因，确定基因多态性和孕妇 PE 易感性，并建立预测模型：我们的研究表明，4G/4G同源基因突变会使孕妇患PE的风险增加4倍（OR = 4.46，95% CI = 1.59-12.50，P = 0.004），而4G等位基因突变会使风险增加2倍（OR = 2.33，95% CI = 1.35-4.04，P = 0.002）。通过四个预测特征，包括 PAI-1 基因多态性、国际正常化比值（INR）、抗凝血酶-Ⅲ（AT-Ⅲ）活性和血小板计数（PLT），建立了预测 PE 孕妇风险的提名图。提名图的曲线下面积（AUC）为 0.821（0.744-0.898）。内部验证组的曲线下面积（AUC）为 0.822（0.674-0.971）。决策曲线分析显示，在以下阈值：概率区间≥15%时，提名图的净收益更高：结论：PAI-1 4G/4G 基因型是妊娠合并 PE 的独立危险因素；此外，4G 等位基因的存在会增加 PE 的风险。该研究建立了预测孕妇 PE 风险的提名图。

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来源期刊

International Journal of Women's Health OBSTETRICS & GYNECOLOGY-

CiteScore

3.70

自引率

0.00%

发文量

194

审稿时长

16 weeks

期刊介绍： International Journal of Women''s Health is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of women''s healthcare including gynecology, obstetrics, and breast cancer. Subject areas include: Chronic conditions including cancers of various organs specific and not specific to women Migraine, headaches, arthritis, osteoporosis Endocrine and autoimmune syndromes - asthma, multiple sclerosis, lupus, diabetes Sexual and reproductive health including fertility patterns and emerging technologies to address infertility Infectious disease with chronic sequelae including HIV/AIDS, HPV, PID, and other STDs Psychological and psychosocial conditions - depression across the life span, substance abuse, domestic violence Health maintenance among aging females - factors affecting the quality of life including physical, social and mental issues Avenues for health promotion and disease prevention across the life span Male vs female incidence comparisons for conditions that affect both genders.