Ang Hocher Berthold Ang Logistic ± ± ng /L P =

34 6 Vol. 34 No. 6 2013 12 Journal of Jinan University Medicine Edition Dec. 2013 Ang 1-7 1 1 1 2 1 3 2 Hocher Berthold 4 3 1. 2. 3. 510630 4. University of Potsdam Institute of Nutritional Science Nuthetal-Potsdam 14558 Germany 1-7 Ang 1-7 Ⅱ AngⅡ 309 37 17 292 Ang 1-7 AngⅡ Logistic Ang 1-7 AngⅡ Ang 1-7 /AngⅡ 399. 86 ± 218. 93 710. 34 ± 598. 22 ng /L P < 0. 001 49. 87 ± 29. 32 72. 51 ± 60. 79 ng /L P = 0. 028 Ang 1-7 /AngⅡ 8. 34 ± 1. 65 9. 79 ± 2. 83 P = 0. 012 Ang 1-7 AngⅡ 486. 15 ± 337. 34 833. 34 ± 698. 12 ng /L P = 0. 001 54. 75 ± 38. 03 84. 41 ± 69. 01 ng /L P = 0. 025 Ang 1-7 /AngⅡ 9. 54 ± 2. 55 9. 85 ± 3. 11 P = 0. 733 Logistic Ang 1-7 OR 8. 54 95% 2. 73 ~ 26. 76 P < 0. 001 0. 31 95% 0. 14 ~ 0. 69 P = 0. 010 Ang 1-7 1-7 Ⅱ R714. 7 A 1000-9965 2013 06-0626 - 06 Impact of both maternal and neonatal plasma angiotensin 1-7 levels on preterm delivery LU Yongping 1 CHEN Youpeng 1 LIU Zhiwei 1 CHEN Wenjing 2 LIANG Xujing 1 CHEN Xin 3 WEN Wangrong 2 HOCHER Berthold 4 XIAO Xiaomin 3 1. Department of Infectious Diseases 2. Centre for Clinical Laboratory Medicine 3. Department of Obstetrics and Gynecology the First Affiliated Hospital Jinan University Guangzhou 510630 China 4. University of Potsdam Institute of Nutritional Science Nuthetal-Potsdam 14558 Germany Abstract Aim To investigate the impact of both maternal and neonatal plasma angiotensin 1-7 Ang 1-7 and angiotensinii AngⅡ levels on preterm delivery and intrauterine fetal growth. Methods 309 cases of pregnant women were prospectively participated in this study. The pregnant women were divided into two groups of preterm birth and full-term birth according to the gestational weeks as low- 2013-05 - 27 21611448 Hocher 20094131068 2013103 1986 -. Tel 020-38688205 E-mail typchen@ jnu. edu. cn

6 Ang 1-7 627 er than 37 weeks n = 17 and 37 weeks or more n = 292. Maternal and neonatal plasma Ang 1-7 and AngⅡ concentrations were tested by enzyme-linked immunosorbent assay. The risk factors of preterm birth were done by logistic regression analysis. Results Compared with full-term birth group maternal plasma Ang 1-7 AngⅡconcentrations and ratio of Ang 1-7 /AngⅡin preterm group were significantly lower. Neonatal plasma Ang 1-7 and AngⅡ levels of umbilical cord in preterm group were also significantly lower than those in full-term birth group. However no significant difference of the ratio of neonatal plasma Ang 1-7 /AngⅡ in umbilical cord was shown. Logistic regression analysis was shown that the risk factors of preterm delivery are premature rupture of membranes OR = 8. 54 P < 0. 001 and low level of neonatal plasma Ang 1-7 OR = 0. 31 95% CI 0. 14-0. 69 P = 0. 010 after adjusted for the confusing factors such as preeclampsia. Conclusion Low neonatal plasma Ang 1-7 level might have the high risk for preterm delivery. Key words angiotensin 1-7 angiotensinⅡ pregnant preterm delivery intrauterine fetal growth 2 angiotensin-converting enzyme type 2 ACE2-1-7 angiotensin 1-7 Ang 1-7 -Mas - renin-angiotensin system RAS ACE-AngⅡ- Ⅱ 1 angiotensinⅡ type 1 receptor AT 1 R AngⅡ Ang 1-7 1. 2 1 1 RAS 37 17 RAS 292 2 3-6 body mass index BMI 7-8 Ang 1-7 AngⅡ RAS 9-10 11-12 13-14 15-17 Apgar RSA Ang 1-7 AngⅡ 9 15-17 Ang 1-7 AngⅡ 3 ml 4 Ang 1-7 2 500 r /min 7 min 1-7 /AngⅡ - 80 1 1. 1 2011 1 12 309 HIV 2 Ang 1-7 AngⅡ 5 ml ELISA Ang 1-7 Ang Ⅱ Ang 1-7 15. 0 ~ 500. 0 ng /L AngⅡ 1. 5 ~ 50. 0 ng /L 5

628 34 10 8. 88 276. 63 ± 6. 89 2 477. 65 ± 523. 90 3 300. 26 ± 357. 27 P < 0. 01Apgar P > 1. 3 SPSS 17. 0 ± x 珋 ± s t 399. 86 ± 218. 93 710. 34 ± 598. 22 ng /L 2 Contiuity Correction Logistic 337. 34 833. 34 ± 698. 12 ng /L Ang 1- P < 0. 05 2 2. 1 P > 0. 053 28. 40 ± 2. 4 3. 69 29. 12 ± 5. 49 159. 83 ± 4. 60 160. 12 ± 4. 12 cm BMI 20. 12 ± 2. 46 21. 21 ± 3. 22 kg /m 2 1. 71 ± 0. 99 1. 74 ± 1. 15 1. 29 ± 0. 59 1. 17 ± 0. 42 Logistic 81. 85% 82. 35% 0. 3% 0% 0. 052 2. 3 Ang 1-7 AngⅡ Ang 1-7 Ang 1-7 486. 15 ± 7 /AngⅡ 8. 34 ± 1. 65 9. 79 ± 2. 83 P < 0. 05 Ang 1-7 / AngⅡ 9. 54 ± 2. 55 9. 85 ± 3. 11 Ang 1-7 Ang Ⅱ Ang 1-7 /AngⅡ 0% ~ 33. 3% 33. 4% ~ 66. 6% 66. 7% ~ 100% 3 1 BMI > 24 28. 77% 29. 41% P > 0. 05 Ang 1-7 Ang 1-7 AngⅡ Ang P > 0. 05 Ⅱ Ang 1-7 /AngⅡ BMI > 24 P < 0. 011 Ang 1-7 2. 2 Ang 1-7 OR 248. 12 ± 5. 65 10. 64 16. 96 6. 18 0. 5 0. 39 4 Table 1 1 Comparison of clinical characteristics in pregnant women between the two groups of full-term birth and preterm birth BMI < 19 19-24 > 24 < 10 kg 10 ~ 15 kg > 15 kg 97 33. 22% 174 59. 59% 20 6. 85% 39. 460. 96 23 7. 88% 121 41. 44% 20 6. 85% 77 26. 37% 11 3. 77% 4 1. 37% 3 1. 03% 0 0% 3 1. 03% 6 2. 05% 45 15. 41% 20 6. 85% 5 29. 41% 7 41. 18% 5 29. 41% 35. 451. 27 4 23. 53% 7 41. 18% 4 23. 53% 2 11. 76% 5 29. 41% 2 11. 76% 3 17. 65% 0 0% 0 0% 0 0% 9 52. 94% 3 17. 65% OR - - - 0. 37 10. 64 9. 60 20. 64-0. 99 0. 98 1. 80 1. 13 t/ 2 3. 2 12. 84 6. 85 1. 12 16. 61 4. 48 15. 39-0 0 13. 20 1. 38 P 0. 073 < 0. 001 0. 009 0. 291 < 0. 001 0. 034 < 0. 001-1. 0 1. 0 < 0. 001 0. 241 Table 2 2 Comparison of clinical parameters of the neonates between the two groups of full-term birth and preterm birth /d /g /g Apgar < 2 500 2 500 ~ 4 000 > 4 000 1 min 5 min 10 min 276. 23 ± 6. 69 3 300. 26 ± 357. 27 4 1. 37% 274 93. 84% 14 4. 79% 8. 91 ± 0. 66 9. 96 ± 0. 25 9. 99 ± 0. 08 248. 12 ± 8. 88 2 477. 65 ± 523. 90 8 47. 06% 9 52. 94% 0 0% 8. 82 ± 0. 39 9. 88 ± 0. 33 9. 88 ± 0. 33 t / 2 12. 84 6. 39 48. 53 0. 56 0. 94 1. 37 P < 0. 001 < 0. 001 < 0. 001 0. 575 0. 363 0. 189

6 Ang 1-7 629 Table 3 3 Ang 1-7 AngII Ang 1-7 /AngⅡ Plasma Ang 1-7 and AngII concentrations and Ang 1-7 / AngII ratio in pregnant women and their neonates Ang 1-7 / AngⅡ / Ang 1-7 / AngⅡ Ang 1-7 / AngⅡ / Ang 1-7 / 710. 34 ± 98. 22 72. 51 ± 60. 79 9. 79 ± 2. 83 833. 84 ± 698. 12 84. 41 ± 69. 01 9. 85 ± 3. 11 399. 86 ± 218. 93 49. 87 ± 29. 32 8. 34 ± 1. 65 486. 15 ± 337. 34 54. 75 ± 38. 03 9. 54 ± 2. 55 t 4. 88 4. 36 2. 84 3. 80 5. 50 0. 34 P < 0. 001 0. 028 0. 025 0. 733 AngⅡ Table 4 4 Univariate regression analysis of risk factor for preterm birth B SE OR 95% CI P BMI > 24 1. 73 0. 58 5. 65 1. 81 ~ 17. 62 0. 003 2. 37 0. 62 10. 64 3. 19 ~ 35. 51 < 0. 001-1. 00 0. 76 0. 37 0. 08 ~ 1. 67 0. 196 2. 83 0. 66 16. 96 4. 69 ~ 61. 31 < 0. 001 2. 26 0. 91 9. 60 1. 63 ~ 56. 64 0. 013 3. 03 0. 86 20. 64 3. 82 ~ 111. 63 < 0. 001 1. 82 0. 51 6. 18 2. 26 ~ 16. 85 < 0. 001 Ang 1-7 - 0. 69 0. 34 0. 50 0. 26 ~ 0. 97 0. 041 Ang 1-7 - 0. 95 0. 37 0. 39 0. 19 ~ 0. 80 0. 010 AngⅡ - 0. 27 0. 37 0. 76 0. 37 ~ 1. 58 0. 468 AngⅡ - 0. 41 0. 38 0. 67 0. 32 ~ 1. 34 0. 280 Ang 1-7 /AngⅡ - 0. 56 0. 39 0. 57 0. 27 ~ 1. 23 0. 154 Ang 1-7 /AngⅡ - 0. 27 0. 37 0. 76 0. 37 ~ 1. 58 0. 468 2 Logistic A Ang 1-7 OR 60. 88 3. 18 ~ 34. 31 0. 24 95% 0. 10 ~ A B 4. 11 - OR 60. 88-95% CI 11. 02 ~ 336. 29 - P 0. 000 002 - B B 2. 35 2. 15 OR 10. 45 8. 54 95% CI 3. 18 ~ 34. 31 2. 73 ~ 26. 76 P 0. 000 1 0. 000 2 Ang 1-7 B - 1. 42-1. 16 OR 0. 24 0. 31 95% CI 0. 10 ~ 0. 59 0. 14 ~ 0. 69 P 0. 002 0. 004 3 RAS RAS Ang 1-7 9 95% 11. 02 ~ 336. 29 10. 45 95% AngⅡ 15-17 0. 59 A 9-10 11 Logistic B 5-12 Ang 1-7 Ang 1-7 /AngⅡ 5 Table 5 Multiple regression analysis of risk factor for preterm birth 18 19-21 AngⅡ 22-24 Ang 1-7 Th1 -α Tumor Necrosis Factorα TNF-α -6 Interleukin-6 IL-6 25-26 Ang 1-7 Ang 1-7 /AngⅡ

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