1
|
Zhang QL, Yue CY, Zhang B, Wang ZH, Ying CM. [The level distribution of serum AMH in different clinical manifestations of women of childbearing age]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:985-989. [PMID: 35899353 DOI: 10.3760/cma.j.cn112150-20210714-00679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
To investigate the distribution and diagnostic value of serum anti-Müllerian hormone (AMH) in healthy women of childbearing age, women with polycystic ovary syndrome (PCOS), ovarian dysfunction (DOR) and premature ovarian failure (POF). This study retrospectively selected female patients of childbearing age who were treated in the affiliated Obstetrics and Gynecology Hospital of Fudan University from January to December 2019. According to different clinical manifestations, they were divided into 133 cases in PCOS group, 120 cases in DOR group and 134 cases in POF group. 125 healthy women in the same period were selected as the control group. The values of serum AMH, estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) were measured in the four groups. Single sample Kolmogorov-Smirnov test, one-way ANOVA, independent sample t-test, Kruskal-Wallis H test, Mann-Whitney U test, logistic regression analysis and ROC curve were used for comparative analysis. The serum AMH levels of PCOS group, DOR group, POF group and control group were 9.10 (6.67, 11.49) ng/ml, 0.11 (0.05, 0.29) ng/ml, 0.03 (0.02, 0.06) ng/ml and 2.99 (1.57, 4.98) ng/ml, respectively [M(Q1,Q3)], the differences were statistically significant (P<0.001). The basal endocrine levels including E2, FSH, LH and T also had significant differences between groups (P<0.001). The results of multiple comparisons showed that there were significant differences in AMH and LH between DOR, POF and PCOS groups and the control group. The T level of PCOS group was significantly higher than that of the control group, the E2, LH and T levels of DOR group were significantly higher than that of the control group, and the FSH level of POF group was significantly higher than that of the control group (P<0.05). The area under the curve (AUC) of AMH and AMH+LH in the diagnosis of PCOS were 0.905 and 0.922, the sensitivity was 82.7% and 85.0%, and the specificity was 88.0% and 88.8%. The AUC of DOR was 0.861 and 0.971, the sensitivity was 89.0% and 92.5%, and the specificity was 63.0% and 92.0%. The AUC of POF was 0.950 and 0.998, the sensitivity was 98.3% and 99.2%, and the specificity was 75.9% and 97.0%, respectively. The AUC of AMH and AMH+LH combined indexes in the differential diagnosis of DOR and POF were 0.768 and 0.937, the sensitivity was 70.3% and 95.5%, and the specificity was 73.9% and 80.8%.
Collapse
Affiliation(s)
- Q L Zhang
- Department of Clinical Laboratory,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China
| | - C Y Yue
- Department of Clinical Laboratory,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China
| | - B Zhang
- Department of Clinical Laboratory,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China
| | - Z H Wang
- Department of Clinical Laboratory,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China
| | - C M Ying
- Department of Clinical Laboratory,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200011,China
| |
Collapse
|
2
|
Chen YS, Wang FF, Lu LKY, Ni YH, Wang Q, Ying CM. [Clinical application of expanded noninvasive prenatal testing for fetal chromosome abnormalities]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:1491-1495. [PMID: 34963249 DOI: 10.3760/cma.j.cn112150-20210716-00685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
To assess the positive predictive value (PPV) of extended noninvasive prenatal testing (NIPT-plus) for fetal chromosomal abnormalities. This retrospective research enrolled 511 cases of pregnant women with positive NIPT-plus results at the Obstetrics and Gynecology Hospital of Fudan University from May 2017 to January 2021. Karyotype analysis and chromosome microarray analysis (CMA) techniques was applied for verification. All cases were followed to determine their pregnancy outcome. The Chi-square test was used in PPV. 63 out of 511 refused prenatal diagnosis after counseling, 448 pregnant women with prenatal diagnosis showed that the PPVs of NIPT-plus test for fetal trisomy 21, 18 and 13 (T21, T18, T13), sex chromosome aneuploidy (SCAs) and chromosome microdeletion/microduplication syndrome (MMS) were 86.0% (92/107), 79.5% (35/44), 54.5% (12/22), 39.5% (75/190), and 41.7% (30/72), respectively. The results revealed that the PPV was higher among older pregnant women compared to young pregnant women (77.8% vs. 51.9%,P<0.01). With increasing maternal age, the PPV of NIPT-plus presented increasing trends for T21, T13, and composite PPV except for T18 or SCAs. In addition, the termination rates for confirmed SCAs fetal karyotypes 45, X; 47, XXX; 47, XXY and 47, XYY were 11/11, 3/15, 91.7% (22/24) and 1/14, respectively. NIPT-plus can safely and effectively detect fetal chromosomal abnormalities and can be extended to MMS screening, significantly reducing the proportion of interventional prenatal diagnoses, and those with positive screening still require further confirmation.
Collapse
Affiliation(s)
- Y S Chen
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - F F Wang
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - L K Y Lu
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Y H Ni
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Q Wang
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - C M Ying
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| |
Collapse
|
3
|
Yue CY, Gao JP, Zhang CY, Ni YH, Ying CM. Development and validation of a nomogram for the early prediction of preeclampsia in pregnant Chinese women. Hypertens Res 2021; 44:417-425. [PMID: 33060833 DOI: 10.1038/s41440-020-00558-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 02/06/2023]
Abstract
To make early predictions of preeclampsia before diagnosis, we developed and validated a new nomogram for the early prediction of preeclampsia in pregnant Chinese women. A stepwise regression model was used for feature selection. Multivariable logistic regression analysis was used to develop the prediction model. We incorporated BMI, blood pressure, uterine artery ultrasound parameters, and serological indicator risk factors, and this was presented with a nomogram. The performance of the nomogram was assessed with respect to its calibration, discrimination, and clinical usefulness. Internal validation was assessed. The signature, which consisted of 11 selected features, was associated with preeclampsia status (P < 0.1) for the development dataset. Predictors contained in the individualized prediction nomogram included BMI, blood pressure, uterine artery ultrasound parameters, and serological indicator levels. The model showed good discrimination, with an area under the ROC curve of 0.8563 (95% CI: 0.8364-0.8761) and good calibration. The nomogram still had good discrimination and good calibration when applied to the validation dataset (area under ROC curve of 0.8324, 95% CI: 0.7873-0.8775). Decision curve analysis demonstrated that the nomogram was clinically useful. The nomogram presented in this study incorporates BMI, blood pressure, uterine artery ultrasound parameters, and serological indicators and can be conveniently used to facilitate the individualized prediction of preeclampsia.
Collapse
Affiliation(s)
- Chao-Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Jiang-Ping Gao
- College of Engineering and Computer Science, Australian National University, Canberra, ACT, Australia
| | - Chun-Yi Zhang
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ying-Hua Ni
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chun-Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
| |
Collapse
|
4
|
Yue CY, Wu Y, Duan CH, Wei J, Zhang D, Luo XH, Zhang QL, Ying CM. Performance evaluation of a fully automated anti-Müllerian hormone immunoassay and multicentre study on the establishment of reference range in adult women. Ann Clin Biochem 2021; 57:170-177. [PMID: 31910641 DOI: 10.1177/0004563220902171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims To evaluate the analytical performance of a fully automatic iFlash anti-Müllerian hormone immunoassay (YHLO Biotech) and establish age-specific reference range for anti-Müllerian hormone in Chinese women based on a multicentre population study. Design and method iFlash anti-Müllerian hormone assay was evaluated for sensitivity, imprecision, serial dilution for linearity, impact of sample type, storage and stability. Method comparison of iFlash anti-Müllerian hormone with Elecsys anti-Müllerian hormone was studied. Reference intervals in healthy females were established for iFlash anti-Müllerian hormone. Results The limit of blank and limit of detection were below 0.001 ng/mL and 0.02 ng/mL, respectively. Assay sensitivity defined as limit of quantitation was 0.08 ng/mL. The assay imprecision was similar at low and high concentration being 3.1% and 3.2%, respectively. The linearity was observed to be between 0.02 ng/mL and 27.22 ng/mL. The stability of AMH was most at −80°C and up to seven days at 4°C, −20°C. No significant difference was observed for anti-Müllerian hormone among different sample types. An excellent agreement of anti-Müllerian hormone concentration was found in 180 samples analysed by iFlash and Roche; the correlation coefficient was 0.975 and regression slope of 1.009. The AMH reference intervals for Chinese women aged between the ages of 20 and 49 years with five-year intervals were 1.20–10.21 ng/mL, 1.14–9.17 ng/mL, 0.55–8.18 ng/mL, 0.25–7.02 ng/mL, 0.07–4.59 ng/mL and 0.01–2.11 ng/mL, respectively (1 ng/mL = 7.14 pmol/L). Conclusion The fully automated iFlash anti-Müllerian hormone immunoassay demonstrates excellent analytical performance. Consequently, the availability of iFlash anti-Müllerian hormone assay will represent a robust, fast, sensitive and precise immunoassay for the determination of anti-Müllerian hormone concentration.
Collapse
Affiliation(s)
- Chao-Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yong Wu
- Department of Laboratory Medicine, The Third Xiangya Hospital of Central South University, Hunan, China
| | - Chao-Hui Duan
- Department of Laboratory Medicine, SUN YAT-SEN Memorial Hospital, SUN YAT-SEN University, Guangzhou, China
| | - Jie Wei
- Department of Laboratory Medicine, SUN YAT-SEN Memorial Hospital, SUN YAT-SEN University, Guangzhou, China
| | - Di Zhang
- Department of Laboratory Medicine, The Third Xiangya Hospital of Central South University, Hunan, China
| | - Xiao-Hong Luo
- Department of Laboratory Medicine, SUN YAT-SEN Memorial Hospital, SUN YAT-SEN University, Guangzhou, China
| | - Qian-Lan Zhang
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chun-Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| |
Collapse
|
5
|
Yue CY, Zhang CY, Ying CM. Serum markers in quadruple screening associated with adverse pregnancy outcomes: A case-control study in China. Clin Chim Acta 2020; 511:278-281. [PMID: 33148533 DOI: 10.1016/j.cca.2020.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/15/2020] [Accepted: 10/19/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND We assessed whether the results of quadruple screening during pregnancy are associated with an increased risk of adverse pregnancy outcomes. METHODS We measured serum marker concentrations using quadruple screening in the second trimester of pregnancy and analyzed the relationship between adverse perinatal outcomes and serum markers in 12,124 pregnant women. A multivariate logistic regression analysis was used to evaluate the relative risk of quadruple screening and adverse pregnancy outcomes. RESULTS Compared with the control group, increased concentrations of alpha-fetoprotein (AFP) and inhibin A were risk factors for preeclampsia and preterm delivery; low concentrations of unconjugated estriol and high inhibin A were risk factors for pregnancy hypertension; an increased concentration of human chorionic gonadotropin (hCG) was a risk factor for gestational diabetes mellitus; high AFP, low hCG, and high inhibin A were risk factors for low birth weight; and low AFP and high hCG were risk factors for macrosomia. CONCLUSIONS Quadruple screening in the second trimester of pregnancy can provide early warning signs for maternal and fetal adverse pregnancy outcomes.
Collapse
Affiliation(s)
- Chao-Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chun-Yi Zhang
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chun-Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
| |
Collapse
|
6
|
Yue CY, Ying CM. Sufficience serum vitamin D before 20 weeks of pregnancy reduces the risk of gestational diabetes mellitus. Nutr Metab (Lond) 2020; 17:89. [PMID: 33088335 PMCID: PMC7574245 DOI: 10.1186/s12986-020-00509-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/08/2020] [Indexed: 12/12/2022] Open
Abstract
Objective Our aim was to evaluate the relationship between serum vitamin D levels before 20 weeks of pregnancy and the risk of gestational diabetes mellitus. Methods This study is a retrospective study. We analyzed the relationship between serum 25 (OH) D level before 20 weeks of pregnancy (first antenatal examination) and the risk of gestational diabetes mellitus. Age, parity and pre-pregnancy body mass index were used as confounding factors. 8468 pregnant women were enrolled in this study between January 2018 and March 2020 at the Obstetrics and Gynecology Hospital of Fudan University. Adjusted smoothing splinespline plots, subgroup analysis and multivariate logistic regression analysis was conducted to estimate the relative risk between 25(OH)D and gestational diabetes mellitus. Results After fully adjusting the confounding factors, serum vitamin D is a protective factor in gestational diabetes mellitus (OR = 0.90). Compared with vitamin D deficiency, vitamin D insufficiency (OR = 0.78), sufficience (OR = 0.82) are a protective factor for gestational diabetes mellitus. Conclusion Sufficience vitamin D before 20 weeks of pregnancy is a protective factor for gestational diabetes mellitus. Vitamin D > 20 ng/mL can reduce the risk of GDM, which is not much different from the effect of > 30 ng/mL. The protective effect of vitamin D is more significant in obese pregnant women.
Collapse
Affiliation(s)
- Chao-Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Fang Xie Road, No 419, Shanghai, China
| | - Chun-Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Fang Xie Road, No 419, Shanghai, China
| |
Collapse
|
7
|
Chen YS, Wu YQ, Zhang Y, Ying CM. Clinical Performance of Cell-Free Fetal DNA Testing for Fetal Aneuploidies and Subchromosomal Deletions/Duplications in a Cohort of 19,531 Pregnancies. Reproductive and Developmental Medicine 2020. [DOI: 10.4103/2096-2924.292951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
8
|
Yue CY, Zhang CY, Ni YH, Ying CM. Are serum levels of inhibin A in second trimester predictors of adverse pregnancy outcome? PLoS One 2020; 15:e0232634. [PMID: 32469905 PMCID: PMC7259778 DOI: 10.1371/journal.pone.0232634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/17/2020] [Indexed: 11/25/2022] Open
Abstract
Objective During pregnancy, inhibin A is mainly derived from the placenta and regulates the implantation and differentiation of embryos. Our aim was to assess whether second trimester serum inhibin A was associated with an increased risk of adverse pregnancy outcomes. Methods We investigated the serum levels of Inhibin A during the second trimester in pregnancy, and analyzed associations between the Inhibin A and the risk of adverse pregnancy outcome. 12,124 pregnant women were enrolled in this study between January 2017 and July 2019 at the Obstetrics & Gynecology Hospital of Fudan University. Multivariate logistic regression analysis was conducted to estimate the relative risk between Inhibin A and adverse pregnancy outcome. Results Compared with the group without adverse pregnancy outcome, during the second trimester of pregnancy, age and Inhibin A were risk factors for pre-eclampsia, gestational diabetes mellitus and preterm delivery; Inhibin A was risk factors for low birth weight. Gravidity and Inhibin A were risk factors for macrosomia; while parity was a protective factor against pre-eclampsia, gestational hypertension and low birth weight. Conclusion Elevated Inhibin A levels in pregnancy are significantly associated with pre-eclampsia, GDM, macrosomia, low birth weight and preterm delivery.
Collapse
Affiliation(s)
- Chao-Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chun-Yi Zhang
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Ying-Hua Ni
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chun-Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- * E-mail:
| |
Collapse
|
9
|
Wu Y, Wu M, Wang Y, Chen Y, Gao J, Ying C. ERG11 couples oxidative stress adaptation, hyphal elongation and virulence in Candida albicans. FEMS Yeast Res 2019; 18:5040230. [PMID: 29931064 DOI: 10.1093/femsyr/foy057] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/18/2018] [Indexed: 12/12/2022] Open
Abstract
Candida albicans is a major fungal opportunistic pathogen for humans. In the treatment of C. albicans, azole drugs target the sterol 14α-demethylase (CYP51) encoded by ERG11 gene. Most studies have focused on the fact that the ERG11 mutant results in drug resistance, but its mechanism of action as a drug target has not been described yet. Our results showed that deletion of ERG11 reduced filamentous and invasive growth, and impaired hyphal elongation in sensing serum. Lack of ERG11 increased susceptibility to H2O2 and was defective in clearing reactive oxygen species. ERG11 may affect oxidative stress adaptation by specifically downregulating CAT1 expression. In addition, C. albicans cells lacking ERG11 were more efficiently killed by macrophages and became avirulent in vivo. This study is the first to indicate that ERG11 plays an essential role in hyphal elongation, oxidative stress adaptation and virulence in C. albicans. We speculated that azole drugs not only inhibit the growth of C. albicans, but also assist the host immune system in clearing the fungal organism. The new understanding of mechanisms of action of antifungal drugs should facilitate the development of treatment strategies for resistant fungal infections.
Collapse
Affiliation(s)
- YongQin Wu
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| | - MengYing Wu
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| | - YuanYuan Wang
- Unit of Pathogenic Fungal Infection and Host Immunity, Institute Pasteur of Shanghai, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - YiSheng Chen
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| | - Jing Gao
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| | - ChunMei Ying
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| |
Collapse
|
10
|
Yue CY, Lu LKY, Li M, Zhang QL, Ying CM. Threshold value of anti-Mullerian hormone for the diagnosis of polycystic ovary syndrome in Chinese women. PLoS One 2018; 13:e0203129. [PMID: 30153296 PMCID: PMC6112651 DOI: 10.1371/journal.pone.0203129] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 08/15/2018] [Indexed: 02/02/2023] Open
Abstract
Objective We intended to establish the threshold for anti-Mullerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS) in China. Methods A total of 771 women (653 with PCOS and 118 healthy controls) were enrolled. The serum AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), FSH/LH, prolactin, estradiol, testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), sex hormone-binding globulin (SHBG), 17α-OH progesterone (17α-OHP), fasting insulin (INS), fasting glucose, free androgen index (FAI%) and homeostasis model assessment for insulin resistance (HOMA-IR) index were analyzed, and the diagnostic utility of AMH, LH/FSH, T and INS was established using receiver operator characteristic (ROC) curves. With AMH, LH/FSH, T and INS as independent variables, a logistic regression model was established, and the ROC curve for combined detection was fitted with the probability value of the model. Results The serum level of FSH, LH, LH/FSH, AMH, FAI%, 17α-OHP, fasting INS, T, SHBG, DHEA-S and HOMA-IR were altered in the PCOS patients. The best compromise between sensitivity and specificity was found at an AMH cut-off level of 8.16 ng/ml and 5.89 ng/ml for the age groups 20–29 and 30–39 years, with the corresponding area under the curve being 0.846 and 0.865 respectively. The area under the ROC curve for combined detection was 0.951, which was significantly greater than that of each index. Finally, the concentration of AMH was associated with FSH, LH, LH/FSH, T, and ovarian volume in PCOS patients. Conclusion The optimal AMH diagnostic threshold for PCOS was 8.16 ng/ml (20–29 years) and 5.89 ng/ml (30–39 years) in the Chinese population of this study. Moreover, serum AMH, LH/FSH, T and INS could be used in combination to improve the diagnostic specificity and sensitivity for the detection of PCOS.
Collapse
Affiliation(s)
- Chao-Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Lou-Kai-Yi Lu
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Meng Li
- Department of Ultrasound, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Qian-Lan Zhang
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chun-Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| |
Collapse
|
11
|
Yue CY, Ying CM. Epidemiological analysis of maternal lipid levels during the second trimester in pregnancy and the risk of adverse pregnancy outcome adjusted by pregnancy BMI. J Clin Lab Anal 2018; 32:e22568. [PMID: 29774596 DOI: 10.1002/jcla.22568] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/14/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Pregnancy is accompanied by profound changes in lipid metabolism. We aimed to assess whether effects of second trimester body mass index and maternal lipid concentrations are associated with an increased risk of adverse pregnancy outcomes. METHODS We investigated the serum levels of maternal lipids during the second trimester in pregnancy, and analyzed associations between the lipid levels and the risk of adverse pregnancy outcome. Seven hundred and seventy-four pregnant women were enrolled in this study between February 2016 and June 2016. Multivariate logistic regression analysis was conducted to estimate the relative risk between maternal lipids and adverse pregnancy outcome. RESULTS Compared with the control group, during the second trimester of pregnancy, BMI, TG, and Lp(a) were risk factors for gestational diabetes mellitus; middle trimester pregnancy BMI, Lp(a), and APO-B were risk factors for pre-eclampsia; second trimester BMI and TG/HDL-C were risk factors for macrosomia; age and Lp(a) were uterine atony postpartum hemorrhage risk factors, while APO-AI was a protective factor of uterine inertia and postpartum hemorrhage; second trimester BMI, TCH, Lp(a), and TG/HDL-C were risk factors for fetal distress, while parity was a protective factor against fetal distress. CONCLUSION Abnormal blood lipid levels in pregnancy are significantly associated with GDM, pre-eclampsia, and other adverse pregnancy outcomes.
Collapse
Affiliation(s)
- Chao-Yan Yue
- Department of Laboratory Medicine, Obstetrics and Gynecology, Hospital of Fudan University, Shanghai, China
| | - Chun-Mei Ying
- Department of Laboratory Medicine, Obstetrics and Gynecology, Hospital of Fudan University, Shanghai, China
| |
Collapse
|
12
|
Wu Y, Gao N, Li C, Gao J, Ying C. A newly identified amino acid substitution T123I in the 14α-demethylase (Erg11p) of Candida albicans confers azole resistance. FEMS Yeast Res 2018; 17:3053043. [PMID: 28334124 DOI: 10.1093/femsyr/fox012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/23/2017] [Indexed: 01/02/2023] Open
Abstract
The increasing prevalence of azole resistance in Candida albicans poses a growing problem for clinical treatment. Amino acid substitution of the 14α-demethylase (Erg11p) encoded by the ERG11 gene is one of the most common mechanisms involved in azole resistance. Although amino acid substitutions of Erg11p have been observed in many clinical isolates, only a few amino acid substitutions have been confirmed to be related to azole resistance. In this study, by amplifying and sequencing the open reading frame of the ERG11 gene from 55 clinical isolates, we identified 27 fluconazole-resistant isolates that harbor a novel amino acid substitution, T123I, in Erg11p, in addition to the previously described homozygous substitution Y132H. We investigated both the contribution of this novel substitution T123I and its synergistic effect with substitution Y132H to azole resistance by heterogeneously expressing the C. albicans Erg11p with different substitution forms in Saccharomyces cerevisiae. Results showed that S. cerevisiae cells harboring the substitution T123I displayed higher (4-fold) minimum inhibitory concentration values to both fluconazole and voriconazole than the cells expressing the wild-type version of C. albicans Erg11p, but this was not true for itraconazolele. More importantly, a synergistic effect of substitutions T123I and Y132H was observed in an assay of voriconazole resistance. These results indicate that amino acid substitutions of Erg11p are prevalent among azole-resistant isolates and that the substitution T123I confers resistance to both fluconazole and voriconazole.
Collapse
Affiliation(s)
- YongQin Wu
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| | - Ning Gao
- Unit of Pathogenic Fungal Infection and Host Immunity, CAS Key Laboratory of Molecular Virology and Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China
| | - Cui Li
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| | - Jing Gao
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| | - ChunMei Ying
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, 419 Fangxie Road, Shanghai 200011, China
| |
Collapse
|
13
|
Wu Y, Li C, Wang Z, Gao J, Tang Z, Chen H, Ying C. Clonal spread and azole-resistant mechanisms of non-susceptible Candida albicans isolates from vulvovaginal candidiasis patients in three Shanghai maternity hospitals. Med Mycol 2017; 56:687-694. [PMID: 29136186 DOI: 10.1093/mmy/myx099] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- YongQin Wu
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, No. 419 Fangxie Road, Shanghai, 200011, China
| | - Cui Li
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, No. 419 Fangxie Road, Shanghai, 200011, China
| | - ZhiHeng Wang
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, No. 419 Fangxie Road, Shanghai, 200011, China
| | - Jing Gao
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, No. 419 Fangxie Road, Shanghai, 200011, China
| | - ZhenHua Tang
- Department of Clinical Laboratory, International Peace Maternity and Child Health Hospital, No. 910 Hengshan Road, Shanghai, 200030, China
| | - HuiFen Chen
- Department of Clinical Laboratory, Shanghai First Maternity and Infant Hospital, No. 536 Changle Road, Shanghai, 200040, China
| | - ChunMei Ying
- Department of Clinical Laboratory, Obstetrics and Gynecology Hospital of Fudan University, No. 419 Fangxie Road, Shanghai, 200011, China
| |
Collapse
|
14
|
Chen XY, Hou PF, Bi J, Ying CM. Detection of human cytomegalovirus DNA in various blood components after liver transplantation. ACTA ACUST UNITED AC 2014; 47:340-4. [PMID: 24714815 PMCID: PMC4075299 DOI: 10.1590/1414-431x20133353] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 12/13/2013] [Indexed: 11/30/2022]
Abstract
The quantification of human cytomegalovirus (HCMV DNA) by real-time PCR is currently
a primary option for laboratory diagnosis of HCMV infection. However, the optimal
sample material remains controversial due to the use of different PCR assays. To
explore the best blood component for HCMV DNA surveillance after liver
transplantation, whole blood (WB), serum (SE), and plasma (PL) specimens were
collected simultaneously from targeted patients and examined for HCMV DNA using one
commercially available assay. The HCMV DNA-positive rate with WB (16.67%) was higher
than that with either SE or PL (8.33%, both P<0.01). Quantitative DNA levels in WB
were of greater magnitude than those in SE (WB-SE mean log-transformed difference,
0.99; 95%CI=0.74-1.25; P<0.0001) and PL (WB-PL mean log-transformed difference,
1.37; 95%CI=1.07-1.66; P<0.0001). Dynamic monitoring revealed that HCMV DNA in WB
was positive sooner and had higher values for a longer period of time during therapy.
With earlier positive detection, higher sensitivity, and yield of greater viral
loads, WB compared favorably to SE or PL and hence is recommended as the superior
material for HCMV DNA surveillance after liver transplantation. In addition, infant
recipients require more intensive monitoring and prophylactic care because of their
higher susceptibility to primary HCMV infection.
Collapse
Affiliation(s)
- X Y Chen
- Department of Clinical Laboratory, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - P F Hou
- Department of Clinical Laboratory, Rushan Hospital, Shandong, China
| | - J Bi
- Department of Clinical Laboratory, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - C M Ying
- Department of Clinical Laboratory, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
15
|
Luo L, Jiang X, Wu Q, Wei L, Li J, Ying C. Efflux pump overexpression in conjunction with alternation of outer membrane protein may induce Acinetobacter baumannii resistant to imipenem. Chemotherapy 2011; 57:77-84. [PMID: 21346352 DOI: 10.1159/000323620] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 08/07/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND To investigate the role of outer membrane proteins in Acinetobacter baumannii resistant to imipenem, 2 strains were procured from the same patient. METHODS The imipenem-resistant strain was obtained following a period of imipenem treatment in vivo. The multilocus sequence typing and repetitive extragenic palindromic PCR results indicated that the imipenem-resistant strain originated from the sensitive one. RESULTS Isoelectric focusing detected no carbapenemases, with neither OXA carbapenemases nor metallo-β-lactamases found. Mass spectrophotometric analysis revealed that 3 outer membrane proteins were expressed differentially in the 2 strains: 2 downregulated proteins (OprD and CarO) and 1 upregulated the 34-kDa efflux pump protein in the resistant strain. A 32-fold decrease in the MIC for imipenem in the presence of Phe-Arg-β-naphthylamide in the same strain indicated a possible involvement of the efflux pump mechanism in its resistance, which was consistent with the findings that the mRNA expression of the 34-kDa efflux pump gene was almost fivefold upregulated in the imipenem-resistant strain compared with that in the imipenem-sensitive strain. Such a significant difference, however, was not found in the expression of AdeB and AdeJ between the 2 strains, and AdeE was not detected. CONCLUSIONS Our results suggested that downregulation of outer membrane proteins in conjunction with efflux pump overexpression might contribute to imipenem resistance induced in vivo in A. baumannii.
Collapse
Affiliation(s)
- LiuLin Luo
- Department of Clinical Laboratory, Renji Hospital, School of Medicine, Shanghai, China
| | | | | | | | | | | |
Collapse
|
16
|
Zhang JW, Du P, Chen DW, Cui L, Ying CM. [Effect of viable Bifidobacterium supplement on the immune status and inflammatory response in patients undergoing resection for colorectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2010; 13:40-43. [PMID: 20099160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the effect of preoperative use of viable Bifidobacterium supplement on the intestinal flora, immune status, inflammatory response and prognosis of patients undergoing colorectal cancer resection. METHODS Sixty patients with colorectal cancer were randomized into treatment group (n=30) and control group (n=30). Patients in the treatment group received oral viable Bifidobacterium with routine enteral nutrition and patients in the control group received routine enteral nutrition alone. The intestinal flora of stool was analyzed and stool SIgA, serum IgG, IgM, IgA, IL-6, and C-reactive protein (CRP) were detected. RESULTS Postoperative Bifidobacterium/E.coli (B/E) ratio in the treatment group decreased significantly as compared to the preoperative ratio (2.01+/-0.36 vs 26.53+/-4.22, P<0.05). However, the ratios remained above one. Both preoperative and postoperative B/E ratios in the control group (0.72+/-0.14, 0.02+/-0.06) were significantly lower than those in the treatment group (P<0.05). Indexes of immunity and inflammation were not significantly different between the two groups (P>0.05). At day 9 after operation, stool SIgA was higher in the treatment group, while serum IgG, IgM, IgA, IL-6, CRP in the treatment group were lower (P<0.05). Postoperative septic complications in the treatment group was less than that in the control group (P<0.05), but other complications and hospital stay were comparable. CONCLUSIONS In patients with colorectal cancer, supplementation of viable Bifidobacterium before surgery can improve bacterial dysbiosis and immunity, and can reconstruct the balance of intestinal flora, and reduce infection complication of surgery.
Collapse
Affiliation(s)
- Ji-Wei Zhang
- Department of Colorectal Surgery, Xinhua Hospital,School of Medicine,Shanghai Jiaotong University, Shanghai 200092, China
| | | | | | | | | |
Collapse
|