Abstract：
BACKGROUND: Androgen could impact cervical remodelling during pregnancy, and a higher level is associated with adverse pregnancy outcomes. A population-based gestation age-specific reference interval (RI) of total testosterone (TT), androstenedione (A4), and 17-hydroxyprogesterone (17-OHP) can help to diagnose maternal hyperandrogenism.
METHODS: We enrolled 600 healthy Chinese women to obtain longitudinal serum samples across gestation. The serum androgen profile was measured by liquid chromatography-tandem mass spectrometry. The equations for medians of TT, A4, and 17-OHP were generated by MedCal, and the variances adjusted for 2-level modeling were generated by MLwiN, a system for the specification and analysis of a range of multilevel models.
RESULTS: A4 and TT levels increased across the gestation, and they closely correlated with each other (R = 0.90, P=<0.001), whereas 17-OHP level decreased from 5th gestational week to 16th gestational week and then increased afterward towards the end of pregnancy. Women diagnosed with preeclampsia (PE) were found to have a significantly higher level of A4, TT, and 17-OHP when compared with non-PE cases with p ≤0.01, whereas mothers carrying male versus female fetuses have comparable levels of A4, TT, and 17-OHP.
CONCLUSIONS: The study highlights a methodology for constructing gestational age-specific TT, A4, and 17-OHP levels to provide a better interpretation of results in a cohort of healthy Chinese women. The observation in PE supports previous findings, and the higher levels of TT, A4, and 17-OHP were observed before the onset of PE.
METHODS: We enrolled 600 healthy Chinese women to obtain longitudinal serum samples across gestation. The serum androgen profile was measured by liquid chromatography-tandem mass spectrometry. The equations for medians of TT, A4, and 17-OHP were generated by MedCal, and the variances adjusted for 2-level modeling were generated by MLwiN, a system for the specification and analysis of a range of multilevel models.
RESULTS: A4 and TT levels increased across the gestation, and they closely correlated with each other (R = 0.90, P=<0.001), whereas 17-OHP level decreased from 5th gestational week to 16th gestational week and then increased afterward towards the end of pregnancy. Women diagnosed with preeclampsia (PE) were found to have a significantly higher level of A4, TT, and 17-OHP when compared with non-PE cases with p ≤0.01, whereas mothers carrying male versus female fetuses have comparable levels of A4, TT, and 17-OHP.
CONCLUSIONS: The study highlights a methodology for constructing gestational age-specific TT, A4, and 17-OHP levels to provide a better interpretation of results in a cohort of healthy Chinese women. The observation in PE supports previous findings, and the higher levels of TT, A4, and 17-OHP were observed before the onset of PE.
摘要：
背景：雄激素会影响怀孕期间的宫颈重塑，较高的水平与不良妊娠结局相关。总睾酮（TT）的基于人群的妊娠年龄特异性参考区间（RI），雄烯二酮(A4),17-羟孕酮（17-OHP）可以帮助诊断母体高雄激素血症。
方法：我们招募了600名健康的中国女性，以获取整个妊娠期的纵向血清样本。通过液相色谱-串联质谱法测量血清雄激素谱。TT的中位数方程，A4和17-OHP由MedCal产生，为2级建模调整后的方差由MLwiN生成，用于规范和分析一系列多级模型的系统。
结果：A4和TT水平在整个妊娠期增加，两者密切相关(R=0.90,P=<0.001),而17-OHP水平从第5孕周到第16孕周下降，然后在妊娠结束后上升。被诊断为先兆子痫（PE）的妇女被发现有明显较高水平的A4，TT，与p≤0.01的非PE病例相比，17-OHP，而携带男性与女性胎儿的母亲具有相当的A4，TT水平，17-OHP
结论：该研究强调了构建胎龄特异性TT的方法，A4和17-OHP水平为健康中国女性队列的结果提供了更好的解释。PE中的观察结果支持先前的发现，TT水平越高,在PE发作之前观察到A4和17-OHP。
方法：我们招募了600名健康的中国女性，以获取整个妊娠期的纵向血清样本。通过液相色谱-串联质谱法测量血清雄激素谱。TT的中位数方程，A4和17-OHP由MedCal产生，为2级建模调整后的方差由MLwiN生成，用于规范和分析一系列多级模型的系统。
结果：A4和TT水平在整个妊娠期增加，两者密切相关(R=0.90,P=<0.001),而17-OHP水平从第5孕周到第16孕周下降，然后在妊娠结束后上升。被诊断为先兆子痫（PE）的妇女被发现有明显较高水平的A4，TT，与p≤0.01的非PE病例相比，17-OHP，而携带男性与女性胎儿的母亲具有相当的A4，TT水平，17-OHP
结论：该研究强调了构建胎龄特异性TT的方法，A4和17-OHP水平为健康中国女性队列的结果提供了更好的解释。PE中的观察结果支持先前的发现，TT水平越高,在PE发作之前观察到A4和17-OHP。
