Comparison of Diagnostic Values of Maternal Arginine Concentration for Different Pregnancy Complications: A Systematic Review and Meta-Analysis.

Lianbin Xu,Huanan Wang,Jia Zeng,Hongyun Liu

doi:10.3390/biomedicines10010166

Abstract

Abnormal arginine metabolism contributes to the development of intrauterine growth restriction (IUGR), preeclampsia (PE), and gestational diabetes mellitus (GDM), which increase the health burden of mothers and induce adverse birth outcomes. However, associations between maternal arginine concentration and different pregnancy complications have not been systematically compared. The PubMed, ScienceDirect, and Web of Science databases were searched for peer-reviewed publications to evaluate the diagnostic value of plasma arginine concentration in complicated pregnancies. Standardized mean difference (SMD) of the arginine concentration was pooled by a random effects model. The results show that increased maternal arginine concentrations were observed in IUGR (SMD: 0.48; 95% CI: 0.20, 0.76; I2 = 47.0%) and GDM (SMD: 0.46; 95% CI: 0.11, 0.81; I2 = 82.3%) cases but not in PE patients (SMD: 0.21; 95% CI: −0.04, 0.47; I2 = 80.3%) compared with the normal cohorts. Subgroup analyses indicated that the non-fasting circulating arginine concentration in third trimester was increased significantly in GDM and severe IUGR pregnancies, but the change mode was dependent on ethnicity. Additionally, only severe PE persons were accompanied by higher plasma arginine concentrations. These findings suggest that maternal arginine concentration is an important reference for assessing the development of pregnancy complications.

Highlights

Our study showed that the plasma arginine concentration was increased significantly in Intrauterine growth restriction (IUGR) women compared with the control group, which was supported by our previous study showing that the umbilical-to-maternal ratio of the arginine concentration decreased most significantly among all essential amino acids in cases of IUGR
We systematically reviewed the association between maternal arginine concentration and different pregnancy complications, including IUGR, PE, and gestational diabetes mellitus (GDM)
Our results provide evidence that the developments of IUGR and GDM are associated with the maternal plasma arginine levels

Summary

Introduction

Preeclampsia (PE), a serious pregnancy complication evidenced by hypertension and proteinuria after 20 weeks of gestation [3], results in elevated maternal and fetal/neonatal morbidity rates and even higher mortality [4]. The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide, resulting in a higher risk of the subsequent development of type 2 diabetes mellitus (T2DM) and cardiovascular diseases in pregnant mothers [5] and health problems in newborns [6]. These findings emphasize the urgent need to improve antenatal detection and management of IUGR, PE, and GDM pregnancies

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Conclusion