Hubalek Michael, Buchner Hannes, Mörtl Manfred G, Schlembach Dietmar, Huppertz Berthold, Firulovic Branka, Köhler Wolfgang, Hafner Erich, Dieplinger Benjamin, Wildt Ludwig, Dieplinger Hans
Department of Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria.
Institute of Medical Informatics, Biometry and Epidemiology, Medical School, Ludwig Maximilian University of Munich, Germany.
Clin Chim Acta. 2014 Jul 1;434(100):41-7. doi: 10.1016/j.cca.2014.03.036. Epub 2014 Apr 24.
Afamin is a liver-derived plasma glycoprotein with vitamin E-binding properties and a putative function in fertility. This study evaluated serum afamin concentrations during and postpartum to uncomplicated pregnancies and investigated a potential association between afamin concentrations and pregnancy outcome.
Afamin serum concentrations were measured in women with uncomplicated pregnancies in a retrospective cohort (n=466) at different gestational ages and a prospective observational study (n=76) in the first, second and third trimester. Furthermore, afamin was determined in the first trimester in a cross-sectional pilot study including women with preeclampsia (PE), pregnancy-induced hypertension (PIH) and women without pregnancy complications (n=13 each). Finally, expression of afamin was investigated in human placental tissue by RT-PCR and immunohistochemistry.
Afamin concentrations increased linearly almost two-fold during pregnancy in both retrospective and prospective studies in women without pregnancy complications with median afamin serum concentrations of 61.9 mg/l, 79.6 mg/l, and 98.6 mg/l in the first, second, and third trimester, respectively. After delivery, median afamin concentrations decreased to baseline values of 54.6 mg/l. In the pilot study with pregnancy complications, women with PE displayed significantly higher median afamin concentrations than did women with uncomplicated pregnancy (70.0 mg/l vs. 55.4 mg/l, P=0.007). Expression analyses revealed no placental afamin expression at either mRNA or protein level in uncomplicated pregnancy.
A linear increase in the maternally expressed glycoprotein afamin during pregnancy may serve as basic reference for subsequent investigations of afamin in pregnancy-related disorders.
载脂蛋白A（afamin）是一种肝脏来源的血浆糖蛋白，具有维生素E结合特性，在生育方面可能具有一定作用。本研究评估了正常妊娠期间及产后血清中载脂蛋白A的浓度，并探讨了载脂蛋白A浓度与妊娠结局之间的潜在关联。
在一项回顾性队列研究（n = 466）中，测定了不同孕周正常妊娠女性的血清载脂蛋白A浓度；在一项前瞻性观察研究（n = 76）中，测定了孕早期、孕中期和孕晚期的血清载脂蛋白A浓度。此外，在一项横断面试点研究中，测定了孕早期患有先兆子痫（PE）、妊娠高血压（PIH）的女性以及无妊娠并发症女性（每组n = 13）的血清载脂蛋白A浓度。最后，通过逆转录聚合酶链反应（RT-PCR）和免疫组织化学方法研究了人胎盘组织中载脂蛋白A的表达。
在回顾性和前瞻性研究中，无妊娠并发症的女性在妊娠期间载脂蛋白A浓度几乎呈线性增加近两倍，孕早期、孕中期和孕晚期血清载脂蛋白A浓度中位数分别为61.9 mg/l、79.6 mg/l和98.6 mg/l。分娩后，血清载脂蛋白A浓度中位数降至54.6 mg/l的基线值。在有妊娠并发症的试点研究中，患有先兆子痫的女性血清载脂蛋白A浓度中位数显著高于无妊娠并发症的女性（70.0 mg/l对55.4 mg/l，P = 0.007）。表达分析显示，正常妊娠时胎盘组织在mRNA或蛋白质水平均无载脂蛋白A表达。
孕期母体表达的糖蛋白载脂蛋白A呈线性增加，可为后续有关妊娠相关疾病中载脂蛋白A的研究提供基础参考。
