Ozturk Gulfer, Ozgu-Erdinc A Seval, Ucar Fatma, Ginis Zeynep, Erden Gonul, Danisman Nuri
1 Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
2 Zekai Tahir Burak Women's Health Care Education and Research Hospital, Ankara, Turkey.
Ann Clin Biochem. 2017 Mar;54(2):258-263. doi: 10.1177/0004563216654724. Epub 2016 Sep 28.
Background Hyperemesis gravidarum, which affects 0.3-2.3% of pregnancies, is defined as excessive vomiting during pregnancy and usually starts in week 4 or 5 of gestation. Symptoms include weight loss, dehydration, ketonaemia, ketonuria, fasting acidosis, alkalosis due to hydrochloric acid loss and hypokalaemia and its exact cause is unknown. The present study was undertaken to investigate the relationship between prealbumin, ghrelin, nesfatin-1 and obestatin concentrations in pregnancies associated with hyperemesis gravidarum. Methods A total of 40 pregnant females with hyperemesis gravidarum and 38 pregnant females without hyperemesis gravidarum as controls were included in this study. Serum concentrations of prealbumin, ghrelin, obestatin and nesfatin-1 were measured. Results There were no significant differences in age, gestational week, gravidity and parity between the two groups. Body mass index was significantly lower in cases than in controls. Serum ghrelin and prealbumin concentrations were significantly lower in cases than in controls ( P <0.05 and P < 0.001, respectively). There was no significant difference in serum concentrations of obestatin and nesfatin-1 between the two groups. There was no significant association between body mass index and serum ghrelin, nesfatin-1, obestatin or prealbumin concentrations in patients with hyperemesis gravidarum. Conclusions Decreased serum concentrations of ghrelin and prealbumin in patients with hyperemesis gravidarum are independent of body mass index. Based on our results, we believe that ghrelin may be considered to play a role in the aetiopathogenesis of hyperemesis gravidarum and that hyperemesis gravidarum may result in disruption of the relationship between nesfatin-1 and ghrelin. In addition, we believe that the measurement of serum prealbumin may be used for assessing nutritional status in pregnancy.
妊娠剧吐影响0.3%-2.3%的孕妇,定义为孕期过度呕吐,通常始于妊娠第4或5周。症状包括体重减轻、脱水、酮血症、酮尿症、空腹酸中毒、因盐酸丢失导致的碱中毒和低钾血症,其确切病因尚不清楚。本研究旨在探讨妊娠剧吐孕妇中前白蛋白、胃饥饿素、nesfatin-1和肥胖抑制素浓度之间的关系。方法:本研究纳入40例妊娠剧吐孕妇和38例无妊娠剧吐的孕妇作为对照。检测血清中前白蛋白、胃饥饿素、肥胖抑制素和nesfatin-1的浓度。结果:两组在年龄、孕周、孕次和产次方面无显著差异。病例组的体重指数显著低于对照组。病例组血清胃饥饿素和前白蛋白浓度显著低于对照组(分别为P<0.05和P<0.001)。两组血清肥胖抑制素和nesfatin-1浓度无显著差异。妊娠剧吐患者的体重指数与血清胃饥饿素、nesfatin-1、肥胖抑制素或前白蛋白浓度之间无显著关联。结论:妊娠剧吐患者血清胃饥饿素和前白蛋白浓度降低与体重指数无关。基于我们的研究结果,我们认为胃饥饿素可能在妊娠剧吐的发病机制中起作用,且妊娠剧吐可能导致nesfatin-1与胃饥饿素之间的关系紊乱。此外,我们认为血清前白蛋白的检测可用于评估孕期营养状况。