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Maternal 25 Hidroksi Vitamin D eksikliği plasental peptidlerin (Serbest β-hCG ve PAPP-A) düzeyini etkiler mi ?

Year 2017, Volume: 3 Issue: 3, 589 - 597, 15.12.2017
https://doi.org/10.30569/adiyamansaglik.410875

Abstract

ÖZET

Amaç: Biz bu
çalışmamızda 25 hidroksi D vitamini düzeyi düşük gebelerde ,
sinsisyotrofoblastlarda plasental hidroksilasyonla yeterince 1,25 dihidroksi D
vitamini sentezi yükselemeyecek ve bunun sonucunda sinsisyotrofoblastik uyarı
eksik yapılarak  plasental peptidler olan
serbest β-hCG  ve PAPP-A sekresyonu
azalacak mıdır sorusuna cevap aramaktayız.

Gereç ve
Yöntemler
: Bu retrospektif çalışmamıza  Medikal 
Park Göztepe Hastanesi‘ne Ocak -Aralık 2017 yılı içerisinde
başvuran  11-14. Gebelik haftasında ikili
tarama testi yapılmış  225 gebe dahil
edilmiştir. Çalışma retrospektif gözlemsel arşiv taraması ve tek merkezli
olarak planlanmıştır. Arşiv dosya taraması için Medikal Park Göztepe Hastane
kompleksinden (2017/13007 sayılı) akademik kurum onay kararı alınmıştır.

 

İkili tarama
testindeki PAPP-A ve serbest β-hCG seviyeleri ile  ilk trimesterde  aile sağlığı merkezlerinde  rutin bakılmış olan 25 hidroksi D vitamini
düzeyleri arasındaki olabilecek 
istatistiksel ilişkiyi araştırdık. Vitamin D düzeyi normal olan 80
gebe  ile vitamin D düzeyi eksik olan 145
gebenin ikili test sonuçları karşılaştırılmıştır.

Çalışmamıza  Ivf gebeliği olanlar , ikiz gebelikler
,sigara içenler, gastrointestinal sistem ve 
troid rahatsızlığı olanlar  ,
pregestasyonel diabet tanılı olanlar ,sistemik hastalığı ve inflamatuar barsak
hastalığı (Ülseratif  kolit, Crohn ,vb )
olanlar, gastrit şikayetleri olanlar  , D
vitamini desteği alan gebeler alınmamıştır.

Bulgular: PAPP-A seviyeleri 
ve anne yaşı arasında negatif korelasyon saptandı
(p=0.219). Serbest β-hCG seviyesi ile anne yaşı arasında pozitif
korelasyon bulundu (p=0.034) .
Düşük  25(OH)D
vitamini seviyeleri ile
serbest β-hCG arasında negatif korelasyon
saptandı (p=0.071). Düşük 25(OH)D vitamini   ile PAPP-A 
seviyeleri arasında pozitif korelasyon saptandı (p=0.414) .















Sonuç: İlk
trimester  serbest β-hCG, ,PAPP-A
seviyeleri  ile vitamin D arasında
istatistiksel olarak anlamlı bir ilişki bulunmamıştır.   

References

  • 1. Özkan B, Döneray H. The non-skeletal effects of vitamin D. Çocuk Sağlığı ve Hastalıkları Dergisi 2011;53:99-119.
  • 2. Perez-Lopez FR. Vitamin D: the secosteroid hormone and human reproduction. Gynecol Endocrinol 2007;23:13–24.
  • 3. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357: 266–81.
  • 4. Lucas RM, Ponsonby AL, Pasco JA, Morley R. Future health implications of prenatal and early-life vitamin D status. Nutr Rev 2008;66:710–20.
  • 5. Evans KN, Bulmer JN, Kilby MD, Hewison M. Vitamin Dand placental-decidual function. J Soc Gynecol Investig 2004;11:263–71.
  • 6. Evans KN, Nguyen L, Chan J, Innes BA, Bulmer JN, Kilby MD, Hewison M. Effects of 25-OHvitamin D3 and 1,25-dihydroxy vitamin D3 on cytokine production by human decidual cells. Biol Reprod 2006;75:816–22.
  • 7. Avila E, Dı´az L, Barrera D, Halhali A, Me´ndez I, Gonza´lez L, et al. Regulation of vitamin D hydroksilases gene expression by 1,25- dihydroxy vitamin D3 and cyclic AMP in cultured human syncytiotrophoblasts. J Steroid Biochem Mol Biol 2007;103:90–6.
  • 8. Barrera D, Avila E, Herna´ndez G, Me´ndez I, Gonza´lez L, Halhali A, et al. Calcitriol affects hCG gene transcription in cultured human syncytiotrophoblasts. Reprod Biol Endocrinol 2008;6:3.
  • 9. Guibourdenche J, Frendo JL, Pidoux G, Bertin G, Luton D, Muller F, et al. Expression of pregnancy-associated plasma protein-A (PAPP-A) during human villous trophoblast differentiation in vitro. Placenta 2003;24(5):532-9.
  • 10. Pe´rez-Lo´pez FR, Can˜ as E, L’Hermite M, Lo´pez E,Roncero MC, Robyn C. Prolactin and human chorionic gonadotrophin (HCG) in amniotic fluid during the two last trimesters of pregnancy. Int Res Commun 1974;2:1101–02.
  • 11. Pujol-Amat P, Gamissans O, Cabero L, Pe´rez-Lo´pez FR, Benito E, Calaf J, et al. Effects of synthetic luteinizing hormone-releasing hormone on serum gonadotrophins, prolactin and chorionic somatomammotrophin during the last trimester of pregnancy.. Springer Verlag 1975; 246–49.
  • 12. Pe´rez-Lo´pez FR, Tierz JA, Abo´ s MD, Pellejero S, Teijeiro J.Dopaminergic regulation of human prolactin, ACTH, aldosterone,TSH, placental lactogen, chorionic gonadotropin and estriol during pregnancy. Akademiai Kiado 1982; 459–66.
  • 13. Bersinger NA, Keller PJ, Naiem A, Fischer M, Schneider H. Pregnancy-specific and pregnancy-associated proteins in threatened abortion. Gynecol Endocrinol 1987;1:379–84.
  • 14. Dugoff L, Hobbins JC, Malone FD, Porter TF, Luthy D, Comstock CH, et al. First-trimester maternal serum PAPP-A and serbest-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). Am J Obstet Gynecol 2004;191:1446–51.
  • 15. Kagan KO, Wright D, Baker A, Sahota D, Nicolaides KH. Screening for trisomy 21 by maternal age, fetal nuchal translucency thickness, serbest β-human chorionic gonadotropin and pregnancy-associated plasma protein-A. Ultrasound Obstet Gynecol 2008;31:618–24.
  • 16. Bayes-Genis A, Conover CA, Overgaard MT, Bailey KR, Christiansen M, Holmes DR Jr,et al. Pregnancy-associated plasma protein A as a marker of acute coronary syndromes. N Engl JMed 2001;345: 1022–29.
  • 17. Krantz DA, Larsen JW, Buchanan PD, Macri JN. First trimester Down syndrome screening: serbest b-human chorionic gonadotropin and pregnancy-associated plasma protein A. Am J Obstet Gynecol 1996;174:612–16.
  • 18. Ramlau-Hansen CH, Moeller UK, Bonde JP, Olsen J, Thulstrup AM. Are serum levels of vitamin D associated with semen quality? Results from a cross-sectional study in young healthy men. Fertil Steril 2011;95:1000–04.
  • 19. Shin JS, Choi MY, Longtine MS, Nelson DM. Vitamin D effects on pregnancy and the placenta. Placenta 2010;31: 1027–34.
  • 20. Equils O, Hewison M. A role for vitamin D in placental immunology. J Infect Dis 2010;201:1950–51.
  • 21. Lewis S, Lucas RM, Halliday J, Ponsonby AL. Vitamin D deficiency and pregnancy: from preconception to birth. Mol Nutr Food Res 2010;54:1092–102.
  • 22. Pérez-López FR, Fernández-Alonso AM, Ferrando-Marco P, González-Salmerón MD, Dionis-Sánchez EC, Fiol-Ruiz G, et al. First trimester serum 25-hydroxyvitamin D status and factors related to lower levels in gravids living in the Spanish Mediterranean coast. Reprod Sci 2011;18:730–36.
  • 23. Christakos S, Ajibade DV, Dhawan P, Fechner AJ, Mady LJ. Vitamin D: metabolism. Endocrinol Metab Clin North Am 2010;39:243–53.
  • 24. Zehnder D, Evans KN, Kilby MD, Bulmer JN, Innes BA, Stewart PM, et al. The ontogeny of 25-hydroxyvitamin D3 1alpha-hydroxylase expression in human placenta and decidua. Am J Pathol. 2002;161:105–14.
  • 25. Liu PT, Stenger S, Tang DH, Modlin RL. Cutting Edge: Vitamin D mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol. 2007;179:2060–3.
  • 26. Halhali A, Tovar AR, Torres N, Bourges H, Garabedian M, Larrea F. Preeclampsia is associated with low circulating levels of insulin-like growth factor I and 1,25-dihydroxyvitamin D in maternal and umbilical cord compartments. J Clin Endocrinol Metab. 2000;85:1828–33
  • 27. Hyppönen E. Vitamin D for the prevention of preeclampsia? A hypothesis. Nutr Rev. 2005;63:225–32.

Does the deficiency of 25-hydroxy vitamin D effect the placental peptides (free β-human chorionic gonadotropin and pregnancy-associated plasma protein A ) levels ?

Year 2017, Volume: 3 Issue: 3, 589 - 597, 15.12.2017
https://doi.org/10.30569/adiyamansaglik.410875

Abstract

Summary

Objective

In this study, we analysed that low maternal 25 hydroxy
vitamin D (25(OH)D) levels cause an 
increase in the level of 1,25 dihydroxy vitamin D in the
syncytiotrophoblasts by placental hydroxilation and also we analysed the
effects of low syncystiotrofoblastic stimulation on placental peptides (free
β-human chorionic gonadotropin and pregnancy-associated plasma protein A)
secretion..

Material
and Methods

This retrospective study was included 225 pregnant women at
11-14 weeks of gestation attending the outpatient clinic of our hospital for
first trimester screening test from January 2017 to December 2017. Vitamin D
levels were deficient in 145 pregnant women and adequate in 80 pregnant women.
Serum
25(OH)D concentrations were measured at 11–14 weeks gestation in 225 singleton
pregnancies using liquid chromatography-tandem mass spectrometry in the same
labaratory.

We assessed the relationship 
between vitamin D, free β-human chorionic gonadotropin ( free β-hCG) and
pregnancy associated plasma protein A 
(PAPP-A) levels during pregnancy.

Results: There was a negative correlation between PAPP-A
levels and maternal age at
sampling (p=0.219). There
was a positive correlation between
free β-hCG levels
and maternal age at sampling (p=0.034).
There was a negative
correlation between Low
25(OH)D levels and free β-hCG levels
(p=0.071). There was a positive 
correlation between Low
25(OH)D levels  and PAPP-A levels (p=0.414).

Conclusion















There was no statistically significant relationship between
free β-hCG, PAPP-A levels and vitamin D in the first trimester.

References

  • 1. Özkan B, Döneray H. The non-skeletal effects of vitamin D. Çocuk Sağlığı ve Hastalıkları Dergisi 2011;53:99-119.
  • 2. Perez-Lopez FR. Vitamin D: the secosteroid hormone and human reproduction. Gynecol Endocrinol 2007;23:13–24.
  • 3. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357: 266–81.
  • 4. Lucas RM, Ponsonby AL, Pasco JA, Morley R. Future health implications of prenatal and early-life vitamin D status. Nutr Rev 2008;66:710–20.
  • 5. Evans KN, Bulmer JN, Kilby MD, Hewison M. Vitamin Dand placental-decidual function. J Soc Gynecol Investig 2004;11:263–71.
  • 6. Evans KN, Nguyen L, Chan J, Innes BA, Bulmer JN, Kilby MD, Hewison M. Effects of 25-OHvitamin D3 and 1,25-dihydroxy vitamin D3 on cytokine production by human decidual cells. Biol Reprod 2006;75:816–22.
  • 7. Avila E, Dı´az L, Barrera D, Halhali A, Me´ndez I, Gonza´lez L, et al. Regulation of vitamin D hydroksilases gene expression by 1,25- dihydroxy vitamin D3 and cyclic AMP in cultured human syncytiotrophoblasts. J Steroid Biochem Mol Biol 2007;103:90–6.
  • 8. Barrera D, Avila E, Herna´ndez G, Me´ndez I, Gonza´lez L, Halhali A, et al. Calcitriol affects hCG gene transcription in cultured human syncytiotrophoblasts. Reprod Biol Endocrinol 2008;6:3.
  • 9. Guibourdenche J, Frendo JL, Pidoux G, Bertin G, Luton D, Muller F, et al. Expression of pregnancy-associated plasma protein-A (PAPP-A) during human villous trophoblast differentiation in vitro. Placenta 2003;24(5):532-9.
  • 10. Pe´rez-Lo´pez FR, Can˜ as E, L’Hermite M, Lo´pez E,Roncero MC, Robyn C. Prolactin and human chorionic gonadotrophin (HCG) in amniotic fluid during the two last trimesters of pregnancy. Int Res Commun 1974;2:1101–02.
  • 11. Pujol-Amat P, Gamissans O, Cabero L, Pe´rez-Lo´pez FR, Benito E, Calaf J, et al. Effects of synthetic luteinizing hormone-releasing hormone on serum gonadotrophins, prolactin and chorionic somatomammotrophin during the last trimester of pregnancy.. Springer Verlag 1975; 246–49.
  • 12. Pe´rez-Lo´pez FR, Tierz JA, Abo´ s MD, Pellejero S, Teijeiro J.Dopaminergic regulation of human prolactin, ACTH, aldosterone,TSH, placental lactogen, chorionic gonadotropin and estriol during pregnancy. Akademiai Kiado 1982; 459–66.
  • 13. Bersinger NA, Keller PJ, Naiem A, Fischer M, Schneider H. Pregnancy-specific and pregnancy-associated proteins in threatened abortion. Gynecol Endocrinol 1987;1:379–84.
  • 14. Dugoff L, Hobbins JC, Malone FD, Porter TF, Luthy D, Comstock CH, et al. First-trimester maternal serum PAPP-A and serbest-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). Am J Obstet Gynecol 2004;191:1446–51.
  • 15. Kagan KO, Wright D, Baker A, Sahota D, Nicolaides KH. Screening for trisomy 21 by maternal age, fetal nuchal translucency thickness, serbest β-human chorionic gonadotropin and pregnancy-associated plasma protein-A. Ultrasound Obstet Gynecol 2008;31:618–24.
  • 16. Bayes-Genis A, Conover CA, Overgaard MT, Bailey KR, Christiansen M, Holmes DR Jr,et al. Pregnancy-associated plasma protein A as a marker of acute coronary syndromes. N Engl JMed 2001;345: 1022–29.
  • 17. Krantz DA, Larsen JW, Buchanan PD, Macri JN. First trimester Down syndrome screening: serbest b-human chorionic gonadotropin and pregnancy-associated plasma protein A. Am J Obstet Gynecol 1996;174:612–16.
  • 18. Ramlau-Hansen CH, Moeller UK, Bonde JP, Olsen J, Thulstrup AM. Are serum levels of vitamin D associated with semen quality? Results from a cross-sectional study in young healthy men. Fertil Steril 2011;95:1000–04.
  • 19. Shin JS, Choi MY, Longtine MS, Nelson DM. Vitamin D effects on pregnancy and the placenta. Placenta 2010;31: 1027–34.
  • 20. Equils O, Hewison M. A role for vitamin D in placental immunology. J Infect Dis 2010;201:1950–51.
  • 21. Lewis S, Lucas RM, Halliday J, Ponsonby AL. Vitamin D deficiency and pregnancy: from preconception to birth. Mol Nutr Food Res 2010;54:1092–102.
  • 22. Pérez-López FR, Fernández-Alonso AM, Ferrando-Marco P, González-Salmerón MD, Dionis-Sánchez EC, Fiol-Ruiz G, et al. First trimester serum 25-hydroxyvitamin D status and factors related to lower levels in gravids living in the Spanish Mediterranean coast. Reprod Sci 2011;18:730–36.
  • 23. Christakos S, Ajibade DV, Dhawan P, Fechner AJ, Mady LJ. Vitamin D: metabolism. Endocrinol Metab Clin North Am 2010;39:243–53.
  • 24. Zehnder D, Evans KN, Kilby MD, Bulmer JN, Innes BA, Stewart PM, et al. The ontogeny of 25-hydroxyvitamin D3 1alpha-hydroxylase expression in human placenta and decidua. Am J Pathol. 2002;161:105–14.
  • 25. Liu PT, Stenger S, Tang DH, Modlin RL. Cutting Edge: Vitamin D mediated human antimicrobial activity against Mycobacterium tuberculosis is dependent on the induction of cathelicidin. J Immunol. 2007;179:2060–3.
  • 26. Halhali A, Tovar AR, Torres N, Bourges H, Garabedian M, Larrea F. Preeclampsia is associated with low circulating levels of insulin-like growth factor I and 1,25-dihydroxyvitamin D in maternal and umbilical cord compartments. J Clin Endocrinol Metab. 2000;85:1828–33
  • 27. Hyppönen E. Vitamin D for the prevention of preeclampsia? A hypothesis. Nutr Rev. 2005;63:225–32.
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Tuğba Gürbüz

Nur Dokuzeylül Güngör

Gökmen İyigün This is me

Seyhan Özcan This is me

Publication Date December 15, 2017
Submission Date March 29, 2018
Acceptance Date April 23, 2018
Published in Issue Year 2017 Volume: 3 Issue: 3

Cite

AMA Gürbüz T, Dokuzeylül Güngör N, İyigün G, Özcan S. Does the deficiency of 25-hydroxy vitamin D effect the placental peptides (free β-human chorionic gonadotropin and pregnancy-associated plasma protein A ) levels ?. ADYÜ Sağlık Bilimleri Derg. December 2017;3(3):589-597. doi:10.30569/adiyamansaglik.410875