Maternal 25 Hidroksi Vitamin D eksikliği plasental peptidlerin (Serbest β-hCG ve PAPP-A) düzeyini etkiler mi ?
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.
Anahtar Kelimeler:
D vitamini, PAPP-A, serbest β-hCG, ikili tarama testi
Does the deficiency of 25-hydroxy vitamin D effect the placental peptides (free β-human chorionic gonadotropin and pregnancy-associated plasma protein A ) levels ?
SummaryObjectiveIn 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 MethodsThis 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.
Keywords:
Vitamin D, PAPP-A, free β-hCG, first trimester screening test,
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- Yayın Aralığı: Yılda 3 Sayı
- Başlangıç: 2015
- Yayıncı: ADIYAMAN ÜNİVERSİTESİ
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