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

Tuğba Gürbüz , Nur Dokuzeylül Güngör , Gökmen İyigün Seyhan Özcan

https://doi.org/10.30569/adiyamansaglik.410875

Cited By: 2

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.   

Keywords

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 ?

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.

Keywords

Vitamin D, PAPP-A, free β-hCG, first trimester screening test

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