leptin and Hyperemesis-Gravidarum

Currently, there is no consensus on the definition of hyperemesis gravidarum (HG; protracted vomiting in pregnancy) and no single widely used set of diagnostic criteria for HG. The various definitions rely on symptoms, sometimes in combination with laboratory tests. Through a systematic review, we aimed to summarize available evidence on the diagnostic value of biomarkers for HG. This could assist diagnosis and may shed light on the, as yet, not understood cause of the disorder.. We searched Medline and Embase for articles about diagnostic biomarkers for either the presence or severity of HG or nausea and vomiting of pregnancy. We defined HG as any combination of nausea, vomiting, dehydration, weight loss, or hospitalization for nausea and/or vomiting in pregnancy, in the absence of any other obvious cause for these complaints.. We found 81 articles on 9 biomarkers. Although 65% of all studies included only HG cases with ketonuria, we did not find an association between ketonuria and presence or severity of HG in 5 studies reporting on this association. Metaanalysis, with the use of the hierarchical summary receiver operating characteristics model, yielded an odds ratio of 3.2 (95% confidence interval, 2.0-5.1) of Heliobacter pylori for HG, as compared with asymptomatic control subjects (sensitivity, 73%; specificity, 55%). Studies on human chorionic gonadotropin and thyroid hormones, leptin, estradiol, progesterone, and white blood count showed inconsistent associations with HG; lymphocytes tended to be higher in women with HG.. We did not find support for the use of ketonuria in the diagnosis of HG. H pylori serology might be useful in specific patients.

Topics: Biomarkers; Chorionic Gonadotropin; Estradiol; Female; Helicobacter pylori; Humans; Hyperemesis Gravidarum; Ketosis; Leptin; Leukocyte Count; Lymphocytes; Pregnancy; Progesterone; Severity of Illness Index; Thyroid Hormones

The aim of our study is to determine the newly introduced systemic inflammation marker, neutrophil lymphocyte ratio (NLR) in hyperemesis gravidarum (HG) patients and to investigate the association between severity of the disease and NLR.. The study population consisted of 55 pregnant patients with HG and 50 pregnant women without complaints matched for gestational age as a control group. The HG patients were grouped as mild (n = 16), moderate (n = 19) and severe (n = 20) according to Modified Pregnancy- Unique Quantification of Emesis and Nausea Scoring Index Questionnaire. Furthermore, hsCRP, neutrophils, lymphocytes, and NLR were evaluated with complete blood count.. The HG group had significantly higher NLR values compared to the control group (2.69 +/- 1.81 vs 1.97 +/- 1.34, p = 0.004). HsCRP levels were significantly higher among HG patients compared to the control group (1.95 +/- 2.2 vs 0.56 +/- 0.30, p < 0.001). The subgroup analysis revealed statistically significant increases in NLR and hsCRP values with increased HG severity (p < 0.001, p = 0.002). The correlation analysis demonstrated a strong correlation between NLR and hsCRP levels (r: 0.703, p < 0.001).. Our study results showed that NLR and hsCRP levels are increased in HG disease compared to gestational age matched control group subjects. Furthermore, NLR and hsCRP values are correlated with severity of disease. NLR could be used as a marker for both presence and severity of hyperemesis gravidarum.

Topics: Adult; Biomarkers; Case-Control Studies; Chorionic Gonadotropin; Female; Humans; Hyperemesis Gravidarum; Inflammation Mediators; Leptin; Pregnancy; Receptors, Leptin; Severity of Illness Index; Young Adult

To assess the serum levels of gut and adipocyte-derived metabolic hormones that control appetite, adipocity, weight gain and energy hemostasis, namely total ghrelin (TG), acylated ghrelin (AG), leptin and PYY-3 in hyperemesis gravidarum (HG).. Plasma samples of 86 women in their first trimester pregnancies with HG (n = 30), morning sickness of pregnancy (MSP) (n = 34) and control (n = 22) groups were obtained. Serum levels of TG, AG, leptin and PYY-3 were compared between the groups, and the correlations with severity of symptoms using modified PUQE (Pregnancy Unique Quantification of Emesis) scoring, BMI, E2, hCG and TSH were calculated.. Levels of TG, AG, PYY-3 and the TG/leptin ratio were significantly higher in HG group compared to MSP and the control groups (p ≤ 0.017). AG/TG ratio was significantly lower in the HG group compared to both MSP and control groups (p ≤ 0.017). There were either weak or no significant statistical correlations between the gut and adipose-related hormones and the modified PUQE scores, BMI, E2, hCG and TSH.. Gut-derived metabolic hormones ghrelin, AG and PYY-3 may be involved in the HG pathophysiology.

Topics: Acetyltransferases; Acylation; Adult; Case-Control Studies; Cross-Sectional Studies; Female; Gestational Age; Ghrelin; Humans; Hyperemesis Gravidarum; Leptin; Peptide Fragments; Peptide YY; Pregnancy; Young Adult

The goal of this study was to compare levels of acyl and des-acyl ghrelin, obestatin, nesfatin-1 and leptin in healthy gravidas to hyperemesis gravidarum (HG) patients.. Twenty pregnant women with HG and twenty healthy pregnant women all of similar ages, BMI and all at similar pregnancy development comprised the study cohort. Fasting serum samples were obtained and measured for acyl and des-acyl ghrelin, leptin, obestatin and nesfatin-1.. Nesfatin-1 concentrations in the HG group were higher compared to the control group whereas; leptin concentrations during pregnancy were lower in the HG group as compared to the control group. The two groups did not differ with regard to acyl and des-acyl ghrelin and obestatin.. This pilot study suggests a possible role of leptin and nesfatin-1, which might be involved in the pathology of the disease.

Topics: Adult; Calcium-Binding Proteins; Case-Control Studies; DNA-Binding Proteins; Female; Ghrelin; Humans; Hyperemesis Gravidarum; Leptin; Nerve Tissue Proteins; Nucleobindins; Pregnancy; Young Adult

To compare the maternal serum leptin level according to the gestational week and to assess the relationship between the adjusted serum leptin level and thyroid hormones. In order to obtain this objective a new parameter is developed: adjusted leptin level (ALL: maternal serum leptin level/gestational week).. A prospective study was carried out at the early prenatal care unit, SSK Ankara Women's Health and Teaching Hospital. Fifty-four women with hyperemesis gravidarum (HG) and 42 pregnant women without HG as a control group were included to the study. The groups were compared for age, parity, body mass index, fasting serum TSH, free T3, free T4 and leptin levels. A new parameter; ALL was also calculated in each case.. Gestational age and body mass index (BMI) were found significantly lower in the HG group than in the control group (p=0.001). ALL was significantly high in the HG group (p=0.009). Serum TSH, free T3, free T4 levels were significantly different in the HG group than in the control group (p=0.003, 0.013, 0.012, respectively). A significant positive correlation was found between ALL and BMI in the HG group (r=0.449 p=0.001). The maternal leptin level was also positively correlated with BMI in the HG group (r=0.313 p=0.025).. Etiology of the hyperemesis gravidarum is multifactorial. However we can postulate the adjusted leptin level is a good predictor for hyperemesis gravidarum.

Topics: Adult; Body Mass Index; Case-Control Studies; Female; Humans; Hyperemesis Gravidarum; Leptin; Pregnancy; Pregnancy Trimesters; Prospective Studies; ROC Curve; Sensitivity and Specificity; Thyroid Hormones

To investigate the association between the leptin, leptin receptor and hormone levels and hyperemesis gravidarum, and to determine whether these two parameters may be early markers for hyperemesis gravidarum.. The study group consisted of 18 pregnant women with hyperemesis gravidarum and the control group consisted of 18 healthy pregnant women. Demographic characteristics were recorded and body mass index (BMI) values were calculated for all the pregnant women. Serum leptin, leptin receptor, insulin, cortisol, thyroid hormone and human chorionic gonadotrophin (hCG) levels were measured.. When the two groups were compared with respect to leptin levels, the group with hyperemesis gravidarum was found to have significantly higher leptin levels (P = 0.037). No intergroup differences were observed in serum cortisol, insulin, hCG, thyroid hormone levels or BMI values. In the group with hyperemesis gravidarum, an inverse correlation was detected between cortisol and leptin (r = -0.762, P < 0.01), and hCG and thyroid-stimulating hormone (r = -0.503, P < 0.05), whereas a significant correlation was detected between insulin and leptin (r = 0.538, P < 0.05), leptin and BMI (r = 0.711, P < 0.01), and between TT3 and hCG (r = 0.605, P < 0.01).. It was concluded that leptin could play a role in, and be defined as, a marker of hyperemesis gravidarum.

Topics: Adult; Case-Control Studies; Chorionic Gonadotropin; Female; Gestational Age; Humans; Hydrocortisone; Hyperemesis Gravidarum; Insulin; Leptin; Pregnancy; Prospective Studies; Receptors, Cell Surface; Receptors, Leptin; Thyrotropin

Topics: Body Constitution; Body Mass Index; Female; Humans; Hydrocortisone; Hyperemesis Gravidarum; Insulin; Leptin; Pregnancy; Prospective Studies; Randomized Controlled Trials as Topic; Skinfold Thickness; Thyroid Hormones; Thyrotropin

Topics: Chorionic Gonadotropin; Female; Humans; Hyperemesis Gravidarum; Hyperthyroidism; Leptin; Pregnancy; Thyroid Hormones

During Ramadan, adult Muslims fast from dawn to dusk. We frequently encounter young pregnant Muslim women with hyperemesis gravidarum who fast during this holy month. We have investigated whether there is an association between the prolonged fasting during Ramadan and excessive vomiting during pregnancy. Possible psychologic and physiologic explanations are presented and discussed.

Topics: Fasting; Female; Humans; Hyperemesis Gravidarum; Islam; Israel; Leptin; Pregnancy; Psychophysiologic Disorders; Religion and Medicine