Maternal type 1collagen N-terminal telopeptide levels in severe hyperemesis gravidarum

Abstract

BackgroundNausea and vomiting occur 50–90% during the first trimester of pregnancy. However, patients with hyperemesis gravidarum (HG) may be hospitalized at an incidence rate of 0.8–2% before the 20th week of gestational age. The symptoms generally start during the 5–6th gestational weeks, reaching the highest degree during the 9th week, and decline after the 16–20th weeks of gestation. Clinical findings are proportional to the severity of the disease and severe HG is characterized with dehydration, electrolyte imbalance, and nutritional deficiency as a result of vomiting.MethodsThe study population consisted of two groups of pregnant volunteers at 5–12 weeks of gestation: a severe HG group and a control group. The HG severity was scored using the Pregnancy-Unique Quantification of Emesis (and nausea) (PUQE).The serum levels of the maternal Ca, parathyroid hormone (PTH), Na, K, blood urea nitrogen(BUN), creatinine, vitamin D(25OHD3), and the maternal urine NTx levels were compared between the groups.ResultsIn total, 40 volunteers were enrolled in this study: 20 healthy pregnant volunteers and 20 with severe HG. There were no statistically significant differences between the maternal characteristics. The first trimester weight loss of ≥5 kg was significantly higher in the severe HG group (p < 0.001), while the control group had a significantly higher sunlight exposure ratio than the severe HG group (p = 0.021). The urine NTx levels were significantly higher in the severe HG group (39.22 ± 11.68NTx/Cre) than in the control group(32.89 ± 8.33NTx/Cre) (p = 0.028).The serum Ca, PTH, Na, K, BUN, and creatinine levels were similar between the groups (p = 0.738, p = 0.886, p = 0.841, p = 0.957, p = 0.892, and p = 0.824, respectively). In the severe HG group, the serum 25OHD3 levels were significantly lower than in the control group (p < 0.001).ConclusionsThe data from this study indicated that severe HG is associated with increased urine NTx levels. However, large-scale studies are required to understand the clinical significance of this finding, as well as the long-term consequences of elevated urine NTx levels and the underlying mechanisms.Trial registrationNCT02862496 Date of registration: 21/07/2016.

Cholesterol and Vitamin D and the Risk of Hyperemesis Gravidarum: A Mendelian Randomization Study

“…To the best of our knowledge, our study is the rst to leverage MR method to investigate the relationship between genetically determined change in vitamin D levels, cholesterol levels and the risk of HG, revealing a negative correlation between vitamin D and HG, and indicated that vitamin D acts as a mediator of the relationship between cholesterol and HG and any direct effect of cholesterol on HG is minimal. These results veri ed the ndings of three earlier cohort studies [14][15][16]. Although one previous observational study disagreed with our results, its outcome might have been confounded by the signi cantly higher history of vitamin usage in its control group [20].…”

“…It was found that women who experienced HG in early pregnancy had signi cantly lower 25OHD3 levels than the control group (p < 0.001). Additionally, the control group had a notably higher proportion of sunlight exposure compared to the HG group (p = 0.021) [14]. In another cohort study investigating vitamin D and high-sensitivity C-reactive protein (hs-CRP) levels in HG patients, researchers observed a slight decrease in vitamin D levels among women with HG compared to the control group (5.30µg/L vs 6.44µg/L, p = 0.090) [15].…”

Effect of hyperemesis gravidarum on maternal renal health: An investigation of the levels of neutrophil gelatinase-associated lipocalin in maternal serum

“…The difference among the groups was considered statistically significant when p <0.05. The number of patients in the current study was referred to in a study by Sahin et al [7]. Accordingly, the 20 volunteers in each group added up to 80 volunteers.…”

“…Malnutrition, electrolyte imbalance, and dehydration are the clinical findings associated with HG [4][5][6]. Sahin et al [6,7] have reported that severe HG is associated with maternal endothelial dysfunction and increased bone resorption.…”

Nutritional consequences and management of hyperemesis gravidarum: a narrative review

“…Results need to be interpreted with caution owing to the dilutional affect that occurs with expansion of blood volume during pregnancy. A study examining factors associated with bone resorption indices found that serum 25OHD3 levels were significantly lower in women with HG compared with the control group (72) . It was not clear, however, whether this was attributable to poor sun exposure or dietary intake, or a combination of factors.…”