Serum betatrophin/angiopoietin-like protein 8 (ANGPTL8) levels in pregnancies affected by hyperemesis gravidarum

• Published in: European journal of obstetrics & gynecology and reproductive biology 2018-06, Vol.225, p.221-227
• Main Authors: Timur, Burcu, Tuncer, Serap Fırtına, Bodur, Serkan, Timur, Hakan, Tokmak, Aytekin, Gucel, Funda, Altay, Metin
• Format: Article
• Language: English
• Subjects: Angiopoietin-like protein 8; Betatrophin; Gestational diabetes; HDL cholesterol; Hyperemesis gravidarum; Insulin resistance; Pregnancy
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2018.04.031

The association between serum betatrophin levels and hyperemesis gravidarum (HEG) remains unknown. The aim of this study was to determine and understand the alterations in serum betatrophin levels in pregnancies complicated by HEG compared with unaffected normal pregnancies. A cohort study was carried out to evaluate serum betatrophin levels in patients with HEG. Serum betatrophin concentrations were measured with other metabolic markers for lipids and glucose metabolism in 40 singleton pregnancies affected by HEG and 40 gestational age– and body mass index–matched controls. The serum betatrophin concentrations were significantly higher in pregnant women with HEG than in the controls (1000 [600–1100] vs. 900 [500–1000] pg/ml, p = 0.003). The serum total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels were significantly higher in patients with HEG than in the healthy counterparts at the first trimester of pregnancy (158.5 ± 29.4 vs. 143.8 ± 29.7 mg/dl and 47.3 ± 14.2 vs. 40.1 ± 8.6 mg/dl, p = 0.031 and p = 0.007, respectively). Receiver operating characteristic (ROC) analyses demonstrated that the area under the curve (AUC) indicative of the betatrophin value for discriminating HEG patients was 0.690 (95% CI: 0.574–0.806, p = 0.003). The optimal cutoff value was 976 pg/ml with a sensitivity of 50% (95% CI: 33.80–66.20%) and a specificity of 82.5% (95% CI: 67.22–92.66%). We also found a positive correlation between betatrophin levels and HDL-C (r = 0.311; p = 0.005). Logistic regression analyses demonstrated that increased levels of betatrophin and HDL-C were risk factors for HEG with odds ratios (95% confidence interval) of 4.884 (1.589–15.009) and 5.346 (1.044–27.366), respectively. We conclude that serum betatrophin concentrations were increased in pregnancies affected by HEG. Furthermore, HDL-C levels seem to be associated with alterations in serum betatrophin levels.