Related Experiment Video
Updated: May 16, 2026
The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo
Published on: August 2, 2017
Reference interval of pregnancy-associated plasma protein-a in healthy men and non-pregnant women
Abdurrahman Coskun1, Mustafa Serteser, Sadik Duran
1Acibadem University, School of Medicine, Department of Medical Biochemistry, Istanbul, Turkey. Coskun2002@gmail.com
Insights
This study established reference intervals for serum pregnancy-associated plasma protein-A (PAPP-A) in adults. The reference interval for PAPP-A differs between men and non-pregnant women, with specific values provided for clinical use.
Area of Science:
- Biochemistry
- Clinical Chemistry
- Reproductive Biology
Background:
- Serum pregnancy-associated plasma protein-A (PAPP-A) is a known biomarker for ischemic cardiac events and renal impairment.
- Establishing reliable reference intervals for PAPP-A is crucial for accurate clinical interpretation.
- Previous studies have not definitively determined PAPP-A reference intervals in non-pregnant populations.
Purpose of the Study:
- To determine the reference interval of serum PAPP-A in healthy adult men and non-pregnant women.
- To provide clinically applicable reference ranges for PAPP-A to aid in the assessment of cardiac and renal health.
- To investigate potential demographic influences on PAPP-A levels.
Main Methods:
- Serum PAPP-A concentrations were measured in 126 healthy individuals (52 males, 74 females) using an ultrasensitive enzyme-linked immunoassay.
- Reference intervals were calculated using the bootstrap method after excluding outliers.
- Statistical analysis was performed to compare PAPP-A levels between smokers and non-smokers and to assess correlation with age.
Main Results:
- The reference interval for PAPP-A in men was determined to be <22.9 ng/mL (90% CI: 19.7-23.3), and for women, it was <33.6 ng/mL (90% CI: 25.2-36.7).
- Serum PAPP-A levels were significantly lower in male smokers compared to non-smokers (p<0.001).
- A positive correlation was observed between serum PAPP-A levels and age in male subjects (r=0.439, p<0.001).
Conclusions:
- The reference interval for serum PAPP-A is distinct for men and non-pregnant women.
- Recommended clinical reference intervals are <22.9 ng/mL for men and <33.6 ng/mL for non-pregnant women.
- These established intervals can support the clinical evaluation of patients at risk for ischemic cardiac events and renal impairment.
Objective:
The serum pregnancy-associated plasma protein-A (PAPP-A) concentration is a predictor of ischemic cardiac events and renal impairment. However, the reference interval of PAPP-A has not been determined. This study determined the reference interval of PAPP-A in men and non-pregnant women.
Methods:
The study enrolled 126 apparently healthy individuals (52 males and 74 females). The mean age of the men and women was 34.7 (range 20-66) years and 34.6 (range 18-65) years, respectively. Serum PAPP-A concentrations were determined using an ultrasensitive enzyme-linked immunoassay kit. Reference intervals were calculated using the bootstrap method.
Results:
The results for three subjects were outliers, so the reference interval of PAPP-A was calculated using the data for 123 subjects. PAPP-A was undetectable in 26 subjects. The reference interval of PAPP-A for men and women (with the 90% confidence interval) was <22.9 ng/mL (19.7-23.3) and <33.6 ng/mL (25.2-36.7), respectively. In male subjects, serum PAPP-A levels of smokers [3.10 (UD, 7.30)ng/mL] were significantly lower than that of non-smokers [11.00 (UD, 24.4)ng/mL] (p<0.001) and there was a positive correlation between serum PAPP-A levels and subjects' age (r=0.439; p<0.001).
Conclusions:
The reference interval of PAPP-A differed for men and non-pregnant women. In clinical practice, <22.9 ng/mL for men and <33.6 ng/mL for non-pregnant women may be used as reference intervals for PAPP-A.
