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Published on: June 29, 2013
Is There a Correlation between Apelin and Insulin Concentrations in Early Second Trimester Amniotic Fluid with Fetal
Dionysios Vrachnis1, Nikolaos Antonakopoulos2, Alexandros Fotiou2
1Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Insights
Amniotic fluid apelin levels in early pregnancy may predict fetal growth. Lower apelin concentrations in the second trimester were associated with larger-than-gestational-age (LGA) fetuses, suggesting a potential predictive marker for fetal overgrowth.
Area of Science:
- Reproductive biology
- Endocrinology
- Perinatal medicine
Background:
- Fetal growth disturbances increase perinatal risks.
- Pathogenesis of abnormal fetal growth is poorly understood.
- Apelin, an adipokine, is implicated in fetal growth regulation.
Purpose of the Study:
- To investigate apelin and insulin concentrations in early second-trimester fetal amniotic fluid.
- To explore the relationship between these factors and fetal growth patterns.
Main Methods:
- Prospective observational cohort study of 80 pregnant women.
- Amniotic fluid collected via amniocentesis in early second trimester.
- Apelin and insulin measured using ELISA kits; fetuses categorized as SGA, AGA, or LGA.
Main Results:
- Statistically significant differences in amniotic fluid apelin concentrations among fetal growth groups (p=0.007).
- Lower apelin levels were observed in large-for-gestational-age (LGA) fetuses compared to AGA and SGA fetuses.
- No significant differences in insulin concentrations were found between groups.
Conclusions:
- A trend of decreasing apelin with increasing birthweight was identified.
- Early second-trimester amniotic fluid apelin may predict the risk of LGA birth.
- Further research is needed to confirm findings and explore apelin's interaction with other metabolic factors.
Introduction:
Fetal growth disturbances place fetuses at increased risk for perinatal morbidity and mortality. As yet, little is known about the basic pathogenetic mechanisms underlying deranged fetal growth. Apelin is an adipokine with several biological activities. Over the past decade, it has been investigated for its possible role in fetal growth restriction. Most studies have examined apelin concentrations in maternal serum and amniotic fluid in the third trimester or during neonatal life. In this study, apelin concentrations were examined for the first time in early second-trimester fetuses. Another major regulator of tissue growth and metabolism is insulin.
Materials And Methods:
This was a prospective observational cohort study. We measured apelin and insulin concentrations in the amniotic fluid of 80 pregnant women who underwent amniocentesis in the early second trimester. Amniotic fluid samples were stored in appropriate conditions until delivery. The study groups were then defined, i.e., gestations with different fetal growth patterns (SGA, AGA, and LGA). Measurements were made using ELISA kits.
Results:
Apelin and insulin levels were measured in all 80 samples. The analysis revealed statistically significant differences in apelin concentrations among groups (p = 0.007). Apelin concentrations in large for gestational age (LGA) fetuses were significantly lower compared to those in AGA and SGA fetuses. Insulin concentrations did not differ significantly among groups.
Conclusions:
A clear trend towards decreasing apelin concentrations as birthweight progressively increased was identified. Amniotic fluid apelin concentrations in the early second trimester may be useful as a predictive factor for determining the risk of a fetus being born LGA. Future studies are expected/needed to corroborate the present findings and should ideally focus on the potential interplay of apelin with other known intrauterine metabolic factors.
