Afamin: an early predictor of preeclampsia

Abstract

PurposeOxidative stress is involved in the pathogenesis of hypertensive disorders such as preeclampsia (PE) and associated with the human vitamin E-binding protein afamin. The aim of this study was, therefore, to analyse afamin in the first trimester of patients developing PE later in pregnancy and in control subjects without pregnancy complications.MethodsIn this retrospective study, 137 serum samples from the first trimester of pregnancy were analysed in a case–control study design. 39 patients developed PE (10 patients with early-onset and 29 patients with late onset disease) and 98 women had an uncomplicated pregnancy. Mann–Whitney U test, t test, logistic regression and ROC analyses were performed for statistical evaluation.ResultsPregnant women developing PE presented with higher afamin concentrations in the first trimester [median 101.81 mg/L; interquartile range (IQR) 88.94–113.26] compared to subjects with uncomplicated pregnancy (median 86.40; IQR 75.26–96.92; p < 0.001). After adjusting for confounders, the odds ratio per afamin standard deviation was 1.60 (95% CI: 1.04–2.58; p = 0.04). An afamin threshold concentration of 87.8 mg/L exhibited the best sensitivity (79.5%) and specificity (57.1%) in predicting PE. Subgroup analysis of early- and late-onset disease resulted in substantially higher afamin concentrations in women with developing late-onset PE compared to controls (p < 0.001) with an odds ratio per afamin standard deviation of 1.62 (95% CI: 0.98–2.70; p = 0.06).ConclusionsSerum afamin concentrations are elevated in the first trimester among patients developing PE compared to controls. Substantial differences were observed mainly among patients with late-onset PE.

Serum Afamin a Novel Marker of Increased Hepatic Lipid Content

“…Each increase of afamin by 10 mg/L increases the probability of metabolic syndrome by 79% ( 8 ) and afamin predicts higher incidence of T2D independently from the other major metabolic risk factors ( 9 ). Increased afamin concentrations were identified as an early biomarker for gestational diabetes ( 10 – 12 ) and pre-eclampsia ( 13 , 14 ) and have been positively associated with insulin resistance in patients with polycystic ovary syndrome ( 15 , 16 ). Afamin is rather stable, it can be measured in serum or plasma, and its circulating values are not modulated by age, gender, menstrual cycle, prandial state or circadian rhythms ( 17 ).…”

Investigating the relationship of serum levels of afamin and interleukin-10 with insulin resistance in infertile women with polycystic ovary syndrome

“…In our study, afamin levels were significantly higher PCOS patients with IR compared to those without. Studies have shown that increased levels of afamin have been observed in patients with oxidative stress and inflammation [12][13][14][15]. A positive correlation between these two variables could be explained with the fact that inflammation and oxidative stress are common in PCOS patients with IR.…”

“…Studies have shown that PCOS is associated with hyperinsulinemia and oxidative stress [27][28][29]. Since afamin is known as an E-binding protein [15], and vitamin E relates to the non-enzymatic antioxidants group, afamin may be a marker of vitamin E-related oxidative stress. Therefore, future studies are recommended to evaluate the oxidative stress status in PCOS patients and its relationship with afamin.…”

“…As an 87 kDa human plasma glycoprotein, afamin has 55% amino acid sequence similarity to albumin and includes 15% carbohydrate [12]. Studies have shown that elevated levels of the human afamin gene increase the body weight, glucose, and fat concentration in the bloodstream [13][14][15]. Some other studies have also shown an association between afamin, IR and metabolic syndrome [16][17][18].…”

Protein biomarkers in serum as a conservation tool to assess reproduction: a case study on brown bears (Ursus arctos)

“…Afamin is a glycoprotein that is primarily sourced in the liver and is responsible for transporting vitamin E in body fluids such as plasma, ovarian follicular fluid, and seminal fluids, suggesting it plays a role in reproduction and more specifically, female fertility ( Voegele et al, 2002 ; Dieplinger and Dieplinger, 2015 ). Research in humans has shown that afamin concentrations increase during uncomplicated pregnancies ( Hubalek et al, 2014 ); however, increased afamin concentrations have also been shown to be an early predictor of pregnancy complications including preeclampsia and gestational diabetes mellitus in pregnant women ( Hubalek et al, 2014 ; Köninger et al, 2018 ; Tramontana et al, 2018 ). In humans, insulin sensitivity increases during early gestation to facilitate the uptake of glucose into adipose stores ( Di Cianni et al, 2003 ); however, later in gestation, the secretion of local and placental hormones promote insulin resistance, resulting in high glucose concentrations that are used to aid in the growth of the foetus ( Catalano et al, 1991 ).…”