Is the sex hormone binding globulin related to preeclampsia independent of insulin resistance?

OBJECTIVE: To evaluate the association between Sex Hormone Binding Globulin and preeclampsia in Iranian women considering the probable confounding effect of insulin resistance. METHODS: The case-control study was conducted at the Semnan University of Medical Sciences, Iran, and comprised pregnant women who received prenatal care at Amiralmomenin Hospital in 2011. Cases represented patients admitted because of preeclampsia, while controls were randomly selected eligible pregnant women without hypertension and/or proteinuria. Fasting blood sugar and insulin were assessed for all participants as well as their blood concentration of Sex Hormone Binding Globulin. The Homeostasis Model Assessment of Insulin Resistance Score was used. The correlation between dependant and independent variables was reported by crude and adjusted odds ratio applying logistic regression models. SPSS 16.0 was used for statistical analysis. RESULTS: Of the 100 pregnant women in the study, 45 (45%) were cases. Insulin resistance was found to be significantly more frequent in the cases compared to the controls (adjusted odds ratio = 2.78; 95% Confidence Interval: 1.11, 6.90; p < 0.01). There was a significant reverse correlation between level of Sex Hormone Binding Globulin in blood and being a case of preeclampsia (adjusted odds ratio = 0.99; 95% Confidence Interval: 0.98, 1.00; p = 0.04). CONCLUSION: Independent of insulin resistance, every 1 nmol/l increase in Sex Hormone Binding Globulin, decreases the odds of preeclampsia by 1%, notifying Sex Hormone Binding Globulin as an important biomarker about its etiology and prediction.

Detection of trisomy 9 mosaicism in the second trimester screening by abnormal level of biochemical markers.

Trisomy 9 is a rare chromosomal abnormality that occurs in both mosaic and non-mosaic states. The present study reports a case of mosaic trisomy 9 detected during pregnancy in a 41-year-old woman in the second trimester screening. Maternal serum screening results were used to diagnose a chromosomal abnormality in utero. The results were validated by karyotyping. High levels of alpha-fetoprotein and low levels of unconjugated estriol (uE3), human chorionic gonadotropin (hCG), and inhibin A indicate a high risk for chromosomal abnormalities, including trisomy 18. Amniotic fluid karyotyping revealed 47, XX, +9 (30)/46, XX (20) in the fetus. Because a high level (60%) of mosaicism for trisomy 9 in the fetus can affect many parts of the body, the pregnancy was terminated. It seems that a significant reduction in the levels of hCG and uE3 is an informative marker for the detection of chromosomal abnormalities such as trisomy 9.