Concentrations of prealbumin and some appetite-controlling hormones in pregnancies associated with hyperemesis gravidarium

Ann Clin Biochem. 2017 Mar;54(2):258-263. doi: 10.1177/0004563216654724. Epub 2016 Sep 28.


Background Hyperemesis gravidarum, which affects 0.3-2.3% of pregnancies, is defined as excessive vomiting during pregnancy and usually starts in week 4 or 5 of gestation. Symptoms include weight loss, dehydration, ketonaemia, ketonuria, fasting acidosis, alkalosis due to hydrochloric acid loss and hypokalaemia and its exact cause is unknown. The present study was undertaken to investigate the relationship between prealbumin, ghrelin, nesfatin-1 and obestatin concentrations in pregnancies associated with hyperemesis gravidarum. Methods A total of 40 pregnant females with hyperemesis gravidarum and 38 pregnant females without hyperemesis gravidarum as controls were included in this study. Serum concentrations of prealbumin, ghrelin, obestatin and nesfatin-1 were measured. Results There were no significant differences in age, gestational week, gravidity and parity between the two groups. Body mass index was significantly lower in cases than in controls. Serum ghrelin and prealbumin concentrations were significantly lower in cases than in controls ( P <0.05 and P < 0.001, respectively). There was no significant difference in serum concentrations of obestatin and nesfatin-1 between the two groups. There was no significant association between body mass index and serum ghrelin, nesfatin-1, obestatin or prealbumin concentrations in patients with hyperemesis gravidarum. Conclusions Decreased serum concentrations of ghrelin and prealbumin in patients with hyperemesis gravidarum are independent of body mass index. Based on our results, we believe that ghrelin may be considered to play a role in the aetiopathogenesis of hyperemesis gravidarum and that hyperemesis gravidarum may result in disruption of the relationship between nesfatin-1 and ghrelin. In addition, we believe that the measurement of serum prealbumin may be used for assessing nutritional status in pregnancy.

Keywords: Hyperemesis gravidarum; ghrelin; nesfatin-1; obestatin; prealbumin.

MeSH terms

  • Adult
  • Appetite / physiology
  • Body Mass Index
  • Calcium-Binding Proteins / blood
  • Calcium-Binding Proteins / genetics*
  • Case-Control Studies
  • DNA-Binding Proteins / blood
  • DNA-Binding Proteins / genetics*
  • Fasting / psychology
  • Female
  • Gene Expression Regulation
  • Gestational Age
  • Ghrelin / blood
  • Ghrelin / genetics*
  • Humans
  • Hyperemesis Gravidarum / blood
  • Hyperemesis Gravidarum / diagnosis*
  • Hyperemesis Gravidarum / genetics*
  • Hyperemesis Gravidarum / physiopathology
  • Nerve Tissue Proteins / blood
  • Nerve Tissue Proteins / genetics*
  • Nucleobindins
  • Prealbumin / genetics*
  • Prealbumin / metabolism
  • Pregnancy
  • Signal Transduction
  • Weight Loss


  • Calcium-Binding Proteins
  • DNA-Binding Proteins
  • Ghrelin
  • NUCB2 protein, human
  • Nerve Tissue Proteins
  • Nucleobindins
  • Prealbumin
  • obestatin, human