Kisspeptin levels in high risk pregnancies related to chronic diseases: insulin dependent diabetes mellitus (IDDM) and arterial hypertension (H)
Dragana Miljic1, Aleksandar Cetkovic2, Aleksandar Ljubic2, Michael Patterson3, Mohammad Ghatei3, Steven Bloom3, Marina Djurovic1, Mirjana Doknic1, Sandra Pekic1, Marko Stojanovic1 & Vera Popovic1
Objective: Kisspeptin is hormone involved in the initiation and maintenance of fertility. Placenta is the major source of kisspeptin but its role during gestation is still matter of debate. Studies investigating kisspeptin levels during gestation in patients with diabetes and hypertension are lacking. Our aim was to prospectively evaluate kisspeptin levels in pregnant women with chronic diseases such as IDDM and H.
Design and methods: Kisspeptin levels were evaluated in 61 singleton pregnancies (16 with IDDM, 20 with H and in 25 healthy pregnant women). Blood samples were collected in the 1st trimester (912 weeks), in the 2nd trimester (2125 weeks) and in the 3rd trimester (3236 weeks). Maternal kisspeptin levels were correlated with pregnancy outcome.
Results: In pregnant women with diabetes and hypertension mean plasma kisspeptin levels were significantly lower compared to control group throughout gestation. In five pregnancies which ended in spontaneous abortion in the 2nd trimester (four in patients with diabetes and one in patient with hypertension) plasma kisspeptin levels were severely decreased in early pregnancy compared to control group. No other adverse outcomes were recorded in patients with diabetes and hypertension nor in healthy pregnant women in the study. ROC curve analysis of kisspeptin levels in the 1st trimester showed cut-off value of 812.4 pmol/l as discriminating between positive and negative pregnancy outcome (Sn=76.4% and Sp=75%).
Conclusions: Kisspeptin levels are significantly lower throughout pregnancy in women with IDDM and H. Severely decreased kisspeptin levels, in these patients, during early pregnancy may be associated with an increased risk of spontaneous abortion. Larger studies are needed to investigate the role of kisspeptin in high risk pregnancies related to various pathologies.