An analysis on inhibin A and activin A combined with uterine artery doppler in the prediction of preeclampsia / 预防医学

Objective To evaluate the predictive value of pre-eclampsia with the combination of inhibin A,activin A and uterine artery doppler.Methods The single pregnant pregnant women were divided into 9-12 week of pregnancy groups and 13-16 week of gestation group based on examination of gestational age.According to the outcome of further follow-up the women are divided into normal pregnancy (9-12 week pregnant or 13-16 week pregnant normal group) and the PE group (9-12 weeks pregnant or pregnant 13-16 PE group).Enzyme-linked immunosorbent assay (ELISA) was used to detect the concentration of inhibin A and activin A.Doppler ultrasound were used to examine UAPI.The results were converted to MoM values to calculate the combined detection specificity and sensitivity.Results The concentration of serum inhibin A and activin A and UAPI in 9-12 week pregnant PE group were significantly higher than that in 9-12 week normal pregnant (P ＜0.05).The concentration of serum inhibin A and activin A and UAPI in 13-16 week pregnant PE group were significantly higher than that in 13-16 week normal pregnant (P ＜0.05).When the maximum area under the curve of three indicator combined application (AUC =0.836) in 9-12 week pregnant,the specificity was 72％ and the sensitivity was 83％.When the maximum area under the curve of three indicators combined application (AUC =0.912) in 13-16 week pregnant,the specificity was 87％ and the sensitivity was 86％.Conclusion The combined application of peripheral blood inhibin A,activin A and UAPI could predict PE.The combined application of three indicator detection index provides a high degree of specificity,sensitivity and predictive value in 13-16 week pregnant.

Clinical Value of Combination Detection of Inhibin A, Progesterone and Fetal Fibronectin in Predicting the Outcome of Threatened Abortion / 医学研究杂志

Objective To study the clinical value of combination dection of inhibin A,progesterone and fetal fibronectin in predicting the outcome of threatened abortion.Methods One hundred and seventy patient with symptoms of threatened abortion were selected as the object of this study.After miscarriage treatment,75 patients continued the pregnancy as the threatened abortion group and 45 patients miscarriage after miscarriage treatment as the abortion group,another 50 normal pregnant women at same period in our hospital were as the control group.Inhibin A,progesterone and fetal fibronectin were detected and compared between the three groups.Results The inhibin A and progesterone levels increased in turn from abortion group,threatened abortion group to normal pregnancy group.fFN positive rates were lower in turn.The difference were statistically significant (P ＜ 0.05).The area under the ROC curve (AUC) of inhibin A,and progesterone levels fFN positive rate for prediction of threatened abortion were 0.899,0.866,0.785,while the AUC of the combine that three index was 0.944.The sensitivity of the combined detection was 92.04％,the specificity was 89.17％,accuracy was 87.95％,positive predictive value was 98.45％,negative predictive value was 89.38％,and Youden index was 0.812.Conclusion Combined detection of inhibin A,progesterone and fetal fibronectin in predicting the outcomes of threatened abortion of pregnant women have a better predictive value than single index,it can enhance the accuracy,specificity and accuracy of forecasts.

Clinical Value of Combination Detection of Inhibin A, Progesterone and Fetal Fibronectin in Predicting the Outcome of Threatened Abortion / 医学研究杂志

Objective To study the clinical value of combination dection of inhibin A,progesterone and fetal fibronectin in predicting the outcome of threatened abortion.Methods One hundred and seventy patient with symptoms of threatened abortion were selected as the object of this study.After miscarriage treatment,75 patients continued the pregnancy as the threatened abortion group and 45 patients miscarriage after miscarriage treatment as the abortion group,another 50 normal pregnant women at same period in our hospital were as the control group.Inhibin A,progesterone and fetal fibronectin were detected and compared between the three groups.Results The inhibin A and progesterone levels increased in turn from abortion group,threatened abortion group to normal pregnancy group.fFN positive rates were lower in turn.The difference were statistically significant (P ＜ 0.05).The area under the ROC curve (AUC) of inhibin A,and progesterone levels fFN positive rate for prediction of threatened abortion were 0.899,0.866,0.785,while the AUC of the combine that three index was 0.944.The sensitivity of the combined detection was 92.04％,the specificity was 89.17％,accuracy was 87.95％,positive predictive value was 98.45％,negative predictive value was 89.38％,and Youden index was 0.812.Conclusion Combined detection of inhibin A,progesterone and fetal fibronectin in predicting the outcomes of threatened abortion of pregnant women have a better predictive value than single index,it can enhance the accuracy,specificity and accuracy of forecasts.

The association between adverse pregnancy outcomes and the serum inhibin A levels in mid-trimester of gestation / 대한산부인과학회지

OBJECTIVES: To investigate the association between abnormal inhibin-A level in Quad test during the 15 and 18 weeks of gestation and adverse pregnancy outcomes. METHODS: From January 2005 to March 2007, women who delivered their babies at our institute after Quad test in second trimester of gestation (N=140) were enrolled. We measured inhibin-A levels (MoM) and other serum markers of the Quad test. And we analyzed the incidence of adverse pregnancy outcomes such as preterm birth, fetal growth restriction, pregnancy induced hypertension, fetal loss, and intrauterine fetal death. RESULTS: When the pregnancy outcomes are hypertensive disorders and fetal losses, the inhibin-A levels are is more elevated with statistically significance. Inhibin-A and hCG levels are elevated with significantly at hypertensive disorders and fetal losses. But inhibin-A levels are more significantly associated with abnormal pregnancy outcomes than hCG. CONCLUSIONS: Measurement of inhibin-A levels may be the most useful among other serum markers of the Quad test in predicting adverse obstetric outcomes.

Maternal Serum and Amniotic Fluid Inhibin A Levels in Women who Subsequently Develop Severe Preeclampsia

The purpose of this study was to evaluate whether maternal serum (MS) and amniotic fluid (AF) inhibin A levels are elevated in patients who subsequently develop severe preecalmpsia, and to investigate the correlation between MS and AF inhibin A levels in the second trimester. The study included 40 patients who subsequently developed severe preecalmpsia and 80 normal pregnant women. Inhibin A levels in MS and AF were measured with enzyme-linked immunosorbent assay (ELISA). The MS and AF inhibin A levels in patients who developed severe preeclampsia were significantly higher than those in the control group (both for p<0.001). There was a positive correlation between MS and AF inhibin A levels in patients who developed severe preeclampsia (r=0.397, p=0.011), but not in the control group (r=0.185, p=0.126). The best cutoff values of MS and AF inhibin A levels for the prediction of severe preeclampsia were 427 pg/mL and 599 pg/mL, respectively; the estimated ORs that were associated with these cut-off values were 9.95 (95% CI 3.8-25.9, p<0.001) and 6.0 (95% CI 2.3-15.8, p<0.001). An elevated level of inhibin A in MS and AF at the time of second trimester amniocentesis may be a risk factor for the subsequent development of severe preeclampsia.

Midtrimester Amniotic Fluid Levels and Each Ratio of Activn A, Inhibin A and B in Down's Syndrome and Other Complicated Pregnancies / 대한산부인과학회잡지

OBJECTIVE: To evaluate the amniotic fluid levels and each ratio of activin A, inhin A and B in Down's syndrome and other complicated pregnancies. METHODS: This study was performed in 71 women who had undergone a midtrimester amniocentesis with the clinical indications and whose pregnancy outcome was retrospectively determined. Ten Down's syndrome, 15 complicated pregnancies including, preeclamsia, gestational diabetesis mellitus, preterm labor, intrauterine growth restriction (IUGR), and 46 noncomplicated pregnancies with normal chromosome were included in this study. Amniotic fluid activin A, inhibin A and B were measured using enzyme linked immunosorbent assays (ELISA). Statistical analysis was performed with Mann-Whitney U test and regression analysis. RESULTS: There were significant positive correlation (r=0.277, p=0.011) between the ratio activin A/ inhibin B level and maternal age and significant positive correlation (r=0.261, p=0.015) between maternal age and the ratio inhibin A/inhibin B level. There were also significant positive correlation (r=0.202, p=0.045) between gestational weeks and inhibin A levels and significant positive correlation (r=0.474, p<0.001) between gestational weeks and inhibin B levels. Amniotic fluid inhibin A and inhibin B levels were significantly (p<0.05) decreased in Down's syndrome compared with the normal chromosomal groups but there was no difference in the ratio activin A/inhibin A and in the ratio activin A/inhibin B between these groups. The amniotic fluid levels of activin A, inhibins (A and B), each ratio of complicated pregnancies groups with normal chromosome was not significantly different from those of uncomplicated pregnancies with normal chromosome. CONCLUSION: This study revealed that amniotic inhibin levels were significantly decreased in Down's syndrome. But, activin A and each ratio were unchanged. The results suggest that activin A may be relatively decreased in each case of Down's syndrome.

Serum Levels of Inhibin A and Inhibin B During Menstrual Cycle / 대한산부인과학회잡지

OBJECTIVE: To understand the physiologic effects and secretion pattern of inhibin A and inhibin B throughout menstrual cycle in the normal reproductive women, serum values of inhibin A and inhibin B were measured. METHODS: Inhibin A and inhibin B levels were measured in 320 serum samples from 160 normal reproductive women by solid phase sandwich ELISA. RESULTS: In the normal reproductive women, inhibin A is secreted in low serum levels until the mid- proliferative phase, begins to increase in the late proliferative phase (16.53+/-1.57 pg/ml), reaches the peak in the early secretory and mid-secretory phase (45.56+/-2.37 and 45.85+/-2.08 pg/ml), and subsequently decreases in the late secretory phase. We found that inhibin B begins to increase in the early proliferative phase (65.40+/-4.08 pg/ml), is secreted in high concentration in the proliferative phase, reaches the peak in the ovulatory phase (110.74+/-9.83 pg/ml), and thereafter declines rapidly to the lowest level in the mid-secretory phase (29.59+/-2.08 pg/ml). CONCLUSION: In conclusion, serum inhibin A levels peak during the luteal phase, indicating the greatest production by the corpus luteum and serum inhibin B levels increase during the follicular phase, indicating the greatest production by follicles in early stage of development. Inhibin A is associated with the luteal function and inhibin B, the follicular function. Both inhibins are associated with the follicular maturation and development.

Serum Levels and Expressions of Inhibin A and Inhibin B in the Ovaries of Perimenopausal Women / 대한산부인과학회잡지

OBJECTIVE: To understand the physiologic effects and secretion pattern of inhibin A and inhibin B during menstrual cycle and menopausal transition, inhibin A and inhibin B levels were measured. And to detect any changes in expression of inhibins in human ovary with age, we examined immunohistochemical staining of alpha, beta A, and beta B subunits of inhibin in ovarian tissues. This study was also designed to investigate whether or not inhibin is an early marker for menopausal transition. METHODS: Inhibin A and inhibin B levels were measured in 320 samples from normal reproductive women, in 60 from perimenopausal women, and in 20 from menopausal women by ELISA. And we examined the immunohistochemical staining of alpha, beta A, and beta B subunits of inhibin in ovarian tissues of 35 normal reproductive, 20 perimenopausal, and 5 menopausal women, respectively. RESULTS: In the normal reproductive women, inhibin A begins to increase in the late proliferative phase (16.53 +/- 1.57 pg/ml), reaches the peak in the mid-secretory phase (45.85 +/- 2.08 pg/ml), and subsequently decreases. Inhibin B begins to increase in the early proliferative phase (65.40 +/- 4.08 pg/ml), reaches the peak in the ovulatory phase (110.74 +/- 9.83 pg/ml), and thereafter declines rapidly. In the perimenopausal women, mean inhibin A serum concentration was 6.68 +/- 0.53 pg/ml during proliferative phase and 21.78 +/- 3.61 pg/ml during secretory phase, which were significantly lower than that of the same phase in the normal reproductive women (P<0.01). Mean inhibin B serum concentration was 52.16 +/- 7.46 pg/ml during proliferative phase and 22.41 +/- 6.73 pg/ml during secretory phase, which were significantly lower than that of the same phase in the normal reproductive women (P<0.01, P=0.025). In the menopausal women, both inhibin A and inhibin B were not detected. In the normal reproductive women, we observed strong immunostaining for alpha subunit in granulosa cells, theca cells, and corpus luteum. Immunostaining for beta A subunit was observed in corpus luteum, but not in growing follicles. Immunostaining for beta B subunit was observed in primary follicle, granulosa and theca cells of growing follicle, and mature follicle, but less strong than immunostaining for alpha subunit. No staining for beta B subunit was observed in the corpus luteum. In the perimenopausal women, immunostaining for inhibin subunits were observed in the same pattern as that of the normal reproductive women, but weaker. Stronger immunostaining was observed in theca cells than in granulosa cells. In the menopausal women, none of the immunostaining of inhibin subunits were observed. CONCLUSION: It is concluded that inhibin A is associated with the luteal function and inhibin B, the follicular function. The secretion of inhibins decreased rapidly in the perimenopausal transition period and were not detected in the menopausal period. Inhibin A and inhibin B are associated with the follicular maturation and development. It suggests that the inhibin A and inhibin B are good candidates as markers for perimenopausal transition.

Changes of Serum Inhibin Concentration in Controlled Ovarian Hyperstimulation for IVF-ET / 대한산부인과학회잡지

Inhibin is a glycoprotein usually produced by granulosa cell of ovary and is known as regulator of FSH secretion. Inhibin is consisted of two heterodimeric subunit of a, B . There are two distinct molecular forms of the B subunit that exist (BA and BB) and when combined with an a subunit, form inhibin A, and inhibin B, respectively. Ovarian reserve describes women's reproductive potential, which usually decreased according to chronological age. Because useful markers claimed for the prediction of ovarian response during controlled ovarian hyperstimulation for IVF-ET have not been always successful, new biomarker has been investigated. The purpose of this study was to observe the changes in serum and ovarian follicular inhibin A concentration during controlled ovarian hyperstimulation for IVF-ET program and to evaluate the clinical significance of inhibin A as a prognostic marker for assisted reproductive technology outcomes. From Jan 1996 to Dec 1996, 48 patients who underwent IVF-ET were included. In each patient, the Day 3 FSH, LH, E2q were measured in the first month of cycle before commencing GnRH agonist administration, In the stimulation period after pituitary down regulation, blood samples for inhibin A were collected at the day 3, day 7, day of hCG injection, day of oocytes aspiration, and day of embryo transfer. Ovarian follicular inhibin A was collected at the day of oocyte aspiration. Inhibin A concentration was measured using test kit for inhibin A (INHIBIN-EASIA (code 40.134.00), Belgium Medgenix). The changes in serum inhibin A, E2 concentration during IVF-ET program showed increasing pattern throughout controlled ovarian hyperstimulation periods. If the cut-off value of day 3 serum inhibin A determined to 0.28 U/ml, the sensitivity and specificity were 80.0%, 75.0% respectively in predicting the number of oocytes retrieved being more than five. If the cut-off value of peak serum E determined to 1316 pg/ml, the sensitivity and specificity were 89.0%, 100.0% respectively in predicting the number of oocytes retrieved being more than five. In conclusion, measurement of serum inhibin A concentration on the day of starting stimulation (day 3) could be used as a useful marker for predicting the ovarian response in IVF-ET program.

The effect of inhibin A and gonadotrophic hormone on the in vitro maturation of mice immature oocytes / 重庆医科大学学报

0.05).There was no difference in the rate of PB1 between PMSG group and none PMSG group.In PMSG group,INH A solutions at concentrations of 200 ng/ml,350 ng/ml had higer rate of PB1 than that in control group(P