Pregnancy-associated plasma protein-A: evaluation of a new biomarker in renal transplant patients.
OBJECTIVE
Trophoblasts produce high concentrations of pregnancy-associated plasma protein-A (PAPP-A) during pregnancy. PAPP-A has been described as a new inflammatory marker and an independent risk factor for posttransplant cardiovascular risk. This study evaluated the clinical significance of PAPP-A in renal transplant patients.


METHODS
The study included 78 adult renal transplant patients (56 men and 22 women) and 37 control subjects (27 men and 10 women). We determined serum PAPP-A, urea, creatinine, uric acid, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, 24-hour proteinuria, and C-reactive protein (CRP) levels.


RESULTS
The PAPP-A level was significantly higher among renal transplant patients [median (interquartile range), 10.5 (6.4 to 15.4) mU/L] than the control group [3.9 (3.1 to 5.2) mU/L; P<.001]. There were significant positive correlations between serum PAPP-A levels and urea (r=.547, P=.001), creatinine (r=.497, P=.001), uric acid (r=.452, P=.001), and CRP values (r=.387, P=.001). The drugs used for immunosuppression in transplant patients (cyclosporine, tacrolimus, and others) did not significantly affect serum PAPP-A levels (P>.05).


CONCLUSIONS
We concluded that PAPP-A level was elevated in renal transplant patients and that high levels of PAPP-A might be a prognostic marker owing to their close association with high serum levels of urea, creatinine, uric acid, and CRP.
Coskun
A
A
Department of Clinical Biochemistry, Duzce University, School of Medicine, Duzce, Turkey.
Duran
S
S
Apaydin
S
S
Bulut
I
I
Sariyar
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D012016:Reference Values; D014508:Urea / Q000097:blood; D014527:Uric Acid / Q000097:blood
D015415:Biomarkers; D007166:Immunosuppressive Agents; D014527:Uric Acid; D014508:Urea; D002097:C-Reactive Protein; D003404:Creatinine; D011266:Pregnancy-Associated Plasma Protein-A