Diminished activity of circulating α1-antitrypsin is associated with pre-gestational isolated obesity.
OBJECTIVE
To examine possible correlation between α1-antitrypsin (AAT) levels and activity in patients with and without obesity, after excluding complications such as gestational diabetes mellitus (GDM), during pregnancy.


METHODS
A prospective case-control study was conducted. AAT levels were determined by standard human AAT ELISA according to the manufacturer's instructions. Elastase inhibition was determined by kinetic assay according to manufacturer recommendations. Assays were performed in duplicates and repeated twice for each sample in separate sessions. Patients with diabetes mellitus were excluded from the study. The Mann-Whitney U-test was performed in order to determine statistical differences between the groups, and AAT concentration and activity.


RESULTS
During the study period, 43 patients were recruited: 21 with isolated obesity and 22 non-obese parturients (control group). According to ELISA, AAT concentrations were mildly lower in obese women compared with non-obese women (8.31 ± 0.28 mg/ml versus 9.5 ± 0.37 mg/ml, p = 0.0155). However, the elastase inhibitory capacity was markedly lower in obese versus non-obese parturients (mean 27.33 ± 2.08 % versus 43.73 ± 3.1%, p < 0.001).


CONCLUSIONS
Isolated obesity in pregnancy is associated with lower activity of AAT. These findings correlate with the reduced concentration and activity of AAT found in patients with GDM. Accordingly, it might suggest an inflammatory axis shared by obesity and the development of insulin resistance.
Department of Obstetrics and Gynecology and.
Shimrit Yaniv
SY
Salem
Galit
G
Shahaf
Eyal
E
Sheiner
Justin
J
Levinson
Joel
J
Baron
Tamar
T
Madar
Guy
G
Twina
Eli C
EC
Lewis
D000328:Adult; D016022:Case-Control Studies; D015536:Down-Regulation; D004789:Enzyme Activation; D005260:Female; D006801:Humans; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D010196:Pancreatic Elastase / Q000037:antagonists & inhibitors / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000453:epidemiology*; D000515:alpha 1-Antitrypsin / Q000097:blood* / Q000378:metabolism
D000515:alpha 1-Antitrypsin; D010196:Pancreatic Elastase
Alpha-1 antitrypsin; GDM; obesity; pregnancy