Aysel Uysal Derbent

Serum hepcidin is associated with parameters of glucose metabolism in women with gestational diabetes mellitus

Abstract Objectives: Hepcidin is considered a major regulator of iron metabolism. Despite previous studies showing elevated ferritin and hepcidin levels in type 2 diabetes mellitus (DM), no study has investigated hepcidin levels in pregnant women with gestational DM (GDM). Methods: A case-control study was conducted in 30 cases of GDM, 47 pregnant women with impaired glucose tolerance (IGT) and 72 pregnant women with normal glucose tolerance (control) between April 2009 and July 2011. Serum hepcidin and other iron metabolism parameters were analyzed in all groups. Results: Serum ferritin and serum iron were significantly elevated in the GDM group compared to controls (p = 0.014, p = 0.018, respectively) and to the IGT group (p = 0.021, p = 0.008, respectively). Hepcidin levels were elevated significantly in the diabetic patients compared to the IGT group (p = 0.011) and controls (p = 0.002). We found no correlation between hepcidin and other iron metabolism parameters (Hb, serum iron and ferritin), whereas positive correlations were found between hepcidin and parameters of glucose metabolism (fasting blood glucose, fasting insulin level and glucose value response to glucose challenge test). Conclusions: Serum hepcidin concentrations were increased in pregnant women with IGT and GDM and this was not related to inflammation parameters.

Effect of maternal anxiety and music on fetal movements and fetal heart rate patterns.

Objective. Aimed to investigate (a) the effect of non-stress test (NST) and music on maternal anxiety (b) the effect of maternal anxiety and music on fetal heart rate (FHR) changes. Material and method. The two hundred and one pregnant women coming for routine prenatal care were randomized to receive either music (n = 96) or no music (n = 105) during NST. Before and after the test, these women were asked to complete the Spielberg State-Trait Anxiety Inventory on two interviews; primary outcome was considered as a maternal state anxiety score before and after NST. Secondary outcome was the baseline FHR, the number of fetal movement, large accelerations, dubious NST, variable decelerations, and the minimum procedure time. Results. Before NST, the mean state anxiety score of the music and control groups was found as 38.1 ± 8.8 and 38.08 ± 8.2, respectively (p > 0.05). On the other hand, after NST, the mean state anxiety score of the music and control groups was found as 35.5 ± 8.2 and 40.2 ± 9.2, respectively (p < 0.001). While in control group, NST brought about a statistically significant increase in a state anxiety score (38.08 ± 8.2 versus 40.2 ± 9.2, p < 0.001), listening to music during NST resulted in decrease in a state anxiety score of the study group but it was not statistically significant (38.1 ± 8.8 versus 35.5 ± 8.2, p > 0.05). The baseline FHR of the music group was significantly higher than that of the control group (134.09 ± 7.2 versus 130.3 ± 5.7, p < 0.001).The number of fetal movement in the music group was significantly higher than that of the control group (8.9 ± 4.7 versus 5.9 ± 3.9, p < 0.001). The number of large accelerations in music group was significantly higher than that of the control group (5.7 ± 2.1 versus 4.5 ± 2.04, p < 0.001). The minimum procedure time in music group was significantly lower than that of control group (13.4 ± 5.2 versus 15.6 ± 6.1, p < 0.05). The number of dubious NST and variable decelerations was found to be similar for both groups (p > 0.05). Conclusion. NST has anxiogenic effects on mothers and listening to music during the test has positive impact on both maternal and fetal parameters but it is an open question whether maternal anxiety during pregnancy may affect fetal accelerations to such an extent that it could influence clinical judgments.

Evaluation of circulating betatrophin levels in gestational diabetes mellitus

Abstract Experimental data indicate that betatrophin plays a significant role in the regulation of lipid metabolism and glucose homeostasis. In recent years, considerable attention has focused on the relationship between betatrophin and diabetes mellitus in humans. This case-control study included 45 women diagnosed with gestational diabetes mellitus (GDM) and 45 pregnant healthy controls. The groups were matched for maternal and gestational age and body mass index. Serum betatrophin levels were significantly higher in women with GDM (median = 635.8 ng/L; range: 290–1841.6 ng/L) compared to control subjects (median = 320.1 ng/L; range: 94.6–936.8 ng/L; p = 0.001). No significant correlations were observed between serum betatrophin levels and clinical or biochemical parameters in the control group. However, in the GDM group, serum betatrophin levels were positively correlated with weight gain during pregnancy (r = 0.304, p = 0.042), systolic blood pressure (r = 0.394, p = 0.007), fasting insulin level (r = 0.348, p = 0.019), and homeostatic model assessment insulin resistance (HOMA-IR; r = 0.311, p = 0.038). Multivariate stepwise linear regression analysis revealed that fasting insulin levels (β = 0.342, p = 0.022) and HOMA-IR (β = 0.312, p = 0.037) were independently associated with serum betatrophin levels. Chinese abstract 实验数据表明，促胰岛生成素在脂质的代谢及糖类的稳态的调节方面起很重要的作用。近年来大量的注意力集中在促胰岛生成素和人类糖尿病的关系上。本病例对照研究包括45例诊断为妊娠期糖尿病的孕妇，以45例健康的孕妇作为对照组。以孕妇、胎龄、体重指数作为匹配项目。妊娠期糖尿病组(中位数=635.8ng/L；范围: 290–1841.6 ng/L)的血清促胰岛生成素水平显著高于对照组(中位数=320.1 ng/L；范围: 94.6–936.8 ng/L; p=0.001)。对照组的血清促胰岛生成素水平和临床、生物化学参数并没有发现有明显相关性。然而，妊娠期糖尿病组血清促胰岛生成素水平和妊娠期间体重增长(r=0.304, p=0.042)、收缩压(r=0.394, p=0.007)、空腹血糖(r=0.348, p=0.019)、与胰岛素抵抗相关的稳态模型(HOMA-IR;r=0.311, p=0.038)均有明显相关性。多元线性回归分析显示空腹血糖(β=0.342, p=0.022)及HOMA-IR (β =0.312, p=0.037)均与血清促胰岛生成素水平有独立相关性。

Hepcidin, iron status, and inflammation variables among healthy pregnant women in the Turkish population

Abstract Purpose: To investigate hepcidin levels in each trimester and their association with other haematological variables and inflammation markers during normal pregnancy among low-risk pregnant women in rural Turkey. Method: The series comprised 103 healthy Turkish primigravida women with a normal pregnancy. Blood samples were obtained at 11–14, 24–28 and 30–34 weeks of gestation. Haemoglobin, hematocrit, red cell indices, white blood cell count, platelet count, iron status indicators (plasma iron, transferrin, ferritin levels and iron binding capacity), serum hepcidin, interleukin-6 and C-reactive protein levels were analysed. The proportions were compared using Pearson’s χ2 test or Friedman’s test. Results: The mean serum hepcidin concentrations at 11–14, 24–28 and 30–34 weeks of gestation were as follows: 7.8 ± 3.4 ng/mL, 8.6 ± 3.1 ng/mL and 7.3 ± 3.0 ng/mL, respectively. The mean serum ferritin concentrations with median values at each trimester were 14.2 (11.5), 9.5 (8.8) and 11.2 (9.3), respectively. The mean serum CRP values at each trimester were 5.1 (4.0), 5.5 (4.6) and 6.0 (5.5), respectively. The serum hepcidin levels were not related to iron status or the haemoglobin, IL-6 or C-reactive protein levels. Conclusions: There was no association between serum hepcidin and serum ferritin, IL-6 or CRP concentrations in each trimester among low-risk pregnant women.

First trimester maternal serum PAPP‐A and free β‐HCG levels in hyperemesis gravidarum

To evaluate whether hyperemesis gravidarum (HG) affects first‐trimester maternal serum PAPP‐A and free β‐hCG levels.

Serum platelet-activating factor acetylhydrolase activity: relationship with metabolic syndrome in women with history of gestational diabetes mellitus

Objective. The aim of this study was to evaluate plasma platelet-activating factor acetylhydrolase (PAF-AH) activity in euglycaemic women with history of gestational diabetes (GDM), and to explore whether this activity is associated with metabolic syndrome (MS) in this group of women. Methods. The cross-sectional study included 36 women with history of GDM and 40 women with history of normal glucose tolerance in pregnancy (control group). Results. Compared to the controls, the GDM group had significantly higher mean values for serum glucose, insulin, HOMA-IR, triglyceride, GGT and plasma PAF-AH activity, and a statistically higher prevalence of MS. Within the GDM group, women diagnosed with MS had significantly higher PAF-AH activity than those without MS (p = 0.002). Conclusion. This is the first study to have shown that plasma PAF-AH activity and GGT levels may be significant for evaluating atherosclerosis risk and metabolic hepatic damage in women with history of GDM.

Irisin as an early marker for predicting gestational diabetes mellitus: a prospective study

Abstract Objective: The objective of this study is to evaluate maternal serum irisin levels in the first and second trimesters of pregnancy in women diagnosed with and without gestational diabetes mellitus (GDM). Methods: We performed a prospective, nested case–control study in 258 pregnant women who were enrolled at the time of the first prenatal visit (6–11th weeks of gestation) and followed until delivery. Among the entire population, we selected 20 women who subsequently developed GDM and 30 women with uneventful pregnancies. Blood samples were collected once from each participant at 6–11th weeks of gestation during the fetal viability scan and at 24–28th weeks of gestation during screening for GDM. Results: In the first trimester, irisin levels were significantly lower in women who later developed GDM (median = 453 ng/mL, range: 257–811 ng/mL) than in controls (median = 721 ng/mL, range: 700–786 ng/mL). In the second trimester, the difference in irisin levels between the GDM group (median = 749 ng/mL; range: 456–910 ng/mL) and controls (median = 757 ng/mL; range: 703–898 ng/mL) was not statistically significant. Conclusions: Irisin may be a useful biomarker in early pregnancy to predict the development of GDM.

Serum levels of visfatin and possible interaction with iron parameters in gestational diabetes mellitus.

Background/Aims: Visfatin is a novel adipokine with insulinomimetic properties that increases in diabetes. However, for gestational diabetes mellitus (GDM) there are conflicting reports. Recent studies have reported a positive association of serum ferritin concentrations with insulin resistance. Thus, we assessed serum levels of visfatin in pregnant women with varying degrees of glucose tolerance and investigated the possible interaction of visfatin with parameters of iron metabolism. Methods: Visfatin levels were measured at 24-28 weeks of gestation in 88 women who were divided into three groups according to their response to a 50-gram glucose challenge test and a 100-gram oral glucose tolerance test: control group (n = 28), impaired glucose tolerance (IGT) group (n = 30) and GDM group (n = 30). Results: Visfatin levels were significantly higher in the GDM and IGT group than in control (p < 0.001 for GDM vs. control, and p = 0.004 for IGT vs. control). Serum visfatin was significantly associated with serum ferritin, insulin, age, gravidity, and body mass index. In a linear regression model, the covariates explained only 17% of variability of serum visfatin concentration. Body mass index (p < 0.001) contributed independently to visfatin variance. Conclusion: Serum visfatin concentration is significantly higher in GDM and is correlated with ferritin levels.

Association of polycystic ovary syndrome and a non-dipping blood pressure pattern in young women

OBJECTIVE The association between polycystic ovarian syndrome and increased cardiovascular disease risk is still a controversial issue. In light of data documenting some common pathways or common end-points, the present study was undertaken to determine whether there is a relationship between sleep blood pressure pattern disturbances and polycystic ovarian syndrome in young women. METHOD The daytime and nighttime ambulatory blood pressures (BPs) were determined for each subject, according to the actual waking and sleeping times recorded in their individual diaries, in this cross-sectional study. RESULTS The study group comprised 168 women (mean age: 25.7±5.5) diagnosed with polycystic ovarian syndrome, while the control group included 52 age- and BMI-matched healthy subjects (mean age: 26.1±5.4). When nocturnal BP declines very little or not at all, with the BP falling less than 10% during sleep compared with waking values, this pattern is classified as a non-dipping BP pattern. However, the non-dipping pattern of BP changes was significantly more common in polycystic ovarian syndrome patients compared to the control group (p<0.01). The prevalence of a non-dipping BP pattern was 43.4% (73 patients) in polycystic ovarian syndrome patients and 3.9% (2 patients) in the control group. CONCLUSION Our cross-sectional study revealed that a non-dipping BP pattern is highly prevalent in polycystic ovarian syndrome patients, even if they are young and non-obese.

Is There Any Relationship between Plasma Pentraxin 3 Levels and Gestational Diabetes Mellitus

Background: Pentraxin 3 (PTX3) is a novel vascular inflammatory marker which increases in vascular events such as diabetes mellitus. The aim of this study was to investigate the relationship between serum PTX3 levels and gestational diabetes mellitus (GDM). Methods: This prospective observational study was comprised of 88 pregnant women with singleton pregnancies. The subjects were classified into 3 groups according to their response to a 50-gram glucose challenge test (GCT) and a 100-gram oral glucose tolerance test: control group (n = 28), impaired glucose tolerance group (n = 30), and GDM group (n = 30). Serum PTX3 levels were measured to examine the relationship between GDM and GCT values. Results: Significant differences in PTX3 levels were observed among the 3 groups in the sample (F = 7.598; p = 0.001). The mean PTX3 value was found to be significantly higher in the GDM group (3.17 ± 1.16 ng/ml) than in the control group (2.20 ± 0.83 ng/ml; p = 0.001). A significant positive correlation between PTX3 and GCT values was detected (r = 0.289; p = 0.008). Conclusion: Maternal serum PTX3 levels were found to be significantly related to high blood glucose levels. This may be an indicator of vascular pathology in GDM around the time of an oral glucose tolerance test.