Cüneyt Eftal Taner

High mean platelet volume, low-grade systemic coagulation and fibrinolytic activation are associated with androgen and insulin levels in polycystic ovary syndrome

ObjectivesThe present study was designed to determine (a) the coagulation parameters, WBC and MPV levels; (b) whether there was any association between androgen and mean platelet volume and low-grade systemic coagulation in PCOS patients.MethodsA total of 48 patients with non-diabetic PCOS were studied in order to evaluate and compare with a non-PCOS group of 30 subjects.ResultsD-dimer, homeostatic model assessment (HOMA-IR), insulin, androgens, glucose, WBC and MPV concentrations were higher in women with PCOS. No difference was observed in fibrinogen, activated partial thromboplastin time and prothrombin time values between the two groups. Free testosterone was positively correlated with D-dimer, insulin, DHEAS, and MPV levels. In multiple stepwise regression analyses, free testosterone positively associated with D-dimer and DHEAS. MPV was positively correlated with insulin levels, HOMA-IR values, DHEAS and free testosterone levels in PCOS patients. In multiple stepwise regression analyses, MPV positively associated with insulin and DHEAS.ConclusionPCOS patients had low-grade systemic coagulation and fibrinolytic activation as evidenced by elevated D-dimer, and increased WBC and MPV levels suggesting that hematological parameters could potentially be used as indicators of risk factor for atherosclerosis in PCOS women.

Cytomegalovirus and rubella seroprevalence in pregnant women in Izmir/Turkey: follow-up and results of pregnancy outcome

PurposeIt is aimed to determine the Rubella and CMV prevalence in the pregnant women in Izmir and to research the effect of these infections on the course of pregnancy in the pregnant women exposed to infection during pregnancy.MethodsThe pregnant women applied to pregnancy outpatient department during 2001–2008 have been examined with enzyme-linked fluorescent assay (VIDAS; bioMérieux) method in terms of Rubella and CMV IgM and IgG antibodies and CMV IgG avidity test.ResultsTotally 5,959 pregnant women were included in the study. The seropositivity rates for Rubella and CMV were found as 97.8 and 98.3xa0%, IgM positivity rates were found as 0.37 and 0.18xa0%, respectively. Curettage was recommended to the pregnant women in which Rubella IgM positivity was detected in the first trimester of the pregnancy. Eight of the pregnant women in which IgM was found as positive after the 20th week of pregnancy were examined and three intrauterine growth retardation, one hypospadias and three normal deliveries were seen in these pregnant women. Any congenital anomaly finding was not detected in the pregnant women with positive CMV IgM.ConclusionsSeroprevalence values are high for Rubella and CMV in our region. It can be recommended not to check the pregnant women routinely for this purpose with the good implementation of Rubella vaccine programs.

Comparison of four different treatment regimens on coagulation parameters, hormonal and metabolic changes in women with polycystic ovary syndrome

ObjectiveTo determine the effects of different treatment regimens on the hormonal features, metabolic parameters, and hematologic variables in women with polycystic ovary syndrome (PCOS).MethodsForty-eight women with PCOS were randomized into four treatment protocols: ethinyl estradiol/cyproterone acetate (EE/CA; nxa0=xa012), EE/CA–metformin (nxa0=xa012), metformin alone (nxa0=xa012) and EE/CA–spironolactone (nxa0=xa012). These treatment protocols were given for 3xa0months and pre- and post-treatment variables were compared.ResultsActivated partial thromboplastin time (APTT) and prothrombin time (PT) levels, D-dimer, HOMA-IR, insulin, WBC, MPV as well as androgen levels decreased in all treatment groups. EE/CA–metformin and metformin alone groups resulted in a higher proportional reduction of D-dimer levels than the other protocols, while no significant different proportional reduction was observed in all the four groups for MPV, WBC, APTT, PT values. EE/CA–metformin group showed higher proportional reduction fasting insulin concentrations, HOMA-IR and free testosterone levels than metformin alone and EE/CA–spironolactone groups. DHEAs levels significantly decreased in group EE/CA–metformin than EE/CA alone and EE/CA–spironolactone groups. In multiple stepwise regression analyses, reduction in proportional insulin levels was independently and positively associated with decrease of MPV, D-dimer, free testosterone levels.ConclusionsIn all treatment groups, we observed reduced levels of coagulation parameters, improvement of hormonal, hematological and metabolical variables by most probably reducing insulin levels. Among the treatment groups, EE/CA–metformin may be a more effective therapeutic option than the other protocols and this may be due to the beneficial effect of EE/CA–metformin on insulin resistance.

Is there a link between premature ovarian failure and serum concentrations of vitamin D, zinc, and copper?

ObjectiveThe risk of primary ovarian insufficiency (POI) increases in association with autoimmune conditions. Adequate intake of vitamin D (vit D) and trace elements is required for the immune system to function efficiently. The aim of this study was to evaluate vit D, zinc, and copper blood levels in women with POI who had given birth to at least one child and in women with normal menstrual cycles. MethodsThis was a cross-sectional, case-control study involving 63 participants divided into two groups: the study group, which is composed of 35 women with POI, and the control group, which is composed of 28 women with normal menstrual cycles. Serum concentrations of zinc, vit D, and copper were determined for each participant. ResultsWomen with POI had significantly higher serum copper levels and copper-to-zinc ratio but significantly lower serum vit D and zinc levels when compared with the healthy control group. Serum follicle-stimulating hormone levels were inversely correlated with zinc and vit D levels and positively correlated with the copper-to-zinc ratio and copper levels. Vit D levels were inversely correlated with follicle-stimulating hormone levels, copper-to-zinc ratio, and copper levels and positively correlated with zinc levels. ConclusionsMost women with POI are deficient in vit D. Zinc, copper, and vit D seem to correlate with hormonal status in the participants. The present study may generate hypotheses for future studies that will investigate the possible mechanisms behind alterations in trace elements and vit D deficiency in women with POI and whether these changes could be used to screen for the risk of developing POI.

Relationship between mean platelet volume and low-grade systemic coagulation with vitamin D deficiency in primary ovarian insufficiency

ObjectivePremature menopause in young women is associated with an increased incidence of cardiovascular disease. The present study was designed to determine vitamin D (vit D) and the coagulation parameters such as activated partial thromboplastin time (APTT), PT, D-dimer, white blood cell (WBC), and mean platelet volume (MPV) levels, in primary ovarian insufficiency (POI) patients and control women with a normal menstrual cycle.Materials and methodsA total of 43 patients with non-diabetic POI were studied in order to evaluate and compare with the control group comprising 33 women with a normal menstrual cycle.ResultsThere was no significant difference between the groups for age and body mass index (BMI). D-dimer, WBC, MPV, PT, total cholesterol, and LDL cholesterol were higher in women with POI. APTT levels were also increased but missed the significance in POI group. Women with POI had significantly lower serum vit D levels compared with healthy control group. FSH level was positively correlated with D-dimer, WBC, MPV, and negatively correlated to vit D and serum D vit level was inversely correlated with MPV, APTT, D-dimer, FSH levels in individual women.ConclusionsThe obtained results seem to indicate that POI patients had low-grade systemic coagulation and fibrinolytic activation as evidenced by elevated D-dimer, WBC, MPV, PT values potentially be used as indicators of risk factor for thrombosis and atherosclerosis in POI women. All of our patients with POI were deficient in vit D. These results also suggest that vit D deficiency plays important roles of POI women and associated with coagulation, independently from age and BMI.

High mean platelet volume, low-grade systemic coagulation, and fibrinolytic activation are associated with pre-term delivery and low APGAR score in intrahepatic cholestasis of pregnancy

Objectives.u2003This study was designed for evaluating coagulation parameters and low APGAR scores in pregnancies with intrahepatic cholestasis of pregnancy (ICP) vs. normal control pregnancies. Methods.u2003We carried out a prospective case–control study by enrolling 40 women with ICP at the third trimester of pregnancy and 40 pregnant women without ICP. Results.u2003Total bile acid levels (TBA), MPV, D-dimer, and umbilical artery systolic/diastolic ratio (UASDR) values were higher in women with ICP. Pregnancies complicated by low APGAR score exhibited significantly higher D-dimer levels than those of unimpaired fetal outcome in patients with ICP and control subjects. Levels of D-dimer were inversely correlated with 5′-Apgar score and positively associated with UASDR values in patients with ICP. Pregnancies that exhibited abnormal UASDR had higher total bile acid (TBA), D-dimer, MPV values and lesser 5′-Apgar score. In linear stepwise regression analyses, D-dimer independently and positively associated with UASDR, inversely associated with 5′-Apgar score in subjects with ICP; positively associated with mean platelet volume (MPV) values and inversely associated with 5′-Apgar score in all subjects. Conclusion.u2003Patients with ICP had low-grade systemic coagulation and fibrinolytic activation as evidenced by elevated D-dimer, and also D-dimer is associated with lower APGAR scores in both ICP and all pregnancies. Increased D-dimer levels suggest that hematological parameters could be potentially used as indicators of risk factor for assessing low APGAR score in ICP.

Prevalence of congenital toxoplasmosis among a series of Turkish women

BACKGROUNDnToxoplasma gondii infection during pregnancy causes congenital malformations. Pregnant women should be screened for this infection since it is preventable and treatable.nnnAIMnTo study the sero prevalence of Toxoplasma gondii infection among pregnant women living in lzmir, Turkey.nnnMATERIAL AND METHODSnA blood sample was obtained from 4651 women aged between 15 and 45 years, during their first trimester of pregnancy. IgM and IgG antibodies against Toxoplasma gondii were measured using an ELISA assay. Among women with both IgG and IgM antibodies positive, an IgG avidity test was performed, using a VIDAS kit.nnnRESULTSnIgG antibodies were positive in 1871 (39.9%) participants. Of these, 48 (2.5%) also had positive IgM antibodies. In 41 of these 48 women, the IgG avidity test was performed and only one woman had a low avidity. This woman was treated with Spiramycin. Her offspring had an intrauterine growth retardation and oligohydramnios. A chorioretinitis was diagnosed in the offspring of other woman with both antibodies positive.nnnCONCLUSIONSnIn this series, the prevalence of congenital toxoplasmosis was low. However, women with positive antibodies against Toxoplasma Gondii should be further studied and followed during their pregnancy.

Oral contraceptives alone and with spironolactone increase sCD40 ligand in PCOS patients

BackgroundThe present study was designed to determine the effect of oral contraceptives (OCP) and OCP plus spironolactone (Sp) on plasma soluble CD40L levels in polycystic ovary syndrome (PCOS) patients.MethodsFifty-six women with PCOS were randomized into two treatment protocols: ethinylestradiolxa0+xa0cyproterone acetate (2xa0mg, EE/CA; nxa0=xa028), and EE/CA with spironolactone (Sp; nxa0=xa028). Plasma sCD40L levels were measured before and after a 3-month treatment.ResultsBefore the initiation of treatment, the sCD40L levels were not significantly different between the groups [EE/CA (1.33xa0ng/mL) vs. EE/CAxa0+xa0Sp (1.23xa0ng/mL); Pxa0>xa00.05]. In the post-treatment period, sCD40L concentrations were increased compared with pre-treatment values in the EE/CA and EE/CAxa0+xa0Sp groups (1.33 vs. 2.70xa0ng/mL, Pxa0=xa00.011; and 1.23 vs. 2.41xa0ng/mL, Pxa0=xa00.017; respectively).ConclusionIncreased plasma concentrations of sCD40L are associated with OCP and OCPxa0+xa0Sp treatment regimens in PCOS patients.

Metformin plus oral contraceptive may decrease plasma sCD40 ligand in women with PCOS patients

Aim.u2003To evaluate sCD40L levels in women with polycystic ovary syndrome (PCOS) who use combination therapy with metformin and oral contraceptives. Methods.u2003Total of 60 patients with PCOS was studied to evaluate and compare with a non-PCOS group consisting of 30 subjects. A low-dose oral contraceptive containing ethinyl oestradiol-cyproterone acetate (EE/CA) and metformin (M; 850u2009mg metformin twice a day) were given for three cycles. Plasma sCD40L was measured before and after the treatment of 3 months. Results.u2003At baseline, the sCD40L levels of the patients with PCOS was significantly higher than those of control subjects (3.1u2009±u20092.0 vs. 2.05u2009±u20091.0, respectively; pu2009=u20090.002). An average of 3 months of EE/CA-M therapy induced a significant decrease of sCD40L levels in the PCOS group (3.1u2009±u20092.0 vs. 2.5u2009±u20091.0; pu2009=u20090.026). After having treated patients with PCOS, the sCD40L level was not completely normalised when compared to the healthy controls (2.5u2009±u20091.0 vs. 2.05u2009±u20091.0; pu2009=u20090.039). Conclusions.u2003PCOS is associated with elevated levels of sCD40L. Adding metformin therapy to EE/CA may decrease sCD40L levels in women PCOS. However, after the treatment for PCOS subjects, the sCD40L was not completely normalised when compared patients to healthy controls.

Effects of an EE/CA compared with EE/CA-metformin on serum ADMA levels in women with polycystic ovary syndrome

To determine the effects of EE/CA (Ethinylestradiol/ Cyproterone Acetate) and EE/CA-metformin treatments on the asymmetric dimethylarginine (ADMA) levels in women with PCOS (Polycystic Ovary Syndrome). Among 43 patients diagnosed with PCOS, one study arm (n=22) was administered (35 µg EE, 2mg CA) and the other (n=21) was administered (35 µg EE, 2mg CA plus 1700mg metformin). Serum ADMA, lipid profile, androgens, insulin, and HOMA-IR (Homeostatic Model Assessment of Insulin Resistance ) values were assessed prior to treatment and after 3 months of therapy. A significant reduction in ADMA levels relative to pre-treatment in the EE/CA+metformin group (1.2±0.4 vs 0.95±0.4, p=0.016) compared to the EE/CA group (1.0±0.5 vs 1.03±0.4, p >0.05). Andogens, insulin and HOMA-IR levels decreased in both treatment groups. All lipid profiles significantly improved in-group EE/CA+metformin while no significant decrease was observed in TG and HDL-cholesterol levels in EE/CA group. Post-treatment levels of HDL-C levels correlated significantly with the reducing ADMA levels in the EE/CA+metformin group (P=0.005, r= 0.602). Adding metformin to EE/CA therapy in PCOS may beneficial endothelium effects associated with reduction of ADMA levels.