Gokce Anik Ilhan

Serum retinol-binding protein 4, leptin, and plasma asymmetric dimethylarginine levels in obese and nonobese young women with polycystic ovary syndrome

OBJECTIVE To evaluate retinol-binding protein 4 (RBP4), leptin, and asymmetric dimethylarginine (ADMA) levels in young women with polycystic ovary syndrome (PCOS) and to investigate their relationship with each other and with clinical, metabolic, and hormonal parameters. DESIGN Clinical study. SETTING University hospital. PATIENT(S) Fifty-seven young women with PCOS (obese [n = 27] and nonobese [n = 30]) and 27 age-matched healthy controls. INTERVENTION(S) History and physical examination, peripheral venous blood sampling. MAIN OUTCOME MEASURE(S) Asymmetric dimethylarginine, RBP4, leptin, LH, FSH, DHEAS, total T, E(2), total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride (TG), and homeostasis model assessment insulin resistance index (HOMA-IR). RESULT(S) Obese women with PCOS had significantly higher HOMA-IR, DHEAS, leptin, RBP4, and ADMA levels. Leptin levels were significantly increased in nonobese subjects with PCOS. Leptin and ADMA levels were positively correlated with HOMA-IR in PCOS. There was no correlation between RBP4 and HOMA-IR. Leptin, RBP4, and ADMA levels are positively correlated in PCOS. CONCLUSION(S) [1] Young obese women with PCOS have increased ADMA, RBP4, and leptin levels, and they are positively correlated with each other. [2] The increased levels of leptin are independent of obesity, and leptin seems to have an association with IR. [3] Levels of RBP4 may not reflect IR in PCOS.

The impact of insulin resistance on clinical, hormonal and metabolic parameters in lean women with polycystic ovary syndrome

Abstract This study was performed to assess insulin resistance (IR) in lean women with polycystic ovary syndrome (PCOS). Retrospective analysis of 100 consecutive lean (body mass index <25 kg/m2) PCOS subjects was performed. Subjects were divided into two groups according to homeostasis model assessment IR index (HOMA-IR), as IR + and IR−. A HOMA-IR value >2.5 was used to indicate IR. A total of 100 lean PCOS subjects were enrolled in the study, of which 47% were insulin resistant. Comparison of group means showed significantly higher values for waist-to-hip ratio (WHR), diastolic blood pressure and Ferriman–Gallwey score (FGS) in IR + group. HOMA-IR values were found to be positively correlated with WHR (r = 0.500, p < 0.01), systolic blood pressure (r = 0.265, p < 0.01), diastolic blood pressure (r = 0.273, p < 0.01), estradiol levels (r = 0.218, p < 0.05), FGS (r = 0.456, p < 0.01) and total testosterone levels (r = 0.291, p < 0.01). When evaluating PCOS subjects, the insulin resistant group should be separated as unique and IR should also be evaluated in lean women with PCOS.

Severe methotrexate toxicity after treatment for ectopic pregnancy: A case report

Severe methotrexate toxicity due to medical treatment of an ectopic pregnancy is presented. The feasibility of low-dose use and success of methotrexate makes it the first drug in the medical treatment of ectopic pregnancies. Besides its advantages, it should be used with caution and severe toxicity should be kept in mind.

The impact of lipid accumulation product (LAP) and visceral adiposity index (VAI) on clinical, hormonal and metabolic parameters in lean women with polycystic ovary syndrome

Abstract This study was performed to assess the impact of lipid accumulation product (LAP) and visceral adiposity index (VAI) on clinical, hormonal, and metabolic parameters in lean women with PCOS. Retrospective analysis of 120 consecutive lean PCOS subjects was performed. Subjects were divided into two groups according to HOMA-IR, as IR + and IR−. A HOMA-IR value above 2.5 was used to indicate IR. Clinical, hormonal and metabolic parameters were compared between the two groups. Correlations between LAP and VAI and clinical, hormonal, metabolic features in women PCOS were analyzed. One hundred twenty lean PCOS subjects were enrolled, of which 39 were insulin resistant. Comparison of group means showed significantly higher values for TG levels, FAI, FGS, TG/HDL-c, TyG, LAP, and VAI indexes and lower values for glucose/insulin ratio and QUICKI in the IR + group. LAP and VAI were both found to be positively correlated with each other and with WC, FAI, FGS, TG, TC levels, lipid ratios, TyG index, and HOMA-IR and negatively correlated with Glucose/Insulin ratio, QUICKI, and HDL-c in lean women with PCOS. LAP and VAI may be promising in early identification of IR and cardiometabolic risk and may be useful for the assessment of hyperandrogenism in lean women with PCOS.

Cardiotrophin-1 as a new metabolic biomarker in women with PCOS

Abstract The objective of this study was to investigate cardiotrophin-1 (CT-1) levels as a new metabolic biomarker in women with polycystic ovary syndrome (PCOS). One hundred consecutive women with PCOS were divided into two groups according to presence of metabolic syndrome as MetS+ and MetS−. Clinical, hormonal and metabolic parameters in addition to CT-1 levels were compared between the groups. Correlation analyses were performed between CT-1 and clinical and metabolic parameters in women with PCOS. One hundred PCOS subjects were enrolled in the study, of which 29 subjects were diagnosed with metabolic syndrome. WHR, systolic and diastolic blood pressures, triglyceride, total cholesterol, HOMA-IR, FAI, FGS and CT-1 levels were significantly higher in the MetS+ group compared with the MetS− group. HDL cholesterol was significantly higher in the MetS− group than the MetS+ one. CT-1 levels were found to be positively correlated with diastolic blood pressure, TG levels and FGS. Cardiotrophin-1 may be a promising new metabolic biomarker in women with PCOS. CT-1 may be beneficial for estimating the risk of long-term adverse health consequences and establishing early intervention and preventation strategies.

The impact of different 75 g oral glucose tolerance test target ranges within normal limits on neonatal outcomes: A validation study

Objective: To investigate the impact of different 75 g glucose tolerance test (OGTT) target ranges within normal limits on neonatal outcomes, thus to investigate the validity of 75 g OGTT thresholds. Materials and Methods: The normal 1-hour and 2-hour ranges of 75 g OGTT levels of 110 pregnant women with no gestational diabetes mellitus (GDM) were further divided into three different sub-groups; for the 1 hour as group 1 (<120 mg/dL), group 2 (120-140 mg/dL), group 3 (>140 mg/dL) and for the 2 hour as group 1 (<120 mg/dL), group 2 (120-135 mg/dL), and group 3 (>135 mg/dL). Results: For the 1-hour results, there was no statistically significant difference between groups in terms of age, body mass index, multiparity, neonatal hypoglycemia, hyperbilirubinemia, neonatal intensive care unit admission, birth weight, and LGT rates; however, the rate of small-for-gestational-age (SGA) infants was significantly higher in group 2 compared with those in group 3. For the 2-hour results, statistically similar results were found between the groups. Conclusion: A 2-hour 75 g OGTT has reliable threshold values for GDM screening. However, because there are still adverse neonatal outcomes in women with OGTT results below the current thresholds and the number of SGA fetuses is higher in the glucose range 120-140 mg/dL of the first hour, the validity of the 75 g OGTT thresholds still needs further investigation.

Evaluation of late adolescent pregnancies: Is late adolescence a risk factor for preterm labor?

Abstract Study objective: We evaluated effect of late adolescence during pregnancy and its confounding factors on neonatal and maternal results. Objective: The aim of the present study is to evaluate the effect of late adolescence on maternal, perinatal outcomes and preterm labor. Methods: This retrospective study was carried out on 172 late adolescents and 160 adult women who delivered in a tertiary center. The demographic features, obstetrical and neonatal properties of the patients were analyzed. Results: Marital status, education levels, preeclampsia–eclampsia, gestational diabetes mellitus (GDM), urinary tract infections during pregnancy, intrauterine growth restriction, bleeding in last trimester, postpartum hemorrhage, perinatal mortality incidence, and mode of delivery for both groups were similar. Regular antenatal follow up and hemoglobin levels during admission to hospital were low in late adolescents. Anemia during pregnancy, preterm labor incidence was high for late adolescents compared with adults. When a logistic regression analysis was made for preterm labor, lack of antenatal follow up, urinary tract infection during pregnancy and history of still birth was risk factors for preterm labor rather than age. Conclusion: We assume that regular antenatal follow up can reduce preterm labor among late adolescents.

Cystatin C, a novel cardiometabolic risk marker in women with polycystic ovary syndrome

Abstract Objective: To investigate the impact of urinary albumin excretion (UAE) and cystatin C on the metabolic components of polycystic ovary syndrome (PCOS). Methods: Seventy-five women with PCOS were divided into two groups according to metabolic syndrome as MetS + and MetS−. Clinical, metabolic and renal parameters were compared between the groups. Correlation analyses were performed between cystatin C, microalbuminuria and clinical and metabolic parameters in women with PCOS. Results: Waist/hip ratio (WHR), body mass index, LDL cholesterol, triglyceride, total cholesterol, cystatin C, UAE were significantly higher in the MetS + group compared with the MetS − one. HDL cholesterol was significantly higher in the MetS − group than the MetS + one. The UAE positively correlates with LDL cholesterol, triglyceride and total cholesterol levels. Cystatin C positively correlates with UAE, WHR, LDL cholesterol, triglyceride, total cholesterol levels. Conclusions: Evaluating UAE and cystatin C may be important for the detection of target subjects at high risk for future metabolic syndrome and cardiovascular disease.

Pregnancy After Renal Transplantation: Case Report

Giriş Son dönem böbrek yetersizliği olan hastalarda böbrek transplantasyonu ile fertilite oranlarında artışlar sağlanmıştır. Gebelik sonuçlarında gelişmeler sağlansa da bu hastalar yüksek riskli olarak kabul edilmelidir. Preeklampsi, erken doğum, düşük doğum ağırlığı, sezaryen oranlarında artış gibi sorunlar nedeniyle multidisipliner ekip yaklaşımı ile yakın takip yapılmalıdır. Bu olgu sunumunda kliniğimizde takip edilen renal transplantlı bir gebenin takibi ve yönetimini sunmayı amaçladık. Renal Transplantasyon Sonrası Gebelik: Olgu Sunumu Pregnancy after Renal Transplantation: Case Report