Metehan Imamoglu

Maternal serum and fetal cord blood irisin levels in gestational diabetes mellitus

AIM To investigate the relationship between maternal and cord blood irisin in gestational diabetes mellitus (GDM). METHODS Twenty women with GDM and 20 pregnant women with uncomplicated pregnancies were recruited for this case-control study. Maternal serum irisin and cord blood irisin levels were measured by enzyme-linked immunosorbent assay kit at the time of birth. The association of maternal serum and cord blood irisin levels with metabolic parameters was analyzed. RESULTS Women with GDM had significantly lower mean serum irisin levels compared to control group (258.3±127.9 vs. 393±178.9ng/ml, p<0.05). Mean cord blood irisin levels for GDM and control groups were not significantly different (357.2±248.0 vs. 333.2±173.4ng/ml, p>0.05). No significant differences were found in terms of maternal age, gestational week at birth, BMI at birth, birth weight, neonatal height, systolic and diastolic blood pressure between the groups as well (p>0.05). Serum irisin level was negatively correlated with BMI at birth and HOMA-IR (r=-0.401, p=0.010; r=-0.395, p=0.012, respectively). No correlations between irisin levels and others parameters were found in both groups. CONCLUSIONS Maternal serum irisin levels of patients with GDM are significantly lower compared with non-GDM controls. However, no significant difference was found between cord blood irisin levels of patients with GDM and healthy pregnant women.

Elevated serum levels of anti-Müllerian hormone can be introduced as a new diagnostic marker for polycystic ovary syndrome

To determine the possible role of anti‐Müllerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS) with a larger population of women and to evaluate its role as a new diagnostic marker.

Implications of circulating irisin and Fabp4 levels in patients with polycystic ovary syndrome

abstract The aim of the study was to evaluate the fatty acid-binding protein-4 (FABP4) and irisin concentrations in women with polycystic ovary syndrome (PCOS). Forty-nine women with PCOS, diagnosed according to Rotterdam criteria and 39 healthy women matched for body mass index (BMI) and age. Serum irisin and plasma FABP4 concentrations were measured in both groups. The association of irisin and FABP4 concentrations with metabolic parameters were also tested. Women with PCOS had significantly lower mean serum irisin concentrations than control subjects (158.5 ± 123.3 versus 222.9 ± 152.2 ng/ml, p < 0.05). Concentrations of FABP4 in PCOS and control groups were not significantly different (10.5 ± 4.4 versus 10.9 ± 4.2 ng/ml, p > 0.05). FABP4 concentrations were correlated with BMI, waist–hip ratio (WHR) and HOMA-IR (r = 0.57, p = 0.001; r = 0.26, p = 0.03; r = 0.26, p = 0.03, respectively). No associations between irisin and all the others parameters except serum levels of LH were found. Serum irisin concentrations of women with PCOS were lower compared to the controls. Moreover, there were no difference in plasma FABP4 concentrations between women with PCOS and controls.

Evaluation of ovarian reserve in Hashimoto's thyroiditis

Abstract Human ovary is commonly the target of an autoimmune attack in cases of organ- or non-organ-specific autoimmune disorders. Hashimoto’s thyroiditis (HT) is likely to be associated with ovarian dysfunction and diminished ovarian reserve. In this study, we aimed to evaluate the possible negative association between this significantly prevalent autoimmune disease and the ovarian reserve. Thirty-two premenopausal women with primary hypothyroidism, who under replacement therapy with thyroxine were recruited. Forty-nine healthy female subjects who had normal anti-thyroid antibody levels and were comparable with the HT group in terms of age and BMI values, comprised the control group. There was no statistically significant difference between the study and the control patients in terms of antral follicle count. Serum anti-Müllerian hormone (AMH) levels were significantly higher in woman with HT compared to the control group. The results of this study found no impairment in ovarian reserve parameters of patients with HT. Interestingly, the results revealed a significant increase in serum AMH levels of the patients with HT compared to controls. Hashimotos thyroiditis may share a common etiologic linkage with polycystic ovary syndrome; therefore, leading to elevated serum AMH levels, which we are currently unable to define elaborately. Chinese abstract 人类卵巢经常成为器官特异性或非器官特异性自身免疫性疾病的靶器官。桥本甲状腺炎(HT)或与卵巢功能不全和卵巢储备功能降低有关。本研究的目标为评估这种常见的自身免疫性疾病与卵巢储备可能存在的负相关性。 32名原发性甲状腺功能低下并使用甲状腺素进行替代治疗的绝经前妇女被纳入了此项研究。对照组包括49名抗甲状腺抗体正常的，与HT组年龄和BMI值相仿的受试者。在窦卵泡数方面，实验组和对照组并无明显的统计学差异。与对照组相比，HT组血清抗苗勒氏管激素水平显著升高。研究结果未发现HT患者的卵巢储备相关参数受到损伤。有趣的是，研究结果显示出HT患者相比较对照组AMH的显著升高。 桥本甲状腺炎与多囊卵巢综合征或具有相同的病原学联系。因此，导致了血清AMH的升高，这是我们目前无法精确判定的。

Shear wave elastography of the placenta in patients with gestational diabetes mellitus

To evaluate placental elasticty in women with gestational diabetes mellitus (GDM) and non-diabetic controls. Thirty-three pregnant women with GDM according to the current criteria of the American Diabetes Association and 43 healthy pregnant women who were admitted to the antenatal clinic were recruited for this case–control study. Elasticity values of both the peripheral and the central parts of the placentas of the patients in both groups were determined by shear wave elastography (SWE) imaging. Mean elasticity values of both the central and the peripheral part of the placentas were significantly higher in GDM pregnancies (p < 0.001). No difference was observed in the mean elasticity values of the central and the peripheral part of the placentas in two groups (p > 0.05). SWE imaging technology might provide a quantitative assessment of the morphological pathologies of placentas in pregnant women with GDM.

Maternal serum copeptin concentrations in early- and late-onset pre-eclampsia

OBJECTIVE Early-onset pre-eclampsia is primarily associated with placental dysfunction, whereas late-onset pre-eclampsia is defined as a maternal constitutional disorder. As a protein cosynthesized with vasopressin, copeptin is a potential marker of metabolic syndrome and insulin resistance, which shares similar risk factors with pre-eclampsia. The aim of this study was to investigate the copeptin levels in patients with early-onset and late-onset pre-eclampsia. MATERIALS AND METHODS A total of 80 pregnant women receiving antenatal and obstetric care were recruited. The patients were subdivided into four groups: Early-onset pre-eclampsia (n = 20), late-onset pre-eclampsia (n = 20), and two control groups of similar gestational ages for both pre-eclamptic groups (n = 20 in each group). The maternal serum copeptin levels were measured using an enzyme-linked immunosorbent assay. RESULTS The mean copeptin levels were 0.92 ± 0.57 ng/mL and 1.65 ± 0.95 ng/mL in the early-onset and late-onset pre-eclampsia groups, respectively. These values were higher compared with the control groups (0.54 ± 0.25 ng/mL and 1.15 ± 0.94 ng/mL, respectively). However, the difference was only statistically significant in the early-onset pre-eclampsia group (p = 0.011). Copeptin levels were associated only with gestational age and systolic-diastolic blood pressure. CONCLUSION Our results suggest that copeptin levels might be useful in the evaluation of the severity of pre-eclampsia. However, copeptin might be involved in early- rather than late-onset pre-eclampsia.

Maternal serum apelin and YKL-40 levels in early and late-onset pre-eclampsia

Objective: The aim of the present study is to investigate whether alterations in the serum levels of apelin and YKL-40 differ between early and late onset pre-eclampsia and whether there is a correlation between apelin and YKL-40 in women who subsequently develop early and late pre-eclampsia. Materials and methods: A total number of 80 pregnant women, 40 with normal pregnancy and 40 with pre-eclampsia, were included in the present study. Both the normal pregnant and pre-eclamptic subjects were subdivided into two groups. Serum YKL-40 and apelin concentrations were measured. Results: Mean maternal serum YKL-40 levels were both lower in women who subsequently developed early (87.45 ± 3.07 versus 103.40 ± 4.29) or late (96.43 ± 4.06 versus 99.87 ± 3.63) pre-eclampsia than those who remained normotensive. The difference was significant in early-onset preeclamptic women (p < 0.05) rather than late-onset pre-eclamptic ones (p > 0.05). Mean maternal serum apelin levels were both higher in women who subsequently developed early (8.6 ± 3.6 versus 5.7 ± 1.2) or late (9.6 ± 2.5 versus 8.1 ± 1.8) pre-eclampsia than those who remained normotensive. The difference was significant in early-onset preeclamptic women (p < 0.05) rather than late-onset pre-eclamptic ones (p > 0.05). There was a significant negative correlation between serum apelin and YKL-40 levels (r = −0.48, p = 0.001). Conclusion: Circulating levels of apelin are significantly increased in early-onset pre-eclampsia, indicating the role of apelin in the discrimination of the early-onset of pre-eclampsia. On the other hand, maternal serum YKL-40 levels are not elavated significantly, indicating that adipose-derived apelin is primarily involved in the vascular pathogenesis of early-onset pre-eclampsia than macrophage-derived YKL-40.

Prenatal diagnosis of left coronary artery to right ventricle fistula

Prenatal diagnosis of a congenital coronary artery fistula between the left coronary artery and the right ventricle was established at 28 weeks of gestation. Hydrops fetalis developed during follow‐up and the baby died on the first day after delivery. It is rare for coronary artery fistulas to become symptomatic during fetal life.

Serum YKL-40 levels are altered in endometriosis

Abstract Endometriosis is traditionally defined as the presence of endometrial glands and stroma in ectopic locations, especially the pelvic peritoneum, ovaries and rectovaginal septum. YKL-40, a new biomarker of inflammation, is secreted by activated macrophages and neutrophils in different tissues with inflammation. Serum concentrations of YKL-40 are elevated in patients with diseases characterized by inflammation. We aimed to investigate the possible association between serum YKL-40 levels and endometriosis. A total number of 88 women were recruited for this case–control study. About 53 patients with surgically proven endometriosis were included, while 35 patients without endometriosis comprised the control group. Patients were classified as having minimal, mild, moderate and severe disease in accordance with the severity. Two new groups were formed by combining patients with minimal and mild disease (Stage 1–2) and with moderate and severe disease (Stage 3–4). Serum YKL-40 levels were statistically higher in the endometriotic group compared to control group (p:0.001). YKL-40 levels were significantly higher in Stage 3–4 group compared to Stage 1–2 group (p values 0.001) as well. Correlation analysis revealed a positive correlation between serum YKL-40 levels and the stage of the disease. YKL-40 may be utilized as a marker for determining the severity of endometriosis.

Absent ductus venosus in the fetus.

pH 7.26 and base excess – 8.5 mEq/l; WBC 13,800; haemoglobin 14.8 g/dl; platelets 14.2 10 4 / μ l; CRP 2.98 mg/dl. Small abscesses were observed in the placenta. Administration of fl omoxef (2 g/day for the mother) and panipenem/betamipron (60 mg/kg per day for the neonate) were continued. Two days later, Listeria monocytogenes was cultured from the maternal blood, chorionic membrane, the placenta and fetal gastric juice, leading to the diagnosis of maternal – fetal listeriosis. Flomoxef or panipenem/betamipron was changed to aminobenzyl penicillin, 12 g/day for the mother and 200 mg/kg per day for the infant. Th e infant was under a respirator for 26 days due to respiratory distress syndrome and is now under the care of pediatricians, without major sequelae. Th e mother recovered well. Th e transmission route of the Listeria was not identifi ed.