Selda Demircan Sezer

Circulating galanin and IL-6 concentrations in gestational diabetes mellitus

Abstract Objective: The aim of this study is to compare galanin and IL-6 levels in pregnant women with gestational diabetes mellitus (GDM) and normal glucose tolerance (NGT). Also association of insulin resistance markers, galanin and IL-6 was investigated. Materials and Methods: The study registered 30 pregnant women with GDM and 30 pregnant women with NGT. Fasting venous blood samples were collected from all patients. Galanin and IL-6 levels were measured by an enzyme-linked immunosorbent assay. Results: Galanin and IL-6 levels were found higher in pregnant women with GDM (p < 0.001). A significant positive correlation was determined between galanin concentrations and glucose (r = 0.240, p = 0.065), insulin (r = 0.681, p < 0.001), HbA1c (r = −0.644, p < 0.001), IL-6 (r = 0.783, p < 0.05) and oral glucose challenge test results (r = 0.745, p < 0.001) in pregnant women included in study, whereas no significant association was determined between galanin and gestational age (r = 0.058, p = 0.662), body mass index (r = −0.019, p = 0.886). Conclusion: Galanin and IL-6 were found to be significantly associated with insulin resistance markers in GDM, thus may play important roles in regulation of glucose hemostasis.

VEGF, PIGF and HIF-1α in placentas of early- and late-onset pre-eclamptic patients

Abstract Purpose: The aim of this study was to compare the VEGF, PIGF, and HIF-1α levels in the placentas of early- and late-onset pre-eclamptic patients, which are thought to be important in pathophysiology of pre-eclampsia. Material and method: Pre-eclamptic early-onset (n = 22) and late-onset (n = 24) pregnant women and a control group of healthy pregnant women (n = 22) were recruited for this case–control study. A semi-quantitative immunohistochemical analysis of VEGF, PIGF and HIF-1α was performed in cross-sections of the placentas of the subjects, after which results were compared. Results: Levels of VEGF and PIGF in the placentas of pre-eclamptic patients were found to be lower than the levels in the placentas of healthy pregnant women (p < 0.001 and p = 0.025, respectively), whereas the levels of HIF-1α were found significantly higher (p < 0.001). No difference was observed in terms of VEGF, PIGF and HIF-1α in a comparison of the early- and late-onset pre-eclampsia groups (p > 0.05). Conclusion: The results of the study indicated that there is no relationship between the time of onset of pre-eclampsia and the placental changes that occur in these factors.

Interleukin-6 levels in relation with hormonal and metabolic profile in patients with polycystic ovary syndrome

Abstract Objective: The aim of this study was to evaluate serum concentrations of interleukin-6 (IL-6) in relation with hormonal and metabolic profile in patients with and without polycystic ovary syndrome (PCOS). Methods: A total of 40 women with PCOS and 40 age-matched controls were eligible for the study. Hirsutism scores, hormonal and metabolic profile as well as IL-6 levels were evaluated in each subject. Results: Women with PCOS exhibited higher body mass index (BMI) and serum concentrations of IL-6 levels than controls (p < 0.05); however, levels of IL-6 were not significantly increased when compared with BMI-matched controls (p > 0.05). IL-6 levels were significantly correlated positively with BMI and triglyceride levels; however, negatively correlated with high-density lipoprotein levels. Conclusion: The data of this study suggested that serum IL-6 levels were found to be higher in women with PCOS as compared to controls; however, IL-6 levels might be dependent on nutritional status but not on PCOS per se. Raised serum IL-6 levels may be related to BMI and serum lipid levels and may be a predictor for cardiometabolic risks.

Comparison of angiogenic and anti-angiogenic factors in maternal and umbilical cord blood in early- and late-onset pre-eclampsia

Purpose: The aim of this study was to compare maternal and umbilical cord serum levels of the angiogenic and anti-angiogenic factors in early- and late-onset pre-eclamptic pregnancies as well as in normal pregnancies, which might have significant importance in the etiology of pre-eclampsia. Materials and Methods: This prospective case-control study was carried out with pre-eclamptic (early-onset, ≤ 34 weeks and late-onset, >34 weeks) and normal pregnant women. VEGF, PIGF, sFlt-1 and sEng levels in maternal and umbilical cord serum were measured before delivery and the findings were compared. Results: The study was conducted with 15 early- and 15 late-onset pre-eclampsia patients, and 17 patients with normal pregnancies. It was found that sEng levels were higher in the umbilical cord serum in the early-onset and in the maternal serum in the late-onset pre-eclampsia group than the control group (p < 0.05). No significant difference in any factor was observed between the early- and late-onset pre-eclampsia groups. Conclusion: In this study, the results showed that angiogenic and anti-angiogenic factor levels in maternal serum and umbilical cord serum may not be related to the time of onset of pre-eclampsia.

Misconceptions about the side effects of combined oral contraceptive pills

Objective: Although combined oral contraceptive pills (COCPs) are one of the most commonly used methods of contraception in western countries, they are taken by only a minority of sexually active women in Turkey. The purpose of this research has been to define women’s specific misconceptions with regard to the side effects of COCPs. Methods: This descriptive and cross-sectional research was conducted on 418 reproductive aged women who agreed to participate. Data were collected through face-to-face interviews with a questionnaire which assessed socio-demographic characteristics and women’s beliefs about the side effects of COCPs. Results: It is observed that 45.2% believed that the pills cause weight gain. Another 7.9% of the cases held the belief that COCPs cause cancer. A group of 13.4% of the subjects thought that COCPs lead to infertility, 28.7% believed that they cause headache, 41.1% believed that they cause acne and/or an increase in body hair, and 11.7% were afraid that they cause a decrease in libido. Conclusion: The present study has shown that misconceptions about the side effects of COCPs were considerably prevalent among this cohort group of Turkish women. Healthcare professionals have the potential of playing an important role in dispersing these misconceptions.

Maternal serum concentrations of s-Endoglin and IL-6 in pregnancy complicated by preterm premature membrane rupture

Abstract Objective: This study aimed to investigate maternal serum concentrations of s-Endoglin and compare s-Endoglin with other inflammatory markers in prediction of time to delivery, in pregnancies complicated by preterm premature rupture of membranes (PPROM). Materials and methods: Fifty five patients complicated by PPROM whose gestational age were between 2433 weeks and 44 matched healthy pregnant women were included in present study. Maternal concentrations of s-Endoglin concentrations were measured by an enzyme-linked immunosorbent assay (ELISA) and compared with maternal inflammatory markers including interleukin-6 (IL-6), white blood cell (WBC) count and serum C-reactive protein (CRP). The best variable for prediction of preterm birth was computed. Results: Mean s-Endoglin levels in PPROM were lower than control groups (0.24 ± 0.12 pg/ml and 0.69 ± 0.25 pg/ml, respectively, p < 0.01). Besides IL-6 (p < 0.01), WBC (p = 0.016) and CRP (p = 0.010) levels were higher in PPROM group. In PPROM group, ROC analysis results of s-Endoglin for prediction of preterm delivery <48 h, <7 days, <32 weeks were not different (p > 0.05). For predicting preterm birth before 48 h and 7 days, only IL-6 at cut off value >0.70 (pg/ml) and >0.55 (pg/ml) had area under curve (AUC); 0.871 (0.7750.965), p < 0.01, AUC; 0.925 (0.8560.993), p < 0.001, respectively. Conclusion: s-Endoglin as an anti-angiogenic marker seemed to have a role in pathogenesis but results of present study showed that, unlike IL-6, it was unsatisfactory for estimating time to delivery in PPROM.

Comparison of interleukin-6 levels in maternal and umbilical cord blood in early- and late-onset preeclampsia.

Purpose: Increased inflammatory response and cytokines are claimed to play a significant role in the etiology of preeclampsia. Interleukin-6 (IL-6) is a proinflammatory cytokine. Limited number of studies evaluating IL-6 levels in preeclamptic patients have produced conflicting results. Therefore, the present study sought to compare maternal and umbilical cord serum levels of IL-6 in early- and late-onset preeclamptic pregnancies as well as in normal pregnancies. Materials and methods: A total of 69 participants were enrolled in the study. The control group consisted of 24 participants with normal pregnancies. Preeclampsia group consisted of 45 participants. The preeclampsia group was further classified into the subgroups of early- and late-onset preeclampsia. Late-onset preeclampsia group consisted of 24 women whereas early-onset preeclampsia group consisted of 21 women. Serum and umbilical cord samples of IL-6 were compared. Results: There was no significant difference between maternal and umbilical cord serum IL-6 concentrations between the preeclampsia and control group. No significant difference was observed in maternal and umbilical cord serum IL-6 levels between early- and late-onset preeclampsia groups. Conclusion: Our results do not support an increase in IL-6 levels in patients with early- and late-onset preeclampsia. The clinical relevance of our findings needs to be further investigated.

Comparison of maternal and umbilical cord blood HIF-1α and nitric oxide levels in early and late onset preeclamptic pregnancies.

Abstract Objective: Despite the absence of a complete physiologic–pathologic understanding, common accepted theory for development of preeclampsia is incomplete trophoblastic invasion leading to failed uterine and spiral arteriolar remodeling, causing maternal vascular endothelial dysfunction by secreted molecules in response to decreased placental perfusion, placental hypoxia, and ischemia. Placental angiogenesis is especially ineffective in early onset preeclampsia and fetal morbidity/mortality rates are higher because of further decreased blood flow. In this study, we aim to compare the maternal and umbilical cord blood levels of hypoxia-inducible transcription factor-1α (HIF-1α), which is believed to regulate hypoxia-related transcriptional responses, to play role in activating genes for initial phases of placental development and angiogenesis and a physiologic vasodilator molecule nitric oxide (NO) in normal, early and late onset preeclamptic pregnant women. Methods: Pregnant women who were diagnosed with preeclampsia (early onset ≤34 weeks; late onset >34 weeks) and delivered in our clinic were enrolled for this prospective case-controlled study. Pregnant women without preeclampsia were recruited as control group. HIF-1α and NO levels in maternal and umbilical cord blood measured and compared among groups. Findings: A total of 46 cases were enrolled for this study, including 25 preeclamptic (13 in the early onset group and 12 in the late onset group) and 21 normal pregnant women in the control group. Comparison of preeclampsia group to controls revealed higher maternal blood HIF-1α levels in the control group, however higher umbilical cord NO levels in the preeclampsia group (p < 0.05 and p < 0.001, respectively). In a second analysis, when compared to control group, both early and late onset preeclampsia subgroups were found to have higher umbilical cord blood NO levels (p < 0.001). Results: In this study, we observed lower maternal blood HIF-1α levels and higher umbilical cord NO levels in preeclampsia group than controls. These findings suggest that umbilical cord blood NO levels in pregnant women with preeclampsia increase in response to hypoxia. However, lower HIF-1α levels in preeclampsia group can be due to our limited number of cases and we think that there is a need for further studies with larger sample size.

Correlation between maternal serum-amniotic fluid anti-angiogenic factors and uterine artery Doppler indices

Abstract Purpose: Elevated sFlt-1 and sEng is usually a clue for impending preeclampsia and intrauterine growth restriction. Likewise, uterine artery Doppler ultrasound is being investigated for prediction of similar conditions. In this study, we aimed to explore the possible relations of these two proteins in different body compartments with uterine artery Doppler indices (UtAD) in a healthy second trimester obstetric population. Methods: Levels of sFlt-1 and sEng were measured in serum and amniotic fluid samples of 43 patients. UtAD were measured on the days of sample collections. Findings were then analyzed for possible correlation. Results: There was a positive correlation between the levels of maternal serum sFlt-1 (MSsFlt-1) and sEng levels (MSsEng) (r= 0.516, p< 0.001). The negative correlation between MSsFlt-1 and UtAD was disappeared after elimination of poor obstetric outcome pregnancies (r= −0.371, p= 0.016). No correlation was found between UtAD and studied protein levels in amniotic fluid. Mean MSsFlt-1 level was 305.2 ± 220.1 pg/ml and mean AFsFlt-1 was 48.9 ± 11.8 ng/ml. Mean MSsEng level was 4.5 ± 1.3 ng/ml, mean AFsEng level was found 0.7 ± 0.3 ng/ml. Mean values for UtAD were 1.3 ± 0.4, 0.6 ± 0.1 and 3.5 ± 1.3 for PI, RI, and S/D, respectively. Conclusion: In normal second trimester pregnancies, there is a positive correlation between serum levels of sFlt-1 and sEng levels. Amniotic fluid levels of sEng and sFlt-1 are not correlated with UtAD in uncomplicated pregnancies.

Predictors of Success of Different Treatment Modalities for Management of Ectopic Pregnancy

Aim. The purpose of this study was to investigate factors affecting the success of different treatment modalities for the management of ectopic pregnancy (EP). Methods. One hundred and ninety-seven patients with EP, were included in the study. Patients were treated with either intramuscular methotrexate (Mtx) or surgical treatment. Results. Mtx was applied in 97 (49.2%) patients. In 67 patients (69.1%), a single dose of Mtx and in 30 patients (30.9%) a multiple dose of Mtx was applied. Forty-seven (70.14%) patients were successfully treated with a single-dose Mtx. In the multiple-dose group, the success rate was 70% (21/30 patients). The difference between the success rates was not statistically significant. When the initial serum βhCG value was <1000 mIU/mL, the overall success rate of Mtx treatment was determined to be 86.11%; however, the rate decreased to 42.3% when the βhCG value was >3000 mIU/mL. On the other hand, if the EP mass diameter was <25 mm, the success rate was 89.28% and decreased to 52.63% when it was ≥25 mm. Conclusion. The results of the study showed that single-dose treatment with Mtx could be as successful as multiple doses. Overall success of Mtx treatment depended on initial βhCG value and EP mass diameter.