Novel bioactive substances in human colostrum: could they play a role in postnatal adaptation?

Objective: To determine maternal colostrum/serum concentrations of the bioactive substances irisin, adropin and copeptin and investigate their association with several perinatal parameters and pathologic conditions during pregnancy.

Methods: In a cohort of 81 mothers with full-term deliveries, colostrum/serum concentrations of irisin, adropin and copeptin were prospectively evaluated by ELISA on Day 3–4 postpartum.

Results: Copeptin and adropin were detectable in human colostrum at higher, while irisin at lower concentrations than in maternal serum (p?r?=?0.421, p?r?=?0.304, p?=?0.006, respectively).

Conclusions: Irisin, adropin and copeptin are present in colostrum and we speculate that they may be implicated in postnatal adaptation with respect to thermoregulation, vascular adaptation, glucose metabolism, lung function and fluid homeostasis. These findings may possibly enhance the necessity for early breastfeeding, particularly of infants born by cesarean section, who are prone to hypothermia, breathing disorders and dehydration.     

Circulating levels of Elabela and Apelin in the second and third trimesters of pregnancies with gestational diabetes mellitus

Abstract

We design this study to detect levels of Elabela (ELA) and Apelin (APLN) in women with and without gestational diabetes mellitus (GDM) in the second and third trimesters, and to identify whether there is any association between ELA, APLN, and metabolic parameters. Seventy-nine GDM and 80 control subjects in the second trimester and 87 GDM and 88 healthy subjects in the third trimester were included. In the second trimester, lower ELA levels [(14.1 versus 16.9) ng/ml, p?=?.025] and higher APLN levels [(1021.8 versus 923.5) pg/ml, p?=?.046] were observed in GDM patients compared to controls. ELA levels were positively correlated with fasting plasma glucose (FPG) (r?=?0.423, p?<?.001) in the control group, and APLN levels were negatively correlated with triglycerides (TG) (r?=??0.251, p?=?.025) in the control group and total cholesterol (TC) (r?=??0.227, p?=?.044) in the GDM group. ELA appeared to be related to glucose metabolism and APLN is involved in lipid metabolism during pregnancy. The expression of ELA is significantly downregulated from the second trimester to the third trimester.     

Clinical significance of neuregulin 4 (NRG4) in gestational diabetes mellitus

Objective: Gestational diabetes mellitus (GDM) is defined as glucose intolerance detected during pregnancy. GDM is increasing worldwide and is associated with adverse maternal and fetal outcomes. Neuregulin 4 (NGR4) is epidermal growth factor like signaling molecule. It plays an important role in cell to cell communication furthermore recent studies indicate that NRG4 may work as a novel adipokine with a possible role in maintaining energy and metabolic homeostasis. The aim of the present study was to assess serum NRG4 levels along with several metabolic parameters in patients diagnosed with gestational diabetic mellitus.

Materials and methods: In this prospective cross-sectional study, the study group was composed of 63 women with GDM and 64 healthy pregnant women matched for age, body mass index (BMI) and gestational age. Blood samples were collected at the 24–28th gestational weeks. Serum NRG4, total cholesterol, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides, glucose levels during 75-gr OGTT, fasting insulin, glycosylated hemoglobin A1c (HbA1c), alanine aminotransferase (ALT) and creatinine levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) values were calculated.

Results: Serum NRG4 values were significantly elevated in the GDM group compared to the control group (p?β?=?0.910, p?β?=?0.866, p?β?=?0.222, p?Conclusions: Serum NRG4 levels were associated with metabolic parameters of GDM. The present study can be considered to be a guide for future studies to clarify the pathophysiology of NGR4 in GDM patients.     

Is there a role for kisspeptin in pathogenesis of polycystic ovary syndrome?

Aim: To investigate association of kisspeptin levels in infertile women with different ovarian reserve patterns.

Materials and methods: In this prospective cross-sectional study, 157 participants were recruited. The women were divided into three groups: (i) adequate ovarian reserve (AOR) (n?=?57), (ii) high ovarian reserve (PCOS) (n?=?60), (iii) diminished ovarian reserve (DOR) (n?=?40). Weight, height, waist circumference (WC), hip circumference (HC), body mass index (BMI), waist/hip ratio (WHR) were measured. The blood samples were analyzed for estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), 17-hydroxy progesterone (17OHP), dehydroepiandrosterone sulfate (DHEAS), antimullerian hormone (AMH), kisspeptin measurements.

Results: FSH concentration was higher and AMH concentration was lower in DOR group (p?p?p?=?.001, p?p?=?.003, respectively). The 17OHP level did not differ among the groups (p?=?.15). Women with PCOS possessed the highest kisspeptin level (p?=?.01). The kisspeptin level was negatively correlated with FSH level (r?=??0.18, p?=?.02) and positively correlated with TT and DHEAS levels (r?=?0.17, p?=?.02 and r?=?0.23, p?=?.003, respectively).

Conclusions: Women with PCOS had increased serum kisspeptin levels. Kisspeptin concentrations were negatively correlated with serum FSH and positively correlated with serum TT and DHEAS levels.     

Neopterin and hsCRP are not correlated in gestational diabetes mellitus

Objective: To determine serum neopterin and high sensitive C-reactive protein (hsCRP) levels in patients with and without gestational diabetes mellitus (GDM).

Methods: Neopterin and hsCRP levels were quantified in 28 women with GDM and 20 pregnant women with normal glucose tolerance (NGT). Postpartum neopterin and hsCRP levels were measured in a follow-up study.

Results: Neopterin levels were significantly higher in women with GDM than in women with NGT (15.89?±?8.19?nmol/L versus 10.4?±?3.8?nmol/L, p?p?p?=?0.9, respectively). In contrast, hsCRP levels decreased after delivery in patients with GDM (5.74?±?3.91 versus 3.78?±?2.78, p?r?=?0.3, p?=?0.02) and fasting glucose (r?=?0.4, p?=?0.004), postprandial glucose (r?=?0.3, p?=?0.01), HbA1c (r?=?0.3, p?=?0.02), whereas hsCRP levels were correlated with pre-pregnancy (r?=?0.3, p?=?0.04) and pregnancy body mass index (r?=?0.4, p?=?0.008). No correlation between serum neopterin and hsCRP levels was found (p?=?0.9).

Conclusion: Neopterin levels increased in patients with GDM; hence, it may be related to inflammation. However, the lack of correlation between neopterin and hsCRP suggests the role of different attitudes of these two parameters in the course of pregnancy and GDM.     

Effect of vitamin D deficiency on the 75 g oral glucose tolerance test screening and insulin resistance

Abstract

Gestational diabetes mellitus (GDM), is the most common medical complications of pregnancy. This study aimed to clarify the effect of second-trimester vitamin D deficiency on the 75?g oral glucose tolerance test (OGTT) screening and insulin resistance. A total of 120 pregnant women with a singleton pregnancy at a gestational age of 26–28?weeks were analyzed. Participants were divided into two groups according to 25-hydroxyvitamin D levels; vitamin D deficiency, and control groups. For GDM scan, 75?g OGTT was preferred. GDM prevalence was 17.5% in vitamin D deficiency group and 13.75% in control group, there is no significant difference in GDM prevalence (p?=?0.149). Fasting plasma glucose and 1-h plasma glucose levels were significantly higher in the vitamin D deficiency group than in the control group (p?<?.001 and p?<?.001, respectively). No significant differences were observed between 2-hour plasma glucose levels (p?=?.266). The HOMA-IR level was significantly higher in the vitamin D deficiency group than in the control group (p?<?.001). The findings of the present study suggested that vitamin D deficiency in the second trimester was inversely correlated with fasting and 1-h plasma glucose after 75?g glucose challenge test; also, low 25 OHD₃ levels were associated with insulin resistance.     

Maternal serum glycodelin levels in preeclampsia and its relationship with the severity of the disease

Purpose: Preeclampsia, in which insufficient trophoblastic invasion is thought to be one of the underlying mechanisms, is a common pregnancy disorder. Glycodelin is a regulator of immunosuppression, fertilization, implantation, and placentation. Because of its inhibitory effects on trophoblastic activity, trophoblast invasion is disturbed when its levels alter. We aimed to analyze serum glycodelin levels in preeclampsia and evaluate whether it correlates with the severity of disease.

Methods: This is a prospective case–control study conducted in a research and training hospital between March and September 2016. In this study, a total of 55 preeclamptic and 65 healthy pregnants were included. Preeclamptic patients were divided into two subgroups: 25 severe and 30 mild. Maternal serum glycodelin levels were measured using enzyme-linked immunosorbent assay.

Results: Glycodelin levels were higher in preeclamptic group as compared with controls (71.38?±?22.78 versus 42.32?±?12.28?ng/ml, p?p?r?=?0.637 and r?=?0.714, respectively, p?r?=?0.369, p?=?.006 and r?=?0.377, p?=?.005) and proteinuria (r?=?0.342, p?=?.011). Moreover, it was correlated with birth weights and gestational age at delivery (r?=??0.386, p?=?.004 and r?=??0.394, p?=?.003, respectively). The role of glycodelin to diagnose preeclampsia was evaluated by receiver operating curve (ROC) curve. Area under the curve for glycodelin is 0.897 with p?53.64?ng/ml. Moreover, area under the curve for glycodelin to diagnose severe preeclampsia is 0.788 with p?83.97?ng/ml.

Conclusion: Glycodelin may be a promising marker in predicting the presence and severity of preeclampsia.     

Serum irisin concentration in women with gestational diabetes

Irisin is a novel myokine and adipokine which induces an increase in total body energy expenditure, improving insulin sensitivity and glucose tolerance in experimental animals. In the present study, serum irisin concentration was measured by an enzyme immunoassay in 130 women with gestational diabetes mellitus (GDM) and 140 BMI-matched patients with normal glucose tolerance (NGT). Median irisin level was significantly lower in the patients with GDM than in the NGT subjects (1703.3 [1354.8–2097.9?ng/ml] versus 1873.8 [1519.8–2294.8?ng/ml], p?=?0.01); however, 3 months after childbirth its concentrations did not differ markedly between the two groups (1165.9 [872.1–1497.5] ng/ml versus 1139.0 [984.0–1376.7] ng/ml). In the whole group, irisin concentration correlated negatively with 2?h glucose level (R?=??0.14, p?=?0.03). In the women with NGT, irisin concentration correlated positively with IS_OGTT (R?=?0.22, p?=?0.04) and the disposition index (DI₁₂₀) (R?=?0.24, p?=?0.03), as well as negatively with 2?h insulin level (R?=??0.23, p?=?0.03) and HOMA-IR (R?=??0.24, p?=?0.02). Multiple regression analysis revealed that 2?h glucose and DI₁₂₀ were the only variables significantly influencing serum irisin (β?=?0.158, p?=?0.03 and β?=?0.159, p?=?0.02, respectively). Our results suggest that serum irisin concentration increases markedly in pregnant women, but this increase seems to be significantly lower in patients with GDM.     

Elevation of the adiponectin/leptin ratio in women with gestational diabetes mellitus after supplementation with alpha-lipoic acid

Alpha-lipoic acid (ALA) is a short chain fatty acid and is known as a universal antioxidant. The aim of the current clinical trial study was to explore the effects of ALA supplementation on maternal circulating values of adiponectin (A), leptin (L); and A/L, L/A, adiponectin/homeostatic model assessment for insulin resistance (A/H), and malondialdehyde/total antioxidant capacity (MDA/TAC) ratios in pregnant women with gestational diabetes mellitus (GDM). Sixty women diagnosed as GDM during 24 and 28?weeks of pregnancy were randomly divided into drug (n?=?30) and placebo (n?=?30) groups. They consumed ALA (100?mg) and cellulose acetate (100?mg) respectively for 8?weeks, per day. The biochemical variables were evaluated before and after the trial. Maternal fasting serum values of glucose (p?<?.001), HOMA-IR (p?<?.001), MDA/TAC (p?<?.001), and L/A (p?=?.008) were decreased while values of adiponectin (p?=?.011), A/L (p?=?.001), and A/H (p?<?.001) were increased in the drug group after the intervention. In summary, current study had shown that after daily supplementation with 100?mg of ALA for 8?weeks in women with GDM, maternal circulating values of adiponectin, A/L, and A/H were increased while values of L/A and MDA/TAC were decreased.     

First-trimester irisin and fetuin-A concentration in predicting macrosomia

Objective: We investigated the diagnostic value of first-trimester adipokines and placental markers in predicting macrosomia.

Methods: Out of 328 women recruited during the prenatal diagnosis between 11th and 13th week of pregnancy and subjected to follow up until delivery, we selected 26 women who gave birth to macrosomic babies and 34 women who gave birth to normal weight neonates for the evaluation of first trimester serum levels of pregnancy associated plasma protein-A, free β-human chorionic gonadotropin, placental growth factor (PIGF), and selected adipokines.

Results: The mothers of macrosomic infants had higher PIGF (p?=?.049) and irisin concentrations (p?=?.00003), and lower fetuin-A levels (p?=?.0002) than had the mothers of normal weight babies. Newborn’s weight correlated positively with maternal irisin (R?=?0.454, p?=?.0003) and negatively with fetuin-A concentrations (R?=??0.497, p?=?.00005). Multiple regression analysis showed that only serum irisin concentration was a significant predictor of birth weight (β?=?0.329, p?=?.03), explaining 14% of its variability. The sensitivity and the specificity of irisin concentration in predicting macrosomia were 0.769 and 0.794, respectively (AUC?=?0.818 [95%CI: 0.708–0.928], p?=?.00001) with a proposed cut-off value of 1725.4?ng/ml.

Conclusions: Our results suggest that mother’s irisin may be an early biomarker of macrosomia.     

Relationship of maternal serum resistin and visfatin levels with gestational diabetes mellitus

Introduction: Adiponectin, resistin and visfatin are thought to play role in the pathophysiology of gestational diabetes (GDM). In this study, we aimed to investigate the association of maternal second trimester serum resistin and visfatin levels with GDM.

Materials and methods: Screening and diagnosis for GDM was performed between the 24–28th gestational weeks. About 40 women diagnosed with GDM and 40 non-diabetic women constituted the study and control groups, respectively. Groups were compared for second trimester maternal serum resistin, visfatin and HbA1c levels, HOMA-IR and postpartum 75?g OGTT results.

Results: Mean serum resistin (p?=?0.071) and visfatin (p?=?0.194) levels were similar between the groups. However, mean BMI (p?=?0.013), HOMA-IR (p?=?0.019), HbA1c (p?p?=?0.037) were significantly higher in GDM group compared to controls. Type 2 diabetes and impaired glucose tolerance were detected in 2 (5%) and 7 (20%) women in the GDM group, respectively, with 75?g OGTT performed at the postpartum 6th week. Resistin levels of patients with GDM and postpartum glucose intolerance were higher than those with GDM but no postpartum glucose intolerance (p?=?0.012). Visfatin levels in the GDM group showed a positive correlation with biparietal diameter, head circumference, abdominal circumference and femur length (p?Conclusion: Maternal serum resistin and visfatin levels are unchanged in GDM. In patients with GDM, second trimester resistin levels may be predictive for postpartum glucose intolerance and second trimester visfatin levels may be related with fetal biometric measurements. Further larger studies are needed.     

Perinatal sclerostin concentrations in abnormal fetal growth: the impact of gestational diabetes

Objective: To prospectively evaluate maternal and cord blood concentrations of sclerostin – an osteocyte-secreted factor, inhibiting osteoblast differentiation and bone formation and associated with adverse metabolism – in pregnancies with normal and abnormal fetal growth.

Methods: Plasma sclerostin concentrations were determined by ELISA in 80 maternal and 80?cord blood samples from asymmetric intrauterine-growth-restricted (IUGR, n?=?30), large-for-gestational-age (LGA, n?=?30), and appropriate-for-gestational-age (AGA, n?=?20) singleton full-term pregnancies. Fourteen out of 30 mothers with LGA offspring presented with gestational diabetes mellitus (GDM).

Results: Maternal and fetal sclerostin concentrations did not differ among LGA, IUGR, and AGA groups. Fetal concentrations were higher than maternal. In LGA group, maternal concentrations were elevated in cases of GDM (b?=?13.009, 95%CI 1.425–24.593, p?=?.029). In a combined group and the IUGR group, maternal concentrations were elevated in older mothers (b?=?0.788, 95%CI 0.190–1.385, p?=?.010, and b?=?0.740, 95%CI 0.042–1.438, p?=?.039, respectively).

Conclusions: Maternal and fetal sclerostin concentrations may not be differentially regulated in pregnancies complicated by abnormal fetal growth. Circulating maternal levels are higher in cases of GDM, probably implying reduced bone formation. Sclerostin up-regulation with aging may be one of the molecular pathways responsible for the observed age-related decline in bone synthesis, leading to accelerated bone loss in humans.     

Maternal circulating levels of irisin in intrahepatic cholestasis of pregnancy

Objective: Intrahepatic cholestasis of pregnancy (ICP), the most common liver disease in pregnancy, is characterized by elevated serum total bile acid levels and pruritus. It has become clear that bile acids are no longer labeled as simple detergent-like molecules, but also represent complex hormonal metabolic regulators. ICP has also been associated with increased incidence rates of gestational diabetes mellitus. Irisin is a newly discovered myokine that is able to regulate glucose and lipid levels, thus improving insulin sensitivity. In this study, maternal serum irisin levels were analyzed in order to provide a new perspective on the pathogenesis of ICP.

Materials and methods: In this controlled cross-sectional study, 58 consecutive pregnant women with ICP (30 with mild and 28 with severe disease) and 30 healthy women with uncomplicated pregnancies (as the control group) were examined. The maternal irisin, fasting blood glucose, fasting insulin and homeostatic model assessment of insulin resistance levels of the two groups were compared.

Results: Serum irisin levels were significantly higher in the severe ICP group than in the mild ICP and control groups (p?=?0.005 and p?<?0.001, respectively). At the best cut-off level of 908.875?pg/ml, irisin accurately predicted ICP [AUC?=?0.827 (95% CI: 0.745–0.909; p?<?0.001)] with sensitivity and specificity rates of 72.5 and 86.8%, respectively. There was a significant negative correlation between irisin and fasting blood glucose levels (r?=??0.399; p?=?0.021).

Conclusion: The results of this study indicate that serum irisin levels were significantly higher in women with ICP compared to healthy pregnant controls. However, it is difficult to infer whether high irisin level is a cause or effect of ICP.     

Serum-free placental growth factor isoform 1 at 11–13-week gestation: effects of maternal factors,mean arterial pressure,placental volume,and uterine artery pulsatility index

Introduction: To define the effects of maternal factors, mean arterial pressure (MAP), placental volume (PV), and uterine artery Doppler pulsatility index (UtAPI) to serum level of free form of placental growth factor isoform 1 (free PlGF-1) measured with a novel automated assay.

Methods: We enrolled 200 Thai women singleton pregnancy from 11⁺⁰ to 13⁺⁶ weeks gestation with low prior risk maternal factors (age, parity, tobacco use, assisted reproductive technology, and body mass index). MAP was measured. Serum-free PlGF-1, PV, and UtAPI were measured with a new assay, transabdominal three-dimensional, and color Doppler ultrasounds, respectively. Effects of these variables to serum-free PlGF-1 level were assessed.

Results: Data from 195 eligible subjects showed an elevation of serum-free PlGF-1 from 11, 12, and 13 weeks (mean?±?SD; 36.89?±?24.92, 38.71?±?17.44, and 49.68?±?22.30?pg/mL, respectively (p?r?=?0.290, p?r?=??0.717, p?=?.05 and r?=??0.221, p?r?=??0.243, p?r?=??0.372, p?p?>?.05). There was no preeclampsia at <34 weeks in 161 subjects (82.6%) with known pregnancy outcomes.

Conclusions: There was modest correlation of serum-free PlGF-1, PV, and UtAPI, but not with maternal factors or MAP. Adjustment of serum-free PlGF-1 in early preeclampsia screening algorithm should be considered.     

Higher levels of thyrotropin in pregnancy and adverse pregnancy outcomes

Objective: To determine the frequency of subclinical hypothyroidism in women with pathological pregnancies and the association between elevated thyroid-stimulating hormone (TSH) and pregnancy outcome.

Subjects and methods: A cross-sectional prospective study investigated value of TSH and free thyroxine (FT4) in (1) pregnant women with hypertension (HTA) (N?=?62) or preeclampsia (PE) (N?=?50), (2) women with gestational diabetes mellitus (GDM) (N?=?92) in pregnancy, and (3) women with normal pregnancies (control) (N?=?201). The level of statistical significance was set at p?Results: Of the total 404 respondents, the highest incidence of subclinical hypothyroidism was in the group with preeclampsia 22%, followed HTA group 9.6%; GDM group 10.9% and in the control group 9% (p?p?3?mIU/L (p?=?.003). There were no differences in the average TSH value between GDM (1.93?±?1.03?mIU/L) and control group (p?=?.962).

Conclusions: Early detection and optimal treatment of thyroid dysfunction before and in the first trimester of pregnancy reduces the risk of adverse pregnancy outcomes.     

Relationship between advanced glycation end products and gestational diabetes mellitus

Objective: To investigate the levels of and dynamic changes of advanced glycation end products (AGEs) in maternal plasma during pregnancy and explore the association between these levels and gestational diabetes mellitus (GDM).

Methods: This study recruited 90 GDM women and 90 healthy pregnant controls. The women received prenatal care and were hospitalized for delivery in Peking University First Hospital in China between October 2015 and April 2016. The patients were recruited and provided blood samples during gestational weeks 24–29. The levels of AGEs, TNF-α, hs-CRP, plasma glucose, and FINS and lipid profiles were measured, and HOMA-IR was calculated. New blood samples were collected and AGE was measured again in the two groups at 33–41 weeks of gestation to identify its dynamic changes.

Results: The levels of AGEs were significantly higher in the GDM group than in the NGT group at both 24–29 weeks (473.65?±?105.32 versus 324.36?±?57.86?ng/L; p?p?p?p?=?.003), TNF-α (p?=?.005), and hs-CRP (p?p?=?.001). In the NGT group, there was no significant change in the concentration of AGEs between the two gestational periods (p?=?.388).

Conclusions: Plasma levels of AGEs are associated with GDM. During pregnancy, the changes observed in the levels of AGEs were different between GDM and normal pregnancies.     

The effects of probiotic supplementation on biomarkers of inflammation,oxidative stress and pregnancy outcomes in gestational diabetes

Objective: This study was designed to evaluate the effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes among subjects with gestational diabetes (GDM).

Methods: This randomized, double-blind, placebo-controlled clinical trial was done among 60 subjects with GDM who were not on oral hypoglycemic agents. Patients were randomly allocated to intake either probiotic capsule containing Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum (2?×?10⁹ CFU/g each) (n?=?30) or placebo (n?=?30) for six?weeks.

Results: Compared with the placebo, probiotic supplementation resulted in significant decreases in fasting plasma glucose (FPG) (?5.3?±?6.7 vs.?+0.03?±?9.0?mg/dL, p?=?.01), serum high-sensitivity C-reactive protein (hs-CRP) (?2.2?±?2.7 vs.?+0.5?±?2.4?μg/mL, p?p?=?.03) and MDA/TAC ratio (?0.0003?±?0.0008 vs.?+0.0009?±?0.002, p?=?.004), and a significant increase in total antioxidant capacity (TAC) levels (+65.4?±?103.3 vs. ?37.2?±?143.7?mmol/L, p?=?.002). Probiotic supplementation did not affect pregnancy outcomes.

Conclusions: Overall, probiotic supplementation among women with GDM for six?weeks had beneficial effects on FPG, serum hs-CRP, plasma TAC, MDA and oxidative stress index, but did not affect pregnancy outcomes.     

Melatonin concentration in follicular fluid is correlated with antral follicle count (AFC) and in vitro fertilization (IVF) outcomes in women undergoing assisted reproductive technology (ART) procedures

The aim of the present study was to evaluate the possible relationship between melatonin levels in the follicular fluid (FF) and in vitro fertilization (IVF) outcomes in women undergoing assisted reproductive treatment. Sixty-three females (20 to 40?years old) scheduled for IVF were divided into three groups based on their antral follicle count (AFC). We determined FF melatonin concentrations in group A (AFC≦6, n?=?21), group B (7≦AFC≦14, n?=?22), group C (AFC≧15, n?=?20) on oocyte retrieval day. Patients in group C had significantly higher melatonin levels as compared to patients in groups A and B (p?p?p?=.001), serum estradiol (E₂) levels on human chorionic gonadotropin (HCG) administration day (p?=?.001), total follicle-stimulating hormone (FSH) dose (p?=?.002), starting FSH dose (p?=?.035), number of retrieved oocytes (p?p?p?p?p?=?.004), blastocysts obtained (p?=?.007) and total embryos obtained (day3 embryos?+?day5/6 blastocysts) (p?=?.005). The levels were significantly negatively correlated with age (p?p?=?.003), serum FSH (p?=?.001) and serum luteinizing hormone (LH) levels (p?=?.003) on HCG administration day. This is the first demonstration of a significant positive correlation of melatonin concentrations with AFC in patients undergoing IVF. We propose that FF melatonin levels may influence the IVF outcomes.     

Second-trimester urinary neutrophil gelatinase-associated lipocalin levels in gestational diabetes: preliminary results

Objective: The objective of this study is to investigate the urinary neutrophil gelatinase-associated lipocalin (uNGAL) levels in the second trimester of pregnant patients at the time of gestational diabetes mellitus (GDM) screening.

Materials and methods: Urinary samples from 88 pregnant women who underwent gestational diabetes screening test were collected in late second trimester (24–28 weeks) prospectively. After an overnight fasting, 75?g GTT was performed. The blood samples were drawn for measurement of glucose, insulin, and HbA1c. The urinary and blood parameters were compared for pregnant women with or without gestational diabetes.

Results: uNGAL levels were significantly elevated in pregnant women with gesting compared with the control groups (p?p?=?.001).

Conclusions: In the second trimester, at the time of GDM screening, high levels of uNGAL indicate tubular injury in GDM cases which seems to be a result of hyperglycemia. uNGAL may correlate with an inflammatory renal involvement in GDM.     

Circulating galanin and IL-6 concentrations in gestational diabetes mellitus

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?r?=?0.240, p?=?0.065), insulin (r?=?0.681, p?r?=??0.644, p?r?=?0.783, p?r?=?0.745, p?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.