Significance of RBP4 in patients with gestational diabetes mellitus: a case-control study of Han Chinese women

The role of retinol binding protein 4 (RBP4) in insulin resistance was recently identified. Our study investigated the correlation between RBP4 levels with lipid and glucose metabolism in a case-control study of women with gestational diabetes mellitus (GDM). Between May 2008 and May 2010, 70 pregnant women (24–28 weeks gestation) were recruited, including 35 women with GDM and 35 healthy controls. Blood samples were collected prior to and after oral glucose tolerance tests (OGTT) to detect serum RBP4, insulin, glycated hemoglobin, triglyceride (TG) and total cholesterol (TC) levels; the insulin resistance index (HOMA-IR) was calculated. Serum RBP4 levels in the GDM group were significantly higher than the control group (22.9?±?3.09?µg/ml versus 17.9?±?3.91?µg/ml; p?p?r?=?0.49, 0.49, 0.52,0.52, respectively; p?相似文献   

Endoglin in pregnancy complicated by fetal intrauterine growth restriction in normotensive and preeclamptic pregnant women: a comparison between preeclamptic patients with appropriate-for-gestational-age weight infants and healthy pregnant women

Objective: The aim of this study was to determine the maternal serum endoglin concentration in pregnancies with intrauterine growth restriction (IUGR) in the presence or absence of preeclampsia and to compare the results with preeclamptic pregnant women with appropriate-for-gestational-age weight infants and with healthy pregnant controls. Patients and methods: The study was performed on 52 normotensive pregnant patients with pregnancy complicated by isolated IUGR, 33 patients with preeclampsia complicated by IUGR and 33 preeclamptic patients with appropriate-for-gestational-age weight infants. The control group consisted of 54 healthy normotensive pregnant patients with singleton uncomplicated pregnancies. The maternal serum endoglin concentrations were determined using a sandwich enzyme-linked immunosorbent assay assay. Results: Our study revealed increased levels of endoglin in the serum of women with normotensive pregnancy complicated by isolated IUGR, and in both groups of preeclamptic patients with and without IUGR. The levels of endoglin were the highest in pregnancy complicated by fetal intrauterine growth restriction (IUGR) in the course of preeclampsia. The mean values were 12.2?±?4.3 ng/ml in the IUGR group, 14.1?±?3.6 ng/ml in preeclamptic patients with normal intrauterine fetal growth, 15.1?±?3.2 ng/ml in preeclamptic pregnant women with IUGR and 10.6?±?3.7 ng/ml in the healthy controls. We also found positive correlations between serum endoglin levels and systolic and diastolic blood pressure and inverse correlations between maternal endoglin and infant birth weight. Conclusions: Our results suggest that increased endoglin concentration may be at least responsible for the pathogenesis of preeclampsia and/or intrauterine fetal growth restriction. It seems that the pathomechanism underlying the development of preeclampsia and isolated IUGR is similar, but that their beginning or intensity may be different in these two pregnancy complications. The positive correlation between endoglin and blood pressure and inverse correlation between endoglin and infant birth weight and additionally higher levels of ENG in patients with pregnancy complicated by HELLP syndrome (hemolysis, increased liver enzymes, low platelet count) or eclampsia suggest that endoglin may be a marker of severity of these pregnancy disorders.     

Asymmetric dimethylarginine in normotensive pregnant women with isolated fetal intrauterine growth restriction: a comparison with preeclamptic women with and without intrauterine growth restriction

Objective.?The aim of this study was to evaluate maternal asymmetric dimethylarginine (ADMA) levels in pregnancies complicated by isolated fetal intrauterine growth restriction (IUGR), in preeclamptic pregnancies with and without IUGR, and in healthy normotensive pregnant women with proper weight fetuses.

Patients and methods.?The study was carried out on 54 normotensive pregnant patients with pregnancy complicated by IUGR, 35 patients with IUGR in the course of preeclampsia, 29 preeclamptic patients with appropriate-for-gestational-age weight infants and 54 healthy normotensive pregnant patients. The ADMA concentrations were evaluated using an ELISA assay.

Results.?The preeclamptic women and normotensive patients with pregnancy complicated by isolated IUGR revealed higher levels of maternal serum ADMA. The mean values of maternal serum ADMA were 0.5730?±?0.1769?μmol/l in the P group, 0.5727?±?0.1756?μmol/l in the PI group, 0.6129?±?0.1517?μmol/l in the IUGR group, and 0.5017?±?0.1116?μmol/l in the control group. The levels of ADMA were additionally higher in the patients with HELLP syndrome and in patients with pregnancy complicated by eclampsia.

Conclusions.?It seems that ADMA is an active agent not only in preeclamptic patients, but also in normotensive pregnant women with isolated fetal IUGR and could be a marker of severity of preeclampsia.     

Oxidized low-density lipoprotein and adiponectin levels in pregnancy

Introduction.?The aim of the present study was to investigate whether normal pregnancy represents a complex state of oxidative stress, inflammation and insulin resistance.

Subjects and methods.?One hundred and six pregnant women, between 24th and 28th week of pregnancy (age 27.9?±?0.4 years) (study group) and one hundred and six age-matched, healthy, non-pregnant women (control group) participated in the study. Serum levels of glucose, insulin, adiponectin, oxidized LDL (oxLDL) and lipid parameters, i.e. total cholesterol (TC), triglycerides (TG), HDL and LDL, were determined. Body mass index (BMI) and QUantitative Insulin sensitivity ChecK Index (QUICKI) were also calculated.

Results.?Pregnant women presented higher BMI values, insulin and oxLDL serum levels and lower glucose serum levels than controls. Serum levels of lipids (TC, TG, LDL and HDL) were higher in pregnant women. There was a significant positive correlation of oxLDL to adiponectin (p?<?0.01) in the study group, but not in the controls, and no other significant correlation with any of the other parameters, in either of groups.

Conclusions.?Pregnancy is a state of insulin resistance, oxidative stress and pro-atherogenic hyperlipidemia. Adiponectin may, though, have cardioprotective role in pregnant women.     

Serum YKL-40 levels in gestational diabetes mellitus

Objective: Serum YKL-40 levels are elevated in patients with type 1 and 2 diabetes. However, the correlation between YKL-40 and gestational diabetes mellitus (GDM) remains unknown. The present study compared serum YKL-40 levels in pregnant women with GDM and those with normal glucose tolerance and evaluated the relationship between YKL-40 and insulin-resistant syndrome.

Methods: Thirty-five patients with GDM and 43 age-matched healthy pregnant women at 24–28 weeks of gestation were studied. In addition to anthropometric assessments, serum glucose, insulin, YKL-40, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein and glycated hemoglobin were measured in all subjects. All subjects underwent a 2-h 75-g oral glucose tolerance test (OGTT). Body mass index (BMI) and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated.

Results: Fasting and 2?h serum YKL-40 levels were significantly higher in pregnant women with GDM compared with controls (77.3?±?29.3 versus 50.9?±?16.7 ng/mL, p?<?0.001, fasting concentrations; 63.5?±?20.1 versus 40.6?±?10.7 ng/mL, p?=?0.009, 2?h concentrations). OGTT had no effect on YKL-40 levels in either group (p?>?0.05). There were significant correlations between YKL-40 and glycated hemoglobin (β?=?0.37, p?=?0.006), fasting insulin (β?=?0.49, p?=?0.001) and HOMA-IR (β?=?0.18, p?=?0.015) in the GDM group.

Conclusions: Serum YKL-40 levels are elevated in patients with GDM but are unaffected by OGTT. YKL-40 levels are related to glycated hemoglobin, fasting insulin and HOMA-IR. These results suggest that YKL-40 may be a major contributor to GDM.     

Assessment of circulating betatrophin levels in intrahepatic cholestasis of pregnancy

Abstract

Objective: To investigate maternal serum levels of betatrophin and their relationship with total bile acid (TBA) levels in patients with intrahepatic cholestasis of pregnancy (ICP).

Materials and methods: Fifty-nine pregnant women with ICP (31 patients with severe and 28 patients with mild disease classifications) and 23 healthy women with uncomplicated pregnancies as the control group included the study. The maternal betatrophin, fasting blood glucose, fasting insulin (FI), and homeostatic model assessment of insulin resistance (HOMA-IR) levels of the groups were compared.

Results: Serum betatrophin levels were significantly higher in the ICP groups than in the control group (p?=?.04 and p?<?.001, respectively). The FI levels and HOMA-IR values were significantly higher in the severe ICP group than in the control group (p?=?.006 and p?=?.001, respectively). While a significant positive correlation was found between betatrophin levels and fasting and postprandial TBA levels, there was no significant correlation among betatrophin and HOMA-IR or FI levels.

Conclusions: Betatrophin levels were shown to correlate with TBA levels, it provides a model for future studies to understand the physiopathology of ICP, a complex metabolic disease. Changes in betatrophin levels may shed light on the pathogenesis of ICP.     

The effect of different doses of vitamin D supplementation on insulin resistance during pregnancy

Abstract

Low serum vitamin D levels are correlated with insulin resistance during pregnancy. We have assessed the effects of different doses of vitamin D on insulin resistance during pregnancy. A randomized clinical trial was done on 120 women with a gestational age of less than 12 weeks. The women were divided into three groups randomly. Group A received 200?IU vitamin D daily, group B 50?000?IU vitamin D monthly and group C 50?000?IU vitamin D every 2 weeks from 12 weeks of pregnancy until delivery. The serum levels of fasting blood sugar (FBS), insulin, calcium and 25-hydroxyvitamin D were measured before and after intervention. We used the homeostatic model assessment of insulin resistance (HOMA-IR) as a surrogate measure of insulin resistance. The mean?±?standard deviation of serum 25-hydroxyvitamin D increased in group C from 7.3?±?5.9 to 34.1?±?11.5?ng/ml and in group B it increased from 7.3?±?5.3 to 27.23?±?10.7?ng/ml, but the level of vitamin D in group A increased from 8.3?±?7.8 to 17.7?±?9.3?ng/ml (p?<?0.001). The mean differences of insulin and HOMA-IR before and after intervention in groups A and C were significant (p?=?0.01, p?=?0.02). This study has shown that supplementation of pregnant women with 50?000?IU vitamin D every 2 weeks improved insulin resistance significantly.     

Serum Fetuin-A levels,insulin resistance and oxidative stress in women with polycystic ovary syndrome

Abstract

This study was designed to determine serum Fetuin-A levels and establish whether serum Fetuin-A level is related with insulin resistance, oxidative stress, ovarian hyperandrogenism and dyslipidemia in women with polycystic ovary syndrome (PCOS). Twenty-two patients with PCOS and twenty-one healthy control women were evaluated in this controlled clinical study. Serum Fetuin-A, lipid fractions, glucose, insulin, malondialdehyde (MDA), myeloperoxidase (MPO), glutathione (GSH), superoxide dismutase (SOD) and other hormone (gonadotropins, androgens) levels were measured. The estimate of insulin resistance was calculated by homeostasis model assessment (HOMA-R). The women with PCOS had significantly higher serum fasting glucose, insulin, luteinizing hormone (LH), MDA, Fetuin-A levels, and LH/follicle-stimulating hormone (FSH) ratio, free androgen index (FAI), HOMA-IR than healthy women. However, sex hormone-binding globulin (SHBG) and GSH levels were significantly lower in patients with PCOS compared with controls. Fetuin-A was positively correlated with insulin, HOMA-IR and FAI. Multiple regression analysis revealed that FAI was strong predictor of serum Fetuin-A level. Serum Fetuin-A level was related with insulin resistance and ovarian hyperandrogenism in women with PCOS. These results suggest that Fetuin-A may have a role in triggering the processes leading to insulin resistance and androgen excess in PCOS.     

Papillary carcinoma of the thyroid arising in struma ovarii – report of a case and review of management guidelines

Abstract

This study was designed to determine serum human leukocyte antigen-G (HLA-G) levels and establish whether serum HLA-G level is related with insulin resistance, oxidative stress, dyslipidemia and ovarian hyperandrogenism in women with polycystic ovary syndrome (PCOS). Twenty-five patients with PCOS and 23 healthy control women were evaluated in this study. Serum HLA-G, lipid fractions, glucose, insulin, malondialdehyde (MDA), glutathione (GSH), white blood cell (WBC), sex hormone-binding globulin (SHBG) and other hormone (gonadotropins and androgens) levels were measured. The estimate of insulin resistance was calculated by homeostasis model assessment (HOMA-IR). Serum luteinizing hormone (LH), total testosterone, fasting insulin, WBC levels and LH/follicle-stimulating hormone (FSH) ratio, free androgen index (FAI) and HOMA-IR values were significantly higher in patients with PCOS compared with healthy women. However, the women with PCOS had considerably lower serum FSH, SHBG, MDA, GSH and HLA-G levels than healthy subjects. HLA-G was inversely related with HOMA-IR, FAI, LH/FSH ratio and WBC, but positively with high-density lipoprotein cholesterol. Decreased serum HLA-G level may be related with insulin resistance, ovarian hyperandrogenism and oxidative stress in women with PCOS. Nevertheless, the exact role of HLA-G in the pathogenesis of the disease remains to be elucidated.     

Maternal serum atrial natriuretic peptide (ANP) and brain-type natriuretic peptide (BNP) levels in gestational diabetes mellitus

Objective: The aim of the study is to evaluate maternal serum atrial natriuretic peptide (ANP) and brain-type natriuretic peptide (BNP) levels in patients with getational diabetes mellitus compared with a control group.

Methods: We have measured maternal serum ANP and BNP levels in 35 otherwise healthy and 45 gestational diabetic women between gestational week 24 and 28 referred to our unit in a cross-sectional study. Independent samples t-test or the Mann–Whitney U-test was used for comparison of two groups where appropriate.

Results: Mean maternal serum homeostasis model assessment of insulin resistance (HOMA-IR), HbA1c, fasting glucose and insulin levels in gestational diabetes mellitus (GDM) group were significantly higher than the control group (p?<?0.01). Mean maternal serum ANP and BNP levels of women with GDM were significantly lower than the control group (12.9?±?9.9 versus 34.8?±?16.9?pg/ml, p?<?0.001; 416.6?±?209.7 versus 629.7?±?162.2?mg/dl, p?<?0.001, respectively). Maternal serum ANP and BNP levels were negatively correlated with insulin levels, HbA1c and HOMA-IR values (p?<?0.05).

Conclusions: Maternal serum ANP and BNP levels are significantly lower in patients with GDM. These biomarkers might be valuable in clinical setting for identifying high-risk women for developing diabetes during pregnancy.     

Evaluation of maternal and umbilical serum TNFalpha levels in preeclamptic pregnancies in the intrauterine normal and growth-restricted fetus.

OBJECTIVE: The aim of this study was to carry out a comparative analysis of the maternal and umbilical cord TNFalpha serum levels in pregnancies complicated by severe preeclampsia with normal intrauterine fetal growth, in preeclamptic pregnancies with intrauterine growth restriction (IUGR), and in normotensive pregnant patients. PATIENTS AND METHODS: The study was carried out on eight patients with severe preeclampsia complicated by IUGR and 18 preeclamptic patients with normal intrauterine fetal growth. The control group consisted of 18 healthy normotensive patients with singleton uncomplicated pregnancies. Maternal and umbilical serum TNFalpha concentrations were estimated using a sandwich ELISA assay. RESULTS AND CONCLUSIONS: Pregnant women with severe preeclampsia had significantly higher maternal and umbilical serum TNFalpha levels than those in the normotensive controls. Our findings and other reports indicate that TNFalpha may participate in the pathogenesis and sequelae of preeclampsia with and without IUGR. The results of excessive umbilical serum activity of tumor necrosis factor alpha (TNFalpha) in preeclamptic pregnancy complicated by intrauterine growth restriction (IUGR) may suggest additional changes and dysfunction of the placental-fetal unit and deterioration of placental function, leading to fetal hypotrophia in the course of preeclampsia.     

Serum brain natriuretic peptide and C-reactive protein levels in adolescent with polycystic ovary syndrome

Objective: Our primary aim was to investigate whether N-terminal pro-brain natriuretic peptide (NT-proBNP) increases in adolescent with polycystic ovary syndrome (PCOS) compared with healthy controls and secondary aim was to determine whether metabolic and hormonal differences exist between groups. Methods: In this cross-sectional study, 25 adolescent patients with PCOS and 25 normal ovulatory control not suffering from PCOS were involved in the study. Fasting serum NT-proBNP, C-reactive protein (CRP), homocystein, insulin levels and biochemical and hormonal parameters were measured. Results: Serum NT-proBNP was not significantly different in PCOS subjects (0.62?±?0.80 vs 1.12?±?1.51?ng/mL, p?=?0.154). The mean serum fasting insulin levels (22.64?±?10.51 vs 13.32?±?3.97 mIU/mL, p?=?0.001) and Homeostasis Model Assessment Insulin–Resistance Index (HOMA-IR) levels (5.16?±?1.81 vs 2.97?±?0.89, p?=?0.001) were significantly high in the study group. The median serum CRP levels were not significantly different between groups (1 [1–12] vs 1 [1–19] g/dL, p?=?0.286). Conclusions: The present study demonstrated that the levels of BNP, CRP and homocystein were not different in PCOS subjects. Serum insulin levels and HOMA-IR were significantly higher in PCOS subjects. Possible serum markers for PCOS-related metabolic abnormalities and cardiovascular events, may not present in the adolescent years.     

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.     

Maternal soluble human leukocyte antigen-G levels in pregnancies complicated by foetal intrauterine growth restriction with and without preeclampsia

ObjectiveThe aim of this study was to investigate the maternal serum of soluble human leukocyte antigen-G (sHLA-G) levels in pregnant women with an isolated intrauterine growth restricted foetus (IUGR) and in preeclamptic pregnancies with and without IUGR.Patients and methodsThe study was conducted on 31 normotensive patients with pregnancy complicated by IUGR, 17 preeclamptic patients with appropriate-for-gestational-age foetal intrauterine growth, 21 with preeclampsia complicated by IUGR, and 32 healthy pregnant controls. Maternal serum sHLA-G levels were calculated using the enzyme-linked immunosorbent assay.ResultsMaternal serum sHLA-G levels tended to be higher in both groups of preeclamptic patients, and were highest in patients with IUGR in the course of severe preeclampsia. Lower serum levels of sHLA-G were observed in the group of normotensive pregnant women with an intrauterine growth restricted foetus, but these differences were not statistically significant. The mean values were 22.759 ± 14.151 units/mL in the IUGR group, 25.948 ± 18.888 units/mL in preeclamptic patients with normal intrauterine foetal growth, 31.646 ± 27.576 units/mL in preeclamptic pregnant women with IUGR, and 24.178 ± 24.828 units/mL in the healthy controls.ConclusionsOur findings suggest that the increased levels of sHLA-G in the maternal serum may play a significant role in the pathogenesis of preeclampsia, especially in preeclampsia complicated by intrauterine foetal growth restriction. These associations may offer a better insight into the etiology and pathogenesis of preeclampsia with and without IUGR. It seems that sHLA-G does not play a clinically significant role in the pathogenesis of isolated intrauterine foetal growth restriction in normotensive pregnancies.     

妊娠期糖尿病患者血清网膜素水平与糖、脂代谢指标的相关性研究

目的:探讨妊娠期糖尿病(GDM)患者血清网膜素(Omentin)水平的变化及其与糖、脂代谢指标的相关性。方法:采用酶联免疫吸附法检测35例孕前肥胖的GDM孕妇(A组)、32例孕前非肥胖的GDM孕妇(B组)、36例正常健康孕妇(C组)的血清Omentin水平;同时测定所有受试者的糖、脂生化指标,并计算胰岛素抵抗指数(HOMA-IR)。结果:(1)GDM孕妇三酰甘油(TG)、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平均高于正常对照组,高密度脂蛋白(HDL-C)水平低于正常对照组(P均<0.05);(2)3组孕妇血清Omentin水平A组相似文献   

The relationship of urocortin-2 with insulin resistance patients having PCOS

In this study, we aimed to compare the serum urocortin-2 (UCN2) levels in women with polycystic ovary syndrome (PCOS) and healthy women. Thirty-eight patients with PCOS and 41 healthy women were included in the study whose age and BMI matched. The fasting serum glucose, insulin, free testosterone, hs-CRP and UCN2 levels of the all participants were examined. HOMA-IR formula was used in order to calculate the insulin resistance. Circulating UCN2 levels were significantly elevated in women with PCOS compared with controls (142.93?±?59.48 versus 98.56?±?65.01?pg/ml, p = 0.002). FBG, serum insulin, hs-CRP and HOMA-IR levels were found to be increased in women with PCOS. There was a positive correlation between UCN2 and free-testosterone in only PCOS group (r?=?0.235, p?=?0.027). Multivariate logistic regression analyses revealed that the odds ratio for PCOS was 2.31 for patients in the highest quartile of UCN2 compared with those in the lowest quartile (OR?=?2.31, 95% CI?=?1.88–2.83, p=0.021). Multiple linear regression analysis revealed that HOMA-IR, hs-CRP and free-testosterone independently predicted UCN2 levels (p?相似文献   

Interleukin-18 concentrations in pregnancies complicated by preeclampsia with and without IUGR: A comparison with normotensive pregnant women with isolated IUGR and healthy pregnant women

ObjectiveThe aim of present study was to assess the maternal serum levels and clinical significance of interleukin-18 (IL-18) in pregnancies complicated by preeclampsia and/or intrauterine growth restriction (IUGR).Patients and methodsThe study was carried out on 30 patients with pregnancy complicated by severe preeclampsia (15 patients with IUGR and 15 with appropriate-for-gestational-age weight fetuses), 11 normotensive pregnant patients with pregnancy complicated by isolated IUGR and 32 healthy normotensive women with uncomplicated pregnancies. The interleukin-18 levels were determined using an ELISA assay.ResultsDecreased levels of maternal serum IL-18 in preeclamptic patients with and without IUGR were observed. Contrary to the preeclamptic women, no difference was found in the maternal serum levels of IL-18 in normotensive patients with pregnancies complicated by isolated fetal growth restriction. These levels were the same as observed in the healthy controls. The mean values of maternal serum IL-18 were 219.118 ± 180.079 pg/mL in the PRE group, 438.170 ± 229.657 pg/mL in the group of women with isolated IUGR, and 457.053 ± 528.142 pg/mL in the control group. The levels of maternal serum IL-18 were similar in both study preeclamptic subgroups. The mean values of IL-18 were 204.823 ± 188.171 pg/mL in the group PI and 233.414 ± 176.995 pg/mL in the P group.ConclusionsOur findings suggest that decreased levels of IL-18 in maternal serum play a significant role in etiology and pathogenesis of preeclampsia. But normotensive pregnancies complicated by isolated IUGR are not associated with the altered interleukin 18 levels in maternal serum.     

Preeclampsia is associated with increased susceptibility of serum lipids to copper-induced peroxidation in vitro

BACKGROUND: Several reports suggest preeclampsia to be associated with oxidative stress. In view of potential experimental artifacts in these studies, we tested the effect of preeclampsia on the oxidizibility of maternal serum lipids, using an optimized ex vivo method. METHODS: This prospective study included 28 pregnant women with preeclampsia and 28 women matched for maternal and gestational age with normal pregnancies. Venous blood was drawn from the consenting women. Serum levels of lipid peroxidation products and the kinetics of copper-induced oxidation ex vivo were monitored spectroscopically by continuous recording of absorbance at 245 nm. RESULTS: The initial optical density (OD) at 245 nm, attributed to preformed products of lipid peroxidation, was higher in the women with preeclampsia than in the controls (1.26 +/- 0.02 vs. 1.17 +/- 0.02 OD units; p = 0.01). The lag phase preceding oxidation, reflecting resistance of serum lipids to oxidation, was significantly shorter in the preeclampsia group than in the controls (47.4 +/- 2.3 vs. 57.6 +/- 4.0 min; p = 0.027). CONCLUSIONS: High levels of serum hydroperoxides and increased susceptibility of serum lipids to copper-induced peroxidation ex vivo indicate preeclampsia to be associated with high oxidative stress. The role of this high oxidizibility in the pathogenesis of preeclampsia has yet to be evaluated.     

Serum leptin levels in hypertensive disorder of pregnancy

OBJECTIVE: To determine serum leptin levels in hypertensive disorder of pregnancy. MATERIALS AND METHODS: In this prospective, cross-sectional, case control study, we measured serum leptin levels of 58 hypertensive pregnant women and 54 normal pregnant women. We also did blood and urine analysis for the evaluation of the severity of hypertensive disorder of pregnancy. The patients were followed until after delivery and information about labour was recorded. We analysed the difference and correlation between anthropometric measures, hormonal and biochemical parameters, and serum leptin levels in two groups. RESULTS: In the study group, serum leptin levels were determined to be higher than the control group. Neonatal birth weight was significantly lower in the hypertensive group. While the serum uric acid, urea, aspartate aminotransferase, fibronectin, and fasting blood glucose levels were found to be higher, serum total protein and albumin levels were significantly lower among the hypertensive pregnant women. Hypertensive pregnant women were more insulin resistant. Serum leptin levels were highly and positively correlated with serum fibronectin, and C peptide levels. A negative significant correlation was observed between maternal serum leptin levels and neonatal birth weight among the pregnant women having the hypertensive disorders. CONCLUSION: Serum leptin levels in hypertensive pregnant women appear to be higher. The determination of serum leptin levels may be as important as serum fibronectin and C peptide levels in the management of hypertensive disorder of pregnancy. C peptide and insulin may be due to hyperinsulinemia which leads to increased stimulation of leptin production by fatty tissue. Insulin resistance which appears in late pregnancy is more significant especially in pregnancies complicated by preeclampsia.