Evaluation of Serum Endocan Levels in Endometriosis: A case-control study.

OBJECTIVE: To evaluate the possible associations between serum endocan levels and endometriosis. STUDY DESIGN: A total of 60 women with histologically proven endometriosis and 40 women who underwent laparoscopy due to unexplained infertility without endometriosis were evaluated in a case-control study. Serum endocan, CA125, CA19.9, and CA15.3 levels were measured. Demographic, clinical, and laboratory parameters were compared. RESULTS: There was no significant difference between the groups regarding age, body-mass-index, parity, and serum CRP and WBC levels. Serum endocan (p<0.001), CA125 (p<0.001), CA19.9 (p=0.022) and CA15.3 (p=0.013) levels were significantly higher in the endometriosis group compared to the control group. The correlation analysis showed that serum endocan level was positively correlated with the stage of the disease, CRP, and WBC, but not with remaining parameters, age, BMI, dysmenorrhea score, CA125, CA19.9, and CA15.3. Serum CA125 can predict endometriosis (Cut off=26.2 IU/mL, AUC=0.955) with a sensitivity of 89% and specificity of 88%. Serum endocan can predict endometriosis (Cut off=454 ng/mL AUC=0.749) with a 93% sensitivity and 61% specificity. CONCLUSIONS: The serum endocan levels were significantly elevated in women with endometriosis compared to the control group. Serum endocan can predict endometriosis with a sensitivity of 93% and specificity of 61.

Can preoperative neutrophil to lymphocyte and platelet to lymphocyte ratios predict cervical stromal involvement in endometrioid endometrial adenocarcinoma?

PURPOSE: To evaluate the possible relationships between preoperative inflammatory markers [neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR)] and cervical stromal involvement in endometrioid endometrial adenocarcinoma. MATERIALS AND METHODS: Charts and pathology results of 639 women who were operated on for endometrioid endometrial adenocarcinoma between 2000 and 2013 in the present clinic were retrospectively reviewed. Demographic, laboratory, and clinical parameters were evaluated. RESULTS: 118 women (18.4%) had cervical stromal involvement. Lymph node positivity was significantly more frequent in the cervical stromal involvement group (p < 0.001). A threshold value of 2.41 for NLR had a sensitivity of 62.7%, specificity of 60.1%, PPV of 61.1%, and NPV of 61.8% for the presence of cervical stromal involvement. In multivariate analysis, increased NLR had a significant predictive value for cervical stromal involvement (p = 0.006, OR = 2.03), although PLR remained non-significant (p = 0.77, OR = 1.08). CONCLUSIONS: The preoperative NLR assessment is a significant predictor for cervical stromal involvement in endometrioid endometrial adenocarcinoma.

Evaluation of cognitive functions in gestational diabetes mellitus.

OBJECTIVE: To evaluate the association between cognitive functions and metabolic status in cases with gestational diabetes mellitus (GDM). METHODS: In this study 44 patients with GDM and 45 normal pregnant were included. Depression was evaluated with Beck's depression inventory (BDI). Cognitive functions were evaluated with Montreal cognitive assessment (MOCA), paced auditory serial addition test (PASAT), spatial recall test (SRT), symbol digit modalities (SDMT), and word list generation (WLG). RESULTS: The mean gestational age, educational level and account of previous birth of the subjects in the study were not statistically different between the groups. The mean scores of BDI of the 2 groups were not statistically different. MOCA score and SDMT was significantly decreased in GDM in comparison to NP (p=0.005, p=0.04 respectively). Also, SDMT score was inversely correlated with number of pregnancies, postprandial blood glucose and HbA1c.The scores of PASAT, SRT, SPART and WLG were statistically similar between the groups. CONCLUSIONS: Our findings may be a clue for early onset of impairment in cognitive functions in cases with new onset diabetes during pregnancy.

Pregnancy outcomes and prognostic factors in patients with intrahepatic cholestasis of pregnancy.

The aim of this study was to describe maternal and fetal characteristics associated with intrahepatic cholestasis of pregnancy (ICP) and to determine clinical and biochemical predictors of fetal complications. A total of 89 singleton pregnancies with ICP were analysed, retrospectively. All data concerning laboratory results, symptom onset time, treatment response, delivery time and infant information were recorded in the study protocol. The mean gestational age at diagnosis was 32.6 ± 3.4 weeks; mean time of delivery was 36.8 ± 1.9 weeks. Binary logistic regression revealed that gestational age at diagnosis was predictive of preterm delivery (OR = 2.3, 95% CI: 1.5-3.3, p = 0.001). The incidence of respiratory distress syndrome (RDS), fetal growth restriction, fetal distress and preterm delivery were significantly higher in patients who were diagnosed before 30 weeks than after 34 weeks' gestation (p < 0.01). Gestational age at diagnosis is an important independent factor predicting adverse perinatal outcomes in patients with ICP.

Diagnosis of late-onset congenital adrenal hyperplasia in clinical practice: current evaluation.

AIM: Aim of the study was to investigate the need to perform the adrenocorticotropic hormone (ACTH) stimulation test by recognizing the importance of a second look at basal serum 17-alpha hydroxyprogesterone (17-OHP) levels and calculating new serum 17-OHP cut-off level. METHODS: A total of 142 patients who had hyperandrogenism symptoms and had basal serum 17-OHP levels of higher than 1.3 ng/mL were scheduled to have an ACTH stimulation test performed. Prior to ACTH stimulation, 17-OHP levels were recorded and as second-look levels. RESULTS: Patients were divided to two groups, late-onset congenital adrenal hyperplasia (LOCAH) (25/142), non-LOCAH (117/142). There were statistically significant results related to cycle length and menstrual irregularity between two groups (P=0.042, P=0.041, respectively). In the LOCAH group, basal serum 17 OHP levels were higher than non-LOCAH (P=0.001). When basal serum 17-OHP levels were measured a second time, the need for performing the ACTH stimulation test was decreased. According to cut-off levels of 1.3 ng/mL, 100% of patients needing to take the second serum 17-OHP decreased to 83.1%, a cut-off level of 2 ng/mL decreased numbers from 74.65% to 35.92% and for 2.25 ng/mL 58.42% of patients was decreased to 26.77%. In this study we established 2.25 ng/ml is a superior cut-off level for 17-OHP, its sensitivity is 84% and specifity is 50.4%. CONCLUSION: The incidence of LOCAH is 1.35% among the patients with hyperandrogenism symptoms. We found a single measurement of serum 17-OHP level can be unreliable. Second 17-OHP test reduces the need of performing the ACTH stimulation test by approximately 30%.

Comparison of maternal and umbilical cord blood soluble lectin-like oxidized low-density lipoprotein receptor 1 levels in early- and late-onset preeclampsia.

BACKGROUND: The main purpose of this study was to determine the maternal and umbilical cord blood oxidized LDL (oxLDL) and soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) levels in early- and late-onset preeclampsia (PE). MATERIALS AND METHODS: A case-control study was conducted in pregnant women with early-onset (before 34 weeks' gestation n = 19) and late-onset (after 34 weeks' gestation n = 22) PE compared to healthy normotensive pregnant controls (n = 44). Groups were compared for the maternal and umbilical cord plasma oxLDL and serum sLOX-1 levels. RESULTS: The mean maternal and umbilical cord serum sLOX-1 and plasma oxLDL levels were significantly increased in early- and late-onset PE compared to controls (p < 0.001). When early- and late-onset PE women were compared with serum sLOX-1 levels, the increase was more pronounced in early PE (p < 0.001). However, same comparison is not statistically significant in cord blood for oxLDL where as it is significantly higher in maternal blood for oxLDL in early-onset PE group. Maternal and cord blood oxLDL and sLOX-1 levels are positively correlated with each other; however, they are negatively correlated with fetal weight and gestational age. CONCLUSIONS: According to our results, maternal and umbilical cord blood levels of oxLDL and sLOX-1 were higher in preeclamptic pregnant. Thus, for the first time it has been shown that oxLDL and sLOX-1 levels were higher in fetal circulation as well as plasma of preeclamptic pregnant. However, sLOX-1 levels seem to be more implying than oxLDL for the differentiation of early and late preeclampsia.

Maternal and cord blood apelin, resistin and visfatin levels in gestational diabetes mellitus.

AIM: The aim of this paper was to investigate maternal and cord blood apelin, resistin and visfatin concentrations in pregnant women with and without gestational diabetes mellitus (GDM). METHODS: This case-control study was conducted on 24 women with GDM and 21 women without GDM. Maternal plasma and cord blood apelin, resistin and visfatin levels were measured with ELISA. RESULTS: The cord blood apelin levels were significantly lower in women with GDM than control subjects (111.23±31.53 vs.. 257.48±133.97 pg/mL, P=0.002). However, the decrease of maternal apelin levels in GDM group was not statistically significant (140.76±48.38 vs. 163.53±91.12 pg/mL, P=0.602). Women with GDM had lower maternal and cord blood visfatin concentrations and higher resistin concentrations than control group. Maternal resistin concentrations were significantly correlated with HOMA-IR (r=0.745, P=0.005). The apelin and visfatin levels did not correlate with HbA1c, BMI, HOMA-IR, glucose and birth weight. CONCLUSION: GDM is associated with lower cord blood apelin levels than control subjects. GDM appears to influence fetoplacental apelin metabolism. Apelin may not be directly involved in the regulation of maternal insulin sensitivity. Our results indicate that there is an increase in resistin concentrations and a decrease in visfatin concentrations in maternal serum and cord blood serum with GDM.