RESUMO
OBJECTIVE: Lipoprotein-associated phospholipase A2 (Lp-PLA2) which is believed to play a role in atherosclerotic inflammatory process due to its function in hydrolysis of phospholipids and release of pro-inflammatory products, is considered as a novel biomarker for vascular risk. In this study we aimed to investigate the alterations in Lp-PLA2 and its relationship with other cardiovascular risk factors in patients with testosterone deficiency. MATERIAL AND METHODS: Forty hypogonadic male and 30 healthy male aged between 18-50 years were enrolled in this study. Height-weight, waist-to-hip circumference, body mass index (BMI) blood pressure, and body fat measurements were performed in all subjects. Blood glucose, albumin, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, high sensitive C-reactive protein (hs-CRP), apo-A1, apo-B, fibrinogen, insulin, total testosterone, sex hormone binding globulin (SHBG), small dense low-density lipoprotein (sd-LDL), paraoxonase 1, oxidized low-density lipoprotein (ox-LDL) and Lp-PLA 2 values were measured. Free and bioavailable testosterone levels were calculated. Data management was carried out with the statistical program SAS Version 9.2. Statistical evaluations were performed using Analysis of Variance (ANOVA), Kruskal-Wallis test, Wilcoxon test, correlation analysis and chi-square analysis. P values <0.05 were considered statistically significant. RESULTS: In patients with hypogonadism, significant increase in Lp-PLA2 levels were accompanied with risk factors of atherosclerosis, such as increase in total cholesterol, apo-B, sd-LDL, weight, BMI, body fat percentage, and decrease in paraoxonase 1 levels. Although the differences were not significant, similarly ox-LDL, hs-CRP, triglyceride, LDL-cholesterol levels were found to be higher in patients with hypogonadism compared to the control group. The mean level of Lp-PLA2 was the highest when compared with the group of secondary hypogonadism with the lowest testosterone level. CONLUSION: Our study has demonstrated that the testosterone deficiency increases cardiovascular risk via its effects on lipid metabolism and Lp-PLA2 can be used to assess this risk.
RESUMO
OBJECTIVE: The aim of this study was to identify the prevalence of anemia and predisposing factors contributing to anemia in pregnant women prior to delivery. MATERIAL AND METHODS: A retrospective case-control study was conducted on 1221 women who delivered between 37 and 42 weeks of gestation between July 2014 and January 2015. Data on the subjects' socioeconomic and demographic characteristics, pregnancy outcomes, and hemoglobin levels within 24 h prior to delivery were collected. The study population was divided into two groups on the basis of the presence of anemia within 24 h prior to delivery. Anemia was defined as a hemoglobin level of <11 g/dL. The prevalence of pre-delivery anemia was estimated, and antenatal predictors of anemia were determined using multivariate logistic regression analysis. RESULTS: The prevalence of anemia in women attending our center for delivery was 41.6% [95% confidence interval (CI) =38.84-44.37]. After multivariate logistic regression analysis, parity >3 [odds ratio (OR) =1.82, 95% CI=1.24-2.96, p=0.002], illiterate (OR=2.23, 95% CI=1.35-3.45, p=0.001) and primary educational level (OR=2.01, 95% CI=1.28-3.39, p=0.008), household monthly income per person <250 Turkish liras (OR=2.34, 95% CI=1.49-3.89, p<0.001), first admission at second (OR=1.63, 95% CI=1.24-2.81, p=0.006) and third trimester (OR=2.45, 95% CI=1.41-4.06, p<0.001), number of antenatal visits <5 (OR=1.45, 95% CI=10.5-2.11) and 5-10 (OR=1.3, 95% CI=1.03-2.09), duration of iron supplementation <3 months (OR=2.62, 95% CI=1.51-4.17) and 3-6 months (OR=1.68, 95% CI=1.13-2.91), and occurrence of preeclampsia (OR=1.55, 95% CI=1.03-2.1, p=0.041) were independently associated with anemia. CONCLUSION: Socioeconomic determinants constitute most of the anemia cases and, hence, should be considered as major risk factors of anemia in women attending for delivery at term.