Correlation of psychological symptoms with cortisol and CRP levels in pregnant women with metabolic syndrome.

BACKGROUND: In pregnancy occurs series of physiological, organic and psychological changes in the female organism. Particularly are significant hormonal and metabolic changes. Elevated cortisol levels are reduced by linking the transport of globulin (transcortin). Triglycerides were increased 50% and other lipids from 20 to 30%. The values of CRP were slightly elevated in the third trimester of pregnancy (10-15 mg/L). To investigate the association of psychological symptoms with the level of cortisol and CRP in women with metabolic syndrome. SUBJECTS AND METHODS: From 1646 pregnant women cross-sectional, prospective study included 180 pregnant women divided into three groups by applying the inclusion and exclusion criteria. Research methods are laboratory and clinical tests and questionnaires. Every pregnant woman have been made complete laboratory findings and determined cortisol in 8 and 17 hours using the chemiluminescent immunoassay method. All pregnant women filled in several questionnaires: socio-demographic, obstetrical-gynecological, standardized psychometric questionnaire (SCL 90-R), a questionnaire syndrome of depression according to ICD 10 and Beck self depression scale. The study was conducted from August 2011 to mid-November 2012. RESULTS: From the total of 1646 hospitalized pregnant women, 176 pregnant women had a BMI>30 and 120 of them were tested, but 60 had criteria for MS. The concentration of morning and afternoon cortisol is increased in pregnant women with the metabolic syndrome Obese pregnant women have a statistically higher level and morning and afternoon cortisol levels than women with normal body weight and without the metabolic syndrome, but these differences are smaller than in the case of pregnant women with the metabolic syndrome. CRP is significantly higher in women with metabolic syndrome. CRP concentration is significantly higher in obese pregnant women compared to pregnant women with normal weight and without the metabolic syndrome, but it is lower than in pregnant women with the metabolic syndrome. The incidence of psychological symptoms as somatization, obsessive-compulsive symptoms, depression, anxiety, phobia, and nonspecific symptoms is statistically increased in pregnant women with elevated morning cortisol, but in women with elevated afternoon cortisol also occurring aggressiveness and paranoia. In pregnant women with elevated CRP is statistically higher incidence of psychological symptoms such as somatization, obsessive-compulsive symptoms, depression, anxiety, and nonspecific symptoms. CONCLUSION: There is a statistically significantly higher levels of cortisol and C-reactive protein in obese pregnant women and pregnant women with the criteria of MS. Morning cortisol has a specific predictive value for the diagnosis of MS, but the values of CRP are changing in numerous physiological and pathological conditions and cannot be taken as a predictive factor in the diagnosis of MS. Pregnant women with MS and elevated morning and evening levels of cortisol and CRP shows a statistically significant higher number of complications in pregnancy and psychological symptoms.

Expression of IMP3 and LIN28A RNA-Binding Proteins in Placentas of Patients with Pre-Eclampsia with and without Severe Features.

BACKGROUND: this study aimed to determine the expression of RNA-binding oncofetal proteins IMP3 and LIN28A in extravillous (EVT) and villous trophoblast (VT) cells of placentas from pre-eclamptic (PE) pregnancies to better understand the pathogenesis of PE. METHODS: placental tissue of 10 patients with PE with severe features, 10 patients with PE without severe features and 20 age-matched healthy pregnancy controls were analyzed by immunohistochemistry, double immunofluorescence and qPCR. RESULTS: We found a decreased percentage of IMP3-positive EVT cells in PE with and without severe features compared to that of the healthy control (p < 0.001). IMP3 expression was significantly low in VT of PE placentas compared to that of the healthy control (p = 0.002). There was no significant difference in LIN28A expression between groups of PE and the control group. Additionally, we noticed the trend toward downregulation of IMP3 mRNA and LIN28A mRNA in severe PE compared to that of healthy controls. CONCLUSIONS: We demonstrated that IMP3 expression is decreased in EVT and VT cells of placentas from pregnancies complicated with both PE with and without severe features. However, additional functional investigations are needed to clarify the role of IMP3 as a potential therapeutic target in the management of PE.

Prognostic Value of IMP3 Expression in Squamous Cervical Cancer.

Cervical cancer remains one of the leading causes of death from malignant diseases in women worldwide. Primary and secondary prevention have led to better outcomes in developed countries, whereas in developing countries, cervical cancer continues to be responsible for an unjustifiably high number of fatalities. The discovery of new tumor biomarkers can lead to earlier diagnosis, better therapeutic decisions, and improved treatment methods. IMP3 is a protein responsible for invasiveness and other aggressive characteristics of tumor processes. Its highly specific expression has been proven in various malignant processes. The level of IMP3 expression in cervical cancer cells could be used as a prognostic factor for a worse disease course. In this study, IMP3 expression was examined in 80 patients who underwent surgery for squamous cell cervical cancer in the first FIGO stage of the disease, and its association with disease-free period and overall survival was investigated. Data analysis did not show a statistically significant association between IMP3 expression and the mentioned primary outcomes, despite its association with clinical-pathological indicators of advanced disease. In conclusion, the analysis of IMP3 protein expression in patients with early-stage cervical cancer is of limited utility.

Association of MTHFR polymorphism, folic acid and vitamin B12 with serum homocysteine levels in pregnant women.

Homocysteine is known to be associated with adverse vascular and metabolic effects, as well as pregnancy complications. Its serum levels are influenced by the function of the enzyme methylenetetrahydrofolate reductase (MTHFR) and the dietary intake of folic acid, vitamin B12, and methionine. In this cross-sectional study, we investigated the association of genetic polymorphisms of the MTHFR gene with vitamin status in pregnant women during mandatory folic acid supplementation. The study included 102 pregnant women between 24 and 28 weeks of gestation who were attending regular outpatient examinations at the maternity clinic. Homocysteine, folic acid, vitamin B12 levels, and MTHFR gene polymorphisms (C677T and A1298C) were analyzed. Significant associations were found between vitamin B12 and folic acid levels with homocysteine (P < 0.001), with lower serum levels of these vitamins being associated with higher homocysteine levels. Surprisingly, there was no significant association between MTHFR genetic polymorphisms and serum homocysteine levels, likely attributed to the supplementation of folic acid and vitamin B12 in vitamin supplements for pregnant women, which counteracts the effect of the mutation. Remarkably, a high prevalence of MTHFR gene mutations was found, with the C677T polymorphism present in 56.9% and the A1298C polymorphism in 87.2% of pregnant women. These findings emphasize the importance of adequate folic acid and vitamin B12 intake during pregnancy to regulate homocysteine levels. Although the MTHFR gene mutations were highly prevalent, their influence on homocysteine levels in this population appears to be mitigated by vitamin supplementation. Further research is warranted to explore the impact of these mutations on other aspects of pregnancy outcomes. The trial is registrated at Clinicaltrail.gov (NCT04952324).

PREVALENCE OF GESTATIONAL DIABETES IN THE SOUTHERN PART OF BOSNIA AND HERZEGOVINA.

BACKGROUND: The prevalence of gestational diabetes mellitus (GDM), as a complex problem in pregnancy, is increasing all over the world, but most noticeable in developing countries. AIMS: To estimate GDM prevalence and associated pregnancy features in the southern part of Bosnia and Herzegovina. METHODS: A cross-sectional observational study was conducted from October 2010 through March 2011. A total of 285 pregnant women with singleton pregnancies participated and were asigned to the study in the order they came for their usual ante-natal clinic examination. They underwent an oral glucose tolerance test (OGTT) with 75 g of glucose. Information on OGTT results, maternal characteristics and pregnancy outcomes were collected from database and medical records. RESULTS: Prevalence of GDM was 10.9% according to 1999 World Health Organisation (WHO) diagnostic criteria. Prenatal cigarette smoking, previous GDM, cesarean delivery rate and neonatal hypoglycemia were significantly more frequent in the GDM group compared to the group of pregnancies with normal glucose tolerance (p = 0.015, p < 0.001, p = 0.015, p = 0.002). CONCLUSION: This study presents a relatively high prevalence of GDM in Bosnia and Herzegovina. There is a need for large well-designed study on GDM prevalence and its other features.