Glucose variability as the risk factor of preeclampsia in pregnant patients with type 1 diabetes mellitus.

OBJECTIVE: To analyze glucose variability and investigate its role as a predictor for preeclampsia development in pregnant women with type 1 diabetes mellitus (T1DM) with various insulin therapy regimens. METHODS: A total of 200 pregnant women with T1DM were included in the study. A hundred women used continuous subcutaneous insulin infusion (CSII), and the rest of the group was administered with multiple daily insulin injections (MDI). Continuous glucose monitoring (CGM), index calculation of glucose variability (MAGE, MODD, CONGA, and CV), assessment of preeclampsia frequency and severity were conducted. RESULTS: The work results show the link between the severity rate of preeclampsia and the duration of T1DM as well as the level of HbA1c before and during pregnancy. The rate of preeclampsia in the group of women, using CSII comprises 26.8% of cases that appear less than in the group of those, administered with MDI that is 46.6% (χ2 = 5.45; р < .05). A negative correlation is defined between pathological glucose variability and gestational age when preeclampsia occurs. A negative correlation was also revealed between MODD, CV, and the time for the detection of preeclampsia: r = -0.30, r = -0.24, respectively. The study illustrates the correlation obtained between preeclampsia and glucose variability and the value of MAGE, MODD, CV, and SD. Preeclampsia development is affected by the duration of hyperglycemic conditions in the third trimester of pregnancy. The data in the group of women using MDI marks the early development of preeclampsia on the 33.0 [32-34] week of pregnancy compared to the group of women practicing CSII on 35.5 [33-36] week of pregnancy (Z = 5.4; p < .001). The increase of risk of preeclampsia development is proved in pregnant patients with T1DM when the hyperglycemic condition lasts more than 25% of a 24-h period according to the rate of CGM and measurements of glucose variability MODD > 1.07 and CONGA > 3.39. CONCLUSION: Comprehensive evaluation of the glycemic profile while using CGM revealed a correlation between pathological glucose variability and the frequency and severity of preeclampsia thus proving the benefits of CSII in pregnant patients with T1DM to perform glycemic targets and decrease glucose variability, which eventually led to the decrease of preeclampsia frequency in this group of women.

The effectiveness of resveratrol in treatment of PCOS on the basis of experimental model in rats.

PURPOSE OF THE STUDY: Polycystic ovary syndrome (PCOS) is a widespread endocrine disorder in women of reproductive age. Further research is required to justify new directions of effective targeted therapy of this condition. Resveratrol possesses anti-inflammatory, antioxidant and antidiabetic properties. The purpose of this study was to evaluate the potential effectiveness of resveratrol in PCOS based on the created model of this disease in Wistar rats. MATERIALS AND METHODS: The PCOS model was created by oral administration of letrozole to female Wistar rats.. The animals received resveratrol at a dosage of 20 mg/kg and 30 mg/kg for the next 30 days. Then ovariectomy was performed for histological confirmation of the effectiveness of resveratrol in the treatment of PCOS. Regularity of estrous cycle, animal's body mass and the level of soluble receptors for advanced glycation end products (sRAGE) in the blood of rats were also evaluated in dynamics. RESULTS: The study revealed that administration of resveratrol leads to dose-dependent restoration of normal morphology of ovarian tissue, normalizes regularity of estrous cycle and decreases body weight of rats with PCOS. CONCLUSION: The results obtained in rats suggest that resveratrol may be a promising agent for the treatment of PCOS in women.

Prevalence of high-risk human papillomavirus types and cervical squamous intraepithelial lesions in women over 30 years of age in St. Petersburg, Russia.

BACKGROUND: Cytology-based screening has significantly decreased incidence of and mortality from cervical cancer. High sensitivity of high-risk human papillomavirus (hrHPV) test for the detection of high-grade cervical intraepithelial neoplasia (CIN) makes it a useful screening tool, especially in settings where cytology is not available or not quality assured. The study aimed to determine the prevalence of hrHPV and associated cervical lesions in Russian women over 30 years of age and to assess usefulness of HPV test for cervical screening in Russia. METHODS: Consecutive women aged 30-65 years (n=823) receiving routine gynaecological care, not pregnant and not treated for high-grade CIN, were recruited. Oncogenic HPV types were detected using Hybrid Capture 2 (HC2) assay and genotyped with direct DNA sequencing. Women with cytological abnormalities higher than atypical squamous cells of undetermined significance (ASCUS) and women positive for hrHPV were referred to colposcopy. RESULTS: HPV infection was present in 107 (13%) women. Cytological abnormalities were found in 81 (9.8%) patients, including 59 (7.2%) with ASCUS, 21 (2.5%) with low-grade squamous intraepithelial lesions (LSIL), and one (0.1%) with high-grade SIL. Only 11 (18.6%) patients with ASCUS were positive for hrHPV. Histological diagnoses were obtained for 63 women. Relative sensitivities and positive predictive values of the HPV test and cytology for the detection of high-grade CIN were 100% (6/6) and 9.5% (6/63), and 83.3% (5/6) and 27.8% (5/18), respectively. The most prevalent hrHPV types were 16 (3.9%), 31 (2.8%), 52 (1.7%), and 33 (1.3%). Cytological abnormalities and symptoms of a urogenital infection were strongly associated with hrHPV infection. CONCLUSIONS: The study provides data on the prevalence of hrHPV types in association with cervical lesions, as well as on hrHPV determinants, in an unvaccinated population of Russian women. Our results indicate that HPV test might be a useful screening tool in Russia.