The Effect of Vitamin D3 Intervention on the Association Among Vitamin D3, Adiponectin, and Body Mass Index in Pregnant Women With Gestational Diabetes.

INTRODUCTION: Vitamin D3 (VD3) deficiency is a strong predictor of gestational diabetes. Therefore, VD3 supplementation during the antenatal period could prevent the development of gestational diabetes via its effects on insulin secretion, insulin sensitivity, body mass index (BMI), and adiponectin production. OBJECTIVES: To observe the effect of VD3 supplementation on adiponectin and BMI and to explore the effect of VD3 supplementation on the association among VD3, adiponectin, and BMI in pregnant women with gestational diabetes. METHODS: A randomized control trial was performed after receiving consent at Postgraduate Medical Institute, Lahore. Subjects at 20-26 weeks of gestation with gestational diabetes and with a deficiency/insufficiency of VD3 were included. The study excluded those who were smokers, had multiple pregnancies, or had other gestational complications. Subjects were categorized into interventional (VD3 supplementation) and control groups. The institutional ethical committee approved the study. Serum samples were used for enzyme-linked immunosorbent assay estimation of VD3 and adiponectin levels. Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Version 21.0, Armonk, NY) software was used to analyze data. Student t-tests were applied to compare quantitative variables, and Chi-square tests were utilized to compare qualitative variables. Pearson's correlation and linear regressions were performed to explore the association. At a 95% confidence interval, a p-value of ≤0.05 was taken as significant. RESULTS: With an increase in serum VD3 levels, a decrease in serum adiponectin level was observed in pregnant women with gestational diabetes (interventional group: r = -0.088, p = 0.74); however, after the intervention of VD3 supplementation in the same subjects, an increase in serum adiponectin level was noted with an increase in VD3 (interventional group: r = 0.273, p = 0.28). A significant direct relationship was found between BMI and adiponectin in the same study population (interventional group: r = 0.7, p = 0.001). Interestingly, after the intervention, BMI tends to be less likely to increase adiponectin levels (interventional group: r = 0.09, p = 0.73). Moreover, an inverse association was exhibited between BMI and VD3 levels in all the study groups before intervention (control group: r = -0.07, p = 0.78; interventional group: r = -0.035, p = 0.89) and after intervention (interventional group: r = -0.12, p = 0.65), except in the control group after the intervention span, where BMI mildly raises the VD3 levels (r = -0.12, p = 0.65). CONCLUSION: BMI increases with an increase in serum adiponectin levels in gestational diabetic women, but after VD3 supplementation, BMI was less likely to influence adiponectin. Also, with an increase in BMI, a decrease in the VD3 in all study groups was observed except in the control group after VD3 supplementation.

The Interplay Between Hyperthyroidism and Ovarian Cytoarchitecture in Albino Rats.

Background Hyperthyroid females often complain of menstrual disturbances and impaired fertility. This study was designed to observe the effect of hyperthyroidism on ovarian folliculogenesis and the hypophyseal-gonadal axis. Methodology Adult female Wistar albino rats (n= 12), six to eight weeks of age, and weighing 70-162 g, were divided randomly into control (Group A) and experimental (Group B) groups. Group A received daily intraperitoneal injections of 250 µL normal saline (10 µL 5 µM NaOH dissolved in it) for 14 days. Group B received a daily intraperitoneal injection of levothyroxine (600 µg/kg body weight) to induce hyperthyroidism. Rats were weighed at the start and the end of the experimental period on the day of sacrifice. Results Statistical analysis of the data revealed successful induction of hyperthyroidism in Group B as their thyroid-stimulating hormone (TSH) levels decreased significantly. The ovarian size was significantly reduced in the hyperthyroid group (p < 0.029). There was a significant decrease in thickness of the ovarian capsule (p < 0.000), an increase in the number of primordial, primary, and secondary follicles (p < 0.001, 0.000, and 0.001, respectively), and a decrease in size of primary and secondary follicles (p < 0.041 and 0.020) in the hyperthyroid group. Conclusion Hyperthyroidism can affect ovarian cytoarchitecture, probably by acting directly on its receptors and thus affects female fertility.

Relationship of Salivary Cortisol Level With Severe Depression and Family History.

Salivary cortisol level is considered a prominent depression biomarker, as saliva induces less stress as compared to blood. The study was performed in the physiology department, Sheikh Zayed Medical Institute Lahore from April 2015 to December 2015. Sixty participants, including 14 (46.67%) males and 16 (53.33%) females, in each non-depressive and depressive group of over 17 years of age, were undertaken. The depression diagnostics were performed both outdoors and in clinics and confirmed with the standards of the Diagnostic and Statistical Manual of Mental Disorders and Beck's Inventory. Saliva specimens were collected and processed for enzyme-linked immunoassay (ELISA), and absorbance was calculated on a microtiter plate reader. The statistics with the Statistical Package for the Social Packages (SPSS) 26.0 (IBM Corp., Armonk, NY) show that patients of the non-depressive category exhibited mean ages 35.73±6.89 years and 39.10±6.89 years in the depressive group (p-value: 0.178). The mean cortisol level was 1.46±0.91 ng/ml among non-depressive and 2.23±1.69 in depressive patients (p-value: 0.031). The mean depression score among non-depressive was 5.73±4.05 and 52.03±5.08 while there was no statistical difference in the mean height and weight of subjects in normal and depressive patients (p-value: 0.0001). Meanwhile, the mean cortisol level was 1.46±0.91 ng/ml among non-depressive patients, while it was 2.23±1.69 in the depressive group, with no statistical difference in mean ages (p-value: 0.031). These findings proved the cortisol level directly linked with severe depression and useful for depression diagnostics and management.

Comparison of Serum Brain-Derived Neurotrophic Factor Levels in Diabetic Patients With and Without Retinopathy.

Introduction Diabetes mellitus (DM) is a disease of carbohydrate, protein, and fats metabolism that results in hyperglycemia. It may also result from defects in the secretion of insulin from beta cells or in its action on target cells or both. Objective To determine the levels of brain-derived neurotrophic factor (BDNF) and glycated hemoglobulin (HbA1c) with the progression of retinopathy. Methodology The study was done on 80 patients who were divided into four groups (A, B, C, D), with 20 individuals each, on the basis of their diabetic status and fundoscopic findings. Serum BDNF levels were measured by using an enzyme-linked immunosorbent assay kit (Glory Science Co., Taichung City, Taiwan). Results On analysis, a significant decline was seen in serum BDNF levels in diabetics as compared with non-diabetics (p < 0.001), but a significant reduction in levels with the progression of retinopathy was observed (p < 0.001). Statistical analysis All the data were processed using the Statistical Package for the Social Sciences (SPSS) v20.0 (IBM Corp., Armonk, NY). Conclusion There is a significant decline in serum BDNF levels in type 2 diabetics with retinopathy in comparison with the healthy control group.

Correlation of Serum Anti-Mullerian Hormone with Ovarian Follicle Output Rate in Infertile Females: A Clomiphene Citrate Challenge Test.

Background Failure to achieve a successful pregnancy after 12 months of unprotected intercourse is a pathology of the reproductive system known as infertility. Anti-Mullerian hormone (AMH) not only reflects the ovarian reserve but also is known to be a predictor of several assisted reproductive techniques, e.g., in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and clomiphene citrate challenge test. In this study, AMH levels are correlated with the follicular output rate after the clomiphene citrate challenge test. Objective The objective of this study is to correlate AMH with the follicular output rate (FORT) after the clomiphene citrate challenge test. Materials and methods This study included a total of 80 primary and secondary infertile females, divided into early (18-30) and late (31-45) reproductive age groups either currently under clomiphene citrate treatment or advised to start clomiphene treatment, culled from out-patient department and centers of assisted reproductive techniques. On the third day of the menstrual cycle, blood samples were taken to determine serum AMH levels by ELISA. Then on the fifth day of the menstrual cycle, antral follicular counts were calculated through transvaginal ultrasound and oral tablet clomiphene citrate was started, and on day 12 and then on day 5, transvaginal ultrasound was repeated to record the number and diameter of dominant follicles. Results The pre-ovulatory (mature) follicle count was divided by the antral follicle count ×100 for calculating the FORT, which showed a negative Spearman Rho correlation (p = 0.048) with AMH. P-value ≤ 0.05 was considered significant.   Conclusion It is concluded that the most commonly administered drug, clomiphene citrate, may not be the treatment of choice for patients with high levels of AMH and may, in fact, interfere with the chances of achieving pregnancy. This study can provide guidelines to clinicians for patient counseling, given the results of the clomiphene citrate challenge test on the basis of AMH levels.

Relationship of Major Depression with Body Mass Index and Salivary Cortisol.

Introduction Depression is one of the most incapacitating psychiatric diseases that disturb life of millions of people round the globe. Its major causes include stressful life events, bereavement, social abuses or certain biological and genetic factors with complex causal mechanisms. Higher salivary cortisol levels for a long period lead to dyslipidemias which increase body mass index (BMI), elevate adiposity and waist-to-hip ratio (WHR). Such individuals with high quartiles of BMI have considerably higher risk of major depressive disorder. The aim of this study was to establish a correlation between major depression, BMI and salivary cortisol. Methods This cross-sectional analysis was accomplished in the Physiology Department, Sheikh Zayed Federal Postgraduate Medical Institute, Lahore as well as in Punjab Institute of Mental Health, Lahore, Pakistan, over a period of six months. A total of 60 participants aged between 18 and 60 years were included in this study; they were divided equally into two groups as normal healthy individuals with no physical or mental illness and severely depressed groups. The patients were categorized as cases of severe depression on outdoor clinical assessment and further confirmed by ICD-10. Patient's BMI was estimated by measuring height in meters (m) and weight in kilograms (kg), and then dividing weight with square height. Early morning saliva samples were collected. Estimation of cortisol levels in saliva was done through ELISA. SPSS version 20.0 (IBM Corp., Armonk, NY) was used to analyze the data and p ≤ 0.05 was considered statistically significant. Results The mean BMI in normal healthy group was 22.02 ± 4.21, while the mean BMI in severely depressive group was 24.64 ± 3.58. The difference was statistically significant (p = 0.012). The mean salivary cortisol level was significantly raised in patients with major depression (2.23 ± 1.69 nmol/L) in contrast to healthy normal individuals (1.46 ± 0.91 nmol/L), with p-value = 0.031. Conclusion BMI and depression has a very noteworthy correlation and there is a remarkable link between raised salivary cortisol, greater BMI and development of major depression.