Premature ovarian insufficiency: the context of long-term effects.

PURPOSE: Premature ovarian insufficiency (POI) is defined as the cessation of the ovarian function before the age of 40 years. POI aetiology may be related to iatrogenic or endogenous factors and in many cases remains unclear. The aim of this review was to characterize the long-term consequences of POI. METHODS: The available literature regarding the long-term consequences of POI from MEDLINE has been reviewed. RESULTS: Lack of ovarian steroids synthesis has serious consequences for women's health. The short-term effects are similar to spontaneous menopause and refer mainly to the climacteric syndrome. In a longer perspective, POI affects a variety of aspects. It obviously and drastically reduces the chances for spontaneous pregnancies. Oestrogen loss leads also to urogenital atrophy. The most common urogenital symptoms include vaginal dryness, vaginal irritation and itching. The urogenital atrophy and hypoestrogenism interferes also with sexual functioning. Patients with POI are threatened by a decrease in bone mineral density (BMD). POI women also experience psychological distress and some studies have shown an increased risk of neurodegenerating diseases. Overall, POI women have a shortened life expectancy, mainly due to cardiovascular disease. Some studies have reported a reduced risk of breast cancer in this group of patients. CONCLUSIONS: In conclusion there are several well-characterized health risks in POI women. With every patient, an individualized approach is required to properly recognize and prevent these risks.

Therapeutic antitumor potential of endoglin-based DNA vaccine combined with immunomodulatory agents.

Therapy targeting tumor blood vessels ought to inhibit tumor growth. However, tumors become refractory to antiangiogenic drugs. Therefore, therapeutic solutions should be sought to address cellular resistance to antiangiogenic therapy. In this regard, reversal of the proangiogenic and immunosuppressive phenotype of cancer cells, and the shift of the tumor microenvironment towards more antiangiogenic and immune-stimulating phenotype may hold some promise. In our study, we sought to validate the effects of a combination therapy aimed at reducing tumor blood vessels, coupled with the abrogation of the immunosuppressive state. To achieve this, we developed an oral DNA vaccine against endoglin. This antigen was carried by an attenuated Salmonella Typhimurium and applied before or after tumor cell inoculation into immunocompetent mice. Our results show that this DNA vaccine effectively inhibited tumor growth, in both the prophylactic and therapeutic settings. It also activated both specific and nonspecific immune responses in immunized mice. Activated cytotoxic T-lymphocytes were directed specifically against endothelial and tumor cells overexpressing endoglin. The DNA vaccine inhibited angiogenesis but did not affect wound healing. In combination with interleukin-12-mediated gene therapy, or with cyclophosphamide administration, the DNA vaccine resulted in reduced microvessel density and lowered the level of Treg lymphocytes in the experimental tumors. This effectively inhibited tumor growth and prolonged survival of the treated animals. Polarization of tumor milieu, from proangiogenic and immunosuppressive, towards an immunostimulatory and antiangiogenic profile represents a promising avenue in anticancer therapy.

Atherosclerotic factors in PR3 pulmonary vasculitis.

Autoimmune disease such as systemic lupus erythematosus or rheumatoid arthritis are connected with higher risk of atherosclerosis and cardiovascular complications and mortality. This results from inflammatory damage to the vessel wall by vasculitis. The aim of the present study was to evaluate whether patients with Wegener's granulomatosis (WG) and pulmonary involvement have an increased prevalence of atherosclerotic disease as characterized traditional risk factors. Twenty one patients with WG in remission and 15 control subject were entered to the study. Traditional risk factor for cardiovascular disease such as hyperglycemia, hypertension, smoking, obesity, and dyslipidemia were assessed. Both systolic and diastolic blood pressure were higher in WG patients (p<0.025). Total cholesterol, LDL and TG levels were markedly elevated in 18 of the 21 in pulmonary WG patients. Compared with controls, plasma levels of hsCRP were raised in WG patients; 3.68 (0.79-9.75) mg/l vs. 0.14 (0.12-0.59) mg/l (p<0.01). We conclude that non-pharmacological and pharmacological treatments of traditional risk factors are crucial to prevent cardiovascular disease in WG patients and thus should be part of therapy to control WG activity and damage caused by it.

Rhinologic and sinonasal changes in PR3 ANCA pulmonary vasculitis.

BACKGROUND: Over 70-95% patients with PR3 ANCA pulmonary vasculitis present with upper respiratory tract symptoms or sings. Nasal cavity usually presents with obstruction and chronic refractory infections (rhinosinusitis) which commonly manifest as bloody discharge or crusting obstruction. Mucopurulent discharge may occur in the acute phase or remission, along with other symptoms suggesting sinusitis. Later on, saddle nose deformities can occur due to collapse of the nasal septum. Other common destruction areas are the maxillary ostia, erosion of the tubinates or damage of soft palate. OBJECTIVE: The aim of the study was to characterize pathologies of nasal and sinonasal CT scans in patients with PR3 pulmonary ANCA vasculitis and to establish the CT diagnostic criteria for WG. Between 2005-2009 sinonasal CT visualization was performed in 35 patients (19 female, 16 male) with PR3 ANCA positive WG. RESULTS: Bony destruction of the nasal cavity was revealed in 15 (42.8%), damage or distortion of the paranasal sinuses in 20 (57.1%), the mastoid cells in 7 (20%), and the orbits in 7 (20%) patients. Sclerosing osteitis of the nasal cavity and paranasal sinuses were observed in 11 (31.4%) and in 24 (68.5%), respectively. Bony thickening of the nasal cavity was shown in 5 (14.2%) patients and of the paranasal sinuses in 7 (20%) (unilateral in 2 and bilateral in 5 patients). Seven patients (20%) had orbital masses; all unilateral. Septal perforation was observed in 11 (31.4%) and saddle nose deformity in 7 (20%) patients. CONCLUSIONS: Maxillary sinuses are regions which are most frequently affected during the course of PR3 ANCA pulmonary vasculitis. CT imagines may be a useful supplement to clinical and activity scoring of WG disease with pulmonary involvement.

Inflammatory Markers in Women with Polycystic Ovary Syndrome.

Several studies have reported the association between polycystic ovary syndrome (PCOS) and low-grade chronic inflammation to be of uncertain cause: obesity, insulin resistance, or PCOS itself. The aim of the study was to investigate the WBC (white blood cell) count and CRP (C-reactive protein) concentration in women with PCOS and to determine the factors that affect their concentration. The study included 200 women aged 18-40 with PCOS and 105 healthy women as the control group, recruited in the Department of Gynaecological Endocrinology of Medical University in Warsaw from 2016 to 2018. Each patient underwent clinical, biochemical, and ultrasonographic assessments. WBC and CRP were significantly higher in the PCOS group (Z = -2,353, p = 0,019 and Z = -2,453, p = 0,014). WBC positively correlated with serum insulin at 0, 60, and 120 min during the oral glucose tolerance test (INS0: r = 0,221, p = 0,001; INS1: r = 0,194, p = 0,003; INS2: r = 0,022, p = 0,001), testosterone (r = 0,130, p = 0,046), androstenedione (r = 0,212, p = 0,001), and DHEAS (r = 0,178, p = 0,006) and negatively correlated with progesterone (r = -0,204, p = 0,002), estradiol (r = -0,140, p = 0,032), and SHBG (r = -0,308, p < 0,001). CRP positively correlated with insulin concentration in 0, 60, and 120 min during the oral glucose tolerance test (INS0: r = 0,343, p < 0,001; INS1: r = 0,276, p = 0,001; INS2: r = 0,320, p < 001) and negatively correlated with progesterone (r = -0,194, p = 0,030) and SHBG (-0,244, p = 0,005). We also estimated positive correlation between BMI and serum CRP and WBC concentration. Multiple linear regression analysis showed that CRP values are positively associated with BMI (beta = 0,374, p < 0,001) and insulin level (INS1) (beta = 0,282, p = 0,004); and WBC results are negatively associated with SHGB (beta = -0,284, p < 0,001) but positively associated with testosterone (beta = 0,163, p = 0,024) and BMI (beta = 0,157, p = 0,047). PCOS is associated with increased WBC and CRP concentrations. The main predicting factors of increased CRP are BMI and insulin resistance, but there is also a relationship between WBC count in PCOS and androgen concentration itself so that inflammation may be mediated not only through adiposity but also through increased androgen concentration.

Alpha-hydroxybutyrate dehydrogenase activity in intrahepatic cholestasis of pregnancy.

OBJECTIVES: Intrahepatic cholestasis of pregnancy (ICP) is associated with increased perinatal mortality and morbidity. Alpha-hydroxybutyrate dehydrogenase (alpha-HBDH) is an enzyme that originates in the cytoplasm of hepatocytes and can be detected in the serum. The aim of this study was to determine the characteristics of alpha-HBDH activity in ICP. METHODS: The study included 100 women in their third trimester of pregnancy, 58 of whom had ICP (the study group) and 42 were healthy (the control group); another group, 26 nonpregnant women, was also analyzed to follow changes in alpha-HBDH activity during pregnancy. The concentrations or activity of fractionated bilirubin; bile acids; total alkaline phosphatase; alanine and aspartate aminotransferases; total high-density and low-density lipoprotein cholesterol; triglycerides; total protein; and alpha-HBDH were assessed. RESULTS: The activity of serum alpha-HBDH is increased during the third trimester of pregnancies complicated by ICP, and it correlates positively with total and direct bilirubin concentration and total alkaline phosphatase activity. CONCLUSIONS: Alpha-hydroxybutyrate dehydrogenase serum activity seems to be another biochemical parameter useful in the assessment of ICP severity.

The biochemical functions of the renal tubules and glomeruli in the course of intrahepatic cholestasis in pregnancy.

Biochemical functions of kidney glomeruli and tubules were estimated in pregnancy complicated by cholestasis. The investigated group consisted of 72 women with pregnancy complicated by cholestasis and 30 healthy pregnant patients as a control group. Biochemical assays were performed for the deamination of amino acids, carbonic acid dissociation and creatinine metabolism. Statistical analysis was carried out using the t-test and P<0.05 was considered to be significant. In diurnal urine samples collected from pregnant patients with cholestasis, decreased concentrations of NH4+ (42.0+/-8.9 versus 50.3+/-7.6 mmol/24 h), H+ (19.0+/-7.0 versus 25.0+/-5.0 mmol/24 h), creatinine (1.15+/-0.2 versus 1.43+/-0.3 mmol/24 h) as well as lower levels of creatinine clearance (89.0+/-23.0 versus 135.0+/-30.0 ml/min) and normal levels of potassium and sodium were observed. Serum creatinine and uric acid concentrations were elevated (86.6+/-7.07 versus 66.3+/-4.42 micromol/l and 32.1+/-8.3 versus 19.0+/-3.57 micromol/l). Diurnal urine volume was lower in patients with cholestasis than in the control group (995+/-313 versus 1264+/-426 ml/24 h). Disturbances of biochemical functions of kidney glomeruli and tubules, regarding creatinine metabolism and deamination of amino acids, and dissociation of carbonic acid, were seen in patients with cholestasis during pregnancy.

Calcium-phosphorus-magnesium homeostasis in women with threatened preterm delivery.

OBJECTIVE: The effect of threatened preterm delivery on calcium, phosphorus, magnesium homeostasis in the third trimester of pregnancy was investigated. METHODS: Serum concentrations of total and ionized calcium, inorganic phosphorus, magnesium, total protein, albumin, total estrogens and human placental lactogen were determined in women with threatened preterm delivery at 29-36 weeks of gestation (the studied group) and in women with uncomplicated pregnancy of the same duration (the control group). Additionally, activities of total alkaline phosphatase and heat-stable alkaline phosphatase fraction were measured. RESULTS: Patients of the studied group compared to the control group showed decreased concentration of total calcium (2.17 +/- 0.09 vs. 2.28 +/- 0.13 mmol/l, P < 0.0005), inorganic phosphorus (1.13 /- 0.27 vs. 1.32 +/- 0.23 mmol/l, P < 0.001) and magnesium (0.64 +/- 0.07 vs. 0.70 +/- 0.10 mmol/l, P < 0.003); they also demonstrated decreased activity of total alkaline phosphatase (70.8 +/- 23.2 vs. 81.9 +/- 14.9 IU/l, P < 0.01) and its heat-stable fraction (30.2 +/- 15.6 vs. 59.6 +/- 14.9 IU/l, P < 0.001). In the studied group no difference was found in concentrations of investigated ions and enzymes between women who delivered at term and women who delivered prematurely. Patients with threatened preterm delivery showed serum deficiency of total calcium, phosphorus and magnesium which might be related to premature uterine contractility but does not predict premature labor by week 36 of gestation (66% of patients delivered at term). CONCLUSION: The deficiency of minerals and lowered activity of total alkaline phosphatase is observed in women with threatened preterm delivery. Laboratory tests of calcium-phosphorus-magnesium homeostatsis have limited predictive value in regard to the term of delivery in women with threatened preterm delivery.

Calcium-phosphorus-magnesium homeostasis in pregnant women after renal transplantation.

OBJECTIVE: The aim of the study was the assessment of calcium-phosphorus-magnesium homeostasis in pregnant women after renal transplantation. METHODS: The study covered 64 pregnant women in the third trimester of gestation including: 33 women after renal transplantation (the study group) and 31 healthy pregnant women (the control group). Women from both groups were at the similar age: 30.8+/-4.7 vs. 31.3+/-5.0 years (NS) and at the same gestational age 34.8+/-2.4 vs. 35.3+/-2.6 weeks (NS). The mean body mass index (BMI) in the women from the study group before pregnancy was 21.49+/-2.81 vs. 22.1+/-3.02 in the control group (NS), BMI before delivery was 25.43+/-3.05 vs. 26.0+/-3.35 (NS), the percentage of the BMI increase during pregnancy was 18.7+/-7.68 vs. 17.65+/-7.13 (NS) and BMI increase during gestation was 3.93+/-1.56 vs. 3.90+/-1.54, respectively (NS). Arterial blood pressure at the time of blood samples collection for biochemical tests was 151.4+/-26.8/92.5+/-16.9 in women from the study group comparing to 115.0+/-6.0/68.0+/-7.0 mmHg (P<0.001) in the patients from the control group. The maximal blood pressure during pregnancy was 169.2+/-20.7/102.7+/-14.0 vs. 118.0+/-7.0/70.0+/-8.0 mmHg (P<0.001), respectively. We estimated serum levels of: total Ca, ionized Ca(2+), inorganic phosphorus (P(i)), Mg, total protein, albumin and blood morphology. Moreover, urine levels of Ca, P(i), Mg and protein were assessed. RESULTS: The pregnant women after renal transplantation presented increases in serum concentrations of total Ca (2.54+/-0.20 vs. 2.16+/-0.10 mmol/l; P<0.001) and ionized Ca(2+) (1.322+/-0.104 vs. 1.12+/-0.07 mmol/l; P<0.001) and the decrease in P(i) level (1.013+/-0.211 vs. 1.10+/-0.16 mmol/l; P<0.05), total protein (59.3+/-7.0 vs. 65+/-5 g/l; P<0.001) and albumin (461.6+/-65.65 vs. 493.2+/-59 micromol/l; P<0.05). Moreover, in the study group drop in red blood cells count to 3.71+/-0.56 vs. 4.01+/-0.35 x 10(12)/l (P<0.02) in the control group was detected. Despite increased volume of 24-h urine collection in the kidney recipients we observed significantly decreased urine 24-h calcium excretion 2.47+/-0.92 vs. 6.72+/-3.49 mmol (P<0.001) and simultaneous increase in urine Mg excretion 3.422+/-1.025 vs. 2.18+/-0.52 mmol/24 h (P<0.001). There was no difference in urine 24-h P(i) excretion between the study and the control group. The pregnant renal transplant recipients presented proteinuria of 1.19+/-1.9 g/24 h. CONCLUSIONS: Women after kidney grafting present vital aberrations in calcium-phosphorus-magnesium homeostasis during pregnancy. The most significant changes are associated with calcium metabolism (high increase in serum Ca levels and impairment of renal elimination of calcium). The observed changes may be influenced by the doses of immunosuppressive agents and disturbed renal function.

Second trimester calcium-phosphorus-magnesium homeostasis in women with threatened preterm delivery.

OBJECTIVE: The effect of threatened preterm delivery on calcium, phosphorus, magnesium homeostasis in the second trimester of pregnancy was investigated. METHODS: Serum concentrations of total and ionized calcium, inorganic phosphorus, magnesium, total protein, albumin, total estrogens and human placental lactogen were determined in women with threatened preterm delivery at 23-28 weeks of gestation (the studied group) and in women with uncomplicated pregnancy of the same duration (the control group). Additionally activities of total alkaline phosphatase and heat-stable alkaline phosphatase fraction were measured. RESULTS: Patients of the studied group compared to the control group showed decreased concentration of total calcium (2.15 +/- 0.073 vs. 2.25 +/- 0.11 mmol/l, P < 0.001), inorganic phosphorus (1.21 +/- 0.26 vs. 1.34 +/- 0.22 mmol/l, P < 0.01) and magnesium (0.63 +/- 0.053 vs. 0.71 +/- 0.12 mmol/l, P < 0.001), total protein (64.0 +/- 5.4 vs. 68.6 + 1.0 g/l, P < 0.001), albumin (546.3 +/- 55.1 vs. 579.6 +/- 49.3 micromol/l, P < 0.003) and placental lactogen (3664 +/- 1806 vs. 4651 +/- 1858 ng/ml, P < 0.02); they also demonstrated decreased activity of total alkaline phosphatase (42.17 +/- 16.99 vs. 50.66 +/- 6.56 IU/l, P < 0.001) and its heat stable fraction (22.65 +/- 7.89 vs. 31.89 +/- 9.09 IU/l, P < 0.001). Patients of the studied group showed normal values of ionized calcium and total estrogens. CONCLUSIONS: Premature uterine contractility in women in the second trimester is accompanied by lowered serum concentrations of total calcium, inorganic phosphorus, magnesium, total protein and albumin. There is also decreased activity of total alkaline phosphatase, its heat-stable fraction and placental lactogen which may have diagnostic value. Premature uterine contractility in women in the second trimester may be related to the disturbances of calcium-phosphorus-magnesium homeostasis and calcium supplementation should be considered.

[Carbohydrate metabolism during cholestasis in pregnancy]. / Metabolizm weglowodanów podczas cholestazy ciezarnych.

Blood glucose levels were measured in fasting state and 2 hours after breakfast, together with glucose tolerance tests (after a load of 100 g of glucose) and 24-hour glycaemia profile in pregnant women with intrahepatic cholestasis of pregnancy in the third trimester of pregnancy. In all these tests abnormalities were found indicating a considerable impairment of carbohydrate metabolism during this complication of pregnancy. The changes manifested themselves as increased blood glucose level 2 hours after breakfast, increased glucose level in 24-hour glucose profile, and raised blood glucose levels in glucose tolerance tests in all studied time intervals besides the first and last determinations.

[Clinical condition of the newborns and the type of labor and pregnancy complications in cases of meconium in the amniotic fluid]. / Stan kliniczny noworodków oraz rodzaje porodu i powiklan ciazy w przypadkach obecnosci smólki w plynie owodniowym.

The studied material comprised 36 newborns and their mothers, among them 12 newborns had meconium in the amniotic fluid (study group) and 24 newborns with clear amniotic fluid served as controls. The fluids were studied biochemically. In both compared groups the analysed factors were: 1) week of labour, 2) body weight and length, 3) clinical condition of the newborn by the Apgar score, 4) type of labour, 5) type of pregnancy complications in mothers. The results were subjected to statistical analysis. It was found that meconium presence in the amniotic fluid correlated with the presence of clinical symptoms suggesting intrauterine asphyxia of the fetus, and the number of caesarean sections was greater in this group. A correlation was noted between the presence of meconium in the amniotic fluid and worse clinical condition of the newborn.

[The effect of frequent ejaculation on semen's parameters in men with inadequate fertility]. / Wplyw czestej ejakulacji na parametry nasienia u mezczyzn z obnizona plodnoscia.

The influence of frequent ejaculation on sperm quality in 96 men with oligozoospermia, asthenozoospermia or oligoastenozoospermia was investigated. Ejaculates were produced by each patient in short period of time (4-6 hours). In oligozoospermic group (n = 31) semen characteristics were similar between two ejaculates. In asthenozoospermic group (n = 27) the motility and the total motile sperm count increased significantly in the second ejaculate (32.1% 5.6 vs. 48.0% +/- 7.1 and 36.7 mln +/- 5.6 vs. 47.8 mln +/- 7.6 respectively). Similarly in oligoasthenozoospermic group (n = 38) the motility and the total motile sperm count increased significantly in the second ejaculate (28.1% +/- 5.3 vs. 44.2% +/- 6.2 and 7.1 mln +/- 1.2 vs. 11.3 mln +/- 2.7 respectively). In three groups, pooling two ejaculates increased significantly the total motile sperm count by 58.1%-136.6% comparing to first ejaculate. Pooling two sequential ejaculates from subfertile men is a simple method to increase the quality of sperm for assisted reproduction techniques.

[Evaluation of intrauterine insemination after two different methods of sperm preparation in cases of oligospermia in stimulated cycles]. / Ocena porównawcza skutecznosci inseminacji domacicznej po dwóch róznych technikach przygotowania nasienia, w przypadku umiarkowanej oligozoospermii w cyklach stymulowanych.

Intrauterine insemination (IUI) is a widely accepted method of infertility treatment in case of oligospermia. Sperm requires special preparation to avoid applying of active ingredients and abnormal cells to uterine cavity. In this paper authors compared the efficiency of IUI after swim-up sperm preparation on Menezo B2 medium, with IxaPrep technic sperm preparation. In our material there were no significant differences in received results in relation to sperm preparation method.

[Alpha-amylase in serum and urine of women with hypertension during the III trimester of pregnancy]. / Alfa-amylaza w surowicy krwi i w moczu u kobiet z nadcisnieniem tetniczym krwi w III trymestrze ciazy.

The urinary and blood serum activity of alpha-amylase was tested in 34 women with arterial hypertension in the III trimester of pregnancy (examined group). The results were compared with a control group of healthy women (35 urine samples and 108 blood-serum samples). In both groups other biochemical examinations were carried additionally (the serum creatinine, urea, uric acid, electrolytes and the acid-base balance levels were established). In the examined group an increased activity of the alpha-amylase in the blood serum was demonstrated.

[Homeostasis of calcium-phosphorus-magnesium in women with pregnancy induced hypertension]. / Homeostaza wapniowo-fosforanowo-magnezowa u kobiet z nadcisnieniem tetniczym krwi indukowanym przez ciaze.

Study group consisted of 63 women in the III trimester of pregnancy (gestational age 29-40 weeks). 32 subjects with PIH (investigated group) were compared to control group consisted of 30 healthy patients with uneventful course of gestation. Women with PIH had no proteinuria nor oedema, their mean blood pressure remained at the level of 161 +/- 16.7/98 +/- 12.8 mm Hg. Concentration of calcium, phosphorus and magnesium in serum blood and urine were determined. It was stated that due to renal impairment observed during PIH, calcium urine excretion and calcium concentration in blood serum are decreased while serum inorganic phosphorus levels are increased. No changes in magnesium and ionised calcium homeostasis were seen in the course of PIH.

[Lipid metabolism in women with threatened abortion]. / Metabolizm lipidów u kobiet z poronieniem zagrazajacym.

The study group consisted of 130 subjects: 50 healthy nonpregnant, 35 healthy women in the I trimester of gestation (gestational age 6-15 weeks) and 45 patients with symptoms of threatened abortion (the same gestational age). In the latter group pain and bleeding ceased after hormonal treatment and spasmolytic drugs. Serum blood concentration of following compounds were determined: total lipids, LDL fraction, total cholesterol, phospholipids, triglycerides, HDL and LDL cholesterol fractions. Threatened abortion had changed lipids profile; diminished concentrations of LDL fraction, total cholesterol, LDL cholesterol fraction and phospholipids were observed. Levels of total lipids, phospholipids and triglycerides++ in blood serum of healthy pregnant women in the I trimester of gestation were higher than in nonpregnant women.

[The effect of total estrogens and lactogen hormone on lipid metabolism in women during normal pregnancy]. / Wplyw estrogenów calkowitych i hormonu laktogennego na metabolizm lipidów u kobiet w prawidlowej ciazy.

Lipids parameters and total oestrogen and HPL levels were estimated in blood serum. Investigated group consisted of 45 women with uneventful course of pregnancy. All pregnant women were in the gestational age between 29 and 40 weeks. This is positive correlation increased concentration of total lipids, LDL fraction, phospholipids, triglycerids and raising of total oestrogens. High concentration of total cholesterol, LDL cholesterol fraction and phospholipids were observed at the same time as increased levels of HPL. We suggest that multivariative hormonal changes during uncomplicated course of gestation could be the cause of modificated lipids profile.

[Bile acids in blood serum of women during normal pregnancy, early puerperium and in the neonate]. / Kwasy zólciowe w surowicy krwi kobiet w przebiegu prawidlowej ciazy, u poloznic oraz u noworodków.

Total bile acids in serum blood samples from 325 subjects were estimated. Study group consisted of 50 nonpregnant women, 40-in the I trimester, 50-in the II and 100-in the III trimester of gestation, 55 patients in the third day of puerperium and 30 newborn infants (cord serum). All women were healthy, their age varied between 20 and 36 years. Children were mature, born in good condition (Apgar score > 8 points). Bile acids concentration were determined using enzymatic method with reagent kits by Nycomed Pharme, Norway. In the course of pregnancy continuous increase of investigated compounds was observed. The concentration of bile acids in puerperium was lower than in the III trimester of pregnancy and equal to that determined in cord serum. Authors conclude that during normal, uneventful course of gestation symptomless, benign intrahepatic cholestasis occurs.

[The influence of chosen hormones on lipids and its correlation during normal pregnancy]. / Wplyw niektórych hormonów na lipidy oraz ich korelacja podczas przebiegu prawidlowej ciazy.

OBJECTIVES: Lipids and hormones levels in nonpregnant and pregnant with uneventful gestation (from I, II, III trimester) were estimated and its correlation was evaluated. METHODS: The study group consisted of 219 women: 49 nonpregnant and 170 pregnant women (35 in I trimester, 35 in II and 100 in III trimester of gestation). All subjects were healthy. Following parameters were measured in blood serum: total lipids, LDL total fraction, (beta-lipoproteids), cholesterol both total and free, HDL cholesterol, LDL cholesterol. Percentage of free cholesterol contained on total cholesterol was evaluated. HPL and estrogens levels were estimated. RESULTS: Serum levels of total lipids, phosphlipids, triglicerides, total fraction of LDL and its contains of cholesterol increase with gestational age (p < 0.001). During pregnancy positive correlation between estrogens, HPL and triglycerides was also observed (p < 0.001). Additionally in II trimester positive correlation of total cholesterol, phospholipids and HPL was noted (respectively r = 0.469 p < 0.001 and r = 0.452 p < 0.01). CONCLUSIONS: In case of women with uneventful pregnancy positive correlation between estrogens and total lipids, total fractions LDL and triglycerides was stated. Also positive correlation among lipids parameters and HPL concentration was noted. No correlation between HPL and free cholesterol, LDL, HDL cholesterol nor between estrogens and total cholesterol, free cholesterol and LDL cholesterol was found. Lipids status in case of nonpregnant women is multihormonaly influenced.