The novel predictor of metabolic risk in patients with polycystic ovary syndrome: could it be the visceral adiposity index?

OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder in women of reproductive age, often accompanied by high androgen levels, irregular menstrual cycles and polycystic ovaries. In addition, patients with PCOS also present with an increase in abdominal adipose tissue and insulin resistance. Recently, the gender-specific mathematical formulation called visceral adiposity index (VAI) has been widely used in assessing cardiometabolic risk. This study aimed at comparing the VAI values of patients with PCOS, patients with idiopathic hirsutism (IH) and a control group. PATIENTS AND METHODS: We obtained demographic data, laboratory results and anthropometric measurements of patients from the hospital database. We retrospectively grouped all cases included in the study as PCOS (n = 52), IH (n = 57) and control (n = 58) according to the diagnoses. We also took venous samples for hormone and biochemical tests in the early follicular phase of the menstrual cycle, at least 8-10 hours after fasting in the early morning hours. Finally, we evaluated the variables using SPSS 22.0 software (IBM Corp., Armonk, NY, USA). RESULTS: We included 167 female individuals in the study. Of these, 57 (34.1%) were diagnosed with IH, while 52 (31.1%) were diagnosed with PCOS. The control group comprised 58 (34.8%) healthy female individuals. The median age of the study group was 25 years [interquartile range (IQR) = 8 years]. The age, height, weight, body mass index (BMI) and waist circumference values of the groups were similar. We found that the VAI values among the groups were significantly different (p = 0.028). Post-hoc analysis determined that this was due to the difference between the group with PCOS and the control group. In addition, we found significantly high HOMA-IR, fasting insulin and androgen levels in the group with PCOS (p < 0.001). CONCLUSIONS: After comparing data in groups with similar BMI levels, we found significantly high VAI values in patients with PCOS. The results reinforce the idea that VAI is a useful marker easily obtained in daily practice for assessing the cardiometabolic risk of patients with PCOS.

Do SGLT2 inhibitors prevent preclinical diabetic retinopathy? A Prospective Pilot Optical Coherence Tomography Angiography Study.

PURPOSE: To evaluate the effects of metformin alone and combined treatment with metformin and an SGLT2 inhibitor on retinal microvascular morphology using optical coherence tomography angiography (OCTA) in isolated type 2 diabetes mellitus (DM) patients with HbA1c above the expected target (>7%). METHODS: Fifty patients with isolated DM, 7%

Tear Film and Ocular Surface Evaluation in Gestational Diabetes Mellitus.

BACKGROUND: Dry eye syndrome is one of the complaints of diabetic patients. The aim of the present study was to evaluate the tear functions in pregnant women with gestational diabetes mellitus (GDM) using tests: Schirmer, tear break-up time (TBUT), and tear film osmolarity (TFO) tests and the Ocular Surface Disease Index score (OSDI). METHODS: Pregnant women with GDM (Group 1, n=46) and healthy pregnant women (Group 2, n=36) were enrolled. Initially, all participants were asked to answer the OSDI and then they underwent a detailed ophthalmic examination including Schirmer, TBUT, and TFO tests. The individuals with ocular or systemic disorders that might affect the tear function tests and who were using topical medications were excluded. RESULTS: The results of Schirmer, TBUT, TFO tests and OSDI scores were 11.20±4.93 mm, 5.59±2.16 sec, 309.65±14.80 mOsm/L, and 9.59 ± 9.69 in Group 1, respectively, and 12.33±5.33 mm, 5.67±2.68 sec, 308.36±16.00 mOsm/L, and 10.62±8.66 in Group 2, respectively. There was no significant difference in any of the tear function tests and OSDI scores between the study groups (p>0.05). CONCLUSION: GDM seems to have no negative effects on tear function tests. This may be due to a lack of duration of hyperglycemia long enough to affect the tear function tests of pregnant women.

Evaluation of prehypertension and masked hypertension rate among clinically normotensive patients.

BACKGROUND: The present cross-sectional study was aimed to identify pre-hypertension and masked hypertension rate in clinically normotensive adults in relation to socio-demographic, clinical and laboratory parameters. METHODS: A total of 161 clinically normotensive adults with office blood pressure (OBP) <140/90 mmHg without medication were included in this single-center cross-sectional study. OBP, home BP (HBP) recordings and ambulatory BP monitoring (ABPM) were used to identify rates of true normotensives, true pre-hypertensives and masked hypertensives. Data on sociodemographic and clinical characteristics were collected in each subject and evaluated with respect to true normotensive vs. pre-hypertensive patients with masked hypertension or true pre-hypertensive. Target organ damage (TOD) was evaluated in masked hypertensives based on laboratory investigation. RESULTS: Masked hypertension was identified in 8.7% of clinically normotensives. Alcohol consumption was significantly more common in masked hypertension than in true pre-hypertension (28.6 vs. 0.0%, p = 0.020) with risk ratio of 2.7 (95% CI 1.7-4.4). Patients with true pre-hypertension and masked hypertension had significantly higher values for body mass index, waist circumference, systolic and diastolic OBP and HBP (p < 0.05 for each) compared to true normotensive subjects. ABPM revealed significantly higher values for day-time and night-time systolic and diastolic BP (p = 0.002 for night-time diastolic BP, p < 0.001 for others) in masked hypertension than true pre-hypertension. CONCLUSIONS: Given that the associations of pre-hypertension with TOD might be attributable to the high prevalence of insidious presentation of masked hypertension among pre-hypertensive individuals, ABPM seems helpful in early identification and management of masked hypertension in the pre-hypertensive population.