High prevalence of early (1st trimester) gestational diabetes mellitus in Polish women is accompanied by marked insulin resistance - comparison to PCOS model.

INTRODUCTION: Both pregnancy and polycystic ovary syndrome (PCOS) constitute insulin-resistant states that are associated with an increased prevalence of glucose intolerance. Some women demonstrate significant insulin resistance (IR) and develop gestational diabetes (GDM) even in the 1st trimester. We compared surrogate IR indices in 1st-trimester pregnant women and in women with PCOS (Rotterdam consensus criteria). MATERIAL AND METHODS: We performed a 75-g oral glucose tolerance test (OGTT) with insulin measurements in 106 healthy 1st-trimester pregnant women at 9.9 ± 2.6 weeks of gestation and in 418 women with PCOS. We assessed IR (HOMA-IR, QUICKI, Matsuda, Belfiore, and Stumvoll indices) as well as the prevalence of GDM according to the International Association of Diabetes and Pregnancy Study Groups (IADSPG) and World Health Organization (WHO) (1999) criteria. RESULTS: Despite having a slightly lower BMI (p = 0.027), pregnant women had either similar (QUICKI, Belfiore index, Stumvoll0-120 min) or greater IR than women with PCOS (e.g. HOMA-IR 3.85 ± 6.11 vs. 2.64 ± 2.04, p = 0.002), while only the Matsuda index demonstrated less IR in pregnant women (p = 0.003). The correlation between IR indices in pregnant women showed marked variability, ranging from r = 0.334 (HOMA-IR vs. Belfiore index) to r = -1.0 (HOMA-IR vs. QUICKI, p < 0.001). This was accompanied by a high prevalence of GDM (14.2% and 9.4%, IADPSG and WHO criteria, respectively). Women with GDM diagnosed according to IADPSG criteria demonstrated greater IR than pregnant women without GDM. In women with GDM diagnosed according to WHO (1999) criteria these differences were visible only for OGTT-derived IR indices (Belfiore, Matsuda, and Stumvoll0-120 index). CONCLUSIONS: Depending on the choice of IR indices, healthy 1st-trimester pregnant women demonstrate either similar or greater IR than women with PCOS, and this is accompanied by a high prevalence of early GDM. It remains to be established whether GDM screening should be performed in the 1st trimester.

[Evaluation of the usefulness of endoglin level as a predictor of preeclampsia in pregnant women with hypertension]. / Ocena przydatnosci stzenia rozpuszczalnej endoglny jako czynnika predykcyjnego wystapienia stanu przedrzucawkowego u ciezarnych z nadcisnieniem tetniczym.

INTRODUCTION: Preeclampsia is a pregnancy-specific syndrome that occurs after the 20 weeks of pregnancy and is characterized by hypertension and proteinuria. It complicates approximately 5-6% of all pregnancies and is a major factor in fetal and neonatal mortality OBJECTIVES: The aim of this study was to evaluate serum concentration of soluble endoglin (sEng) as the predictor of preeclampsia in pregnant women with hypertension. MATERIAL AND METHODS: The study was conducted at the Department of Pathology of Pregnancy (Department of Gynecology and Obstetrics, Medical University of Lodz), and the clinical ambulatory of the WSSz--M. Madurowicz (at present, WSSz--M. Pirogow) in Lodz, between 2008-2012. The Committee of Bioethics, Medical University of Lodz approved of the research (RNN/106/08/KE, May 20, 2008). The study included 86 pregnant women, between 25 and 40 weeks of pregnancy The subjects were divided into 3 groups: - Group HA--33 pregnant women with hypertension arterialis (> 140/90 mmHg) without proteinuria, --Group P--21 pregnant women with hypertension arterialis (>140/90 mmHg) with proteinuria, --Group K--32 pregnant women with normal blood pressure (< 140/90 mmHg) without proteinuria. Markings were determined with the ELISA method, using Quantikine kit. RESULTS: A significantly higher value of endoglin levels were found in pregnant women with preeclampsia syndrome (P) than in women with hypertension (HA) and the control group (K). Levels of endoglin in the P group was 29.70 pg/ml, 19.54 pg/ml in the HA group and 12.99 pg/ml in the K group. CONCLUSIONS: Elevated serum concentration of soluble endoglin (SENG) in pregnant women constitutes a risk factor for preeclampsia.