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1.
J Obstet Gynaecol Can ; 46(3): 102255, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37914028

RESUMO

OBJECTIVES: To estimate C-reactive protein (CRP) levels in Saudi women with and without polycystic ovary syndrome (PCOS), and to investigate the associations between CRP and metabolic syndrome (MetS) components. METHODS: We randomly recruited 200 women with and without PCOS, between 18 and 38 years, in this age-matched case-control study. Study subjects were allocated to 1 of 4 groups according to the presence or absence of MetS. Interviews were conducted with all participants, and anthropometric measurements and blood samples were obtained for subsequent analysis of biochemical variables. RESULTS: Two-thirds of the study population and all study subjects had central obesity. Fasting insulin and homeostasis model assessment insulin resistance index were significantly higher in PCOS and MetS groups than all other groups (P < 0.05). CRP levels were significantly higher among women with PCOS than their age-matched controls, regardless of the presence of MetS (P < 0.05). Body mass index was the only independent predictor of serum high-sensitivity-CRP, accounting for 17% of the variability in circulating levels (ß = 0.407; 95% CI 0.248-0.472, P < 0.0001). CONCLUSIONS: Obesity and insulin resistance are important risk factors for MetS in PCOS. The presence of MetS in PCOS subjects aggravates the proinflammatory state reflected by CRP levels.


Assuntos
Resistência à Insulina , Síndrome Metabólica , Síndrome do Ovário Policístico , Humanos , Feminino , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/epidemiologia , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Obesidade/complicações , Índice de Massa Corporal
2.
J Obstet Gynaecol Res ; 47(4): 1409-1415, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33522094

RESUMO

OBJECTIVE: To evaluate the relationship between plasma levels of the inflammatory markers tumor necrosis factor-alpha (TNF-α), C reactive protein (CRP), and interlukin-6 (IL-6) with insulin resistance in Saudi women with polycystic ovaries syndrome (PCOS). METHODS: One hundred eighty Saudi women with and without PCOS, aged 22-38 years, were randomly recruited in this age and body mass index matched case-control study. Clinical assessment, anthropometric measurements, and biochemical parameters were determined for all study participants. RESULTS: Levels of TNF-α, IL-6, hs-CRP, insulin, and insulin resistance indices were significantly higher among PCOS group than their age and BMI matched controls (p < 0.05). Results showed that only QUICK-I (ß = -0.247, p < 0.0001, 95% CI: -3.009 to -0.977) independently predicted TNF-α levels after adjustment for potential confounders. CONCLUSIONS: Elevated plasma levels of TNF- α and IL-6 among PCOS women reflects a state of chronic inflammation with potential implication for insulin resistance, independent of obesity.


Assuntos
Resistência à Insulina , Síndrome do Ovário Policístico , Adulto , Biomarcadores , Índice de Massa Corporal , Proteína C-Reativa/análise , Estudos de Casos e Controles , Feminino , Humanos , Insulina
3.
J Obstet Gynaecol ; 40(8): 1133-1137, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32157932

RESUMO

Our aim was to investigate the relationship between plasma interleukin-6 (IL-6) levels with different measures of central obesity among Saudi women with and without polycystic ovarian syndrome (PCOS). One hundred and sixty-four Saudi females, between 22 and 38 years of age, with and without PCOS were enrolled in this case-control study. Physical examination and laboratory tests were completed for every subject. 2/3 of the study population were obese. Fasting serum insulin, plasma IL-6 levels and insulin resistance show significant increase among POCS than the controls (p<.05). Based on linear regression analysis, C-reactive protein (hs-CRP) was the only independent predictor of plasma IL-6 levels, accounting for 4% of the variability in plasma IL-6 (ß = 0.217, p=.005, 95% CI: 0.049-0.275). Coexistence of metabolic and inflammatory factors in PCOS females is accompanied by central obesity which overpowers the effect of insulin resistance, contributing to higher plasma levels of IL-6 and CRP.Impact statementWhat is already known on this subject? Polycystic ovary syndrome (PCOS) is a cluster of many cardiovascular risk factors, but is also known as an inflammatory condition. Insulin resistance and abdominal obesity are classic components of PCOS. High circulatory levels of inflammatory markers in PCOS patients have been reported but it remains unclear whether their elevation is related to PCOS itself, or are a function of abdominal adiposity.What the results of this study add? The relationship between plasma interleukin-6 levels and different measures of central obesity was investigated among Saudi women with and without PCOS. Elevations of proinflammatory cytokines and inflammatory markers were reported in PCOS patients independently of insulin resistance. It remains to be established whether the proinflammatory state in PCOS is primarily due to inflamed adipose tissue.What the implications are of these findings for clinical practice and/or further research? The present study demonstrates that coexistence of metabolic and inflammatory factors in PCOS females are accompanied by central obesity which overpowers the effect of insulin resistance, contributing to higher plasma levels of IL-6 and CRP. Future studies including a larger population are needed to investigate the mechanisms by which IL-6 and hs-CRP promote cardiovascular risk in PCOS patients.


Assuntos
Interleucina-6/sangue , Obesidade Abdominal/sangue , Síndrome do Ovário Policístico/sangue , Adulto , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Feminino , Humanos , Resistência à Insulina , Modelos Lineares , Obesidade Abdominal/complicações , Síndrome do Ovário Policístico/complicações , Fatores de Risco , Arábia Saudita , Adulto Jovem
4.
J Obstet Gynaecol Res ; 43(2): 330-338, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27987337

RESUMO

AIM: Uterine leiomyomas (UL) are smooth muscular nodes, whose growth is dependant up on the complex interplay of hormones with genes and uterine physiology. Global statistics indicate the role of ethnic and racial background as contributory factors for UL development. Owing to the lack of data, this study aimed to examine the association between genetic polymorphisms and susceptibility of Arab women of developing UL. METHODS: We genotyped 105 UL patients and 112 healthy controls for five genetic polymorphisms through real time PCR method. The strength of the association between genotype and allele frequencies with risk of developing UL was tested with their χ2 and odds ratio (OR) values. The synergistic cooperation between genetic polymorphisms was estimated through multifactor dimensionality reduction assay. RESULTS: We found that Saudi women with the AG genotype for the rs12484776 polymorphism are at a 2.6-fold higher risk of developing UL compared to those with other genotypes (OR, 2.69; 95% confidence interval [CI]: 1.45-5.00; P < 0.001). This significance persisted even under co-dominant models (i.e., AA vs GG + AG [OR, 2.74; 95%CI: 1.48-5.08; P = 0.001; and AG vs GG + AG [OR, 2.41; 95% CI: 1.33-4.39; P = 0.003). Genotype distribution frequencies for rs1056836, rs7913069, rs2280543, and rs4247357 were not shown to elevate the disease risk (for all tests P > 0.05). CONCLUSION: The rs12484776 significantly contributes to UL risk among Saudi women, both in single and also in synergistic cooperation with rs2280543, rs7913069, and rs1056836 markers. Our results have yielded mixed findings in replicating European- and Japanese-specific UL genetic susceptibility loci among a geographically and culturally distinct population of the Saudi Arabian Peninsula.


Assuntos
Estudo de Associação Genômica Ampla , Leiomioma/genética , Proteínas de Ligação a RNA/genética , Neoplasias Uterinas/genética , Adulto , Feminino , Loci Gênicos , Predisposição Genética para Doença , Humanos , Pessoa de Meia-Idade , Arábia Saudita
5.
Am J Obstet Gynecol ; 210(1): 56.e1-6, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23999422

RESUMO

OBJECTIVE: The objective of the study was to compare the efficacy and safety of hourly titrated oral misoprostol with vaginal dinoprostone insert. STUDY DESIGN: Subjects were randomized into hourly titrated oral misoprostol or dinoprostone 10 mg vaginal insert. Misoprostol was given as 20 µg hourly for 2 doses. In the absence of regular uterine contractions, the dose was increased to 30 µg hourly for 3 doses and then 40 µg for 1 dose, 50 µg for 1 dose, and 60 µg hourly for 4 doses. Before the 40 and 50 µg doses, 1 more hour of observation was given. The primary outcome variable was vaginal delivery within 24 hours. Safety assessments included the incidence of maternal morbidity and adverse neonatal outcomes. RESULTS: A total of 160 women was enrolled in the study. The groups were similar for demographic and clinical factors. Vaginal delivery was achieved within 24 hours in 100 women (62.5%): 44 in the dinoprostone group (55.0%) and 56 in the misoprostol group (70.0%) (P = .05). The proportion of women who achieved vaginal delivery within 24 hours was significantly greater for nulliparous women in the misoprostol group (24 of 51, 58.5%) compared with the dinoprostone group (12 of 36, 33.3%; P = .0270). Significantly more women with baseline Bishop score of 3 or less in the misoprostol group had successful induction (43 of 59, 72.9%) compared with the dinoprostone group (27 of 60, 45.0%; P = .002). Frequencies of maternal adverse events were similar between groups. CONCLUSION: Hourly titrated oral misoprostol can provide an efficacious and safe substitute for the expensive dinoprostone vaginal insert.


Assuntos
Dinoprostona/administração & dosagem , Trabalho de Parto Induzido/métodos , Misoprostol/administração & dosagem , Ocitócicos/administração & dosagem , Contração Uterina/efeitos dos fármacos , Administração Intravaginal , Administração Oral , Adulto , Parto Obstétrico , Dinoprostona/efeitos adversos , Feminino , Humanos , Trabalho de Parto Induzido/efeitos adversos , Misoprostol/efeitos adversos , Ocitócicos/efeitos adversos , Gravidez , Arábia Saudita , Adulto Jovem
6.
Can J Anaesth ; 58(12): 1083-9, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21971743

RESUMO

BACKGROUND: Patient position after spinal anesthesia has had variable effects on blood pressure and ephedrine requirements. The aim of this study was to determine the effects that sitting the patient up for five minutes after spinal anesthesia would have on intraoperative fluid and ephedrine requirements. METHODS: The study included 120 women at term gestation who were scheduled for Cesarean delivery under spinal anesthesia. After anesthetic administration, the women were randomized either to sit up for five minutes then lie down (Group S) or to lie down immediately (Group L) to a tilted supine position. A blinded observer recorded sensory block level, systolic blood pressure, heart rate, ephedrine and fluid requirements, adverse events, and time to motor recovery (modified Bromage score of 2). RESULTS: Group S had a lower intraoperative sensory block height than Group L [T4 (1) vs T2 (1), respectively; P < 0.001]; Group S also required less ephedrine (8% vs 47%, respectively; P < 0.001), received less fluid [709 (59) mL vs 789 (90) mL, respectively; P < 0.001], and experienced less nausea and vomiting (5% vs 22%, respectively; P = 0.014) and shortness of breath (3% vs 28%, respectively; P < 0.001) intraoperatively. In Group S, the odds of requiring ephedrine were 0.09 compared with 0.89 in Group L (odds ratio 0.10). There were no differences in systolic blood pressure (P = 0.127) or heart rate (P = 0.831) over time between groups. Time to a modified Bromage score of 2 was longer in Group S than in Group L [101 (15) min vs 88 (14) min, respectively; P < 0.001]. CONCLUSIONS: Sitting the patient up for five minutes rather than laying the patient down immediately after spinal anesthesia for Cesarean delivery decreased intraoperative sensory block height, ephedrine and fluid requirements, and intraoperative nausea, vomiting, and shortness of breath without affecting systolic blood pressure or the success of the anesthetic. However, the method resulted in delayed postoperative motor recovery.


Assuntos
Anestesia Obstétrica/métodos , Raquianestesia/métodos , Cesárea/métodos , Postura , Adulto , Anestesia Obstétrica/efeitos adversos , Raquianestesia/efeitos adversos , Pressão Sanguínea , Efedrina/administração & dosagem , Feminino , Hidratação/métodos , Frequência Cardíaca , Humanos , Cuidados Intraoperatórios/métodos , Gravidez , Estudos Prospectivos , Método Simples-Cego , Decúbito Dorsal , Simpatomiméticos/administração & dosagem , Fatores de Tempo
7.
Front Genet ; 9: 552, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30619444

RESUMO

MED12, a subunit of mediator complex genes is known to harbor genetic mutations, (mostly in exon 2), causal to the genesis of uterine leiomyomas among Caucasian, African American, and Asian women. However, the precise relationship between genetic mutations vs. protein or disease phenotype is not well-explained. Therefore, we sought to replicate the MED12 mutation frequency in leiomyomas of Saudi Arabian women, who represents ethnically and culturally distinct population. We performed molecular screening of MED12 gene (in 308 chromosomes belonging to 154 uterine biopsies), analyzed the genotype-disease phenotype correlations and determined the biophysical characteristics of mutated protein through diverse computational approaches. We discovered that >44% (34/77) leiomyomas of Arab women carry a spectrum of MED12 mutations (30 missense, 1 splice site, and 3 indels). In addition to known codon 44, we observed novel somatic mutations in codons 36, 38, and 55. Most genetically mutated tumors (27/30; 90%) demonstrated only one type of genetic change, highlighting that even single allele change in MED12 can have profound impact in transforming the normal uterine myometrium to leiomyomas. An interesting inverse correlation between tumor size and LH is observed when tumor is positive to MED12 mutation (p < 0.05). Our computational investigations suggest that amino acid substitution mutations in exon-2 region of MED12 might contribute to potential alterations in phenotype as well as the stability of MED12 protein. Our study, being the first one from Arab world, confirms the previous findings that somatic MED12 mutations are critical to development and progression of uterine leiomyomas irrespective of the ethnic background. We recommend that mutation screening, particularly codon 44 of MED12 can assist in molecular diagnostics of uterine leiomyomas in majority of the patients.

8.
Obstet Gynecol ; 120(1): 98-103, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22914397

RESUMO

OBJECTIVE: To assess the routine practice of defibulation during vaginal delivery for women who have undergone female genital mutilation or cutting. MATERIALS AND METHODS: A case-control study was conducted on women from Sudan, Somalia, Ethiopia, Egypt, and Yemen who delivered at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from January 1, 2000, to November 30, 2011. Women who had defibulation were identified, and their records were examined. For each woman who had defibulation, a woman from the same nationality who delivered without defibulation on the same day or the next days was chosen as a control. Data collected included demographics, mode of delivery, blood loss, intraoperative and postoperative complications, and labor outcome. RESULTS: During the study period, 388 women underwent defibulation during vaginal delivery. Women who did not have defibulation were chosen as a control group (n=388). In the defibulation group, 300 (77.3%) women were registered during pregnancy; 88 (22.7%) women were unregistered. Defibulation during vaginal delivery was successfully performed by residents and senior residents under the care of the attending on call. No cesarean delivery was performed because of female genital mutilation or cutting, and no spontaneous rupture of the scar occurred. There were no statistically significant differences between women who had defibulation with those who did not or between infibulated registered and unregistered women in the duration of labor, episiotomy rates, blood loss, Apgar score, or fetal birth weight. CONCLUSION: Defibulation during vaginal delivery is a valid management option. Labor attendants should be trained to perform it.


Assuntos
Circuncisão Feminina/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Egito , Etiópia , Feminino , Procedimentos Cirúrgicos em Ginecologia/estatística & dados numéricos , Humanos , Complicações do Trabalho de Parto/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Gravidez , Arábia Saudita , Somália , Sudão , Iêmen
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