Maternal and fetal indicators of oxidative stress during Pregnancy-Induced Hypertension (PIH).

The present study demonstrates the possibility of increased lipid peroxidation and protein oxidation in both maternal and fetal erythrocytes as markers of oxygen radical activity during pregnancy induced hypertension (PIH). The erythrocyte malondialdehyde (MDA) levels were significantly elevated in mothers with PIH when compared to controls (p<0.001). The endogenous protein damage due to oxidative stress was significantly higher in mothers with PIH when compared to controls (p<0.01). Similarly the proteolytic activity in erythrocyte lysates against oxidatively damaged hemoglobin was significantly increased in mothers with PIH compared to controls (p<0.001). In babies born to mothers with PIH, erythrocyte MDA levels were significantly elevated in comparison those of normal newborns (p<0.01). Both the endogenous oxidative protein damage and erythrocyte proteolytic activity were significantly higher in newborns born to mothers with PIH than in newborns in the control group (p<0.01). The results of this study indicate that oxidative stress is induced both in mothers with PIH as well as their babies which is manifested as increased lipid peroxidation and protein oxidant damage.

Metformin - A convenient alternative to insulin for Indian women with diabetes in pregnancy.

Objective : To compare the use of metformin with that of insulin for the treatment of gestational diabetes mellitus (GDM) and type 2 diabetes mellitus (T2DM) unresponsive to diet therapy. Materials and Methods : In this prospective observational study, maternal glycemic control and perinatal outcome in diabetic pregnancies were compared between 2 obstetric units, one using insulin therapy and the other using metformin therapy. Baseline pretreatment glycemic profile was done and then repeated weekly throughout pregnancy. The outcome measures studied were glycemic control, maternal complications and perinatal outcome. Results :Sixty women with gestational and type 2 diabetes were enrolled, 30 each for metformin and insulin. Both groups were comparable with respect to age, body mass index (BMI), parity and pretreatment plasma glucose levels. Glycemic control was better with metformin after 1 week of therapy and also throughout gestation (P = 0.03-0.007). There were no major complications or perinatal deaths in this study. Mean gestational age and birth weight (2.9 ± 0.4 kg versus 3.1 ± 0.4 kg, P = 0.30) were comparable. However, there was a significant increase in neonatal intensive care unit (NICU) admission and stay for babies born in the insulin group. The cost of treatment was tenfold higher in thethe insulin group. Conclusion :Metformin is clinically effective, cheap and a safe alternative to insulin therapy in pregnant diabetic women.

Antioxidants and lipid peroxidation in gestational diabetes--a preliminary study.

Increased free radical activity in gestational diabetes (GDM) can lead to a host of damaging and degenerative maternal and fetal complications. Hence antioxidant levels in blood of GDM mothers and cord blood were estimated. Erythrocyte glutathione (GSH), superoxide dismutase (SOD) and thiobarbituric acid reactive substances (TBARS), plasma vitamins C and E and serum total glutathione-S-transferase (GST), protein thiols and ceruloplasmin (Cp) were estimated spectrophotometrically in maternal blood of age matched controls and mothers with GDM and also in cord blood samples of the above. There was a significant increase in the erythrocytic GSH, serum total GST and protein thiols in GDM maternal blood when compared to controls whereas erythrocytic SOD exhibited a marked decrease in GDM cases. The changes in plasma vitamins C and E, Cp and erythrocytic TBARS in GDM were not significantly different from controls. Cord blood levels of protein thiols were also significantly increased in GDM. No significant changes were observed in the serum Cp and GST levels of the same. Hence, elevated glucose levels can induce oxidative stress in GDM mothers.

Association of obesity and insulin resistance with dyslipidemia in Indian women with polycystic ovarian syndrome.

BACKGROUND: Dyslipidemia, diabetes and obesity are all potent cardiovascular risk factors that tend to cluster in women with polycystic ovary syndrome (PCOS). Metabolic disorders in patients with PCOS cannot be explained solely by the presence of obesity. OBJECTIVE: To study the correlation between insulin resistance and serum lipid profile in Indian women with PCOS. SETTING: Gynecology clinic of a tertiary care hospital. MATERIALS AND METHODS: In this prospective study done from April 2004 to December 2004, 65 women with PCOS had their body mass index (BMI) and waist hip ratio calculated. Fasting glucose, insulin and lipid profiles were also estimated in each case. Insulin resistance was defined by fasting glucose-to-insulin ratio <or=4.5. The association of obesity markers and insulin resistance with lipid parameters was then studied. Statistical analysis using student 't' and Mann Whitney U tests was done as indicated. RESULTS: Insulin resistance was seen in 50 of the 65 PCOS women. There was no correlation seen between markers of obesity such as BMI and waist/hip ratio with various lipid parameters. But in PCOS women with insulin resistance, the lipid profile was significantly different [high triglycerides, total cholesterol and lower high-density lipoprotein (HDL)] compared to insulin-sensitive women. The difference between the two groups for total cholesterol (P = 0.002), triglycerides (P =or<0.001) and HDL (P <or=0.001) was statistically significant but that for low-density lipoprotein (LDL) (P <or=0.07) was not statistically significant. CONCLUSION: Insulin resistance is associated with dyslipidemia in women with PCOS, independent of obesity.