Association Between Overactive Bladder and Polyneuropathy in Diabetic Patients / 대한배뇨장애요실금학회지

PURPOSE: Diabetes mellitus (DM) is a chronic metabolic disorder that often leads to complications. We aimed to correlate two complications of DM, polyneuropathy and hyperactive bladder syndrome, using noninvasive measures, such as screening tests. METHODS: We included 80 female and 40 male type 2 diabetic patients in this prospective study. Diabetic polyneuropathy evaluations were conducted using the Douleur Neuropathique 4 Questions (DN4), and overactive bladder (OAB) evaluations were performed using the Overactive Bladder Questionnaire (OAB-V8). The patients were also evaluated for retinopathy and nephropathy. The diabetic male and female patients with or without OAB were chosen and compared for microvascular complications (polyneuropathy, retinopathy, and nephropathy). RESULTS: There were no significant correlations between OAB and retinopathy as well as between OAB and nephropathy among diabetic patients (female patients, P>0.05; male patients, P>0.05). However, the patients with OAB were significantly more likely to develop polyneuropathy (female patients, P<0.05; male patients, P<0.05). CONCLUSIONS: In diabetic patients, OAB and diabetic peripheral neuropathy are significantly correlated. These correlations were demonstrated using short, understandable, valid, and reliable disease-specific tests without invasive measures. Using these screening tests, both neurologists and urologists can easily diagnose these complications.

Postmenopausal Osteoporosis Is Associated with Serum Chemerin and Irisin but Not with Apolipoprotein M Levels

OBJECTIVES: The objective of this study was to describe the levels of chemerin, irisin and apolipoprotein M (apoM) in women with postmenopausal osteoporosis. METHODS: The study included 88 women with postmenopausal osteoporosis. Based on World Health Organization criteria, women with a T-score of ≤–2.5 were defined as osteoporotic. In this case-control study, postmenopausal women with T-score >–1 were selected as controls (n = 88) and case-matched in a 1:1 ratio based on age (within 2 years) and body mass index (BMI) (within 1.0 kg/m2). ApoM, irisin and chemerin levels were determined by a commercially available enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: There were no significant differences in age, BMI, parity, cholesterol and apoM levels between the two groups. C-reactive protein levels were significantly increased in women with osteoporosis. Serum chemerin levels (240.1 ± 46.1 vs. 261.5 ± 50.8 ng/mL) were significantly lower in the women with osteoporosis, as compared to the controls (P = 0.004). Serum irisin levels were also decreased in women with osteoporosis (0.7 ± 0.2 vs. 0.8 ± 0.2 ng/mL; P = 0.007). CONCLUSION: In the present study, osteoporosis was associated with decreased levels of circulating chemerin and irisin. These findings suggested that adipokines might play a role in the pathogenesis of osteoporosis.

Evaluation of Bone Density Measurement in Type 2 Diabetic Postmenopausal Women with Hypertension and Hyperlipidemia

OBJECTIVES: The aim of the study was to compare bone mineral density (BMD) in healthy postmenopausal women to BMD in type 2 diabetic hypertensive postmenopausal women with hyperlipidemia. METHODS: Fifty type 2 diabetic and hypertensive postmenopausal women with hyperlipidemia and 51 age and body mass index (BMI) matched healthy postmenopausal women were included. Lumbar spine and femoral neck BMD were noted in both groups. BMD was measured using dual energy X-ray absorptiometry (DXA). Serum alkaline phosphatase (ALP), calcium and phosphorous were also measured. Pearson correlation coefficients were used to establish the relationship between various clinical characteristics. RESULTS: There were no significant differences between two groups in respect to lumbar and vertebral BMD values, age, BMI, gravidity, parity. Serum cholesterol and fasting glucose levels were significantly different between each groups (P = 0.0001, P = 0.002). CONCLUSION: We found that, accompanying chronic diseases such as diabetes, hypertension and hyperlipidemia don't affect the BMD measurements at postmenopausal period. So these postmenopausal women don't have excess risk regarding osteoporosis.

Factors Associated with Mammographic Density in Postmenopausal Women

OBJECTIVES: Breast density increases the risk of breast cancer, but also in the interpretation of mammography is also important. This study examine the risk factors affecting breast density in postmenopausal women. METHODS: Between January 2013 and January 2014, 215 patients admitted to The Clinics of Gynecology and Obstetrics with complaints of menopause were taken. According to the results of mammography, Group I (non-dense, n = 175) and Group II (dense, n = 40) were created. The informations of the caseswere analyzed retrospectively. RESULTS: In Group I, body mass index (BMI), number of pregnancies, parity were significantly higher than group II (P < 0.05). In group II, the withdrawal period of menstruation and progesterone levels were significantly higher (P < 0.05). In logistic regression analysis, BMI for dense breasts and number of pregnancies were found to be an independent risk factor (P < 0.05). CONCLUSION: Increased BMI, pregnancy and parity, result of reduction in density , but longer duration of menopause and increased progesterone cause an increase in density. BMI and the number of pregnancy was found to be independent risk factors for reducing breast density.

Recurrent pregnancy loss and association with anti phospho lipid syndrome

Recurrent miscarriage, the occurrence of three consecutive first-trimester losses of pregnancy, affects 1-3% of pregnant women. The purported causes of recurrent miscarriage include chromosomal abnormalities, thrombophilia, metabolic disorders, anatomical and immunological disturbances. At present, the only recommended investigations are testing for lupus anticoagulant and anticardiolipin antibody levels to diagnose the antiphospholipid syndrome, an acquired thrombophilia and the karyotyping of both parents for chromosomal abnormalities. The Antiphospholipid Syndrome [APS] is an autoimmune disorder characterized by thrombosis, recurrent loss of pregnancy combined with laboratory tests that indicate the presence of antibodies against phospholipid binding proteins. Clinically relevant antiphospholipid antibodies are mainly anticardiolipin antibodies detected by enzyme linked immuno sorbent assay [ELISA] and lupus anticoagulants demonstrated by in vitro coagulation assay. Women with antiphospholipid syndrome should be offered treatment with aspirin and low subcutaneous heparin. We aimed to summarize current concepts on diagnosis and treatment in recurrent loss of pregnancies and APS