Serum chemerin levels in Polycystic Ovary Syndrome after metformin therapy.

OBJECTIVES: The aim of this study was to study the effects of metformin therapy on serum chemerin levels in some phenotypes of polycystic ovarian syndrome cases, and to correlate chemerin levels with insulin resistance parameters and with hormonal profile. MATERIAL AND METHODS: This study was carried on 100 polycystic ovary cases and 70 control women. These cases were further subdivided into obese and normal weight cases. Fasting serum chemerin was measured by Enzyme-Linked Immunosorbent Assay method. Data were analyzed using SPSS for Windows 7. RESULTS: Before metformin therapy, the serum chemerin were significantly increased in PCOS cases as compared with the control cases. Also, a significantly higher chemerin levels were found in obese polycystic ovarian syndrome cases as compared with normal weight cases with polycystic ovarian syndrome. The serum chemerin levels were significantly positively correlated with glucose levels, insulin levels, and HOMA-IR in polycystic ovarian syndrome cases. After three months of metformin therapy, the serum chemerin, insulin, and HOMA-IR concentrations were significantly decreased in polycystic ovarian syndrome cases as compared with the levels before therapy. CONCLUSION: The serum chemerin levels were significantly higher in cases of PCOS cases as compared with the controls. Metformin therapy resulted in a significant decrease in chemerin levels in polycystic ovarian syndrome cases. The analysis of Receiver Operation Characteristic curves of serum chemerin suggested that serum chemerin levels may be of value to evaluate the polycystic ovarian syndrome cases under various methods of treatments.

Serum irisin levels in polycystic ovary syndrome after ovarian drilling.

BACKGROUND: Many cases of Poly-Cystic Ovary Syndrome (PCOS) are overweight and presenting with insulin resistance. MAIN OBJECTIVE: was to evaluate the effects of ovarian drilling on the serum levels of Irisin in women with polycystic ovaries. STUDY DESIGN AND SETTING: Serum Irisin levels were investigated in 100 cases with PCOS before ovarian drilling and 3 months after drilling, and in 80 control cases. Serum Irisin, hormonal profile and HOMA-IR were estimated in PCOS cases before and after ovarian drilling. Statistical analysis was performed by using Statistical Package for Social Scientists (SPSS). RESULTS: The serum irisin levels in overweight and in normal weight PCOS cases before ovarian drilling were significantly higher as compared with the corresponding control cases. Fasting serum Irisin levels were found to be significantly elevated in PCOS patients before ovarian drilling as compared to the levels after drilling. The serum irisin levels in overweight and in normal weight PCOS cases before ovarian drilling were found to be significantly positively correlated with BMI, insulin levels, and HOMA-IR. CONCLUSION: Elevated serum Irisin levels in PCOS may contribute to the development of insulin resistance. Ovarian drilling for polycystic ovaries results in a significant decrease in the serum Irisin levels. The analysis of ROC curves may suggest that serum Irisin may be a valuable biomarker for diagnosis and for monitoring cases with PCOS during treatment.

Effects of delivery on maternal & neonatal irisin levels in normal and preeclamptic pregnant women.

STUDY OBJECTIVE: The aim of this work was to measure the irisin levels in maternal and umbilical cord serums at cesarean section and vaginal delivery. STUDY DESIGN: This is a case-control study conducted at the Obstetric Department of the Mansoura University Hospital, Mansoura University, Egypt. MATERIAL AND METHODS: The 150 nulliparous cases were divided into three groups. MAIN OUTCOME MEASURE: Serum irisin concentrations were assayed by enzyme-linked immunosorbent assay (ELISA) method. STATISTICAL ANALYSIS: Unpaired t-test and correlation were done by using the Statistical Package for Social Scientists (SPSS). RESULTS: The maternal irisin levels in cases with mild preeclampsia were found to be significantly lower than that of the normal cases. In cases with mild preeclampsia, the maternal irisin levels early in labor for vaginal deliveries were significantly higher than that during cesarean section. The maternal irisin levels after vaginal deliveries were significantly higher than the levels early in labor. The maternal serum irisin was a significantly correlated with the duration of the first stage. The umbilical cord serum irisin levels were significantly correlated with the neonatal weight and with the duration of the first stage of labor. MAJOR CONCLUSION: Labor is a strong stimulus to the release of irisin into the maternal and fetal circulations. Neonatal serum irisin levels are positively correlated with the birth weight and with the duration of the first stage. The neonatal birth weight and the duration of the first stage of labor are positively correlated with the umbilical cord serum irisin levels.

Maternal and neonatal copeptin levels at cesarean section and vaginal delivery.

OBJECTIVE: The objective of the study was to measure the copeptin levels in maternal serum and umbilical cord serum at cesarean section and vaginal delivery in normotensive pregnancy and pre-eclamptic women. STUDY DESIGN: This was a prospective study at Mansoura University Hospital, Egypt. Ninety cases were included. They were divided into six groups: (1) normal pregnancy near term, as a control group, (2) primiparas who had vaginal delivery, (3) primiparas who had vaginal delivery and mild preeclampsia, (4) elective repeat cesarean section, (5) intrapartum cesarean section for indications other than fetal distress, and (6) intrapartum cesarean section for fetal distress. Serum copeptin concentrations were quantified with an enzyme-linked immunosorbent assay (ELISA). Mean, standard deviation, and paired t-test were used to test for significant change in quantitative data. RESULTS: The vaginal delivery groups had higher levels of maternal serum copeptin than the elective cesarean section group (P<0.01). Higher maternal serum copeptin levels were found in cases with pre-eclampsia as compared with the normotensive cases. The maternal copeptin levels during intrapartum cesarean section were higher than that during elective repeat cesarean section. There was a significant correlation between maternal copeptin levels and the duration of the first stage. In the presence of fetal distress, umbilical cord serum copeptin levels were significantly higher than other groups. CONCLUSION: Vaginal delivery can be very painful and stressful, and is accompanied by a marked increase of maternal serum copeptin. Increased maternal levels of serum copeptin were found in cases with pre-eclampsia as compared with the normotensive cases, and it may be helpful in assessing the disease. Intrauterine fetal distress is a strong stimulus to the release of copeptin into the fetal circulation.

Prevalence of genital tract infection with Entamoeba gingivalis among copper T 380A intrauterine device users in Egypt.

BACKGROUND: This study was performed to study the prevalence and potential pathogenicity of E. gingivalis in the genital tracts of intrauterine contraceptive device (IUD) users. STUDY DESIGN: A prospective study conducted at the Obstetrics and Gynecology Department and Fertility Care Unit, Mansoura University Hospital, Egypt. The study was carried out on 87 IUD users and 87 nonusers. The copper T 380A IUD was removed from each woman and washed with phosphate-buffered saline (PBS) pH 7.4; the IUD wash was centrifuged. The sediment was resuspended in 2 ml PBS and divided into two portions. One portion was used for preparation of direct and iron hematoxylin-stained smears. Direct smears and stained smears were examined for detailed morphology. The second portion of the sediment was used for DNA extraction and subsequent PCR amplification targeting the small subunit ribosomal RNA of E. gingivalis. RESULTS: The parasite was found in 12.64% of IUD users and in 6.9% of non users (p>.3). It was found that 90.9% of those harboring E. gingivalis in their genital tract had the parasite in their oral cavity. The percentage of genital infection in IUD users increased with low level of education, rural areas, insertion in primary health-care center and among those not washing hands before checking the strings. In the infected cases, vaginal discharge was more common (81.8%) than in noninfected cases (32.9%), such difference was statistically significant (p<.05). Also, excessive vaginal discharge is more common than backache and menorrhagia in the infected cases. CONCLUSION: Higher incidence of E. gingivalis infection in IUD users is related to oral cavity infection, residence, the facility where they inserted their IUD and washing hands attitude before checking the strings. We recommend treatment of gingival infection, proper counseling and medical education on oral and genital tract hygiene for IUD users.