The Alteration of Carnitine Metabolism in Second Trimester in GDM and a Nomogram for Predicting Macrosomia.

OBJECTIVE: The metabolism of three major nutrients (sugar, lipid, and protein) will change during pregnancy, especially in the second trimester. The present study is aimed at evaluating carnitine alteration in fatty acid metabolism in the second trimester of pregnancy and the correlation between carnitine and GDM. METHODS: 450 pregnant women were recruited in the present prospective study. Metabolic profiling of 31 carnitines was detected by LC-MS/MS in these women. Correlation between carnitine metabolism and maternal and neonatal complication with GDM was analyzed. RESULTS: We found the levels of 7 carnitines increased in age > 35, BMI ≥ 30, weight gain > 20 kg, and ART pregnant groups, but the level of free carnitine (C0) decreased. Nine carnitines were specific metabolites of GDM. Prepregnancy BMI, weight gain, and carnitines (C0, C3, and C16) were independent risk factors associated with GDM and related macrosomia. C0 was negatively correlated with FBG, LDL, TG, and TC. A nomogram was developed for predicting macrosomia in GDM based on carnitine-related metabolic variables. CONCLUSION: The carnitine metabolism in the second trimester is abnormal in GDM women. The dysfunction of carnitine metabolism is closely related to the abnormality of blood lipid and glucose in GDM. Carnitine metabolism abnormality could predict macrosomia complicated with GDM.

The effect of neonatal immune challenge on reproduction by altering intraovarian kisspeptin/GPR54 system in the rat.

Immune challenge in early life has been observed to influence the long-term reproductive dysfunction. On PNDs 3 and 5, female offsprings were administered with LPS (50µg/kg, i.p.) or saline. Vaginal opening was recorded, and oestrous cyclicity was monitored immediately post puberty and again at 56-70 days. At 10 weeks of age, the ovaries were removed for immunostaining and RNA analysis. Neonatal exposure to LPS resulted in a significant delay puberty onset as well as destroyed expression of ovulation related genes. At PND 42 and 70, a significant increase in Kiss1 mRNA and Kisspeptin expression was detected at proestrus and oestrus in neo-LPS treated rats compared with the counterparts. Therefore, neonatal LPS exposure had a long-term effect on reproductive function and the up-regulated expression of ovarian Kiss1 and kisspeptin during the ovulatory transition stage may contribute to ovulatory dysfunction induced by peripheral LPS administration in early life.

A case report of eosinophilic myocarditis and a review of the relevant literature.

BACKGROUND: Eosinophilic myocarditis (EM) is a relatively rare condition that may result from parasitic infections and allergic disease. Antituberculosis drugs may lead to focal myocardial infiltration by eosinophils (eosinophilic myocarditis). Symptoms may be severe, and, lead to rapidly-fatal outcomes. Early diagnosis and high-dose corticosteroids are the cornerstone of treatment, and, may lead to restoration of cardiac function with full recovery. CASE PRESENTATION: We report a case of eosinophilic myocarditis secondary to eosinophilia caused by antituberculosis drugs with markedly elevated ECP, focal eosinophilic infiltration in CMR imaging and endomyocardial biopsy. Finally, high-dose corticosteroids were used to reverse the cardiac injury and to improve the clinical outcome. CONCLUSION: Antituberculosis drugs can cause eosinophilic infiltration of, and damage to, the myocardium leading to rapid progression of the clinical symptoms. Myocardial biopsy is helpful in diagnosing the disease in the early stages and high-dose corticosteroids effectively improves the prognosis of this disease.

High-fat diet decreases the expression of Kiss1 mRNA and kisspeptin in the ovary, and increases ovulatory dysfunction in postpubertal female rats.

BACKGROUND: Female reproductive health is noticeably compromised by obesity. The underlying mechanisms remain to be elucidated. Accumulating evidence indicates that the expression level of ovarian Kiss1 peaks in the afternoon during prooestrus, suggesting local regulatory roles for Kiss1 in the ovulatory process. We used a diet-induced model of obesity to evaluate whether the ovarian Kiss1 system is affected by obesity, and, to investigate the association of the Kiss1 system with ovulatory disorders in female rats. METHODS: Post-weaning, female, Sprague-Dawley rats were randomly fed either a high-fat diet (HFD) or a normal chow diet (NCD) until they reached postnatal day 30 (PND 30), PND 42, or PND 70. The timing of vaginal opening was recorded, and oestrous cyclicity was monitored for 2 consecutive weeks immediately post puberty and again at 8-9 weeks of age. Tissues from the left ovary were collected for determination of the levels of Kiss1 and G protein-coupled receptor 54 (GPR54) mRNA, and tissues from the right ovary were collected for assessment of the immunoreactivity (IR) of the corresponding protein products, kisspeptin and GPR54. RESULTS: The high-fat diet resulted in a significantly higher body weight and an earlier puberty onset. Oestrous cyclicity was disrupted by the HFD with significant reductions in the expression of ovulation-related genes. A marked suppression of ovarian Kiss1 mRNA levels was observed during prooestrus and oestrus at PND 42, and, during prooestrus, oestrus, and metoestrus at PND 70 in the HFD rats compared with the NCD controls. In the HFD group, the immunoreactivity of kisspeptin was significantly lower in theca cells from antral follicles during prooestrus and oestrus at PND 42, and, during prooestrus, oestrus at PND 70. At the prooestrus stage, in the HFD group the immunoreactivity of kisspeptin was also lower in the theca cells of preovulatory follicles at both PND 42 and PND 70. CONCLUSIONS: Exposure of female rats to an post-weaning, high-fat diet has long-term deleterious effects on ovulation, that may involve down-regulation of ovarian Kiss1 mRNA and kisspeptin.