Evaluation of body fat distribution in PCOS and its association with carotid atherosclerosis and insulin resistance.

OBJECTIVE: The aim of this study was to compare body fat distribution in PCOS with healthy controls and to investigate the factors associated with carotid artery intima media thickness (IMT) and insulin resistance. SUBJECTS AND METHODS: A case control study was conducted in 46 women with PCOS and 43 age matched controls. Anthropometrical measurements, hormonal levels, lipid and glucose profile were evaluated. Body fat thickness in four regions and carotid IMT were measured. Body fat distribution was compared between groups. Correlation of these parameters with carotid artery IMT and insulin resistance was investigated. RESULT(S): Visceral and subcutaneous fat thickness and the mean carotid artery IMT were significantly higher in PCOS subjects (p < 0.01). In correlation analysis, age, body mass index (BMI) and waist hip ratio (WHR) showed correlation with carotid artery IMT (r = 0,55, p < 0,001; r = 0.41, p < 0.008 and r = 0.34 p = 0.03, respectively), whereas visceral fat thickness presented a correlation with HOMA-IR index as a sign of insulin resistance. CONCLUSION(S): Fat accumulation is more prominent in visceral and subcutaneous regions in PCOS. Increased BMI and abdominal type of obesity are closely related to the increased carotid artery IMT and insulin resistance. Weight control and regional weight loss are important part of the treatment for the future health of women with PCOS.

Iron, folate and vitamin B12 levels in first trimester pregnancies in the Southwest region of Turkey.

OBJECTIVE: Iron, folate and vitamin B12 play important roles in the healthy development of the fetus in pregnancy. Preconceptional levels of these micronutrients is influenced by dietary habits. The purpose of this study was to investigate the status of iron, vitamin B12 and folate in first trimester pregnancies in the southwest region of Turkey where the Mediterranean Cuisine, rich in fresh fruit and vegetables is commonly consumed. MATERIAL AND METHODS: Two hundred and one low-middle income pregnant women were recruited during their first prenatal visit. Hemoglobin, ferritin, folate and vitamin B12 levels were evaluated and a structured questionnaire was given to gather information including age, gravida, parity, frequency of pregnancy, history of abortion, and intrauterine device usage. Based on WHO and international guidelines, anemia was defined as hemoglobin <11 g/dl, and iron deficiency as ferritin <15 µg/L. Serum folate and vitamin B12 deficiencies were defined as levels below 3 ng/ml and 200 pg/ml respectively. RESULTS: The mean age and gestational week were 26.4±5.3 years and 9±3 weeks respectively. Mean plasma concentrations were 12.8±9.7 g/dl for hemoglobin, 22.7±17.2 µg/L for ferritin, 12.2±5.6 ng/ml for folate and 266.6±100.2 pg/ml for vitamin B12. Anemia was detected in 4.5% of pregnant women, iron deficiency in 40.3%, vitamin B12 deficiency in 29.8% and folate deficiency in 0.5% of patients. In 10.9% of patients, both vitamin B12 and iron iron deficiency was detected. There was no significant difference for age, body mass index, gravida, parity, frequency of pregnancy, history of abortion, and intrauterine device usage between women with low and normal levels of vitamin B12 and Ferritin (p>0.05). CONCLUSION: Iron and vitamin B12 deficiencies were relatively common in the pregnant population consuming vegetable based diets. Iron and vitamin B12 supplementation in addition to folate must be considered for the wellbeing of the fetus in pregnant women living in areas where dietary patterns are mainly vegetable based.