Evaluation of serum adiponectin as a marker of insulin resistance in women with polycystic ovarian syndrome: a comparative cross-sectional study.

BACKGROUND: Insulin resistance (IR) is known to be prevalent amongst women with polycystic ovarian syndrome (PCOS). Its presence has been linked to chronic anovulation and marked long term complications in women. Hence, identification and treatment of IR in women with PCOS is required to prevent the metabolic and reproductive complications of the disease. The aim of this study is to determine if serum adiponectin could be used as a surrogate marker for insulin resistance among women with PCOS. MATERIALS AND METHODS: A total number of 148 consenting women with PCOS diagnosed using the Rotterdam criteria were recruited for this study. Fifty-two of these women had insulin resistance were compared with 96 of the women who did not have insulin resistance. The serum Adiponectin levels, fasting blood glucose and fasting insulin levels were assayed in all study participants. Insulin resistance was assessed in all the study participants using the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Data were analyzed using relevant inferential statistics at 95% confidence interval and p value of < 0.05. RESULTS: The prevalence of insulin resistance among the study participants was 35.1%. Majority of the women (83.1%) had a high body mass index (BMI). More than half (68.2%) of the participants were in the age range of 21-30years and 76.4% (113) were nulliparous. There was no statistically significant difference in the median adiponectin level among insulin resistant (3.735 ug/ml) and non-insulin resistant participants vs. (3.705 ug/ml) (p = 0.6762). Both univariate and multivariate regression analysis did not show a statistically significant relationship between adiponectin and insulin resistance in PCOS. CONCLUSION: The prevalence of insulin resistance in women with PCOS is high and serum adiponectin is not a suitable surrogate marker of insulin resistance in women with PCOS.

Maternal hyperlipidemia and spontaneous preterm delivery: a multi-centre cohort study.

BACKGROUND: Hyperlipidemia is a precursor of inflammation and oxidative stress and suggested to be associated with adverse pregnancy outcomes such as preterm delivery. This study evaluated the association between maternal hyperlipidemia and spontaneous preterm delivery. METHODS: This was a prospective, multicentre cohort study in which 239 pregnant women aged 20-35 years with singleton pregnancy, were consecutively recruited at estimated gestational ages of 14-18weeks. Maternal serum lipids were determined at recruitment over a 2-month period and they were followed up until 37 weeks for the subsequent 6 months. Pregnant women with medical conditions and medications that could alter serum lipid levels were excluded from the study. Demographic and baseline variables were summarized using descriptive statistics. Comparison of continuous variables was done using the student's t-test and categorical variables were compared using the Chi square or Fisher's exact test as appropriate. Correlation was determined using Pearson's correlation. Odd ratios were calculated at 95% confidence interval, width of CI as 10% (0.1) and all significances are reported at p < .05. FINDINGS: The prevalence of spontaneous preterm delivery and maternal hypercholesterolemia was 10.2% and 33.1% respectively. There was no significant association between spontaneous preterm delivery and hyperlipidemia in pregnancy (p = .102). Mean serum total cholesterol (mmol/L), LDL cholesterol (mmol/L), HDL cholesterol (mmol/L) and triglyceride (mmol/L) was 5.31 ± 0.84, 2.60 ± 0.72, 1.64 ± 0.36 and 1.23 ± 0.40 respectively in women with spontaneous preterm delivery was similar to mean values of 5.23 ± 0.98, 2.54 ± 0.82, 1.64 ± 0.49 and 1.30 ± 0.59 respectively in women with term delivery. There was no significant correlation between mean individual serum lipids, determined at 14-18weeks gestational age, and gestational age at delivery. CONCLUSION: Serum lipid values determined early in pregnancy were observed to be similar in women with preterm and term delivery. There was no association between hyperlipidemia and spontaneous preterm delivery. There was no correlation of individual mean lipid values, determined early in pregnancy, and gestational age at delivery.

Correlation of sonographic and cytologic patterns of thyroid nodules.

INTRODUCTION: thyroid nodules are palpable in about 8% of adults. It is necessary to differentiate benign nodules from malignant ones by the non-invasive ultrasonography thereby reducing the frequency of the invasive fine needle aspiration cytology (FNAC). The study assessed the sonographic and FNAC patterns of thyroid nodules for benign and malignant features in a black African population. METHODS: this was a hospital-based, cross-sectional study design over a 1-year period in which one hundred and seven (107) consenting patients between 15 to 80 years of age with palpable thyroid masses by convenience sampling, were consecutively recruited to have both thyroid ultrasound scan and FNAC of their thyroid mass sequentially. Frequency, percentages and two-by-two contingency table were employed for data analysis. RESULTS: the sonographic features of the thyroid nodules varied from round 80 (74.8%) to oval 25 (23.4%) masses, the presence of thin peripheral halo 83 (77.6%), heterogeneous echo-pattern 104 (97.2%) with cystic component and peripheral vascularity 75 (70.1%). One hundred and five (98.1%) study participants showed benign features on sonography while two had features suspicious of malignancy; however FNAC result in the same group of patients was suggestive of benign masses in all 107 (100%) patients. Histology however confirmed malignancy in the 2 participants with ultrasound features suggestive of malignant thyroid nodules. CONCLUSION: ultrasonography is very sensitive in the characterization of thyroid nodules into benign or suspicious for malignancy in black African population.