Assessment of relationship between serum vascular adhesion protein-1 (VAP-1) and gestational diabetes mellitus.

Purpose: VAP-1 plays a crucial role in inflammation, oxidative stress and endothelial dysfunction which are main pathophysiologic mechanisms for gestational diabetes. We aimed to determine serum VAP-1 levels, assess its diagnostic value and correlation with clinical parameters in gestational diabetes.Methods: A total of 60 pregnant women with gestational diabetes and 75 healthy pregnant women between 24-28th gestational weeks between January-June 2017 were included. Pregnant women were screened for gestational diabetes by two-step protocol. Demographic, clinical and laboratory parameters of patients were recorded. VAP-1 was measured using an enzyme-linked immunosorbent assay method.Results: Gestational diabetes group had higher fasting and postprandial glucose, HbA1c, neutrophil-to-lymphocyte-ratio, platelet-to-lymphocyte-ratio, plateletcrit and C-reactive protein. Furthermore, VAP-1 levels were higher in gestational diabetes (3.35 ± 1.52 vs 2.2 ± 0.74; p < 0.001). VAP-1 levels >2.315 could predict gestational diabetes with a sensitivity of 70% and specificity of 65.3%. VAP-1 was correlated with clinical follow-up parameters such as fasting glucose (r = 0.473, p < 0.001), postprandial glucose (r = 0.416, p < 0.001), HbA1c (r = 0.462, p < 0.001) and inflammatory biomarkers such as platelet-to-lymphocyte-ratio (r = 0.254, p = 0.04), neutrophil-to-lymphocyte-ratio (r = 0.375, p = 0.003) and C-reactive protein (r = 0.306, p = 0.017).Conclusions: Elevated VAP-1 levels in gestational diabetes correlated with clinical follow-up and inflammatory markers may suggest the pathogenetic role of VAP-1 in gestational diabetes. Hence, we think that VAP-1 could be a promising marker for the prediction of gestational diabetes.

TWEAK and monocyte to HDL ratio as a predictor of metabolic syndrome in patients with polycystic ovary syndrome.

We aimed at analyzing serum TWEAK levels and monocyte/HDL ratio in polycystic ovary syndrome (PCOS) and their predictivity for metabolic syndrome (MS) in PCOS. We included 71 women with PCOS and 40 healthy controls without any cardiovascular risk factors in this cross-sectional study. Patient group was classified as MS positive (n = 34) and negative (n = 37). Study group had higher monocyte/HDL ratio and TWEAK levels (9.59 ± 2.82 vs 8.2 ± 2.46, p = .007 and 1085.54 ± 780.95 vs 694.88 ± 369.67 ng/ml, p = .009). Monocyte/HDL ratio and TWEAK levels were higher in MS positive group (10.47 ± 2.81 vs 8.77 ± 2.61, p = .01 and 1417.59 ± 921.52 vs 780.41 ± 455.67, p = .009). In multivariate regression analysis, monocyte/HDL ratio (>9.9, OR 3.42, 95%CI 1.41-5.78, p = .008) and TWEAK (>846.5 ng/ml, OR 5.49, 95%CI 3.14-7.59, p = .002) were found to be independent predictors of MS in study group. Discriminative value of monocyte/HDL ratio for MS in study group was evaluated by receiver operating curve. Area under curve for monocyte/HDL ratio was 0.669 with a sensitivity of 70.3% and specifity of 67.7%, cutoff value was >9.9. Receiver operating curve for TWEAK at >846.5 pg/ml threshold to diagnose MS in study group was performed and area under the curve was 0.769 with a sensitivity of 73% and specifity of 72%. TWEAK and monocyte/HDL ratio may be promising in predicting MS at early stages in PCOS to prevent future cardiovascular diseases by modifying life-style or giving pharmacotheraphy.

Unsuspected Diagnosis of Uterine Leiomyosarcoma after Laparoscopic Myomectomy in an Isolated Bag.

Minimally invasive techniques are generally applied for patients suspected of having benign fibroids if medical treatment is insufficient. On the other hand, sometimes some occult carcinomas of uterus like leiomyosarcomas may be reported for the patients' applied morcellation. This condition is rare but outcomes are clinically significant. Fragmentation of occult sarcoma in the abdominal cavity without isolation bag results in widespread and poor survival. In this article, we report a case of 37-year-old woman suffering from pain due to unexpected leiomyosarcoma. Laparoscopic myomectomy was performed with power morcellation in an isolated bag. Although isolation bag is generally reported to be preventive, recurrence of sarcoma was seen at 5th month of follow-up. Even though morcellation within a bag seems to block wide spreading, dispersion of tumor cannot be stopped and more investigations have to be done.