Cord blood and maternal serum preptin and irisin concentrations are regulated independently in GDM.

OBJECTIVE: The aim of this study is to examine the maternal serum and cord blood irisin and preptin levels in gestational diabetes mellitus (GDM) and correlate their levels with demographic and biochemical parameters. PATIENTS AND METHODS: A total of 21 pregnant women with GDM and 21 BMI and age-matched pregnant women without GDM were included in the study. They underwent 50 g glucose challenge test (GCT) between 24-28th gestational weeks. Women with a GCT result higher than 140 mg/dl received 100 g oral glucose tolerance test (OGTT). Detection of one of the following criteria after OGTT was accepted as GDM: fasting plasma glucose level 92 mg/dL; 1-h plasma glucose level 180 mg/dL; and 2-h plasma glucose 153 mg/dL. Correlation between metabolic parameters and cord blood and maternal serum preptin and irisin levels in GDM and non-GDM subjects were analyzed. RESULTS: Maternal serum preptin values of GDM subjects were similar to the serum preptin values of non-GDM control subjects (123.12±34.3 pg/mL vs. 112.02±12.0 pg/mL, p<0.23). Cord blood preptin levels of GDM (64.3±1.09 pg/mL vs. 123.12±34.3 pg/mL, p<0.03) and non-GDM subjects (59.2±021 pg/mL vs. 112.02±12.0 pg/mL, p<0.02) were significantly lower than the maternal serum preptin values. Serum preptin levels of GDM group were positively correlated with HOMA-IR (r=0.33, p<0.04), but not with other parameters. Maternal serum irisin levels in the GDM group were lower than the non-GDM control group (5.32±0.44 µg/mL vs. 7.74±4.52 µg/mL, p<0.01). Cord blood irisin concentrations were found similar in women with GDM and non-GDM subjects (4.91±3.12 µg/mL vs. 5.01±2.14 µg/mL, p<0.14). Cord blood irisin levels of GDM subjects were similar to maternal serum irisin levels (4.91±3.12 µg/mL vs. 5.32±0.44 µg/mL, p<0.57). We found positive correlation between irisin concentration and fasting insulin, HOMA-IR, and BMI in women with GDM. In subgroup analysis of 6 patients using insulin treatment, serum and cord blood irisin and preptin levels were similar to those that did not use insulin. CONCLUSIONS: Maternal serum and cord blood preptin and irisin concentrations are regulated independently in women with GDM.

Outcomes of percutaneous endoscopic gastrostomy in hospitalized patients at a tertiary care center in Turkey.

BACKGROUND/OBJECTIVES: The aim of this study was to perform a retrospective analysis characterizing patients receiving tube feeding following percutaneous endoscopic gastrostomy (PEG) tube placement between 2004 and 2012 at Erciyes University Hospital in Turkey. SUBJECTS/METHODS: Patients above the age of 18 years who required long-term enteral tube feeding were studied. All PEGs were performed using the pull-through technique by one experienced endoscopist. Demographic, clinical outcomes and PEG-related complication data were collected. RESULTS: Of the 128 subjects studied, 91 were men (71%) and 37 were women (29%). The mean age of this patient population was 54 ± 19 years. The most common reason for PEG tube insertion was the inability to consume oral diet due to complications of cerebrovascular disease (27%), while cerebral hypoxia, occurring after nonneurological medical disorders, was the second most common indication (23%). A total of 70 patients (55%) had chronic comorbidities, with hypertension being the most common (20%). The most common procedure-related complication was insertion-site bleeding, which occurred in 4% of patients. Long-term complications during 1 year were insertion-site cellulitis, gastric contents leakage and peristomal ulceration, which occurred in 14%, 5% and 0.5% of patients, respectively. There were no PEG insertion-related mortalities; 1-year mortality was unrelated to the indication for PEG tube insertion. CONCLUSIONS: PEG tube insertion was a safe method to provide enteral access for nutrition support in this hospitalized patient population.

Determination of oxidative protein and lipid damage in adult hypopituitary patients with GH deficiency.

The aim of this study is to determine oxidative protein and lipid damage in adult hypopituitary GH-deficient patients. Eighteen hypopituitary GH-deficient--otherwise healthy-adults on conventional replacement therapy other than GH (9 male, 9 female, age 41.8 +/- 16.4 yr) and 18 healthy subjects (6 male, 12 female, age 40.3 +/- 16.2 yr) participated in the study. Plasma products of oxidative protein damage [protein carbonyl (PCO) and nitrotyrozine (NT)], plasma oxidized LDL (oxLDL), plasma product of oxidative lipid damage [lipid hydroperoxide (LHP)] and antioxidant status of the plasma [total thiol (T-SH)] were measured. Body fat percentage, total and LDL-cholesterol concentrations were significantly higher in the hypopituitary group. Plasma PCO, NT, LHP and T-SH concentrations did not differ significantly between patients and controls. OxLDL concentration was significantly higher in the hypopituitary patients (62.4 +/- 17.8 vs 43.1 +/- 11.3 U/l, p = 0.001). In the patients, oxLDL correlated significantly with the duration of hypopituitarism (r = 0.6323, p = 0.01). In the controls, oxLDL correlated significantly with blood pressure, total and VLDL-cholesterol concentrations. Increased oxLDL concentration may indicate increased oxidative stress within the vascular compartment and may contribute to the proatherogenic state in GH-deficient hypopituitary patients independent from conventional risk factors.