Evaluation of elabela, apelin and nitric oxide findings in maternal blood of normal pregnant women, pregnant women with pre-eclampsia, severe pre-eclampsia and umbilical arteries and venules of newborns

Pre-eclampsia is multisystem metabolic diseases, commonly accompanied by hypertension and proteinuria, which are among the important causes of maternal and perinatal mortality and morbidity worldwide. In a pre-eclampsia animal model study in the last year, Elabela (ELA) infusion was reported to correct hypertension and proteinuria and to normalise the birth weights of the offspring. Therefore, our main goal in this human study is to compare ELA, apelin (APLN) and nitric oxide (NO) levels in the maternal blood of pregnant women with pre-eclampsia and severe pre-eclampsia and in their newborns’ venous-arterial cord blood with maternal blood of healthy pregnant women and their newborns’ venous-arterial cord blood. Thirty controls, 28 pre-eclampsia and 24 severe pre-eclampsia cases and their newborns participated in this study. Maternal blood and newborn venous-arterial cord blood samples were collected from these patients. ELA, APLN and NO levels in these samples were measured by ELISA method. When the maternal blood ELA, APLN and NO amounts were compared with control groups, there was a significant decrease in both pre-eclamptic and severe pre-eclamptic women and this was more prominent in the women with severe pre-eclampsia. When ELA, APLN and NO levels in the newborn venous-arterial cord blood of control group was compared with that of severe pre-eclamptic and pre-eclamptic women; it was parallel with maternal findings. ELA, APLN and NO levels appear to play a role in the pathophysiology of pre-eclampsia. It is predicted that if these molecules, which are reduced due to pre-eclampsia and severe pre-eclampsia, are brought to physiological limits in the future; pre-eclampsia related maternal and perinatal mortality and morbidity can be reduced.Impact Statement What is already known on this subject? There are two studies (one human and one animal) in the literature evaluating only maternal elabela (ELA) levels in pre-eclamptic pregnancies. The animal study demonstrated decreased blood ELA levels in pre-eclamptic animals and the human study found increased blood ELA levels in pre-eclamptic patients. There are no studies evaluating maternal ELA levels in severe pre-eclampsia patients and also there are no studies evaluating maternal ELA levels in pre-eclampsia and severe pre-eclampsia patients. There are no studies evaluating newborns’ venous-arterial blood APLN and NO levels. Apelin (APLN) and nitric oxide (NO) results were controversial in pre-eclampsia and severe pre-eclampsia patients. What the results of this study add? The present study, for the first time, demonstrates that decreased blood ELA, APLN and NO levels in maternal blood of pregnant women with pre-eclampsia and severe pre-eclampsia and in their newborns’ venous-arterial blood. Furthermore, we have also demonstrated for the first time that decreased ELA, APLN and NO are also related with low birth weights. What the implications are of these findings for clinical practice and/or further research? The low levels of ELA, APLN and NO in maternal blood and newborns’ venous-arterial blood may be the result or the cause of pathologic changes in pre-eclampsia and severe pre-eclampsia. Also, ELA, APLN and NO may be new indicator parameters of systemic endothelial dysfunction together. More studies are needed to evaluate the relationship between of ELA, APLN and NO and pre-eclampsia and severe pre-eclampsia and in newborns’ venous-arterial blood

Subfatin and asprosin, two new metabolic players of polycystic ovary syndrome

Asprosin and subfatin are recently discovered two new hormones of adipocyte origin that play a role in the regulation of glucose metabolism. Polycystic ovary syndrome (PCOS) is a gynaecological syndrome presenting with energy turbulence. The aim of this study was to investigate whether asprosin and subfatin play a role in PCOS disease. Thirty participants with a diagnosis of PCOS and thirty control group participants were included in this case-control study. Hormone profiles of the participants (subfatin, asprosin, insulin, prolactin, thyroid-stimulating hormone (TSH), oestradiol (E2), follicle-stimulating hormone (FSH), luteinising hormone (LH), dehydroepiandrosterone sulphate (DHEA-SO4), lipid profiles [(total testosterone, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, cholesterol)], fasting blood sugar (FBS) and high-sensitivity C-reactive protein (hs-CRP) values were measured. While the levels of asprosin, LDL and triglyceride, TSH, E2, FSH, LH, DHEA-SO4 were found to be significantly higher in patients with PCOS compared to controls (p = .005; p = .01), subfatin and HDL levels were found to be low. Significantly decreasing subfatin and increasing asprosin levels in circulation in PCOS may play a role in the etiopathology of this disease and that they may also be new candidate molecules in addition to classical laboratory parameters in the diagnosis and follow-up of PCOS in the future.Impact statement What is already known on this subject? The studies investigating the relationship between PCOS and asprosin are contradictory. Although subfatin has been studied in many metabolic diseases, it has not been studied yet whether it is associated with PCOS. Furthermore, whether there is a mutual relationship between subfatin and asprosin in patients with PCOS has not been studied yet. What do the results of this study add? This available data indicates that significantly decreasing subfatin and increasing asprosin levels in the circulation in PCOS may play a role in the etiopathology of this disease. What are the implications of these findings for clinical practice and/or further research? The findings are promising in that decreasing subfatin and increasing asprosin levels will shed new light on reproductive endocrinology changes caused by PCOS and may help to clarify the pathophysiology of PCOS. Furthermore, in our study, the asprosin/subfatin ratio was above three in PCOS disease. This ratio reported here is anticipated to contribute to the course or follow-up of the disease in the future. Also, subfatin has been investigated here for the first time, may also be a new candidate molecule in addition to classical laboratory parameters in the diagnosis and follow-up of PCOS

P wave dispersion in patients with premenstrual dysphoric disorder

Background: Growing evidence has revealed that fear and anxiety related situations could affect cardiac parameters. P wave dispersion (Pd) is an important index. In the present study, we aimed to evaluate Pd values in patients with premenstrual dysphoric disorder. Methods: The study was composed of twenty-five female patients with premenstrual dysphoric disorder and same number of healthy controls. Pd, Pmin and Pmax values were determined by electrocardiogram (ECG) in the subjects. Results: It was found that patients with premenstrual dysphoric disorder had considerably higher Pmax and Pmin values compared to those of healthy subjects. Pd was also significantly higher in patients with premenstrual dysphoric disorders than that of healthy subjects. Conclusion: Study suggests that patients with premenstrual dysphoric disorder seems to have increased Pd, as can be seen in anxiety and fear related clinical conditions, considering that this group of patients have an increased trend to cardiac abnormalities, particularly cardiac arrythmias. To access strong conclusion, it is required novel studies with larger samples

Serum elabela levels in women with tubal ectopic pregnancy: A case-control study

Elabela, a circulating peptide hormone derived from the placenta, plays a crucial role in embryonic development and function of the human placenta during pregnancy. We aimed to investigate serum elabela levels in ectopic pregnancy. Sixty cases admitted to Emergency Department and Obstetrics and Gynecology Clinic were included in this case-control study. Thirty women with tubal ectopic pregnancy constituted Group 1 and 30 women with healthy pregnancy served as controls (Group 2). Blood samples were collected from all participants. Demographic and obstetric characteristics of the whole study cohort were also recorded. Levels of serum elabela were measured in each group by enzyme-linked immunosorbent assay . Age, gender, gestational age, obstetrics history, and body mass index of the groups were similar. Mean serum elabela levels were 7.52 ± 1.1 ng/mL and 7.05 ± 1.2 ng/mL in group 1 and group 2, respectively. There was no statistically significant difference between the two groups with respect to serum elabela levels ‎ (t=1.581, p=0.119). In the present study, serum elabela levels were not significantly different in women with ectopic pregnancies than healthy pregnancies. Since placenta is the primary source of elabela, this lack of difference might be due to the insufficient placental as well as fetal development in fallopian tubes. [Med-Science 2020; 9(2.000): 289-92

Changes in serum obestatin, preptin and ghrelins in patients with Gestational Diabetes Mellitus

Objectives: The present study aims to establish the levels of acylated ghrelin, desacylated ghrelin, obestatin and preptin, during pregnancy and the postpartum period in pregnant women with Gestational Diabetes Mellitus (GDM) and healthy pregnancy women