Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?

This study aimed to determine the relationship between the metabolic and endocrinological pathologies in polycystic ovary syndrome (PCOS) and the levels of arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper to evaluate the relationship of these toxic metals with inflammatory/oxidative parameters. This study included a total of 154 patients (84 with PCOS, 70 healthy volunteers). Metabolic and endocrine parameters and arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper serum levels of the patients were compared between the groups. Considering the action mechanism of toxic metals, serum malondialdehyde (MDA), superoxide dismutase (SOD), serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tumor necrosis factor-alpha (TNFα), and high-sensitivity C-reactive protein (HsCRP) levels were determined. Serum TAS (p = 0.002), OSI (p = 0.006), SOD (p = 0.006), zinc (p = 0.010), and copper (p = 0.030) values were statistically lower whereas TOS (p = 0.008), MDA (p < 0.001), HsCRP (p < 0.001), TNFα (p < 0.001), antimony (p < 0.001), cadmium (p < 0.001), lead (p < 0.001), and mercury (p < 0.001) levels were significantly higher in the PCOS group than those determined in the control group. Antimony was positively correlated with fasting glucose (FG) and HOMA-IR while cadmium, in addition to FG and HOMA-IR, positively correlated with insulin and lead had a positive correlation only with FG (p < 0.05). Also, these three heavy metals correlated positively with some oxidative system and inflammatory parameters and negatively with the antioxidant system parameters (p < 0.05). In conclusion, heavy metal exposures in PCOS may be related to insulin resistance and hirsutism through oxidative and inflammatory mechanisms. This approach can be used to identify the risky patient group and to develop new treatment modalities. © 2020, Springer Science+Business Media, LLC, part of Springer Nature

Sexual function and depression in polycystic ovary syndrome: Is it associated with inflammation and neuromodulators?

Numerous studies have been carried out on depression and sexual dysfunction concomitant with polycystic ovary syndrome (PCOS). Increasing evidence has revealed the importance of inflammation in the etiology of PCOS. In addition, it has been known that some neuromodulators affect depression and sexual function. However, their effects on PCOS are not known. This study aimed to evaluate the relationship of depression and sexual function with cytokines and neuromodulators in PCOS patients. The present study included 20 fertile and 30 infertile patients diagnosed with PCOS and 30 healthy volunteers. Metabolic and endocrine parameters, interleukin (IL)-1β, IL-6, TNFα, γ-aminobutyric acid (GABA), Glutamate, Brain-derived neurotrophic factor (BDNF) serum levels, Beck Depression Index (BDI) and Female Sexual Function Index (FSFI) scores of the patients were compared between the groups. TNFα, IL-1β, IL-6, glutamate, GABA, and BDI scores were found to be significantly higher (p 0.05). Multivariate logistic regression analysis was conducted with potential factors that may affect sexual dysfunction. The results indicated that high waist-to-hip ratio (WHR) (> 0.80) with an odds ratio of 1.81 in PCOS patients, and body mass index (BMI) with an odds ratio of 2.3 and high WHR (> 0.80) with an odds ratio of 1.97 in all patients were found to be independent risk factors affecting sexual dysfunction. The results of the present study suggested that chronic low-dose inflammation seen in PCOS may interact with some neuromodulators, leading to the development of depression. However, no relationship was found between these parameters and sexual function. © 2020 Elsevier Lt

Serum copeptin level can be a helpful biomarker in evaluation of myocardial perfusion scintigraphy results

Background: Myocardial perfusion scintigraphy (MPS) is a well-established diagnostic tool. The sensitivity and specificity of single photon emission computed tomography (SPECT) MPS to detect significant coronary lesion were 86% and 74%, respectively. The aim of this study was to examine the role of serum copeptin in evaluation of MPS. Methods: Sixty-two consecutive patients underwent both SPECT MPS using 99mTc-sestamibi and transthoracic echocardiography were enrolled prospectively. Age, gender, height, weight, presence of cardiovascular risk factors were recorded. Exercise treadmill test (ETT) with modified Bruce protocol was used to induce coronary ischemia during MPS. While performing MPS, blood samples for serum copeptin level were drawn three times at pre-exercise, at the peak of ETT, and 6 h after ETT, respectively. The patients were enrolled into three groups according to MPS results (normal, equivocal and ischemia). Results: The study included 62 patients (23 with normal, 20 with equivocal, 19 with ischemia on MPS). Pre-, peak-, and post-exercise B-type natriuretic peptide and troponin I values were similar across the groups (p &gt; 0.05 for all comparisons). Serum copeptin values for pre- and peak-exercise were similar among all groups (p = 0.883 and p = 0.089). Post-exercise copeptin values of the normal and equivocal groups were similar (p = 0.661, z = –0.438) while that of the ischemia group was significantly higher than both the normal (p &lt; 0.001) and equivocal group (p &lt; 0.001). Conclusions: Serum copeptin was found to be increasing significantly in case of ischemia on MPS. It may be used in differentiation of equivocal results from false positive results.

The role of inflammation, oxidation and Cystatin-C in the pathophysiology of polycystic ovary syndrome

Objective: The relationship between Cystatin-C levels and inflammatory, oxidant, and antioxidant markers in polycystic ovary syndrome (PCOS) was investigated. Materials and Methods: A total of 96 participants were included in the study as PCOS (n=58) and control (n=38) groups. Tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1B), interleukin 6 (IL-6), malondialdehyde (MDA), superoxide dismutase (SOD), and Cystatin-C were evaluated by ELISA method. Relationships metabolic and endocrine parameters seen in PCOS were examined. Univariate and multivariate logistic regression analyzes were performed to identify risk factors that may affect the PCOS group. Bivariate correlations were investigated by the Spearman's correlation analysis. Results: While Cystatin-c, TNF-alpha, IL-1B, IL-6, MDA were found to be higher in patients with PCOS compared with the control group, SOD was found to be lower than the control group (p<0.05). In the correlation analysis, increased Cystatin-C levels were found to be associated with high IL-6 (r=0.214, p=0.037) and low SOD levels (r=-0.280, p=0.006). Conclusion: In our study, it was found that the increase in Cystatin-C levels was associated with an increase in IL-6 and a decrease in SOD. These results may bring up different treatment options to reduce cardiovascular risks for treating PCOS

Comparison of glucose degradation product and receptor levels in diabetic and normal pregnancy

Objective: The aim of this study was to assess the diagnostic values of new biochemical markers that may be an alternative to the oral glucose tolerance test (OGTT) and determine the differences in these markers among three groups of women with varying degrees of glucose homeostasis dysregulation. Material and Methods: This was a prospective study. All women were screened with 50 gram (g) oral glucose and a 100 g OGTT for gestational diabetes mellitus (GDM). The patients were divided into three groups depending on the result of the tests: No evidence of glucose metabolism abnormality (controls); impaired glucose tolerance (IGT); and GDM. All three groups were evaluated for serum human advanced glycation end-products (AGEs) concentrations, carboxymethyl lysine (CML) concentration and receptor for advanced glycation end-product concentrations (RAGE/AGER), body mass index (BMI), age, fasting glucose levels, obstetrical parameters and gestational age. Results: The study included 180 women divided into 59 (32.8%) GDM, 50 (27.8%) IGT and 71 (39.4%) controls. Age was similar among the three groups. Whereas fasting glucose levels and BMI in the three groups was significantly different, AGEs, CML, RAGE/AGER levels were found as significantly different between the groups (p[removed

Seroprevalences of Hepatitis B, C, HIV and Hepatitis B Vaccination in Healthcare Workers in Bozok University Faculty of Medicine

Introduction: Healthcare workers are in the high-risk group for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection. Materials and Methods: In our study, 140 healthcare workers employed in our hospital were studied for the frequency of infection with HBV, HCV and HIV, and immune status against HBV. No HBsAg, anti-HCV or anti-HIV antibody positivity was found in any case. Results: Seventy eight (55.71%) cases had anti-HBs positivity. 96.43% of anti-HBs-positive cases had been vaccinated previously, and 3.57% of cases were naturally immune. Healthcare workers with negative anti-HBs were included into the hepatitis B vaccination program. The vaccination rate among physicians was significantly higher than among other occupational groups (p< 0.001). Vaccination rates were found to increase with an increase in age. Housekeeping staff had the lowest immunization rate. Conclusion: As a result, we recommend that training for healthcare workers, especially housekeeping staff, should be maintained and increased by the infection control committees

Sixth-Month Perinatal Outcomes of Anemic Pregnancies

OBJECTIVE: In this study, we retrospectively compare the outcomes of anemia in 3rd trimester pregnant women who applied to our clinic, in terms of maternal factors and its fetal effects, in 0 and 6th months. STUDY DESIGN: 139 cases admitted to our clinic during December 2010 - May 2012 due to pregnancy in their 3rd trimester and were diagnosed with anemia and whose records were available were included in the study. The pregnant women were divided into two groups according to their hemoglobin (Hb) levels; hemoglobin levels below 11 g/dL formed the anemia group (AG Hb<11 g/dL) and those above were the non-anemia group (NAG Hb ›11 g/dL). Maternal age, occupation, number of live births, Hb and hematocrit (Hct) levels, mode of delivery, labor time, and head circumference, weight and height of infants at birth and 6th month were compared. RESULTS: Anemia was determined in 69 pregnant women (49.6%). No significant difference among the groups in terms of age and parity was detected. Anemia was found to be higher in housewife mothers (p=0.0001). No difference in terms of birth weight and height was detected among the babies of mothers of the two groups, but the head circumference of the babies from anemic mothers were determined to be significantly lower (p= 0.0001). In terms of the 6th month outcomes; weight, height and head circumference of babies from anemic mothers were found to be significantly lower (p=0.0001). Risk analysis has determined a negative correlation between anemia and fetal development at 6th month. CONCLUSION: There is a negative correlation between anemia and preterm delivery week, fetal development and small head circumference at birth. Therefore maternal candidates with high rates of anemia such as housewives should be closely monitored during pregnancy and in the postpartum period for fetal development