The effects of serum granulin levels on anthropometric measures and glucose metabolism in infertile women with different ovarian reserve status

Introduction: Granulin (GRN) is an adipokine with proinflammatory features, which plays important role in glucose metabolism and insulin resistance pathogenesis. It has been reported that granulin precursors were localised in developing follicles in animal studies. The purpose of this study was to evaluate the association of granulin levels with anthropometric features, glucose metabolism, and ovarian reserve. Material and methods: A total of 109 infertile women were included in this cross-sectional, prospective study, who attended a tertiary clinic. All participants were categorised into diminished ovarian reserve (DOR) and normal ovarian reserve groups (NOR), in accordance with Bologna criteria. The demographic characteristics, including age, BMI, waist-hip circumferences, and biochemical parameters, were recorded. Serum granulin level was determined by enzyme-linked immunosorbent assay. Results: No significant difference was observed in the GRN levels (p = 0.229) between the groups. There was a positive correlation between GRN levels and BMI, WC, HC, and 75 g oral glucose tolerance values in NOR group (p < 0.01, p < 0.05, p < 0.01, and p < 0.05, respectively). Conclusions: Our results suggest that granulin is associated with anthropometric features in infertile patients and might be an important indicator of obesity and impaired glucose metabolism. Elevated levels of granulin may have a diabetogenic effect and predispose women to high glucose levels

Serum progranulin levels are elevated in infertile women with obesity

Introduction: The aim of the present study was to investigate the changes in serum progranulin and sex hormone levels in infertile women with obesity. Material and methods: A total of 171 infertile women who had fertility desire were included in this cross-sectional study. The initial assessment included measurements of weight, height, waist circumference, and hip circumference to calculate body mass index (BMI) and waist/hip ratio. All participants were categorised into two groups in accordance with BMI as a control group ( < 30 kg/m2, n = 135) and a study group (≥ 30 kg/m2, n = 36). After anthropometric measurements, venous blood samples were taken for analyses of oestradiol and follicle stimulating hormone (FSH), luteinising hormone, total testosterone (TT), 17-hydroxyprogesterone, dehydroepiandrosterone sulphate, anti-Müllerian hormone, and progranulin. Results: The present study demonstrated that the overweight women had higher FSH levels (p < 0.01). Elevated TT levels were detected in obese women (p < 0.05). Progranulin concentrations were higher in the study group than in the control group (p < 0.05). Regression analysis demonstrated that there was a relationship between the serum progranulin concentrations and BMI (p < 0.05). Conclusions: Our findings support that the elevated progranulin levels are associated with obesity in infertile women. Therefore, infertile and obese patients may benefit if their serum progranulin levels decrease. Further studies are needed to elucidate this issue

Adverse Effect of Different Exercise Types on Ovarian Reserve

In this study, it was aimed to determine the negative effect of different types of exercise on ovarian reserve of sedentary women. A total of 40 sedentary women who met the criteria for admission to work were categorized as aerobic exercise (AE; n:20; age: 33.0±2.0 years old) and strength exercise (SE; n:20; age: 32.7±2.1 years old) groups. Participants in both groups received two different exercises of 60-minute with an intensity of 60-70% for 16 weeks and 4 days per week. Participants' anthropometric (body weight, BMI, waist and hip circumference, waist and hip rate (WHR)), estradiol (E2), luteinizing hormone (LH) follicle stimulating hormone (FSH), and levels antimülerian hormone (AMH), which used as over-reserve indicators, were measured for before and after exercise. Comparisons of these parameters were evaluated at p0.05). In the SE group, there was a decrease in AHM level (p0.05). As a results; strength exercise triggers to decrease in serum AMH levels and to increase in serum FSH levels. For this reason, strength exercise practices can have negative consequences for fertility, especially for women with lower ovarian reserve values

Abdominal Sarcoidosis May Mimic Peritoneal Carcinomatosis

Sarcoidosis is a multisystem inflammatory disorder of unknown etiology. It shows a great variety of clinical presentation, organ involvement, and disease progression. Lungs and lymphoid system are the most common sites involved with a frequency of 90% and 30%, respectively. Extrapulmonary involvement of sarcoidosis is reported in 30% of patients and abdomen is the most frequent site. Furthermore, peritoneal involvement is extremely rare in sarcoidosis. The case presented here described peritoneal manifestations of sarcoidosis without involvement of lungs. A 78-year-old woman possessing signs of malignancy on blood test and abdominal magnetic resonance imaging underwent laparatomy with a suspicion of ovarian malignancy. The macroscopic interpretation during surgery was peritoneal carcinomatosis. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal biopsies, total omentectomy, and appendectomy were performed. Final histopathological result revealed the diagnosis of sarcoidosis. Clinicians must keep in mind that peritoneal sarcoidosis can mimic intra-abdominal malignancies

Efficacy of striae gravidarum extension and localization on predicting intraperitoneal adhesion risk

Aim: To evaluate the diagnostic value of striae gravidarum (SG) presence and localization in predicting the intraperitoneal adhesion (IPA) risk in pregnant women with a history of at least one previous cesarean delivery (CD). Methods: A total of 100 pregnant women with repeated CD were included in this prospective observational study. Patients were divided into three groups according to severity of SG with Davey scoring system. Intraoperative adhesion severity and extension were evaluated by using Nair classification system. Moreover, operation duration and neonatal outcomes were analyzed. Results: Demographic features were comparable between the groups. Adhesion scores were significantly higher in mild and severe SG groups (for mild SG: 1.93 ± 0.99, for severe SG: 2.81 ± 0.88 and for no SG: 1.4 ± 0.57; P < 0.001). Analysis revealed a positive correlation between IPA and severity of SG (P < 0.001). There was a correlation between increased striae density and adhesion severity especially in the right and left upper quadrants of the abdomen (for right quadrant: r = 0.515, P < 0.001; for left quadrant: r = 0.359, P = 0.005). Conclusion: Our results suggest that preoperative evaluation of SG severity and extend particularly in upper quadrants is a feasible option to predict IPA risk in patients with repeated CD

Case Report Abdominal Sarcoidosis May Mimic Peritoneal Carcinomatosis

Sarcoidosis is a multisystem inflammatory disorder of unknown etiology. It shows a great variety of clinical presentation, organ involvement, and disease progression. Lungs and lymphoid system are the most common sites involved with a frequency of 90% and 30%, respectively. Extrapulmonary involvement of sarcoidosis is reported in 30% of patients and abdomen is the most frequent site. Furthermore, peritoneal involvement is extremely rare in sarcoidosis. The case presented here described peritoneal manifestations of sarcoidosis without involvement of lungs. A 78-year-old woman possessing signs of malignancy on blood test and abdominal magnetic resonance imaging underwent laparatomy with a suspicion of ovarian malignancy. The macroscopic interpretation during surgery was peritoneal carcinomatosis. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal biopsies, total omentectomy, and appendectomy were performed. Final histopathological result revealed the diagnosis of sarcoidosis. Clinicians must keep in mind that peritoneal sarcoidosis can mimic intra-abdominal malignancies

Impact of anxiety levels on difficulty of intrauterine insemination and treatment outcomes

Aim: The objective of this study was to determine the effect of anxiety on intrauterine insemination (IUI) results in couples with unexplained infertility. Second, the relationship between difficulty level of IUI procedure and anxiety were investigated. Methods: A total of 100 women undergoing first IUI treatment were enrolled into this prospective cross-sectional study. Participants were asked to complete the Beck Anxiety Inventory (BAI) before the IUI procedure and classified into two groups according to the anxiety score (minimal anxiety; BAI score <8, n = 73 and mild-to-moderate anxiety; BAI score ?8, n = 27). Cervical condition was evaluated with speculum and presence of congenital anomalies, extensive leucorrhea or polypoid lesions were classified as unfavorable cervix. All of the patients were evaluated for difficulty of IUI and asked to state the severity of their pain with a visual analog scale after the procedure. Clinical pregnancy rates were also analyzed. Results: There was no statistically significant difference between the groups in terms of pregnancy rates (12.3% vs 14.8%, P = 0.743). visual analog scale score was significantly higher in mild-to-moderate anxiety group (P = 0.002). Anxiety levels were higher in patients with difficult IUI (10.5 vs 4.3, P < 0.001). In multivariate analysis, higher BAI scores (odds ratio: 1.1, 95% confidence interval: 1.0–1.2, P = 0.01) and unfavorable cervical condition (odds ratio: 3.6, 95% confidence interval: 1.2–10.7, P = 0.01) emerged as independent predictors for difficulty of IUI. Conclusion: Evaluation of anxiety before IUI might help to predict difficulty of IUI and related pain. Although anxiety increases the difficulty of IUI, it does not affect pregnancy outcomes of the treatment

Obesity Does not Compromise Ovarian Reserve Markers in Infertile Women

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