The Effects of Calcium, Vitamins D and K co-Supplementation on Markers of Insulin Metabolism and Lipid Profiles in Vitamin D-Deficient Women with Polycystic Ovary Syndrome

Background Data on the effects of calcium, vitamins D and K co-supplementation on markers of insulin metabolism and lipid profiles among vitamin D-deficient women with polycystic ovary syndrome (PCOS) are scarce. Objective This study was done to determine the effects of calcium, vitamins D and K co-supplementation on markers of insulin metabolism and lipid profiles in vitamin D-deficient women with PCOS. Methods This randomized double-blind, placebo-controlled trial was conducted among 55 vitamin D-deficient women diagnosed with PCOS aged 18–40 years old. Subjects were randomly assigned into 2 groups to intake either 500 mg calcium, 200 IU vitamin D and 90 µg vitamin K supplements (n=28) or placebo (n=27) twice a day for 8 weeks. Results After the 8-week intervention, compared with the placebo, joint calcium, vitamins D and K supplementation resulted in significant decreases in serum insulin concentrations (−1.9±3.5 vs. +1.8±6.6 µIU/mL, P=0.01), homeostasis model of assessment-estimated insulin resistance (−0.4±0.7 vs. +0.4±1.4, P=0.01), homeostasis model of assessment-estimated b cell function (−7.9±14.7 vs. +7.0±30.3, P=0.02) and a significant increase in quantitative insulin sensitivity check index (+0.01±0.01 vs. −0.008±0.03, P=0.01). In addition, significant decreases in serum triglycerides (−23.4±71.3 vs. +9.9±39.5 mg/dL, P=0.03) and VLDL-cholesterol levels (−4.7±14.3 vs. +2.0±7.9 mg/dL, P=0.03) was observed following supplementation with combined calcium, vitamins D and K compared with the placebo. Conclusion Overall, calcium, vitamins D and K co-supplementation for 8 weeks among vitamin D-deficient women with PCOS had beneficial effects on markers of insulin metabolism, serum triglycerides and VLDL-cholesterol levels

A comparison between serum levels of interleukin-6 and CA125 in patients with endometriosis and normal women

Background: The purpose of the present study was to compare the serum levels of IL6 and CA125 in women with and without endometriosis. They were also compared in mild, moderate and severe cases. Methods: In this case-control study, CA125 and IL6 levels in 76 women with laparoscopic proven endometriosis were compared with 76 women without evidence of endometriosis. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were then calculated for each test. Results: Both groups did not show significant difference in their age, BMI, ESR and gravidity. Mean serum levels of IL-6 and CA125 were significantly higher in the case group (30.4±6.43 vs 13.9±3.17 Pg/ml and 62.6±10.69 vs 16.6±1.79 IU/ml respectively). Considering a cutoff point of 30 Pg/ml for IL-6, sensitivity, specifically, PPV and NPV value of 21.1, 66.6, 86.8 and 23.37 were obtained, respectively. Considering a cutoff point of 35 IU/ml for CA125, sensitivity, specifically, PPV and NPV were 44.76, 94.73, 89.47 and 63.15, respectively. Area under the ROC curve was 0.69 for CA125 and 0.54 for IL6, which showed a low value for these tests. Conclusion: Although CA125 and IL-6 were higher than normal controls in endometriosis, area under the ROC curve, did not show significant any diagnostic value for these tests

Effect of vaginal misoprostol on cervical priming in diagnostic dilatation and curettage

Introduction:Dilatation of cervix is essential for dilatation and curettage and hysteroscopy as well. Complications encountered during the procedure are partly related to difficulties in cervical dilatation. Finding the materials which can cause cervical dilatation more easily is important. The purpose of the present study is to evaluate the effect of vaginal Misoprostol on priming the cervix before dilatation in patients who are candidate for this procedure. Methods: A randomized clinical trial was performed on 60 women who were candidated for D&C. In 30 patients (case group), 200 mg Misoprostol (one tablet) was administered in posterior fornix of vagina 4 hours before operation, whereas in other 30 patients (control group), placebo was used. Then the two groups were compared according to their need to Hagar dilatator thinner than number 5 for dilatation of cervix and the duration of dilatation and curettage. Results: It was revealed that measures like age, parity and previous delivery methods did not show a statistically significant difference between two groups. 6 patients (20), in the case group, and 26 (87) in the control group needed the Hager dilatator number 5 to dilate the cervix (P<0.005) which their difference was statistically significant. The mean duration of D&C in the control group was 19±4 minute versus 12.7±2.8 minute in case group which showed a statistically significant difference (P<0.001). Conclusion: Vaginal misoprostol is a suitable agent for priming the cervix in order to dilate more easily before D&C