Assessment of impaired glucose tolerance prevalence with hemoglobin A(1c) and oral glucose tolerance test in 252 Turkish women with polycystic ovary syndrome: a prospective, controlled study

What is the prevalence of abnormalities in glucose metabolism in patients with polycystic ovary syndrome (PCOS) and controls in a Turkish population? The total prevalence of glucose abnormalities in PCOS patients was 16.3 [impaired glucose tolerance (IGT) 14.3; type 2 diabetes mellitus (T2DM) 2] and was higher than in healthy subjects (IGT 8.5; T2DM 0, respectively). One of the most common markers of chronic glycemia is hemoglobin Alc (HbA(1c)). However, little is known about whether the use of HbA(1c) results in diagnosis of more cases of glucose intolerance in the PCOS population than the oral glucose tolerance test (OGTT) alone. This was a prospective study, including 252 women with PCOS and 117 control women without PCOS. The study was carried out in the gynecological outpatient department of Namik Kemal University Hospital, Turkey, between 2010 and 2012. Women with PCOS (n 252) were diagnosed according to Rotterdam criteria. The control group included 117 women (aged 1745 years) who were selected randomly. BMI of participants ranged between 15.6 and 47.9 kg/m(2). Patients with PCOS were comparable to controls in terms of age (24.8 versus 25.9 years, respectively) and had higher BMI (26.1 versus 24.9 kg/m(2), respectively). Of 252 patients with PCOS, 41 had glucose intolerance (IGT 14.3; T2DM 2) when compared with 10 of the 117 control patients (IGT 8.5; T2DM 0; odds ratios 2.08; P 0.045) during the OGTT. When an HbA(1c) value 5.6 was used to divide the total population, the prevalence of abnormal glucose metabolism was 7.9 in the patients with PCOS, below the value detected in the control patients (8.5), which showed that 20 of 41 patients with abnormal glucose tolerance would not have been diagnosed, if the HbA(1c) alone had been used. When compared with the OGTT results, HbA(1c) provided 52.4 sensitivity, 74.4 specificity, 67.1 positive and 60.9 negative predictive values with a threshold value of 5.6 in abnormal glucose tolerance. The receiver operating characteristic analysis suggested a threshold value of 5.35 in HbA(1c) (75.6 sensitivity and 52.6 specificity) for the prediction of abnormal glucose tolerance. This study did not involve weight-matched healthy subjects, which may cause a difference in prevalence of abnormal glucose metabolism between the groups, and the results are limited to an unselected population of patients who have the full PCOS phenotype. In addition, the incidence of T2DM among the first-degree relatives and 2-h insulin levels could not be reported in full. Further investigation of the efficacy of HbA(1c) for the prediction of abnormal glucose tolerance should be undertaken in long-term prospective studies and in different geographic populations. At present, the only way to reliably detect abnormal glucose metabolism in Turkish women with PCOS appears to be using the OGTT. No financial support. The authors have no competing interests to declare. Not applicable

Artikain Difüzyon Hacminin Manyetik Rezonans Görüntüleme Yöntemi İle İn Vivo Olarak Değerlendirilmesi

Amaç: İn vivo olarak artikain solüsyonunun difüzyon hacminin manyetik rezonans görüntüleme yöntemi ile değerlendirilmesi ve adrenalin miktarının ve enjeksiyon bölgesinin artikainin difüzyon hacmi üzerine etkisinin belirlenmesidir. Gereç ve Yöntem: Otuz gönüllüye birinci premolar (15 gönüllü) veya birinci molar (15 gönüllü) diş bölgesine bilateral olarak maksiller bukkal supraperiostal enjeksiyon 1:100.000 oranında (1.7 ml) ve 1:200.000 oranında (1.7 ml) adrenalin içeren % 4’lük artikain solüsyonu kullanılarak uygulanmıştır. Manyetik rezonans görüntüleri enjeksiyondan önce ve enjeksiyondan 5 dakika sonra elde edilmiştir. Lokal anestezik solüsyonun difüzyon hacmi planimetri metodu ve Cavalieri prensibi kullanılarak hesaplanmıştır. İstatistiksel analiz Student t testi kullanılarak yapılmıştır. Bulgular: Artikain solüsyonun ortalama difüzyon hacmi 3.23 cm3 olarak hesaplanmıştır. Adrenalin miktarının ve enjeksiyon lokalizasyonunun difüzyon hacmi üzerindeki etkisinin istatistiksel olarak önemli olmadığı görülmüştür (P>0.05). Sonuç: Artikainin 5 dakikalık bekleme süresi sonunda enjekte edilen solüsyon hacminin yaklaşık iki katı büyüklükteki dokuya difüze olabildiği görülmüştü

Alterations of Ionized and Total Magnesium Levels in Pregnant Women with Gestational Diabetes Mellitus

Background/Aims: The aim of this prospective study was to determine ionized and total magnesium (Mg) levels in pregnant subjects with and without gestational diabetes mellitus (GDM). Methods: Eighty-five women, 26-28 weeks pregnant, were recruited for routine oral glucose tolerance tests (OGTT); 45 had normal OGTT results and 40 were diagnosed with GDM. Electrolyte levels, including ionized and total Mg, were analyzed. Results: Gestational age and BMI were similar between the two groups (p = 0.800, p = 0.025). Multivitamin use was higher in the control group (p = 0.036). Fasting blood glucose was higher in the GDM group (p < 0.001). The median total Mg levels were 1.9 mg/dl (range 1.6-2.2) in the control group and 1.8 mg/dl (range 1.2-2.1) in the GDM group (p < 0.001). The median ionized Mg levels were 0.5 mmol/l (range 0.4-0.6) in the control group and 0.4 mmol/l (range 0.4-0.5) in the GDM group (p < 0.001). Conclusion: Our study revealed a relationship between low total and ionized Mg levels and GDM, as in type 2 diabetes mellitus (DM). The literature regarding type 2 DM and our findings suggest that Mg is the key ion in the pathophysiology of GDM. Low-dose Mg supplementation was not related to GDM; however, pharmacological doses in the various stages of pregnancy could be beneficial and should be investigated. (C) 2014 S. Karger AG, Base

Influence of an aerobic selector on copper and hexavalent chromium biosorption by activated sludge

The definitive version may be found at www.wiley.comUfuk Alkan, Siddik Cindoruk, Yücel Tasdemir, Christopher Colb

Can complete blood count inflammatory parameters in epithelial ovarian cancer contribute to prognosis? - a survival analysis

Abstract Subjective The aim of the present study was to investigate the prognostic significance of preoperative complete blood count inflammatory markers in women operated for invasive Epithelial Ovarian Cancer (EOC). Method Two hundred forty four patients that underwent operation with the diagnosis of invasive EOC between 2006 and 2014 were included in the study. The date of operation, date of recurrence and final mortality evaluations were performed for survival analysis. The sensitivity, specificity, PPV and NPV were separately calculated with ROC analysis. Survival analysis was carried out with Kaplan Meier-Log Rank Method. Results Five-years overall survival rate was 56, 9% and 5-year disease-free survival (DFS) rate was 45,5%. Advanced disease stage, moderate-poor tumor differentiation, and the presence of recurrence were determined to have significant inverse relation at mean survival and 5-year survival rates. Neutrophil/lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) had prognostic effect on both DFS and overall survival based upon the cut-off values determined in the study (PLR = 231, s36, NLR = 3,83). Histopathological subtypes were not found to have any prognostic value. In correlation analysis, PLR and NLR had positive correlation with each other and negative correlation with overall survival. Conclusions Inflammatory markers such as NLR and PLR have independent prognostic value for women who undergo surgery for invasive EOC

Protective effect of infliximab on ischemia/reperfusion injury in a rat ovary model: biochemical and histopathologic evaluation

Objective: The aim of this study was to investigate the effect of infliximab on experimentally induced ovarian ischernia/reperfusion injury (IRi)

No relationship between osteoprotegerin concentrations and endothelial dysfunction in non-obese women with and without polycystic ovary syndrome

To investigate the relationships of osteoprotegerin (OPG) concentrations to brachial artery flow-mediated vasodilation (FMD) and the carotid artery intima media thickness (CIMT) in polycystic ovary syndrome (PCOS)