ULTRASOUND FINDING OF THE »TULIP SIGN« IN A FETUS WITH ARNOLD-CHIARY II MALFORMATION AND ASSOCIATED NEUROGENIC INCONTINENCE

Ultrazvučni nalaz ’znaka tulipana’ u dosadašnjoj je literaturi opisivan kao »specifični i karakteristični znak za hipospadiju«. U osobitim okolnostima, kada se kod fetusa dijagnosticira spina bifida ili složena malformacija koja uključuje spinu bifidu, a fetus je pritom u stavu zatkom, nalaz ’znaka tulipana’ može ukazivati i na neurogenu inkontinenciju, kao u našem prikazu. Autori pretpostavljaju da je u ovom slučaju ventralna fleksija penisa nastala uslijed međudjelovanja neurogeno uvjetovane atonije penisa i gravitacijske sile.Ultrasound finding of the ’tulip sign’ has been described as »unique sonographic picture of hypospadias«. In some special conditions, if a fetus with spina bifida or a complex malformation which includes spina bifida, sits in breech presentation, this finding could indicate a neurogenic incontinence, like in our case. The autors assumed that in this case, the ventral flexion of the penis was the result of the neurogenically induced atonia of the penis and the gravitational force

COVID-19 and pregnancy

COVID-19 bolest je uzrokovana novim koronavirusom nazvanim SARS-CoV-2. Virus se iznimno brzo proširio cijelim svijetom te tako predstavio veliki izazov svim zdravstvenim sustavima. Budući je riječ o novootkrivenom virusu, veliki se napori još uvijek ulažu u razumijevanje virusa i bolesti koju uzrokuje te potrazi za učinkovitim lijekom/cjepivom. O COVID-19 i trudnoći još uvijek nedostaje informacija zbog nedostatnog broja slučajeva opisanih u literaturi te prekratkog razdoblja trajanja bolesti. U daljnjem smo tekstu opisali trenutne spoznaje o utjecaju virusa na trudnoću, porođaj i postpartalno razdoblje koristeći podatke sa službenih stranica i znanstvenih radova objavljenih do 9. svibnja 2020. godine. Klinički je tijek bolesti kod trudnica sličan onome u općoj populaciji. Loš utjecaj virusa na tijek i ishod trudnoće još uvijek nije dokazan. Još uvijek nema sigurnih dokaza o vertikalnoj transmisiji niti transmisiji virusa putem majčinog mlijeka.COVID-19 is a disease caused by a new coronavirus named SARS-CoV-2. The virus has spread throughout the world in a very short time, thus becoming a great challenge to every healthcare system. Great efforts are still being made attempting to clarify the characteristics of the virus, the disease it is causing and also in discovering an efficacious antiviral drug or vaccine. There is still a lack of information about COVID-19 in pregnancy due to a short duration of the disease and a small number of cases described in literature. This paper describes current insights about the effect of the virus on the pregnancy, delivery and postpartal period by using information from the official websites and articles published by May 9, 2020. Clinical course of the disease in pregnant women is very similar to its course in general population. There is still no evidence on the negative effect of the virus on the course and outcome of pregnancy. Also, there is still no strong evidence of vertical transmission of the virus or its transmission through breastfeeding

Preventative Valve-Sparing Aortic Root Replacement and Pregnancy Outcome in Marfan Syndrome

In Marfan syndrome, with dilatation of the aortic root secondary to an underlying connective tissue defect, pregnancy can cause hemodynamic stress leading to the development of an aortic aneurysm and even a fatal aortic dissection. In the presence of existing aortic root enlargement and a family history of aortic dissection, preventative elective surgery is suggested. Aortic root replacement with or without a valve-sparing procedure is superior to total aortic root replacement with prosthetic valve/tube graft. It provides excellent survival with low rates of aortic – valve related complications

Preventative Valve-Sparing Aortic Root Replacement and Pregnancy Outcome in Marfan Syndrome

In Marfan syndrome, with dilatation of the aortic root secondary to an underlying connective tissue defect, pregnancy can cause hemodynamic stress leading to the development of an aortic aneurysm and even a fatal aortic dissection. In the presence of existing aortic root enlargement and a family history of aortic dissection, preventative elective surgery is suggested. Aortic root replacement with or without a valve-sparing procedure is superior to total aortic root replacement with prosthetic valve/tube graft. It provides excellent survival with low rates of aortic – valve related complications

Angiogeneza u malignih tumora

Angiogeneza ili neovaskularizacija je proces stvaranja krvnih žila u odraslih, a eksperimenti upućuju na dva puta stvaranja novih krvnih žila: s pomoću endotelnih prekursorskih stanica iz koštane srži i iz već postojećih krvnih žila. Tumorski rast i metastaziranje ovisni su o angiogenezi. Klinička primjena istraživanja angiogeneze može biti dijagnostička i terapijska. Gustoća tumorske mikrocirkulacije (MVD, engl. microvessel density) pokazatelj je intenziteta angiogeneze - broj krvnih žila po jedinici površine. Imunohistokemijski biljezi (antitijela) upotrijebljeni za određivanje MVD-a prikazani su prema specifičnosti. Dokazana je povezanost MVD-a s ekspresijom stimulatora angiogeneze, tumorskim rastom i pojavom udaljenih metastaza, odnosno MVD je nezavisni prognostički čimbenik u predviđanju ishoda mnogih karcinoma. Angiogeneza u sklopu tumorskog rasta atraktivan je terapijski cilj koji se svodi na liječenje inhibicijom stimulatora angiogeneze i egzogenu primjenu inhibitora. Prikazan je pregled svih poznatih lijekova koji su u različitim fazama pretkliničkog i kliničkog ispitivanja, a samo su rijetki u široj primjeni

Primjena diodnog lasera u histeroskopiji: što trenutno znamo i što možemo očekivati u budućnosti?

Histeroskopija je metoda vizualizacije šupljine maternice koja se koristi u svrhu dijagnosticiranja i liječenja intrakavitarne patologije. Zahvaljujući razvoju tehnike uloga histeroskopije mijenjala se od dijagnostičke, preko operativne u operacijskoj dvorani, do operativne u ambulantnom okruženju. Cilj ovog preglednog članka je analizirati uporabu diodnog lasera u histeroskopiji i minimalno invazivnim postupcima u području ginekologije, raspravljajući o pozitivnim i negativnim aspektima ove tehnologije s posebnim osvrtom na buduće primjene i perspektive u području ambulantne kirurške histeroskopije

Reactive oxygen species within the vaginal space: An additional promoter of cervical intraepithelial neoplasia and uterine cervical cancer development?

Uterine cervical intraepithelial abnormalities and cancer development may also depend upon biological problems that arise as a result of complex molecular disturbances within the vaginal space, in addition to the widely known causative effect of human papillomavirus (HPV) infection. Chronic oxidative stress is a consequence of oxygen reduction in the vaginal space. Reactive oxygen species (ROS) and free radicals are yet unrecognizable causative agents and are probably very important factors for cervical intraepithelial neoplasia (CIN) and cancer development. The intermediate compounds of oxygen reduction on these metabolic pathways are superoxide anion (O2˙-), hydrogen peroxide (H2O2), hydroxide ions (OH-), and hydroxyl radical (HO˙). Considering these points, the aim of this work was to summarize how these compounds can damage all molecules, including DNA, of vulnerable metaplastic cervical epithelium. Finally, in some women with a poor immune defense system, ROS alone or accompanied by a high-risk HPV type may promote all levels of CIN and cancer development

Adipokines in patients with polycystic ovary syndrome

Sindrom policističnih jajnika (PCOS) je multisistemski, endokrinološki, reprodukcijski i metabolički poremećaj, karakteriziran oligo/anovulacijama, hiperandrogenizmom i policističnim izgledom jajnika. Često je udružen s debljinom i inzulinskom rezistencijom. Žene s PCOS imaju povišen rizik za šećernu bolest tipa 2, dislipidemiju i kardiovaskularne bolesti. Sve je više studija koje govore u prilog da je lučenje hormona masnog tkiva – adipokina (leptina, adiponektina, grelina i rezistina) promijenjeno u bolesnica s PCOS te da bi promjene u lučenju adipokina kod žena s PCOS mogle biti važan pretskazatelj kliničkog tijeka bolesti uključujući nastanak dijabetesa i kardiovaskularnih bolesti. ----- ISPITANICE I METODE: U istraživanje smo uključili 151 ženu s dijagnozom PCOS postavljenu prema Rotterdamskim kriterijima i 95 zdravih žena usklađenih prema dobi i tjelesnoj težini. Usporedili smo razine leptina, rezistina, grelina i adiponektina te biokemijskih pokazatelja inzulinske rezistencije (inzulin i HOMA indeks) i kardiovaskularnog rizika (kolesterol, LDL, hsCRP) između ispitivanih skupina s ciljem utvrđivanja razlika u njihovim vrijednostima. Potom smo usporedili vrijednosti ovih adipokina između različitih fenotipa PCOS i pokušali utvrditi koji od ispitivanih čimbenika ima najveći utjecaj na njihove serumske razine. ----- REZULTATI: Utvrdili smo statistički značajne razlike u serumskim razinama svih adipokina između ispitivanih skupina ( p<0,001). Vrijednosti inzulina i HOMA indeks te kolesterol, LDL i hsCRP bili su značajno viši u PCOS skupini (p<0,001). Značajna razlika nađena je u razinama svih adipokina unutar PCOS skupine kada smo usporedili bolesnice normalne težine s onima prekomjerne težine (p<0,001). Utvrdili smo značajnu pozitivnu povezanost koncentracija leptina i rezistina i značajnu negativnu povezanost koncentracija adiponektina i grelina s porastom težine PCOS fenotipa koji se razlikovao obzirom na nazočnost ili izočnost hiperandrogenemije, inzulinske rezistencije i debljine. Metodom standardne linearne regresije ustanovili smo najveći utjecaj same dijagnoze PCOS na razine adiponektina (β= -0,743, p<0,001) i grelina (β= -0,660, p<0,001), u serumu ispitanica, dok je na razinu leptina najveći utjecaj imao ITM (β= 0,540, P<0,001). Na razinu rezistina utjecaj dijagnoze (β= 491, p<0,001) i ITM (β= 491, p<0,001) bio je gotovo identičan. Unutar skupine PCOS ispitanica na razine svih adipokina u cirkulaciji najviše je utjecala debljina, odnosno ITM. ----- ZAKLJUČAK: Bolesnice s PCOS imaju značajno povišene razine leptina i rezistina i značajno snižene razine adiponektina i grelina u serumu u odnosu na zdrave žene, a njihove koncentracije mijenjaju se s težinom fenotipa. Identifikacijom bolesnica s promjenama u lučenju adipokina, kao putativnih markera kasnijih metaboličkih komplikacija, na vrijeme bi se moglo započeti s preventivnim strategijama u smislu promjena životnih navika i/ili korištenja lijekova koji smanjuju osjetljivost na inzulin.Polycystic ovary syndrome (PCOS) is a multisystem endocrinological reproductive-metabolic disorder, characterised with oligo/anovulation, hyperandrogenism and polycystic ovaries. PCOS is often connected with obesity and insulin resistance. Patients with PCOS have increased risk for infertility, diabetes mellitus type 2, hypetension and cardiovascular diseases. ----- STUDY SUBJECTS AND METHODS: The study included 151 women diagnosed with PCOS set by the Rotterdam criteria and 95 healthy women matched by age and weight. We compared the levels of leptin, resistin, ghrelin, and adiponectin, and biochemical parameters of insulin resistance (insulin and HOMA index) and cardiovascular risk factors (cholesterol, LDL, hsCRP) between the two groups to determine differences in their values. Furthermore, we compared the values of these adipokines among different PCOS phenotypes and tried to determine which of the examined factors have the greatest impact on their serum levels. ----- RESULTS: We found statistically significant differences in all adipokines serum levels between PCOS patients and healthy controls (p <0.001). The values of insulin and HOMA index, and cholesterol, LDL, and hsCRP were significantly higher in PCOS group (p <0.001). There were a significant differences in adipokines serum levels between normal weight (BMI ≤25) and overweight (BMI ≥25) PCOS patients (p <0.001). A significant positive correlation for the leptin and resistin concentrations, and significant negative correlation for the adiponectin and ghrelin concentrations with increasing severity of PCOS phenotype was observed (the more risk factors, such as higher BMI, hyperandrogenemia, and greater insulin resistance patient had, the lower concentration of adiponectin and ghrelin, and the higher concentration of leptin and resistin were found). By the method of standard linear regression, we found the greatest impact of the diagnosis of PCOS on adiponectin levels (β = -0.743, p <0.001) and ghrelin levels (β = -0.660, p <0.001) in the serum of patients, whereas on the leptin levels BMI had the greatest impact (β = 0.540, P <0.001). The impact of PCOS diagnosis (β = 491, p <0.001) and BMI (β = 491, p <0.001) on serum resistin levels was nearly identical. Among the PCOS patients, the greatest impact of ITM on the circulating adipokine levels was found. ----- CONCLUSIONS: Women with PCOS have significantly elevated leptin and resistin serum levels, and significantly lower adiponectin and ghrelin serum levels than healthy women, and their concentrations change with the severity of the phenotype. Identification of women with altrued adipokine expression as putative markers of possible metabolic and cardiovascular complications, would be usefull for settingup preventive strategies by life-style changes and/or use of insulin-sensitising agens

Adipokines in patients with polycystic ovary syndrome

Sindrom policističnih jajnika (PCOS) je multisistemski, endokrinološki, reprodukcijski i metabolički poremećaj, karakteriziran oligo/anovulacijama, hiperandrogenizmom i policističnim izgledom jajnika. Često je udružen s debljinom i inzulinskom rezistencijom. Žene s PCOS imaju povišen rizik za šećernu bolest tipa 2, dislipidemiju i kardiovaskularne bolesti. Sve je više studija koje govore u prilog da je lučenje hormona masnog tkiva – adipokina (leptina, adiponektina, grelina i rezistina) promijenjeno u bolesnica s PCOS te da bi promjene u lučenju adipokina kod žena s PCOS mogle biti važan pretskazatelj kliničkog tijeka bolesti uključujući nastanak dijabetesa i kardiovaskularnih bolesti. ----- ISPITANICE I METODE: U istraživanje smo uključili 151 ženu s dijagnozom PCOS postavljenu prema Rotterdamskim kriterijima i 95 zdravih žena usklađenih prema dobi i tjelesnoj težini. Usporedili smo razine leptina, rezistina, grelina i adiponektina te biokemijskih pokazatelja inzulinske rezistencije (inzulin i HOMA indeks) i kardiovaskularnog rizika (kolesterol, LDL, hsCRP) između ispitivanih skupina s ciljem utvrđivanja razlika u njihovim vrijednostima. Potom smo usporedili vrijednosti ovih adipokina između različitih fenotipa PCOS i pokušali utvrditi koji od ispitivanih čimbenika ima najveći utjecaj na njihove serumske razine. ----- REZULTATI: Utvrdili smo statistički značajne razlike u serumskim razinama svih adipokina između ispitivanih skupina ( p<0,001). Vrijednosti inzulina i HOMA indeks te kolesterol, LDL i hsCRP bili su značajno viši u PCOS skupini (p<0,001). Značajna razlika nađena je u razinama svih adipokina unutar PCOS skupine kada smo usporedili bolesnice normalne težine s onima prekomjerne težine (p<0,001). Utvrdili smo značajnu pozitivnu povezanost koncentracija leptina i rezistina i značajnu negativnu povezanost koncentracija adiponektina i grelina s porastom težine PCOS fenotipa koji se razlikovao obzirom na nazočnost ili izočnost hiperandrogenemije, inzulinske rezistencije i debljine. Metodom standardne linearne regresije ustanovili smo najveći utjecaj same dijagnoze PCOS na razine adiponektina (β= -0,743, p<0,001) i grelina (β= -0,660, p<0,001), u serumu ispitanica, dok je na razinu leptina najveći utjecaj imao ITM (β= 0,540, P<0,001). Na razinu rezistina utjecaj dijagnoze (β= 491, p<0,001) i ITM (β= 491, p<0,001) bio je gotovo identičan. Unutar skupine PCOS ispitanica na razine svih adipokina u cirkulaciji najviše je utjecala debljina, odnosno ITM. ----- ZAKLJUČAK: Bolesnice s PCOS imaju značajno povišene razine leptina i rezistina i značajno snižene razine adiponektina i grelina u serumu u odnosu na zdrave žene, a njihove koncentracije mijenjaju se s težinom fenotipa. Identifikacijom bolesnica s promjenama u lučenju adipokina, kao putativnih markera kasnijih metaboličkih komplikacija, na vrijeme bi se moglo započeti s preventivnim strategijama u smislu promjena životnih navika i/ili korištenja lijekova koji smanjuju osjetljivost na inzulin.Polycystic ovary syndrome (PCOS) is a multisystem endocrinological reproductive-metabolic disorder, characterised with oligo/anovulation, hyperandrogenism and polycystic ovaries. PCOS is often connected with obesity and insulin resistance. Patients with PCOS have increased risk for infertility, diabetes mellitus type 2, hypetension and cardiovascular diseases. ----- STUDY SUBJECTS AND METHODS: The study included 151 women diagnosed with PCOS set by the Rotterdam criteria and 95 healthy women matched by age and weight. We compared the levels of leptin, resistin, ghrelin, and adiponectin, and biochemical parameters of insulin resistance (insulin and HOMA index) and cardiovascular risk factors (cholesterol, LDL, hsCRP) between the two groups to determine differences in their values. Furthermore, we compared the values of these adipokines among different PCOS phenotypes and tried to determine which of the examined factors have the greatest impact on their serum levels. ----- RESULTS: We found statistically significant differences in all adipokines serum levels between PCOS patients and healthy controls (p <0.001). The values of insulin and HOMA index, and cholesterol, LDL, and hsCRP were significantly higher in PCOS group (p <0.001). There were a significant differences in adipokines serum levels between normal weight (BMI ≤25) and overweight (BMI ≥25) PCOS patients (p <0.001). A significant positive correlation for the leptin and resistin concentrations, and significant negative correlation for the adiponectin and ghrelin concentrations with increasing severity of PCOS phenotype was observed (the more risk factors, such as higher BMI, hyperandrogenemia, and greater insulin resistance patient had, the lower concentration of adiponectin and ghrelin, and the higher concentration of leptin and resistin were found). By the method of standard linear regression, we found the greatest impact of the diagnosis of PCOS on adiponectin levels (β = -0.743, p <0.001) and ghrelin levels (β = -0.660, p <0.001) in the serum of patients, whereas on the leptin levels BMI had the greatest impact (β = 0.540, P <0.001). The impact of PCOS diagnosis (β = 491, p <0.001) and BMI (β = 491, p <0.001) on serum resistin levels was nearly identical. Among the PCOS patients, the greatest impact of ITM on the circulating adipokine levels was found. ----- CONCLUSIONS: Women with PCOS have significantly elevated leptin and resistin serum levels, and significantly lower adiponectin and ghrelin serum levels than healthy women, and their concentrations change with the severity of the phenotype. Identification of women with altrued adipokine expression as putative markers of possible metabolic and cardiovascular complications, would be usefull for settingup preventive strategies by life-style changes and/or use of insulin-sensitising agens

Adipokines in patients with polycystic ovary syndrome

Sindrom policističnih jajnika (PCOS) je multisistemski, endokrinološki, reprodukcijski i metabolički poremećaj, karakteriziran oligo/anovulacijama, hiperandrogenizmom i policističnim izgledom jajnika. Često je udružen s debljinom i inzulinskom rezistencijom. Žene s PCOS imaju povišen rizik za šećernu bolest tipa 2, dislipidemiju i kardiovaskularne bolesti. Sve je više studija koje govore u prilog da je lučenje hormona masnog tkiva – adipokina (leptina, adiponektina, grelina i rezistina) promijenjeno u bolesnica s PCOS te da bi promjene u lučenju adipokina kod žena s PCOS mogle biti važan pretskazatelj kliničkog tijeka bolesti uključujući nastanak dijabetesa i kardiovaskularnih bolesti. ----- ISPITANICE I METODE: U istraživanje smo uključili 151 ženu s dijagnozom PCOS postavljenu prema Rotterdamskim kriterijima i 95 zdravih žena usklađenih prema dobi i tjelesnoj težini. Usporedili smo razine leptina, rezistina, grelina i adiponektina te biokemijskih pokazatelja inzulinske rezistencije (inzulin i HOMA indeks) i kardiovaskularnog rizika (kolesterol, LDL, hsCRP) između ispitivanih skupina s ciljem utvrđivanja razlika u njihovim vrijednostima. Potom smo usporedili vrijednosti ovih adipokina između različitih fenotipa PCOS i pokušali utvrditi koji od ispitivanih čimbenika ima najveći utjecaj na njihove serumske razine. ----- REZULTATI: Utvrdili smo statistički značajne razlike u serumskim razinama svih adipokina između ispitivanih skupina ( p<0,001). Vrijednosti inzulina i HOMA indeks te kolesterol, LDL i hsCRP bili su značajno viši u PCOS skupini (p<0,001). Značajna razlika nađena je u razinama svih adipokina unutar PCOS skupine kada smo usporedili bolesnice normalne težine s onima prekomjerne težine (p<0,001). Utvrdili smo značajnu pozitivnu povezanost koncentracija leptina i rezistina i značajnu negativnu povezanost koncentracija adiponektina i grelina s porastom težine PCOS fenotipa koji se razlikovao obzirom na nazočnost ili izočnost hiperandrogenemije, inzulinske rezistencije i debljine. Metodom standardne linearne regresije ustanovili smo najveći utjecaj same dijagnoze PCOS na razine adiponektina (β= -0,743, p<0,001) i grelina (β= -0,660, p<0,001), u serumu ispitanica, dok je na razinu leptina najveći utjecaj imao ITM (β= 0,540, P<0,001). Na razinu rezistina utjecaj dijagnoze (β= 491, p<0,001) i ITM (β= 491, p<0,001) bio je gotovo identičan. Unutar skupine PCOS ispitanica na razine svih adipokina u cirkulaciji najviše je utjecala debljina, odnosno ITM. ----- ZAKLJUČAK: Bolesnice s PCOS imaju značajno povišene razine leptina i rezistina i značajno snižene razine adiponektina i grelina u serumu u odnosu na zdrave žene, a njihove koncentracije mijenjaju se s težinom fenotipa. Identifikacijom bolesnica s promjenama u lučenju adipokina, kao putativnih markera kasnijih metaboličkih komplikacija, na vrijeme bi se moglo započeti s preventivnim strategijama u smislu promjena životnih navika i/ili korištenja lijekova koji smanjuju osjetljivost na inzulin.Polycystic ovary syndrome (PCOS) is a multisystem endocrinological reproductive-metabolic disorder, characterised with oligo/anovulation, hyperandrogenism and polycystic ovaries. PCOS is often connected with obesity and insulin resistance. Patients with PCOS have increased risk for infertility, diabetes mellitus type 2, hypetension and cardiovascular diseases. ----- STUDY SUBJECTS AND METHODS: The study included 151 women diagnosed with PCOS set by the Rotterdam criteria and 95 healthy women matched by age and weight. We compared the levels of leptin, resistin, ghrelin, and adiponectin, and biochemical parameters of insulin resistance (insulin and HOMA index) and cardiovascular risk factors (cholesterol, LDL, hsCRP) between the two groups to determine differences in their values. Furthermore, we compared the values of these adipokines among different PCOS phenotypes and tried to determine which of the examined factors have the greatest impact on their serum levels. ----- RESULTS: We found statistically significant differences in all adipokines serum levels between PCOS patients and healthy controls (p <0.001). The values of insulin and HOMA index, and cholesterol, LDL, and hsCRP were significantly higher in PCOS group (p <0.001). There were a significant differences in adipokines serum levels between normal weight (BMI ≤25) and overweight (BMI ≥25) PCOS patients (p <0.001). A significant positive correlation for the leptin and resistin concentrations, and significant negative correlation for the adiponectin and ghrelin concentrations with increasing severity of PCOS phenotype was observed (the more risk factors, such as higher BMI, hyperandrogenemia, and greater insulin resistance patient had, the lower concentration of adiponectin and ghrelin, and the higher concentration of leptin and resistin were found). By the method of standard linear regression, we found the greatest impact of the diagnosis of PCOS on adiponectin levels (β = -0.743, p <0.001) and ghrelin levels (β = -0.660, p <0.001) in the serum of patients, whereas on the leptin levels BMI had the greatest impact (β = 0.540, P <0.001). The impact of PCOS diagnosis (β = 491, p <0.001) and BMI (β = 491, p <0.001) on serum resistin levels was nearly identical. Among the PCOS patients, the greatest impact of ITM on the circulating adipokine levels was found. ----- CONCLUSIONS: Women with PCOS have significantly elevated leptin and resistin serum levels, and significantly lower adiponectin and ghrelin serum levels than healthy women, and their concentrations change with the severity of the phenotype. Identification of women with altrued adipokine expression as putative markers of possible metabolic and cardiovascular complications, would be usefull for settingup preventive strategies by life-style changes and/or use of insulin-sensitising agens