Group Of Healthy Pregnant Women Research Articles

PP015. Plasma levels and placental expression of BNP/NT-proBNP in early and late onset preeclampsia

Women with preeclampsia (PE) have elevated plasma levels of NT-proBNP. We hypothesized that the placenta may be a source to these elevated levels. Our objectives were to study the plasma levels of NT-proBNP and the protein and mRNA expression of placental BNP in women with early and late onset PE and controls. Plasma levels of NT-proBNP were measured in women with early (n=18) and late (n=20) onset PE, in two groups of healthy pregnant women in gestational week 24-32 (n=22) and 36-42 (n=14), and in non-pregnant women (n=20). Placental BNP protein and mRNA was studied with immunohistochemistry and qPCR. Placental release of NT-proBNP was studied with tissue culturing. Women with early (365 (14-9815) pg/ml) and late (176 (33-2547) pg/ml) onset PE had higher levels of NT-proBNP in plasma than their respective controls (p<0.001). A tendency towards higher plasma levels in early compared to late onset PE was observed (p=0.057). 20 out of 25 placental tissue samples had proBNP mRNA, no differences between the study groups were found. BNP protein was found in maternal spiral arteries and syncytiotrophoblasts. NT-proBNP peptide (6-7pg/ml) was present in medium used for placenta cultures. Our results suggest that there may be a placental source of NT-proBNP. If this source is responsible for the elevated plasma levels of NT-proBNP in preeclamptic women and what role, if any, BNP/NT-proBNP play in PE pathophysiology remains to be elucidated.

Assessment of hemostatic function in pregnant women undergoing surgery using a Platelet Function Analyzer-100

Assessment of hemostatic function in pregnant women undergoing surgery using a Platelet Function Analyzer-100

Following Healthy Pregnancy by Nuclear Magnetic Resonance (NMR) Metabolic Profiling of Human Urine

In this work, untargeted NMR metabonomics was employed to evaluate the effects of pregnancy on the metabolite composition of maternal urine, thus establishing a control excretory trajectory for healthy pregnancies. Urine was collected for independent groups of healthy nonpregnant and pregnant women (in first, second, third trimesters) and multivariate analysis performed on the corresponding NMR spectra. Models were validated through Monte Carlo Cross Validation and permutation tests and metabolite correlations measured through Statistical Total Correlation Spectroscopy. The levels of 21 metabolites were found to change significantly throughout pregnancy, with variations observed for the first time to our knowledge for choline, creatinine, 4-deoxyerythronic acid, 4-deoxythreonic acid, furoylglycine, guanidoacetate, 3-hydroxybutyrate, and lactate. Results confirmed increased aminoaciduria across pregnancy and suggested (a) a particular involvement of isoleucine and threonine in lipid oxidation/ketone body synthesis, (b) a relation of excreted choline, taurine, and guanidoacetate to methionine metabolism and urea cycle regulation, and (c) a possible relationship of furoylglycine and creatinine to pregnancy, based on a tandem study of nonfasting confounding effects. Results demonstrate the usefulness of untargeted metabonomics in finding biomarker metabolic signatures for healthy pregnancies, against which disease-related deviations may be confronted in future studies, as a base for improved diagnostics and prediction.

Relationship between cord blood atherogenic index and birth weight in preeclampsia

The present study was designed to analyze cord blood atherogenic index (AI) in newborns of normal pregnant and preeclamptic subjects and to correlate them with birth weight and maternal AI. The study consisted of 50 healthy pregnant women (Group I: controls) and 50 women with preeclampsia. Ten milliliter cord blood was collected from placental end of umbilical cord and 5 ml of maternal venous sample was drawn from antecubital vein at the time of delivery. Serum was separated by centrifugation and Apo A-I and Apo B levels were analyzed by immunoturbidimetric Immunoassay kits. AI was calculated as ratio of Apo B to Apo A-I. Apo B levels were significantly elevated in Group II in both cord blood and maternal blood as compared to Group I (p < 0.001). Apo A-I levels were lower in maternal blood and higher in cord blood of group II. In maternal blood, AI was higher in Group II as compared to Group I (p < 0.001). In group I, a significant positive correlation was observed between cord blood AI and birth weight and values being higher in males. In group II, a significant negative correlation observed between cord blood AI and birth weight was higher in females.

Flujo sanguíneo de la arteria hepática fetal en preeclámpticas severas y embarazadas normotensas sanas

ObjectiveTo compare blood flow in the hepatic artery in severely preeclamptic and healthy normotensive pregnant women. MethodsThe sample was composed of 30 severely preeclamptic women (group A) and 60 healthy normotensive pregnant women (group B) with single pregnancies of more than 30 weeks’ gestation. The pulsatility and resistance indexes of the uterine, umbilical, fetal middle cerebral and fetal hepatic arteries were measured. ResultsNo significant differences were found in maternal or gestational age (P=ns). Group A showed significantly higher values in the pulsatility and resistance indexes in the uterine and umbilical arteries with significantly lower values of both measurements in the fetal middle cerebral artery compared with group B (P=0.0001). Values of the pulsatility and resistance indexes of the fetal hepatic artery were significantly higher in group A than in group B (P=0.0001 and P=0.0021, respectively). The fetal hepatic artery pulsatility index was significantly correlated with the pulsatility index of the three vessels (P=0.0001). The fetal hepatic artery resistance index was correlated with the resistance index of the umbilical artery and the fetal middle cerebral artery (P=0.005 and P<0.0001, respectively). ConclusionSeverely preeclamptic women have blood flow alterations in the fetal hepatic artery when compared with healthy normotensive pregnant women.

Thermal skin reference values in healthy late pregnancy

Digital thermal imaging has been employed in medicine for over 50 years. However, its use has been focused on vascular, musculoskeletal and neurological conditions, while other potential applications, such as obstetrics, have been much less explored.This paper presents a study conducted during 2011 at the Hospital of Braga on a group of healthy pregnant women in the last third of gestation. The analysis focused on characterizing typical pregnant women steady temperature profiles in specific defined regions of interest (ROI), and determining if the thermal symmetry values for late pregnant healthy women are in line with the values for non-pregnant healthy women.A temperature distribution pattern was found in the defined ROI. The obtained thermal symmetry value had a maximum of 0.3±0.2°C, and there was no evidence for the influence of age (p>0.05) in the observed group. The influence of the BMI requires further investigation since one ROI (P2 right) presented a p=0.059, close to the threshold of statistical evidence in the influence of BMI. The study group presented symmetry values in line with non-pregnant reference values, but the profiles in temperature distribution are different. Assumptions can therefore now be used with higher confidence when assessing abnormalities in specific pathologic states during pregnancy using the defined ROI. This work represents a first contribution towards establishing guidelines for future research in this specific field of study.

OS004. A link between the complement system and angiogenic imbalance inpreeclampsia: ficolin-2 deficiency

An excessive maternal systemic inflammatory response to pregnancy, as well as an imbalance between circulating angiogenic factors and their antagonists plays a central role in the pathogenesis of preeclampsia. The complement system, as part of innate immunity, is fundamental to the host's immune defense against microbial pathogens, apoptotic and necrotic cells. Both of its excessive activation and deficiencies can lead to various disorders. The aim of this study was to determine circulating levels of components of the complement system and their relationship to those of angiogenic factors in normal pregnancy and preeclampsia. Sixty preeclamptic patients, 60 healthy pregnant women and 59 healthy non-pregnant women were involved in this case-control study. Circulating levels of C1rC1sC1-inh, C3bBbP, C4d, C3a, SC5b9, ficolin-2, ficolin-3, soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF), as well as activity of the complex of mannose-binding lectin and mannose-binding lectin-associated serine protease 2 (MBL-MASP2 complex) were measured. For statistical analyses, non-parametric methods were applied. Circulating levels of C3bBbP, C4d, C3a, SC5b9, sFlt-1, PlGF, as well as MBL-MASP2 activity were significantly higher, while ficolin-2 concentrations were significantly lower in healthy pregnant than in healthy non-pregnant women. Furthermore, preeclamptic patients had significantly higher C1rC1sC1-inh, C3bBbP, C4d, C3a, SC5b9 and sFlt-1 levels and significantly lower ficolin-2, ficolin-3 and PlGF concentrations than healthy pregnant women. In the groups of healthy pregnant women and preeclamptic patients, plasma ficolin-2 levels showed a significant positive correlation with serum PlGF concentrations and a significant inverse correlation with serum levels of sFlt-1. There was no other relationship between complement components and angiogenic factors in either study group. Elevated levels of activation products in the systemic circulation indicate complement activation with increased terminal complex formation in preeclampsia, which seems to be independent from alterations in circulating angiogenic factors. Nevertheless, low ficolin-2 concentrations might contribute to the angiogenic imbalance in preeclampsia by impaired removal of the sFlt-1-containing trophoblast-derived material released into the maternal circulation by the hypoxic and oxidatively stressed preeclamptic placenta.

Salivary cortisol levels as a predictor of preeclampsia in adolescents

Objective: To determine the usefulness of salivary cortisol as a predictor of preeclampsia in adolescents.Methods: We carried out a nested case- control study. Somatometric, clinical, and biochemical data were obtained from 100 healthy pregnant adolescents and salivary cortisol was measured at 8:00, 12:00, and 20:00 hours on twooccasions during pregnancy, before 20 weeks, and after 30 weeks of gestation. The cortisol values between the group of healthy pregnant women and the group that developed preeclampsia were compared by using the Student’s t, Mann-Whitney, and Wilcoxon tests. Also, the ROC curve of cortisol values and the Positive and Negative Predictive values of cortisol were estimated.Results: Values &gt;14.9 nmol/L of cortisol were observed in the group that developed preeclampsia, providing a positive predictive value of 1 (100%). Values &lt;10.1 nmol/L were observed in the control group, the negativepredictive value was 1 (100%). The cutoff point of the ROC curve -before 20 weeks of gestation- in the members of the cohort was 13.9 nmol/L.Conclusions: The salivary cortisol values observed in the two evaluations made to each of the groups showed statistically significant differences between the groups at 8 and 12 hours of the day. The values obtained enable establishing gradients that allow separating the group of healthy women that got ill with preeclampsia from the group that did not develop the illness before week 20. After week 30, the cortisol gradients are established more clearly in the group with preeclampsia and in the control group. The validation of these findings in larger samples would allowimplementing this procedure as a screening test for preeclampsia in groups of pregnant adolescents.

Plasma IL-4, IL-8, IL-12, interferon-γ and CRP levels in pregnant women with preeclampsia, and their relation with severity of disease and fetal birth weight

Objective: The aim of the present study was to evaluate the hypothesis that preeclampsia is associated with increased systemic inflammatory responses of Th1-type as well as decreased Th2-type responses compared with normal pregnancy. We also sought to determine whether there was a correlation between these markers with severity of preeclampsia and fetal birth weight. Methods: The study population consisted of maternal age, gestational age, and body mass index matched 138 pregnant women; 56 normotensive healthy pregnant women (group 1), 42 women with mild preeclampsia (group 2), 40 women with severe preeclampsia (group 3). Results: Plasma interleukin (IL)-8 and C-reactive protein (CRP) levels were significantly higher in group 3 than group 1 (p < 0.05). Plasma IL-4, IL-12, and interferon (IFN)-γ levels were similar in all groups. Although plasma IL-8 and CRP levels of mild preeclamptic group were higher than control group and lower than severe preeclamptic group, the differences were not statistically significant. There was a positive correlation between IL-12 and fetal birth weight in severe preeclamptic group (p < 0.05). Conclusions: Elevated maternal serum pro-inflammatory cytokine IL-8 and CRP in severe preeclamptic women compared with normal pregnant women supports the hypothesis that preeclampsia is associated with increased inflammatory responses.

The use of hormones indicators in human saliva in diagnosing parodontitis in pregnant women.

AIMS:The purpose of this work– was to study the dynamics of biochemical parameters of human saliva and analyze the features of the chemical composition of the saliva of women with abnormal pregnancy and in periodontitis against pregnancy.MATERIALS AND METHODS:The study included four groups of women: a control group of nonpregnant women of childbearing age (10), pregnant women with physiological pregnancy (24-28 weeks) without any signs of periodontal disease (10), pregnant with a generalized periodontitis I--II degrees in remission (10), women with pathological pregnancy with no signs of periodontal inflammation (10). In each of the groups over two samples of saliva were collected, the first collection of saliva in the morning on an empty stomach. Then mouthwash 0.9% sodium chloride solution was assigned and after 30 minutes the second portion of saliva. By enzyme immunoassay in samples of saliva of control groups of nonpregnant and pregnant women, as well as women with signs of a pathological course of pregnancy, the content of estriol, testosterone, and dehydroepiandrosterone sulfate was determined.STATISTICAL ANALYSIS USED:Statistical data analysis was performed by the standard technique using Student's t-test.RESULTS:The results of biochemical analysis of saliva samples collected before rinsing the mouth with saline in groups of healthy nonpregnant and pregnant women were compared. It was established that during pregnancy the concentration of salivary estriol increases, but in pregnant women with periodontitis, the amount of this hormone in the saliva was significantly reduced. The highest content of testosterone in saliva samples, observed in healthy pregnant women, was significantly higher than nonpregnant women.In pregnant women with periodontitis concentration of testosterone in saliva is reduced, while remaining significantly higher than its level in the saliva of nonpregnant women. The highest concentration of testosterone is observed in the saliva of healthy pregnant women with periodontitis, but the smallest concentration of testosterone is found in the saliva of nonpregnant women. Also the nonpregnant group has the lowest levels of DHEA in pregnancy, and its content increases almost threefold when periodontal disease further growsCONCLUSIONS:It was established that periodontitis against pregnancy is characterized by higher levels of salivary DHEA sulfate and lower estriol, compared with a control group of pregnant women.

THE PATHOPHYSIOLOGY OF ENDOTHELIAL FUNCTION IN PREGNANCY AND THE USEFULNESS OF ENDOTHELIAL MARKERS

The aim of this study was to assess coagulation markers of endothelial damage and examine new markers of endothelial activation such as matrix metalloproteinases (MMPs) in a group of healthy pregnant women. Matrix metalloproteinase (MMP)-2, in particular, plays a major role in the degradation of the extracellular matrix confirming its essential function in both the survival (angiogenesis) and death of endothelial cells. Detection of specific coagulation factors, mainly released from the vascular endothelium such as vWF, sTM (soluble thrombomodulin) and ePCR (endothelial protein C receptor) and factors dependent on endothelial activation such as t-PA and PAI-1, could provide information on possible endothelial dysfunction and help differentiate pregnant patients with an altered thrombotic state. Healthy pregnant women underwent complete assessment for endothelial damage (as vWF, vWF activity, sTM, ePCR, EMP, MMP-2, MMP-9 and TIMP-2) using the ELISA and other methods. The results show that endothelial activation during pregnancy is different from that in other pathological conditions involving endothelial damage and typically characterized by higher levels of both coagulation endothelial markers and MMPs. In pregnancy, changes in extracellular matrix composition and matrix metalloproteinase activity also occur and promote vascular remodeling but, only in the uterus. Predisposing risk factors for epithelial dysfunction, and vascular mediators associated with vascular remodeling must be assessed from concentrations in whole blood. The levels of MMPs are not increased in the circulation and the local situation in the uterus cannot be monitored this way. However, MMP-2 processes and modulates the functions of many other vasoactive and pro-inflammatory molecules including adrenomedullin, big endothelin-1, calcitonin gene-related peptide, CCL7/MCP-3, CXCL12/SDF-1, galectin-3, IGFBP-3, IL-1 Beta, S100A8, and S100A9. These molecules represent new potential molecular markers of endothelial damage during pregnancy.

Flujo sanguíneo de las arterias renales fetales en preeclámpticas graves y embarazadas normotensas sanas

Objective To compare the blood flow in fetal renal arteries in severe preeclamptic and healthy normotensive pregnant women. Method The sample consisted of 30 women with severe preeclampsia (group A) and 30 healthy normotensive pregnant women (group B) with single pregnancies of more than 30 weeks. The pulsatility and resistance indexes of the uterine, umbilical, fetal middle cerebral and fetal renal arteries were measured. Results There were no significant differences in maternal age, gestational age or newborn weight (p = ns). Pulsatility and resistance index values in the uterine and umbilical arteries were significantly higher and both measurements for the fetal middle cerebral artery were significantly lower in group A than in group B (p = 0.0001). Pulsatility and resistance index values in the fetal renal artery were significantly higher in group A than in group B (p = 0.0001). The fetal renal artery pulsatility index was significantly correlated with the pulsatility index of the uterine artery (p = 0.011) and the fetal middle cerebral artery (p < 0.007). The fetal renal artery resistance index was correlated with the resistance index of the three vessels (p < 0.05). Conclusion Women with severe preeclampsia show blood flow alterations in the fetal renal arteries compared with healthy normotensive pregnant women.

Micropartículas endoteliales en preeclampsia y eclampsia

Objective To compare endothelial microparticles values in eclamptic, preeclamptic and normotensive pregnant women. Materials and methods Patients were selected among those who assisted to Obstetrics Emergency at Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. There were included 30 patients with mild preeclampsia (group A), 30 patients with severe preeclampsia (group B) and 30 patients with eclampsia (group C). A control group was selected for having similar age and body mass index to studied groups and consisted in 35 healthy pregnant women (group D). There were included only nuliparous patients. Blood samples were collected in all patients before delivery and in studied groups immediately after diagnosis for endothelial microparticles determination. Results There were statistically significant differences in gestational age between groups B and C compared with controls ( P < .05). Higher values of endothelial microparticles were observed in eclamptic patients together with severe preeclamptic patients. Lower values were found in mild preeclamptic patients. Studied groups presented significant higher values of endothelial microparticles compared with controls ( P < .05). When linear regression was performed, factors that significantly affected endothelial microparticles values were: uric acid, 24-hour proteinuria, transaminases and platelet count ( P < .05). Conclusions The findings of this research showed that eclamptic and preeclamptic patients had higher endothelial microparticles values than normotensive pregnant women.

Role of Maternal Serum Procalcitonin, Interleukin-6 and hs-C Reactive Protein in Prediciton of Subclinical (Intrauterine) Infection in Preterm Premature Rupture of Membranes

Objective: To evaluate the role of procalcitonin (PCT), high senstive C-reactive protein (hs-CRP) and Interleukin-6 (IL-6) for prediction of subclinical intrauterine infection in pregnant women with preterm premature rupture of membranes. Methods: Twenty patients with preterm premature rupture of membranes PPROM (study group) and twenty apparently healthy pregnant women (control) group between 26-34 weeks of pregnancy were enrolled in this study. In all cases analysis of serum procalcitonin by high performance liquid chromatography, Il-6 by ELISA method and hs-CRP by nephelometry were done. Culture of vaginal bacteria was done for study group only. Results: Procalcitonin levels in the PRROM group were significantly higher than in healthy pregnant women (median 1.95 versus 0.39-Interquartile range 1.375 versus 0.213 – P0.001). A significant correlation was observed between PCT and hs-CRP (r=0.510; P0.031) and leucocytosis (r=0.544- P 0.013). Also IL-6 levels were significantly higher in cases of PPROM compared with control group (median 40.01 versus 5.55 – Interquartile range, 45.88 versus 4.22 P 0.001). No significant correlation was present between PCT and IL-6 Conclusion: Determination of PCT, hs-CRP and IL-6 in mother's blood sample can be useful for diagnostics of PPROM cases suspected of intrauterine infection. However PCT more valuable and specific.

Assessment of ischemia-modified albumin level in patients with recurrent pregnancy loss during the first trimester

ObjectiveThe finding that ischemia-modified albumin (IMA) is increased in pre-eclamptic pregnancy suggests a role for IMA as a potential biomarker for abnormal placental development related to miscarriage. This study was undertaken to evaluate IMA levels in women with recurrent pregnancy loss (RPL). Study designThis case–control study was performed between March 2008 and September 2009, at the Department of Obstetrics and Gynecology of Meram School of Medicine. Serum IMA and albumin concentrations were assessed in 43 women with a history of two or more unexplained first trimester miscarriages (group 1), and 42 healthy pregnant women (group 2) in the first trimester. IMA, adjusted IMA and albumin concentrations were compared between the groups. Statistical analysis was performed using Student's t-test and Mann–Whitney U test. ResultsIMA and adjusted IMA levels were significantly higher in women with RPL (1.11+0.08 and 1.09+0.09, respectively) compared to women in group 2 (0.88+0.10 and 0.88+0.11, respectively). Albumin levels in group 1 were significantly lower compared with group 2. There was a negative correlation between IMAand albumin levels in each group. ConclusionMaternal IMA levels appear to be elevated in women with early RPL. This finding may suggest that an abnormally high hypoxic intrauterine environment may be associated with abnormal placental development that contributes to early miscarriage.

The classification and diagnosis of lumbopelvic pains in pregnant women

The known definitions and classifications of lumbopelvic pain (LPP) in pregnant women describe only or mostly the pain localization, but do not reveal its essence. The article contains materials concerning the improvement of the clinical classification of LPP in pregnancy and diagnostic evaluation of clinical syndromes and provocative tests on the basis of the study of protocols of clinical examinations of pregnant women, who took medical advice for their LPP (group A, n = 76), and a group of healthy pregnant women without LPP (group B, n = 25). The suggested classification reflects the modern level of knowledge about the essence of LPP and, as the knowledge improves, can be supplemented and modified. In order to improve the quality of LPP diagnosis in pregnancy, it is necessary to use at least 3-5 of the most informative clinical syndromes and provocative tests.

Obstetrical and fetal outcomes of a new management strategy in patients with intra-hepatic cholestasis of pregnancy

To determine the incidence, obstetrical, and fetal complication rates of intrahepatic cholestasis of pregnancy (ICP) in patients managed expectantly to 40-weeks gestation. In a prospective cohort study conducted between February 2008 and January 2010, a total of 21,960 pregnant women in Qassim Region of Saudi Arabia were screened for ICP using specific criteria for diagnosis. The course of pregnancy was monitored to 40-weeks gestation or spontaneous onset of labor, whichever comes first. The measured outcomes were compared with a cross-matched group of healthy pregnant women. Continuous variables were analyzed with t test, while χ(2) test was used for comparing percentages. The incidence of ICP was 0.35% (76/21,960). There was no significant difference between groups in gestational age at delivery, preterm labor, intrauterine fetal death, cesarean section, or respiratory distress syndrome. There was significantly higher intrapartum non-reassuring fetal heart rate patterns and meconium-stained amniotic fluid in ICP group (P < 0.01 and <0.0001, respectively). The incidence of ICP in this region is low compared to worldwide range. Expectant management to 40-weeks gestation is associated with obstetrical and fetal outcomes comparable to normal pregnancy; however, intrapartum fetal asphyxia is more likely.

Plasma lipocalin-2 levels in pregnant women with pre-eclampsia, and their relation with severity of disease

Objective. To compare lipocalin-2 (LCN2) levels in pre-eclamptic women with those in healthy pregnant women, and to determine whether there is a correlation between LCN2 levels and the severity of the disease.Methods. The study included 66 pregnant women: 22 healthy pregnant women (Group 1), 23 women with mild pre-eclampsia (Group 2), and 21 women with severe pre-eclampsia (Group 3). Pre-eclamptic women and normal controls were carefully matched for maternal age, gestational age, and body mass index (BMI). The maternal levels of plasma LCN2 were determined by enzyme-linked immunosorbent assay.Results. Plasma LCN2 levels in the pre-eclamptic group were significantly lower than those in the healthy control group (p < 0.05). Although plasma LCN2 level was lower in the severe compared to the mild pre-eclamptic group, the difference was not statistically significant (p > 0.05). There was no significant correlation between LCN2 levels and the homeostasis model assessment of insulin resistance (HOMA-IR), BMI, triglyceride, gestational week at delivery, birth weight, and systolic and diastolic blood pressure in pre-eclamptic and healthy pregnant women (p > 0.05).Conclusions. Our results show that there are decreased concentrations of plasma LCN2 in pre-eclamptic subjects and this may indicate that LCN2 plays a role in the pathogenesis of pre-eclampsia. However, further experiments are needed to clarify this role.

Ovarian cancer: evaluation of the leukocyte adherence inhibition assay.

The Leukocyte Adherence Inhibition (LAI) assay has been evaluated for clinical use in the management of patients with ovarian cancer. Studies on the tube method included determination of the optimal concentration of cells used and the type, or presence or absence, of serum supplement utilised; also the effect on LAI of various specific and non-specific crude antigen preparations. A refined assay was used to compare data from 21 patients with epithelial ovarian cancer, a miscellaneous group of other types of cancer and control groups of healthy pregnant and non-pregnant women of reproductive age. Positive LAI responses were produced in some patients with ovarian cancer, but there were no significant differences between the groups. It was concluded that lack of reactivity in patients with widespread disease, early loss of reactivity in remission, and moderation of the LAI index by concurrent therapy would limit the practical use of this assay to monitor the host response of patients with ovarian cancer.

Plasma visfatin levels in pregnant women with normal glucose tolerance, gestational diabetes and pre-gestational diabetes mellitus

Objective. Visfatin, an adipocytokine, is a peptide predominantly expressed in and secreted from visceral adipose. In this study, we aimed to compare visfatin levels in gestational (GDM) and pre-gestational diabetic (pre-GDM) women with healthy pregnant women. We also sought to determine whether there was a correlation between visfatin levels and serum glucose levels at 1 h after the 50-g oral glucose challenge test in pregnant women with GDM and normal glucose tolerance.Methods. The study consisted of 65 pregnant women: 21 patients with GDM (Group 1), 20 patients with pre-GDM (Group 2) and 24 gestational age and BMI-matched healthy pregnant women (Group 3) were enrolled.Results. Plasma visfatin levels in Groups 1 and 2 were significantly higher than in Group 3 (P < 0.001). Plasma visfatin levels in Groups 1 and 2 were similar (P > 0.05). There was no significant correlation between visfatin levels and serum glucose levels at 1 h after the glucose tolerance test in both Groups 1 and 3 (P > 0.05).Conclusions. Our results support the literature indicating higher visfatin levels in women with GDM compared to women with normal glucose tolerance. Interestingly, we found similarly high visfatin levels in women with pre-GDM.