The aim of this study was to evaluate the myocardial changes in infants of diabetic mother either with gestational or pregestational diabetes and its relation to maternal diabetic control. The study included 45 infants of diabetic mother (IDMs) and 45 healthy newborn as a control group. IDMs were then categorized into 2 subgroups: twenty infants of mother with pregestational diabetes and twenty-five infants of mothers with gestational diabetes. The studied groups underwent measurement of the maternal and neonatal glycated Hb % (HbA1c), conventional echocardiography, tissue Doppler imaging (TDI) and two-dimensional speckle tracking imaging (STI). The weight, the rate of complications, and the rate of cesarean section were significantly higher in the IDMs group than in the control group. Significant positive correlation was present between the levels of HbA1c of IDMs and HbA1c of their mothers (P < 0.05). A significant deterioration of both systolic and diastolic functions measured by both conventional echocardiography and TDI was present in IDMs with both pre-gestational and gestational diabetes compared with the control group. Also, the septal/posterior wall ratio (SW/PW) was significantly higher in pregestational (1.86 ± 0.3) and gestational (2 ± 0.4) groups than in the control group (1 ± 0.06). Two-dimensional STI showed that the cardiac torsion was significantly impaired in pre-gestational (9.66 ± 2.5) and gestational (8.66 ± 3.9) groups when compared with the control group (5.4 ± 2.4) [P < 0.0001]. It also showed that the global strain was significantly impaired in pre-gestational (-10.4 ± 3.2) and gestational (-13.1 ± 4.7) groups when compared with the control group (-19 ± 2) [P < 0.0001]. However, no significant differences were present among the two patients' subgroups in echocardiographic data except for a significant decrease of E'/A' ratio and S wave at tricuspid annulus derived by TDI and impaired global strain derived by STI in infants of mothers with pre-gestational DM than those with gestational DM [P = 0.02]. SW/PW and cardiac torsion were significantly higher in infant of diabetic mother than the normal newborn and on the contrary systolic function and global strain were significantly lower in IDMs especially in infants of mother with pre-gestational diabetes. All the previous TDI findings did not show any significant correlation to neither maternal nor fetal HbA1c. Also, there was no significant correlation between cardiac torsion and the rest of TDI data neither in IDMs group nor in the control group. TDI and two-dimensional STI were efficient and sensitive tools able to early detect cardiac dysfunction in IDMs even in the absence of morphologic cardiac changes.
Background: Gestational diabetes mellitus (GDM) is a common complication in pregnancy, affecting more than 10% pregnancies worldwide. However, the true underlying causes remain to be fully elucidated. Aim: This study aimed at searching for any relation between first trimester uric acid concentration and the development of GDM. Subjects and Methods: The study was conducted on 250 first trimester pregnant females at risk of diabetes mellitus attending the outpatient clinic of Tanta University Hospital. All cases underwent estimation of first trimester-fasting blood sugar and maternal serum uric acid concentration. Between 24 and 28 weeks' gestation random blood sugar and glucose challenge test were done. Positive cases were confirmed by 3 h glucose tolerance curve. Results: The results demonstrated an association between first trimester maternal serum uric acid concentration obesity and GDM. Approximately, 41.4% (60/145) of non-diabetic women were at first quartile, while 44.8% (47/105) of the diabetic women were at fourth quartile. Conclusion: We concluded that the cutoff level of maternal serum uric acid of 4 mg/dl in the first trimester was associated with developing GDM. Therefore, we suggest that serum uric acid level should be done as routine test during the first antenatal care visit.
Background: Polycystic ovary syndrome (PCOS) is a multifactorial, heterogeneous, endocrine-metabolic disorder that commonly affects women at their reproductive age. PCOS is a complex syndrome characterized by chronic oligo-or anovulation, menstrual irregularities, hyperandrogenism, infertility, and polycystic ovarian morphologic features. The aim of the work WAS to evaluate the effect of vitamin D3 supplementation on insulin resistance, and visceral fat thickness in vitamin D3 deficient women with polycystic ovarian syndrome. Methods: Patients were allocated randomly into 2 groups: Group I: 30 women received 50.000 Iu of oral vitamin D3 (Cholecalciferol) (Breva) once weekly for (12) weeks. Group II (placebo group): 30 women received placebo capsules once weekly for (12) weeks. Trans-abdominal US and transvaginal US examination were performed for detailed ovary imaging Results: The difference in the glucose tolerance profile after treatment. There was a statistically significant difference between both groups regarding the mean fasting blood sugar levels (p =0.001), where the mean FBS in the intervention group was (79.60±9.464), while that of the placebo group was (89.67±9.181). Moreover, the HOMA-IR level varied significantly (p=0.017), where in the intervention group the mean level was (2.99±0.621), compared to a mean of (3.59±1.179) in the placebo group., none of the mean hormonal levels varied significantly among the intervention group from before to after treatment, except for the mean 25-hydroxy-vitamin D level (p= <0.001), which increased from (13.26±7.203) before treatment, to (26.76±15.531) after treatment. Conclusion:In conclusion, Vitamin D supplementation in an oral dose of 50.000 IU of vitamin D3 (Cholecalciferol) once weekly for (12) weeks among women with PCOS significantly increased serum 25OHD levels, and significantly decrease insulin resistance and visceral fat thickness no potential effect was detected on BMI, waist circumference (WC)and waist to hip Ratio.
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