The most common microvascular complication of diabetes is diabetic retinopathy (DR). A new and recently emerged marker of oxidative stress and inflammation is monocyte to high-density lipoprotein cholesterol ratio (MHR). Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) have also been shown as they are biomarkers of systemic inflammation in various diseases. The present study aims to assess MHR, its predictive value and relations between other inflammation markers in DR patients. Materials and Methods: Sixty-eight patients with DR, fifty-four DM patients without DR and forty-two control subjects were included in this study. Complete blood count, lipoprotein and uric acid levels were recorded. MHR was calculated. Results: MHR, NLR and PLR were statistically significantly higher in DR group than DM without DR group (p=0.008, p=0.042, p=0.003, respectively). Then, receiver operating characteristic (ROC) curve analysis was performed and pointed that MHR predicted DR using a cutoff level of 0.0156 with 63% sensitivity and 76% specificity. Conclusion: In this study, we investigated MHR in DR patients and its relationship with other inflammatory markers, lipoproteins and uric acid. We suggested that an elevated admission of MHR may be of benefit to detect DR and to determine the CVD risk of these patients.
Context Enhanced levels of catecholestradiols, 2-OHE2 or 4-OHE2, are reported in endometriosis. During gestation, catecholestradiol activation of adrenergic receptors (AR) elevates estrogen receptor (ER)-independent proliferation of uterine arterial endothelial cells. Objective To investigate β-AR-mediated catecholestradiol effects on human endometrial stromal cell (HESC) and epithelial cell survival in endometriosis. Design β-AR immunostaining of eutopic and ectopic endometria (n=9). Assays for cell viability, BrdU proliferation, apoptosis, q-PCR, and estrogenicity (alkaline phosphatase activity), as well as siRNA β-AR silencing and immunoblot analyses of cultured HESCs or Ishikawa cells treated with control or 2-OHE2 or 4-OHE2 ±β-AR antagonist or ±p38 MAPK inhibitor. Setting University research institution. Patients Women ±endometriosis. Interventions None. Main Outcome Measures β-AR expression in eutopic vs. ectopic endometria and regulation of HESC survival by 2-OHE2 and 4-OHE2. Results Eutopic and ectopic endometrial stromal and epithelial cells displayed β2-AR immunoreactivity with increased staining in the functionalis vs. basalis layer (P<0.05). Both 2-OHE2 and 4-OHE2 enhanced HESC and Ishikawa cell survival (P<0.05), an effect abrogated by β-AR antagonist propranolol, but not ER antagonist ICI182,780. 2-OHE2 or 4-OHE2 failed to induce cell survival and estrogenic activity in ADRB2-silenced HESCs and in Ishikawa cells, respectively. While 2-OHE2 inhibited apoptosis and BAX mRNA expression, 4-OHE2 induced proliferation and decreased apoptosis (P<0.05). Both catecholestradiols elevated phospho-p38 MAPK levels (P<0.05), which was blocked by propranolol, and p38 MAPK inhibitor reversed catecholestradiol-enhanced HESC survival. Conclusions Catecholestradiols increase endometrial cell survival by an ER-independent β-AR-mediated p38 MAPK activation, suggesting that agents blocking β-AR, e.g., propranolol, or inhibiting 2-OHE2- or 4-OHE2-generating enzymes (i.e., CYP1A1/B1) could treat endometriosis.
gestational age (SGA)] or an intrauterine fetal demise due to placental insufficiency. METHODS AND MATERIALS: We conducted a retrospective cohort study of autologous fresh IVF cycles resulting in delivery between 2005 and 2018. All IVF procedures were conducted at a large, university-affiliated center. Patients were divided into tertiles based on their serum progesterone level on the day of hCG administration; the lowest tertile served as the reference group. We identified pregnancies complicated by preeclampsia and placental abruption using ICD-9 and ICD-10 codes and medical record review. We defined SGA as <10th percentile using U.S. growth curves. We calculated risk ratios (RR) and 95% confidence intervals (CI). RESULTS: The cohort included 143 deliveries in the lowest tertile of progesterone (0.2-0.73 ng/ml), 148 deliveries in the middle tertile (0.65-1.05 ng/ ml) and 142 deliveries in the highest tertile (1.06-5.6 ng/ml). The median maternal age was 35.3 years (interquartile range 32.6-38.3) and 23.1% of pregnancies were multiple gestations; both were similar across tertiles. The majority of patients were Caucasian (71.8%), and 64.9% were nulliparous; this also did not differ by tertile. There was a higher incidence of preterm delivery in the middle tertile (32.4%) and the highest tertile (28.2%) compared to the lowest tertile (21.7%). IPD developed in 25.9% of pregnancies. Compared with the lowest tertile, risk of IPD was greater in the middle (RR 1.5; 95% CI 1.01-2.2) and highest tertile (RR 1.2; 95% CI 0.79-1.9), after adjustment for maternal age, parity, number of oocytes retrieved, and estradiol. Compared to the lowest tertile, the risk of preeclampsia was greater in the middle tertile (RR 2.1, 95% CI 1.04-4.3,) and similar in the highest tertile (RR 1.1, 95% CI 0.49-2.5). The middle and highest tertiles were associated with an increased risk of placental abruption (RR 2.9 (95%
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