In pregnancy, complex alterations occur in lipid metabolism. Percent change in TG is affected positively by the nutrition level. The neonatal weight also increases as well but postnatal weight is unaffected. Conversely TG levels significantly decrease in preterm birth. No association between preeclampsia and gestational diabetes mellitus with lipid profile changes were noted except in patients with glucose intolerance (>140 mg/dl in 50 g screening test) in which change in cholesterol, LDL was low and TG was high.

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Polycystic ovary syndrome (PCOS) is one of the most common causes of female infertility. It affects nearly 5-10% of young women. It is characterized by the presence of hirsutism, acne, anovulation, hyperandrogenism, polycystic ovaries, and infertility [1]. Many mechanisms have been reported to be responsible for the pathophysiology of PCOS. The condition is thought to be determined by complex interactions between the hypothalamic-pituitary-ovarian or hypothalamic-pituitary-adrenal axis functions and metabolic disorders, such as obesity, insulin resistance (IR), and compensatory hyperinsulinemia [2]. PCOS increases the prevalence of hyperglycemia, hypertension, and dyslipidemia [3], increasing thus the risk of developing cardiovascular diseases [4].Nesfatin-1 (N1) is derived from nucleobindin 2 (NUCB2), which is encoded by the NUCB2 gene. It is a newly identified peptide that has 82 amino acids [5]. It is released from several tissues including forebrain, hindbrain, brainstem, spinal cord, adipose tissues [6]. It has an anorexigenic effect and plays an important role in hypothalamic pathways such as regulating food intake, energy homeostasis, water intake, and body temperature [7,8]. In addition, it exerts cardiovascular and hypertensive effects [9]. It is closely related to glucose, insulin metabolism, and IR [5,10]. Several studies have demonstrated N1 to be associated with body mass index (BMI), IR, inflammatory stimulation in diabetes, hypertension, and PCOS [9][10][11]. It may also affect the control of the reproduction system, e.g. puberty onset and gonadotropin secretion [12]. ABSTRACTObesity, insulin resistance (IR), inflammation, and hyperandrogenism may lead to polycystic ovary syndrome (PCOS) and hypertension. Nesfatin-1 (N1) may be related to IR, obesity, and hypertension. Furthermore, a vitamin D (VD) deficiency is associated with hypertension and PCOS. We aimed to investigate N1 and VD levels in PCOS that have an effect on systolic and diastolic blood pressure (BP) and heart rate (HR). This study included 54 patients with PCOS and 48 age-body mass index (BMI)-matched healthy controls. PCOS was diagnosed according to clinical practice guidelines. Ferriman-Gallwey scores (FGS) were calculated, while N1, VD, and other hormonal and biochemical parameters were measured for all subjects. Systolic and diastolic BP was measured as well. HR was calculated using an electrocardiogram. The levels of N1 (p < 0.001), high-sensitivity C-reactive protein (hs-CRP) (p = 0.036), homeostasis model assessment as an index of insulin resistance (HOMA-IR) (p < 0.001), systolic (p < 0.001) and diastolic (p < 0.001) BP and HR (p < 0.001) in the PCOS group were significantly higher than in the control group. However, the VD levels of the PCOS group were lower than the control group (p = 0.004). N1 had a strong positive correlation with BMI, HOMA-IR, hs-CRP, luteinizing hormone, systolic and diastolic BP, and HR. VD levels were negatively correlated with HOMA-IR and luteinizing hormone. Elevated N1 and decreased VD levels may...

Suction curettage is a viable alternative for conservative treatment in selected cases of patients who are diagnosed with CSP early in gestation and who have a myometrial thickness of more than 4.5 mm.

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Objectives: The aim of our study was to compare serum irisin concentrations in pregnant women with and without gestational diabetes mellitus (GDM). Material and methods:This study was performed at the Tertiary Care Center, Department of Obstetrics and Gynecology, between January 2014 and April 2014. A total of 45 pregnant women with GDM (diabetes group) and 41 BMI-and age-matched healthy pregnant women (control group) were recruited. Maternal serum irisin levels were measured by enzyme-linked immunosorbent assay kit at 24-28 weeks of gestation. An association between maternal serum irisin levels and metabolic parameters was analyzed. Body mass index, serum levels of glucose, insulin and irisin were tested and analyzed in the study group and controls.Results: Pregnant women with GDM had significantly higher fasting plasma glucose (p = 0.001), first-hour OGTT glucose (p = 0.001), second-hour OGTT glucose (p = 0.001), and fasting insulin (p = 0.045) levels as compared to controls. Serum irisin levels were 1.04 ± 0.3 and 1.3 ± 0.2 in pregnant women with GDM and healthy pregnant controls, respectively (p = 0.001). Correlation analysis between irisin levels and anthropometric and biochemical parameters in patients with gestational diabetes revealed that none of the investigated parameters correlated with serum irisin level. Conclusions:Our results suggest that serum irisin levels might be introduced as a novel marker for GDM, with decreased levels of irisin being indicative of GDM.

We assessed the impact of pain, dysmenorrhoea and dyspareunia on the quality of life among Turkish fertile women with severe endometriosis. A total of 33 patients with histopathologically diagnosed severe endometriosis (Stage IV, revised criteria of the American Fertility Society (rAFS score) were enrolled into the study. Patients reported chronic pelvic pain using a visual analogue scale (VAS) and severity of dysmenorrhoea, dyspareunia and pelvic tenderness using the verbal rating scale (VRS). Quality of life (physical, psychological, social, environmental domains) was evaluated using the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF). There were no correlations between quality of life and VRS and VAS scores of chronic pelvic pain in patients with dyspareunia (p > 0.05). VRS in patients with dysmenorrhoea negatively correlated with physical, social and environmental dimensions of quality of life (r = -0.382, r = -0.221, r = -0.373 and p = 0.028, p = 0.013, p = 0.033, respectively). Although the severity of dysmenorrhoea seems to be related with lower quality of life, chronic pelvic pain and dyspareunia due to endometriosis may not have any deleterious effects on the quality of life.

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