Resent data concerning the role of insulin resistance, hyperinsulinemia and ovarian aromatase deficiency in pathogenesis of polycystic ovary syndrome are presented.
Hypothesis/aims of study. Using early non-invasive markers of diabetic nephropathy (DN) in clinical practice is important to early start of nephroprotective therapy and leads to improving the quality of life, while decreasing disability and mortality of diabetic patients. The aim of the study was to estimate the potential of using serum cystatin C and glomerular filtration rate (GFR) calculated by CKD-EPIcys and CKD-EPIcr-cys equations for an early diagnosis of DN in type 1 diabetic (T1D) women who were planning pregnancy or were in the I trimester of pregnancy. Study design, materials, and methods. 47 T1D women were examined, of whom 25 individuals were pregnant and 22 ones were planning pregnancy. In all patients, glycated hemoglobin and serum cystatin C levels were determined, GFR was estimated by the creatinine clearance test, MDRD, CKD-EPIcr, CKD-EPIcys, and CKD-EPIcr-cys equations, with diabetes training done. Results. The pregnant group and the planning pregnancy group were distinguished by glycated hemoglobin (p = 0.001), serum creatinine (p = 0.001), and GFR estimated by the creatinine clearance test (р = 0.017), CKD-EPIcr (р = 0.005), and CKD-EPIcr-cys (р = 0.046) equations. There was no difference in urinary creatinine, serum cystatin C, and GFR estimated by CKD-EPIcys equation and daily urinary protein excretion between the study groups. Most pregnant women (87.5%) were in stage C1 and only 12,5% in stage C2 as determined by estimated GFR using the CKD-EPIcr formula, which was significantly different compared to the planning pregnancy group, where the percentage of women in stages C1 and C2 was comparable (р = 0.002). In addition, most pregnant patients were in stage C1, while most of the patients planning pregnancy were referred to stage C2 by GFR estimated by CKD-EPIcysequation. Stage C3a was diagnosed in the both study groups only when CKD-EPIcys equation for GFR estimation was used. Most women from both groups were in stage C1 when GFR was estimated by the creatinine clearance test, the percentage ratio of patients in stages C1 and C2 in both groups being comparable. Conclusion. Our results demonstrated that serum cystatin C and GFR estimation by CKD-EPIcys equation could improve nephropathy diagnostic accuracy among T1D patients with a normal serum creatinine level and intact GFR based on creatinine level.
The prevalence of chronic kidney disease (CKD) is increasing worldwide. It leads to a high risk of cardiovascular disease, early disability and mortality. The severity of CKD is determined by the level of reduction in glomerular filtration rate (GFR). Modern formulas for calculating GFR based on serum creatinine give errors. The search for new informative methods of evaluation of GFR is an urgent task. A number of studies have shown the effectiveness of cystatin C determination in serum as a more sensitive indicator of GFR decline for early detection of renal pathology. The timely detection of diabetic nephropathy and the administration of nephroprotective and cardioprotective therapy is an important task in reducing the risk of cardiovascular disease and mortality. This review article discusses the possibility of using cystatin C as a marker of renal function decline, diagnosis of cardiovascular disease, and the development of preeclampsia. (For citation: Glavnova OB, Yarmolinskaya MI, Syslova SV, Borovik NV. Сystatin C potential use in the diagnosis of various diseases. Journal of Obstetrics and Women’s Diseases. 2018;67(4):40-47. doi: 10.17816/JOWD67440-47).
Hypothesis/aims of study. Polycystic ovary syndrome (PCOS) is a common disease. Depending on the diagnostic criteria, the disease is seen in 10-20% of women of reproductive age and accounts for 70-80% of all forms of hyperandrogenic syndrome. PCOS is a heterogeneous condition of multifactorial etiology characterized by various clinical, endocrine and metabolic disorders. Therefore, it is important to clarify the specific features of steroid hormone biosynthesis and metabolism and steroidogenesis enzyme activity, as well as to search for new laboratory criteria for early diagnosis and prompt treatment. The aim of this study was to perform metabolic profiling of androgens, progestins and glucocorticoids using gas chromatography-mass spectrometry (GC-MS) in obese and non-obese women with PCOS. Study design, materials and methods. We examined 53 women of reproductive age diagnosed with PCOS. The first group included 30 women aged 22 to 29 years with normal body weight. The second group comprised 23 obese patients aged 25 to 33 years with an average body mass index (BMI) of 35.3 0.4 kg/m2. The control group consisted of 25 healthy women aged 26 0.6 years having a normal BMI without clinical and biochemical signs of hyperandrogenism. Immunoassay methods were used to determine the serum levels of luteinizing hormone, follicle-stimulating hormone, free testosterone, 17-hydroxyprogesterone, and sex hormone-binding globulin. A glucose tolerance test was performed to determine glucose and insulin levels before and after load. Urine steroid profiles were studied by GC-MS with the optimization of the sample preparation schedule. Statistical data processing was performed using the STATISTICA for WINDOWS software system (version 10). The main quantitative characteristics of the patients are presented as the median (Me), the 25th percentile and the 75th percentile (Q25Q75). To compare the results obtained in the study groups, the nonparametric Mann-Whitney test was used. The 95% confidence interval was considered statistically significant. Results. The article presents a metabolomics analysis of androgens, glucocorticoid hormones and progestins in women with PCOS compared to the control group. It was revealed that non-obese patients with PCOS had increased urinary excretion of androstenedione metabolites, dehydroepiandrosterone and its metabolites, 17-hydroxypregnanolone, pregnantriol, and 5-ene-pregnenes, while obese patients with PCOS had increased that of androsterone and dehydroepiandrosterone metabolites (16-oxo-androstenediol and androstenediol-17) compared to the control group findings. Decreased ratios of cortisol and cortisone tetrahydro metabolite amount to the levels of 11-oxo-pregnanetriol, pregnanetriol and 17-hydroxypregnenolone, when compared to the control group, was obtained in non-obese patients with PCOS, which indicates 21-hydroxylase deficiency. In obese patients with PCOS, four signs of increased 5-reductase activity were obtained, and in PCOS patients with a normal BMI, three signs were obtained, which indicates varying 5-reductase activity in PCOS patients depending on the BMI. Conclusion. Quantitative evaluation of androgen and progestin metabolites, as well as 5- and 5-metabolites of androstenedione and glucocorticoids in the study of urine steroid profiles by GC-MS method opens new opportunities for PCOS diagnostics.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.