Atherosclerosis and Endometriosis: The Role of Diet and Oxidative Stress in a Gender-Specific Disorder

Eating for Optimization: Unraveling the Dietary Patterns and Nutritional Strategies in Endometriosis Management

Endometriosis is a chronic gynecological disorder affecting millions of women worldwide, causing chronic pelvic pain, dyspareunia, dysmenorrhea, and infertility, and severely impacting their quality of life. Treatment primarily involves hormonal therapies and surgical excision, but high recurrence rates and the economic burden are substantial. With these challenges, significant discussion surrounds the potential role of dietary patterns in managing endometriosis, making it necessary to bridge this critical gap. This review investigates the current scientific evidence on the dietary patterns (eg, Mediterranean, vegetarian, anti-inflammatory, low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols [low-FODMAP], and Western-style diets) associated with endometriosis and provides a concise, yet thorough, overview on the subject. In addition, antioxidants, microbiota, and artificial intelligence (AI) and their potential roles were also evaluated as future directions. An electronic-based search was performed in MEDLINE, Embase, Cochrane Library, CINAHL, ClinicalTrials.gov, Scopus, and Web of Science. The current data on the topic indicate that a diet based on the Mediterranean and anti-inflammatory diet pattern, rich in dietary fiber, omega-3 fatty acids, plant-based protein, and vitamins and minerals, has a positive influence on endometriosis, yielding a promising improvement in patient symptoms. Preclinical investigations and clinical trials indicate that dietary antioxidants and gut microbiota modulation present potential new approaches in managing endometriosis. Also, AI may offer a promising avenue to explore how dietary components interact with endometriosis. Ultimately, considering genetic and lifestyle factors, a healthy, balanced, personalized approach to diet may offer valuable insights on the role of diet as a means of symptom improvement, facilitating the utilization of nutrition for the management of endometriosis.

High-Intensity Interval Training Enhances the Positive Effect of Pentoxifylline on Lipid Profile and Inflammatory Markers in an Endometriosis Animal Model

Background: The relationship between endometriosis and cardiovascular disease (CVD) is well established. However, the effects of various exercise training modalities and the anti-inflammatory effects of pentoxifylline (PTX) remain inadequately understood. This investigation is aimed at evaluating the effects of PTX, both independently and in conjunction with high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), on lipid and inflammatory markers including triglycerides (TGs), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and C-reactive protein (CRP) in a rat model of endometriosis. Materials and Methods: Sprague-Dawley's rats were divided into two primary groups: the healthy control group that received no intervention and the induced endometriosis group. Endometriosis was surgically induced in rats, and those with confirmed endometriotic lesions were further categorized into six groups: control, MICT, drug of PTX (D), MICT+D, HIIT, and HIIT+D. Two weeks after laparotomy, PTX consumption and exercise training were performed for 8 weeks. PTX was administered orally at 100 mg/kg/day. MICT and HIIT sessions were conducted 5 days per week, with MICT beginning at 55% of maximum capacity for 31 min in the first week and progressing to 70% of maximum capacity for 46 min by the eighth week. HIIT sessions consisted of 2 min of running followed by 1 min of passive rest at 85% of maximum capacity, starting with seven intervals in the first week and increasing to twelve by the end of the eighth week. The macroscopic size of endometriosis lesions was measured, and cardiovascular risk factors, including hs-CRP, TC, TG, HDL-C, and LDL-C, were assessed in serum samples. Results: The induction of endometriosis was associated with elevated cardiovascular risk factors, including hs-CRP, TC, and TG. HIIT+D significantly decreased lesion volume (p < 0.0001, 95%confidence interval (CI) = 57.239-94.718), hs-CRP (p = 0.049, CI = -54.083 to - 29.478), TC (p = 0.045, CI = -38.607 to - 25.392), and TG (p = 0.042, CI = 25.531-55.801). PTX significantly decreased lesion volume (p < 0.0001, CI =34.709-73.919) and TC (p = 0.016, CI = -45.153 to - 30.179). Conclusion: All interventions except MICT reduced lesion volume, whereas only HIIT+PTX and PTX, in the order of importance, improved some cardiovascular risk indices in the rat model of endometriosis.

Evaluation of Heavy Metal and Specific Trace Elements Levels Among Fast-Food Workers and Their Susceptibility to Atherosclerosis

Fast-food workers in Iraq face significant health risks due to exposure to heavy metals from fumes and dust during cooking activities. Heavy metals, such as lead (Pb), cadmium (Cd), and nickel (Ni), are toxic to cells even at low concentrations and can cause health risks, including atherosclerosis, due to oxidative stress and reduced antioxidant activity. To the best of our knowledge, this is the first study assess the levels of heavy metals in fast-food workers and investigate their potential link to atherosclerosis development by monitoring the levels of copper (Cu), zinc (Zn), magnesium (Mg), manganese (Mn), and iron (Fe). A total of 120 male participants aged between 20 and 40 years were included in the study, with 40 fast-food workers, 40 patients with atherosclerosis, and 40 healthy individuals evaluated. The levels of Pb, Cd, Ni, Cu, Zn, Mg, Mn, and Fe in all blood samples were determined using atomic absorption spectrometry. Results showed that the fast-food worker group had significantly higher levels of Pb, Cd, Cu, and Fe compared to the healthy control group, with increases of 57%, 75%, 30%, and 55%, respectively. Conversely, their levels of Zn and Mg were significantly lower, decreasing by 15% and 16%, respectively. On the other hand, the atherosclerosis patients' group had significantly higher levels of Pb, Cd, Cu, and Fe, with increases of 47%, 74%, 34%, and 28%, respectively, as well as significantly lower levels of Zn and Mg, decreasing by 17% and 21%, respectively, compared to the control group. These findings suggest that fast-food workers are at risk of developing atherosclerosis due to exposure to high levels of heavy metals and imbalances in essential trace elements. The results showed a significant increase in the levels of Pb and Cd in the sera of these workers, which was expected because of the long duration and high intensity of exposure to toxic heavy metals. This is a serious indicator that must be considered, as it has been previously established that increased levels of Pb and Cd in the body are linked to the risk of atherosclerosis. Additionally, an association between Pb and Cd levels and an imbalance in trace element levels (Cu, Zn, Mg, and Fe) were observed. The Implementation of stricter regulations and guidelines for maintaining cleanliness and safety in fast-food restaurants may be crucial for protecting workers and preventing long-term health complications.

Endometriosis and risk of cardiovascular disease: a systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis aimed to evaluate the association between endometriosis and the risk of cardiovascular disease (CVD).

METHODS

A comprehensive literature search was conducted in PubMed (Medline), Scopus, Web of Science, and Embase, covering studies published from January 2000 to April 2023. Cohort and case-control studies investigating the relationship between endometriosis and CVD risk were included. Random-effects or fixed-effects models were used depending on the heterogeneity among studies. Pooled relative risks (RR) with 95% confidence intervals (CIs) were calculated. Study quality was assessed using an appropriate tool, and statistical heterogeneity was evaluated using the I2 statistic. The review was conducted following PRISMA 2020 guidelines.

RESULTS

Six studies were included in the meta-analysis. Women with endometriosis had a 23% higher risk of developing CVD (RR = 1.23; 95% CI: 1.16-1.31) compared to those without endometriosis. Additionally, the risk of hypertension was 13% higher among women with endometriosis (RR = 1.13; 95% CI: 1.10-1.16). Moderate heterogeneity was observed across studies, and a random-effects model was applied.

CONCLUSION

This meta-analysis highlights an increased risk of CVD and hypertension among women with endometriosis. These findings underscore the importance of cardiovascular monitoring and preventive strategies in this population.

TRIAL REGISTRATION

PROSPERO (ID: CRD42023398887).

Fibrinogen Structural Changes and Their Potential Role in Endometriosis-Related Thrombosis

Endometriosis (EM), a chronic inflammatory condition predominantly affecting women of reproductive age, has been linked to an elevated risk of thrombosis, though its underlying molecular mechanisms remain incompletely understood. In this case-control study, involving 71 EM patients and 71 matched controls, we explored the structural and functional changes in fibrinogen and their potential role in thrombosis. Key oxidative stress markers, such as reactive oxygen species (ROS) levels in blood lymphocytes, monocytes, and granulocytes, along with plasma lipid peroxidation markers and total antioxidant capacity, were measured. Fibrinogen structure was examined using circular dichroism spectroscopy and intrinsic fluorescence, while functional properties were evaluated by analyzing thrombin-mediated polymerization and plasmin-induced lysis. Compared to controls, EM patients exhibited elevated ROS production and systemic oxidative stress, leading to notable fibrinogen oxidation and structural alterations. These changes were associated with impaired fibrin polymerization and enhanced resistance to plasmin-induced lysis, which are indicative of a pro-thrombotic state. These findings suggest that oxidative stress-driven fibrinogen modifications may contribute to the heightened thrombotic risk in women with EM, highlighting a potential therapeutic target to mitigate cardiovascular complications.

The association between vitamin intake and endometriosis: a cross-sectional study of the NHANES 1999-2006

BACKGROUND

Endometriosis is a common cause of female reproductive problems, and vitamin intake may affect its incidence. Therefore, we further explored the association between multivitamin intake and endometriosis in a large population-based study.

METHODS

This study included 3351 participants from the National Health and Nutrition Examination Survey (NHANES) 1999-2006. The dietary intake of eight vitamins was calculated as the average of two 24-h recall interviews, and information on endometriosis was obtained through questionnaires that included gynecological history. Multiple logistic regression analysis was used to explore the relationship between multivitamin intake and endometriosis. Smoothed curve fitting analysis was employed to assess the dose-response relationship between vitamins and endometriosis. Finally, subgroup analysis and interaction tests were conducted to determine the association of covariates between vitamins and endometriosis.

RESULTS

In this large-scale cross-sectional study, multiple logistic regression analysis showed that the intake of vitamins A, B1, B2, B6, C and folate was negatively associated with the occurrence of endometriosis. The odds ratios associated with a per-SD increase were 0.836 (95%CI: 0.702, 0.997), 0.817 (95%CI: 0.702, 0.951), 0.860 (95%CI: 0.746, 0.991), 0.784 (95%CI: 0.669, 0.919), 0.845 (95%CI: 0.718, 0.994), and 0.772 (95%CI: 0.660, 0.903), respectively. Smoothed curve fitting analysis revealed that the intake of vitamins A, B1, B2, B6, C, and folate was negatively associated with the risk of endometriosis (P < 0.05). Vitamin E showed a saturating effect, with an optimal cutoff point at 13.18. Below this cutoff, the intake of vitamin E was negatively correlated with the risk of endometriosis (OR = 0.947, 95% CI: 0.906, 0.989), whereas above the cutoff, there was no significant correlation between vitamin E intake and the risk of endometriosis (OR = 1.001, 95% CI: 0.997, 1.005).

CONCLUSIONS

The results of this study indicate a significant linear negative correlation between the intake of vitamins A, B1, B2, B6, C, and folate, and the risk of endometriosis, and reveal a threshold effect for vitamin E intake on the risk of endometriosis. These findings could inform clinical dietary interventions and may support the development of preventive strategies for endometriosis, potentially aiding in its reduction.

Endometriosis, Anxiety, and Atherosclerosis: A Study of Eight Million Young Hospitalized Women in the USA

OBJECTIVE

In recent years, several studies have proposed an association between endometriosis and various cardiovascular diseases. Our study evaluated the association between endometriosis and atherosclerosis in patients under 35 years of age using a large population database.

DESIGN

This was a cross-sectional retrospective population-based study.

PARTICIPANTS/MATERIALS, SETTING, METHODS

We used the data of more than eight million hospitalized women under 35 years of age who were registered in one of the hospitals participating in the Healthcare Cost and Utilization Project - National Inpatient Sample (HCUP NIS) during the study period of 2007-2014. The prevalence of endometriosis, atherosclerosis, and related conditions was estimated, and logistic regression model was used to examine the association.

RESULTS

In the period of study of 8,061,754 patients, we noted an upward pattern for the prevalence of atherosclerosis and a downward trend for endometriosis. Adjusting the analysis for sociodemographic characteristics and comorbidities, the probability of being diagnosed with atherosclerosis was 42% higher in patients with endometriosis (odds ratio [OR] = 1.421; 95% confidence interval [CI]: 1.058-1.910); 35% higher in patients with anxiety (OR = 1.352; 95% CI: 1.249-1.464); and three times higher in women with both endometriosis and anxiety (OR = 3.075; 95% CI: 1.969-4.803) compared to women without those conditions.

LIMITATIONS

In HCUP NIS databases, some information such as the severity of disease, laboratory findings, or medical treatment is not available.

CONCLUSION

The strong association between endometriosis and atherosclerosis suggests that they may share a similar mechanism possibly endothelial dysfunction related to chronic inflammation. Further studies on the potential role of psychological conditions, such as anxiety, on systemic inflammatory diseases are also deemed timely and important.

Dietary Antioxidants and Natural Compounds in Preventing Thrombosis and Cardiovascular Disease

Reactive oxygen species (ROS) contribute to endothelial dysfunction, platelet activation, and coagulation abnormalities, promoting thrombus formation. Given the growing interest in non-pharmacological approaches to modulate oxidative stress, we examine the potential of various dietary interventions and antioxidant supplementation in reducing oxidative damage and preventing thrombotic events. Key dietary patterns, such as the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and ketogenic diets, as well as antioxidant-rich supplements like curcumin, selenium, and polyphenols, demonstrate promising effects in improving oxidative stress markers, lipid profiles, and inflammatory responses. This review highlights recent advances in the field, drawing from in vitro, ex vivo, and clinical studies, and underscores the importance of integrating dietary strategies into preventive and therapeutic approaches for managing thrombosis and cardiovascular health. Further research is needed to better understand long-term effects and personalize these interventions for optimizing patient outcomes.

Oxidative stress-induced fibrinogen modifications in liver transplant recipients: unraveling a novel potential mechanism for cardiovascular risk

BACKGROUND

Cardiovascular events represent a major cause of non-graft-related death after liver transplant. Evidence suggest that chronic inflammation associated with a remarkable oxidative stress in the presence of endothelial dysfunction and procoagulant environment plays a major role in the promotion of thrombosis. However, the underlying molecular mechanisms are not completely understood.

OBJECTIVES

In order to elucidate the mechanisms of posttransplant thrombosis, the aim of the present study was to investigate the role of oxidation-induced structural and functional fibrinogen modifications in liver transplant recipients.

METHODS

A case-control study was conducted on 40 clinically stable liver transplant recipients and 40 age-matched, sex-matched, and risk factor-matched controls. Leukocyte reactive oxygen species (ROS) production, lipid peroxidation, glutathione content, plasma antioxidant capacity, fibrinogen oxidation, and fibrinogen structural and functional features were compared between patients and controls.

RESULTS

Patients displayed enhanced leukocyte ROS production and an increased plasma lipid peroxidation with a reduced total antioxidant capacity compared with controls. This systemic oxidative stress was associated with fibrinogen oxidation with fibrinogen structural alterations. Thrombin-catalyzed fibrin polymerization and fibrin resistance to plasmin-induced lysis were significantly altered in patients compared with controls. Moreover, steatotic graft and smoking habit were associated with high fibrin degradation rate.

CONCLUSION

ROS-induced fibrinogen structural changes might increase the risk of thrombosis in liver transplant recipients.

Bidirectional causality between the levels of blood lipids and endometriosis: a two-sample mendelian randomization study

BACKGROUND

Observational studies have found a correlation between the levels of blood lipids and the development and progression of endometriosis (EM). However, the causality and direction of this correlation is unclear. This study aimed to examine the bidirectional connection between lipid profiles and the risk of EM using publicly available genome-wide association study (GWAS) summary statistics.

METHODS

Eligible exposure variables such as levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were selected using a two-sample Mendelian randomization (MR) analysis method following a series of quality control procedures. Data on EM were obtained from the publicly available Finnish database of European patients. Inverse variance weighted (IVW), MR Egger, weighted median, and weighted mode methods were used to analyze the causal relationship between lipid exposure and EM, exclude confounders, perform sensitivity analyses, and assess the stability of the results. Reverse MR analyses were performed with EM as exposure and lipid results as study outcomes.

RESULTS

IVW analysis results identified HDL as a protective factor for EM, while TG was shown to be a risk factor for EM. Subgroup analyses based on the site of the EM lesion identified HDL as a protective factor for EM of the uterus, while TG was identified a risk factor for the EM of the fallopian tube, ovary, and pelvic peritoneum. Reverse analysis did not reveal any effect of EM on the levels of lipids.

CONCLUSION

Blood lipids, such as HDL and TG, may play an important role in the development and progression of EM. However, EM does not lead to dyslipidemia.

Green Synthesis of Silver Nanoparticles with Extracts from Kalanchoe fedtschenkoi: Characterization and Bioactivities

In this work, the hexane, chloroform, and methanol extracts from Kalanchoe fedtschenkoi were utilized to green-synthesize silver nanoparticles (Kf1-, Kf2-, and Kf3-AgNPs). The Kf1-, Kf2-, and Kf3-AgNPs were characterized by spectroscopy and microscopy techniques. The antibacterial activity of AgNPs was studied against bacteria strains, utilizing the microdilution assay. The DPPH and H2O2 assays were considered to assess the antioxidant activity of AgNPs. The results revealed that Kf1-, Kf2-, and Kf3-AgNPs exhibit an average diameter of 39.9, 111, and 42 nm, respectively. The calculated ζ-potential of Kf1-, Kf2-, and Kf3-AgNPs were -20.5, -10.6, and -7.9 mV, respectively. The UV-vis analysis of the three samples demonstrated characteristic absorption bands within the range of 350-450 nm, which confirmed the formation of AgNPs. The FTIR analysis of AgNPs exhibited a series of bands from 3500 to 750 cm-1, related to the presence of extracts on their surfaces. SEM observations unveiled that Kf1- and Kf2-AgNPs adopted structural arrangements related to nano-popcorns and nanoflowers, whereas Kf3-AgNPs were spherical in shape. It was determined that treatment with Kf1-, Kf2-, and Kf3-AgNPs was demonstrated to inhibit the growth of E. coli, S. aureus, and P. aeruginosa in a dose-dependent manner (50-300 μg/mL). Within the same range, treatment with Kf1-, Kf2-, and Kf3-AgNPs decreased the generation of DPPH (IC50 57.02-2.09 μg/mL) and H2O2 (IC50 3.15-3.45 μg/mL) radicals. This study highlights the importance of using inorganic nanomaterials to improve the biological performance of plant extracts as an efficient nanotechnological approach.

Low Diet Quality and Nutritional Knowledge in Women with Endometriosis: A Pilot Study

Endometriosis is a chronic gynecological disease characterized by ectopic endometrial tissue outside the uterus that can cause chronic pain, dysmenorrhea, fatigue, and infertility. The aim of this study was to assess diet quality and nutritional knowledge of women with endometriosis. A questionnaire was used to collect data on lifestyle, dietary habits and nutritional knowledge from 90 women. More than 80% of women with endometriosis (82.2%) confirmed that diet and lifestyle are related to the progression of endometriosis. After being diagnosed with endometriosis, 77.3% of respondents reported a change in their dietary habits and made various changes to their diet by increasing or eliminating the consumption of certain foods. The majority declared reducing pro-inflammatory products, increasing anti-inflammatory foods, including the consumption of vegetables and fruits, avoiding white/or red/or processed meat, and avoiding sweets. Nevertheless, diet quality as assessed by the pro-healthy diet index (pHDI-10) and the Mediterranean Diet Score (MDS) showed a low intensity of consumption of pro-healthy food (average pHDI-10 value 31.4%; MDS 7.55/14 points, p = 0.0001). Women with endometriosis reported lower than recommended consumption of fruits, vegetables, dairy products and whole grains. A higher percentage of healthy controls had a "good" level of nutritional knowledge than women with endometriosis. The results of our study highlight the need to improve diet quality and nutritional knowledge among women with endometriosis as well as developing targeted dietary recommendations to help improve well-being and reduce the pain symptoms of endometriosis.

S-propargyl-cysteine promotes the stability of atherosclerotic plaque via maintaining vascular muscle contractile phenotype

Introduction: Plaque rupture in atherosclerosis contributes to various acute cardiovascular events. As a new sulfide-containing donor, S-propargyl-cysteine (SPRC) has been reported to play a beneficial role in cardioprotection, potentially through its anti-inflammatory, anti-oxidative and anti-atherogenic activities. Our previous study observed an increase in eNOS phosphorylation in endothelial cells. However, it remains unclear whether SPRC influences vascular smooth muscle cells (VSMCs) within the plaque and if this effect contributes to plaque stabilization. Methods: An atherosclerotic unstable plaque mouse model was established by subjecting ApoE-/- mice to tandem stenosis of the right carotid artery along with a Western diet. Daily SPRC administration was conducted for 13 weeks. Plaque morphology and stability were assessed using MRI scanning and histopathological staining. In our in vitro studies, we stimulated human artery vascular smooth muscle cells (HAVSMCs) with platelet-derived growth factor-BB (PDGF-BB), both with and without 100 μM SPRC treatment. Cell phenotype was assessed using both Western blot and Real-time PCR. Cell proliferation was assessed using the BrdU cell proliferation kit and immunofluorescence of Ki-67, while cell migration was measured using scratch wound healing and transwell assay. MiR-143-3p overexpression and knockdown experiments were used to investigate whether it mediates the effect of SPRC on VSMC phenotype. Results and Discussion: SPRC treatment reduced plasma lipid levels, increased collagen content and decreased cell apoptosis in atherosclerotic plaques, indicating improved plaque stability. Both in vivo and in vitro studies elucidated the role of SPRC in preserving the contractile phenotype of VSMCs through up-regulation of miR-143-3p expression. Furthermore, SPRC suppressed the pro-proliferation and pro-migration effects of PDGF-BB on HAVSMCs. Overall, these findings suggest that the inhibitory effect of SPRC on phenotype switch from contractile to synthetic VSMCs may contribute to its beneficial role in enhancing plaque stability.

Mediterranean Diet and Oxidative Stress: A Relationship with Pain Perception in Endometriosis

BACKGROUND

Endometriosis is a chronic and inflammatory disease associated with pelvic pain. Dietary changes may be therapeutic for chronic inflammatory processes, reducing visceral input. The aim was to evaluate the role of dietary changes according to the Mediterranean Diet (MD) on pain perception in endometriosis and their relationship with oxidative stress.

METHODS

in this prospective study, we included 35 endometriosis women. At baseline (T0) and after 3 (T1) and 6 (T2) months from the start of the diet, we investigated pain intensity with VAS (Visual Analogue Scale, from 0 to 10), vitamin profile, and oxidative stress.

RESULTS

we found a significant increase in the diet score (p < 0.001). At T1, patients reduced pain in terms of dyspareunia (p = 0.04), non-menstrual pelvic pain (p = 0.06), dysuria (p = 0.04), and dyschezia (p < 0.001). Dyspareunia (p = 0.002) and dyschezia (p < 0.001) were further significantly reduced also at T2. We observed a significant positive correlation between lipid peroxidation and VAS non-menstrual pelvic pain and dysuria and a significant negative correlation between Oxygen radical absorbance capacity and VAS non-menstrual pain and dyschezia.

CONCLUSIONS

our findings show a clear tendency toward a relationship between pain relief in endometriosis and MD. This appears promising to treat endometriosis-related symptoms and could be considered a new effective strategy for chronic pain management in the long term.

Effects of dysregulated glucose metabolism on the occurrence and ART outcome of endometriosis

BACKGROUND

Endometriosis is associated with systemic metabolic indicators, including body mass index (BMI), glucose metabolism and lipid metabolism, while the association between metabolic indexes and the occurrence and assisted reproductive technology (ART) outcome of endometriosis is unclear. We aimed to evaluate the characteristics of systemic metabolic indexes of endometriosis patients with infertility and their effects on pregnancy outcome after ART treatment.

METHODS

A retrospective cohort study involve 412 endometriosis patients and 1551 controls was conducted. Primary outcome was metabolic indexes, and secondary measures consisted of the influence of metabolic indexes on the number of retrieved oocytes and ART outcomes.

RESULTS

Endometriosis patients had higher insulin (INS) [6.90(5.10-9.50) vs 6.50(4.80-8.90) μU/mL, P = 0.005]. A prediction model for endometriosis combining the number of previous pregnancies, CA125, fasting blood glucose (Glu) and INS, had a sensitivity of 73.9%, specificity of 67.8% and area under curve (AUC) of 0.77. There were no significant differences in ART outcomes and complications during pregnancy. The serum levels of Glu before pregnancy were associated with GDM both in endometriosis group (aOR 12.95, 95% CI 1.69-99.42, P = 0.014) and in control group (aOR 4.15, 95% CI 1.50-11.53, P = 0.006).

CONCLUSIONS

We found serum Glu is related to the number of retrieved oocytes in control group, serum INS is related to the number of retrieved oocytes in endometriosis group, while serum Glu and INS before pregnancy are related to the occurrence of GDM in two groups. A prediction model based on metabolic indexes was established, representing a promising non-invasive method to predict endometriosis patients with known pregnancy history.

Atherosclerosis Potential Drug Targets: Current Scenario and Future Perspectives

BACKGROUND

The global burden of atherosclerosis and its implication to cause coronary heart disease and ischemic cardiac problems is the most prevalent cause of morbidity and hospitalization. In the US, there has been an increase in the number of patients with cardiac problems in the last decade, and still remains the primary cause of death in Europe as well as in the US.

OBJECTIVES

Even though therapeutic interventions and early diagnosis the formation of the fatty lesion and its subsequent steps are possible, the therapeutic management of the disease remains questionable when clinical data is observed. There is still scope for proper target identification and biomarker recognition, which can serve as a baseline to develop efficient pharmacological agent and delivery systems so that the disease incidence and prevalence can be controlled. The present article highlights the current pathophysiological state of the disease and emerging strategies that are applied to manage the disease.

FINDINGS

This article gives an insight into the limitations of various conventionally used therapeutic agents for disease treatment. The emerging strategies that could prove efficacious in disease treatment. This article also gives an insight into current discoveries in the field of cellular and molecular biology, such as the genetic role in causing dyslipidemia and the role of immune cells and the role of non-coding small RNA, which can set the future direction to develop therapeutics interventions for atherosclerosis.