Omentin-1 and its relationship with inflammatory factors in maternal plasma and visceral adipose tissue of women with gestational diabetes mellitus

PURPOSE

To investigate the association of omentin-1 and inflammatory factors in serum and visceral adipose tissue (VAT) of women with gestational diabetes mellitus (GDM) compared to normal pregnant (NP) subjects. Furthermore, to examine their correlation with maternal clinical characteristics.

METHODS

We compared 116 GDM women to 115 NP women, at the time of cesarean section. Circulating omentin-1 and pro-inflammatory (IL-1β, IL-6, TNF-α), and anti-inflammatory cytokines (IL-1RA, IL-10) were examined. Moreover, their mRNA expression in VAT, along with inflammatory factors involved in the NF-κB pathway (TLR2, TLR4, NF-κB, IKκB), were examined.

RESULTS

Circulating omentin-1 (p = 0.022) was lower and circulating IL-1-β, IL-1RA, as well as IL-10 (p = 0.005, p = 0.007, and p = 0.015, respectively), were higher in GDM compared to NP women. Omentin-1 correlated negatively with pre-pregnancy and gestational BMI, and HOMA-IR in all women, but was not associated with cytokines. TLR2, TLR4, IL-1β, IL-1RA, IL-6, IL-10 mRNA expression in VAT was lower in GDM compared with controls (p < 0.05 all). In multivariate analysis, BMI at delivery was significantly correlated to omentin-1 concentrations in all and NP subjects. In addition, omentin-1 expression was correlated to inflammatory gene expression in all, GDM and NP, women (p < 0.05 all).

CONCLUSION

Serum levels and VAT gene expression of omentin-1 are not independently linked to GDM; notwithstanding, GDM women have a VAT-altered inflammatory status. In addition, no systemic association between omentin-1 and inflammatory factors was found, whereas associations between their expression in all women were observed, indicating that expression of these adipokines is linked between them regardless of GDM.

Osteocalcin, under-carboxylated osteocalcin and osteopontin are not associated with gestational diabetes mellitus but are inversely associated with leptin in non-diabetic women

OBJECTIVE

To measure serum osteocalcin (OC), under-carboxylated osteocalcin (ucOC), osteopontin (OPN), and leptin in pregnant women with gestational diabetes mellitus (GDM) and in healthy pregnant women during pregnancy and after birth and relate these markers to glucose metabolism.

METHODS

This was a prospective study including 60 women with GDM and 60 subjects with normal gestation who were evaluated at gestational week 30 and 6 weeks postpartum. Serum OC, ucOC, OPN, leptin, insulin and insulin resistance were evaluated during the study.

RESULTS

Bone biomarkers and leptin were similar between GDM and normal pregnancy. After delivery, OC, ucOC and OPN increased in both groups, while leptin decreased only in healthy controls. Bone markers did not correlate with insulin and insulin resistance in the two groups, but leptin was positively correlated with insulin and insulin resistance and negatively correlated with bone biomarkers only in healthy women. Furthermore, the women who developed diabetes postpartum had lower levels of OC than women with normal glucose tolerance.

CONCLUSION

GDM is not associated with OC, ucOC, OPN, and leptin and does not correlate with insulin resistance. At postpartum, women who develop diabetes have lower osteocalcin concentrations. Leptin correlates with insulin resistance and bone biomarkers in non-diabetic women.

Atrioventricular septal defect: quantitative anatomy of the left ventricle

A morphometric study was performed in 18 human hearts with atrioventricular septal defect not associated with other anomalies; 16 hearts had common atrioventricular orifices, and 2 presented separate right and left atrioventricular orifices. A total of eight parameters were analyzed, characterizing ventricular wall thickness, length and circumference of the inflow and outflow tracts, and circumference of the left orifice and aortic orifice. The data were compared with previously published patterns of normality. In addition, the volume of the aortic outflow tract was calculated. The inflow tract was shorter than the outflow tract, and the length of the diaphragmatic wall was equal to the sum of the lengths of the inflow tract and ventricular wall thickness at the level of the apex.

Swine hearts: quantitative anatomy of the right ventricle

The right ventricle was studied in 75 anatomically normal swine hearts, using, in all, nine geometric and volumetric parameters: ventricular-wall thickness, length of the right-ventricular inflow and outflow tracts, and volume of the right-ventricular inflow and outflow tracts. The data for these parameters were compared with previously published patterns for human hearts and volumetric data were compared with patterns of normality found in human hearts. As in the human heart, the ventricular inflow tract in swine hearts was significantly shorter than the outflow tract (P < 0.0001).

[The swine heart: the papillo-tendino-valvular system of the right ventricle]

The right ventricle was studied in 75 anatomically normal swine hearts. Nine parameters in the papillo-tendino valvular system and three corresponding to the tricuspid orifice, pulmonary orifice and length of the inflow tract were measured. Correlations were established between the parameters and heart weight in grams, between the different parameters themselves, and between heart weight and body weight. The results were compared with similar data from human hearts, and were considered of use to researchers planning to use the swine heart as an experimental model to study congenital or induced heart diseases, or as a reference for the clinical interpretation of spontaneous cardiac, anomalies in swine.

[Differential aspects of drug prescriptions in elderly people living in the northeast area of Granada: study of 366 individuals]

BACKGROUND

The geriatric population consumes greater numbers of medicines than other age groups. We compared drug prescription and consumption in elderly persons residing in a nursing home or living in their own home.

METHODS

We studied 366 elderly men and women (older than 65 years) who lived either in nursing homes or in their own home. The variables recorded were the most frequent diseases, number and types of drugs prescribed per person, and adverse reactions of the most frequently prescribed drugs.

RESULTS

The most common diseases recorded among subjects living at home were arterial hypertension and rheumatic diseases; among those in nursing homes, the most common ailment was dementia. Subjects in nursing homes were prescribed more different drugs (2.8 +/- 1/person) than individuals living on their own (1.8 +/- 1/person). The percentage of adverse reactions was highest in ambulatory patients (64%) and in patients taking benzodiazepines (56%). A large proportion of all prescriptions (74.5%) were for solid galenic forms.

CONCLUSIONS

We draw attention to the greater consumption of drugs by elderly persons residing in nursing homes, as well as the prescription of benzodiazepines and analgesic-antiinflammatory drugs within old age.

Morphometric data on the arterial duct in the human fetal heart

In a total of 496 fetuses and newborns ranging in body weight from 60 to 5000 g, we performed a morphometric study of the ascending aorta, the descending aorta, the aortic isthmus, the right pulmonary artery, the left pulmonary artery and the arterial duct. In all, nine different parameters were measured in each specimen. The variations in the correlations between two measurable characteristics, namely body weight and each of the morphometric parameters, were analyzed. The minimum, normal and maximum patterns of normality for each parameter were obtained with regression equations. We compared statistically the diameter of the arterial duct with the diameter of the ascending and descending aorta, the aortic isthmus, the right pulmonary artery and the left pulmonary artery with one way analysis of variance, using Bonferroni's test in the pairwise comparisons. The diameter of the arterial duct was smaller than the diameter of the ascending and descending aortas, the aortic isthmus, the right pulmonary artery and the left pulmonary artery, and the diameter of the ascending aorta was larger than that of the descending aorta. These morphological data have immediate clinical and surgical applications in the treatment of fetal and perinatal cardiovascular disorders.

Morphometric data concerning the great arterial trunks and their branches

In a total of 496 fetuses and newborns ranging in body weight from 60 to 5000 g, we performed a morphometric study of the vascular complex, that is the orifices of the great arterial trunks, ascending aorta, aortic arch, vessels branching from the aortic arch, the aortic isthmus, descending aorta, pulmonary trunk, orifices of the pulmonary arteries and arterial duct. In all, 17 different parameters were measured in each specimen, using several new parameters in addition to the measurements classically used in the aortic isthmus, arterial duct and pulmonary trunk. Anatomo-geometric models of these structures were developed, and stereometric formulas used to calculate the real volumes of the aortic isthmus, arterial duct and pulmonary trunk. The variations in the correlations between two measurable characteristics, that is, body weight and each of the morphometric parameters were analyzed, and the minimum, normal and maximum patterns of normality for each parameter were obtained with regression equations. The results show that the volume of the aortic isthmus increases by 0.03 ml for each millilitre increase in left ventricular volume. The isthmic volume increases by 0.32 ml for each millilitre increase in volume of the arterial duct and the volume of the pulmonary trunk increases by 6.4 ml for each increase of 1 millilitre in the volume of the aortic isthmus. The inner circumference of the aortic isthmus is greater than that of the arterial duct, whereas the former vessel is always shorter than the latter. We believe that these morphological data, when appropriately interpreted, have immediate clinical and surgical applications in the treatment of fetal and perinatal cardiovascular disorders.

[Use of aminoglycoside antibiotics in a general hospital: kinetics consequences in those patients whose blood levels are not monitored]

A surprise monitoring of plasma aminoglycoside level was carried out in our Hospital in 55 patients. Basal samples and samples one hour after i.m. or i.v. administration were obtained. A protocol sheet with personal, clinical and therapeutic data was filled for each patient. The FPIA analysis technique (CV less than 5%) was used. Only the data related to gentamicin were evaluated, because the number of patients receiving other aminoglycosides was very low (5 cases). The most usual dose and interval were 80 mg (91%) and 12 hours (69%), respectively. The administration routes were i.v. (52%) and i.m. (48%). Blood urea and/or creatinine levels were not measured in 22% of patients. The baseline gentamicin levels were subtherapeutic in 30%, therapeutical in 57%, and toxic in 13%, and 50%, 46% and 4%, respectively, for the levels after one hour. In patients with abnormal renal function a good correlation could be demonstrated (r = 0.96; p less than 0.001) between creatinine level and gentamicin 1/2 time. This correlation was absent in patients with normal renal function. When the dose of the antibiotic was adjusted to the weight of the patient, the frequency of therapeutic levels was higher (47%; p less than 0.03); in these cases, the most common administration interval was 8 hours (p less than 0.01). We emphasize the lack of control of the renal function in 22% of patients, stressing that the lack of monitoring systematically results in potentially subtherapeutic levels in more than one half of the investigated patients (57%).

[Levels of blood theophylline in patients with acute bronchospasm]

Plasma theophylline levels (mcg/ml) of 93 patients with a bronchopulmonary disease (asthma and chronic obstructive lung disease) who were on theophylline (normal or retarded) treatment, were determined on admission at the emergency ward because of acute bronchospasm. Our results show that theophylline blood levels were subtherapeutical in patients treated either with normal (2.1 +/- 0.8 mcg/ml) or retarded theophylline (9.6 +/- 1.3 mcg/ml). This was probably due to insufficient dosing and/or poor patient compliance. The necessity of monitoring this type of treatment is once again evident.

The quantitative anatomy of the normal human heart in fetal and perinatal life

A total of 367 human fetuses and newborn subjects weighing from 60 to 5000 g provided the material for a morphometric study of the heart. A total of 17 interventricular parameters were measured in each specimen, one of the parameters representing an innovation with regard to the classically used set of measurements. A new anatomo-geometric configuration is described for each ventricle along with a new component for the left ventricular outflow tract, designated as the aortic outflow tract. The appropriate stereometric formulas were used to calculate real ventricular volumes rather than the previously studied volumetric indices. Additionally, correlation indices were calculated for ventricular wall thickness as well as the circumferences and diameters of the atrioventricular and arterial valves. The results show that, in fetuses of up to 2700 g in body weight, ventricular wall thickness is greater in the right than in the left ventricle, although the opposite is true in fetuses weighing above 2700 g. Throughout the range of weights studied, ventricular volume was greater in the left than in the right chamber. Tricuspid and pulmonary valve circumference and diameter were consistently greater than in the mitral and aortic valves, respectively. We believe the new morphometric data and their innovative interpretation to have immediate applications in both the morphological and functional areas of cardiology.