RESUMEN
Introduction: Some studies indicate the role of selected adipokines in the development of endometriosis. However, a comprehensive assessment of plasma, peritoneal, and endometrioma fluids adipokines concentrations in women with ovarian endometriosis has not yet been performed. Therefore, this study aimed to analyze plasma, peritoneal, and endometrioma fluids selected adipokines concentrations in women operated on for ovarian endometriosis. Materials and methods: A cross-sectional cohort study involved 56 women operated on for ovarian endometriosis. Body mass, height, and waist circumference were measured, and BMI was calculated. Plasma, peritoneal, and endometrioma fluids adiponectin, leptin, omentin resistin, RBP4, and visfatin/NAMPT were determined by ELISA. Results: The highest plasma levels of adiponectin, leptin, omentin, and RBP4 than in the endometrioma and peritoneal fluids were found, while levels of resistin and visfatin/NAMPT were significantly higher in endometrioma fluid than in plasma and peritoneal fluid. In addition, levels of visfatin/NAMPT were significantly higher in peritoneal fluid than in plasma. There were also positive correlations between leptin, RBP4, and adiponectin levels in endometrioma and peritoneal fluids (ρ = 0.28; p < 0.05; ρ = 0.31; p < 0.05; ρ= 0.32; p < 0.05, respectively). There were no associations between adipokines levels in plasma, endometrioma, and peritoneal fluids and endometriosis stage. Conclusion: Our results show that visfatin/NAMPT and resistin may be locally secreted in endometrioma related to inflammation regardless of the stage of endometriosis.
Asunto(s)
Endometriosis , Neoplasias Ováricas , Humanos , Femenino , Adipoquinas , Leptina/metabolismo , Resistina , Endometriosis/cirugía , Nicotinamida Fosforribosiltransferasa , Adiponectina , Estudios Transversales , Proteínas Plasmáticas de Unión al RetinolRESUMEN
OBJECTIVE: To analyze potential interactions of visfatin and retinol-binding protein 4 (RBP4) levels with body mass, metabolic, and hormonal status in normal weight and obese women with PCOS. STUDY DESIGN: Body composition was determined by bioimpedance in 83 women (44 obese) diagnosed with PCOS and in 67 women (36 obese) without PCOS. In addition, serum glucose, lipids, androgens, FSH, LH, SHBG, insulin, visfatin, and RBP4 were measured in a fasting state and the free androgen index (FAI) was calculated, as was insulin resistance using the HOMA-IR assessment. RESULTS: Plasma RBP4 levels were significantly higher in women of normal weight compared to obese subjects when both were diagnosed with PCOS (14.1 ± 4.6 vs.10.9 ± 4.5 ng/mL, p<0.001); while in non-PCOS subjects the opposite was found (10.8 ± 4.5 vs. 18.4 ± 11.6 ng/mL, p<0.01; respectively). Plasma visfatin levels were similar in PCOS and non-PCOS subjects. In non-PCOS subjects, positive correlations between RBP4 level and anthropometric parameters were observed. In PCOS, RBP4 levels inversely correlated with serum insulin levels and HOMA-IR values. No correlation was found between plasma visfatin levels and anthropometric parameters in all study groups. Similarly, no correlation was found in PCOS and non-PCOS subgroups. Additionally, there was an inverse correlation between RBP4 and LH concentrations and LH/FSH ratio in all study subjects. CONCLUSIONS: Plasma visfatin level is not a useful biomarker of insulin resistance and hyperandrogenism. RBP4 level reflects visceral body fat content in non-PCOS women. Decreasing RBP4 release along with increasing insulin resistance and hormonal disturbances may be a compensatory mechanism preventing deterioration in obese PCOS.
Asunto(s)
Peso Corporal/fisiología , Nicotinamida Fosforribosiltransferasa/sangre , Obesidad/sangre , Síndrome del Ovario Poliquístico/sangre , Proteínas Plasmáticas de Unión al Retinol/metabolismo , Adulto , Biomarcadores/sangre , Glucemia/metabolismo , Femenino , Humanos , Hiperandrogenismo/sangre , Hiperandrogenismo/complicaciones , Insulina/sangre , Resistencia a la Insulina/fisiología , Obesidad/complicaciones , Síndrome del Ovario Poliquístico/complicacionesRESUMEN
According to World Health Organization, abortion is defined as an induced termination of pregnancy by use of medications or surgical interventions after implantation of the embryo and before the fetus is able to survive outside the maternal organism (before 22nd week of pregnancy). More than 75 millions of women experience unwanted pregnancy every year. Contraception for that group was either unavailable or the information about contraceptives use possibility was not efficient. Lack of conversation about family planning with the partner, rapes and inefficiency of contraceptives (8 to 30 millions women a year) might be other reasons. More than two-third such pregnancies are terminated by abortions. The number of women in reproductive age (15-44) is 1.38 million. Most of them are sexually active but not willing to have progeny. The decision of abortion is taken every year by 35 per 100 females (26 millions of legal abortions each year, 20 millions of illegal). By 1986, 36 countries introduced liberal abortion law that gives permission for abortion only for social, medical and personal reasons. The main law regulating the permission of abortion in Poland is a resolution of Family planning, embryo protection and conditions for conducting pregnancy termination from 1993, modified in 1997. In 1999, 151 abortion procedures were performed and that number is decreasing gradually. The development of so called "abortion basement", where unsafe abortion is usually performed, is a consequence of restrictive policy about the abortion law. In the last few years the holistic and individual approach to the patient has started to play an important role. Unfortunately, in the case of sexual education and knowledge of conscious family planning, medical services, and medical doctors especially, play only the minimal role. It seems to be essential in gynecological and general medicine practice to give information about different methods of family planning and protection against sexual transmitted diseases as well as to control patient's health when using contraceptives.