scholarly journals AMH Is a Good Predictor of Metabolic Risk in Women with PCOS: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Miaoxian Ou ◽  
Pei Xu ◽  
Han Lin ◽  
Kaichi Ma ◽  
Mingxing Liu

Objective. The relationship between metabolic risk and ovarian function is ambiguous. This retrospective study analyzed the medical records of 461 PCOS patients collected between January 2019 and June 2020 to investigate the relationship between serum anti-Müllerian hormone (AMH) and parameters of metabolic risk in the population with polycystic ovary syndrome (PCOS). Methods. A total of 461 PCOS patients aged 20–40 years were included and stratified into four groups according to the AMH level. The association between AMH and the parameters related to metabolic risk in these groups was compared, and the discrepancies were further explored. Binary logistic regression was performed to examine the risk factors of HOMA-IR. The values of AMH that best predicted the risk of HOMA-IR were also analyzed by ROC curves. Results. AMH was negatively associated with HOMA-IR (odds ratio (OR) −0.279, 95% confidence interval (CI) −0.36 to −0.20), fasting insulin (OR −0.282, 95% CI −0.36 to −0.20), 1-hour postprandial insulin (OR −0.184, 95% CI −0.28 to −0.11), 2-hour postprandial insulin (−0.180, 95%CI −0.28 to −0.11), 3-hour postprandial insulin (OR −0.198, 95% CI –0.30 to −0.13), waist-hip ratio (OR −0.235, 95% CI −0.31 to −0.14), and body mass index (OR −0.350, 95% CI −0.43 to −0.27). There was no statistically significant relationship between blood pressure, serum glucose profile, or lipid levels and AMH. Binary logistic regression showed that AMH protected against the occurrence of PCOS patients (OR: 0.835, 0.776, and 0.898). For the prediction of HOMA-IR, AMH had an AUC-ROC of 0.704 (95% CI 0.652–0.755) with a cutoff value of 7.81 mmol/L, a sensitivity of 70.3%, and a specificity of 70.1%. Conclusions. Higher AMH levels were significantly associated with a lower insulin profile and might be a useful predictor for HOMA-IR in PCOS patients.

Author(s):  
Scott Moodie ◽  
Simon Dolan ◽  
Roland Burke

Purpose – The purpose of this research is to explore the relationship between the positive and negative psychological states of work (i.e. engagement and burnout, respectively) and their effects on an individual’s mental and physical health. This study analyzes their separate and joint manifestations. In total, 2,094 nurses were segmented into quadrants that represent a 50/50 median split on both engagement and burnout. The four resulting quadrants were then examined in a series of analyses including logistic regression and ANOVA. Design/methodology/approach – This is a cross-sectional study based on a very large survey (> 2,000 people) in Spain. Data were collected from nurses in collaboration with the official nurses corporations in half a dozen provinces in Spain. Data were analyzed in stages which included zero-item correlations and ANOVA to determine their independence and suitability for predicting states of engagement and burnout. This was followed by a series of binary logistic regression analyses. Findings – The findings suggested that engagement and burnout were generally inversely related (67 per cent of the sample) which is the conventional wisdom in this regard, but 33 per cent of the sample manifested concurrently at either extreme. Burnout was chiefly driven by work demands, as both quadrants of low burnout had lower demands and both quadrants of high burnout had higher demands. Engagement was primarily driven by resources and affinity. Social support acted independently (perhaps as a moderator) by aligning with states of burnout. Worker health was primarily driven by burnout, wherein both states of low burnout exhibited better health and both states of high burnout exhibited poorer health. Originality/value – Much of the current research on this topic considers engagement and burnout to be linear dimensions and focuses on building structural models of the precise relationships between variables. That approach is to be encouraged, but there is also a need to jointly deconstruct dimensions and relationships in a tactile manner that can inform future structural models. The secondary benefit of this approach is that these findings can be submitted directly to managers to provide an easily understood approach for assessments and interventions.


2020 ◽  
Vol 16 ◽  
Author(s):  
Salman Khazaei ◽  
Erfan Ayubi ◽  
Saeid Bashirian ◽  
Ronak Hamzehei ◽  
Ensiyeh Jenabi

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.


Author(s):  
Yoshihiro Kugimiya ◽  
Masanori Iwasaki ◽  
Yuki Ohara ◽  
Keiko Motokawa ◽  
Ayako Edahiro ◽  
...  

Oral hypofunction, resulting from a combined decrease in multiple oral functions, may affect systemic-condition deterioration; however, few studies have examined the association between oral hypofunction and general health among older adults. In this cross-sectional study, we examined the relationship between oral hypofunction and sarcopenia in community-dwelling older adults. We included 878 adults (268 men and 610 women, mean age 76.5 ± 8.3 years). Tongue coating index, oral moisture, occlusal force, oral diadochokinesis (/pa/,/ta/,/ka/), tongue pressure, mas-ticatory function, and swallowing function were evaluated as indicators of oral hypofunction. Grip strength, gait speed, and skeletal muscle mass index were measured as diagnostic sarcopenia parameters. The association between oral hypofunction and sarcopenia was examined via logistic regression using sarcopenia as the dependent variable. Oral hypofunction prevalence was 50.5% overall, 40.3% in men, and 54.9% in women. The prevalence of sarcopenia was 18.6% overall, 9.7% in men, and 22.5% in women. A logistic regression showed oral hypofunction, age, body mass index, higher-level functional capacity, and serum albumin level were significantly associated with sarcopenia. Sarcopenia occurred at an increased frequency in patients diagnosed with oral hypofunction (odds ratio: 1.59, 95% confidence interval: 1.02–2.47); accordingly, oral hypofunction appears to be significantly associated with sarcopenia.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Weerakit Naweera ◽  
Thapat Wannarong

Abstract Background and Aims Snakebite is a common animal bite injury in tropical countries. Acute kidney injury (AKI) is an important complication in snakebite patients. This study aimed to comprehensively investigate the clinical profiles and outcomes of patients following hematotoxin-related snakebite associated with kidney impairment. Method We conducted a hospital-based, cross-sectional study of 238 patients with hematotoxin-related snakebite injuries. Data were retrieved from the King Narai Hospital Registry from October 2014 to August 2020. The prevalence of complications associated with snakebite injuries, including acute kidney injury (AKI) and its severity, was determined. Univariate and Multivariate predictors of AKI diagnosis were evaluated using binary logistic regression analysis Results A total of 238 patients, with 63.4% men, median (IQR) age 49.8 (39-61) years and median duration from injury to a hospital arrival of 1 hour (0.5-2) hours, were injured by Green pit viper (85.7%), Russell’s viper (12.6%) and Malayan pit viper (1.7%). AKI mostly occurred in Russell’s viper group 66.7%. An AKI was reported in thirty (12.6%, 95% CI: 8.7 % - 17.5%) patients, with the severity of 66.7% stage one, 6.7% stage two, 26.6% stage three by KDIGO classifications, and 13.3% requiring hemodialysis. Complete renal recovery was seen in twenty-two patients (73.3%), while partial renal recovery was 23.3%. Other complications included 84.4 % limb cellulitis, 4.6% significantly bleeding, 2.5% hypotension, 25.6% prolonged venous clotting time (VCT), 46.7% prolonged prothrombin time (PT), and 14.3% prolonged partial thromboplastin time (PTT). Of total patients, 60.1% were treated with anti-venom. Mortality was relatively low (0.4%). In multivariable logistic regression analyses, AKI was significantly associated with time to hospital arrival more than 3 hours (p = 0.04), Russell’s viper bitten (p = 0.01), clinical bleeding (p = 0.01), and prolonged PT (p < 0.01). Conclusion The prevalence of AKI in patients bitten by hematotoxin snakes was 12.6%, mostly from Russell’s viper. Factors associated with AKI outcomes were time to hospital arrival more than 3 hours, Russell’s viper bitten, clinical bleeding, and prolonged PT. Besides, one-fourth of AKI patients turned to chronic kidney disease.


2020 ◽  
Author(s):  
GRACIA CASTRO-LUNA ◽  
ANTONIO PÉREZ-RUEDA

Abstract Background: The diagnosis of keratoconus in the early stages of the disease is necessary to initiate an early treatment of keratoconus. Furthermore, to avoid possible refractive surgery that could produce ectasias. This study aims to describe the topographic, pachymetric and aberrometry characteristics in patients with keratoconus, subclinical keratoconus and normal corneas. Additionally to propose a diagnostic model of subclinical keratoconus based in binary logistic regression models Methods: The design was a cross-sectional study. It included 205 eyes from 205 patients distributed in 82 normal corneas, 40 early-stage keratoconus and 83 established keratoconus. The rotary Scheimpflug camera (Pentacam® type) analyzed the topographic, pachymetric and aberrometry variables. It performed a descriptive and bivariate analysis of the recorded data. A diagnostic and predictive model of early-stage keratoconus was calculated with the statistically significant variables Results: Statistically significant differences were observed when comparing normal corneas with early-stage keratoconus/ in variables of the vertical asymmetry to 90º and the central corneal thickness. The binary logistic regression model included the minimal corneal thickness, the anterior coma to 90º and posterior coma to 90º. The model properly diagnosed 92% of cases with a sensitivity of 97.59%, specificity 98.78%, accuracy 98.18% and precision 98.78%Conclusions: The differential diagnosis between normal cases and subclinical keratoconus depends on the mínimum corneal thickness, the anterior coma to 90º and the posterior coma to 90º.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Antonio Pérez-Rueda ◽  
Gracia Castro-Luna

Abstract This paper aims to calculate a relevance model of visual limitation (V.L.) in keratoconus patients based on refractive and topographic parameters. A cross-sectional study was carried out in Torrecárdenas Hospital, Almería, Spain, between February 2018 and July 2019. It included 250 keratoconus patients. Two groups were created according to a grading system of V.L. based on RETICS (Red Temática de Investigación Cooperativa en Salud) classification: keratoconus patients with no V.L. (best spectacle-corrected visual acuity (BSCVA) ≤ 0.05 logMAR) and keratoconus patients with V.L. (BSCVA > 0.05 logMAR). Correlations and a binary logistic regression were established. V.L. was correlated with maximum curvature (r = 0.649, p < 0.001) and root mean square higher-order aberrations (HOARMS) (r = 0.625, p < 0.001). Binary logistic regression included V.L. as the dependent variable and spherical equivalent, HOARMS, spherical aberration and interaction between the anterior and posterior vertical coma as independent variables. The model was a good fit. Area under the curve (A.U.C.) of receiver operating characteristic (R.O.C.) curve was 0.924, sensitivity 91.90%, specificity 83.60%, accuracy 88.94%; and precision 91.17%. Binary logistic regression model of V.L. is a good fit model to predict the early loss of visual acuity in keratoconus patients.


2020 ◽  
Author(s):  
GRACIA CASTRO-LUNA ◽  
ANTONIO PÉREZ-RUEDA

Abstract Background: The diagnosis of keratoconus in the early stages of the disease is necessary to initiate an early treatment of keratoconus. Furthermore to avoid possible refractive surgery that could produce ectasias. This study aims to describe the topographic, pachymetric and aberrometry characteristics in patients with keratoconus, subclinical keratoconus and normal corneas. Additionally to propose a diagnostic model of subclinical keratoconus based in binary logistic regression models Methods: The design was a cross-sectional study. It included 205 eyes from 205 patients distributed in 82 normal corneas, 40 subclinical keratoconus and 83 established keratoconus The rotary Scheimpflug camera (Pentacam® type) analyzed the topographic, pachymetric and aberrometry variables. It performed a descriptive and bivariate analysis of the recorded data. A diagnostic and predictive model of subclinical keratoconus was calculated with the statistically significant variables Results: Statistically significant differences were observed when comparing normal corneas with subclinical keratoconus/ in variables of the vertical asymmetry to 90º and the central corneal thickness. The binary logistic regression model included the minimal corneal thickness, the anterior coma to 90º and posterior coma to 90º. The model properly diagnosed 92% of cases Conclusions: The differential diagnosis between normal cases and subclinical keratoconus depends on the mínimum corneal thickness, the anterior coma to 90º and the posterior coma to 90º.


2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Meliza Wahyuni ◽  
Eva Decroli ◽  
Putri Sri Lasmini

Abstrak Sindrom Ovarium Polikistik (SOPK) merupakan kelainan endokrin dan metabolik pada wanita usia reproduksi. SOPK merupakan kumpulan gejala dari amenore, oligomenore, infertilitas, obesitas, hirsutisme, acne, alopesia, dan akantosis nigrikan. Resistensi insulin diyakini sebagai salah satu penyebab tersering dari SOPK melalui berbagai mekanisme. Tujuan penelitian ini adalah untuk mengetahui hubungan resistensi insulindengan gambaran klinis SOPK. Penelitian ini dilakukan pada pasien SOPK dengan menggunakan studi cross sectional dengan pendekatan retrospektif, yaitu mengumpulkan kejadian masa lalu dari tahun 2009 - 2011, jumlah sampel 105 orang. Analisis statistik yang digunakan adalah uji chi-square. Hasil penelitian didapatkan 33,3% penderita SOPK mengalami resistensi insulin. Berdasarkan gambaran klinis 35,23% amenore, 64,77% oligomenore, 72,04% infertilitas, 50,5% obesitas, 0,95% hirsutisme, acne 20%, alopesia dan akantosis nigrikan0%. Dari 33,3% SOPK dengan resistensi insulin 40% amenore, 60% oligomenore, 71,9% infertilitas, 77,14% obesitas, dan 0% hirsutisme. Berdasarkan hasil uji statistik ditemukan hubungan bermakna antara resistensi insulin dengan obesitas (p<0,05) dan tidak ditemukan hubungan bermakna antara resistensi insulin dengan infertilitas, hirsutisme, dan acne (p>0,05).Kata Kunci: SOPK, resistensi insulin, gambaran klinisAbstract Polycystic Ovary Syndrome (PCOS) is an endocrine and metabolic disorders that is common in reproductive-aged women. PCOS is a group of symptoms, such as amenorrhea, oligomenorrhea, infertility, obesity, hirsutism, acne, alopecia, and achanthosis nigricans. Insulin resistance is believed to be one of the most common causes of PCOS through a various mechanisms. The objective of this study was to find out the relationship between insulin resistance and clinical manifestation of PCOS. This research was done in patients with PCOS using cross sectional study with retrospective approach. Data was collected from 2009-2011, with the sample of 105 patients. This research used statistical analysis, that was chi square test. This research found that  33.3% patients of PCOS have insulin resistance. Based on clinical manifestation found that 35.23% amenorrhea, 64.77% oligomenorrhea, 72.04% infertility, 50.5% obesity, 0.95% hirsutism, 20% acne, 0% alopecia and achanthosis nigricans. From 33.3% PCOS with insulin resistance, 40% amenorrhea, 60%  oligomenorrhea, 71.9% infertility, 77.14% obesity, and 0% hirsutism. The results showed that there is a significant relationship between insulin resistance and obesity (p<0.05) and no significant reslationship between insulin resistance and infertility, hirsutism, and acne (p>0.05).Keyword: PCOS, insulin resistance, clinical manifestation 


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xue Tang ◽  
Lulu Ding ◽  
Yuejing Feng ◽  
Yi Wang ◽  
Chengchao Zhou

Abstract Background Reasonable use of antenatal care (ANC) services by pregnant women played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. This study aimed to investigate the ANC use, and to explore the factors associated with ANC use among migrant women during the first delivery in China. Methods This study used the data of National Health and Family Planning Commission of People Republic of China in 2014. A total of 1505 migrant primiparous women were included in our current analysis. Frequencies and proportions were used to describe the data. Chi-square tests and multivariate binary logistic regression models were performed to explore the determinants that affect the number of times migrant women used ANC during their first delivery. Results Of the 1505 participants, 279 (18.54%) women received the ANC less than 5 times, and 1226 (81.46%) women used the ANC at least 5 times during the first delivery. The multivariate logistic regression model showed that migrant primiparous women with college and above education(P < 0.05;OR = 2.57;95%CI = 1.19–5.55), from the households with higher monthly income (P < 0.01;OR = 2.01;95%CI = 1.30–3.13), covered by maternity insurance(P < 0.01;OR = 2.01;95%CI = 1.28–3.18), with maternal health records (P < 0.001;OR = 2.44;95%CI = 1.61–3.69), migrating across county (P < 0.05;OR = 2.57;95%CI = 1.14–5.81), having migration experience before pregnancy(P < 0.05;OR = 1.37;95%CI = 1.03–1.81) were more likely to use ANC for at least five times. Conclusions This study demonstrated that there were still some migrant maternal women (18.54%) who attended the ANC less than 5 times. Targeted policies should be developed to improve the utilization of ANC among migrant pregnant women.


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