scholarly journals Triglyceride Induced Metabolic Inflammation: Potential Connection of Insulin Resistance and Recurrent Pregnancy Loss

2021 ◽  
Vol 12 ◽  
Author(s):  
Yongjie Liu ◽  
Mengyang Du ◽  
Yuexin Gan ◽  
Shihua Bao ◽  
Liping Feng ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Lymphocyte Subsets ◽  
Clinical Chemistry ◽  
Venous Blood ◽  
Multiple Logistic Regression Analysis ◽  
Oral Glucose ◽  
Significant Positive Association ◽  
Color Flow

The underlying correlative mechanisms between Insulin resistance (IR) and recurrent pregnancy loss (RPL) in patients without polycystic ovarian syndrome (PCOS) remain inconclusive. To investigate the association between triglyceride (TG) levels, lymphocyte subsets, and IR in RPL patients without PCOS and obesity. Eighty-nine subjects with an unexplained RPL, independent of PCOS/obesity were enrolled in this study. A 75-g oral glucose tolerance test was performed on each subject with plasma tested for glucose and insulin. The fasting venous blood of all subjects was collected for routine clinical chemistry analysis. Lymphocyte subsets were analyzed by four-color flow cytometry. As a result, TG levels were significantly elevated in RPL patients with IR compared to those without IR. Pearson linear correlation model and receiver operating characteristic (ROC) curve analyses revealed a significant positive association between TG and HOMA-IR index value. In multiple logistic regression analysis, TG was significantly associated with the risk of hyperinsulinemia and increased CD3+CD4+/CD3+CD8+ ratio which was significantly negatively correlated with disposition index (DI30) and DI120, indicators for insulin sensitivity. In addition, DI30 and DI120 were significantly decreased in the higher CD3+CD4+/CD3+CD8+ group. Our findings showed that the elevated TG and altered immune responses in RPL patients with IR are independent of PCOS and obesity, and could be used as an indicator of IR in RPL patients. These results contribute to the understanding of the pathophysiology of IR in RPL for potential prevention and therapeutic targets.

The association of insulin resistance and recurrent pregnancy loss.

2001 ◽  
Vol 76 (3) ◽  
pp. S158
Author(s):  
L.J Barker ◽  
R.W Ke ◽  
G.S Ghazeeri ◽  
W.H Kutteh
Keyword(s):  
Insulin Resistance ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss

scholarly journals Recurrent Pregnancy Loss in Polycystic Ovary Syndrome: Role of Hyperhomocysteinemia and Insulin Resistance

PLoS ONE ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. e64446 ◽  
Author(s):  
Pratip Chakraborty ◽  
S. K. Goswami ◽  
Shweta Rajani ◽  
Sunita Sharma ◽  
Syed N. Kabir ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Polycystic Ovary ◽  
Ovary Syndrome

Telomere Length in Idiopathic Recurrent Pregnancy Loss

2021 ◽  
Author(s):  
Taylan Onat ◽  
Melike Demir Çaltekin ◽  
Nihal Inandiklioglu ◽  
Emre Baser ◽  
Demet Aydogan Kirmizi ◽  
...  
Keyword(s):  
Telomere Length ◽  
Base Pair ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Venous Blood ◽  
Biological Aging ◽  
Control Group ◽  
Early Follicular Phase ◽  
Recurrent Pregnancy Losses ◽  
Endocrine Parameters

Abstract Objective Telomere length is used as an indicator of biological aging. It is well known that one of the most remarkable risk factors of recurrent pregnancy losses is advanced maternal age. The objective of this study was to investigate the correlation between idiopathic recurrent pregnancy loss and telomere length. Method The study group included 40 women, while the control group consisted of 41 healthy women whose age and body mass index were matched. A venous blood sample was taken from all participants into EDTA tubes in the early follicular phase, and telomere length was measured through the qPCR technique. Results When the mean TL of the groups was compared, it was determined that TL was significantly shorter among the iRPL group (7763.89±924.58 base pair) compared to the control group (8398.84±1102.95 base pair) (p<0.006). Whereas FSH and E2 were higher in the iRPL group, TAFC was lower (p<0.001). When the correlation between telomere length and endocrine parameters was statistically tested in the iRPL group, a negative correlation was found between FSH and telomere length (r=-0.437; p<0.001). Conclusion Shortened telomere length might play a role in the etiology of iRPL. We are of the opinion that patients with RPL should be screened for the presence of cardiovascular diseases and other chronic diseases, as is the case for POF.

scholarly journals Relationship of insulin resistance with recurrent pregnancy loss

2017 ◽  
Vol 6 (4) ◽  
pp. 1312 ◽  
Author(s):  
Asifa Ali Wani ◽  
Irfan Gul ◽  
Farhat Jabeen ◽  
Shiveta Kaul ◽  
Farhat Ali Lone ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Fasting Glucose ◽  
Histopathological Examination ◽  
Control Group ◽  
Study Group ◽  
Fasting Insulin ◽  
Significant Difference ◽  
Mean Glucose

Background: The recurrent pregnancy loss (RPL) is defined as two and more failed pregnancies as documented by ultrasound and histopathological examination and suggested some assessment after each loss with a thorough evaluation after three or more losses. RPL is one of the most frustrating and difficult areas in reproductive medicine because the aetiology is often unknown and there are few evidence based diagnostic and treatment strategies.Methods: 150 Non pregnant females were taken as both cases and controls in the study. All the pregnancy losses were documented by ultrasound or histological examination after uterine curettage. The control group consisted of women with no RPL with at least one live birth. These two groups were matched on the basis of age and BMI. All the women underwent following examinations, viz. Hysterosalpingography, karyotype of both partners, serum TSH, FT4, prolactin and antibodies for APLA. In addition blood sample were taken for fasting serum glucose and serum insulin level later insulin resistance was calculate using three parameters Fasting insulin > 20IU/ml. Diagnostic of Insulin Resistance. (2) Fasting glucose / Fasting insulin. A ratio of < 4.5 being diagnostic of insulin resistance. (3) HOMA IR.        FG (mg/dl) x FPI (IU/ml) FG (mmol/l) x FPI (IU/ml)------------------------------------ OR -----------------------------------                                             405 22.5Where 1 mmol/l = 18mg/dl, A value of > 4.5 being diagnostic of insulin resistance.Results: 150 patients were enrolled in this study among which 75 were selected as cases and 75 as controls after fulfilling inclusion and exclusion criteria with mean age cases group was28.4+2.37 years and 29.1+2.70 years in control group mean miscarriage rate in study group was 3.17+83 and control group with 0.35+0.48 with statistically significant difference. Mean fasting glucose (96.5+ 7.86) mg/dl, Fasting Insulin (14.1±5.91) IU/ml. Mean Glucose Insulin ratio (8.1±3.39), HOMA-IR (3.4 ±1.51) in the study group and in control group mean fasting glucose was (87.1+11.49) mg/dl, Fasting Insulin (6.9 ± 4.99) IU/ml. Mean Glucose Insulin ratio (17.8 ±11.44), HOMA-IR (1.5 ±1.27) respectively with statistically significant difference.Conclusions: In women with recurrent pregnancy loss fasting insulin and insulin resistance are higher than those in women without spontaneous abortion. The most sensitive parameter for calculating insulin resistance was found to be fasting insulin followed by HOMA – IR and followed by fasting glucose/fasting insulin ratio. It is therefore important to recommend a fasting insulin and fasting glucose level while evaluating a case of recurrent pregnancy loss to assess for insulin resistance.

scholarly journals High Fasting Insulin Levels and Insulin Resistance May Be Linked to Idiopathic Recurrent Pregnancy Loss: A Case-Control Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Corina-Alina Ispasoiu ◽  
Radu Chicea ◽  
Florin Vasile Stamatian ◽  
Florin Ispasoiu
Keyword(s):  
Insulin Resistance ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Case Control Study ◽  
Fasting Glucose ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Fasting Insulin ◽  
Control Study

Objective. Patients with more than two spontaneous pregnancy losses are diagnosed with recurrent pregnancy loss. The aim of this study was to evaluate the IR (insulin resistance) in patients with idiopathic recurrent pregnancy loss.Material and Method. A single center, case control study was performed on one hundred eighteen women divided into case group (with at least two pregnancy losses, earlier than 20 weeks of gestation, and negative for the recurrent pregnancy loss testing) and control group (with at least one live birth, no pregnancy loss). FG (fasting glucose) and FI (fasting insulin) were determined for all patients. IR was evaluated by HOMA-IR index.Results. There were not significant differences between the mean age and BMI in cases and controls (P>0.05). Fasting glucose was significantly higher in the control group (85.6 versus 79.8P<0.01), but fasting insulin (15.24 versus 12.83,P<0.001) and HOMA-IR (2.98 versus 2.69,P<0.05) were significantly higher in the case group.Conclusion. In women with idiopathic recurrent pregnancy loss FI and IR are higher than those in women without spontaneous abortion.

scholarly journals Comparison of 2-Hour Oral Glucose Tolerance Test and Hemoglobin A1C in the Identification of Pre-Diabetes in Women with Infertility and Recurrent Pregnancy Loss

2019 ◽  
Vol 13 ◽  
pp. 117955811983128 ◽  
Author(s):  
Alice J Shapiro ◽  
Emily C Holden ◽  
Peter G McGovern ◽  
Donald Alderson ◽  
Sara S Morelli
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Gold Standard ◽  
Pregnancy Loss ◽  
Hemoglobin A1c ◽  
Recurrent Pregnancy Loss ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance

Research question: Does hemoglobin A1C (HbA1C) predict pre-diabetes (pre-DM) in a population of women with infertility and/or recurrent pregnancy loss (RPL), when considering the 75 g, 2-hour oral glucose tolerance test (2h GTT) as the gold standard? Design: Retrospective study of 242 patients with infertility or RPL presenting to a university-affiliated reproductive endocrinology and infertility clinic between January 2012 and December 2016 who underwent screening for disorders of glucose metabolism with a 2h GTT. The prevalence of pre-DM as defined by HbA1C 5.7% to 6.4% and 2h GTT values of 140-199 mg/dL, and predictive values of HbA1C for the identification of pre-DM when compared with 2h GTT, were calculated and compared. Results: Of 242 patients, 188 (77.7%) women had both HbA1C and 2h GTT performed. Of these, 89 (47.3%) tested positive for pre-DM by one or both methods. Of 89 patients, 14 (15.7%) had both an abnormal 2h GTT and an abnormal HbA1C. Only 6 out of 89 (6.7%) patients tested positive for pre-DM by an abnormal 2h GTT in the setting of a normal HbA1C result. Conversely, 69 of these 89 patients (77.5%) tested positive for pre-DM by an abnormal HbA1C in the setting of a normal 2h GTT. The prevalence of pre-DM, as defined by 2h GTT, was 10.6% (20/188) (95% CI, 6.6-16.0), compared with a prevalence of 44.1% (83/188) (95% CI, 36.9-51.6) when pre-DM was defined by HbA1C alone. When the 2h GTT was considered the gold standard for the identification of pre-DM, the negative predictive value (NPV) of HbA1C compared with 2h GTT was 94.3% (95% CI, 88.0-97.9), whereas the positive predictive value (PPV) of HbA1C compared with 2h GTT was only 16.9% (95% CI, 9.5-26.7). Conclusions: Although a normal HbA1C was highly predictive of a normal 2h GTT, the two tests demonstrate poor agreement in the identification of pre-DM in women with infertility and/or RPL. Hemoglobin A1C is superior to the 2h GTT as an initial screening test for pre-DM in this population, since it identified a substantial number of women who would otherwise remain undiagnosed in the setting for a normal 2h GTT alone. However, the long-term clinical relevance of an elevated HbA1C in this population needs to be better defined.

scholarly journals Thyroid Disorders in Pregnancy and Prevalence of Subclinical Hypothyroidism in Recurrent Early Pregnancy Losses

2021 ◽  
Vol 15 (8) ◽  
pp. 2366-2369
Author(s):  
Mehwish Younus ◽  
Urooj Yasir Khan ◽  
Urooj Naz ◽  
Aruna Kumari Hira ◽  
Sana Shahmir ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Venous Blood ◽  
Thyroid Stimulating Hormone ◽  
Free T4 ◽  
Cross Sectional ◽  
History Of ◽  
The Mean ◽  
Thyroid Profile

Objective: Determine the frequency of hypothyroidism in recurrent pregnancy loss. Study Design: This is cross sectional. Place and Duration of Study: This study was conducted at Obstetrics and Gynaecology department of Dow Medical University & Hospital, Ojha Campus, Karachi, from 7th July 2018 to 6th July 2019. Methodology: This study was conducted on 83 patients. Detailed history was taken from all the patients with special regard to demographics like age, parity and recurrent pregnancy loss. A 3 ml venous blood was drawn by the staff on duty and sent to institutional laboratory for TSH and free T4 level. TSH values more than 4.5 μIU/L and normal free T4 level (0.7 to 1, 8 ng/ml) were considered as hypothyroidism. All pregnant female was between age 20-35 years with > 6 months gestational age and history of parity 3 and gravida 4 were included in the study. Exclusion criteria were known case of hypothyroidism or history of taking medication for hypothyroidism, history of Hypertension and DM. Results: This study was conducted on 83 patients. There was wide variation of age ranging from a minimum of 20 years to 35 years. The mean age was 28.4+ 4.49 years. Mostly patients were parity 3 and gravid 4 in 55(66.26%) cases followed by parity 4 and gravid 4 in 28(33.73%) cases. Gestational age was measured on ultrasound ranging from 8 weeks to 22 weeks. The mean gestational age was 14.20+4.71 years. Patient's thyroid profile mean Thyroid-stimulating hormone (TSH) level was 2.39+1.66 mU/L, mean free T4 was 17.23+6.41 nmol/L and mean free T3 was 4.87+1.18 μmol/L. Observed hypothyroidism was in 11(13.3%) cases while rest of 72(86.7%) cases within normal range. Conclusion: We concluded that hypothyroidism is problem in recurrent pregnancy loss. 11(13.3%) cases Frequency of hypothyroidism in women with pregnancy, the possible role of thyroid functional disorders in etiology of at least some part of recurrent pregnancy loss, had emphasized the importance of thyroid functions tests screening as routine in all pregnancies. Keywords: Thyroid disease, Pregnancy outcome, Hypothyroidism.

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