Adiponectin is an exclusively adipose tissue-derived protein. Low plasma adiponectin levels have been found in hypertensive men. Our objective was to evaluate whether low first-trimester plasma adiponectin values were predictive of hypertensive disorders later in pregnancy.A nested case-control study was carried out on a cohort of 1,842 pregnant women who participated in the first-trimester Down syndrome screening program; 34 developed preeclampsia and 48 gestational hypertension. A control group of 82 nonhypertensive uneventful pregnancies was selected. Plasma adiponectin was determined using an enzyme-linked immunosorbent assay (ELISA).Adiponectin median concentrations in the group which subsequently became hypertensive were significantly lower than those in the control group (7.6 versus 13.0 microg/mL) (P < .001). When the 2 hypertensive subgroups were considered, the plasma adiponectin median value in the preeclampsia group was significantly lower than that in the gestational hypertension group (6.6 versus 9.3 microg/mL) (P = .01). Regression analysis showed an inverse correlation between plasma adiponectin concentrations and maternal age, gestational age, body mass index, systolic blood pressure, and proteinuria. Approximately 34% of hypertensive pregnancies, compared with 7% of controls (P < .001), had plasma adiponectin concentrations less than 6.4 microg/mL (mean value of lower quartile of distribution among control patients). After adjusting for maternal age, all these women experienced a 6.6-fold (95% confidence interval 2.5-17.8) increased risk of pregnancy hypertension, compared with those women who had higher concentrations.Our findings suggest a strong association between hypoadiponectinemia and the risk of hypertensive disorders in pregnancy, especially with preeclampsia.
The aim of this study was to evaluate whether myo-inositol, an insulin-sensitizing substance, may improve some features of metabolic syndrome in postmenopausal women.Eighty postmenopausal women affected by the metabolic syndrome were enrolled prospectively in the study and treated with diet plus supplementation of myo-inositol (2 g BID plus diet: intervention group) or with diet plus placebo (control group) for 6 months. They were evaluated at baseline and after 6 months for insulin resistance (homeostasis model assessment ratio [HOMA] insulin resistance), lipid profile, and blood pressure.Myo-inositol plus diet improved systolic and diastolic blood pressure, HOMA index, cholesterol, and triglyceride serum levels with highly significant differences, compared with the groups treated only with diet and placebo. In the group treated with myo-inositol, a decrease in diastolic blood pressure (-11%), HOMA index (-75%), and serum triglycerides (-20%) and an improvement in high-density lipoprotein cholesterol (22%) were shown.Supplementation with myo-inositol may be considered a reliable option in the treatment of metabolic syndrome in postmenopausal women.
To evaluate the relation between CD34+ cells count in maternal blood and potential development of fetal congenital renal abnormalities.We enrolled 16 women that gave birth to newborns carrying congenital renal malformations over a 3-year period and 48 women with uncomplicated pregnancies (controls) in a 1:3 ratio (three controls per case).CD34+ cells in the maternal peripheral blood were significantly lower in the group of women who gave birth to newborns carrying congenital renal malformations compared to the controls (p < .0001).CD34+ cells in maternal blood could be validated as a potential marker to predict the development of possible kidney malformations.
Psoriasis is a chronic immune-mediated disease that can be challenging to treat, especially in patients with severe disease or high body weight. Tildrakizumab is a monoclonal antibody which inhibits IL-23, approved for moderate-to-severe psoriasis with a standard 100 mg dose. A 200 mg dose may provide greater efficacy for patients over 90 kg or with high disease burden.
Abstract Objective. To evaluate the ability of endoglin, placental growth factor (PlGF) and the soluble form of vascular endothelial growth factor receptor (sFlt‐1) measurements in gestational weeks 24–28 were used to predict pre‐eclampsia. Design. Observational, prospective study. Setting. Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina. Sample. Fifty‐two pre‐eclamptic and 52 healthy pregnant women. Methods. A maternal serum sample was frozen and stored at 1‐h 50‐g glucose challenge test between 24 and 28 weeks’ gestation. A second maternal serum sample was collected at admission for the onset of the disease in the pre‐eclamptic group and at admission for delivery in the control group. Levels of endoglin, sFlt‐1 and the PlGF were measured in the stored serum. Pre‐eclamptic subjects were also divided into women with early‐onset (<37 weeks) and women with late‐onset pre‐eclampsia (≥37 weeks). Results. Levels of endoglin, sFlt‐1, and sFlt‐1: PlGF ratio were found to be higher in the pre‐eclamptic group in both trimesters. No differences were found between early‐ and late‐onset pre‐eclamptic. The Receiver Operating Characteristics curve, applied to the second trimester marker values, showed the best diagnostic profile for sFlt‐1: PlGF (area under the curve, AUC =0.92) followed by endoglin (AUC =0.88), sFlt‐1 (AUC =0.87) and PlGF (AUC = 0.83). This finding was confirmed by Bayesian analysis which highlighted a specificity, a sensitivity, a diagnostic accuracy, a positive predictive value and a negative predictive value of 88.5% for sFlt‐1: PlGF using a cut‐off of 38.47. Conclusions. Endoglin, PlGF and sFlt‐1 might be used as markers for predicting pre‐eclampsia, but sFlt‐1: PlGF seems to be more accurate.
Background . Given the chronic relapsing, remitting course of psoriasis, data about long‐term effectiveness may be useful to assess the maintenance of clinical response over time. Objective . To evaluate 2‐year drug survival of risankizumab and identify any predictive factor of discontinuation for ineffectiveness. Materials and Methods . A multicenter retrospective study was conducted in patients who initiated risankizumab between July 2019 and December 2020. PASI was measured at baseline and after 104 weeks. Any adverse event was registered during visits. Univariable and multivariable logistic regressions were used to assess baseline patients’ characteristics that predicted clinical response. The drug survival analysis was descriptively performed using the Kaplan–Meier survival curve. Results . 112 patients with moderate‐to‐severe plaque psoriasis were included. The overall median observation time was 35.3 months (26.7–37.3); the estimated survivor cumulative function at months 12 and 24 was 93.6% and 90.6%, respectively. No differences in BMI, disease duration, disease severity, or previous biological therapies were observed in patients who responded or did not respond to treatment. No significant adverse events were reported, but there was relapse of psoriatic arthritis and ulcerative colitis in a patient. Conclusions . We found that risankizumab was associated with long‐term effectiveness, and a favorable safety profile in a population of psoriatic patients was observed, over a period of 2 years.
