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Aryee NA, Adu-Bonsaffoh K, Arko-Boham B, Quaye O, Asazu H, Tagoe E. Thyroid hormone profile in preeclampsia patients: a case control study. Gynecol Endocrinol 2023; 39:2186136. [PMID: 36927356 DOI: 10.1080/09513590.2023.2186136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Objective: Preeclamptic women are reported to have a higher incidence of thyroid dysfunction that correlates with the severity of preeclampsia. The aim of this study was to assess thyroid hormone profiles in in pregnant women with preeclampsia and gestational hypertension and the risk for thyroid dysfunction.Methods: In this study, age-matched pregnant females in the second trimester of pregnancy, diagnosed with preeclampsia (PE), gestational hypertension (GH), as cases, and apparently healthy normotensive (NT) pregnant woman as controls were recruited. Blood samples were drawn for the assessment of thyroid hormone (TSH, FT3 and FT4) levels and thyroid dysfunction.Results: Out of the total of 133 pregnant women recruited for this study, sub-clinical hypothyroidism was the only thyroid dysfunction common to all study groups, with a prevalence of 3.3% in both PE and NT groups, and 4.3% in the GH group. 1% of women in the PE group had sub-clinical hyperthyroidism, compared to 3.3% in the NT group. Although TSH and FT3 were elevated in normotensives, mean differences between the three groups were not statistically significant. However, mean FT4 levels in the GH group (12.99 ± 1.24) and PE group (12.33 ± 2.26), when compared to the control group (11.55 ± 1.94), were significantly higher (p < 0.05).Conclusion: Undiagnosed subclinical hypothyroidism was found in all the categories of pregnant women studied, which if uncontrolled, could increase the risk of pregnancy-related complications, especially in pregnant women with preeclampsia and gestational hypertension.
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Affiliation(s)
- Nii Ayite Aryee
- Department of Medical Biochemistry, University of Ghana Medical School, University of Ghana, Legon, Ghana
| | - Kwame Adu-Bonsaffoh
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, University of Ghana, Legon, Ghana
| | - Benjamin Arko-Boham
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Legon, Ghana
| | - Osbourne Quaye
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana
| | - Hope Asazu
- Department of Medical Biochemistry, University of Ghana Medical School, University of Ghana, Legon, Ghana
| | - Emmanuel Tagoe
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, University of Ghana, Legon, Ghana
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Hajifoghaha M, Teshnizi SH, Forouhari S, Dabbaghmanesh MH. Association of thyroid function test abnormalities with preeclampsia: a systematic review and meta-analysis. BMC Endocr Disord 2022; 22:240. [PMID: 36163002 PMCID: PMC9511725 DOI: 10.1186/s12902-022-01154-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/15/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Preeclampsia is a life-threatening disorder during pregnancy and postpartum periods. Preeclampsia can affect the activity of many organs. It is very important because if this disorder is associated with changes in thyroid function, it can affect the results of maternal and fetal tests. Accordingly, the aim of this meta-analysis study was to assess the abnormalities in thyroid function tests in preeclampsia. METHODS Studies were selected through a systematic search of the MEDLINE/PubMed, Scopus, Web of Science Core Collection, and Google Scholar databases in 31st August 2021. Also, reference lists of review articles and relevant studies were manual-searched to identify other potentially eligible studies. English studies that compared TSH, T4 and T3 of normal pregnant with preeclamptic women (Known to be normotensive before pregnancy; gestational age 20 week or more; singleton pregnancy; no previous history of thyroid dysfunction) were screened. Data sets were screened for eligibility by two independent reviewers. Articles were assessed by the Newcastle-Ottawa Scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels. RESULTS After reviewing 886 published studies, 63 observational studies were selected and used for this meta-analysis. The study population included 21,528 pregnant women. The findings revealed that TSH (SMD = 1.70, 95%CI: 1.39 to 2.02; p < 0.001) was significantly higher in preeclamptic women. TT4 (SMD = -0.82, 95%CI: -1.16, -0.49; p < 0.001), TT3 (SMD = -0.88, 95%CI: -1.36 to -0.41; p < 0.001) and FT3 (SMD = -0.59, 95%CI: -0.91 to -0.27; p < 0.001) were less in preeclamptic women. There was no statistically significant difference in FT4 between two groups (SMD = 0.002, 95%CI: -0.27 to 0.27; p = .990). The results of publication bias and sensitivity analysis confirmed the reliability and stability of this meta-analysis. The quality of evidence was regarded as moderate, low, and very low for these risk factors according to the GRADE approach. CONCLUSIONS Findings of this meta-analysis indicated preeclamptic women were more at risk of changes in thyroid function tests. In order to prevent thyroid disorders, it is recommended that thyroid function tests be performed in women with pre-eclampsia.
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Affiliation(s)
- Mahboubeh Hajifoghaha
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Hosseini Teshnizi
- Department of Community Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar-Abbas, Iran
| | - Sedighe Forouhari
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Adam I, Rayis DA, ALhabardi NA, Ahmed ABA, Sharif ME, Elbashir MI. Association between breastfeeding and preeclampsia in parous women: a case -control study. Int Breastfeed J 2021; 16:48. [PMID: 34187508 PMCID: PMC8243720 DOI: 10.1186/s13006-021-00391-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/08/2021] [Indexed: 12/21/2022] Open
Abstract
Background Preeclampsia is a global health problem and it is the main cause of maternal and perinatal morbidity and mortality. Breastfeeding has been reported to be associated with lower postpartum blood pressure in women with gestational hypertension. However, there is no published data on the role that breastfeeding might play in preventing preeclampsia. The aim of the current study was to investigate if breastfeeding was associated with preeclampsia in parous women. Method A case-control study was conducted in Saad Abualila Maternity Hospital in Khartoum, Sudan, from May to December 2019. The cases (n = 116) were parous women with preeclampsia. Two consecutive healthy pregnant women served as controls for each case (n = 232). The sociodemographic, medical, and obstetric histories were gathered using a questionnaire. Breastfeeding practices and duration were assessed. Results A total of 98 (84.5%) women with preeclampsia and 216 (93.1%) women in the control group had breastfed their previous children. The unadjusted odds ratio (OR) of preeclampsia (no breastfeeding vs breastfeeding) was 3.55, 95% confidence interval (CI) 1.64,7.70 and p value = 0.001 based on these numbers. After adjusting for age, parity, education level, occupation, history of preeclampsia, history of miscarriage, body mass index groups the adjusted OR was 3.19, 95% CI 1.49, 6.82 (p value = 0.006). Conclusion Breastfeeding might reduce the risk for preeclampsia. Further larger studies are required.
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Affiliation(s)
- Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, P.O Box 102, Khartoum, Sudan.
| | - Nadiah A ALhabardi
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Abdel B A Ahmed
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Manal E Sharif
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Mustafa I Elbashir
- Faculty of Medicine, University of Khartoum, P.O Box 102, Khartoum, Sudan
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Su X, Liu Y, Li G, Liu X, Huang S, Duan T, Du Q. Associations of Hypothyroxinemia With Risk of Preeclampsia-Eclampsia and Gestational Hypertension. Front Endocrinol (Lausanne) 2021; 12:777152. [PMID: 34803932 PMCID: PMC8600315 DOI: 10.3389/fendo.2021.777152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/18/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the association between hypothyroxinemia and the risk of preeclampsia-eclampsia and gestational hypertension. DESIGN Historical cohort study. METHODS The study included pregnant individuals who delivered live-born singletons and had at least one thyroid function assessment during pregnancy at a tertiary hospital. Hypothyroxinemia was defined as thyroid-stimulating hormone (TSH) levels within the normal reference range and free thyroxine (FT4) levels lower than the tenth percentile. Risk ratios (RRs) with 95% confidence intervals (95% CIs) for preeclampsia-eclampsia and gestational hypertension between women with and without a diagnosis of hypothyroxinemia during pregnancy were estimated using a generalized estimating equation model. RESULTS A total of 59,463 women with live-born singletons were included in the analysis. Logistic regression models with restricted cubic spline suggested that there was a U-shaped association between FT4 levels and preeclampsia-eclampsia risk. Compared with euthyroid women, those with hypothyroxinemia had an increased risk of preeclampsia-eclampsia (RR = 1.16, 95% CI: 1.02-1.31), and the risk increased with the increasing severity of hypothyroxinemia (p for trend < 0.001). Moreover, persistent hypothyroxinemia from the first to second trimesters was associated with an increased risk of preeclampsia-eclampsia (RR = 1.37, 95% CI: 1.03-1.83), especially for women with severe hypothyroxinemia (RR = 1.70, 95% CI: 1.12-2.58). In contrast, there was no association between hypothyroxinemia and gestational hypertension. CONCLUSION Our study suggested that hypothyroxinemia was only associated with an increased risk of preeclampsia-eclampsia, especially in women with persistent hypothyroxinemia in the first half of pregnancy. Analyses of the associated risk of gestational hypertension with hypothyroxinemia were not significant.
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Affiliation(s)
- Xiujuan Su
- Clinical Research Centre, Shanghai Key Laboratory of Maternal Foetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yang Liu
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Guohua Li
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaosong Liu
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shijia Huang
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tao Duan
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiaoling Du
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Qiaoling Du,
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Pan X, Wei B, Wang H, Ma L, Du Z, Chen Y. Novel association between FOXO3 rs2232365 polymorphism and late-onset preeclampsia: a case-control candidate genetic study. BMC Pregnancy Childbirth 2020; 20:779. [PMID: 33317466 PMCID: PMC7737381 DOI: 10.1186/s12884-020-03479-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Both genetic susceptibility and dysregulated lipid metabolism are important susceptibilities to preeclampsia. In the study, we devote to investigate the associations of FOXO3 and TLR7 genetic polymorphisms with preeclampsia in a Chinese population. METHODS This case-control study involved 335 Han Chinese pregnant women, including 177 pregnant women with preeclampsia and 158 healthy controls. The preeclampsia group was further sub-grouped into early-onset preeclampsia (EOPE, n = 70)and late-onset preeclampsia (LOPE, n = 107. Three single nucleotide polymorphisms (SNPs), including FOXO3 (rs2232365, rs3761548), and TLR7 rs3853839 were genotyped by multiplex PCR for targeted next-generation sequencing. The χ2 test and multiple interaction effect analyses were performed to determine the association of three SNPs with serum lipid levels and thyroid function in women with preeclampsia. RESULTS The genotype (CC vs. TT + CT) distribution of rs2232365 revealed a significant association with LOPE (P = 0.004, odds ratio = 3.525 (0.95 CI: 1.498-8.164)). No significant difference was found in the genotype and allele frequencies of rs3761548 and rs3853839 between controls and cases (P > 0.05). Moreover, the genotype CT/TT of rs2232365 was significantly correlated with increased TG/HDL levels in the LOPE group (p = 0.014). CONCLUSIONS The polymorphisms of rs2232365 are associated with the risk of LOPE and may modulate TG/HDL levels in pregnant women with LOPE.
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Affiliation(s)
- Xuefeng Pan
- Department of Obstetrics, The First Hospital of Jilin University, Xinmin Street 1, Changchun, Jilin Province 130021 China
| | - Benjie Wei
- Institute of Genetic Technology, Yinfeng Bilogical Group, No. Three Road No. 1109, Shandong, Ji’nan Hi Tech Development Zone Export Processing Zone, Jinan, Shandong Province 250014 China
| | - Hong Wang
- Department of Obstetrics, The First Hospital of Jilin University, Xinmin Street 1, Changchun, Jilin Province 130021 China
| | - Lingyu Ma
- Department of Obstetrics, The First Hospital of Jilin University, Xinmin Street 1, Changchun, Jilin Province 130021 China
| | - Zhaoli Du
- Institute of Genetic Technology, Yinfeng Bilogical Group, No. Three Road No. 1109, Shandong, Ji’nan Hi Tech Development Zone Export Processing Zone, Jinan, Shandong Province 250014 China
| | - Ying Chen
- Department of Obstetrics, The First Hospital of Jilin University, Xinmin Street 1, Changchun, Jilin Province 130021 China
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Abbas W, Adam I, Rayis DA, Hassan NG, Lutfi MF. Thyroid hormones profile among obese pregnant Sudanese women. J Clin Transl Res 2020; 6:14-19. [PMID: 33005815 PMCID: PMC7524270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Previous studies evaluating thyroid function among obese pregnant women failed to demonstrate a consistent pattern of thyroid hormones profile, probably due to the variations in biological/environmental determinants of thyroid function in different countries. AIM The aim of the study was to evaluate thyroid hormones profile in Sudanese pregnant women with varying degrees of obesity. PATIENTS AND METHODS Obstetric/sociodemographic characteristics were gathered from 178 singleton pregnant Sudanese women using questionnaires. Weight and height were measured; body mass index (BMI) was calculated and categorized into four groups: Underweight (BMI <18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (≥30 kg/m2). Free triiodothyronine (FT3), free thyroxin (FT4), and thyroid-stimulating hormone (TSH) were measured. RESULTS Of the 178 enrolled women, 9 (5.1%), 52 (29.2%), 73 (41.0%), and 44 (24.7%) were underweight, normal BMI, overweight, and obese, respectively. FT3 level was significantly higher in obese women compared with normal BMI (P=0.004) as well as overweight women (P=0.015). Higher FT3 levels were significantly associated with obesity (odds ratio [OR]=9.5, 95% confidence interval [CI] =3.1-29.0, P<0.001). Lower levels of FT4 were significantly associated with overweight (OR=0.06, 95% CI=0.007-0.58, P=0.015) and obesity (OR=0.048, 95% CI=0.004-0.5, P=0.018). Based on linear regression analysis, BMI was positively associated with FT3 (4.7 pmol/l, P<0.001) and negatively associated with FT4 (-8.26 pmol/l, P=0.001). CONCLUSIONS BMI correlates with FT3 differently compared to FT4. Pregnant women with higher BMI are likely to have higher levels of FT3, but lower FT4. In contrast, TSH levels were comparable in different BMI groups. RELEVANCE FOR PATIENTS Increased iodothyronine 5´deiodinase (5´D) activity associated with obesity may give an explanation for thyroid profile in those with higher BMI. High 5´ activity increases FT3 at the expense of FT4. Alternatively, high FT3 and low FT4 are expected to feedback differently on TSH, which explains the loss of positive correlation between BMI and TSH.
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Affiliation(s)
- Wisal Abbas
- 1Department of Physiology, Faculty of Medicine, Al-Neelain University, Khartoum, Sudan
| | - Ishag Adam
- 2Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Duria A. Rayis
- 2Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Nada G. Hassan
- 2Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Mohamed F. Lutfi
- 3Department of Physiology, College of Medicine, Qassim University, Kingdom of Saudi Arabia,4Department of Physiology, Nile College of Medicine, Khartoum, Sudan,Corresponding author: Mohamed Faisal Lutfi Department of Physiology, College of Medicine, Qassim University, Kingdom of Saudi Arabia/Department of Physiology, Nile College of Medicine, Khartoum, Sudan. Tel.: +249912257731, +966507675335
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Mahmoud S, Nasri H, Nasr AM, Adam I. Maternal and umbilical cord blood level of macrophage migration inhibitory factor and insulin like growth factor in Sudanese women with preeclampsia. J OBSTET GYNAECOL 2018; 39:63-67. [PMID: 30286674 DOI: 10.1080/01443615.2018.1473350] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Preeclampsia is a health concern and it is the main cause of maternal and perinatal mortality. The macrophage migration inhibitory factor (MIF) and insulin-like growth factor-I (IGF-I) are factors associated with preeclampsia. A case-control (45 women in each arm) study was conducted at Saad Abualila Maternity Hospital (Khartoum, Sudan). The cases were of women who had preeclampsia, and the controls were healthy pregnant women. The clinical and obstetrical characteristics were gathered using a questionnaire and MIF and IGF-I levels were measured by ELISA. The cases and the controls (45 in each arm) were matched in their basic data. In comparison with the healthy controls, while the median (interquartile range) of the maternal MIF [8.221 (7.334-8.820) vs. 3.717 (2.385-4.883) ng/mL, p < .001] was significantly higher, the levels of the maternal IGF-1 [1.250 (0.670-1.980) vs. 1.939 (1.056-2.752), ng/mL, p < .001] were significantly lower in the women with preeclampsia. There was no significant difference in the cord levels of both the MIF and IGF-1 between the cases and controls. In linear regression, preeclampsia was the only factor that was significantly associated with the log of the maternal MIF (-0.338 ng/mL, p < .001), IGF-1 (0.293 ng/mL, p = .005) and cord MIF (-0.340 ng/mL, p < .001) levels. Impact statement What is already known on this subject? Macrophage migration inhibitory factor (MIF) has a pivotal role in pro-inflammatory processes during pregnancy/labour and its levels have been correlated with preeclampsia. Insulin like factors are produced in the liver under the stimulation of the growth hormones; they stimulate cell differentiation proliferations. IGF-I may be implicated in the pathogenesis of the adverse effects of preeclampsia (mainly the birth weight). What do the results of this study add? The current study showed a significantly higher level of MIF and lower level IGF-1 in the women with preeclampsia. Thus, both MIF and IGF-1 might have a role in the pathogeneses of preeclampsia. What are the implications of these findings for clinical practice and/or further research? MIF and IGF might be used as reliable markers to detect preeclampsia. These markers might be used as preventive or therapeutic elements for preeclampsia.
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Affiliation(s)
- Selma Mahmoud
- a Faculty of Medicine , University of Khartoum , Khartoum , Sudan
| | - Hind Nasri
- b Faculty of Veterinary , Bahri University , Bahria , Sudan
| | - Abubakr M Nasr
- a Faculty of Medicine , University of Khartoum , Khartoum , Sudan
| | - Ishag Adam
- a Faculty of Medicine , University of Khartoum , Khartoum , Sudan
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Agabain E, Mohamed H, Elsheikh AE, Hamdan HZ, Adam I. Maternal serum anti-Müllerian hormone in Sudanese women with preeclampsia. BMC Res Notes 2017. [PMID: 28646929 PMCID: PMC5483251 DOI: 10.1186/s13104-017-2544-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objectives A case–control study was conducted at Omdurman Maternity Tertiary Hospital, Sudan, during the period from May to August 2014 to investigate AMH level in women with preeclampsia compared to healthy controls. The cases were women with preeclampsia and healthy pregnant women were the controls. The obstetrics and medical history was gathered using a questionnaire. AMH level was measured using ELISA. Results There was no significant difference between the two groups (40 in each arm of the study) in the age, parity and gestational age. Thirty-three of the 40 cases were patients with severe preeclampsia. There was no significant difference in median inter-quartile of the AMH level between the women with preeclampsia and the controls [0.700 (0.225–1.500) vs. 0.700 (0.400–1.275) ng/ml, P = 0.967]. In a linear regression model there was no association between the log of AMH and age, parity, gestational age, BMI, hemoglobin level and preeclampsia.
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Affiliation(s)
- Eiman Agabain
- Medical College, Qassim University, Buraydah, Kingdom of Saudi Arabia
| | - Hameed Mohamed
- Faculty of Medicine, Alneelain University, Khartoum, Sudan
| | | | | | - Ishag Adam
- Medical College, Qassim University, Buraydah, Kingdom of Saudi Arabia. .,Faculty of Medicine, University of Khartoum, P.O. Box 102, 11111, Khartoum, Sudan.
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Thyroid function/antibodies in sudanese women with polycystic ovarian disease. Obstet Gynecol Sci 2017; 60:187-192. [PMID: 28344960 PMCID: PMC5364101 DOI: 10.5468/ogs.2017.60.2.187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 09/20/2016] [Accepted: 10/24/2016] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate thyroid function and hormonal profile in women with polycystic ovary syndrome (PCOS). Methods A case-control study was conducted at Saad Abualila Center, Khartoum, Sudan. The cases were women with confirmed PCOS based on Rotterdam criteria. The controls were infertile women with no evidence of PCOS. The socio-demographic characteristics and medical history were gathered using a questionnaire. Thyroid hormones (thyroid-stimulating hormone, free tri-iodothyronine, and free thyroxine), anti-thyroid peroxidase, and anti-thyroglobulin antibodies were measured. Results While there were no significant differences in the age and haemoglobin levels of the two studied groups (55 women in each arm), body mass index was significantly higher in women with PCOS. There were no significant differences in the levels of thyroid-stimulating hormone, luteinizing hormone, follicle stimulating hormone, luteinizing hormone/follicle stimulating hormone, anti-thyroid peroxidase, anti-thyroglobulin antibodies, cholesterol, triglycerides and low-density lipoprotein cholesterol between the cases and the controls. The mean±standard deviation of free tri-iodothyronine (3.50±0.2 vs. 3.38±0.3 pg/mL, P=0.040) and median (interquartile) high-density lipoprotein cholesterol (37.0 [34.0 to 42.0] vs. 35.80 [29.0 to 41.0] mg/dL, P=0.015) were significantly higher in PCOS patients compared with the control group. In linear regression, PCOS (0.151 pg/mL, P=0.023) and anti-thyroid peroxidase levels (-0.078 pg/mL, P=0.031) were significantly associated with free tri-iodothyronine. Conclusion Free tri-iodothyronine was a significantly higher among PCOS patients compared with the control group.
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Elmugabil A, Hamdan HZ, Elsheikh AE, Rayis DA, Adam I, Gasim GI. Serum Calcium, Magnesium, Zinc and Copper Levels in Sudanese Women with Preeclampsia. PLoS One 2016; 11:e0167495. [PMID: 27911936 PMCID: PMC5135106 DOI: 10.1371/journal.pone.0167495] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 11/15/2016] [Indexed: 01/24/2023] Open
Abstract
Background Although the exact pathophysiology of preeclampsia is not fully understood, several elemental micronutrient abnormalities have been suggested to play a contributory role in preeclampsia. Aims To investigate the levels of calcium, magnesium, zinc and copper in women with preeclampsia. Subjects and Methods A case—control study was conducted in Omdurman Maternity Hospital, Sudan, during the period of September through December 2014. The cases were women with preeclampsia while healthy pregnant women were the controls. The medical and obstetrics history was gathered using questionnaires. The serum levels of calcium, magnesium, zinc and copper were measured using atomic absorption spectrophotometer. Results There was no significant difference between the two groups in their age, gestational age, parity and body mass index. Zinc and copper levels were not significantly different between the two groups. In comparison with the controls, women with preeclampsia had a significantly lower median (inter-quartile) serum calcium [7.6 (4.0─9.6) vs. 8.1 (10.6─14.2), mg/dl, P = 0.032] and higher levels of magnesium [1.9 (1.4─2.5) vs. 1.4 (1.0─1.9) mg/dl; P = 0.003]. In binary logistic regression, lower calcium (OR = 0.73, 95% CI = 0.56 ─ 0.95, P = 0.021) and higher magnesium (OR = 5.724, 95% CI = 1.23 ─ 26.50, P = 0.026) levels were associated with preeclampsia. There were no significant correlations between levels of hemoglobin and these trace elements. Conclusion The current study showed significant associations between preeclampsia and serum levels of calcium and magnesium.
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Affiliation(s)
| | | | | | - Duria A. Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- * E-mail:
| | - Gasim I. Gasim
- Faculty of Medicine, Alneelain University, Khartoum, Sudan
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Elhaj ET, Adam I, Ahmed MA, Lutfi MF. Trimester-specific thyroid hormone reference ranges in Sudanese women. BMC PHYSIOLOGY 2016; 16:5. [PMID: 27795209 PMCID: PMC5087113 DOI: 10.1186/s12899-016-0025-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/13/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Trimester-specific reference ranges for T3, T4, and TSH need to be established in different communities. Neither Sudan nor other African countries have established trimester-specific reference ranges for TSH, free T3 (FT3), and free T4 (FT4) in healthy pregnant women. This study aimed to establish trimester-specific reference ranges for TSH, FT3, and FT4 in healthy pregnant Sudanese women. RESULTS We performed a longitudinal study, which included 63 women with singleton pregnancies who were followed since early pregnancy until the third trimester. The study was performed in Saad Abu-Alela Hospital, Khartoum, Sudan, during January to October 2014. An equal number of age- and parity-matched non-pregnant women were enrolled as a control group. Basic clinical and obstetrics data were gathered using questionnaires. TSH, FT3, and FT4 levels were measured. Median (5th-95th centile) values of TSH, FT3, and FT4 were 1.164 IU/ml (0.079-2.177 IU/ml), 4.639 nmol/l (3.843-6.562 nmol/l), and 16.86 pmol/l (13.02-31.48 pmol/l) in the first trimester. Median values of TSH, FT3, and FT4 were 1.364 IU/ml (0.540-2.521 IU/ml), 4.347 nmol/l (3.425-5.447 nmol/l), and 13.51 pmol/l (11.04-31.07 pmol/l) in the second trimester. These values were 1.445 IU/ml (0.588-2.460 IU/ml), 4.132 nmol/l (3.176-5.164 nmol/l), and 12.87 pmol/l (9.807-23.78 pmol/l) in the third trimester, respectively. TSH levels increased throughout the trimesters. FT3 and FT4 levels were significantly higher in the first trimester compared with the second and third trimesters. TSH, FT3, and FT4 levels were significantly lower in pregnant women compared with non-pregnant women (P < 0.001). CONCLUSIONS The present study is the first to establish trimester-specific reference ranges of TSH, FT3, and FT4 in Sudanese women with normal pregnancies. Our results suggest that pregnancy is likely to suppress TSH, T3, and T4 levels in healthy women.
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Affiliation(s)
- Enaam T Elhaj
- Faculty of Applied Medical Science, Gezira University, Wad Madani, Sudan
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mohamed A Ahmed
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mohamed F Lutfi
- Faculty of Medicine and Health Sciences, Alneelain University, Khartoum, Sudan.
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Heart Rate Variability and Autonomic Modulations in Preeclampsia. PLoS One 2016; 11:e0152704. [PMID: 27043306 PMCID: PMC4820118 DOI: 10.1371/journal.pone.0152704] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 03/17/2016] [Indexed: 12/19/2022] Open
Abstract
Background Although the exact pathophysiology of preeclampsia is not well understood, autonomic nervous system imbalance is suggested as one of the main factors. Aims To investigate heart rate variability (HRV) and autonomic modulations in Sudanese pregnant women with preeclampsia. Subjects and Methods A case-control study (60 women in each arm) was conducted at Omdurman Maternity Hospital—Sudan, during the period from June to August, 2014. Cases were women presented with preeclampsia and healthy pregnant women were the controls. Studied groups were matched for important determinants of HRV. Natural logarithm (Ln) of total power (TP), high frequency (HF), low frequency (LF) and very low frequency (VLF) were used to determine HRV. Normalized low and high frequencies (LF Norm and HF Norm) were used to evaluate sympathetic and parasympathetic autonomic modulations respectively. Results Patients with preeclampsia achieved significantly higher LF Norm [49.80 (16.25) vs. 44.55 (19.15), P = 0.044] and LnLF/HF [0.04 (0.68) vs. -0.28 (0.91), P = 0.023] readings, but lower HF Norm [49.08 (15.29) vs. 55.87 (19.56), P = 0.012], compared with healthy pregnant women. Although all other HRV measurements were higher in the patients with preeclampsia compared with the controls, only LnVLF [4.50 (1.19) vs. 4.01 (1.06), P = 0.017] and LnLF [4.01 (1.58) vs. 3.49 (1.23), P = 0.040] reached statistical significance. Conclusion The study adds further evidence for the dominant cardiac sympathetic modulations on patients with preeclampsia, probably secondary to parasympathetic withdrawal in this group. However, the higher LnVLF and LnLF readings achieved by preeclamptic women compared with the controls are unexpected in the view that augmented sympathetic modulations usually depresses all HRV parameters including these two measures.
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