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Rosta K, Binder J, Kuczwara V, Horvath M, Heinzl F, Hörhager C, Mayrhofer D, Mandl P, Fritsch-Stork R, Ott J, Mazzucato-Puchner A. Periconceptional Counselling in Women with Autoimmune Inflammatory Rheumatic Diseases. J Clin Med 2024; 13:2483. [PMID: 38731018 PMCID: PMC11084745 DOI: 10.3390/jcm13092483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
Systemic autoimmune rheumatic diseases (SARDs) in pregnancy represent a complex challenge for both patients and healthcare providers. Timely preparation for pregnancy enables adequate disease control, thereby reducing the risk of disease flare and pregnancy complications. Interdisciplinary care starting from the pre-pregnancy period throughout pregnancy and during breastfeeding ensures better fetal and maternal outcomes. This review provides a comprehensive guide to pre-pregnancy counselling in SARDs, an overview of medication management strategies tailored to pregnancy, disease activity and pregnancy monitoring in patients, and the promotion of shared decision making between healthcare providers and patients. Guidelines from international organizations were selected to provide a basis for this review and guidance through the quintessential discussion points of care.
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Affiliation(s)
- Klara Rosta
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Julia Binder
- Division of Obstetrics and Fetomaternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Valerie Kuczwara
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Mira Horvath
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Florian Heinzl
- Division of Obstetrics and Fetomaternal Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Christina Hörhager
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Daniel Mayrhofer
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Peter Mandl
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria
| | - Ruth Fritsch-Stork
- Health Care Centre Mariahilf, ÖGK and Rheumatology Department, Sigmund Freud Private University, 1060 Vienna, Austria
| | - Johannes Ott
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Antonia Mazzucato-Puchner
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria
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Beitl K, Ott J, Rosta K, Holzer I, Foessleitner P, Steininger J, Panay N. Premature ovarian insufficiency and autoimmune profiles: a prospective case-control study. Climacteric 2024; 27:187-192. [PMID: 38108204 DOI: 10.1080/13697137.2023.2287631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Autoimmunity seems to be present in a large proportion of women with spontaneous premature ovarian insufficiency (POI). Whether these women are at increased risk for autoimmune disease has not been determined to date. Therefore, the aim of this study was to investigate a large series of antibodies in order to shed more light into the autoimmune risk of POI women. METHODS In a prospective case-control study, blood samples from 66 patients with spontaneous POI and 66 healthy controls were analyzed for a series of autoimmune antibodies. RESULTS POI women revealed significantly increased thyroglobulin antibodies (TGAb) (p = 0.045) and thyroid peroxidase antibodies (TPOAb) (p = 0.002). At least one abnormal autoimmune parameter was present in 37.9% of POI women, compared to 18.2% in healthy controls (p = 0.045). A strong association between POI and increased TGAb (adjusted odds ratio 3.586, p = 0.028), increased TPOAb (adjusted odds ratio 7.496, p = 0.003) and any increased autoimmune parameter (adjusted odds ratio 3.189, p = 0.008) could be demonstrated in a binary logistic regression model. CONCLUSION A high prevalence of autoimmunity in POI women compared to a healthy young collective could be demonstrated. Thyroid antibodies were significantly increased in POI women. Our data highlight the increased risk for autoimmune diseases, especially for thyroid disorders.
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Affiliation(s)
- K Beitl
- Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - J Ott
- Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - K Rosta
- Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - I Holzer
- Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - P Foessleitner
- Clinical Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - J Steininger
- Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - N Panay
- Department of Gynaecology, Imperial College Healthcare, NHS Trust, London, UK
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Puchner A, Rosenberg N, Valenta N, Ritschl V, Stamm T, Mandl P, Aletaha D, Rosta K. AB1177 SEXUALITY, FAMILY PLANNING AND MENTAL HEALTH AMONG REPRODUCTIVE-AGE WOMEN WITH RHEUMATIC DISEASE DURING THE COVID-19 PANDEMIC. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundWomen with rheumatic disease are more likely to suffer from sexual dysfunction, infertility, depression, and anxiety. The pandemic may have affected these constraints.ObjectivesTo investigate the effect of the Covid-19 pandemic on sexuality, family planning and mental health in a sample of women with rheumatic disease.MethodsWomen aged 18-50 with a rheumatic disease and women in an age-matched healthy control group received questionnaires featuring: 1) demographic information, sexual frequency, family planning; 2) the Female Sexual Function Index (FSFI); 3) the Depression, Anxiety and Stress Scale (DASS-21); and 4) the Coronavirus Anxiety Scale (CAS). Recruitment took place 3/21-12/21. Patients with rheumatic conditions were recruited at the Vienna University Clinic (AKH) and the control group through social media. Parameters were compared between the patients and the healthy control group, and with data on sexuality from women with rheumatic disease from 2019.ResultsA preliminary analysis was conducted with 83 patients with rheumatic disease and 124 healthy controls. The rheumatic disease group exhibited lower levels of stress (6.46 vs. 8.36 p<0.01) and Coronavirus Anxiety (6.27 vs 7.50 p<0.01) than the control group and was less likely to report that the pandemic led to a reduction of their sexual frequency (p<0.01). The control group cited “stress” frequently the decrease of sexual frequency. The FSFI analysis revealed that patients with rheumatic disease experienced higher levels of pain (p<0.001) during sex than the control group but were more satisfied with their relationships (p<0.05). In comparison to 58 patients with rheumatic conditions, whose data was collected in 2019, the 2021 cohort reported reduced FSFI values in the domains of desire (p<0.01), arousal (p<0.05), lubrication (p<0.05), and orgasms (p<0.01).ConclusionConsistent with research on female sexuality during the pandemic among healthy women, we found that patients with rheumatic conditions reported lower FSFI values in 2021, in comparison to 2019. Our finding that the pandemic had less impact on the patient group than a healthy control group, is consistent with research on MS and IBD patients, who showed surprising resilience in the face of the Covid-19 pandemic.Disclosure of InterestsNone declared
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Rosenberg N, Mazzucato-Puchner AB, Valenta N, Stamm T, Rosta K. Sexualität, Familienplanung und psychische Gesundheit bei Frauen im gebärfähigen Alter mit rheumatischen Erkrankungen während der Covid-19 Pandemie. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- N Rosenberg
- Klinische Abteilung für Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - A B Mazzucato-Puchner
- Klinische Abteilung für Rheumatologie, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien
| | - N Valenta
- Klinische Abteilung für Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - T Stamm
- Zentrum für Medizinische Statistik, Informatik und Intelligente Systeme, Medizinische Universität Wien
| | - K Rosta
- Klinische Abteilung für Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
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Herczeg G, Somogyi A, Herold M, Fodor A, Rosta K, Dank M, Lang Z, Herold Z. Does diabetes affect paraneoplastic thrombocytosis in colorectal cancer? Open Med (Wars) 2022; 17:160-173. [PMID: 35071777 PMCID: PMC8760180 DOI: 10.1515/med-2021-0407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 02/05/2023] Open
Abstract
Background A large variety of factors can affect colorectal cancer (CRC) survival, including type 2 diabetes mellitus (T2DM) and paraneoplastic thrombocytosis. Although several common factors play a role in their development and platelets are damaged in both diseases, the combined relationship of the three conditions was never investigated previously. Methods A prospective, real-life observational cohort study was conducted with the inclusion of 108 CRC patients and 166 voluntary non-CRC subjects. Plasma interleukin-6 and thrombopoietin levels were measured. Results Study participants were divided into cohorts based on the presence of T2DM. Platelet count (p < 0.0500) and interleukin-6 (p < 0.0100) level were significantly higher in the CRC groups. Thrombopoietin level was higher in the T2DM, CRC, and CRC + T2DM groups (p < 0.0500). Analysis of parameter changes over time and survival models revealed that neither platelet count, interleukin-6, nor thrombopoietin levels were affected by T2DM. Death of patients was associated with higher baseline platelet count (p = 0.0042) and interleukin-6 level (p < 0.0001). Conclusion Although the independent, disease-worsening effect of paraneoplastic thrombocytosis and T2DM is known, the coexistence of the two did not further impair the survival of CRC patients, suggesting that T2DM has no significant effect over paraneoplastic thrombocytosis.
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Affiliation(s)
- Gyorgy Herczeg
- Department of General Surgery, Szent Imre University Teaching Hospital, Budapest, Hungary
| | - Aniko Somogyi
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Magdolna Herold
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Agnes Fodor
- Department of General Surgery, Szent Imre University Teaching Hospital, Budapest, Hungary
| | - Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Magdolna Dank
- Department of Internal Medicine and Oncology, Division of Oncology, Semmelweis University, Budapest, Hungary
| | - Zsolt Lang
- Department of Biomathematics and Informatics, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Zoltan Herold
- Department of Internal Medicine and Haematology, Semmelweis University, Szentkiralyi utca 46., H-1088 Budapest, Hungary
- Department of Internal Medicine and Oncology, Division of Oncology, Semmelweis University, Tomo utca 25-29., H-1083 Budapest, Hungary
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Rosta K, Mazzucato-Puchner A, Kiss H, Malik V, Mandl P, Petricevic L, Foessleitner P, Shafran I, Temsch W, Farr A. Vaginal microbiota in pregnant women with inflammatory rheumatic and inflammatory bowel disease: A matched case-control study. Mycoses 2021; 64:909-917. [PMID: 33884668 PMCID: PMC8360144 DOI: 10.1111/myc.13288] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Rheumatic diseases and vaginal infections both increase the risk of preterm birth. It is unclear whether pregnant women with rheumatic disease are more likely to experience vaginal infections, which might potentially accumulate modifiable risk factors. OBJECTIVE In this study, we sought to evaluate the vaginal microbiota of pregnant women with inflammatory rheumatic and inflammatory bowel disease. METHODS A total of 539 asymptomatic women with singleton pregnancy were routinely screened for an abnormal vaginal microbiota between 10 + 0 and 16 + 0 gestational weeks. Vaginal smears were Gram-stained and microscopically analysed. Those with inflammatory diseases (with or without immunomodulatory therapy) were assigned to the case group and matched in a 1:3 ratio to healthy pregnant controls. RESULTS Overall, an abnormal vaginal microbiota occurred more frequently among women of the case group, compared with those of the control group (33.8% vs 15.6%; 95% CI: 1.78-4.27, p < .001). In particular, Candida colonisation (22.3% vs 9.2%; 95% CI: 1.69-4.75, p < .001), but also bacterial vaginosis (14.9% vs 7.2%; 95% CI: 1.25-4.1, p = .006), occurred more often in the case than in the control group. No significant difference was found with regard to the occurrence of an abnormal vaginal microbiota between subgroups with and without immunomodulatory treatment (37.0% vs 27.1%; 95% CI: 0.29-1.35, p = .232). CONCLUSION Pregnant women with inflammatory rheumatic and inflammatory bowel disease are at risk for bacterial vaginosis and Candida colonisation, which might pose a risk for preterm birth. Prospective studies are needed to further evaluate the influence of autoimmune conditions and immunosuppressive therapy on the vaginal microbiota.
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Affiliation(s)
- Klara Rosta
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Herbert Kiss
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Veronika Malik
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Peter Mandl
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Ljubomir Petricevic
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Philipp Foessleitner
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
| | - Inbal Shafran
- Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Wilhelm Temsch
- Section for Medical Statistics, Center of Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Alex Farr
- Department of Obstetrics and Gynecology, Division of Obstetrics and feto-maternal Medicine, Medical University of Vienna, Vienna, Austria
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Herold Z, Dank M, Herold M, Nagy P, Rosta K, Somogyi A. Histopathological Chromogranin A-Positivity Is Associated with Right-Sided Colorectal Cancers and Worse Prognosis. Cancers (Basel) 2020; 13:cancers13010067. [PMID: 33383764 PMCID: PMC7796394 DOI: 10.3390/cancers13010067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Several factors are known to affect colorectal cancer (CRC) patient survival, including elevated platelet counts (thrombocytosis) and chromogranin A-positive neuroendocrine-cell differentiation (CgA+). Thrombocytosis can occur due to biochemical changes caused by the tumor itself (known as paraneoplastic thrombocytosis) or due to the bleeding of the tumor (reactive thrombocytosis). Our effort was primarily focused on (1) determining if CgA+ and paraneoplastic thrombocytosis combined can affect CRC and (2) finding out if there is a possible connection between the two. With the help of chromogranin A immunohistochemical staining, the measurement of circulating biochemical markers of paraneoplastic thrombocytosis (interleukin-6 and thrombopoietin) and chromogranins A and -B, indication was found that CRC combined with CgA+ has a well-distinguishable pathophysiology, compared to CRCs without CgA+. A possible, new subtype of CRC is proposed, which can be identified easily with chromogranin A immunohistochemical staining. However, its impact should be further studied. Abstract Background: Colorectal cancer (CRC) is known to be affected by paraneoplastic thrombocytosis and chromogranin A-positive neuroendocrine-cell differentiation (CgA+). Their combined effect has never been previously investigated. Methods: A prospective cohort pilot study of 42 CRC patients and 42 age- and sex-matched controls was carried out. Plasma interleukin-6, thrombopoietin, and serum chromogranin A and -B were measured; furthermore, tumor tissue was immunohistochemically stained for CgA+. Results: Twenty-seven and 15 patients were assigned to the chromogranin A-negative (CgA−) and CgA+ groups, respectively. Within the CgA+ group, right-sided tumors were more frequent (18.5% vs. 53.3%), no stage I cancer was found, and patients of this group were in worse general condition. Compared to control subjects, chromogranin A level was higher in the CgA+ group (p = 0.0086), thrombopoietin (p = 0.0040) and chromogranin B (p = 0.0070) in the CgA− group, while interleukin-6 was high in both tumor groups (p ≤ 0.0090). Survival was significantly worse in the CgA+ group (hazard ratio: 5.73; p = 0.0378). Conclusions: Different thrombopoietin levels indicated distinct thrombocytosis types. Within the two CRC groups, serum levels of chromogranins changed in different directions suggesting two well-distinguishable pathophysiologies. Based on these observations we propose a new subtype of CRC, which can be characterized by chromogranin A-positive neuroendocrine-cell differentiation.
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Affiliation(s)
- Zoltan Herold
- Department of Internal Medicine and Oncology, Semmelweis University, Tomo u. 25-29., H-1083 Budapest, Hungary;
- Department of Internal Medicine and Hematology, Semmelweis University, Szentkiralyi u. 46., H-1088 Budapest, Hungary; (M.H.); (A.S.)
- Correspondence: ; Tel.: +36-1-266-0926
| | - Magdolna Dank
- Department of Internal Medicine and Oncology, Semmelweis University, Tomo u. 25-29., H-1083 Budapest, Hungary;
| | - Magdolna Herold
- Department of Internal Medicine and Hematology, Semmelweis University, Szentkiralyi u. 46., H-1088 Budapest, Hungary; (M.H.); (A.S.)
| | - Peter Nagy
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Ulloi ut 26., H-1085 Budapest, Hungary;
| | - Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, Wahringer Gurtel 18-20, A-1090 Vienna, Austria;
| | - Aniko Somogyi
- Department of Internal Medicine and Hematology, Semmelweis University, Szentkiralyi u. 46., H-1088 Budapest, Hungary; (M.H.); (A.S.)
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Herold Z, Uhlyarik A, Herold M, Nagy P, Huszty GD, Rosta K, Doleschall M, Somogyi A. Regular chromogranin A monitoring facilitated the early detection of a gastrointestinal neuroendocrine tumour in a patient with type 1 diabetes. Endokrynol Pol 2020; 71:483-484. [PMID: 32856287 DOI: 10.5603/ep.a2020.0054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/20/2020] [Indexed: 02/05/2023]
Abstract
Not required for Clinical Vignette.
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Affiliation(s)
- Zoltan Herold
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary.
| | - Andrea Uhlyarik
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Magdolna Herold
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
| | - Peter Nagy
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Gergely Denes Huszty
- Department of Transplantation and Surgery, Semmelweis University, Budapest, 1082, Hungary
| | - Klara Rosta
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
| | - Marton Doleschall
- Molecular Medicine Research Group, Eotvos Lorand Research Network and Semmelweis University, Budapest, Hungary
| | - Aniko Somogyi
- Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
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Rosta K, Al-Bibawy K, Al-Bibawy M, Temsch W, Springer S, Somogyi A, Ott J. Vaginal Progesterone Has No Diabetogenic Potential in Twin Pregnancies: A Retrospective Case-Control Study on 1686 Pregnancies. J Clin Med 2020; 9:jcm9072249. [PMID: 32679847 PMCID: PMC7408737 DOI: 10.3390/jcm9072249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 01/02/2023] Open
Abstract
Background: In this study, we aimed to investigate the incidence of gestational diabetes mellitus (GDM) in women who carried twin pregnancies and received vaginal progesterone. Methods: In this retrospective cohort study, 203 out of 1686 women with twin pregnancies received natural progesterone (200 mg/day between gestational weeks 16 + 0 and 36 + 0) vaginally for ≥ 4 weeks. The control group consisted of 1483 women with twin pregnancies without progesterone administration. Pearson’s Chi squared test, Fisher’s exact test, and Student’s t-test was used to compare differences between the control and the progesterone-treated groups. A multivariate binary logistic regression was performed to assess relative independent associations on the dependent outcome of GDM incidence. Results: Vaginal progesterone treatment in twin pregnancies had no significant influence on developing GDM (p = 0.662). Higher pre-pregnancy BMI (OR 1.1; p < 0.001), GDM in previous pregnancy (OR 6.0; p < 0.001), and smoking during pregnancy (OR 1.6; p = 0.014) posed an increased risk for developing GDM. Conclusion: In twin pregnancies, the use of vaginal progesterone for the prevention of recurrent preterm delivery was not associated with an increased risk of GDM.
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Affiliation(s)
- Klara Rosta
- Department of Obstetrics and Gynecology, Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna 1090, Austria; (K.R.); (K.A.-B.); (M.A.-B.); (S.S.)
| | - Katharina Al-Bibawy
- Department of Obstetrics and Gynecology, Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna 1090, Austria; (K.R.); (K.A.-B.); (M.A.-B.); (S.S.)
| | - Maria Al-Bibawy
- Department of Obstetrics and Gynecology, Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna 1090, Austria; (K.R.); (K.A.-B.); (M.A.-B.); (S.S.)
| | - Wilhelm Temsch
- Center for Medical Statistic and Informatic and Intelligent Systems, Medical University of Vienna, Vienna 1090, Austria;
| | - Stephanie Springer
- Department of Obstetrics and Gynecology, Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna 1090, Austria; (K.R.); (K.A.-B.); (M.A.-B.); (S.S.)
| | - Aniko Somogyi
- 2nd Department of Internal Medicine, Semmelweis University, 1085 Budapest, Hungary;
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Clinical Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna 1090, Austria; (K.R.); (K.A.-B.); (M.A.-B.); (S.S.)
- Correspondence: ; Tel.: +43-140-4002-8160
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Zwick C, Hütter L, Mazzucato-Puchner A, Redlich K, Sevelda P, Rosta K. Lupus, das Chamäleon. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- C Zwick
- KH Hietzing, Abteilung für Gynäkologie und Geburtshilfe, Wien
| | - L Hütter
- KH Hietzing, 2. Medizinische Abteilung (Rheumatologie), Wien
| | | | - K Redlich
- KH Hietzing, 2. Medizinische Abteilung (Rheumatologie), Wien
| | - P Sevelda
- KH Hietzing, Abteilung für Gynäkologie und Geburtshilfe, Wien
| | - K Rosta
- Universitätsklinik für Gynäkologie und Geburtshilfe, Wien
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Valenta N, Mrak D, Puchner A, Rosta K. Sexualität und Verhütungsmethoden von Patientinnen mit einer rheumatischen Erkrankung. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- N Valenta
- Abteilung für Geburtshilfe und fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - D Mrak
- Universitätsklinik für Innere Medizin III, Klinische Abteilung für Rheumatologie, Medizinische Universität Wien
| | - A Puchner
- Abteilung für Geburtshilfe und fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - K Rosta
- Abteilung für Geburtshilfe und fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
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Mair K, Mazzucato-Puchner A, Mandl P, Rosta K. Management der hämophagozytären Lymphohistiozytose in der Schwangerschaft. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- K Mair
- Abteilung für Geburtshilfe und fetomaternale Medizin, Universitätsklinik für Frauenheilkunde Medizinische Universität Wien
| | - A Mazzucato-Puchner
- Universitätsklinik für Innere Medizin III, Klinische Abteilung für Rheumatologie, Medizinische Universität Wien
| | - P Mandl
- Universitätsklinik für Innere Medizin III, Klinische Abteilung für Rheumatologie, Medizinische Universität Wien
| | - K Rosta
- Abteilung für Geburtshilfe und fetomaternale Medizin, Universitätsklinik für Frauenheilkunde Medizinische Universität Wien
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13
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Falcone V, Reischer T, Springer S, Husslein PW, Rosta K. Beta Thalassemia minor and its impact on glucose metabolism during pregnancy: a retrospective study to assess implication for mothers and offspring. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- V Falcone
- Department of obstetrics and gynecology, Medical University of Vienna
| | - T Reischer
- Department of obstetrics and gynecology, Medical University of Vienna
| | - S Springer
- Department of obstetrics and gynecology, Medical University of Vienna
| | - P W Husslein
- Department of obstetrics and gynecology, Medical University of Vienna
| | - K Rosta
- Department of obstetrics and gynecology, Medical University of Vienna
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Rosta K, Mrak D, Valenta N, Stamm T, Ritschl V, Husslein P, Puchner A. Preliminary Results from the Nationwide Austrian Register for Reproduction and Rheumatic Disease (RhePro Register). Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- K Rosta
- Abteilung für Geburtshilfe und fetomaternale Medizin, Universitätsklinik für Frauenheilkunde Medizinische Universität Wien
| | - D Mrak
- Universitätsklinik für Innere Medizin III, Klinische Abteilung für Rheumatologie, Medizinische Universität Wien
| | - N Valenta
- Abteilung für Geburtshilfe und fetomaternale Medizin, Universitätsklinik für Frauenheilkunde Medizinische Universität Wien
| | - T Stamm
- Zentrum für Medizinische Statistik, Informatik und Intelligente Systeme, Medizinische Universität Wien
| | - V Ritschl
- Zentrum für Medizinische Statistik, Informatik und Intelligente Systeme, Medizinische Universität Wien
| | - P Husslein
- Abteilung für Geburtshilfe und fetomaternale Medizin, Universitätsklinik für Frauenheilkunde Medizinische Universität Wien
| | - A Puchner
- Universitätsklinik für Innere Medizin III, Klinische Abteilung für Rheumatologie, Medizinische Universität Wien
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Firneisz G, Rosta K, Rigó J, Nádasdi Á, Harreiter J, Kautzky-Willer A, Somogyi A. Identification and Potential Clinical Utility of the MTNR1B rs10830963 Core Gene Variant Associated to Endophenotypes in Gestational Diabetes Mellitus. Front Genet 2020; 11:332. [PMID: 32373162 PMCID: PMC7186410 DOI: 10.3389/fgene.2020.00332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 03/20/2020] [Indexed: 01/28/2023] Open
Affiliation(s)
- Gábor Firneisz
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
- MTA-SE Molecular Medicine Research Group, Hungarian Academy of Sciences - Semmelweis University, Budapest, Hungary
| | - Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - János Rigó
- 1st Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Ákos Nádasdi
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Anikó Somogyi
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
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Herold Z, Herold M, Rosta K, Doleschall M, Somogyi A. Lower serum chromogranin B level is associated with type 1 diabetes and with type 2 diabetes patients with intensive conservative insulin treatment. Diabetol Metab Syndr 2020; 12:61. [PMID: 32684986 PMCID: PMC7362558 DOI: 10.1186/s13098-020-00569-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/04/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Chromogranin B (CgB) plays an important role in the physiological insulin secretion of pancreatic beta cells. Serum CgB levels were investigated in type 1 and type 2 diabetes patients in a cross-sectional study. METHODS An observational cross-sectional study was performed with the inclusion of 94 control subjects, 100 type 1 and 100 type 2 diabetes patients, at the Metabolic Outpatient Clinic of the Department of Internal Medicine and Hematology, Semmelweis University. Serum CgB levels were measured with enzyme-linked immunosorbent assay. RESULTS Serum CgB level was lower in type 1 diabetes patients than in matched control subjects (p = 0.0241), while they were equal in type 2 diabetes patients and controls (p = 0.1698). The subgroup of type 2 diabetes patients who received intensive conservative insulin treatment had significantly lower CgB levels compared to those with other regimens of antidiabetic therapies (p = 0.0283). CONCLUSION The lower serum CgB levels in the patients with type 1 diabetes and the type 2 diabetes patients with progressed disease stage suggested that the CgB production might be decreased due to the beta cell destruction and depletion.
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Affiliation(s)
- Zoltan Herold
- Department of Internal Medicine and Hematology, Semmelweis University, H-1088 Szentkiralyi u. 46, Budapest, Hungary
| | - Magdolna Herold
- Department of Internal Medicine and Hematology, Semmelweis University, H-1088 Szentkiralyi u. 46, Budapest, Hungary
| | - Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Marton Doleschall
- Molecular Medicine Research Group, Eotvos Lorand Research Network and Semmelweis University, Budapest, Hungary
| | - Aniko Somogyi
- Department of Internal Medicine and Hematology, Semmelweis University, H-1088 Szentkiralyi u. 46, Budapest, Hungary
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Firneisz G, Rosta K, Al-Aissa Z, Hadarits O, Harreiter J, Nádasdi Á, Bancher-Todesca D, Németh L, Igaz P, Rigó J, Sziller I, Kautzky-Willer A, Somogyi A. The MTNR1B rs10830963 Variant in Interaction with Pre-Pregnancy BMI is a Pharmacogenetic Marker for the Initiation of Antenatal Insulin Therapy in Gestational Diabetes Mellitus. Int J Mol Sci 2018; 19:E3734. [PMID: 30477160 PMCID: PMC6321391 DOI: 10.3390/ijms19123734] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 11/26/2022] Open
Abstract
The rs10830963 variant of the Melatonin Receptor 1B (MTNR1B) gene is associated with the development of gestational diabetes mellitus (GDM). We hypothesized that carrying the rs10830963/G risk allele had effect on antenatal insulin therapy (AIT) initiation in GDM in a body mass index (BMI)-dependent manner. Design: In this post hoc analysis the MTNR1B rs10830963 genotype and the clinical data of 211 Caucasian GDM patients were assessed. As a first step, a pre-pregnancy BMI threshold was determined where the effect of MTNR1B rs10830963/G allele carrying on AIT initiation was the most significant using logistic regression. Maternal age adjusted real-life odds ratios (OR) values were calculated. The chi-square test was also used to calculate the p value and 10.000 bootstrap simulations were performed in each case to re-assess the statistical power and the OR. Carrying the MTNR1B rs10830963/G allele increased the odds of AIT initiation (OR = 5.2, p = 0.02 [χ² test], statistical power = 0.53) in GDM patients with pre-pregnancy BMI ≥ 29 kg/m². The statistical power reached 0.77, when the pre-pregnancy BMI cutoff of 27 kg/m² was used and the genetic effect on AIT initiation was still significant, but only using the logistic regression model. Carrying the MTNR1B rs10830963/G risk allele-in interaction with pre-pregnancy BMI-is likely be considered as a candidate pharmacogenetic marker of antenatal insulin therapy initiation and should be further assessed in precision medicine trials in GDM.
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Affiliation(s)
- Gábor Firneisz
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
- MTA-SE Molecular Medicine Research Group, Hungarian Academy of Sciences⁻Semmelweis University, H-1088 Budapest, Hungary.
| | - Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, A-1090 Vienna, Austria.
- Department of Obstetrics and Gynecology, Semmelweis University, H-1088 Budapest, Hungary.
| | - Zahra Al-Aissa
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
| | - Orsolya Hadarits
- Department of Obstetrics and Gynecology, Semmelweis University, H-1088 Budapest, Hungary.
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, A-1090 Vienna, Austria.
| | - Ákos Nádasdi
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
| | - Dagmar Bancher-Todesca
- Department of Obstetrics and Gynecology, Medical University of Vienna, A-1090 Vienna, Austria.
| | - László Németh
- Department of Probability Theory and Statistics, Eötvös Loránd University, H-1088 Budapest, Hungary.
| | - Péter Igaz
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
- MTA-SE Molecular Medicine Research Group, Hungarian Academy of Sciences⁻Semmelweis University, H-1088 Budapest, Hungary.
| | - János Rigó
- Department of Obstetrics and Gynecology, Semmelweis University, H-1088 Budapest, Hungary.
| | - István Sziller
- Department of Obstetrics and Gynecology, Szent Imre Teaching Hospital, H-1088 Budapest, Hungary.
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, A-1090 Vienna, Austria.
| | - Anikó Somogyi
- 2nd Department of Internal Medicine, Semmelweis University, H-1088 Budapest, Hungary.
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Rosta K, Ott J, Kelemen F, Temsch W, Lahner T, Reischer T, Helmer H, Somogyi A. Is vaginal progesterone treatment associated with the development of gestational diabetes? A retrospective case-control study. Arch Gynecol Obstet 2018; 298:1079-1084. [PMID: 30225687 PMCID: PMC6244685 DOI: 10.1007/s00404-018-4895-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 09/06/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the incidence of gestational diabetes mellitus (GDM) in pregnant women who received vaginal progesterone due to short cervical length or to prevent recurrent preterm birth. METHODS In this retrospective study, we included 190 women with singleton pregnancies at risk for preterm birth who received vaginal natural progesterone (200 mg daily between gestational weeks 16 + 0 and 36 + 0) for a minimum of 4 weeks and delivered > 28 weeks. The control group consisted of 242 age- and body mass index (BMI)-matched patients without progesterone administration. Data were acquired from a database containing prospectively collected information. Patients with pre-existing diabetes, and conception after in vitro fertilisation procedure were excluded. RESULTS The incidence of GDM did not differ significantly between the progesterone-treated and the control group (14.7% vs. 16.9%, respectively; p = 0.597). In a binary regression model, patients with higher pre-pregnancy BMI (OR 1.1; p = 0.006), and those with a family history of diabetes had a higher risk for GDM development (OR 1.8; p = 0.040), whereas vaginal progesterone treatment had no significant influence (p = 0.580). CONCLUSION The use of vaginal progesterone for the prevention of recurrent preterm delivery and in women with a short cervix does not seem to be associated with an increased risk of GDM.
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Affiliation(s)
- Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Johannes Ott
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Fanni Kelemen
- University of Szeged, 12 Dóm tér, 6720, Szeged, Hungary
| | - Wilhelm Temsch
- Center for Medical Statistic and Informatics and Intelligent Systems, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Tobias Lahner
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Theresa Reischer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Hanns Helmer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Aniko Somogyi
- 2nd Department of Internal Medicine, Semmelweis University, Szentkirályi u.46, Budapest, Hungary
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Rosta K, Bancher-Todesca D, Hadarits O, Al-Aissa Z, Kautzky-Willer A, Firneisz G. Neue Aspekte in der Entwicklung des Gestationsdiabetes: Eine Studie an 77 einzelnen Nucleotid-Gen-Polymorphismen in der Schwangerschaft. Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1602339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- K Rosta
- Abteilung für Geburtshilfe und Fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - D Bancher-Todesca
- Abteilung für Geburtshilfe und Fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - O Hadarits
- Abteilung für Geburtshilfe und Fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - Z Al-Aissa
- Abteilung für Geburtshilfe und Fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - A Kautzky-Willer
- Abteilung für Geburtshilfe und Fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
| | - G Firneisz
- Abteilung für Geburtshilfe und Fetomaternale Medizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien
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Rosta K, Al-Aissa Z, Hadarits O, Harreiter J, Nádasdi Á, Kelemen F, Bancher-Todesca D, Komlósi Z, Németh L, Rigó J, Sziller I, Somogyi A, Kautzky-Willer A, Firneisz G. Association Study with 77 SNPs Confirms the Robust Role for the rs10830963/G of MTNR1B Variant and Identifies Two Novel Associations in Gestational Diabetes Mellitus Development. PLoS One 2017; 12:e0169781. [PMID: 28072873 PMCID: PMC5224877 DOI: 10.1371/journal.pone.0169781] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 12/21/2016] [Indexed: 12/31/2022] Open
Abstract
CONTEXT Genetic variation in human maternal DNA contributes to the susceptibility for development of gestational diabetes mellitus (GDM). OBJECTIVE We assessed 77 maternal single nucleotide gene polymorphisms (SNPs) for associations with GDM or plasma glucose levels at OGTT in pregnancy. METHODS 960 pregnant women (after dropouts 820: case/control: m99'WHO: 303/517, IADPSG: 287/533) were enrolled in two countries into this case-control study. After genomic DNA isolation the 820 samples were collected in a GDM biobank and assessed using KASP (LGC Genomics) genotyping assay. Logistic regression risk models were used to calculate ORs according to IADPSG/m'99WHO criteria based on standard OGTT values. RESULTS The most important risk alleles associated with GDM were rs10830963/G of MTNR1B (OR = 1.84/1.64 [IADPSG/m'99WHO], p = 0.0007/0.006), rs7754840/C (OR = 1.51/NS, p = 0.016) of CDKAL1 and rs1799884/T (OR = 1.4/1.56, p = 0.04/0.006) of GCK. The rs13266634/T (SLC30A8, OR = 0.74/0.71, p = 0.05/0.02) and rs7578326/G (LOC646736/IRS1, OR = 0.62/0.60, p = 0.001/0.006) variants were associated with lower risk to develop GDM. Carrying a minor allele of rs10830963 (MTNR1B); rs7903146 (TCF7L2); rs1799884 (GCK) SNPs were associated with increased plasma glucose levels at routine OGTT. CONCLUSIONS We confirmed the robust association of MTNR1B rs10830963/G variant with GDM binary and glycemic traits in this Caucasian case-control study. As novel associations we report the minor, G allele of the rs7578326 SNP in the LOC646736/IRS1 region as a significant and the rs13266634/T SNP (SLC30A8) as a suggestive protective variant against GDM development. Genetic susceptibility appears to be more preponderant in individuals who meet both the modified 99'WHO and the IADPSG GDM diagnostic criteria.
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Affiliation(s)
- Klara Rosta
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
- 1 Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Zahra Al-Aissa
- 2 Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Orsolya Hadarits
- 1 Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Ákos Nádasdi
- 2 Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Fanni Kelemen
- University of Szeged, Faculty of Medicine, Szeged, Hungary
| | | | - Zsolt Komlósi
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - László Németh
- Department of Probability Theory and Statistics, Eötvös Loránd University, Budapest, Hungary
| | - János Rigó
- 1 Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - István Sziller
- Department of Obstetrics and Gynecology, Szent Imre Teaching Hospital, Budapest, Hungary
| | - Anikó Somogyi
- 2 Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Gábor Firneisz
- 2 Department of Internal Medicine, Semmelweis University, Budapest, Hungary
- Hungarian Academy of Sciences - Semmelweis University, Molecular Medicine Research Group, Budapest, Hungary
- * E-mail:
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Rosta K, Hadarits O, Al-Aissa Z, List A, Feichtinger M, Sziller I, Rigo J, Somogyi A, Firneisz G, Kautzky-Willer A, Harreiter J, Bancher-Todesca D. VEGF und IL1RA Konzentrationen im Nabelschnurserum von Frauen mit Gestationsdiabetes. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Rosta K, Al-Aissa Z, Hadarits O, Zóka A, Harreiter J, Kautzky-Willer A, Rigó J, Sziller I, Somogyi A, Bancher-Todesca D, Firneisz G. Erniedrigte fetale Dipeptidylpeptidase 4 (DPP4) Aktivität bei Gestationsdiabetes. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Banki NF, Ver A, Wagner LJ, Vannay A, Degrell P, Prokai A, Gellai R, Lenart L, Szakal DN, Kenesei E, Rosta K, Reusz G, Szabo AJ, Tulassay T, Baylis C, Fekete A. Aldosterone antagonists in monotherapy are protective against streptozotocin-induced diabetic nephropathy in rats. PLoS One 2012; 7:e39938. [PMID: 22761931 PMCID: PMC3386228 DOI: 10.1371/journal.pone.0039938] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 05/29/2012] [Indexed: 11/30/2022] Open
Abstract
Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) are the standard clinical therapy of diabetic nephropathy (DN), while aldosterone antagonists are only used as adjuncts. Previously in experimental DN we showed that Na/K ATPase (NKA) is mislocated and angiotensin II leads to superimposed renal progression. Here we investigated the monotherapeutic effect of aldosterone blockers on the progression of DN and renal NKA alteration in comparison to ACEi and ARBs. Streptozotocin-diabetic rats developing DN were treated with aldosterone antagonists; ACEi and ARB. Renal function, morphology, protein level and tubular localization of NKA were analyzed. To evaluate the effect of high glucose per se; HK-2 proximal tubular cells were cultured in normal or high concentration of glucose and treated with the same agents. Aldosterone antagonists were the most effective in ameliorating functional and structural kidney damage and they normalized diabetes induced bradycardia and weight loss. Aldosterone blockers also prevented hyperglycemia and diabetes induced increase in NKA protein level and enzyme mislocation. A monotherapy with aldosterone antagonists might be as, or more effective than ACEi or ARBs in the prevention of STZ-induced DN. Furthermore the alteration of the NKA could represent a novel pathophysiological feature of DN and might serve as an additional target of aldosterone blockers.
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Affiliation(s)
- Nora F. Banki
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
- SE-MTA “Lendulet” Diabetes Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Agota Ver
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Laszlo J. Wagner
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Adam Vannay
- Research Laboratory for Pediatrics and Nephrology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Peter Degrell
- 2nd Department of Medicine and Nephrological Center, Pécs, Hungary
| | - Agnes Prokai
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Renata Gellai
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
- SE-MTA “Lendulet” Diabetes Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Lilla Lenart
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
- SE-MTA “Lendulet” Diabetes Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | | | - Eva Kenesei
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Klara Rosta
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Gyorgy Reusz
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Attila J. Szabo
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Tivadar Tulassay
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
- Research Laboratory for Pediatrics and Nephrology, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
| | - Chris Baylis
- Departments of Physiology and Functional Genomics and Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Andrea Fekete
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
- SE-MTA “Lendulet” Diabetes Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
- * E-mail:
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Abdul-Rahman O, Sasvari-Szekely M, Ver A, Rosta K, Szasz BK, Kereszturi E, Keszler G. Altered gene expression profiles in the hippocampus and prefrontal cortex of type 2 diabetic rats. BMC Genomics 2012; 13:81. [PMID: 22369239 PMCID: PMC3299604 DOI: 10.1186/1471-2164-13-81] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 02/27/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There has been an increasing body of epidemiologic and biochemical evidence implying the role of cerebral insulin resistance in Alzheimer-type dementia. For a better understanding of the insulin effect on the central nervous system, we performed microarray-based global gene expression profiling in the hippocampus, striatum and prefrontal cortex of streptozotocin-induced and spontaneously diabetic Goto-Kakizaki rats as model animals for type 1 and type 2 diabetes, respectively. RESULTS Following pathway analysis and validation of gene lists by real-time polymerase chain reaction, 30 genes from the hippocampus, such as the inhibitory neuropeptide galanin, synuclein gamma and uncoupling protein 2, and 22 genes from the prefrontal cortex, e.g. galanin receptor 2, protein kinase C gamma and epsilon, ABCA1 (ATP-Binding Cassette A1), CD47 (Cluster of Differentiation 47) and the RET (Rearranged During Transfection) protooncogene, were found to exhibit altered expression levels in type 2 diabetic model animals in comparison to non-diabetic control animals. These gene lists proved to be partly overlapping and encompassed genes related to neurotransmission, lipid metabolism, neuronal development, insulin secretion, oxidative damage and DNA repair. On the other hand, no significant alterations were found in the transcriptomes of the corpus striatum in the same animals. Changes in the cerebral gene expression profiles seemed to be specific for the type 2 diabetic model, as no such alterations were found in streptozotocin-treated animals. CONCLUSIONS According to our knowledge this is the first characterization of the whole-genome expression changes of specific brain regions in a diabetic model. Our findings shed light on the complex role of insulin signaling in fine-tuning brain functions, and provide further experimental evidence in support of the recently elaborated theory of type 3 diabetes.
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Affiliation(s)
- Omar Abdul-Rahman
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
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Vastagh I, Horváth T, Garamvölgyi Z, Rosta K, Folyovich A, Rigó J, Kollai M, Bereczki D, Somogyi A. Preserved structural and functional characteristics of common carotid artery in properly treated normoglycemic women with gestational diabetes mellitus. ACTA ACUST UNITED AC 2011; 98:294-304. [PMID: 21893468 DOI: 10.1556/aphysiol.98.2011.3.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Women with gestational diabetes mellitus (GDM) are at high risk of subsequently developing type 2 diabetes mellitus which is an important cardiovascular risk factor. We have evaluated whether preclinical morphological and functional arterial changes are present in GDM. Diameter, intima-media thickness (IMT), intima-media cross-section area (IMCSA) and elasticity features (compliance, distensibility coefficient, circumferential strain, stiffness index (SI) α and β, incremental elastic modulus) of the common carotid arteries (CCA) were studied in the 3rd trimester in 25 women with GDM, and 17 normal pregnant women matched for age and body mass index using an ultrasonographic vessel wall-movement tracking system and applanation tonometry. Mean IMT, IMCSA and SI α tended to be larger, whereas compliance was smaller in women with GDM but none of these differences were significant. Serum glucose (4.99 ± 0.51 vs. 4.79 ± 0.61 mmol/L, p=0.37) and HbA1c (5.33 ± 0.27 vs. 5.36 ± 0.47 mmol/L, p=0.85) proved normoglycemia in both groups. In conclusion, by the combination of methods we applied in this case control study, neither morphological nor functional characteristics of large elastic arteries differ significantly between well-treated normoglycemic women with GDM and non-diabetic pregnant women in the 3rd trimester.
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Affiliation(s)
- Ildikó Vastagh
- Department of Neurology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
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Fekete A, Rosta K, Wagner L, Prokai A, Degrell P, Ruzicska E, Vegh E, Toth M, Ronai K, Rusai K, Somogyi A, Tulassay T, Szabo AJ, Ver A. Na+,K+-ATPase is modulated by angiotensin II in diabetic rat kidney--another reason for diabetic nephropathy? J Physiol 2008; 586:5337-48. [PMID: 18818245 DOI: 10.1113/jphysiol.2008.156703] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Angiotensin II (ANGII) plays a central role in the enhanced sodium reabsorption in early type 1 diabetes in man and in streptozotocin-induced (STZ) diabetic rats. This study investigates the effect of untreated STZ-diabetes leading to diabetic nephropathy in combination with ANGII treatment, on the abundance and localization of the renal Na(+),K(+)-ATPase (NKA), a major contributor of renal sodium handling. After 7 weeks of STZ-diabetes (i.v. 65 mg kg(-1)) a subgroup of control (C) and diabetic (D7) Wistar rats were treated with ANGII (s.c. minipump 33 microg kg(-1) h(-1) for 24 h; CA and D7A). We measured renal function and mRNA expression, protein level, Serin23 phosphorylation, subcellular distribution, and enzyme activity of NKA alpha-1 subunit in the kidney cortex. Diabetes increased serum creatinine and urea nitrogen levels (C versus D7), as did ANGII (C versus CA, D7 versus D7A). Both diabetes (C versus D7) and ANGII increased NKA alpha-1 protein level and enzyme activity (C versus CA, D7 versus D7A). Furthermore, the combination led to an additive increase (D7 versus D7A, CA versus D7A). NKA alpha-1 Ser23 phosphorylation was higher both in D7 and ANGII-treated rats in the non-cytoskeletal fraction, while no signal was detected in the cytoskeletal fraction. Control kidneys showed NKA alpha-1 immunopositivity on the basolateral membrane of proximal tubular cells, while both D7 and ANGII broadened NKA immunopositivity towards the cytoplasm. Our study demonstrates that diabetes mellitus (DM) increases the mRNA expression, protein level, Ser23 phosphorylation and enzyme activity of renal NKA, which is further elevated by ANGII. Despite an increase in total NKA quantity in diabetic nephropathy, the redistribution to the cystosol suggests the Na(+) pump is no longer functional. ANGII also caused translocation from the basolateral membrane, thus in diabetic states where ANGII level is acutely elevated, the loss of NKA will be exacerbated. This provides another mechanism by which ANGII blockade is likely to be protective.
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Affiliation(s)
- Andrea Fekete
- 1st Department of Pediatrics, Semmelweis University Budapest, H-1082, Budapest, Hungary
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