Our results suggest that irisin may be involved in reproductive function and in the pregnancy-associated metabolic changes, and this condition may be an irisin-resistant state during gestation.
Adipsin is a protease produced at high levels by adipose tissue. It is involved in complement activation and metabolic control. The objective of this study was to determine the changes in adipsin levels during different stages of normal pregnancy, and its association with obstetric outcomes, such as preeclampsia. This nested case-control study in a longitudinal cohort included normal pregnant (n = 54) and preeclamptic (n = 18) women, both followed throughout pregnancy. Additionally, some of the normal pregnant women were followed up three months postpartum (n = 18). Healthy non-pregnant women were also studied during their menstrual cycle (n = 20). The results of this study show that in healthy non-pregnant women, adipsin levels did not change significantly during the menstrual cycle. In normal pregnant women, adipsin levels were lower (p < 0.01) when compared with non-pregnant healthy women, but these serum levels increased again during postpartum (p < 0.001). Adipsin levels were significantly elevated in preeclamptic women in late pregnancy (P < 0.01). A significant correlation was not found between leptin and adipsin during the three periods of gestation studied in healthy pregnant and preeclamptic women. Our results suggest that adipsin may be involved in pregnancy-associated metabolic changes. Moreover, the increase of adipsin levels towards late gestation in preeclamptic women could be related to the pathophysiology of this disease.
En las últimas décadas se ha sugerido una asociación entre la esplenectomía y el desarrollo de estados protrombóticos. Estos pacientes pueden tener un mayor riesgo de episodios tromboembólicos venosos, incluida la embolia pulmonar. La mayoría de los casos notificados son de pacientes con afecciones hematológicas que pueden ser factores de confusión debido al aumento del riesgo protrombótico. Además, la cirugía después de una lesión abdominal traumática puede ser un factor relevante en el tromboembolismo como complicación médica temprana. Se presenta el caso de un hombre de 48 años con antecedente de esplenectomía traumática hace 22 años, que acudió al servicio de urgencias con un cuadro de un año de disnea durante el ejercicio, fatiga y presíncope. Durante los últimos dos meses experimentó empeoramiento de la disnea y la tos. La tomografía computarizada con contraste mostró una embolia pulmonar aguda extensa y la ecocardiografía transesofágica mostró un ventrículo derecho dilatado con alta probabilidad de hipertensión arterial pulmonar. Fue dado de alta con warfarina y oxigenoterapia. A los cuatro meses el ecocardiograma mostró persistencia de signos indirectos de hipertensión pulmonar. La gammagrafía de perfusión demostró persistencia de embolia pulmonar en el segmento apical posterior del lóbulo superior izquierdo y segmento apical del lóbulo superior derecho. Fue sometido a cateterismo cardíaco derecho que mostró hipertensión pulmonar tromboembólica crónica. En el seguimiento presentó mejoría de los síntomas. La anticoagulación se continuó indefinidamente. Los pacientes esplenectomizados tienen una mayor incidencia de eventos trombóticos venosos y potencialmente podrían tener un mayor riesgo de desarrollar hipertensión pulmonar tromboembólica crónica.
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