Introduction: Endometriosis affects up to 1 every 5 women at their reproductive age, with variable and complex symptomatology. Patients may be asymptomatic but may have pain episodes or subfertility. Its negative impact is on patients' health and quality of life. Objective: it was to investigate the serum and peritoneal fluid (PF) concentrations of Angiopoietin-2, Interleukin-1β, and Vascular Endothelial Growth Factor, aiming to evaluate their diagnostic performance in endometriosis. Methods: Serum and peritoneal fluid samples were taken from 112 women undergoing laparoscopy for infertility, pelvic pain or adnexal masses. 61 diagnosed with endometriosis and 51 controlled. Primary outcome was to estimate serum and PF concentrations of Angio-2, IL-1β and VEGF and secondarily correlate these concentrations to disease stages thus assuming their diagnostic potential. Results: Significant differences were found between patients and control as regards serum and PF concentration of all studied markers except serum IL-1β. Serum Angio-2 and PF VEGF showed a significantly higher level in more advanced stages of endometriosis. PF VEGF showed a positively significant correlation with the stage of the disease, spearman coefficient t = 0.442 p = 0.014. PF concentrations of Angio-2 and Serum VEGF did not show significant pattern changes with stage-related levels. Diagnostic potential of serum and PF concentrations of the 3 markers were assessed by the ROC curve. Angio-2 proved an excellent diagnostic ability for endometriosis. PF and serum VEGF proved an equal diagnostic performance, whereas, PF IL-1β was the least efficient. Based on the results, we suggested preliminary serum threshold values for these markers to be used as diagnostic or follow-up landmarks with relatively acceptable sensitivity, specificity, positive and negative predictive values. Conclusion: Non-invasive predictive biomarkers for endometriosis were Serum Angio-2, IL-1β, and VEGF independently or in combination with the estimated threshold values. Serum Angio-2 merit is considered as a novel marker for endometriosis due to its diagnostic power.

BACKGROUND/OBJECTIVE: Ghrelin is a peptide hormone known to play a role in glucose homeostasis; therefore, functional variants of the human ghrelin gene could contribute to the genetic susceptibility to diabetes or may modulate some aspects of the glucose intolerance phenotype. The study aimed at investigating the differences in the frequencies of Arg51Gln polymorphisms among Egyptian patients with type II diabetes and healthy control subjects and at verifying whether this polymorphism could influence the diabetes phenotype. METHODS: One-hundred-four Egyptian type II diabetic patients attending the Medical Research Institute were enrolled into the study. Clinical data concerning medical and family history were collected by a clinical interview. Another group of 100 non-diabetic apparently healthy subjects were included to compare the Arg51Gln genotypes frequencies. The ghrelin Arg51Gln polymorphism was studied by PCR restriction fragment length polymorphism method in the diabetic and control subjects. The metabolic profile of the diabetic patients was also analyzed. A 2 test was adopted to compare the ghrelin Arg51Gln genotype and allele frequencies among the two groups. Moreover, in order to test whether the differences in phenotypic variables between the patient groups were influenced by ghrelin genotype, ANOVA test was performed. RESULTS: The frequency of the 51gln heterozygotes and homozygotes were significantly higher in the patients' group than in the control sample (X 2 =8.962, p= 0.0113). The 51gln allele frequency was higher in the patients than in the control group (q=0.27 and q=0.14, respectively); a difference that was found statistically significant (X 2 =5.185, p= 0.022). The fasting blood sugar and triglycerides levels were higher in patients carrying the ghrelin 51Gln allele than in those with the wild allele (statistically significant, p=0.014 and p=0.004, respectively). No statistically significant difference was observed between the total cholesterol, HDL and LDL cholesterol concentrations among these two groups. CONCLUSIONS: There is a significant positive association between ghrelin 51Gln polymorphism and type II diabetes in the Egyptian population. Further studies are warranted to elucidate the role of ghrelin in the development of this disease.