Biomarkers are important tools to improve the early detection of patients at high risk for developing diabetes as well as the stratification of diabetic patients towards risks of complications. In addition to clinical variables, we analyzed 155 metabolic parameters in plasma samples of 51 healthy volunteers and 66 patients with diabetes using nuclear magnetic resonance (NMR) spectrometry. Upon elastic net analysis with lasso regression, we confirmed the independent associations of diabetes with branched-chain amino acids and lactate (both positive) as well as linoleic acid in plasma and HDL diameter (both inverse). In addition, we found the presence of diabetes independently associated with lower concentrations of free cholesterol in plasma but higher concentrations of free cholesterol in small HDL. Compared to plasmas of non-diabetic controls, plasmas of diabetic subjects contained lower absolute and relative concentrations of free cholesterol in all LDL and HDL subclasses except small HDL but higher absolute and relative concentrations of free cholesterol in all VLDL subclasses (except very small VLDL). These disbalances may reflect disturbances in the transfer of free cholesterol from VLDL to HDL during lipolysis and in the transfer of cell-derived cholesterol from small HDL via larger HDL to LDL.

Introduction: Cervical cancer in pregnancy is a rare disease, with an incidence of 0.01-0.1%, of which most are squamous epithelial cancers. We here present the first case of a uterine cervical adenocarcinoma during pregnancy with a concomitant papillary adenocarcinoma of the thyroid gland. Materials and Methods: Data were extracted from the patient’s records. Literature review was performed using the databases PubMed, Web of science and Embase. Case Report: A 36-year-old Gravida IV, Para III was admitted to the Cantonal Hospital St. Gallen, Switzerland with an invasive adenocarcinoma of the uterine cervix cT1B2 cNx Mx G1 ER neg PR neg Ki67 80% at 31 weeks of gestation. She was treated with 2 cycles of neoadjuvant chemotherapy (carboplatin and paclitaxel). Following caesarean section at 36 2/7 weeks of gestation, treatment was switched to chemoradiation therapy. The patient delivered a healthy girl. A concomitant papillary thyroid cancer pT1a, pN1a (1/6) was successfully treated by surgery. The patient is free of recurrence and metastasis at 4.5 years of follow-up for either of the tumors. Conclusion: Management of cervical cancers in pregnancy has to be individualized based on factors like gestational age, stage and histology of the cancer, and the wish for pregnancy continuation or termination. Neoadjuvant chemotherapy seems to be a reasonable option to postpone radical surgery or chemoradiotherapy to prevent preterm delivery. To the best of our knowledge, this is the first report of a cervical adenocarcinoma in pregnancy with a concomitant papillary thyroid cancer.