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Association between foetal growth and different maternal metabolic characteristics in women with gestational diabetes mellitus
(Macedonian Academy of Sciences and Arts/De Gruyter, 2009-12)
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Velkoska Nakova, Valentina
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Adamova, Gordana
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Dimitrovski, Chedomir
Objective: The aim of the study was to investigate the association between foetal growth and different maternal metabolic characteristics in women with gestational diabetes mellitus (GDM). Methods: The study group included 200 consecutive pregnant women who attended the Endocrinology, Diabetes and Metabolic Disorders Outpatient Department in the period from 02.2006 to 02.2009 with singleton pregnancy and GDM diagnosed following ADA criteria. The following parameters were studied: pre-pregnancy maternal body mass index (BMI), 3-hours 100g oral glucose tolerance test (OGTT) results, glycosylated haemoglobin (HbA1c), total lipids (TL), total cholesterol (TH), triglycerides (TG), HDL- and LDL-cholesterol levels at admission. Neonatal birth weight and the prevalence of being large for gestational age (LGA) was an end-point. Results: We found a significant association between birth weight and pre-pregnancy BMI, HDL-C and birth weight of a large child born previously. Birth weight of a large child born previously was the strongest independent predictor for LGA. The prevalence of LGA (from 27% to 80%) was related to a number of altered maternal characteristics. Conclusion: Pre-pregnancy BMI, HDL-C and birth weight of a large child born previously are the independent predictors for LGA, but results of glucose levels during OGTT are not useful in the prediction of LGA in GDM pregnancies. Probably more factors and other maternal metabolic parameters than glucose levels during OGTT are responsible for the risk of LGA.
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Prevalence of thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes and diabetes type 1
(Macedonian Academy of Sciences and Arts/De Gruyter, 2010-12)
Velkoska Nakova, Valentina
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Dimitrovski, Chedomir
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The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during pregnancy in women with diabetes type 1 and gestational diabetes mellitus (GDM).
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Prevalence and predictors of impaired glucose tolerance and diabetes mellitus type 2 in patients with polycystic ovary syndrome
(Macedonian Academy of Sciences and Arts / Sciendo, 2021)
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Velkoska Nakova, Valentina
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Serafimoski, Vladimir
Aim: To estimate the prevalence of impaired glucose tolerance (IGT) and diabetes mellitus type 2 (DMT2), as well as the predictors for glucose abnormalities in women with polycystic ovary syndrome (PCOS). Material and methods: A cross-sectional study with 80 consecutive patients with newly diagnosed PCOS who underwent the standard 75g oral glucose tolerance test (OGTT) and the measurement of sex steroid hormone and lipid profile. Results: According to the results from the OGTT, 63% had a normal test (NT), 23% had IGT, and 9% had DMT2. The NT group was younger with lower BMI than IGT and DMT2 groups (25.1 ± 7.3, 31.5 ± 6.5, 37.4 ± 4.0 years, and 29.1 ± 8.3 kg/m2, 31.7 ± 4.6 kg/m2, and 34.5 ± 5.6 kg/m2, respectively). The testosterone levels were highest in the group with a normal test (2.7 ± 0.8 nmol/l) and lowest in the DMT2 group (1.9 ± 0.8 nmol/L), with statistical significance. The sex hormone bounding globulin (SHBG) levels were low in all three groups, with statistically significant differences between NG and IGT, and the NT and DMT2 groups. The multivariate linear regression model identified age, BMI, SHBG and testosterone as major independent predictors for abnormal glucose metabolism. Conclusion: It seems that the prevalence of IGT and DMT2 among PCOS women in our country is not as high as in Western countries. Age, BMI, and SHBG increase the risk for the development of IGT and DMT2. Thus, close monitoring of older, obese women with low SHBG is needed because of the higher risk for the development of IGT and DMT2 in such patients.
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Demographic, Clinical and Biochemical Characteristics of Pediatric Obesity: Interim Analysis of a Larger Prospective Study
(Medical University of Plovdiv, 2020-12)
Tankoska Maja
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Stamatova Ana
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Murtezani Avni
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Maneva Elita
Introduction: Pediatric obesity is a common nutritional disorder that affects more than a third of the young population and predisposes individuals to greater future morbidity and mortality. Materials and methods: Sixty-two children were recruited in the study. Demographic and clinical information regarding the patients and their parents was collected. Data about the weight, height, systolic (SP) and diastolic (DP) blood pressure, lipid metabolic profile, thyroid hormone levels, glucose and insulin levels before and after oral glucose tolerance test (OGTT) of participants were also collected. Body mass index (BMI) was calculated and patients were classified into groups according to the International Obesity Task Force criteria. Descriptive, comparative parametric, non-parametric tests and Spearman’s ranked correlations were used in the statistical analysis. Results: The study sample consisted of 34 males and 28 females aged 11.6 and 11.8 years, respectively (p=0.781). The mean BMI was 30.5 (SD 5.5): 8 of participant had normal weight (≤25 BMI), 22 were overweight (25-30 BMI), and 32 were obese (≥30 BMI). The children’s BMIs were significantly associated with parental BMIs (r=0.395, p=0.004). Both SP and DP were significantly different between BMI subgroups (p=0.005 and p=0.001, respectively) with the obese group having the highest values (post-hoc Benjamini, p=0.004). Obese children had lower average T4 levels when compared to the comparators (7.5 μg/dL vs. 9.9 μg/dL, p=0.021). Obese children had significantly lower baseline glucose levels and higher insulin levels when compared to the overweight/normal BMI children (73.8 mg/ dL vs. 86.4 mg/dL, p<0.001 and 21.8 μgU/mL vs. 132 μgU/mL, p=0.003). Obese children had the greatest numerical increase in glucose levels during the OGTT (Δ63.0 mg/dL vs. Δ43.2 mg/dL, p=0.063) and numerically smaller absolute insulin response (Δ86.1 μIU/mL vs. Δ125.7 μIU/mL, p=0.307). Conclusions: Pediatric patients demonstrate familial type of obesity and premorbid asymptomatic endocrine impairments. In order to maintain normal glucose levels, obese pediatric patients demonstrate high levels of resting insulin levels and diminished response after OGTT load

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