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Concentrations of visfatin are increased in insulin-resistant conditions, but the relationship between visfatin and insulin and/or insulin resistance indices in pregnancy remains unclear. Insulin resistance in pregnancy is further accentuated in women with gestational diabetes mellitus (GDM). Thus we assessed serum levels of visfatin in pregnant women with varying degrees of glucose tolerance. Fasting visfatin levels were measured at 28 weeks of gestation in 51 women divided according to their response to a 50-g glucose challenge test (GCT) and a 75-g OGTT: control subjects ( n = 20) had normal responses to both a GCT and an OGTT; the intermediate group (IG; n = 15) had a false-positive GCT, but a normal OGTT; the GDM group ( n = 16) had abnormal GCTs and OGTTs. There were no age or BMI differences between analysed groups. Across the subgroups there was a progressive increase in glucose and insulin at 120 min of the OGTT ( p < 0.01). This was accompanied by an increase in visfatin, from 76.8 ± 14.1 ng/ml in the control subjects, to 84.0 ± 14.7 ng/ml in the IG group and 93.1 ± 12.3 ng/ml in the GDM group ( p < 0.01 for GDM vs control subjects). There was a positive correlation between visfatin and fasting insulin ( r = 0.38, p = 0.007) and insulin at 120 min of the OGTT ( r = 0.39, p = 0.006). An increase in fasting visfatin, the levels of which correlate with both fasting and post-glucose-load insulin concentrations, accompanies worsening glucose tolerance in the third trimester of pregnancy. However, the significance of these findings, and in particular the role of visfatin in the regulation of insulin sensitivity during pregnancy, remains to be elucidated. [ABSTRACT FROM AUTHOR]

Purpose To determine the frequency of occurence and severity of dysthyroid optic neuropathy (DON), in relation to the degree of inflammatory signs, exophthalmos, asymetrical disease and diplopia, among patients with newly diagnosed inflammatory thyroid related ophthalmopathy (TAO) or suffering from the recurrence of the inflammatory phase of previously inactive/fibrotic stage of the disease. Methods 400 subjects with TAO, 76% women and 24% men aged 29.0 to 88.0 (mean 55.5 +/‐ 9.8) years with Clinical activity scores between 2 and 9 (mean 4.6 +/‐ 2.3) were included into the study. 30 healthy age and sex matched patients served as control. Diagnosis of DON was based on the presence of at least two features related to the optic nerve involvement, different than reduction of visual acuity. Results Two or more clinical features of DON werefound in 27 patients with inflammatory TAO. 20 of whom displayed asymmetrical involvement (> 2mm difference in exophthalmos and > 2 in CAS scale). There was slight statistical association between neuropathy and diplopia with neuropathy patients being more likely to suffer from constant double vision. There was no correlation between CAS and DON. Visual acuity was reduced from 2 to 7 Snellen lines in patients with DON and from 2 to 6 lines in TAO and not DON. Conclusion Clinical features of DON occour in 6.75% of patients with inflammatory TAO. There is no correlation between the degree of inflammatory involvement and DON, therefore it must be carefully excluded in all patients even with apparently mild ophthalmopathy. Thera numerous other, than DON,causes of visual loss related to TAO. Majority of patients present with mild and moderate visual loss only, which is reversible on immunomodulatory treatment. [ABSTRACT FROM AUTHOR]