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Obesity and diabetes increase the risk of complications during gestation and at delivery. The aim of this study was to compare the perinatal outcomes in the populations of diabetic and obese Polish women, based on the results of a national survey performed in years 2012 and 2017, as well as to determine the risk factors of the gestational diabetes mellitus (GDM). Questionnaires from 6276 women were collected. Obese women constituted 5.5% and 7.5% of study population in years 2012 and 2017, respectively. Among women whose pregnancies were complicated by diabetes mellitus, GDM constituted the most common type of glucose intolerance during both time periods (2012: 89% vs. 2017: 85.6%). In the group of obese women an insignificant increase in the rate of induced deliveries was noted (2012: 9.9% vs. 2017: 11.7%), whereas the fetal birth-weight decreased significantly (2012: 3565g vs. 2017: 3405g, p < 0.05). In the group of diabetic pregnant women the percentage of cesarean sections, labour inductions and fetal birth defects was characterized by an insignificant upward trend. Risk of GDM was significantly increased in women aged over 35 years—(2012: OR 1.9 (95% CI: 1.1–2.9) and 2017: OR = 2.1 (95% CI: 1.5–2.9), p < 0.05—, as well as in overweight women—2012: OR 1.8 (95% CI: 1.2–2.7) and 2017: OR 2.6 (95% CI: 1.9–3.4), p < 0.05—during both analysed time periods. Based on the study results, it is necessary to develop population-based programmes to prevent obesity and to introduce and enforce the rules of appropriate screening for glucose tolerance disorders during pregnancy.
Cezary Wojtyla; Pawel Stanirowski; Pawel Gutaj; Michal Ciebiera; Andrzej Wojtyla. Perinatal Outcomes in a Population of Diabetic and Obese Pregnant Women—The Results of the Polish National Survey. International Journal of Environmental Research and Public Health 2021, 18, 560 .
AMA StyleCezary Wojtyla, Pawel Stanirowski, Pawel Gutaj, Michal Ciebiera, Andrzej Wojtyla. Perinatal Outcomes in a Population of Diabetic and Obese Pregnant Women—The Results of the Polish National Survey. International Journal of Environmental Research and Public Health. 2021; 18 (2):560.
Chicago/Turabian StyleCezary Wojtyla; Pawel Stanirowski; Pawel Gutaj; Michal Ciebiera; Andrzej Wojtyla. 2021. "Perinatal Outcomes in a Population of Diabetic and Obese Pregnant Women—The Results of the Polish National Survey." International Journal of Environmental Research and Public Health 18, no. 2: 560.
Background: Our aim was to investigate whether the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) glycemic thresholds used for detecting hyperglycemia in pregnancy can be predictive for malformations in women with hyperglycemia detected in early pregnancy. Methods: a single-center, retrospective observational trial of 125 mother-infant pairs from singleton pregnancies with hyperglycemia according to the IADPSG criteria diagnosed at the gestational age below 16 weeks. Glucose values obtained from 75-g OGTT (oral glucose tolerance test) were investigated as predictors for congenital malformations in newborns. Results: Characteristics of the cohort: maternal age: 31.5 ± 5.2, pre-pregnancy body mass index (BMI) ≥ 30 kg/m2: 42.0%, gestational age at diagnosis (weeks): 12.0 ± 4.0, and newborns with congenital malformations: 8.8%. Fasting blood glycemia (FBG) and HbA1c (Haemoglobin A1c) at baseline significantly predicted the outcome (expB: 1.06 (1.02–1.1), p = 0.007 and expB: 2.05 (1.24–3.38), p = 0.005, respectively). Both the fasting blood glucose (FBG) value of 5.1 mmol/dL (diagnostic for gestational diabetes mellitus (GDM)) and 5.5 mmol/dL (upper limit for normoglycemia in the general population) significantly increased the likelihood ratio (LR) for fetal malformations: 1.3 (1.1; 1.4) and 1.5 (1.0; 2.4), respectively. Conclusions: (1) Fasting glycemia diagnostic for GDM measured in early pregnancy is associated with a significantly elevated risk for congenital malformations. (2) Our data suggest that women at elevated risks of GDM/diabetes in pregnancy (DiP) should have their fasting blood glucose assessed before becoming pregnant, and the optimization of glycemic control should be considered if the FBG exceeds 5.1 mmol/dL.
Agnieszka Zawiejska; Katarzyna Wróblewska-Seniuk; Paweł Gutaj; Urszula Mantaj; Anna Gomulska; Joanna Kippen; Ewa Wender-Ozegowska. Early Screening for Gestational Diabetes Using IADPSG Criteria May Be a Useful Predictor for Congenital Anomalies: Preliminary Data from a High-Risk Population. Journal of Clinical Medicine 2020, 9, 3553 .
AMA StyleAgnieszka Zawiejska, Katarzyna Wróblewska-Seniuk, Paweł Gutaj, Urszula Mantaj, Anna Gomulska, Joanna Kippen, Ewa Wender-Ozegowska. Early Screening for Gestational Diabetes Using IADPSG Criteria May Be a Useful Predictor for Congenital Anomalies: Preliminary Data from a High-Risk Population. Journal of Clinical Medicine. 2020; 9 (11):3553.
Chicago/Turabian StyleAgnieszka Zawiejska; Katarzyna Wróblewska-Seniuk; Paweł Gutaj; Urszula Mantaj; Anna Gomulska; Joanna Kippen; Ewa Wender-Ozegowska. 2020. "Early Screening for Gestational Diabetes Using IADPSG Criteria May Be a Useful Predictor for Congenital Anomalies: Preliminary Data from a High-Risk Population." Journal of Clinical Medicine 9, no. 11: 3553.
Aims: Our study aimed to examine the pregnancy outcomes (maternal and fetal) concerning different models of antenatal care across a period of over 25 years (1993–2018) in 459 women with type 1 diabetes. Data from patients with a history of the condition lasting at least 15 years were considered eligible for analysis. Methods: The study group was divided into three cohorts based on the different models of treatment used in Poznan University Hospital, Poland: 1993–2000 (cohort I, n = 91), 2001–2005 (cohort II, n = 83), 2006–2018 (cohort III, n = 284). To identify predictors for the selected dichotomous outcomes, we calculated the risks for fetal or maternal complications as dependent variables for cohorts II and III against cohort I, using multivariate logistic regression analysis. Results: The mean gestational age was 36.8 ± 2.4 weeks in the total cohort. The percentages of deliveries before the 33rd and the 37th weeks was high. We observed a decreasing percentage during the following periods, from 41.5% in the first period to 30.4% in the third group. There was a tendency for newborn weight to show a gradual increase across three time periods (2850, 3189, 3321 g, p <0.0001). In the last period, we noticed significantly more newborns delivered after 36 weeks with a weight above 4000 g and below 2500 g. Caesarean section was performed in 88% of patients from the whole group, but in the subsequent periods this number visibly decreased (from 97.6%, 86.7%, to 71%, p = 0.001). The number of emergency caesarean sections was lowest in the third period (27.5%, 16.7%, 11.2%, p = 0.006). We observed a decreasing number of “small for gestational age” newborns (SGA) in consecutive periods of treatment (from 24.4% to 8.7%, p = 0.002), but also a higher percentage of “large for gestational age” (LGA) newborns (from 6.1% to 21.6%, p = 0.001). Modification of treatment might be associated with the gradual reduction of SGA rates (cohort I 3.6%, cohort III 2.3% p <0,0005). Conclusions: Strict glycemic and blood pressure control from the very beginning of pregnancy, as well as modern fetal surveillance techniques, may contribute to the improvement of perinatal outcomes in women with long-duration type 1 diabetes.
Ewa Wender-Ozegowska; Paweł Gutaj; Urszula Mantaj; Jakub Kornacki; Stefan Ozegowski; Agnieszka Zawiejska. Pregnancy Outcomes in Women with Long-Duration Type 1 Diabetes—25 Years of Experience. Journal of Clinical Medicine 2020, 9, 3223 .
AMA StyleEwa Wender-Ozegowska, Paweł Gutaj, Urszula Mantaj, Jakub Kornacki, Stefan Ozegowski, Agnieszka Zawiejska. Pregnancy Outcomes in Women with Long-Duration Type 1 Diabetes—25 Years of Experience. Journal of Clinical Medicine. 2020; 9 (10):3223.
Chicago/Turabian StyleEwa Wender-Ozegowska; Paweł Gutaj; Urszula Mantaj; Jakub Kornacki; Stefan Ozegowski; Agnieszka Zawiejska. 2020. "Pregnancy Outcomes in Women with Long-Duration Type 1 Diabetes—25 Years of Experience." Journal of Clinical Medicine 9, no. 10: 3223.
Mitochondria are organelles whose main role is energy production and might influence obesity. They are the only organelles with their own genome. Here we have genotyped 435 patients with type 1 diabetes using Illumina Infinium Omni Express Exome-8 v1.4 arrays and performed mitoGWAS on BMI. We have analyzed additive interactions between mitochondrial and nuclear variants in genes known to be associated with mitochondrial functioning (MitoCarta2.0) and confirmed and refined the results on external cohorts - Framingham Heart Study (FHS) and GTEx data. The linear mixed model analysis was performed using the GENESIS package in R/Bioconductor We have found a nominal association between rs28357980 localized to MT-ND2 and BMI (β=−0.69, p=0.056). This was confirmed on 1889 patients from FHS cohort (β =−0.312, p=0.047). Next, we have searched for additive interactions between mitochondrial and nuclear variants. MT-ND2 variants interacted with variants in SIRT3, ATP5B, CYCS, TFB2M and POLRMT genes. TFB2M is a mitochondrial transcription factor and together with TFAM creates transcription promoter complex for mitochondrial polymerase POLRMT. We have found that the interaction between rs3021088 of MT-ND2 gene and rs6701836 in TFB2M has led to BMI decrease (inter_pval=0.0241), while interaction of rs3021088in MT-ND2 and rs41542013 in POLRMT gene led to BMI increase (inter_pval=0.0004). The influence of these interactions on BMI was confirmed on external cohorts. Here, we have shown that variants in mitochondrial genome as well as additive interactions between mitochondrial and nuclear SNPs influence BMI in T1DM and general cohorts.Author summaryObesity is an epidemic of our times. It is known that it results from an imbalance between energy intake and its expenditure, while mitochondria are organelles whose main role is energy production. They are the only organelles that contain their own genome. Thus, we have genotyped 435 patients with type 1 diabetes and looked on single mitochondrial variant influence as well as on additive interactions between mitochondrial and nuclear variants which might affect BMI. Our analysis has shown, that rs28357980 localized to MT-ND2 is associated with BMI. Next, we looked whether variants in this gene, which builds complex I of the electron transport chain, might interact with nuclear variants and together they modify obesity risk. We focused mainly on mitochondrial biogenesis and found that interactions between variants in TFB2M (rs6701836) or POLRMT (rs41542013) and MT-ND2 (rs3021088) affect patients BMI. TFB2M is a mitochondrial transcription factor which, together with TFAM, creates transcription promoter complex and enables transcription by mitochondrial polymerase POLRMT. The obtained results were also confirmed and refined on external cohorts - Framingham Heart Study (FHS) and GTEx data. Thus, we have shown that variations in mitochondrial genome and its interactions with nuclear variants might have an influence on BMI.
Agnieszka H. Ludwig-Słomczyńska; Michał T. Seweryn; Przemysław Kapusta; Ewelina Pitera; Urszula Mantaj; Katarzyna Cyganek; Paweł Gutaj; Łucja Dobrucka; Ewa Wender-Ożegowska; Maciej T. Małecki; Paweł P. Wołkow. “Mitochondrial GWAS and Association of Nuclear – Mitochondrial Epistasis with BMI in T1DM Patients”. 2018, 436519 .
AMA StyleAgnieszka H. Ludwig-Słomczyńska, Michał T. Seweryn, Przemysław Kapusta, Ewelina Pitera, Urszula Mantaj, Katarzyna Cyganek, Paweł Gutaj, Łucja Dobrucka, Ewa Wender-Ożegowska, Maciej T. Małecki, Paweł P. Wołkow. “Mitochondrial GWAS and Association of Nuclear – Mitochondrial Epistasis with BMI in T1DM Patients”. . 2018; ():436519.
Chicago/Turabian StyleAgnieszka H. Ludwig-Słomczyńska; Michał T. Seweryn; Przemysław Kapusta; Ewelina Pitera; Urszula Mantaj; Katarzyna Cyganek; Paweł Gutaj; Łucja Dobrucka; Ewa Wender-Ożegowska; Maciej T. Małecki; Paweł P. Wołkow. 2018. "“Mitochondrial GWAS and Association of Nuclear – Mitochondrial Epistasis with BMI in T1DM Patients”." , no. : 436519.
Ewa Wender-Ożegowska; Dorota Bomba-Opoń; Jacek Brązert; Zbigniew Celewicz; Krzysztof Czajkowski; Paweł Gutaj; Aneta Malinowska-Polubiec; Agnieszka Zawiejska; Mirosław Wielgoś. Standards of Polish Society of Gynecologists and Obstetricians in management of women with diabetes. Ginekologia Polska 2018, 89, 341 -350.
AMA StyleEwa Wender-Ożegowska, Dorota Bomba-Opoń, Jacek Brązert, Zbigniew Celewicz, Krzysztof Czajkowski, Paweł Gutaj, Aneta Malinowska-Polubiec, Agnieszka Zawiejska, Mirosław Wielgoś. Standards of Polish Society of Gynecologists and Obstetricians in management of women with diabetes. Ginekologia Polska. 2018; 89 (6):341-350.
Chicago/Turabian StyleEwa Wender-Ożegowska; Dorota Bomba-Opoń; Jacek Brązert; Zbigniew Celewicz; Krzysztof Czajkowski; Paweł Gutaj; Aneta Malinowska-Polubiec; Agnieszka Zawiejska; Mirosław Wielgoś. 2018. "Standards of Polish Society of Gynecologists and Obstetricians in management of women with diabetes." Ginekologia Polska 89, no. 6: 341-350.
Despite improvement in diabetic care over the years, the incidence of hypertensive disorders of pregnancy is still very high. Therefore, the aim of our study was to determine risk factors for PE in women with T1DM. This study was a prospective, nested case–control study on a population of 165 women with T1DM. Women were divided into 3 subgroups: normotensive (N = 141), gestational hypertension (GH) (N = 8), and PE (N = 16). Clinical data were collected in the first trimester (< 12th week), in mid-pregnancy (20–24th weeks), and just prior to delivery (34–39th weeks). IR in the first trimester was quantified using the estimated glucose disposal rate formula (eGDR, milligrams/kilogram/minute). Simple logistic regression was used to search for factors associated with PE and GH. For multivariate comparisons, we used multiple logistic regression with stepwise selection. All preeclampsia cases were diagnosed in primiparae. The presence of vasculopathy was the strongest determinant of PE (OR 10.8, 95% CI 3.27–35.97, P = 0.0001), followed by a history of chronic hypertension (6.05, 1.75–20.8, P = 0.004) and the duration of diabetes (1.11, 1.03–1.12, P = 0.009). However, chronic hypertension and duration of diabetes were no longer associated with PE after adjustment for the presence of vasculopathy. Higher gestational weight gain (GWG) was associated with PE, and this association remained significant after adjustment for first trimester body mass index (1.14, 1.02–1.28, P = 0.02). Both systolic and diastolic blood pressure assessed in the first trimester were significant determinants of PE; however, this association was no longer observed after adjustment for the presence of chronic hypertension. Glycated hemoglobin (HbA1c) levels from all 3 trimesters were significantly associated with PE (first trimester: 1.38, 1.01–1.87, P = 0.04; second trimester: 2.76, 1.43–5.31, P = 0.002; third trimester: 2.42, 1.30–4.51, P = 0.005). There was a negative association between eGDR and PE (0.66, 0.50–0.87, P = 0.003). Among lipids, triglycerides (TG) in all 3 trimesters were positively associated with PE, and this association was independent of HbA1c levels (first trimester: 5.32, 1.65–17.18, P = 0.005; second trimester: 2.52, 1.02–6.26, P = 0.05; third trimester: 2.28, 1.39–3.74, P = 0.001. We did not find any predictors of GH in the regression analysis among all analyzed factors. Primiparity and diabetic vasculopathy seem to be the strongest risk factors for PE in women with type 1 diabetes. However, preexisting hypertension and higher GWG were also associated with PE in women with T1DM. Among laboratory results, higher HbA1c and TG levels in all 3 trimesters were associated with PE. The association between higher IR and PE in women with T1DM needs further study.
Paweł Gutaj; Agnieszka Zawiejska; Urszula Mantaj; Ewa Wender-Ożegowska. Determinants of preeclampsia in women with type 1 diabetes. Acta Diabetologica 2017, 54, 1115 -1121.
AMA StylePaweł Gutaj, Agnieszka Zawiejska, Urszula Mantaj, Ewa Wender-Ożegowska. Determinants of preeclampsia in women with type 1 diabetes. Acta Diabetologica. 2017; 54 (12):1115-1121.
Chicago/Turabian StylePaweł Gutaj; Agnieszka Zawiejska; Urszula Mantaj; Ewa Wender-Ożegowska. 2017. "Determinants of preeclampsia in women with type 1 diabetes." Acta Diabetologica 54, no. 12: 1115-1121.
Introduction : Despite improvement in diabetes care over the years, the incidence of macrosomia in type 1 diabetic mothers is still very high and even shows an increasing tendency. It is suggested that other factors that maternal hyperglycemia might be associated with excessive fetal growth in...
Paweł Gutaj; Ewa Wender-Ożegowska; Jacek Brązert. Maternal lipids associated with large-for-gestational-age birth weight in women with type 1 diabetes: results from a prospective single-center study. Archives of Medical Science 2017, 4, 753 -759.
AMA StylePaweł Gutaj, Ewa Wender-Ożegowska, Jacek Brązert. Maternal lipids associated with large-for-gestational-age birth weight in women with type 1 diabetes: results from a prospective single-center study. Archives of Medical Science. 2017; 4 (4):753-759.
Chicago/Turabian StylePaweł Gutaj; Ewa Wender-Ożegowska; Jacek Brązert. 2017. "Maternal lipids associated with large-for-gestational-age birth weight in women with type 1 diabetes: results from a prospective single-center study." Archives of Medical Science 4, no. 4: 753-759.
INTRODUCTION Increased C-reactive protein (CRP) concentrations during pregnancy are associated with several perinatal complications. OBJECTIVES The aim of the study was to assess serum CRP concentrations and identify its determinants in pregnant women with type 1 diabetes. PATIENTS AND METHODS CRP concentrations were determined using a high-sensitivity assay (hs-CRP) in the first trimester (I, week <12 of gestation), in mid-pregnancy (II, weeks 20 to 24 of gestation), and in the late third trimester (III, weeks 34 to 39 of gestation) in a group of 73 patients with type 1 diabetes. RESULTS There was a significant increase in CRP concentrations between the first trimester and mid‑pregnancy (median [interquartile range], 2.5 mg/l [1.3-4.5 mg/l] and 5.6 mg/l [2.5-11.6 mg/l]; P = 0.0001), which then stabilized with no further change between mid-pregnancy and the late third trimester (5.7 mg/l [2.5-9.6 mg/l]). CRP concentrations in all 3 trimesters were positively correlated with the waist‑to-hip ratio (I, P <0.0001; II, P = 0.0004; III, P = 0.0369) and body mass index (I, P = 0.015; II, P = 0.0025; III, P = 0.0048), measured in the first trimester. CRP concentrations during pregnancy were positively correlated with a measure of insulin resistance, namely, the estimated glucose disposal rate, assessed in the first trimester (I, P = 0.01; II, P = 0.0165; III, P = 0.0062). There was a positive correlation between the levels of hs-CRP and total cholesterol (P = 0.001), low-density lipoprotein cholesterol (P = 0.013), and triglycerides (P = 0.0014) in the first trimester. There was no significant correlation between CRP and hemoglobin A1c, daily insulin requirement/kg, high-density lipoprotein cholesterol levels, maternal age, and diabetes duration. CONCLUSIONS Adiposity, abnormal body fat distribution, and insulin resistance are the major determinants of CRP concentrations in pregnant women with type 1 diabetes. Our results confirm the importance of weight control before pregnancy in women with type 1 diabetes.
Paweł Gutaj; Patrycja Krzyżanowska; Jacek Brązert; Ewa Wender-Ożegowska. Determinants of C-reactive protein concentrations in pregnant women with type 1 diabetes. Polish Archives of Internal Medicine 2016, 126, 1 .
AMA StylePaweł Gutaj, Patrycja Krzyżanowska, Jacek Brązert, Ewa Wender-Ożegowska. Determinants of C-reactive protein concentrations in pregnant women with type 1 diabetes. Polish Archives of Internal Medicine. 2016; 126 (4):1.
Chicago/Turabian StylePaweł Gutaj; Patrycja Krzyżanowska; Jacek Brązert; Ewa Wender-Ożegowska. 2016. "Determinants of C-reactive protein concentrations in pregnant women with type 1 diabetes." Polish Archives of Internal Medicine 126, no. 4: 1.
This review discusses available literature on the diagnosis and management of intrauterine growth restriction (IUGR) in women with type 1 diabetes. IUGR is diagnosed when ultrasound-estimated fetal weight is below the 10th percentile for gestational age. IUGR diagnosis implies a pathologic process behind low fetal weight. IUGR in pregnancy complicated by type 1 diabetes is usually caused by placental dysfunction related to maternal vasculopathy. Prevention of IUGR should ideally start before pregnancy. Strict glycemic control and intensive treatment of nephropathy and hypertension are essential. Low-dose aspirin initiated before 16 gestational weeks can also reduce IUGR risk in women with vasculopathy. Umbilical and uterine artery Doppler studies can guide diagnosis and surveillance of fetuses with IUGR. Decisions regarding the timing of delivery should be based on assessment of umbilical artery Doppler. The risk of prematurity and impaired fetal lung maturation should always be considered, especially in fetuses younger than 32 weeks.
Paweł Gutaj; Ewa Wender-Ożegowska. Diagnosis and Management of IUGR in Pregnancy Complicated by Type 1 Diabetes Mellitus. Current Diabetes Reports 2016, 16, 39 .
AMA StylePaweł Gutaj, Ewa Wender-Ożegowska. Diagnosis and Management of IUGR in Pregnancy Complicated by Type 1 Diabetes Mellitus. Current Diabetes Reports. 2016; 16 (5):39.
Chicago/Turabian StylePaweł Gutaj; Ewa Wender-Ożegowska. 2016. "Diagnosis and Management of IUGR in Pregnancy Complicated by Type 1 Diabetes Mellitus." Current Diabetes Reports 16, no. 5: 39.
Insulin resistance (IR) is defined clinically as the inability of a known quantity of exogenous or endogenous insulin to increase glucose uptake and utilization. In recent years the increasing role of IR in the pathogenesis of type 1 diabetes mellitus (T1DM) related complications has been taken into account. The aim of this article is to discuss the possible role of IR in pregnancy complicated by T1DM. At the moment, there is no doubt that IR is not only frequently observed in T1DM patients, but also is a separate risk factor of several complications in nonpregnant patients. The role of IR in pregnancy complicated by T1DM has not been widely studied yet. However, data from the studies on different populations showed that IR may predispose to such conditions as miscarriage, preeclampsia and macrosomia. Interestingly all of these are more frequently diagnosed in women with T1DM in comparison to healthy subjects. The literature on the role of IR in human pregnancy is relatively rich. However despite its significance in pathophysiology of T1DM and its complications in general population, there is a lack of understanding of how it affects maternal and fetal health in pregnancy complicated by this disease. Nonetheless, based on the available literature, IR may be proposed as an additional factor modifying pregnancy outcome in woman with T1DM. Therefore, measures that might reduce IR such as good glycemic control and control of weight gain should be recommended for every woman with T1DM, optimally when planning but also throughout the pregnancy
Paweł Gutaj; Nadia Sawicka-Gutaj; Maciej Brązert; Ewa Wender-Ożegowska. Insulin resistance in pregnancy complicated by type 1 diabetes mellitus. Do we know enough? Ginekologia Polska 2015, 86, 219 -223.
AMA StylePaweł Gutaj, Nadia Sawicka-Gutaj, Maciej Brązert, Ewa Wender-Ożegowska. Insulin resistance in pregnancy complicated by type 1 diabetes mellitus. Do we know enough? Ginekologia Polska. 2015; 86 (3):219-223.
Chicago/Turabian StylePaweł Gutaj; Nadia Sawicka-Gutaj; Maciej Brązert; Ewa Wender-Ożegowska. 2015. "Insulin resistance in pregnancy complicated by type 1 diabetes mellitus. Do we know enough?" Ginekologia Polska 86, no. 3: 219-223.
Many studies have shown that cigarette smoking exerts multiple effects on the thyroid gland. Smoking seems to induce changes in thyroid function tests, like decrease in TSH and increase in thyroid hormones. However, these alterations are usually mild. In addition, tobacco smoking may also play a role in thyroid autoimmunity. Many studies have confirmed a significant influence of smoking on Graves' hyperthyroidism and particularly on Graves' orbitopathy. Here, smoking may increase the risk of disease development, may reduce the effectiveness of treatment, and eventually induce relapse. The role of smoking in Hashimoto's thyroiditis is not as well established as in Graves' disease. Nonetheless, lower prevalence of thyroglobulin antibodies, thyroperoxidase antibodies and hypothyroidism were found in smokers. These findings contrast with a study that reported increased risk of hypothyroidism in smokers with Hashimoto's thyroiditis. Moreover, cigarette smoking increases the incidence of multinodular goitre, especially in iodine-deficient areas. Some studies have examined cigarette smoking in relation to the risk of thyroid cancer. Interestingly, many of them have shown that smoking may reduce the risk of differentiated thyroid cancer. Furthermore, both active and passive smoking during pregnancy might modify maternal and foetal thyroid function. This review evaluates the current data concerning the influence of cigarette smoking on thyroid gland, including hormonal changes, autoimmunity and selected diseases. These findings, however, in our opinion, should be carefully evaluated and some of them are not totally evidence-based. Further studies are required to explain the effects of smoking upon thyroid pathophysiology.
Nadia Sawicka-Gutaj; Paweł Gutaj; Jerzy Sowiński; Ewa Wender-Ożegowska; Agata Czarnywojtek; Jacek Brązert; Marek Ruchała. Wpływ palenia papierosów na tarczycę — aktualizacja. Endokrynologia Polska 2014, 65, 54 -62.
AMA StyleNadia Sawicka-Gutaj, Paweł Gutaj, Jerzy Sowiński, Ewa Wender-Ożegowska, Agata Czarnywojtek, Jacek Brązert, Marek Ruchała. Wpływ palenia papierosów na tarczycę — aktualizacja. Endokrynologia Polska. 2014; 65 (1):54-62.
Chicago/Turabian StyleNadia Sawicka-Gutaj; Paweł Gutaj; Jerzy Sowiński; Ewa Wender-Ożegowska; Agata Czarnywojtek; Jacek Brązert; Marek Ruchała. 2014. "Wpływ palenia papierosów na tarczycę — aktualizacja." Endokrynologia Polska 65, no. 1: 54-62.
To analyze the role of maternal placental growth factor (PlGF) in the prediction of small for gestational age (SGA) birth weight in pregnancy complicated by type 1 diabetes mellitus (T1DM). A prospective observational study on 59 normotensive T1DM pregnant women, assessing maternal PlGF concentrations between the 10th-14th and 22nd-25th weeks of gestation. Number of SGA vs. non-SGA newborns was 11 (18.6%) vs. 48 (81.4%), respectively. First trimester PlGF serum concentrations (pg/mL) were similar between SGA vs. non-SGA groups [data given as median (interquartile range)]: 65.5 (35.58-159.20) vs. 68.23 (11.59-150.03), respectively; P=0.44. A trend for lower PlGF concentrations was observed in the second trimester in the SGA vs. non-SGA group: 63.34 (12.79-119.16) vs. 116.75 (33.93-235.82); P=0.07. In the SGA group, PlGF concentrations did not differ between the first and the second trimester: 65.5 (35.58-159.20) vs. 63.34 (12.79-119.16), respectively; P=0.36. In the non-SGA group, PlGF concentrations were significantly higher at the gestational age of 22-25 weeks compared to 10-14 weeks [116.75 (33.93-235.82) vs. 68.23 (11.59-150.03); P=0.03). Decreased PlGF serum concentration in mid-pregnancy, as well as a lack of physiological increase in PlGF levels between early and mid-gestation, may precede development of SGA in women with T1DM.
Paweł Gutaj; Ewa Wender-Ożegowska; Rafał Iciek; Agnieszka Zawiejska; Marek Pietryga; Jacek Brązert. Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus. Journal of Perinatal Medicine 2014, 42, 629 -33.
AMA StylePaweł Gutaj, Ewa Wender-Ożegowska, Rafał Iciek, Agnieszka Zawiejska, Marek Pietryga, Jacek Brązert. Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus. Journal of Perinatal Medicine. 2014; 42 (5):629-33.
Chicago/Turabian StylePaweł Gutaj; Ewa Wender-Ożegowska; Rafał Iciek; Agnieszka Zawiejska; Marek Pietryga; Jacek Brązert. 2014. "Maternal serum placental growth factor and fetal SGA in pregnancy complicated by type 1 diabetes mellitus." Journal of Perinatal Medicine 42, no. 5: 629-33.
Diabetes is one of the most frequent chronic diseases in women of childbearing age, which significantly increases the risk of complications at every stage of pregnancy.
Paweł Gutaj; Agnieszka Zawiejska; Ewa Wender-Ożegowska; Jacek Brązert. Maternal factors predictive of first?trimester pregnancy loss in women with pregestational diabetes. Polish Archives of Internal Medicine 2013, 123, 21 -28.
AMA StylePaweł Gutaj, Agnieszka Zawiejska, Ewa Wender-Ożegowska, Jacek Brązert. Maternal factors predictive of first?trimester pregnancy loss in women with pregestational diabetes. Polish Archives of Internal Medicine. 2013; 123 (1):21-28.
Chicago/Turabian StylePaweł Gutaj; Agnieszka Zawiejska; Ewa Wender-Ożegowska; Jacek Brązert. 2013. "Maternal factors predictive of first?trimester pregnancy loss in women with pregestational diabetes." Polish Archives of Internal Medicine 123, no. 1: 21-28.
Ewa Wender-Ozegowska; Katarzyna Ożegowska; Paweł Gutaj. Hormonalna terapia zastępcza a cukrzyca. Menopausal Review 2013, 1, 63 -68.
AMA StyleEwa Wender-Ozegowska, Katarzyna Ożegowska, Paweł Gutaj. Hormonalna terapia zastępcza a cukrzyca. Menopausal Review. 2013; 1 (1):63-68.
Chicago/Turabian StyleEwa Wender-Ozegowska; Katarzyna Ożegowska; Paweł Gutaj. 2013. "Hormonalna terapia zastępcza a cukrzyca." Menopausal Review 1, no. 1: 63-68.
Jerzy Sowiński; Leszek Czupryniak; Andrzej Milewicz; Alicja Hubalewska-Dydejczyk; Malgorzata Szelachowska; Marek Ruchała; Andrzej Lewinski; Maria Górska; Katarzyna Siewko; Ewa Wender-Ożegowska; Dorota Zozulinska-Ziolkiewicz; Roman Junik; Nadia Sawicka; Paweł Gutaj; Polish Society Of Endocrinology; Polish Diabetes Association. Recommendations of the Polish Society of Endocrinology and Polish Diabetes Association for the management of thyroid dysfunction in type 1 and type 2 diabetes. Endokrynologia Polska 2013, 64, 1 .
AMA StyleJerzy Sowiński, Leszek Czupryniak, Andrzej Milewicz, Alicja Hubalewska-Dydejczyk, Malgorzata Szelachowska, Marek Ruchała, Andrzej Lewinski, Maria Górska, Katarzyna Siewko, Ewa Wender-Ożegowska, Dorota Zozulinska-Ziolkiewicz, Roman Junik, Nadia Sawicka, Paweł Gutaj, Polish Society Of Endocrinology, Polish Diabetes Association. Recommendations of the Polish Society of Endocrinology and Polish Diabetes Association for the management of thyroid dysfunction in type 1 and type 2 diabetes. Endokrynologia Polska. 2013; 64 (1):1.
Chicago/Turabian StyleJerzy Sowiński; Leszek Czupryniak; Andrzej Milewicz; Alicja Hubalewska-Dydejczyk; Malgorzata Szelachowska; Marek Ruchała; Andrzej Lewinski; Maria Górska; Katarzyna Siewko; Ewa Wender-Ożegowska; Dorota Zozulinska-Ziolkiewicz; Roman Junik; Nadia Sawicka; Paweł Gutaj; Polish Society Of Endocrinology; Polish Diabetes Association. 2013. "Recommendations of the Polish Society of Endocrinology and Polish Diabetes Association for the management of thyroid dysfunction in type 1 and type 2 diabetes." Endokrynologia Polska 64, no. 1: 1.
Paweł Gutaj; Ewa Wender-Ozegowska; Urszula Mantaj; Agnieszka Zawiejska; Jacek Brazert. [Maternal body mass index and gestational weight gain and their association with perinatal outcome in women with gestational diabetes]. Ginekologia Polska 2011, 82, 1 .
AMA StylePaweł Gutaj, Ewa Wender-Ozegowska, Urszula Mantaj, Agnieszka Zawiejska, Jacek Brazert. [Maternal body mass index and gestational weight gain and their association with perinatal outcome in women with gestational diabetes]. Ginekologia Polska. 2011; 82 (11):1.
Chicago/Turabian StylePaweł Gutaj; Ewa Wender-Ozegowska; Urszula Mantaj; Agnieszka Zawiejska; Jacek Brazert. 2011. "[Maternal body mass index and gestational weight gain and their association with perinatal outcome in women with gestational diabetes]." Ginekologia Polska 82, no. 11: 1.
Ewa Wender-Ozegowska; Pawel Gutaj; Urszula Szczepanek; Katarzyna Ozegowska; Agnieszka Zawiejska; Jacek Brazert. [Influence of pregnancy planning on obstetrical results in women with pregestational diabetes mellitus]. Ginekologia Polska 2010, 81, 1 .
AMA StyleEwa Wender-Ozegowska, Pawel Gutaj, Urszula Szczepanek, Katarzyna Ozegowska, Agnieszka Zawiejska, Jacek Brazert. [Influence of pregnancy planning on obstetrical results in women with pregestational diabetes mellitus]. Ginekologia Polska. 2010; 81 (10):1.
Chicago/Turabian StyleEwa Wender-Ozegowska; Pawel Gutaj; Urszula Szczepanek; Katarzyna Ozegowska; Agnieszka Zawiejska; Jacek Brazert. 2010. "[Influence of pregnancy planning on obstetrical results in women with pregestational diabetes mellitus]." Ginekologia Polska 81, no. 10: 1.