Importance of the Glycated Hemoglobin Assay in Congolese Women with Polycystic Ovary Syndrome: A Case-Control Study in Kinshasa, DR Congo

Context: Polycystic ovary syndrome (PCOS) is considered a syndrome related to the metabolic syndrome with a high risk for developing diabetes mellitus. The evaluation of the glycated hemoglobin (HbA1c) seems to be an interesting tool to detect states of hyperglycemia that may be associated with this syndrome and to understand her pathophysiology. Aims: The purposes of this study are to determine the profile of HbA1c in Congolese women with PCOS, to determine the frequency of states of hyperglycemia and to assess the impact of this marker on clinical signs on this syndrome. Material and methods: This is a case-control study of 130 Congolese subfertile women;65 with a diagnosis of PCOS and 65 others without PCOS. This is conducted from June 2016 to June 2019 among Congolese women of childbearing age. All these women were recruited at the subfertility outpatient clinic of the University Hospital of UNIKIN as well of the YANGA medical centers in Kinshasa, Democratic Republic of Congo. Sickle cell disease was excluded as also the cases of anemia. HbA1c was assayed via the immunoturbidimetric method and the results interpreted according to the ADA recommendations with a pathological cut-off point ≥ 6.5%. Results: Mean hemoglobin was 11.6 ± 1.2 g/dl (11.5 ± 1.1 g/dl vs. 11.8 ± 1.4 g/dl, P = 0.568). The proportion of diabetics was 1.6% (1.6% vs. 1.5%, P = 0.74). Higher HbA1c values were noted in the PCOS group compared to the control group (7.3% ± 2.1% vs. 5.6% ± 0.6%, P 0.001). The multivariate analysis showed a strong correlation between elevated HbA1c levels and PCOS (OR 14.79 (CI 5.43 - 40.32), P 0.001). In the PCOS group, higher HbA1c values were significantly correlated with a higher socio-economic status (OR 3.38 (1.67 - 8.47), P = 0.018) and with obesity (OR 3.48 IC (1.31 - 7.13) P = 0.029). A perfect, positive and significant linear correlation was found between HbA1c and fasting blood glucose (r = 0.807). 60% of women in the PCOS group had pathological values of HbA1c (≥6.5%)

Seric Calcium and Magnesium in Normal and Pre Eclamptic Pregnant Women: A Case-Control Study in Kinshasa, D R Congo

Goal: The present study aimed to determine the profile of seric calcium and magnesium in pre-eclamptic and eclamptic pregnant women of Kinshasa province in the Democratic Republic of Congo where preeclampsia is characterized not only by a high incidence, but also by a seasonal variation probably related to nutritional intake. Study Design: This is a case-control study that took place during the period from September 2014 to March 2015 in four quaternary and tertiary maternity hospitals in Kinshasa. A total of 113 healthy pregnant women (controls) and 112 pre-eclamptic and eclamptic pregnant women (cases) were included in this study. Seric calcium and magnesium were measured in all these gravidas by the principle of spectrophotometry with a HUMALYSER Primus semi-automaton. Results: The mean age of those gravidas was 26.8 ± 6.3 years (26.7 vs 26.9, p = 0.11). The majority of these gravidas were primiparous. The mean gestational age in both groups was 31.35 ± 0.9 weeks (32.1 vs 30.6, p = 0.21). The average seric calcium value was 4.47 ± 0.23 mEq /L in healthy pregnant women compared to 3.80 ± 0.71 mEq/l in pre-eclamptics (P 0.001). The mean of seric magnesium was 1.56 ± 0.15 mg/dL in healthy pregnant women compared to 1.20 ± 0.41 mg/dL in pre eclamptics (P 0.001). Seric calcium and magnesium values were low in the pre-eclamptic group and lower in the eclamptic group (P 0.001). Conclusion: This study establishes a relationship between the low concentration of seric calcium and magnesium with pre-eclampsia and eclampsia, which could be one of the determinants of the high prevalence and seasonality of the disease in Kinshasa.

The Profile of Glycated Hemoglobin in Non-Diabetic Pregnant Women with Preeclampsia: A Case-Control Study in Kinshasa, the Democratic Republic of Congo

Background: A disturbed glucose metabolism is quite common during pregnancy. It is due to the diabetogenic potential of pregnancy and responsible for many obstetric complications. The glycated hemoglobin is one of the markers used to depict these disorders. Higher concentrations of this marker would be associated with unfavorable results of pregnancy. Objective: To describe the profile of HbA1c in non-diabetic preeclamptic pregnant women and to establish the association between the values of this marker and the maternal and fetal complications. Materials and Method: This is a case-control study of 142 pregnant women in their second and third trimester. They were followed in the maternity hospitals of University Clinics and the General Reference Hospital in Kinshasa, Democratic Republic of Congo between May and October 2019. The sampling of preeclamptic pregnant women was exhaustive. Controls were healthy pregnant women carrying pregnancies of the same type and of the same gestational age as the cases. Ultimately, 71 were preeclamptic and 71 healthy (controls). HbA1c was determined by immunoturbidimetry. Results: A total of 142 pregnant women took part in this study consisting of 71 preeclamptic women (cases) and 71 healthy pregnant women (controls). The average age of these pregnant women was 28.8 ± 6.8 (28.2 ± 6.8 years vs 29.5 ± 6.8 years p = 0.559), with an average parity of 2.3 ± 1.5 (2.2 ± 1.7 vs 2.4 ± 1.2, p = 0.005). The majority were carriers of monofoetal pregnancy. Higher HbA1c values were observed in the preeclamptic pregnant women compared to the controls (5.7 ± 1.3% vs 4.8 ± 0.7%, p 0.001). The proportion of pregnant women with pathological HbA1c values (>5.6%) was also higher in the group of preeclamptic pregnant women (46.5% vs 9.9%, p Conclusion: This study established that 46.5% of non-diabetic pregnant women with preeclampsia have high HbA1c values, which moreover are associated with preeclampsia and its complications. Systematic screening is essential for detecting preeclampsia or diabetes or both.