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Purpose@#Researchers suggest that the prevalence of infertility varies between developing and developed countries, with differences in infertility care, socioeconomic status, lifestyle, and reproductive disorders such as pelvic inflammatory disease and sexually transmitted infections being the main risk factors. The research project aims is to define risk factors for female fertility in the Mongolian population. @*Methods@#This study was conducted between 2016-2018 using a cross-sectional survey of analytical research. Participants were randomly selected from Ulaanbaatar and the Central, Western, Eastern, and Khangai provinces according to Mongolia’s regional geographic model. The contents of a questionnaire were comprised of 5 units with 95 questions including socio-economic, geographical, lifestyle, health education, reproductive health indicators, sexual behavior. General physical characteristics were measured according to the standard. @*Results@#The prevalence of the female fertility rate in the Mongolian population is 7.4%. Female participants were classified into 2 groups, namely infertile and fertile, and we developed a case-control study. Among the socio-economic factors influencing infertility, primary education aOR: 1.6 (95% CI 0.98-2.66), monthly household income lower than the average aOR: 1.1 (95% CI 0.77- 1.66), living in rural areas OR: 2.3 ( 95% CI 1.46-3.68) were crucial risk factors. As for reproductive and general health indicators, STIs aOR: 1.8 (95% CI 0.98-3.50), especially gonorrhea OR: 2.8 (95% CI 1.14-6.91), and thyroid disorders OR: 1.7 (95% CI 1.03). -2.97), grade 3 obesity OR: 3.8 (95% CI 1.05-13.95) are estimated risk factors for infertility.@*Conclusions@#Of all potential socio-economic factors, residence status, education and financial situation are significant for female infertility meanwhile reproductive health indicators include sexually transmitted infections, thyroid disease, and obesity.
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Background@#Thyroid hormone disorders have an adverse effect on human spermatogenesis. Thyroid function has regulated by hypothalamic-pituitary-thyroid axis and thyroid stimulation hormone is a critical measurement of thyroid disorders. This study aimed to investigate the relationship between thyroid stimulating hormone and sperm parameters.@*Methods@#This study has conducted 99 man who have visited RMC and Ojinmed IVF centers. Serum level of thyroid stimulating hormone (TSH) was measured by automated immunoassay analyzer (TOSOH AIA-360, Japan). Semen analysis was done in all the participants and evaluated by World Health Organization’s guidelines(2010). Results were calculated by SPSS 26 program. @*Results@#The average age was 35.2±5.76. The mean serum TSH level was 1.37±0.57 and 1.85±1.16 normal subjects and spermatogenesis dysfunction group, respectively. Furthermore, serum TSH level and sperm parameters were significantly different between two groups (p<0.05). Logistical regression analysis showed that increased TSH level negatively affected the motility (r=-0.28; p<0.05) and progressive motility (r=-0.34;p<0.05) of sperm more than other parameters (r=-0.34; p=0.035). There was no correlation between serum TSH and other sperm parameters. We analyzed binary logistic regression for TSH with spermatogenesis dysfunction in case control groups. According to the analysis, elevation of serum TSH level increases the risk of spermatogenesis dysfunction by 5.0 times (OR=5.06, p<0.05).@*Conclusions@#Subclinical hypothyroidism adversely affect some sperm parameters, including motility and progressive motility. Subclinical hypothyroidism increases the risk of spermatogenesis dysfunction.
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@#BACKGROUND. According to the World Health Organization (WHO), 10-15% of couples of reproductive age have infertility. According to researcher D. Sukhe (1999), hormonal infertility in the reproductive age of women was 33.6%, which was a large part of the cause of infertility. In recent years, the number of cases of endocrine disorders, including malignancy and sexually transmitted infections, have been increasing year by year. According to WHO reports, thyroid disorders have a prevalence of 49.3% among active reproductive age (30-50) group. According to the report of the Health Development Center in 2016, since the thyroid disorders are the second most common disease in endocrine gland disease, our study has found that the infertility in reproductive age of women can be substantial due to the loss of thyroid gland. OBJECTIVE. To study the relationship between the thyroid gland antibodies and female infertility. MATERIAL AND METHODS. The study was carried out in 20-45 year old couples and was modeled as an analytical study model. The questionnaire was used for the couple’s interviews, antroplogical measurements, and serum was analysed. On the serum, anti-TPO and аnti-TG carbohydrates were identified by the Cobas e-411 analyzer under the manufacturer’s accompanying protocol. RESULTS. Prevalence of TAI, in 6.7% positive anti-Tg were found, and 14.3% had positive TPO. In 3.7% of cases, both types of autoantibodies were present. We analysed binary logistic regression for anti-TPO and anti-TG autoantibody in the positive and negative group in relation to the past obstetrics history. A=Accoding to the analysis, evidence of positive anti-TPO and anti-Tg increased the risk of miscarriage by 2.2 times (OR = 2.2, p <0.01). CONCLUSION: Women with infertility in our study have high percentage of subclinical hypothyroidism and have higher rate of thyroid autobodies in serum which could be a problem for women with infertility and pregnancy complications due to the loss of thyroid gland. Thus, there is a need to develop intervention guidelines for recovery and treatment of these types of infertility.
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@#BACKGROUND. According to the International osteoporosis foundation, the incidence of osteoporose in men is increasing rapidly. Some investigations mention the serum testosterone hormone decreases by aging and may cause of osteoporose. Our study was aimed to evaluate relation between serum total testosterone and bone mineral density in men. MATEREALS AND METHOD. Relatively healthy 624 men aged between 18-87 were randomly selected from Mongolian 4 provinces and Ulaanbaatar city. Specially designed questionnaire was used in the survey. And some of measurement, Weight, height and BMI, was measured. Bone mass density was diagnosed according to the WHO criteria by the T-score. Serum total testosterone level were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the laboratory of MHI.The statistical result was analyzed by SPSS 22 program. RESULTS. The subjects mean age was 48.56±16.63, with a range of 18-87. The mean SOS was -4055.23±228.89. And the osteoporse was 14.6% (n=91) in all of participants. 152 participants were randomly selected from all participants and classified 2 groups(case and control) according to WHO osteoporosis criteria and evaluated relation between serum total testosterone and bone mineral density. The mean of serum total testosterone level was significantly low (8.80±2.67) in case group than (9.33±2.44) control group (p<0.05). Our study showed that positive correlation between bone mass density values at testosterone hormone (r=0.17 p<0.034). CONCLUSION. Our study showed decreased serum total testosterone hormone affected to decrease of bone mineral density.
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@#BACKGROUND: According to the World Health Organization (WHO), 10-15% of couples of reproductive age have infertility. According to researcher D. Sukhe (1999), hormonal infertility in the reproductive age of women was 33.6%, which was a large part of the cause of infertility. In recent years, the number of cases of endocrine disorders, including malignancy and sexually transmitted infections, has been increasing year by year. According to WHO reports, thyroid disorders have a prevalence of 49.3% for active reproductive age (30-50). According to the report of the Health Development Center in 2016, since the thyroid disorders are the second most common disease in endocrine gland disease, our study found that the infertility in reproductive age of women can be substantial due to the loss of thyroid gland. METHODS: The study was carried out by the couple of 20-45 year-olds and modeled as an analytical study model. The questionnaire was used for the couple’s interviews and some of the measurement of body and serum use of TOSOH Corporation AIA-360, Tokyo, Japan. On the serum, anti-TPO and аnti-TG carbohydrates are identified by the Cobas e-411 analyzer under the manufacturer’s accompanying protocol. RESULTS: 76.7% of women were diagnosed with infertility euthyroid, 0.7% hyperthyroidism, 22.6% hypothyroidism (3.8% with overt hypothyroidism and 18.8% subclinical hypothyroidism). Prevalence of TAI, in 6.7% isolated positive anti-Tg were found, and 14.3% had isolated positive TPO, In 3.7% of cases, both types of autoantibodies were present. We analysed binary logistic regression for anti-TPO and anti-TG autoantibody in the positive and negative group in past obstetrics history, evidence of positive of anti-TPO and anti-Tg was increased risk of miscarriage 2.2 times (OR = 2.2, p <0.01). CONCLUSIONS: Women with disorders in our study have high percentage of subclinical hypothyroidism and have higher rate of thyroid autobodies in serum which may be a problem for women with infertility and pregnancy complications due to the loss of thyroid gland. There is a need to develop a principle of recovery and treatment.
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@#BACKGROUND. 2.3 billion Individuals have latent TB infection(LTBI), up to 10 million new cases of TB arise and killing nearly 2 million individuals around this globe, annually [1,2]. In Mongolia, tuberculinskin test is used to detection of mycobacterial infection, which has many disadvantages. Interferon gamma release assay (IGRA, QFT-G), a method advised by WHO, is the most reliable detection of latent infection. If we can detect LTBI in childhood, it is possible to prevent from active TB decreasing prevalence in the future. That is why it is important to screen the LTBI among children. GOAL: To estimate the prevalence of LTBI among 6-13 age children and to define the LTBI risk factors. Methods: We enrolled 9126 children for our study, indicating a possible estimation for LTBI prevalence among 6-13 age children in Ulaanbaatar city. Under ethical permission, our study was performed, as well as the consent of parents and children. We determined the LTBI by using QFT-G. We took a questionnaire about a socio-economic status, a history of TB contact and also conducted anthropometric measurements in all participants. The study design was a descriptive, cross-sectional and a case-control which based on QFT-G results. SPSS version 20.0.0 was used for statistical analyses. RESULTS: Regardingthe QFT-G test, 8214(90%) number of children were negative, 908 (10%) were positive, 4 (<0.1%) samples were indeterminable. There were statistically significant differences between control and case group in some questionnaire of socio-economic status. No significant difference was seen between two groups in all anthropometric measurements. In multinomial logistic regression, a tuberculosis contact, a household type, and passive smoking were identified as independent LTBI risk factors (p<0.01). CONCLUSIONS: The LTBI prevalence is high (10%) in school-age children living in Ulaanbaatar. It has increased at 6-13 age (p<0.05). Several important risk factors for LTBI in school age children elicited. Most powerful risk factors were tuberculosis contact (p<0.001), type of residence (p<0.05) and passive smoking (p<0.001).
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Osteoporosis is a disease in which the density of bone is decreased with consequent increase in bone fragility and susceptibility to fracture risk. Vitamin D deficiency may cause secondary hyperparathyroidism and low bone mineral density. Our study was aimed to assess relation between vitamin D status and parathyroid hormone and bone density in adults. Relatively healthy 369 participants aged between 20-60 were randomly selected from Ulaanbaatar city. Specially designed questionnaire was used in the survey. Bone mass density was diagnosed according to the WHO criteria by the T-score. Respondents serum calcium and phosphorus levels were described by the fully automated analyzer (Cobas Integra 2800, Germany). Serum parathyroid hormone and 25-hydroxivitamin D levels were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the Molecular biology laboratory of MNUMS.The statistical result was analyzed by SPSS 21 program. The subjects mean age was 47.61±12.92, with a range of 20-83. The mean T-score was -0.60±2.17. Our study showed that negative correlation between bone mass density values at parathyroid hormone (r=-0.58, p<0.05), 25-hydroxyvitamin D (r=-0.48, p<0.05) and serum calcium (r=-0.21, p<0.05). Our study showed increased serum parathyroid hormone led the releasing calcium from bone and decreasing bone mass density.
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IntroductionOsteoporosis is becoming an increasingly important economic and public health problem as ourpopulation ages. Different results are reported about osteoporosis rate among various geographicalzones and ethnic groups even in same country. These differences cannot be attributed to hormonalstate or to the dietary intake of calcium, but do accord in general with the living standards of the differentcountries and the degree of physical activity undertaken by the different populations and sexes.GoalTo determine the osteoporosis rate among Mongolian adults and evaluate the geographical distributionsof osteoporosis rateMaterials and MethodsOur study group was 1990 adults who are over 18 years and participated from Uvs, Arkhangai, Dundgovi,Sukhbaatar province and Ulaanbaatar. We have evaluated serum PTH, 25-hydroxyvitamin D level andbone mineral density via bone sonometer (Sunlight Mini-Omni, Beammed, USA). Lifestyle risk factorswere evaluated through a specific questionnaire.ResultsThe osteoporosis rate is 25.5% (n=507) among Mongolian adults and 2 times higher in women thanmen in all age group. SOS was inversely correlated with age in both sexes (men: r=-0.286, p<0.01,women: r=-0.513, p<0.01). Osteoporosis rate was lowest in Ulaanbaatar but highest in Arkhangai(male osteoporosis) and Dundgovi province (female osteoporosis). Of 25-hydroxyvitamin D values 29%were below 20ng/ml (deficient), 39.8% ranged from 20-29.9ng/ml (insufficient) and 31.2% were above30ng/ml (sufficient). In addition, 25-hydroxivitamin D concentrations were not related to bone density.Serum 25-hydroxivitamin D level was highest in Dundgovi province in both sexes. Mean PTH level was26.0±17.7pg/ml and inversely correlated with T-score (r=-0.248, p<0.01) in men.ConclusionOsteoporosis rate among Mongolian adult is lowest in Ulaanbaatar comparing to other rural areas. Andserum 25-hydroxivitamin D deficiency is 68.8% in Mongolian adults.
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Kidney transplantation is the best alternative treatment for end-stage renal disease and health-related quality of life and survival of the patients are improved compared with dialysis. Worldwide, more than 1.4 million patients with CKD receive renal replacement therapy with incidence growing by approximately 8% annually.1 Unfortunately, despite significant improvement in graft function, kidney transplants can still fail due to acute rejection and chronic allograft nephropathy.2 Kidney biopsy after transplantation, which has evaluated by Banff 09 classification is usefull method for diagnose of transplanted kidney disease.3,4Kidney graft rejection was diagnosed in 10 renal allograft biopsy specimens (bs) obtained from transplant patients followed up at our institute between 2015 and 2016. All specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgA, IgM, IgG and complement component (C3, C4, C1q, C4d). All the renal biopsies were examined by the same pathologist.Out of 117 transplantations, 10 episodes of rejection selected. Among the 10 patients, 30% had an acute T cell rejection and 70% had a chronic allograft nephropathy. Interstitial inflammation (i1-7) was present in 7 bs (70%), tubulitis (t1-4,t2-2) in 6 bs (60%), transplant glomerulitis (g1-1, g2-2, g3-1) in 4 bs (40%), transplant interstitial fibrosis (ci1-2, ci2-2, ci3-2) in 6 bs (60%), tubular atrophy (ct1-6, ct2-2, ct3-1) in 9 bs (90%), mesangial matrix increase (mm1-5) in 5 bs (50%), vascular fibrosis intimal thickeness (cv1-3) in 3 bs (30%), arteriolar hyaline thickening (ah1-5) in 5 bs (50%), tubulitis (ti1-6, ti2-3, ti3-1) in 10 bs (100%) and peritubular capillaritis (ptc1-1, ptc2-2, ptc3-1) in 4 bs (40%). C4d deposition was present very mild in wall of the vessels and peritubular capillaries. Because of not good working Methenamin silver stain, we couldn’t demostrate glomerular basement membrane changes (cg) fully.We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis. C4d deposition in the wall of the vessels and peritubular capillaritis is not always present in biopsy specimens of transplant glomerulopathy.
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The burden of endocrine disorders, especially thyroid and women reproductive gland dysfunction and its related disease numbers are rapidly increasing for the recent years. Determining prevalence of thyroid disease among population with serum TSH level, primary hypothyroidism is more common than secondary hypothyroidism (1000:1) for all age and gender. In the statistical report of Center for Health Development in 2013, there were 2615 female patients with thyrotoxicosis (E05) registered which more than 531 female patients with hypothyroidism (E00-E02). Therefore, we studied bone mineral density changes due to thyroid dysfunction in female patients. Ovarian dysfunction and irregular menstrual period during hypothyroidism can cause of sexual dysfunction and infertility. Early screening, right diagnosis and treatment for hypothyroidism can prevent from infertility caused by thyroid dysfunction.We used a hospital-based case-control study design. In the study 90 reproductive age (15-49) female patients were participated. 60 of them were evaluated as relatively healthy patients and 30 of them were diagnosed by laboratory test with hypothyroidism. Serum level of TSH, fT3, fT4, estradiol and progesterone (TSH, fT3, fT4, E2, P4 TOSOH Corporation, Tokyo, Japan) were evaluated by ELISA. The ovarian function was evaluated by ultrasound (Hitachi alokа-Prosound alpa F37, Japan) and ovarian follicle numbers were counted at the 3-5th and 10-15th day of menstruation cycle.Total 90 patients ranging 24-46 years old (average age was 33.4±5.7 in control group, 35.5±6.1 in hypothyroid group) were participated. Comparison of fT3 and fT4 average level between control (fT3 2.47±0.34 pg/ml, fT4 1.23±0.19 ng/dL) and hypothyroid group (fT3 2.48±0.31 pg/ml, fT4 1.07±0.14 ng/dL), fT3 wasn’t statistically relevant (p>0.05) but, fT4 was statistically relevant (p0.05). Comparison of estradiol and progesterone average level between hypothyroid group (estradiol 185.4±54.7pg/ml and progesterone 0.8±0.6 pg/ml) and control (estradiol 224.6±76.8 pg/ml and progesterone 0.8±0.5 pg/ml) at the 10th day of menstrual cycle, in the ovarian follicle phase, were statistically relevant (p0.05). The ovarian dominant follicle size was 16.2±2.5 mm in the hypothyroid group and 17.6±2.1 mm in the control group. The dominant follicle size have statistical relevance as 2 groups (p<0.01). Comparison of estradiol and progesterone average level between control (estradiol 139.8±42.9 pg/ml and progesterone 15.0±4.1 pg/ml) and hypothyroid group (estradiol 158.9±75.2 pg/ml and progesterone 12.1±5.3 pg/ml) in the lutein body phase, serum progesterone level was decreased during hypothyroidism (p<0.01). The increased serum level of fT4 can expand serum fT3 as well (r=0.218, p=0.039). The increased serum TSH was inversed correlation to fT4 (p<0.01, r= -0.420). The increased serum TSH was inversed correlation to progesterone (P<0.05, r= -0.234). Ovarian follicle size are direct correlation to increased serum estradiol (r=0.507, p<0.01).The serum TSH level were extremely increased during hypothyroidism (p<0.001). Serum female hormone level was decreased depending on the fT3, fT4 and TSH level for patients with hypothyroidism.
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Osteoporosis is a disease in which the density of bone is decreased with consequent increase in bone fragility and susceptibility to fracture risk. Vitamin D deficiency may cause secondary hyperparathyroidism and low bone mineral density. Our study was aimed to assess relation between vitamin D status and parathyroid hormone and bone density in adults.Relatively healthy 369 participants aged between 20-60 were randomly selected from Ulaanbaatar city. Specially designed questionnaire was used in the survey. Bone mass density was diagnosed according to the WHO criteria by the T-score. Respondents serum calcium and phosphorus levels were described by the fully automated analyzer (Cobas Integra 2800, Germany). Serum parathyroid hormone and 25-hydroxivitamin D levels were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the Molecular biology laboratory of MNUMS.The statistical result was analyzed by SPSS 21 program.The subjects mean age was 47.61±12.92, with a range of 20-83. The mean T-score was -0.60±2.17. Our study showed that negative correlation between bone mass density values at parathyroid hormone (r=-0.58, p<0.05), 25-hydroxyvitamin D (r=-0.48, p<0.05) and serum calcium (r=-0.21, p<0.05).Our study showed increased serum parathyroid hormone led the releasing calcium from bone and decreasing bone mass density.
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Coronary heart disease is a leading cause of mortality in many countries. Acute coronary syndrome is the basis pathophysiology of coronary heart disease. Complication of coronary atherosclerosis composes rupture of plaque and erosion of vulnerable plaque. Endothelial dysfunction is main influence of coronary plaque erosion. But then recently research oxidative stress and reaction of immunocomplex is leading cause of coronary plaque rupture. So the research background will study markers of endothelial dysfunction, oxidative stress, immune reaction in the complication of coronaryatherosclerosis. Aim: Determine the effect of some marker for causing complication of the coronary atherosclerosis. The research has been conducted using case-control study method. In the case group, patients with complication of the coronary atherosclerosis as determined by coronary angiography (stenosis >85%) as in the control group healthy people with carotid artery stenosis (<0.7mm) has been involved. In the study we defined Anti-oxLDL (anti-oxidized low density lipoprotein) using ELISA Kit (Eucardio Lab, USA) and oxLDL (oxidized low density lipoprotein) titer by ELISA Kit (Mercadio, USA), ADMA (Asymmetric dimethylarginine) titer by ELISA kit (Eucardio Lab, USA) reagents in the enzyme binding reaction. Total antioxidant capacity (TAC) was determined by using spectrophotometer method. The average age of people involved in the research is 57.2±9.72 and for the average age is case group 28 (32%) and 50 (68%) for the control group. ADMA titer level for complication of coronary atherosclerosis or case group is (30.1±1.98 ng/ml) which is (13.2±0.57 ng/ml) greater than the control group. It was statistically significant result (p<0.001). Also titer level for case group is oxLDL (72±2.75 mU/l), anti-oxLDL antibody (766±29.8 mU/ml), which is oxLDL (45.1±2.28 mU/l), anti-oxLDL antibody(603±17.74 mU/ml) greater than the control group. It was statistically significant result (p<0.001). But TAC titer level for control group is (116±2.47 nmol/l) which is (108.3±5.43 nmol/l) greater than the case group. It was not statistically significant result (p=0.098). According to the Binary Logistic Regression test the anti-oxLDL (OR=0.992, p<0.001), ADMA (OR=0.681, p<0.001), TAC (OR=1.017, p=0.105), oxLDL (OR=0.900, p<0.001) levels significantly influence the complication of coronary atherosclerosis. Therefore according to the Binary Logistic Regression test the anti-oxLDL level high significantly influence the complication of coronary atherosclerosis. Anti-oxLDL antibody titer are correlated directly with oxLDL (r=0.413, p<0.01), ADMA (r=0.42, p<0.001) levels. However, correlated negative directly with TAC (r=-0.233, p<0.01) level. Markers of endothelial dysfunction (ADMA OR=0.681, p<0.001) and oxidative stress (oxLDL, OR=0.900, p<0.001), (anti-oxLDL antibody, OR=0.992, p<0.001) high influence causing of complication of coronary atherosclerosis.
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Cardiovascular diseases (CVD) are the leading cause of death in the World (31% of all deaths)and Mongolia as well. CVD has been the leading cause of death in Mongolia for the last 20 years and consists one of 3 death cases. In its turn 59.6% of CVD mortality caused by Ischemic heart diseases. When the coronary atherosclerotic plaque becomes vulnerable, it will a thrombus develops on that ruptured plaque and then occludes the coronary artery, which causes acute blood deficiency in the downstream myocardium. Some studies indicate that matrix metalloproteinase-9 (MMP-9) plays a key role on pathogenesis of plaque rupture. Aim:To study the involvement of serum MMP-9 enzyme in the pathogenesis during the rupture of the coronary atherosclerosis plaque.The study was conducted using case-control design. The main inclusion criteria of the case group is that the patient should have a ruptured coronary atherosclerotic plaque, confirmed by angiography. The total number of patients is 80, half of them belongs to the case group. MMP-9 was determined in serum by ELISA. We used CIIS (cardiac infarction injury score) by ECG and Gensini score system (Coronary Angiographic Scoring System) for assessing the severity of coronary heart disease.The average level of MMP-9 in case and control groups are 0.396±0.155 ng/ml, 0.223±0.087 ng/ ml respectively with p75%) stenosis (0.317±0.132 ng/ml), 2 vessel severe stenosis (0.348±0.157 ng/ml), 3 vessel severe stenosis (0.422±0.112 ng/ml). Furthermore, serum MMP-9 enzyme increases with accordance of severity of the myocardium injury with the statistical significance (p15, 0.376±0.132 ng/ml) group. MMP-9 levels were significantly higher in the probable injury (CIIS >15) patients compared to the possible injury (CIIS 10-15) patients (p < 0.001). An increase in serum MMP-9 enzyme levels is a risk factor of the coronary atherosclerotic plaque rupture (OR=0.001, p<0.001). MMP-9 enzyme may be a possible marker of atheromatous plaque rupture in coronary heart disease.
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Background. When the coronary atherosclerotic plaque becomes vulnerable, a thrombus develops on that ruptured plaque and then occludes the coronary artery, which causes an acute blood defi ciency in the downstream myocardium. Furthermore oxLDL (oxidized Low Density Lipoprotein) is involved in the coronary atherosclerotic plaque pathogenesis, MMP-9 (Matrix Metalloproteinase-9) enzymes plays role during the plaque rupture and CPR (C Reactive Protein) has a prognostic value in myocardial infarction. Objective. To determine the involvement of oxLDL, MMP-9, CRP markers in the pathogenesis of myocardial infarction, to study their involvement in the injury of the myocardium and to evaluate the complications. Material and Methods. The study was conducted using case-control design. The main inclusion criteria of the 40 case groups are that the patient should have a ruptured coronary atherosclerotic plaque, confi rmed by clinical symptom, ECG, serum troponin I, and coronary angiography. Also 40 patients with coronary stenosis or chronic occlusion without ruptured plague were included in the control group. Serum MMP-9 enzyme and oxLDL titers were determined by ELISA according to the manufacturer’s recommended protocol. Additionally CRP was measured by full-automated analyzater. We used CIIS (cardiac infarction injury score) by ECG and Gensini score system (Coronary Angiographic Scoring System) for assessing the severity of coronary heart disease. Results. Serum MMP-9, oxLDL levels (p15, 0.376±0.132 ng/ ml) groups. MMP-9 levels were signifi cantly higher in the probable injury group patients (CIIS >15) compared to the possible injury group patients (CIIS 10-15) (p<0.001). ROC Curve analysis shows that MMP-9 enzyme levels variance (area=0.87, p<0.001) are more than other biomarkers making it a diagnostically benefi cial for the coronary atherosclerotic plaque rupture (CRP area=0,733, p<0.001, oxLDL area=0.635, p<0.05). Conclusion: Serum MMP-9, oxLDL and CRP are signifi cantly involved in the pathogenesis of coronary atherosclerotic plaque rupture in the myocardial infarction.
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Background Systemic Lupus Erythematous (SLE) is a multi-systemic autoimmune disease with numerous patterns of clinical and immunological manifestations. Renal disease in SLE occurs in 40–75% of patients, most often within five years of disease onset, and is one of the strongest predictors of a poor outcome. Anti-dsDNA antibodies are reported to be more prevalent in patients with SLE who have renal disease. Anti-Sm, anti SSA and anti SSB antibodies are also considered to play a pathogenic role in inducing renal symptoms in SLE, and a strong correlation has been seen in lupus nephritis (LN) between disease activity and anti-dsDNA antibody levels. Objective The aim of our study is to highlight the clinical and laboratory features in SLE patients. Methods This is a three year hospital based case-control study of patients with renal diseases, who were admitted to the nephrology and rheumatology units of the 1st central Hospital and 3rd central hospital, Mongolia. Standard methods were used for laboratory testing. Autoantibodies (C/P-ANCA, anti-dsDNA, anti-Sm, anti-SS-A/Ro, anti-SS-B/La, anti-Scl-70, anti-GBM) measured by Enzyme Immuno Assay (Germany, ORGENTEC Diagnostika GmbH). Renal function was evaluated by the eGFR (estimated glomerular filtration rate) using the Cockcroft-Gault formula. Result The study included 27 patients with lupus nephritis and 78 controls with other types of GN. There were 85.2% of female patients in the lupus nephritis group. Patients with LN were significantly younger than the controls (mean (SD) 31.9 (10.1) years vs. 37.1 (11.9) years; p=0.036). For the serology, a higher proportion of anti dsDNA (46.1%), anti Sm (29.6%), anti SSA (63%) and anti SSB (11.1%) were seen in the group with lupus nephritis (p=0.001; p=0.043; p<0.0001; p=0.096, respectively). The Pearson’s correlation analysis indicated that the level of anti-dsDNA (r=-0.249, p=0.021) and anti SSA (r=-0.195, p=0.048) were significantly correlated with the renal function (eGFR). All had dipstick proteinuria 1+/2+/3+, more than 10 red blood cells/hpf hematuria (n-12, 44.4%) in lupus nephritis group and renal function (mean eGFR (SD) 88.1 (51.3) ml/min vs. 112.3 (67) ml/min; p=0.05) was more decreased in lupus nephritis patients than controls. Conclusion Notably, rising titers of antibodies to dsDNA, SSA may indicate exacerbations of glomerulonephritis.
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IntroductionStudies on structure and function of reproductive system of experimental animal by developing coldstress model have been getting attractions from researchers. The study on changes of reproductive system of offspring from experimental animal which had cold stress has been done in recent times.GoalCold stress modeling in female experiment rats and, identifying the changes of stages of estrous cycleand reproductive hormone.Materials and MethodsIn order to identify stages of changes of reproductive hormone of experiment female rat which is model of cold stress, 90 Wistar breeding rats weight of 170-178 g were divided into following 6 groups:Non-gravid control group–15, gravid control group–15, non-gravid group for cold stress–15:15:15, gravid group for cold stress–15. Pathologic cold stress was modeled in 15:15:15 rats of non-gravid group for cold stress by putting in fridge everyday between 8 to 11 o’clock for 7:14:21 days and in 15 rats of gravid group for cold stress by putting in fridge (-150) every day between 8 to 11 o’clock for 28 to 30 days (Avcina AP(1989), Melovanov АP(1991)). Time to vaginal opening was determined to use method of Volkova OB in offspring of gravid experiment rats and control group after 2 months. After that selected 15 female offspring were put to sleep with ether and taken blood of 4-5 ml from their hearts and compared the amount of estradiol and progesterone in that blood using rat kits of Ausmausco Pharma with control group.Result Determining hormone level in blood of control group, estradiol is 4.73±0.45ng/l, progesterone is 2, 45±0,50ng/l. After a week pathologic cold stress was modeled in rats, estradiol is determined 3.93±0.70ng/l, progesterone is determined and after 2 weeks, estradiol is 4.0±0.53ng/l, progesterone is 1.97ng/l and after 3 weeks, estradiol is 3,8±0,63ng/l, progesterone is 1,94±0,09ng/l Birth weight of offspring from gravid rats with cold stress, was 1,6g (р=0,001) less than control group.Time to vaginal opening of offspring was 14 days later than control group. Determining hormone of control group offspring, estradiol is 4.53±0.51ng/l, progesterone is 2,39±0,40ng/l. Estradiol is 3.73±0,59.ng/l, progesterone is determined 1.97±0.07ng/l in offspring of gravid experiment rats.Conclusion: 1. When develop cold stress model, gravid rats had miscarriage and preterm delivery and born low birth-weight offspring in 16-22 days of experiment and this reveals that pathologic changes occurred in sexual hormonal regulation of 3 groups of non-gravid rats of experiment because of cold stress. 3. In offspring from gravid rats which had cold stress time of vaginal opening was lengthened and estradiol and progesterone level was decreased in offspring from gravid rats and
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To measure hardness of bone density, and study its relationship with serum calcium, phosphorus, Calcitonin levels and urine calcium level.Pre-designed questionnaire is used to reveal any risk factors associated with osteoporosis and also BMI is evaluated based on measurements of weight, height, bust and waist circumference. Study participants were measured their bone mass density of wrist and shin by ultrasound ( Sunlight MiniOmni, Beammed, USA). Serum calcium and phosphorus levels were analyzed by automatedbiochemical analyzer, Integra 800, according to the adhered protocol to the machine. New, clean urine containers were distributed to participant a day before urine test day and middle part of urine is collected into the container. The urine calcium level was analyzed by automated biochemical analyzer, Cobas Integra 800, according to the machine protocol. Calcitonin level was analyzed by ELISA kit by Eu cardio company of United States.Total of 80 people ages 26 to 87 from Ulaanbaatar were participated for this study. 29 (36.3%) ofthem were males whereas, 51 (63.8%) of them were females. Serum calcium average level was2.0+-0.2mmol/L, serum phosphorus average level was 0.8+-0.1mmol/L while urine calcium level was 3.9+-2.5mmol/L. According to our result, bone mass density was related to age (r=-0.495), serum calcium level has statistically important relationship (p<0.05) with bone mass density (r=-0.326), age(r=0.277), serum phosphorus (r=0.351), and urine calcium level (r=-0.316). Measurement above did not have statistically important relationship with Calcitonin level.Osteoclast might be dominating in osteoporosis since bone mass density is decreasing while serum calcium level is increasing along with aging.
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As the proportion of aged population has been increasing worldwide by the rapid development of socio-economy, health science, and educational level that affect the policy against health service and social welfare, one of the urgent issues of Mongolian society and medical science facing is to develop healthy aging process and prevention of pathological aging. As we know, healthy aging process depends upon several factors such as heritage, biological and physiological internal factors, living condition, climate, geography, socio-economy, nutrition, drinking water, lifestyle etc,. Thus, the development of healthy aging and its influential factors is an immediate issue of Mongolian medicine and society.A cross-sectional regression analysis has been used to measure socioeconomic and physiological factors for longevity. Total of 1897 participants aged less than 80 are randomly collected from Ulaanbaatar city and Mongolian 4 regions.Total of 1897 participants, less than 80 years old are involved in this study. People in an urban area are higher than those in countryside. About housing condition, 63.5% of total participants are in apartment at UB and 37.8% is in House and 44.3% in Mongolian Ger. Estimating participant’s income, 25% of relatively healthy population is below than the minimum of subsistence. However 50% of elderly people aged between 75-80 is below than minimum of subsistence. Comparing income level by age and gender income is decreased while age is increased, males are relatively higher than females. Middle income people are by 20.9%, high income people are by 57.7% less the risky than low income people. Unhealthy status is increased by 1.0% while a year of smoking, LDL by 96.5%, HDL by 94.7%, Triglycerid by 71.2%, CAVI by 91% increase risks respectively.Below indicators are more influential for the healthy aging of Mongolian elderly people as follows, education level (ρ-0.001), household income (OR=0.423, ρ<0.0001), living conditions (OR=0.326, ρ<0.05), LDL (OR=0.035, ρ<0.0001), HDL (OR=0.053, ρ<0.0001), glucose (OR=0.014, ρ<0.0001), CAVI (OR=0.090, ρ<0.0001). Higher density of healthy aged populations is found in the central region of Mongolia where altitude is 1000-1500 meters above than sea level (MASL) and temperature is between 0-6 Celsius.
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Coronary heart disease is a leading cause of mortality in many countries. Acute coronary syndrome is the basis pathophysiology of coronary heart disease. Complication of coronary atherosclerosis composes rupture of plaque and erosion of vulnerable plaque. Endothelial dysfunction is main influence of coronary plaque erosion. But then recently research oxidative stress and reaction ofimmunocomplex is leading cause of coronary plaque rupture. So the research background will study markers of endothelial dysfunction, oxidative stress, immune reaction in the complication of coronaryatherosclerosis. Aim: Determine the effect of some marker for causing complication of the coronary atherosclerosis.The research has been conducted using case-control study method. In the case group, patients with complication of the coronary atherosclerosis as determined by coronary angiography (stenosis >85%) as in the control group healthy people with carotid artery stenosis (<0.7mm) has been involved. In the study we defined Anti-oxLDL (anti-oxidized low density lipoprotein) using ELISA Kit (Eucardio Lab, USA) and oxLDL (oxidized low density lipoprotein) titer by ELISA Kit (Mercadio, USA), ADMA (Asymmetric dimethylarginine) titer by ELISA kit (Eucardio Lab, USA) reagents in the enzyme binding reaction. Totalantioxidant capacity (TAC) was determined by using spectrophotometer method. The average age of people involved in the research is 57.2±9.72 and for the average age is case group 28 (32%) and 50 (68%) for the control group. ADMA titer level for complication of coronaryatherosclerosis or case group is (30.1±1.98 ng/ml) which is (13.2±0.57 ng/ml) greater than the control group. It was statistically significant result (p<0.001). Also titer level for case group is oxLDL (72±2.75 mU/l), anti-oxLDL antibody (766±29.8 mU/ml), which is oxLDL (45.1±2.28 mU/l), anti-oxLDL antibody(603±17.74 mU/ml) greater than the control group. It was statistically significant result (p<0.001). But TAC titer level for control group is (116±2.47 nmol/l) which is (108.3±5.43 nmol/l) greater thanthe case group. It was not statistically significant result (p=0.098). According to the Binary LogisticRegression test the anti-oxLDL (OR=0.992, p<0.001), ADMA (OR=0.681, p<0.001), TAC (OR=1.017, p=0.105), oxLDL (OR=0.900, p<0.001) levels significantly influence the complication of coronary atherosclerosis. Therefore according to the Binary Logistic Regression test the anti-oxLDL level high significantly influence the complication of coronary atherosclerosis. Anti-oxLDL antibody titer arecorrelated directly with oxLDL (r=0.413, p<0.01), ADMA (r=0.42, p<0.001) levels. However, correlated negative directly with TAC (r=-0.233, p<0.01) level.Markers of endothelial dysfunction (ADMA OR=0.681, p<0.001) and oxidative stress (oxLDL, OR=0.900, p<0.001), (anti-oxLDL antibody, OR=0.992, p<0.001) high influence causing of complication of coronary atherosclerosis.
ABSTRACT
Atherogenic dyslipidemia comprises a triad of increased blood concentrations of small, dense low density lipoprotein (LDL) particles, decreased high-density lipoprotein (HDL) particles, and increased triglycerides. A typical feature of obesity, the metabolic syndrome, atherogenic dyslipidemia has emerged as an important risk factor for cardiovascular disease. We have determined levels of serum lipid profiles in 1861 older people who lives 5 regions in Mongolia. The concentrations of total cholesterol, triglycerides and high density lipoprotein cholesterol (HDL-C) were measured using a biochemical reagents by biochemical fully automated analyzer. The levels of LDL-C were calculated by the Friedewald equation. Overall prevalence of dyslipidemia was 4.3% in men and 3.0% in women. Logistic regression showed that Odds ratio of the atherogenic dyslipidemia was OR=1.3, p=0.001 (CI 95% 0.93-2.47) for body mass index, OR=1.6, p=0.02 (CI 95% 1.0-2.88) for waist circumference, OR=1.76, p=0.03 (CI 95% 1.12-3.54) for waist hip ratio. Odds ratio of the atherogenic dyslipidemia was OR=0.98, p=0.001 (CI 95% 0.34-1.05) for gender and OR=1.0 p=0.001 (CI 95% 0.65-1.03) for age. Overall, 3.3% of older people had atherogenic dyslipidemia and 4.3% of men and 3.0% of women had atherogenic dyslipidemia. An increase of physical parameters are getting a risk factor of atherogenic dyslipidemia.