Serum leptin in patients with chronic renal failure on different modes of management

To study serum leptin level in chronic renal failure [CRF] patients on different modes of management and to analyze the impact of the mode of therapy on serum leptin level. This study was conducted on 64 patients [33males and 31 females] with chronic renal failure divided into three groups: group I: Twenty-six patients treated conservatively and did not start dialysis yet [predialysis], group II: Twenty-four patients treated by hemodialysis, group III: Fourteen patients treated by continuous ambulatory peritoneal dialysis [CARD]. Twenty healthy subjects were included as control group. All patients and controls were subjected to full clinical examination including height and weight to calculate body mass index [BMI]. Blood urea and serum creatinine were measured as renal function tests. Serum leptin was measured by EAS1A and so serum insulin. In predialysis and CAPD groups, there is a significant increase in leptin, leptin/BMI and insulin in patients in comparison to control subjects. In hemodialysis group, there is a significant increase in leptin and leptin/BMI and a non-significant increase in insulin level in patients in comparison to control subjects. Insulin is significantly correlated with leptin in the first group, while in the second and third groups there is no correlation. The highest leptin level is found in the CAPD group of patients followed by the predialysis one then the hemodialysis group. Leptin level is significantly higher in females than males in all groups. This difference remained after adjusting leptin level to BMI. No correlation was found between leptin level and age or between leptin level and renal function in the three groups of patients. No correlation was found between leptin level and the duration of dialysis in the hemodialysis and CAPD groups. Serum leptin is elevated in CRF patients irrespective of the type of management they are undergoing. Dialysis, has no significant effect on leptin level. The two main predictors of serum leptin level are sex and BMI in CRF patients and in healthy subjects, Leptin level may serve as a valuable clinical marker for body adiposity

Antiphospholipid antibodies in Egyptian patients with chronic renal failure

The objectives of present research was to detect the incidence of antiphospholipid antibodies among Egyptian patients with chronic renal failure and its relation to their clinical manifestation and vascular access thrombosis. This study including 80 patients with chronic renal disease divided into two groups. Group A, forty patients with impaired renal function and group B, forty patients in chronic renal failure on hemodialysis. In addition to 10 age and sex matched subjects as a control group. All of them were subjected to clinical examination and laboratory investigation including antiphospholipid antibodies. Lupus anticoagulant was present in 21.25%, aCL IgM in 18.75% while aCL IgG in 11.25% of whole chronic renal disease patients. There was higher incidence of antiphospholipid antibodies in-group B end stage renal failure on hemodialysis [28/40[70%]] compared to group A of renal impairment [25/40[62.5%]]. Also there was insignificant relationship between antiphospholipid antibodies and age, kidney function or liver function tests. There is increase of antiphospholipid antibodies among patients with chronic renal failure with great liability for thrombosis of vascular access. Also patients with positive LA have a great possibility to be hypertensive. HCV infection in hemodialysis group may be the cause of increased incidence of antibodies. Antiphospholipid antibody profile should be done for patients with recurrent thrombosis of vascular shunt, as it is the main cause of hospitalization of dialysis patients

Association between insulin like growth factor 1 and bone mineral density in the elderly

To assess the relationship between insulin like growth factor-I and bone mineral density in elderly, this study was conducted on 46 elderly subjects subdivided into 23 elderly males [50%] age ranged between 60-89 years [66.95 +/- 8.4] and 23 elderly females [50%] age ranged between 60-81 years [63.39 +/- 4.95] in addition to 20 adult healthy subjects 10 males [50%] and 10 females [50%]. Their age ranged between 20-41 years [28.5 +/- 6.37] as a control group. The results showed highly significant reduction of bone mineral density by both T and Z scores in elderly males compared to control group, [- 3.33 +/- 2.07] and [-0.57 +/- 1.51] [P <0.01] in T- score and [-2.06 +/- 2.13] [- 0.54 +/- 1.49] in Z- score respectively [P < 0.01] with highly significant reduction of IGF-I in elderly males [60.01 +/- 35.84] compared to control group[145.00 +/- 64.00] [P<0.01]. Among elderly healthy females our results showed significant reduction of bone mineral density T- socre in elderly healthy females compared to control [-1.64 +/- 1.31] [- 0.57 +/- 1.51] respectively [P< 0.05]. But there is non-significant reduction of Z score in elderly healthy females in comparison to controls [-0.13 +/- 1.24] [- 0.54 +/- 1.49] [P > 0.05], with a highly significant reduction of IGF-1 in elderly females compared to controls [59.44 +/- 43.40] [145.00 +/- 64.00] respectively [P<0.01]. When we compared IGF-1 in osteopenic group [T> -1 SD] and osteoporotic [T > -2 SD] to that of control group we found a significant reduction of IGF- I in osteoporotic than osteopenic than control group which may postulate the role of IGF-1 reduction in the pathogenesis of osteoporosis in elderly

Prevelance of hepatitis C virus infection and beta 2-microglobulin among diabetic patients

One hundred diabetic patients [48 males and 52 females, their ages ranged between 26-64 years with a mean of 51.5 +/- 10.15] and 40 healthy subjects of matched age and sex as controls were studied for the presence of HCV-RNA in their sera. Also, the study measured beta2-microglobulin [beta2-MG] levels among them. Laboratory investigations including fasting, postprandial blood sugar and liver function tests were carried out for all patients and control subjects. The study did not detect significant difference in HCV-RNA in diabetic [21%] and control [20%] subjects. High levels of beta2-MG play a key role in influencing the immune response to viral infections, as it is an integrating part of the main histocompatibility system [HLA]. MG was found in all diabetic patients [>15 mug/ml] versus control group. Laboratory data showed the increase of fasting, postprandial blood sugar and the increase of serum level of aspartate aminotransferase [AST], alanine aminotransferase [ALT] and alkaline phosphatase in diabetic in relation to control group

Assessment of some biochemical parameters of the hepatocellular carcinoma, liver cirrhosis and hepatitis C patients

Hepatitis C virus is a major etiological agent associated with the development of cirrhosis. Cirrhosis is associated with an increased risk of hepatocellular carcinoma [HCC]. Early detection of HCC in cirrhotic patients can usually be achieved by screening with non invasive techniques such as ultrasound scan and serum alpha-fetoprotein [AFP]. The aim of this study was to determine the plasma levels of immunoreactive matrix metalloproteinase [MMP-9], AFP and basic fibroblast growth factor [FGF] in patients with hepatitis C virus [HCV] infection, liver cirrhosis [LC] and [HCC]. This study included 30 patients with HCV infection, 30 patients with [LC] and 30 patients with HCC. The plasma MMP-9 levels in patients with HCC increase significantly than [LC] group P < 0.05. The plasma AFP levels in patients with HCC were significantly higher than those with hepatitis C group [P < 0.05] and insignificantly higher than those with LC [P > 0.05]. The FGF levels in patients with [LC] were significantly higher than those with [HCV] infection P < 0.01 but FGF level in HCC group increased insignificantly than HCV patients [P > 0.05]

Laboratory method predicting the maximal effective NSAID's in management of rheumatoid arthritis

Macrophages were isolated from 32 patients with acute rheumatoid arthritis [RA]. Macrophages of each patient were separately treated in-vitro with different NSAID's in the presence of immune complex [IC]. Cells inhibition was determined by measuring intracellular enzymes and number of FC receptors before and after treating the cell with NSAID's. Drug that caused maximal inhibition of FC receptors of the macrophages in-vitro was given to the patient for two weeks. Clinical assessment was done for each patient before and after treatment. The same previous procedures were followed for another 15 patients with acute RA as a control group. That group of patients were treated for two weeks by the drug that showed minimal FC receptors inhibition, It was found that the percentage of FC receptors inhibition is proportional to the clinical improvement of the disease parameters. Accordingly, this method can be used to predict the optimal effective NSAIDs for each patient before starting treatment