Urinary neutrophil gelatinase associated lipocalin as a biomarker of lupus nephritis in adult population

Objective: The purpose of this study was to evaluate the levels of Neutrophil Gelatinase Associated Lipocalin, a tubular stress protein in the urine of diagnosed cases of SLE with and without lupus nephritis

Study design: Cross sectional analytical study

Place and Duration of Study: Department of Biochemistry and Chemical Pathology, Sheikh Zayed Hospital Lahore from January 2015 to January 2016

Materials and methods: Including a total of 84 subjects, 42 cases were SLE without renal involvement and 42 cases were diagnosed cases of SLE with lupus nephritis. The diagnosis of lupus nephritis was established on the basis of renal biopsy

Results: This study revealed that the nephritis group had increased levels of uNGAL along with increased serum creatinine, increased urinary albumin creatinine ratio and decreased creatinine clearance [CG Formula] ascompared to systemic lupus erythematosus patients without having lupus nephritis [p Value <0.05]

Conclusion: These findings clearly indicate that uNGAL levels correlate strongly with the renal components of the disease activity. Thus, it can be stated that uNGAL can prove to be a noninvasive, reliable and sensitive biomarker to diagnose cases of lupus nephritis

Comparison of urinary NGAL with conventional renal function markers in type 2 diabetic patients

Objective: To compare and correlate urinary neutrophil gelatinase-associated lipocalin [NGAL] with serum creatinine and creatinine clearance, as biomarkers of renal injury in type 2 diabetic patients

Materials and Methods: It was a cross-sectional study conducted at Shaikh Zayed Hospital, Lahore in the Department of Biochemistry from October 2009 to October 2010. Ninety five subjects both males and females were divided into two groups. 75 type 2 diabetic patients [33 males and 42 females] were included in the 'Diabetic' group and 20 healthy individuals were taken as 'Controls'. uNGAL was measured using Bioporto's NGAL Rapid Elisa Kit 037. Serum creatinine was estimated on fully automated chemistry analyzer. Creatinine clearance was calculated by using the Cockcroft and Gault formula. uNGAL levels were compared and correlated with the sCreatinine and creatinine clearance of the Diabetic and the Control group

Results: The diabetic group showed elevated sCreatinine and significantly low creatinine clearance along with highly increased levels of uNGAL, when compared with the controls. When correlated, uNGAL had a significant positive correlation with sCreatinine and a highly significant negative correlation with creatinine clearance of the female diabetics only

Conclusion: uNGAL relates closely with renal function markers. It may prove to be a sensitive and non-invasive biomarker for the early detection of diabetic nephropathy as well as renal injuries caused by reasons other than diabetes

Insulin deficiency among newly diagnosed type 2 diabetics

Any patient above the age of 40 years, coming with the symptoms of diabetes is labelled as type 2 diabetic. If insulin levels are included in the protocol for initial investigations of diabetic patients, they can be differentiated as having insulin deficiency or insulin resistance. They can thus be treated accordingly. This study was conducted to see the prevalence of insulin resistance and insulin deficiency in newly diagnosed type 2 diabetics. This study was conducted on 75 newly diagnosed diabetic subjects, and 75 control subjects for comparison. Fasting serum insulin was assayed by ELISA and HOMA-IR index was calculated. The diabetic subjects with fasting hyperglycaemia and serum insulin level below 20 micro IU/ml and HOMA-IR index below 3.5 were grouped as insulin deficient [Group-A], and the diabetic subjects with fasting insulin level above 20 micro IU/ml and HOMA-IR index above 3.5 were grouped as insulin resistant [Group-B]. Twenty-eight percent subjects were found to have insulin level below 20 micro IU/ml while 72% subjects had insulin resistance. When gender was taken into consideration, it was seen that 18.7% males had fasting insulin level of 6.98 +/- 0.737 micro IU/ml and 9.3% females had fasting insulin level of 5.21 +/- 0.885 micro IU/ml while 32% males and 40% females had insulin resistance. The mean age of male subjects with insulin resistance was significantly higher compared to the male subjects with insulin deficiency. Mean weight and body mass index of the male and female subjects having insulin resistance was significantly higher than their respective control groups and also higher than the subjects with insulin deficiency. Pearson coefficient of correlation was calculated for fasting serum insulin level with age and BMI. A significant positive correlation was observed between fasting serum insulin and age of females with insulin resistance. A considerable number of persons who develop diabetes after 40 years of age but are not insulin resistant. Twenty-eight percent subjects have relative insulin deficiency, and 72% subjects have insulin resistance.

Serum bilirubin and antioxidant levels in first degree relatives of patients with ischemic heart disease and normal subjects

Coronary diseases appear to result from an overbalance between radical-generating, compared with radical-scavenging systems, a condition called as oxidative stress. Total antioxidant status [TAS] in human plasma reflects the balance between oxidants and antioxidants in each system. Bilirubin has been considered an antioxidant, with capacity to remove reactive species of oxygen. Present study tried to measure the total antioxidant status of first degree relatives of patients with IHD. Study also tried to evaluate the prognostic role of serum bilirubin in disease prevention or progression. Seventy five apparently healthy subjects in age group 20-50 years, comprising equal number of males and females, who were first degree relatives of ischemic heart disease patients, were included in the study. Family members were divided on the bases of their numbers, i.e., one family member [Group-A], 2 family members [Group-B] and more than 3 family members [Group-C]. Study was cross sectional and carried out in a period of 6 months [Jun 2008-Jan 2009]. Subjects with letter of consent were taken from general population. Seventy five healthy age matched people with no history of ischemic heart disease in family were taken as control. An overnight fasting blood sample was taken. Total antioxidant status was determined using a commercially available kit. Serum bilirubin was estimated by auto analyzer. Family history of ischemic heart disease with serum bilirubin showed a significant negative correlation [p<0.05]. But the values of TAS failed to show any significant correlation with the family history. It was observed that the value of serum bilirubin was decreased significantly [p<0.05] with an increased number of family members. Total antioxidant status failed to show any significant difference among all the three groups. Our data demonstrated that reduced serum levels of bilirubin were seen in people with a higher prevalence of coronary artery disease in the family. The levels of serum bilirubin showed a downward trend with an increase in number of family members affected with ischemic heart disease. Present study failed to show a definite association of total antioxidant status with family history of ischemic heart disease. Additional studies are still necessary on large number of first degree relatives to confirm and demonstrate the association of these findings with clinical outcomes