ABSTRACT
Objective:To investigate the relationship of lipid peroxide (LPO), total oxidation state (TOS), apolipoprotein (a) [apolipoprotein(a), Apo(a)] and pregnancy outcome in patients with polycystic ovarian syndrome (PCOS) treated by ovulation induction-in vitro fertilization-embryo transfer (IVF-ET).Methods:The clinical of 215 patients with PCOS treated by IVF-ET who were admitted to Hengshui People′s Hospitalfrom May 2017 to February 2020 were collected and they were divided into clinical pregnancy group (155 cases) and biochemical pregnancy group (60 cases) according to pregnancy outcome. The levels of LPO, TOS, and Apo(a) in the peripheral blood of the two groups were detected and the data were analyzed.Results:The levels of LPO and TOS before ovulation induction and human chorionic gonadotropin (HCG) dayin the biochemical pregnancy group were higher than those in the clinical pregnancy group: (10.35 ± 3.67) μmol/L vs. (7.16 ± 1.59) μmol/L, (17.98 ± 3.15) mmol H 2O 2 equiv/L vs. (15.03 ± 3.21) mmol H 2O 2 equiv/L; (12.81 ± 4.09) μmol/L vs. (7.38 ± 2.14) μmol/L, (19.66 ± 3.02) mmol H 2O 2 equiv/L vs. (15.19 ± 3.34) mmol H 2O 2 equiv/L; and the level of Apo(a) was lower than that in the clinical pregnancy group: (379.8 ± 95.9) mg/L vs. (486.5 ± 100.3) mg/L, (335.8 ± 84.7) mg/L vs. (473.5 ± 112.9) mg/L, the differences were statistically significant ( P<0.05). LPO and TOS before ovulation induction and HCG day were negatively correlated with the number of high-quality embryos ( P<0.01), and Apo(a) was positively correlated with the number of high-quality embryos ( P<0.01). The risk of non-clinical pregnancy for those with LPO, TOS, Apo(a) higher than the average before ovulation induction was 1.435, 1.233, 0.678 times of those with lower than the average ( P<0.05). The risk of non-clinical pregnancy for those with LPO, TOS, and Apo(a) higher than the average on HCG day was 1.443, 1.689, 0.762 times of those with lower than average ( P<0.05). After receiver operating characteristic (ROC) curve analysis, the area under the curve(AUC) of all indicators before ovulation induction combined to predict clinical pregnancy was 0.844. The AUC of all indicators on HCG day combined to predict clinical pregnancy was 0.894. Conclusions:Peripheral blood LPO, TOS, Apo(a) levels are closely related to the number of high-quality embryos, and are the main influencing factors of pregnancy outcome. Therefore, dynamic monitoring of the above-mentioned index levels can provide a reference for the clinical improvement of the treatment plan.
ABSTRACT
Damage control and gastrointestinal surgery have come a long way from the first reported case of an enterocutaneous fistula to advances in Intestinal transplant and vacuum assisted therapy. Everything we have known in between such as intestinal resections, enteral/parenteral nutrition, delayed abdominal wall closure and intestinal reconstruction have all lead to an exponential increase in our knowledge of gastrointestinal surgery. One area that still remains a significant challenge and clinical dilemma to the general surgeon is intestinal failure in short bowel syndrome. Not only does the anatomical complexity of short bowel syndrome offer difficulties in the definite reconstruction, but also the accompanying intestinal failure increases patient morbidity and mortality. There are no current algorithms or systematic approaches to these daunting clinical scenarios and although surgery has come a long way, there is still room for determining optimal approaches. Therefore, it is critical to keep researching new ways to treat these patients. A relatively new horizon in managing intestinal failure in short bowel syndrome is the use of biomarkers. Here we present a short review on the possible future treatment. The aim of this paper is to provide a pathway for future research into the treatment of this complex area of general surgery
La cirugía gastrointestinal y de control de daños ha tenido un recorrido amplio desde el primer caso reportado de fístula entero-cutánea, hasta llegar al uso de presión subatmosférica para el cierre asistido y el trasplante intestinal. Todos los avances propuestos en el intermedio, como las resecciones intestinales, los planes de nutrición entérica y parenteral, el cierre postergado de la pared abdominal y la reconstrucción intestinal, han llevado a un aumento exponencial del conocimiento de la cirugía gastrointestinal. A pesar de esto, hay un área que permanece como un reto significativo y un dilema clínico para el cirujano general: la falla intestinal en el síndrome de intestino corto. En esta, su complejidad anatómica presenta dificultades a la hora de su reconstrucción, y su alteración funcional aumenta la morbimortalidad del paciente. Así como sucede en la mayoría de las fallas específicas de órganos, esta se caracteriza por cambios en los marcadores séricos que ya han sido bien descritos en la literatura médica. En la falla cardiaca hay elevación del péptido natriurético auricular; en la falla renal, elevación de la creatinina sérica; en la falla hepática, elevación de las transaminasas, y así sucesivamente. Estos marcadores no solo indican la gravedad de la situación, sino que se relacionan con la suficiencia del órgano en cuanto a su función y su mejoría con la rehabilitación. Ahora, ¿cuáles son los marcadores del sistema gastrointestinal? Recientemente, la seriedad de la falla intestinal y su solución han sido objeto de la observación clínica y sintomática con el fin de determinar la orientación de la rehabilitación intestinal y el momento ideal para el inicio de la vía oral. En los últimos años han surgido biomarcadores pertinentes al estudio del sistema digestivo. En esta revisión se discuten los aspectos relacionados con el presente y el futuro de los marcadores serológicos intestinales en el síndrome de intestino corto
Subject(s)
Humans , Short Bowel Syndrome , Biomarkers , Citrulline , Apoprotein(a)ABSTRACT
Introducción y objetivos: La enfermedad cardiovascular es la primera causa de muerte en Costa Rica, razón por la cual seplantea el estudio de nuevos factores de riesgo en una población adulta de la provincia de San José.Métodos: Este estudio evaluó las concentraciones séricas del perfil lipídico, glucosa, lipoproteína (a), apoproteínas A1, B100y otros factores de riesgo de enfermedad cardiovascular en una población de 430 adultos con edades entre los 20 y 60años del área metropolitana de San José, Costa Rica.Resultados: La prevalencia de hiperlipoproteinemia (a) (≥ 0,3 g/L), hiperapoproteinemia B (> 0,65 g/L), hipercolesterolemia(> 5,17mmol/L), intolerancia a la glucosa (5,55-6,98 mmol/L) y diabetes mellitus (≥ 6,99 mmol/L) en la población es de67,8%, 87,4%, 46,3%, 14,2% y 5,7% respectivamente, sin diferencias significativas por sexo. La prevalencia de hipertrigliceridemia(>1,69 mmol/L) en la población es de 45,3%, siendo significativamente mayor en hombres que en mujeres (53,4%vs 37,2%; p = 0,001). Un porcentaje considerable de la población estudiada con niveles elevados de lipoproteína (a) (n =313) mostró simultáneamente uno o varios parámetros del perfil lipídico y la glucosa elevados. El 52,1 % presentó colesteroltotal ≥ 5,17 mmol/L; 44,4% triglicéridos ≥ 1,69 mmol/L; 25,2% HDL-colesterol < 1,03 mmol/L; 67,4 % LDL-colesterol ≥2,58 mmol/L, 45,0 % índice de Castelli ≥ 4,5, 17,9% glucosa ≥ 5,55 mmol/L y 88,8% apoproteína B > 0,65g/L. La prevalenciade síndrome metabólico en la población en estudio y según los criterios diagnósticos establecidos por la OrganizaciónMundial de la Salud es de 4,2%, fue mayor entre el género masculino (7,3% vs 1,7%; p = 0,008)...
Introduction and objectives: Cardiovascular disease is the first death cause in Costa Rica. This investigation proposes thestudy of new risk factors in an adult population of the province of San José.Methods: This study evaluated the lipid profile, glucose and other related cardiovascular risk factors in 430 adults aged20 to 60 years, residents of the metropolitan area of San José, Costa Rica.Results: The prevalences of hyperlipoprotein (a) (≥ 0,3 g/L), hyperapoprotein B (> 0,65 g/L), hypercholesterolemia (> 5,17mmol/L), impaired glucose tolerance (5,55-6,98 mmol/L) and diabetes mellitus (≥ 6,99 mmol/L) were 67,8%, 87,4%, 46,3%, 14,2% and 5,7% respectively, without significant differences between genders. The prevalence of hypertriglyceridemia(>1, 69 mmol/L) was 45,3%, being higher among the male population (53,4% vs. 37,2%; p = 0,001). A significantpercentage of the people included in this study had simultaneously high levels of lipoprotein (a) (n =313) and high levelsof another coronary risk factors such as: high cholesterol (52,1% had levels ≥ 5,17 mmol/L); high triglycerides (44,4% hadlevels ≥ 1,69 mmol/L); low HDL-cholesterol (25,2% had levels < 1,03 mmol/L); high LDL-cholesterol (67,4% had levels ≥2,58 mmol/L), high Castelli Index (45,0% had levels ≥ 4,5) , high glucose (17,9% had levels ≥ 5,55 mmol/L) and finally highlevels of apoprotein B (88,8% had levels > 0,65 g/L). The prevalence of metabolic syndrome in the studied population,according to the World Health Organization diagnostic criteria, was 4,2%, being higher among the male group (7,3% vs.1,7%; p = 0,008)...
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Biomarkers , Cardiovascular Diseases , Lipoproteins/analysis , Risk FactorsABSTRACT
BACKGROUNDS: Cardiovascular diseases is one of the major causes of death in patients with end stage renal disease(ESRD) receiving hemodialysis. Elevated plasma concentrations of lipoprotein(a)[Lp(a)] have been established as an independent risk factor for atherosclerotic cardiovascular disease. In this study, we investigated the pattern of apolipoprotein(a)[apo(a)] phenotypes in Korean ESRD patients on hemodialysis and evaluated the relationship between Lp(a) concentration and apo(a) phenotype. METHOD: Fasting serum Lp(a) was measured in 100 patients with ESRD undergoing hemodialysis and in 100 age-and gender-matched normal subjects as control. Apo(a) phenotyping was also performed with SDS-PAGE using Phast system in both groups. RESULT: Lp(a) concentrations were significantly elevated in ESRD patients as compared with the controls(19.2mg/dL, 9.8-38.9mg/dL vs. 4.3mg/dL, 1.0-18.8mg/dL)(p<0.05). Ninety eight patients had apo(a) phenotypes of high molecular weight such as S3, S3S4, S3S5, S4, S4S5, and S5. The distribution of apo(a) isoform in the ESRD patients was not different from that of normal controls. With common apo(a) isoforms such as S3, S4 and S5, elevation of Lp(a) level was demonstrated in ESRD patients compared with normal subjects. CONCLUSIONS: Most of Korean ESRD patients on hemodialysis had apo(a) phenotypes of high molecular weight. And elevation of serum Lp(a) in these patients could be due to the nongenetic factors related with renal failure rather than the apo(a) polymorphism.