Some biochemical markers of bone formation and bone resorption in elderly patients with hip fracture

Serum concentrations of some biochemical markers of bone turnover were measured in 40 elderly patients who sustained hip fracture. They were 20 elderly males and 20 postmenopausal females showing different grades of radiological and histopathological osteoporosis. In addition, 20 radiologically free subjects [10 postmenopausal females, and 10 elderly males] served as controls. To all studied subjects the following bone markers were done: serum osteocalcin, serum total and bone specific alkaline phosphatase and urinary hydroxyproline.Serum total and ionized calcium, inorganic phosphorus and urinary calcium were also estimated. Markers of bone formation: osteocalcin and bone specific alkaline phosphatase were significantly increased in postmenopausal female patients and elderly male patients. Urinary hydroxyproline, a marker of bone resorption was also significantly increased in these two groups when compared to the controls. Based on some biochemical data [and not radiological] osteomalacia could be suspected in 20% of postmenopausal female patients and 15% of elderly male patients. These data are suggestive of high rate of bone turnover in such elderly patients where bone resorption exceeds bone formation leading to low skeletal mass which has an essential role in bone fracture

impact of some biliary oxidative parameters and proteins on gallbladder lithogenicity

Gallbladder bile from thirty patients undergoing elective cholecystectomy for calcular and noncalcular chronic cholecystitis were included in this study. Normal bile was also aspirated from gallbladders of 10 subjects undergoing surgery for surgical conditions not involving liver or biliary tract [control group]. The present work aimed at studying some proteins and some oxidative state parameters in gallbladder bile of normal subjects and patients with calcular and noncalcular cholecystitis and their possible contribution in gallbladder lithogenicity. Collected bile was examined for total cholesterol, bilirubin, proteins, mucoproteins and procollagen Ill peptide. Protein and glycoprotein fractionation was done by polyacrilamide gel electrophoresis. In addition some oxidative state parameters were done biliary ferritin, superoxide dismutase [SOD] glutathione and thiobarbituric acid reactive substances [TBARS]. It could be noticed that: there was an increase in total biliary proteins and mucoproteins in gall stone formers than in controls. Pronucleating glycoproteins of 130 KD and 42 KD were found in higher frequency in the calcular than noncalcular and control groups. Antinucleating 58 KD glycoprotein and 120 KD protein were found in higher frequency in controls than in calcular groups. As regards the oxidative state prameters studied, mean values for SOD, glutathione and ferritin were significantly lower in calcular and noncalcular groups when compared to control group and TBARS were significantly higher. It could be concluded that the state of increased oxidative stress in bile of calcular group and also the biliary protein pattern may contribute to the Iithogenicity of bile

Some biochemical aspects associated with accelerated atherosclerosis in chronic renal failure

This study included fifteen patients diagnosed as chronic non-nephrotic renal failure to whom dialysis had never been done and thirty patients diagnosed as chronic non-nephrotic renal failure who were under maintenance hemodialysis for at least one year. In addition a control group of 10 healthy subjects of matched age, sex and socioeconomic status was included in the study. To all subjects the following was done: serum Lp[a], apolipoprotein-B, Thiobarbituric acid reactive substances [TBARS] and lipid profile. Serum Lp[a] was found to be higher in both chronic renal failure groups, either dialyzed or un-dialyzed, when compared to controls. TBARS levels were significantly elevated in both dialyzed and undialyzed group of patients than the control group. The prevalence of cardiovascular diseases was 20% in the non-dialyzed group of patients and 40% in the dialyzed group in-spite of the normal or subnormal serum total cholesterol. This point out to the possibility that other lipoprotein abnormalities such as the increased Lp[a] and increased lipid peroxidation are probably incriminated in the prevalence of accelerated atherosclerosis. It could be concluded that Lp[a] is an independent risk factor for atherosclerosis in chronic renal failure patients. This risk increases with the process of hemodialysis. Increased lipid peroxidation in these patients is an additional factor for the accelerated atherosclerosis

Study of some acute phase reactants and cardiac troponin T in patients with acute coronary syndromes

In an attempt to clarify the occurrence of inflammation in acute coronary syndromes, this study was performed on 20 patients with unstable angina [UA] and 20 patients with myocardial infarction [MI]. Twenty healthy volunteers were taken as controls. All studied patients and controls were subjected to full clinical examination and standard 12 lead ECG. Laboratory investigations included serum creatine kinase [CK], CK-MB, Troponin T [TnT], C-reactive protein [CRP], alpha 1-acid glycoprotein [AGP] and sialic acid. Complete Selvester ECG scoring was done for MI patients. Holter monitoring for 24 hours starting immediately after hospital admission was done for UA group. CK, CK-MB and TnT were significantly elevated in MI group [P<0.05], while CRP, AGP and sialic acid were elevated in both UA and MI groups [P<0.05]. ST-episodes were detected in 10 patients with UA [50%]. All of them had CRP above the cut off value of 10 ug/ml while 6 of these patients had measurable TnT above a cut off value of 0.2 ug/ml. In UA group CRP showed the highest sensitivity [70%] followed by AGP [45%] and TnT [30%]. Meanwhile, TnT showed 95% sensitivity, 100% specificity in MI and was positively correlated with QRS score [r = 0.813, P<0.001]. Sialic acid and AGP were positively correlated with ST ischemic changes in UA group [r= 0.75 and 0.574 respectively]. It was observed that the 4 patients with UA who developed cardiac C Vents [20%] showed marked elevation in both CRP and AGP on hospital admission. Meanwhile, they had measurable TnT and showed ST ischemic changes on Holter monitoring. We conclude that acute phase reactants, cardiac specific troponins as well as Holter monitoring are useful prognostic indicators in patients with acute coronary syndrome