Study of serum irisin in patients with thyroid dysfunction

Background: irisin, identified as a proteolytic cleavage product of the fibronectin type III domain-containing protein 5 [FNDC5], It is a novel myokine secreted by contracting skeletal muscle, possibly mediating some exercise health benefits via "browning" of white adipose tissue. Irisin causes a significant increase in total body energy expenditure and resistance to obesity-associated insulin resistance in mice, while controversy still exists concerning irisin origin, regulation and function in humans

Aim of the work: our study aimed to detect relation of thyroid status [hypo, hyperthyroid] with serum irisin, ck and peripheral neuropathy

Patient and methods: this study was conducted on 60 candidates consisted of 40 patients with thyroid dysfunction selected from Endocrine outpatient Clinic and Inpatient Department of Ain Shams University Hospitals and 20 healthy volunteers from April 2016 to October 2016. Informed consent was obtained from all participants. Patients of both genders, age more than 18 years old, 20 patients with hypothyroidism, 20 patients with hyperthyroidism and 20 healthy volunteers. We excluded significant renal, hepatic and cardiac disease, severe associated acute illness or depression, pregnant females, diabetes, hypercortisolism, hypocortisolism, muscular or neurological disorders, routinely taking drugs as statins, intensively involved in a sport or any strenuous physical activity. All participants were subjected to full medical history taking, general clinical examination and laboratory investigations as thyroid and thyroid-related hormone concentrations as well as a thyroid ultrasound examination and thyroid scan for patients with hyperthyroidism. Serum irisin level, CK and nerve conduction velocity were measured

Results: irisin level was higher in hyperthyroid group than euthyroid group with a significant difference. In comparison with normal NCV candidates and reduced NCV candidates with other variables there was only border line significant difference with irisin p-value. Non-significant value of irisin and CK level were detected for diagnosis of hypothyroidism. Irisin has highly significant value for diagnosis of hyperthyroidism with [sen 95%, sp 42.5]. Increased BMI is the only independent predictor for hypothyroidism by using multivariable binary logistic regression analysis. Decreased BMI and irisin are independent predictors for hyperthyroidism

Conclusion: serum irisin level is one of predictors for hyperthyroidism; on the other hand irisin does not have a significant value to predict hypothyroidism. Serum irisin was found to be higher in patients with hyperthyroidism in comparison with euthyroid participant with non-statistically significant difference between hypo and hyperthyroidism. Serum CK level does not have a significant value in diagnosis of thyroid dysfunction [hypothyroidism or hyperthyroidism]. Serum irisin level was low in thyroid dysfunction cases with delayed NCV compared to thyroid dysfunction cases and normal NCV with border line significant difference

Evaluation of different biochemical markers of bone turnover as a diagnostic tool for osteoporosis in postmenopausal women

Osteoporosis is a major global health problem affects mainly elderly and postmenopausal women with increased risk of bone fractures. The value of different biochemical markers of bone turnover as diagnostic tool for osteoporosis is still debated. The aim of this study is to assess the value of different biochemical markers of bone turnover as a diagnostic tool for osteoporosis in postmenopausal women. We measured fasting urinary calcium [Uca], total ALP, inorganic phosphorus [Pi], urinary deoxypyridino-line [DPD], carboxyterminal telopeptide of collagen type I [ICTP] and serum N-terminal telopeptide [NTX] in 40 postmenopausal females [diagnosed by DEXA as osteoporotic, | mean age, 60.2 years], 16 preimenopausal non-osteoporotic females [mean age, 39.1 years] and 24 healthy controls [mean; age, 29.2 years]. The postmenopausal osteoporotic group showed significantly higher levels of ALP, DPD, NTX and ICTP compared to controls [p<0.001] and only ALP was significantly higher in preimenopausal group compared to controls [p<0.001]. However, there was no significant difference of Uca and Pi among the three groups. On comparing peri and postmenopausal groups together, DPD, NTX and ICTP were the only markers that clearly discriminate the two groups being higher in the osteoporotic postmenopausal group. There were significant negative correlations between bone mineral density [BMD] and each of ALP, DPD, NTx, and ICTP. The clinical utility of DPD, NTx and ICTP in identifying patients with osteoporosis was assessed by ROC [receiver operating characteristic] curve analysis. This revealed that the best diagnostic cut-off level for DPD was 6.8nM DPD/mM creatinine. This gave a diagnostic sensitivity of 100% and specifity 100%, whereas NTx at a level 17.0 nM BCE had a diagnostic sensitivity of 100% and specifity of 98%. Regarding ICTP at cut-off level of 3.6 microg/L its sensitivity was 88% and specifity was 65% which considered the lesser better sensitivity and specifity among the three studied parameters

Hemostatic suturing technique for uterine bleeding in post-partum hemorrhage

The objective of this study was to assess the efficacy of multiple square suturing technique as a conservative surgical intervention in the management of postpartum hemorrhage. This technique was used in 20 patients with postpartum hemorrhage who did not respond to the conservative management. In 18 cases, bleeding decreased markedly and hysterectomy was avoided. Hemostatic multiple square suturing was an easy, safe conservative surgical technique alternative to hysterectomy for treating uncontrollable postpartum hemorrhage