Serum retinol-binding protein 4 in patients with nonalcoholic fatty liver disease: does it have a significant impact on pathogenesis?

OBJECTIVES: Conflicting data have been reported in the literature about the role of retinol-binding protein 4 (RBP4) in insulin sensitivity, type 2 diabetes, and obesity in humans. It is of interest whether serum RBP4 is associated with various features of nonalcoholic fatty liver disease (NAFLD). METHODS: Serum RBP4, adiponectin, leptin, and resistin were measured by enzyme-linked immunosorbent assay in 76 nondiabetic NAFLD patients, 55 of whom had elevated alanine aminotransferase (ALT). Thirty-four of 55 underwent a liver biopsy. Fasting insulin, liver and lipid panels were analyzed and ultrasound score, body mass index, and homeostasis model assessment for insulin resistance were recorded for each patient. Twenty-four healthy individuals served as controls. RESULTS: Serum RBP4 levels were not different between the steatosis group and controls as well as between the groups with high and normal ALT. Serum adiponectin was significantly lower and resistin was higher (P<0.001) in steatosis group compared with controls. RBP4 and resistin were negatively correlated, whereas leptin and resistin were correlated positively in patients with high ALT. At multivariate analysis, homeostasis model assessment for insulin resistance [odds ratio (OR): 10.71; 95% confidence interval (95% CI): 1.40-81.74], leptin (OR: 22.14; 95% CI: 2.40-204.12), resistin (OR: 6.29; 95% CI: 0.94-41.91), ALT (OR: 1.205; 95% CI: 1.05-1.39), and aspartate aminotransferase (OR: 0.846; 95% CI: 0.72-0.99) were independent variables associated with steatosis. Serum leptin, adiponectin, resistin, gamma-glutamyl transferase, and cholesterol were associated with histological activity by multivariate linear regression. CONCLUSION: Serum RBP4 is not a predictive factor in NAFLD irrespective of ALT. Low adiponectin, elevated resistin, and leptin were significantly associated with necroinflammation.

Serum leptin, atherogenic lipids and glucose levels in patients with skin tags.

AIM: To investigate the relationship between serum leptin, atherogenic lipid and glucose levels in patients with skin tags and healthy controls. MATERIALS AND METHODS: A total of 58 patients, with at least three skin tags, aged 24 to 85 years, and 31 healthy controls aged 30 to 70 years, were examined in the present study. The subjects in all the groups were selected with statistically similar Body Mass Index (BMI). Fasting concentrations of plasma glucose, serum lipids including triglyceride, total cholesterol, and high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), HbA1c, and leptin were measured by enzyme-linked immunosorbent assay (ELISA). In addition, serum LDL level was calculated using Friedewald's formula. RESULTS: There was no significant difference in age, sex, BMI, HbA1c, triglyceride, HDL and leptin levels between the groups. Skin tags group showed significantly higher levels of total cholesterol and LDL, when compared with the healthy controls groups (P < 0.01). In addition, regression analysis showed that leptin level was positively correlated to serum triglyceride level (r = 0.265, P = 0.044). CONCLUSION: Total cholesterol and LDL serum levels should be controlled in patients with skin tags. On the other hand, glucose, leptin and HbA1c serum levels may not be as important as is being considered in recent times.

Migraine, Helicobacter pylori, and oxidative stress.

BACKGROUND: The aim of this study was to ascertain whether oxidative stress is a causative factor of migraine attacks for Helicobacter pylori-infected migraineurs. MATERIALS AND METHODS: A total of 35 consecutive migraine patients without aura who came to gastroenterology polyclinic with various complaints and diagnosed H. pylori infection were included in the study group and compared with a group of 29 patients (control group) without migraine and H. infection. H. pylori infection was diagnosed by histopathological biopsies, which were taken by endoscopy (Olympus-GIFXQ240 endoscope). Both the diagnosis and the classification of migraine were made according to the International Headache Society criteria. Blood samples for nitric oxide were taken from patients with migraine during headache-free period as well as the control group. The interaction of nitric oxide was measured by the determination of both nitrite and nitrate concentrations in the sample. RESULTS: The study group included 31 women and 4 men (mean age 49 +/- 8 years) and the control group included 25 women and 4 men (mean age 52.6 +/- 11 years). The mean frequency of migraine attacks was 2.94 +/- 1.58 days/month and the mean duration of attacks was 21.2 +/- 3 hours. It was found that the study group has lower nitrate levels than the control group. CONCLUSIONS: Our results do not support the role of oxidative stress in patients suffering from H. pylori infection and migraine.

Clinical importance of gamma glutamyltransferase in the Ankara-Pursaklar region of Turkey.

OBJECTIVE: The aim of this study is to determine the etiologies of serum gamma glutamyltransferase (GGT) elevation and relations between multiple etiologies prevalent in the Pursaklar region of Ankara in Turkey. PATIENTS AND METHODS: The patients referred to the Family Medicine and Internal Medicine departments with various complaints from the Pursaklar region of Ankara between July 2000 and July 2002 were evaluated, and values for GGT, alkaline phosphatase (ALP), and alanine aminotransferase (ALT) levels were determined. GGT elevation was classified as being associated with hepatic, biliary, and other origins. RESULTS: For GGT elevation, hepatobiliary etiologies were more prevalent. The most prevalent hepatic etiology was nonalcoholic steatohepatitis, followed by biliary etiologies. The most prevalent etiology of biliary origin was cholelithiasis. Other etiologies, in order of prevalence, were drug exposure and urinary infection. There were no gender-related differences for distribution of GGT elevation; however, the GGT values for women were higher than those for men.