Vitamin D status, serum lipid concentrations, and vitamin D receptor (VDR) gene polymorphisms in Familial Mediterranean fever.

Vitamin D (VitD) is critical for the regulation of inflammatory processes, and VitD deficiency has been linked to several chronic inflammatory disorders. We aimed to investigate the concentrations of serum 25(OH)D3, lipid parameters, and three known VDR polymorphisms (BsmI, FokI, and TaqI) in patients with Familial Mediterranean fever (FMF), an autosomal recessive autoinflammatory disease. The study included 123 FMF patients and 105 controls. Seventy patients had no attack (group 1), 30 had 1-2 attacks (group 2), and 23 had 3 or more attacks (group 3) within last three months. Serum 25(OH)D3 concentrations were determined using liquid chromatography-tandem mass spectrometry. BsmI, FokI, and TaqI polymorphisms were analyzed by a competitive allele specific polymerase chain reaction assay (KASPar). Serum lipid parameters were measured with enzymatic colorimetric methods. 25(OH)D3 concentrations were lower in FMF patients compared to controls (p < 0.001). No difference was observed in 25(OH)D3 concentration between groups 1, 2, and 3. The distributions of FokI and TaqI genotypes were not significantly different between FMF patients and controls. There was a significant difference in the distribution of AA BsmI genotype between male FMF patients and male controls. Increased concentrations of triglycerides (p = 0.012) and decreased concentrations of high-density lipoprotein cholesterol [HDL-C] (p = 0.006) were found in FMF patients compared to controls. Although lower 25(OH)D3 concentrations were observed in FMF patients versus controls, no association was determined between FMF attack frequency and 25(OH)D3 concentrations. We showed that the AA genotype of BsmI polymorphism is associated with FMF in males but not in females. The effects of decreased HDL-C and increased triglyceride concentrations on cardiovascular events in FMF patients should be further investigated.

Effects of Remote Ischemic Conditioning Methods on Ischemia-Reperfusion Injury in Muscle Flaps: An Experimental Study in Rats.

BACKGROUND: The aim of this study was to investigate the effects of remote ischemic conditioning on ischemia-reperfusion injury in rat muscle flaps histopathologically and biochemically. METHODS: Thirty albino rats were divided into 5 groups. No procedure was performed in the rats in group 1, and only blood samples were taken. A gracilis muscle flap was elevated in all the other groups. Microclamps were applied to the vascular pedicle for 4 hours in order to achieve tissue ischemia. In group 2, no additional procedure was performed. In groups 3, 4, and 5, the right hind limb was used and 3 cycles of ischemia-reperfusion for 5 minutes each (total, 30 minutes) was applied with a latex tourniquet (remote ischemic conditioning). In group 3, this procedure was performed before flap elevation (remote ischemic preconditoning). In group 4, the procedure was performed 4 hours after flap ischemia (remote ischemic postconditioning). In group 5, the procedure was performed after the flap was elevated, during the muscle flap ischemia episode (remote ischemic perconditioning). RESULTS: The histopathological damage score in all remote conditioning ischemia groups was lower than in the ischemic-reperfusion group. The lowest histopathological damage score was observed in group 5 (remote ischemic perconditioning). CONCLUSIONS: The nitric oxide levels were higher in the blood samples obtained from the remote ischemic perconditioning group. This study showed the effectiveness of remote ischemic conditioning procedures and compared their usefulness for preventing ischemia-reperfusion injury in muscle flaps.

Decreased Chitotriosidase Activity and Levels in Familial Mediterranean Fever.

Different studies have demonstrated changes in chitotriosidase (ChT) activity and concentrations in multiple diseases. However, changes in ChT activity and concentrations have not been concurrently evaluated in patients with Familial Mediterranean Fever (FMF). In this study, we analyzed the changes in serum ChT activity and concentrations in patients with FMF. The study included a total of 80 patients with FMF and 80 healthy controls. ChT enzyme activity and concentrations were measured and then compared between the groups. ChT activity was measured by using fluorometric ELISA and ChT concentrations were measured by using colorimetric ELISA methods. The median ChT activity was 10.00 (6.00-15.00) nmol/mL/hr in the patients and 14.00 (6.25-20.75) nmol/mL/hr in the controls. There was a statistically significant difference in the ChT activity between the controls and patients (P = 0.027). The median ChT concentrations were 65.40 (46.20-84.92) pg/mL and 125.00 (75.72-143.95) pg/mL in the patients and controls, respectively (P < 0.001), which were expressed as median percentiles (25th-75th). Additionally, we found no correlation between C-reactive protein and ChT activity (P = 0.978, r = 0.003) and concentrations (P = 0.446, r = -0.87). Serum ChT enzyme activity and concentrations may not be considered as a biomarker in FMF patients taking colchicine. New studies are needed to evaluate the changes of enzyme activity and concentration in colchicine-negative patients.

Increased oxidative stress markers may be a promising indicator of risk for primary ovarian insufficiency: a cross-sectional case control study.

PURPOSE: The aim of this study was to evaluate serum levels of inducible nitric oxide synthase (INOS), myeloperoxidase (MPO), total antioxidant status (TAS), and total oxidative status (TOS) in women with primary ovarian insufficiency (POI) and to compare them with healthy fertile women. We also examined the possible risk factors associated with POI. METHODS: This cross-sectional case control study was conducted in Zekai Tahir Burak Women's Health Education and Research Hospital. The study population consisted of 44 women with POI (study group) and 36 healthy fertile women (control group). In all patients, serum levels of INOS, MPO, TAS, and TOS were determined. INOS and MPO levels were measured by enzyme-linked immunosorbent assay whereas colorimetric method was used for evaluating TAS and TOS levels. Age, body mass index (BMI), obstetric history, smoking status, family history, comorbidities, sonographic findings, complete blood count values, C-reactive protein and baseline hormone levels were also analyzed. Student's t-test or Mann-Whitney U test was used to compare continuous variables between the groups; categorical data were evaluated by using Pearson χ2 or Fisher exact test, when appropriate. Binary logistic regression method was used to identify risk factors for POI. RESULTS: We found significantly elevated levels of INOS (234.1±749.5 versus133.8±143.0; p=0.005), MPO (3,438.7±1,228.6 versus 2,481.9±1,230.1; p=0.001), and TOS (4.3±1.4 versus 3.6±1.4; p=0.02) in the sera of the study group when compared to the BMI-age matched control group. However, difference in serum levels of TAS were not significant between the 2 groups (1.7±0.2 versus 1.6±0.2; p=0.15). Logistic regression method demonstrated that BMI <25 kg/m2, nulliparity, family history of POI, smoking, and elevated serum levels of INOS, MPO, and TOS were independent risk factors for POI. CONCLUSION: We found an increase in INOS, MPO, and TOS in women with POI. These serum markers may be promising in early diagnosis of POI. Further large-scale studies are required to determine whether oxidative stress markers have a role in diagnosing POI.

Stability of urine specimens stored with and without preservatives at room temperature and on ice prior to urinalysis.

OBJECTIVES: Laboratories determine the most appropriate approach for the collection and transport of urine specimens. We investigated the effect of a chlorhexidine-based preservative tube on sample stability, compared the results of refrigerated polystyrene tubes with no additives, and investigated the effect of temperature on the performance of preservative tubes. DESIGN AND METHODS: Fresh urine specimen (n=48) aliquots in BD Vacutainer® Plus Urinalysis Preservative Tubes and polystyrene tubes were analyzed on an Iris Diagnostics iQ200. Samples in polystyrene tubes were refrigerated for 4 and 8h. Four aliquots in preservative tubes were kept at room temperature for 4, 8, 24, and 72h, while two aliquots were kept on ice for 4 and 8h. RESULTS: There was good agreement for all chemistry and microscopy parameters with the exceptions of white blood cells (WBCs) at 24 and 72h and red blood cells (RBCs) at 72h. Preservative tubes on ice showed a significant decrease in concordance of WBCs and calcium oxalate (CaOx) parameters compared with the results at room temperature. Results of refrigerated polystyrene tubes showed good agreement with the exceptions of WBC clumps and amorphous crystal at 8h. CONCLUSIONS: A chlorhexidine-containing preservative tube seems advantageous for urine sample transport from outside healthcare services. A preservative tube offers comparable results with urine samples kept in a refrigerator for 4-8h for the majority of parameters. Keeping samples at room temperature is recommended when preservative tubes are used because ice produces a negative effect on WBCs and CaOx.

An alternative marker of low-density lipoprotein cholesterol in coronary artery disease: non-high-density lipoprotein cholesterol.

BACKGROUND/AIM: Dyslipidemia is one of the most important risk factors for coronary artery disease (CAD), and low-densitylipoprotein cholesterol (LDL-C) is used to measure dyslipidemia. Non-high-density lipoprotein cholesterol (non-HDL-C) seems to be an alternative parameter to LDL-C as it is not influenced by triglyceride (TG) levels. The aim of this study is to compare non-HDL-C and LDL-C levels as risk markers in CAD patients. MATERIALS AND METHODS: One hundred and ten CAD patients and 42 individuals with normal coronary angiography results were included in this study. Patients were divided into 2 groups: TG < 200 mg/dL (n = 75) as group 1 and TG > 200 mg/dL (n = 35) as group 2. Total cholesterol (TC), TG, and HDL-C levels were analyzed with a Roche Modular P800 autoanalyzer. LDL-C and non-HDL-C levels were calculated. RESULTS: There were statistically significant differences in TC, TG, HDL-C, and non-HDL-C levels when the groups were compared. Non-HDL-C levels of group 2 were statistically higher than those of group 1 and the control group. There was no significant difference in LDL-C levels between the groups. CONCLUSION: Non-HDL-C levels are better risk markers than LDL-C levels, especially in patients with TG > 200 mg/dL, and non-HDL-C levels should be taken into consideration when evaluating the risk of CAD.

Comparison of iSED and Ves-Matic Cube 200 Erythrocyte Sedimentation Rate Measurements With Westergren Method.

BACKGROUND: The erythrocyte sedimentation rate (ESR) test is performed widely in laboratories. Besides the traditional Westergren method, new methods have been developed for ESR measurements. We aimed to compare the instruments using new methods, iSED (Alcor Scientific) and Ves-Matic Cube 200 (Diesse Diagnostica Senese, Italy) with the Westergren method. METHODS: Blood samples from 136 patients were taken into EDTA tubes for automated analyzers and citrated tubes for Westergren method. Patients were divided into three groups- low, medium, and high-according to their sedimentation rates. Precision, stability, and interference studies of the methods were performed. RESULTS: The iSED sedimentation method (n = 136) yielded a slope of (0.61-0.84), with an intercept of (-2.32 to 1.89), which resulted in a mean bias of 13; and the Ves-Matic Cube 200 method (n = 136) yielded a slope of (0.85-1.00), with an intercept of (0.00-3.07), which resulted in a mean bias of 1.4 in Passing-Bablok regression analysis compared to the reference method. CONCLUSION: iSED sedimentation showed a poor correlation and a high bias (>10%) with the Westergren method, and Ves-Matic Cube 200 method showed a higher correlation and a lower bias than the iSED device when compared with Westergren reference method. These instruments should be carefully monitored.