Maternal serum fatty acid binding protein-4 level is upregulated in fetal growth restriction with abnormal Doppler flow patterns.

PURPOSE: This study aimed to determine fatty acid binding protein-4 (FABP-4) concentrations in maternal serum of fetal growth restriction (FGR) pregnancies and controls of normal pregnancies. Furthermore, we hypothesized that the alterations in FABP-4 levels might correlate with FGR severity. METHODS: We performed this prospective case-control study with 83 pregnant women. The study groups included 26 FGR pregnancies without abnormal fetal Doppler flow patterns and 25 pregnancies complicated with FGR accompanied by abnormal fetal Doppler flow patterns. RESULTS: The median serum FABP-4 concentrations were significantly higher in the FGR cases with abnormal Doppler flow pattern group (2.09 ng/mL) than in the FGR cases without abnormal Doppler flow pattern group (1.62 ng/mL) and the control group (1.20 ng/mL, p < 0.001). A significant negative correlation was observed between maternal serum FABP-4 levels and time to birth from blood sample collection (r = -0.356 and p = 0.001), gestational week at birth (r = -0.386 and p < 0.001), and birth weight (r = -0.394 and p < 0.001). A 1.35 ng/mL cut-off value of serum FABP-4 level could be used to discriminate FGR cases with a 78.4% sensitivity and 60.6% specificity. The optimal cut-off value of FABP-4 levels as an indicator for the diagnosis of FGR with abnormal Doppler flow pattern was estimated to be 1.76 ng/mL, which yielded a sensitivity of 84.0% and a specificity of 75.8%. CONCLUSION: FABP-4 is a crucial biomarker in the diagnosis and determining the severity of pregnancies with restricted fetal growth. We consider that FABP-4 is a powerful, reliable, and unique biomarker to diagnose FGR pregnancies.

Hemolysis detection for ethanol measurement in whole blood samples before centrifugation: HemCheck device evaluation.

Background: As previously reported, the measurement of ethanol can also be affected by interference from hemolysis. This is a matter of concern since ethanol is widely regarded as the most commonly abused substance globally. When sample re-collection is ordered to eliminate hemolysis effects for ethanol testing, this can have unfavourable consequences for these patients. Rapid detection of hemolysed specimens would alleviate some issues associated with forensic samples. This study aimed to assess the qualitative analytical performance of a novel point-of-care testing device per the guidelines specified in CLSI-EP-12A document. HemCheck™ is a novel POCT device that qualitatively detects free-hemoglobin levels on the specimen shortly after drawing the sample. Methods: The system consists of two components. One is a cartridge with a needle that is used to transfer a small volume of whole blood from a vacuum tube to vertical and lateral flow filtration. The second component is the reader. The consumable cartridges are designed to be inserted into the reader without requiring the syringe or blood collection tube removal. A red indicator led illuminates, indicating that the sample has been hemolysed. To assess the imprecision of the method, we determined the C5-C95 interval and C50, using the Roche Cobas clinical chemistry analyser as the comparator. For this study, we utilised residual samples.

Evaluation of new biomarkers in stage III and IV endometriosis.

OBJECTIVE: To investigate the efficacy of new endometriosis biomarkers in diagnosis and treatment. METHODS: Thirty women with Stage III-IV endometriosis who were given an indication for surgery and 49 control patients were compared. Preoperative and postoperative serum levels of Annexin A5 (ANXA5), soluble intercellular adhesion molecule-1 (sICAM-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), soluble vascular cell adhesion molecule-1 (sVCAM-1), vascular endothelial growth factors (VEGF) and Ca-125 measurements were compared. RESULTS: AUCs of ANXA5, sICAM-1, IL-6, TNF-α, VCAM-1, VEGF biomarkers were not found to be significant in diagnosing endometriosis when evaluated alone (p > 0.05). Only the AUC of the Ca-125 biomarker values were found to be significant with 73% sensitivity and 98% specificity (p < 0.001). However, when Ca-125 and ANXA5 were evaluated together, it was concluded that the diagnosis of endometriosis could be made with 73% sensitivity and 100% specificity. CONCLUSION: When Ca-125 and ANXA5 are evaluated together, it seems to be more valuable than Ca-125 alone in diagnosing endometriosis.

Evaluation of the Succeeder SF-8200 Fully Automated Coagulation Analyzer.

BACKGROUND: The SF-8200 is a new coagulation analyzer developed by Beijing Succeeder Technology Inc., China. The SF-8200 is able to perform clotting, chromogenic, and immunoturbidimetric tests. System capability is a throughput of up to 360 tests per hour, 60 sample tubes can be loaded at any time, and its reaction cuvette capacity is 1,000. The analyzer also has an optional cap piercing module to reduce manual sampling time. We aimed to perform an analytical performance comparison study between Succeeder SF-8200 and Stago Compact Max3 because fully automated coagulation analyzers have become one of the most essential components of clinical laboratories. METHODS: Routine coagulation tests were assessed, which are the most ordered in laboratories such as PT, aPTT, and fibrinogen. Stago Compact Max-3 was accepted as the reference instrument in the comparison study. The assay precisions were assessed using fresh and pooled plasma samples or consumer internal quality controls. Hemolysis, lipemia, and icterus interferences were also verified. RESULTS: The coefficients of variation assessed in the intra and inter-assay precision analyses were below 5% representatively for assessed parameters. The inter-analyser comparison demonstrated good results. Results obtained by the SF-8200 showed high comparability predominantly to used reference analyzers, with correlation coefficients ranging from 0.953 to 0.976. In our routine laboratory setting, SF-8200 reached a sample throughput rate of 360 tests per hour. No considerable influence on tests was found for elevated levels of free hemoglobin, bilirubin, or triglycerides. CONCLUSIONS: In conclusion, the SF-8200 was an accurate, precise, and reliable coagulation analyzer in routine testing. According to our study, the results demonstrated excellent technical and analytical performance.

The use of preanalytical quality indicators: a Turkish preliminary survey study.

OBJECTIVES: The utilization of reliable quality indicators (QIs) proven to be suitable for monitoring and improvement tools is one of the best choices to minimize of the risk of errors in all laboratory processes called as total testing process (TTP). In 2008, a Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) established by International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) developed the Model of Quality Indicators (MQI) complying with requirements of the ISO 15189:2012 standard for laboratory accreditation. They have also been dealing with harmonizing the QIs in most laboratories worldwide since then. The present study was set out to investigate the frequency of using IFCC WG-LEPS' pre-QIs by Turkish laboratories and to assess the conformity of them, by taking into account Turkey's conditions. METHODS: A survey consisting nine questions was applied in 81 laboratories using SurveyMonkey. RESULTS: According to the survey results, most of the laboratories reported they have used pre-QIs in the quality standards of health prepared by Turkish Ministry of Health (MOH). A part of IFCC WG-LEPS' pre-QIs were being utilized by more than 80% of the laboratories, the rest of which only used by 10% of laboratories. CONCLUSIONS: The majority of the medical laboratories have been using the pre-QIs included in the guidelines of Quality Standards prepared by the MOH. The pre-QIs are partially compatible with IFCC WG-LEPS' pre-QIs. The definitions of IFCC WG-LEPS' pre-QIs may also be revised to make them more clear and understandable by IFCC WG-LEPS. The insufficiency of Health Information Management Systems (HIMS) limits the use of pre-QIs proposed by IFCC WG-LEPS. Finally, the education of relevant personnel about the use of HIMS and pre-QIs is very crucial to harmonize and to extend the use of IFCC WG-LEPS' pre-QIs in Turkish medical biochemistry laboratories.

Serum osteoprotegerin levels in school-aged children with asthma

BACKGROUND: Various inflammatory biomarkers have been used in asthma cases for evaluating inflammation, however it has been determined that the majority of these biomarkers are insufficient for putting forth the course and severity of the disease. Osteoprotegerin is a glycoprotein mediator in the lung and macrophages. As far as we know, there are no studies about the role played by osteoprotegerin in child patients with asthma. OBJECTIVE: It was planned to examine the relationship between osteoprotegerin levels in childhood asthma and respiratory functions and airway inflammation and to assess its use as a biomarker. METHODS: The study included patients aged 6-16 years who were diagnosed with asthma at the pediatric allergy outpatient clinic of Bagcilar Training and Research Hospital in Turkey. The correlation analyses for the osteoprotegerin levels of asthma patients and their respiratory functions were examined. RESULTS: The age average of asthma cases was 10.61 ± 3.04 years and 51.2 % were female. No statistically significant difference was observed between the osteoprotegerin levels of the groups (p > 0.05). A negative and statistically significant correlation was observed between the FEV1 and FVC values and osteoprotegerin levels (p = 0.015, p = 0.003). CONCLUSIONS: This was the first study to examine the relationship between osteoprotegerin levels and airway inflammation in children with asthma. We believe that there is a need for wider scale studies in which clinical symptoms and more parameters are evaluated for defining the role played by osteoprotegerin level in children with asthma and for determining its usability as a biomarker

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Serum osteoprotegerin levels in school-aged children with asthma.

BACKGROUND: Various inflammatory biomarkers have been used in asthma cases for evaluating inflammation, however it has been determined that the majority of these biomarkers are insufficient for putting forth the course and severity of the disease. Osteoprotegerin is a glycoprotein mediator in the lung and macrophages. As far as we know, there are no studies about the role played by osteoprotegerin in child patients with asthma. OBJECTIVE: It was planned to examine the relationship between osteoprotegerin levels in childhood asthma and respiratory functions and airway inflammation and to assess its use as a biomarker. METHODS: The study included patients aged 6-16 years who were diagnosed with asthma at the pediatric allergy outpatient clinic of Bagcilar Training and Research Hospital in Turkey. The correlation analyses for the osteoprotegerin levels of asthma patients and their respiratory functions were examined. RESULTS: The age average of asthma cases was 10.61±3.04 years and 51.2 % were female. No statistically significant difference was observed between the osteoprotegerin levels of the groups (p>0.05). A negative and statistically significant correlation was observed between the FEV1 and FVC values and osteoprotegerin levels (p=0.015, p=0.003). CONCLUSIONS: This was the first study to examine the relationship between osteoprotegerin levels and airway inflammation in children with asthma. We believe that there is a need for wider scale studies in which clinical symptoms and more parameters are evaluated for defining the role played by osteoprotegerin level in children with asthma and for determining its usability as a biomarker.

Therapeutic effectiveness of rectally administered fish oil and mesalazine in trinitrobenzenesulfonic acid-induced colitis.

AIM: Fish oil (FO) and mesalazine have well-known anti-inflammatory and antioxidant effects; on the other hand, information related to combined intrarectal administration of FO and mesalazine is limited. The present study was conducted to make comparison on therapeutic effectiveness of rectally administered FO and mesalazine in rats with trinitrobenzenesulfonic acid (TNBS)-induced colitis. METHODS: Wistar rats were randomly assigned to 5 groups as (1) Control, (2) Colitis, (3) Colitis + Mesalazine (Colitis + M), (4) Colitis + Fish Oil (Colitis + F), and (5) Colitis + Mesalazine + Fish Oil (Colitis + M + F). Intrarectally administered TNBS induced colitis. At the end of the trial, the rats' macroscopic and histopathologic lesions were rated and tumour necrosis factor (TNF)-α, Interleukin 6 (IL6), glutathione reductase (GR), glutathione peroxidase (GP), myeloperoxidase (MPO), malondialdehyde (MDA), Superoxide dismutase (SOD), Total nitrate and nitrite, and catalase (CAT) in serum and tissue were detected. RESULTS: As a result of macroscopic and microscopic examination, although separate administrations of FO and mesalazine partly decreased the damage, their combined administration decreased the damage scores significantly (p < 0.01). It was observed that separate and combined administrations of FO and mesalazine decreased the increase in the serum and tissue TNF-α and IL-6 levels caused by colitis (p < 0.05). It was observed that the serum MPO, serum GR, tissue SOD, tissue nitrite/nitrate values of both Colitis + M and Colitis + F groups were close to the control in terms of all the parameter values in Colitis + M + F group (p > 0.05). Also based on the histological results, the inflammation damage in the tissue caused by colitis in the Colitis + M + F group recovered significantly. CONCLUSIONS: We found that microscopic and macroscopic damage, serum IL-6 level decreased and increased serum and tissue GP and tissue GR values in Colitis + M + F group compared to Colitis + M and Colitis + F groups. Combined intrarectal administration of FO and mesalazine may bring a new insight concerning the treatment of ulcerative colitis.

Serum omentin-1 levels in obese children.

Background Obesity is an important cause of morbidity, and it has an increasing frequency in childhood. Studies have reported that 33% of adults and 20-27% of children and adolescents are obese. Recently, it has been shown that the prevalence of obesity in the childhood group is higher than the past years. Omentin-1 is an adipokine which is synthesized from the visceral fat tissue but not synthesized in the subcutaneous fat tissue. Omentin-1 has been shown to increase insulin-mediated glucose uptake, especially in the adipose tissue. Studies have shown that plasma omentin-1 levels, which play an important role in the pathogenesis of insulin resistance, are significantly lowered in obese, polycystic ovary syndrome (PCOS) and diabetic patients. The aim of this study was to investigate the relationship between obesity and omentin-1 levels in children. Methods The study included obese children with a body mass index (BMI) greater than the 95th percentile and healthy children with a BMI lower than the 85th percentile. Obese and healthy individuals had similar age and sex distributions. Glucose, insulin, lipid profiles, thyroid panels and metabolic markers were evaluated. Results The levels of omentin-1 in obese children were significantly lower than in the control group (p<0.05). Results of Spearman's correlation analysis for all participants showed that omentin-1 levels were negatively related with triglycerides, total cholesterol, serum free thyroxine (FT4), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), body weight, waist circumference (WC) and BMI percentile values. Conclusions Our findings indicate that serum omentin-1 levels are lower in obese children than in non-obese individuals. Omentin-1 can be used as a metabolic biomarker in children and adolescents.

Are there any new reliable markers to detect renal injury in obese children?

AIM: The aim of this study was to examine the serum and urine levels of kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), matrix metalloproteinase-9 (MMP-9), and serum Cystatin-C to determine the renal effect of obesity in obese children. METHODS: Seventy-two obese and 35 non-obese healthy children were included in this study. Blood pressure (BP) was evaluated with office measurement. Creatinine, cystatin C, lipids, fasting glucose, and insulin levels were measured, and homeostasis model assessment -insulin resistance (HOMA-IR) was calculated. The urine albumin/creatinine ratio was calculated. The serum and urine KIM-1, NGAL, OPN, and MMP-9 levels were measured. RESULTS: Serum cystatin-C, triglyceride, and homeostasis model assessment-insulin resistance (HOMA-IR) index were found to be significantly higher in the obese group (p = .0001), and high-density lipoprotein (HDL) cholesterol was found to be significantly lower (p = .019) in the obese group. No significant differences were found in serum KIM-1, NGAL, OPN or MMP-9 levels between groups (p > .05). No significant differences were found in urine KIM-1 and MMP-9 levels (p > .05), Urine NGAL, and OPN levels were found significantly higher in obese groups (p < .05). CONCLUSIONS: According to our results, although serum KIM-1, NGAL, OPN, MMP-9, and urine MMP-9, urine KIM-1 do not appear to be ideal markers to evaluate renal injury in the early period of obesity, the serum levels of cystatin C and urine NGAL, urine OPN can be used as a good marker for assessing the renal effect of obesity which can lead end stage renal disease in pediatric population.

Effects of statin treatment with atorvastatin on urolithiasis-associated urinary metabolic risk factors: an experimental study.

PURPOSE: To investigate whether atorvastatin has favorable effects on urinary metabolic risk factors associated with urolithiasis. METHODS: Sixteen male Sprague-Dawley rats were randomly divided into two groups, and baseline spot and 24-h urine samples were collected. Distilled water and atorvastatin were administered to rats during 4 weeks in the control and atorvastatin groups, respectively. At the end of the experimental procedure, spot and 24-h urine samples were collected again. Citrate, oxalate, cystine, uric acid, calcium and magnesium levels were determined in 24-h urine samples. Citrate/creatinine, oxalate/creatinine, uric acid/creatinine, calcium/creatinine and magnesium/creatinine ratios were also calculated in spot urine samples. Comparison of the baseline and post-experimental levels of these parameters was made in each group. RESULTS: The majority of the parameters were similar before and after the experimental procedure in each group. In the atorvastatin group, uric acid and calcium levels were affected. Administration of atorvastatin was significantly decreased the levels of uric acid, whereas increased the levels of calcium (P = 0.025 and P = 0.017, respectively). CONCLUSIONS: Our study revealed that atorvastatin has decreasing effect on UUa levels, whereas increasing effect on UCa levels. We think it cannot certainly be deduced that atorvastatin could be beneficial on overall urinary metabolic risk factors. Contrarily, atorvastatin may lead to an increased risk of calcium stones, but when considering its UUa decreasing effect, it may help in reducing the uric acid stone recurrence.

Effects of alpha lipoic acid on motor function and antioxidant enzyme activity of nerve tissue after sciatic nerve crush injury in rats.

AIM: Background: Alpha lipoic acid (ALA) that is a strong antioxidant drug is tried for both protection and treatment of various diseases of central and peripheral nervous systems. MATERIAL AND METHODS: Material and Methods: Protective effects of ALA on crush type peripheral nerve injury were evaluated. 28 Sprague-Dawley rats were divided into four groups: In Group 1, sciatic nerve was only explored. Sciatic nerve crush injury was performed after serum physiologic injection intraperitoneally in Group 2, and after ALA injection in Groups 3 and 4. In all subjects, Sciatic Functional Index (SFI) was calculated. All subjects were sacrificed 1 hour after injury in first three groups, and 48 hours after in Group 4. Nerve samples were taken. Superoxide dismutase, catalase and glutathione peroxidase activities were measured in nerve tissue. RESULTS: Results: Administration of ALA before injury provided significantly better SFI values and higher levels of antioxidant enzymes than control group. These effects were significantly prominent 48 hours after injury. CONCLUSION: Conclusion: ALA that was given before crush type peripheral nerve injury provided to decrease damage of the nerve. Specific mechanisms of this effect must be clarified and must be shown that it is whether effective when it is given after injury or not.

Serum antioxidant enzyme levels are decreased in patients with urinary calcium oxalate stones.

PURPOSE: To compare the serum antioxidant enzyme levels between patients with urinary stone disease and healthy volunteers to determine the effect of cellular oxidative stress on urinary calcium oxalate stones formation.Materials & Methods: A total of 51 patients with proven urinary calcium oxalate stones (female 35.3%, mean age: 49.3 years) and 37 healthy subjects (female 45.9%, mean age: 44.1 years) were included. The serum levels of antioxidant catalase, glutathione peroxidase, superoxide dismutase and lipid peroxidation were measured in serum samples taken from the peripheral venous circulation. RESULTS: Mean serum catalase level of patient group was insignificantly higher than healthy subjects (7.54 mmol- H2O2/mg/sec versus 6.16 mmolH2O2/mg/sec, respectively; P = .06) whereas mean superoxide dismutase level (1.56 U/ml versus 3.86 U/ml, P = .047), glutathione peroxidase level (6.70 U/ml versus 8.19 U/ml, P = .022) and lipid peroxidation level (2.35 nmol/ml versus 3.31 nmol/ml, P = .034) of patient group were significantly lower than healthy subjects. Patients with family history of urinary stone disease had significantly lower mean serumlevels of catalase (P = .037), superoxide dismutase (P = .047) and glutathione peroxidase (P = .01), compared with patients without family history. CONCLUSION: The findings of this study provide evidence regarding the role of oxidative stress in the development of urinary calcium oxalate stones. Future clinical trials are necessary to elucidate the actual mechanisms of the calcium oxalate stone formation in the environment with increased oxidative stress.

Is Chronic Curcumin Supplementation Neuroprotective Against Ischemia for Antioxidant Activity, Neurological Deficit, or Neuronal Apoptosis in an Experimental Stroke Model?

AIM: To investigate the neuroprotective effect of chronic curcumin supplementation on the rat forebrain prior to ischemia and reperfusion. MATERIAL AND METHODS: Forebrain ischemia was induced by bilateral common carotid artery occlusion for 1/2 hour, followed by reperfusion for 72 hours. Older rats were divided into five groups: Group I received 300 mg/kg oral curcumin for 21 days before ischemia and 300 mg/kg intraperitoneal curcumin after ischemia; Group II received 300 mg/kg intraperitoneal curcumin after ischemia; Group III received 300 mg/kg oral curcumin for 21 days before ischemia; Group IV had only ischemia; Group V was the sham-operated group. The forebrain was rapidly dissected for biochemical parameter assessment and histopathological examination. RESULTS: In forebrain tissue, enzyme activities of superoxide dismutase, glutathione peroxidase, and catalase were significantly higher in Group I than Groups II or III (p < 0.05) while xanthine dehydrogenase and malondialdehyde enzyme activities and concentrations of interleukin-6 and TNF-alpha were significantly lower in Group I when compared to Groups II and III (p < 0.05). A significant reduction in neurological score was observed after 24 and 72 hours in the curcumin-treated groups compared with the ischemic group. We also found a marked reduction in apoptotic index after 72 hours in the groups receiving curcumin. Significantly more TUNEL-positive cells were observed in the ischemic group compared to those treated with curcumin. CONCLUSION: We demonstrated the neuroprotective effect of chronic curcumin supplement on biochemical parameters, neurological scores and apoptosis following ischemia and reperfusion injury in rats.

Nesfatin-1 alleviates extrahepatic cholestatic damage of liver in rats.

Obstructive jaundice (OJ) can be defined as cessation of bile flow into the small intestine due to benign or malignant changes. Nesfatin-1, recently discovered anorexigenic peptide derived from nucleobindin-2 in hypothalamic nuclei, was shown to have anti-inflammatory and antiapoptotic effects. This study is aimed to investigate the therapeutic effects of nesfatin-1 on OJ in rats. Twenty-four adult male Wistar-Hannover rats were randomly assigned to three groups: sham (n = 8), control (n = 8), and nesfatin (n = 8). After bile duct ligation, the study groups were treated with saline or nesfatin-1, for 10 days. Afterward, blood and liver tissue samples were obtained for biochemical analyses, measurement of cytokines, determination of the oxidative DNA damage, DNA fragmentation, and histopathologic analyses. Alanine aminotransferase and gamma-glutamyl transferase levels were decreased after the nesfatin treatment; however, these drops were statistically non-significant compared to control group (p = 0.345, p = 0.114). Malondialdehyde levels decreased significantly in nesfatin group compared to control group (p = 0.032). Decreases in interleukin-6 and tumor necrosis factor-α levels from the liver tissue samples were not statistically significant in nesfatin group compared to control group. The level of oxidative DNA damage was lower in nesfatin group, however this result was not statistically significant (p = 0.75). DNA fragmentation results of all groups were similar. Histopathological examination revealed that there was less neutrophil infiltration, edema, bile duct proliferation, hepatocyte necrosis, basement membrane damage, and parenchymal necrosis in nesfatin compared to control group. The nesfatin-1 treatment could alleviate cholestatic liver damage caused by OJ due to its anti-inflammatory and antioxidant effects.

Association of Osteoprotegerin with Obesity, Insulin Resistance and Non-Alcoholic Fatty Liver Disease in Children.

BACKGROUND: Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily. Reduced OPG levels are related to obesity, insulin resistance, and non-alcoholic fatty liver disease (NAFLD). OBJECTIVES: The aim of this study was to evaluate the relationship between OPG levels, obesity, insulin resistance, and NAFLD in pediatric patients. METHODS: This was a prospective, cross-sectional, controlled study that was conducted in the department of pediatrics at Bagcilar training and research hospital in Istanbul, Turkey, between April and August 2015. The study was performed on 107 children with obesity and 37 controls aged 5 - 17 years. In the obese subset, 62 patients had NAFLD. Homeostatic model assessment-insulin resistance (HOMA-IR) was used to calculate insulin resistance. Insulin resistance was defined as a HOMA-IR value greater than 2.5. Plasma OPG levels were measured using enzyme-linked immunosorbent assays. NAFLD was diagnosed by hepatic ultrasound. RESULTS: The mean age was 11.25 ± 3.38 years in the patient group and 10.41 ± 3.15 years in the control group. The OPG level in the obese group with the mean of 55.20 ± 24.55 pg/mL (median = 48.81 pg/mL) was significantly lower than that in the control group with the mean of 70.78 ± 33.41 pg/mL (median = 64.57 pg/mL) (P = 0.0001). The optimal cut-off point (sensitivity, specificity) of the OPG level for the diagnosis of obesity was ≤ 46, 19 pg/mL. According to logistic regression analysis, fasting insulin (P = 0.036) and OPG (P = 0.01) levels were most affected by obesity. In the obese patients, who had HOMA-IR < 2.5, the mean level of OPG was 58.91 ± 6.88729 pg/mL (median = 49.55). In the obese patients, who had HOMA-IR ≥ 2.5, the mean level of OPG was 54.19 ± 22.21 pg/mL (median = 48.47). No significant correlations were found between OPG and HOMA-IR (P = 0.791). No statistically significant difference was observed in the mean OPG between patients with hepatosteatosis (mean = 54.55 ± 25.01 pg/mL) (median = 49.46) and those without the disease (56.30 ± 24.02 pg/mL) (mean = 48.34) (P = 0.089). CONCLUSIONS: We confirmed that serum OPG concentrations reduce in obese children. However, no correlation was identified between OPG and insulin resistance. OPG levels are not meaningful in the diagnosis of NAFLD in children with obesity.

Serum sclerostin is decreased following vitamin D treatment in young vitamin D-deficient female adults.

Sclerostin is produced almost exclusively by osteocytes, which also express receptors for 1,25 dihydroxyvitamin D3. The aim of this study was to investigate the effects of vitamin D3 treatment on serum sclerostin levels in young adult females with severe vitamin D deficiency. A total of 26 subjects were treated orally with calcium (1.200 mg/day for 2 months) and vitamin D3 (300.000 IU/week for 1 month). Serum 25-hydroxyvitamin D (25(OH)D) and sclerostin levels were measured before and after treatment. Baseline serum 25(OH)D and sclerostin levels were at 5.7 ± 2.4 ng/mL and 39.1 ± 14.4 pg/mL, respectively. Serum 25(OH)D was significantly increased, to 62.4 ± 18.7 ng/mL, following treatment; serum sclerostin was significantly decreased, to 29.3 ± 8.8 pg/mL. We conclude that serum sclerostin level is decreased following vitamin D3 treatment in patients with vitamin D deficiency.

The place of YKL-40 in non-small cell lung cancer.

INTRODUCTION: Despite varies treatment options, the survival rate of non-small cell lung cancer (NSCLC) is less than 1%. If biological behaviour of any cancer could be known, the information would potentially tailor the clinical work-up, assessment and treatment. The prognostic value of serum YKL-40 level has been investigated in different types of cancer and showed poor prognostic indication with more aggressive clinical course. We studied the role of serum YKL-40 levels in patients with NSCLC to determine the stage. MATERIALS AND METHODS: Serum YKL-40 levels in venous blood samples of 55 patients was studied. 49 (89.1%) male and 6 (10.9%) female newly diagnosed NSCLC patients whom received neither cancer specific or symptom relieving treatment are enrolled. TNM staging was determined based on the findings of computerized tomography (CT), positron emission tomography (PET), cranial magnetic resonance imaging (MRI), bronchoscopy and mediastinoscopy. The patients with NSCLC were divided into two groups; Group A: stage Ia, Ib, IIa, IIb, Group B: stage IIIa, IIIb and IV. RESULTS: There was a statistical difference in YKL-40 serum levels between groups (Group A, Group B) when compared (p< 0.05). A medium and statistical correlation was found (r= 0.48; p< 0.01) between YKL-40 levels and age. CONCLUSION: YKL-40 levels in advanced stage NSCLC (stage III, IV) was found to be significantly high compared to early stage. It should be kept in mind that when YKL levels are high, higher stages of the disease should be suspected and future tests should be performed.

Urinary 8-hydroxy-2'-deoxyguanosine level and plasma paraoxonase 1 activity with Alzheimer's disease.

BACKGROUND: Alzheimer's disease (AD) is the most frequent cause of dementia and age is the most important risk factor for AD. Aging is associated with increased free radical production and oxidative stress plays an important role in the pathogenesis of AD. 8-Hydroxy-2'-deoxyguanosine (8-OHdG) is a biomarker indicating oxidative DNA damage. Paraoxonase 1 (PON1) is a high-density lipoprotein (HDL)-associated antioxidant enzyme and prevents especially oxidation of low-density lipoproteins. The aim of this study is to measure urinary 8-OHdG levels and serum PON1 activity in patients with AD. METHODS: A total of 21 elderly patients diagnosed with moderate AD (10 men and 11 women, aged 76 ± 7.8 years) were included in the study. A total of 20 healthy elderly volunteers (11 men and nine women, aged 81 ± 7.2 years) were enrolled as a control group. Levels of urinary 8-OHdG, serum PON1 activity and lipid profile were determined in patients and controls. RESULTS: Urinary 8-OHdG levels were significantly increased, but serum PON1 activity was significantly decreased in patients compared to controls. Lipid profile did not show a difference between the groups. There was a negative correlation between 8-OHdG levels and PON1 activity only in the patient group (r=-0.536). Analytical performance characteristics of the methods used were satisfactory. CONCLUSIONS: In this study, evidence of increased oxidative DNA damage was determined in AD patients as well as decreased serum PON1 activity. Oxidant stress and oxidative DNA damage are important pathological processes in AD. The biomarkers, urinary 8-OHdG level and serum PON1 activity can be used to determine and monitor the status of patients with AD.

Coenzyme Q10 and high-sensitivity C-reactive protein in ischemic and idiopathic dilated cardiomyopathy.

BACKGROUND: Cardiomyopathy (CMP) is a common debilitating illness, associated with a high mortality and poor quality of life. There is extensive evidence from in vitro and animal experiments that CMP is a state of increased oxidative stress. Coenzyme Q10 (CoQ10) and high-sensitivity C-reactive protein (hs-CRP) are important markers to evaluate the oxidative stress and inflammatory status of patients with CMP. METHODS: A total of 28 patients with chronic stable heart failure (21 men and 7 women, ages 18-76 years) were included in the study. Causes of heart failure were ischemic CMP in 17 patients and idiopathic dilated CMP in 11 patients. A total of 28 patients (12 men and 16 women; ages 30-71 years) with normal coronary angiography were enrolled as a control group. Levels of CoQ10, albumin, total thiol groups (T-SH), bilirubin, uric acid as plasma antioxidants, hs-CRP as an inflammation marker and lipid profile were studied in patients and controls. RESULTS: Plasma CoQ10, T-SH and albumin levels were significantly decreased in patients compared to controls. Uric acid, bilirubin and hs-CRP levels were found to be significantly increased compared to controls. CONCLUSIONS: In this study, evidence of decreased antioxidant status was determined in CMP patients together with vascular inflammation. CoQ10, other plasma antioxidants and hs-CRP measured routinely can reflect decreased antioxidant status and inflammatory process in patients with dilated CMP. These markers can be used to monitor the status of patients with CMP.