Role of Serum and Urinary Hepcidin in Young Females of Reproductive Age in North India.

Introduction Iron deficiency is one of the most common nutritional disorders in the world affecting young females of the reproductive age group. Indeed, an ideal screening test should be capable of identifying iron deficiency long before developing anemia. Henceforth, the present study was aimed to determine utility of hepcidin in iron deficiency and to see its correlation with different iron indices. Methods This cross-sectional study was conducted in the Department of Biochemistry, SGT Medical College Hospital and Research Institute, Budhera, Gurugram, Haryana, India. It included 200 nonpregnant female students aged between 18 and 25 years. Estimation of hepcidin was by enzyme-linked immunosorbent assay. Quantitative estimation of serum iron, total iron-binding capacity (TIBC), and transferrin saturation was done via semi-autoanalyzer. Statistical analysis was done using SPSS v22. Results The reference range of urinary hepcidin established in this study was 110 to 969 ng/mg creatinine (mean ± standard deviation 328.3 ± 195.07 ng/mg creatinine). Serum hepcidin and urinary hepcidin had a significant correlation with iron indices. Area under the curve of urinary hepcidin was obtained with best combination of diagnostic sensitivity (82.6%) and specificity (83.1%) at a cutoff value of > 15.7 ng/mL and ≤ 199 ng/mg, respectively. Conclusion Since ferritin, TIBC, transferrin saturation, and hepcidin each represent different aspects of iron metabolism, incorporating hepcidin in the present diagnostics and combined evaluation of these indices may accord enhanced clinical information. Hepcidin would help to stratify the vulnerable young healthy female population in early stages of iron deficiency and guide proper interventions to reduce morbidity.

Lipid Risk Factors in Vitiligo: Homocysteine the Connecting Link?

BACKGROUND: Vitiligo is an acquired, depigmenting skin disease with unclear, multifactorial etiopathogenesis affecting not only skin but also connected with metabolic abnormalities, including glucose and lipid abnormalities, confirming the systemic nature of the disease. Vitamin B12 and folic acid deficiencies have also been implicated in vitiligo that can lead to increased homocysteine levels in the circulation, a finding that can be expected in vitiligo. Further, an association between hyperlipidemia and hyperhomocysteinemia has been suggested in vitiligo patients showing the eminent need of management of vascular risk factors especially in diseases with metabolic abnormalities. The present study was thus aimed to assess homocysteine levels and lipid risk factors in vitiligo patients and to study their interrelationship to predict the cardiometabolic risk in vitiligo and its management. METHODS: The present cross-sectional study included 54 case of generalized vitiligo and 54 age and gender-matched healthy adults as controls. Patients were assessed for disease activity and severity (VASI Score). All the subjects were evaluated for the lipid profile and serum homocysteine levels. RESULTS: Lipid profile analysis showed significantly higher LDL-cholesterol concentration (p = 0.010), significantly lower HDL-cholesterol concentration (p = 0.003) and significantly higher LDL/HDL ratio (p = 0.001) in patients with vitiligo in comparison with the control group. The mean serum homocysteine levels in vitiligo patients (18.76 ± 10.02 µmol/L) were significantly higher than in controls (10.04 ± 5.34 µmol/L) (p = 0.000). Serum homocysteine levels showed a positive correlation with the duration of disease which was near to significant (p = 0.064) and VASI score (p = 0.000). No significant correlation was observed between serum Hcy levels and lipid profile. CONCLUSIONS: The present study showed significantly higher Hcy levels in vitiligo patients than controls which may be a precipitating factor in the pathogenesis of vitiligo in predisposed individuals. The results of our study are also indicative of lipid disturbances in vitiligo. These findings may reflect some ongoing abnormal metabolic processes in patients with vitiligo. Therefore, we recommend routine estimation of homocysteine and lipid profile in vitiligo patients both of which should be regarded as independent significant contributing factors of cardiometabolic risk worth considering in the management of patients with vitiligo.

Association of VDBP and CYP2R1 gene polymorphisms with vitamin D status in women with polycystic ovarian syndrome: a north Indian study.

PURPOSE: Polycystic ovarian syndrome (PCOS) is the most common endocrine abnormality among women of reproductive age and is usually associated with oligo-ovulation/anovulation, obesity, and insulin resistance. Hypovitaminosis D may also be a primary factor in the initiation and development of PCOS. However, little is known about the role of genetic variation in vitamin D metabolism in PCOS aetiology. Therefore, we studied the genetic polymorphisms of CYP2R1 and vitamin D binding protein (VDBP) in an Indian population. METHODS: Serum vitamin D was measured by ELISA. Genotyping of VDBP single nucleotide polymorphisms (SNPs) rs7041 (HaeIII; G>T) and rs4588 (StyI; A>C) and CYP2R1 SNP rs2060793 (HinfI; A>G) was carried out by restriction fragment length polymorphism in 50 cases of PCOS that were compared with 50 age-matched healthy women. RESULTS: Vitamin D levels were found to be significantly lower in women with PCOS (p = 0.008) than in age-matched controls. There was no significant difference in genotype frequencies of all three polymorphisms (rs7041, rs4588, and rs2060793) between PCOS and control women. In women with a vitamin D deficiency (<20 ng/ml), the GT allele of the VDBP SNP rs7041 (p value =0.04), the VDBP allelic combination Gc1F/1F (T allele of rs4588 and C allele of rs7041) (p value =0.03), and the GA allele of the CYP2R1 SNP rs2060793 (p = 0.05) were associated with an increased risk of developing PCOS. CONCLUSIONS: The present study shows that the GT allele of VDBP SNP rs7041, the VDBP allelic combination (GC1F/1F), and GA allele of CYP2R1 SNP rs2060793 in vitamin D deficient women increase the risk of PCOS.

Study of Vitamin D Receptor Gene Polymorphism (FokI, TaqI and ApaI) Among Prostate Cancer Patients in North India.

INTRODUCTION: Incidence of prostate cancer is rising worldwide. Multiple factors have been suggested for the aetiology of prostate cancer including ethnic, genetic and diet. Vitamin D (calcitriol) has been shown to have role in cell growth and differentiation and its deficiency is implicated as one of the aetiological factors in prostate cancer. Prostatic epithelial cells express Vitamin D Receptor (VDR) as well as 1α- hydroxylase enzyme that are required for the synthesis of calcitriol and its action. Polymorphism in VDR gene has been associated with prostate cancer in some epidemiological studies; but, there is paucity of information in the Indian context. AIM: The present study was aimed to explore the association of VDR gene polymorphism with the development of prostate cancer. MATERIALS AND METHODS: Three Single Nucleotide Polymorphisms (SNP) sites viz., FokI, TaqI and ApaI were analysed in 120 cases of prostate cancer which were compared with their 120 healthy first degree relatives and 120 non-related controls in the Department of Biochemistry in collaboration with the Department of Urology. RESULTS: Analysis showed significantly decreased incidence of Tt and Aa genotype in prostate cancer patients as compared to healthy non-relative controls (p=0.016 and 0.043 respectively). As compared to first degree relatives, incidence of Tt genotype is significantly lower in cases (p=0.005). No significant association was found with FokI polymorphism. CONCLUSION: This study suggests the protective role of heterozygous genotypes of TaqI and ApaI polymorphism against the development of prostate cancer.