Comparison of Insulin Sensitivity in Subclinical and Overt Hypothyroidism.

OBJECTIVE: To assess the association of thyroid hormone levels with insulin sensitivity in patients with subclinical (SCH) and overt hypothyroidism (OH). MATERIALS AND METHODS: The present cross-sectional case-control study observed the association of thyroid hormone levels with insulin sensitivity in patients with SCH and OH as compared to their age-matched controls with euthyroidism (ET). Thyroid profile status, fasting blood sugar and triglyceride level, and basic anthropometric measurements were noted. Fasting insulin level (FIL) was analyzed using serum. Body mass index (BMI) and quantitative insulin sensitivity check index (QUICKI) were calculated. RESULTS: Insulin levels were found to be significantly increased (p = 0.038) in patients with SCH as well as those with OH when compared with compared with age-matched ET controls. insulin sensitivity index (ISI) was comparable among the subjects of the three groups. CONCLUSION: Subclinical hypothyroidism (SCH) and OH had high insulin levels but without statistically significant association between thyroid-stimulating hormone (TSH) levels and QUICKI.

Aldose reductase and glutathione in senile cataract nucleus of diabetics and non-diabetics.

PURPOSE: The aim is to evaluate the aldose reductase (AR) and glutathione (GSH) activity in the nucleus of senile cataract in type 2 diabetes and non-diabetic group of patients. METHODS: A total of 62 patients including 31 diabetics and 31 non- diabetics who were undergoing cataract surgery were included. Nucleus extracted was sent for analysis of AR and GSH activity while blood sample was taken for glycated haemoglobin (HbA1c) levels. STATISTICAL ANALYSIS: Data were analysed using IBM SPSS 25. Comparison was carried out by unpaired T-test and correlations were established by Pearson's correlation. The p value less than 0.05 was considered significant for all analyses. STUDY DESIGN: This is a prospective cross-sectional comparative study. RESULTS: In this study, diabetic group patients showed earlier progression of cataract as compared to the non-diabetic group (p-value 0.0310). Mean HbA1c in the diabetic group was 7.34% compared to the non-diabetic group of 5.7% (p value < 0.001). AR in the diabetic patients was 2.07 mU/mg while the non-diabetic group was 0.22 mU/mg (p-value < 0.001). GSH in the diabetic group was 3.38 µMol/g and the non-diabetic group was 7.47 µMol/g (p value < 0.001). HbA1c showed positive correlation with AR among the diabetic group (p-value 0.028). CONCLUSION: Elevated oxidative stress can be strongly attributed to high AR and low GSH activity among the diabetic group as compared to the non-diabetic group and can lead to early cataract formation.

Relationship between physical activity, objective sleep parameters, and circadian rhythm in patients with head and neck cancer receiving chemoradiotherapy: A longitudinal study.

OBJECTIVES: This study was developed to assess the relationship between physical activity, sleep and circadian rhythm using accelerometer and urine melatonin levels in patients with head and neck cancer (HNC). Also, this study evaluated the changes in physical activity, sleep, and circadian rhythm during the seven-week course of chemoradiotherapy. METHODS: This longitudinal study recruited 27 participants diagnosed with HNC who were planning to undergo chemoradiotherapy. Accelerometers worn for 3 days during the 1st, 3rd, and 7th weeks of chemoradiotherapy were used to assess physical activity levels (step count and metabolic equivalents [METs]) and sleep quality (total sleep time [TST], sleep onset latency [SOL], and sleep efficiency [SE]). Urine melatonin analysis was conducted using the morning void urine sample on 1st, 3rd, and 7th weeks. The change in variables during the seven weeks and the correlation between them were analyzed. RESULTS: During the seven weeks, trends of reduction in variables of physical activity, sleep and circadian rhythm were observed with significant decrease in step count, TST and melatonin levels. SE was found to have strong negative correlation with physical activity. TST was found to have moderate correlation with SE and step count. The variables of physical activity also showed moderate correlation among them. CONCLUSION: This study concludes that higher physical activity is associated with poor SE due to increased night-time activity. There was a significant reduction in physical activity and sleep observed during seven weeks with moderate association between them. The significant circadian rhythm deregulation however showed poor association with the other variables.Level of Evidence: 2b.

His bundle pacing-is it the final frontier of physiological pacing ?-A single centre experience from the Indian sub-Continent.

BACKGROUND: Long term right ventricular pacing can have deleterious effects on left ventricular (LV) function. His bundle pacing (HBP), a novel procedure can probably circumvent this setback. We investigated if (1) HBP is associated with pacing induced LV dysfunction by using LV global longitudinal strain (GLS) and (2) intermediate term performance of the Select Secure (3830) lead in the His bundle location. This report is probably the first on HBP in the Indian population. METHODS: 61 patients, with normal LV ejection fraction (EF) with a guideline based indication for permanent pacing underwent a HBP pacemaker implantation using the His Select Secure 3830 lead; with lead guided mapping for locating the His bundle. The patients underwent GLS assessment; evaluation of the His lead parameters - sensing, impedance and capture thresholds immediately after implantation and at 6 months in addition to the standard follow up. RESULTS: At 6 month follow up, the average GLS did not show significant variation from baseline in patients requiring ventricular pacing more than 40% and was similar, irrespective of selective or non selective His bundle pacing. All the patients had stable pacemaker parameters - with little change in capture threshold, lead impedance or sensing of the His bundle lead - implying electrical and mechanical stability on intermediate term follow-up. CONCLUSION: HBP is a feasible procedure in the hands of an experienced operator, with stable lead performance. It does not appear to be associated with pacing mediated left ventricular dysfunction at intermediate term follow up. It should probably become the default method of permanent pacing.

Homeostatic Model Assessment-Insulin Resistance (HOMA-IR 2) in Mild Subclinical Hypothyroid Subjects.

Despite various studies with conflicting results, the effect of thyroid hormones on lipids and insulin levels in dysthyroidism is of great interest. This case control study was aimed to perceive the existence of IR and dyslipidemia in mild subclinical hypothyroid subjects (TSH ≤ 9.9 µIU/ml) as compared to their age and gender matched euthyroid controls. Basic demographic information like height, weight was recorded. Serum samples of all the subjects were assayed for thyroid profile, lipid profile, blood glucose, HbA1C and insulin. BMI and insulin resistance was calculated. Compared to controls patients with mild subclinical hypothyroidism demonstrated hyperinsulinemia and dyslipidemia observed by the higher LDL cholesterol. A significantly positive correlation was observed for HOMA-IR with TSH and LDL cholesterol. Hence, even in the mild subclinical hypothyroid state assessment of thyroid function should be combined with estimation of plasma glucose, insulin and serum lipids to monitor and prevent its associated effects.

Thalassaemia Trait with Gaucher Disease: A Diagnostic Dilemma.

Gaucher Disease is an autosomal recessive disease caused by the accumulation of glucocerebrosidase due to deficiency in lysosomal glucocerebrosidase. Thalassaemia trait is asymptomatic and is usually an incidental diagnosis. Both thalassaemia and Gaucher disease can have similar haematologic manifestations and hence, their coexistence causes diagnostic dilemma. Our patient presented at one-and-a-half years with weakness, pallor, failure to thrive and massive hepatosplenomegaly. Clinical examination and history pointed to a lipid storage disease. Peripheral smear revealed microcytic hypochromic cells and nucleated red cells with haemolytic blood picture. Thalassaemia trait was indicated on haemoglobin variant analysis using High Performance Liquid Chromatography. Liver biopsy, bone marrow aspirate and therapeutic splenectomy revealed Gaucher-like cells. Type 1 Gaucher disease can be clinically asymptomatic as well as present with massive liver and spleen enlargement and involvement of bone marrow. Anaemia, splenomegaly and thrombocytopenia are the usual presentations at diagnosis, similar to the haemoglobinopathies. Gaucher-like cells with normal beta-glucocerebrosidase (pseudo-Gaucher cells) are seen in thalassaemia, leukaemia, mycobacterial infections and myeloma. Gaucher disease coexisting with thalassaemia trait is uncommon. We report the occurrence of thalassaemia trait and Gaucher disease in a child, which resulted in confusion regarding the haematological diagnosis. This report highlights the necessity of independent establishment of the diagnosis in every patient so that appropriate management decisions are taken.

Effect of DOTS Treatment on Vitamin D Levels in Pulmonary Tuberculosis.

INTRODUCTION: Vitamin D (Vit D) modulates a variety of processes and regulatory systems including host defense, inflammation, immunity, and repair. Vit D Deficiency (VDD) is been implicated as a cause in diabetes, immune dysfunction and Tuberculosis (TB). Impaired metabolism of Vit D and an adverse outcome is associated with Pulmonary Tuberculosis (PTB). Directly Observed Treatment Short Course (DOTS) consist of drugs like rifampicin and isoniazid, which respectively cause accelerated loss of Vit D due to increased clearance and impairment of 25-hydroxylation causing diminished Vit D action. AIM: The aim of the present study was to estimate and compare serum Vit D status in newly diagnosed PTB patients before and after DOTS to validate the supplementation of Vit D in PTB patients. MATERIALS AND METHODS: Forty four newly diagnosed PTB patients of both the sexes in the age group of 18 to 60 years before starting DOTS were recruited to participate in this non- randomized controlled trial with their voluntary consent. Vit D status in these patients and the effect of DOTS on Vit D were evaluated. RESULTS: Mean Vit D levels of the study population aged 43±13 years was 20.74 ng/ml (normal >30 ng/ml) at the time of diagnosis. After completion of six months of therapy mean Vit D reduced to 17.49 ng/ml (p-value=0.041). On individual observations, 70% of the participants showed a decrease in Vit D levels from their baseline, whereas 30% showed an increase. Comparison between the two groups indicated the possible role of younger age in the improved status. CONCLUSION: VDD was seen in PTB patients, which worsened in majority of the study population after treatment; hence it would be advisable to recommend Vit D supplementation in PTB patients for a better outcome.

Acute pulmonary thromboembolism: Epidemiology, predictors, and long-term outcome - A single center experience.

INTRODUCTION: Acute pulmonary thromboembolism (PTE) is a life-threatening disease. Mortality in PTE still remains very high in spite of progress in diagnostic tools. Mortality rate is about 30% in patients with unrecognized acute PTE. METHODS: It is a single center observational study of 31 consecutive patients who were hospitalized in the Department of Cardiology at MS Ramaiah Memorial hospital between January 1, 2010 and June 2015. All the patients confirmed with diagnosis of acute PTE by CT scan (either HRCT or CTPA) were included in the study. Following relevant investigations chosen patients were risk stratified as per standard guidelines into massive, sub massive or low risk and treated accordingly. The included patients were followed up for a period of 1 year with 2D-echocardiogram and other relevant investigations for comparison to assess improvement. Mortality due to either acute PTE or other causes was noted in the study. RESULTS: Of the 31 patients enrolled in our study, 71% (n=22) of the patients belonged to the age range 20-50 years with those in the age group 31-40 years comprising 39% (n=12) of the total. Elderly people over 65 years of age comprised only 19% (n=6) of the total number of patients. Dyslipidemia, prolonged immobilization, deep vein thrombosis, post-operative state, malignancy and post-partum period were the commonly reported risk factors. We thrombolysed a total of 18 (58%) patients with massive and submassive PTE, of which 12 (39%) received tenecteplase and 6 patients received streptokinase (19%). Three (9%) patients required repeat thrombolysis with streptokinase due to failed thrombolytic therapy with tenecteplase. CONCLUSIONS: Our study reported higher incidence of acute PTE in the middle age group population. Prevalence of dyslipidemia was high in this cohort of patients studied although the exact association of it in APE could not be determined. Thrombolytic therapy can be considered for patients with both massive and submassive pulmonary thromboembolism. Repeat thrombolysis can be considered in case one thrombolytic agent failed to give the desirable results.

The 2017 International Joint Working Group recommendations of the Indian College of Cardiology, the Academic College of Emergency Experts, and INDUSEM on the management of low-risk chest pain in emergency departments across India.

There have been no published recommendations for the management of low-risk chest pain in emergency departments (EDs) across India. This is despite the fact that chest pain continues to be one of the most common presenting complaints in EDs. Risk stratification of patients utilizing an accelerated diagnostic protocol has been shown to decrease hospitalizations by approximately 40% with a low 30-day risk of major adverse cardiac events. The experts group of academic leaders from the Indian College of Cardiology and Academic College of Emergency Experts in India partnered with academic experts in emergency medicine and cardiology from leading institutions in the UK and USA collaborated to study the scientific evidence and make recommendations to guide emergency physicians working in EDs across India.

Association of Interleukin-6 and Myeloperoxidase with Insulin Resistance in Impaired Fasting Glucose Subjects.

Impaired fasting glucose (IFG) is a high risk subclinical condition for the progression of type 2 diabetes mellitus and the hyperglycemia seen in this condition is because of the development of insulin resistance (IR). Obesity, inflammation, oxidative stress and many other factors have been implicated in development of IR in type 2 diabetes mellitus and its successive complications. Current study was aimed to ascertain the correlation of inflammation and oxidative stress markers [interleukin-6 (IL-6) and myeloperoxidase (MPO)] with IR in subjects with IFG. In this study, 80 subjects (40 IFG, 40 healthy controls) aged 25-45 years were selected based on their fasting plasma glucose (FPG) values and clinical history. Serum insulin, IL-6 and MPO were estimated by ELISA method and IR was calculated using Homeostatic Model Assessment Index 2 (HOMA 2) calculator. Pearson's correlation coefficient and independent sample 't' test were used for statistical analysis. IL-6 and MPO were found to be significantly elevated in IFG group and both correlates significantly with IR (r 0.413, r 0.645). Only MPO had significant correlation with FPG (r 0.388). In conclusion, the association of altered levels of IL-6 and MPO with IR are suggestive of a role of inflammation and oxidative stress in the initiation and progression of IR in individuals with IFG.

Association of Serum Selenium, Zinc and Magnesium Levels with Glycaemic Indices and Insulin Resistance in Pre-diabetes: a Cross-Sectional Study from South India.

A growing understanding of antioxidant mechanisms and insulin-like actions of trace elements selenium and zinc has rekindled researchers' interest towards their role in diabetes mellitus, nutritional management of which concentrates predominantly on macronutrient intake. However, selenium studies limiting largely to diabetes have yielded inconsistent results with sparse knowledge in the pre-diabetes population. This hospital-based cross-sectional study screened 300 people who came to the institutional hospital laboratory with fasting plasma glucose and glycosylated haemoglobin requisition over a period of 6 months. Thirty-five pre-diabetes subjects aged 25-45 years and 35 age-matched healthy controls were selected as per inclusion criteria and clinical history. Serum selenium was estimated by inductively coupled plasma-mass spectrometry, zinc and magnesium by colorimetric end-point methods and insulin by enzyme-linked immunosorbent assay, and insulin resistance was calculated using a homeostasis model assessment (HOMA) 2 calculator. Data analysis was done using SPSS ver. 16 employing an independent sample t test for intergroup comparison of means and Pearson's correlation for correlation analysis. Serum mineral levels in the pre-diabetes group (selenium 63.01 ± 17.6 µg/L, zinc 55.78 ± 13.49 µg/dL, magnesium 1.37 ± 0.38 mg/dL) were significantly reduced (p < 0.05) in comparison to the healthy controls (selenium 90.98 ± 15.81 µg/L, zinc 94.53 ± 15.41 µg/dL, magnesium 2.12 ± 0.22 mg/dL). A significant negative correlation was seen with glycaemic indices and insulin resistance. This study conducted in pre-diabetes subjects highlights a considerable deficiency of serum selenium, zinc and magnesium observed at a much earlier pre-clinical phase. This coupled with the evidence of a strong inverse association with glycaemic indices and insulin resistance postulates the role of mineral alterations in the pathophysiology of hyperglycaemia and insulin resistance.

Cord Blood Insulin Levels: It's Correlation with Gender, Birth Weight and Placental Weight in Term Newborns.

The cause of more insulin resistance in female than males are still unknown. To know the cause from early life, normal values of relevant parameters are required. So, aim of this study was to determine the reference levels of glucose and insulin in cord blood of term newborns and to examine their effects on gender, placental and birth weight of term newborns. In cross sectional study 60 consecutive term newborns were included from constituent hospitals. Placental and birth weights were measured and cord blood was collected for estimation of serum insulin and plasma glucose. Plasma glucose estimation was done by auto analyzer (GOD-POD method) and serum insulin analysis was done using Insulin ELISA Kit. After analysis, mean ± 2SD used for estimating cord blood insulin and glucose levels, which were 10.1 ± 7.8 µIU/mL and 67.8 ± 33.8 mg/dL respectively. Correlation of insulin with both birth weight and placental weight were r = 0.359 and 0.41 respectively; p < 0.001. Interestingly we found higher insulin levels in females as compared to male newborns in spite of having lower birth weight in them. In conclusion this study reported the levels of insulin and glucose in cord blood of term newborns. Incidentally, this is the first study as per our knowledge to report significant correlation between cord blood insulin, glucose with birth weight, placental weight and gender in south India. Female newborns had higher insulin levels than males, despite lesser birth weight can be attributed to intrinsic insulin resistance in them.

Cord Blood Levels of Insulin, Cortisol and HOMA2-IR in Very Preterm, Late Preterm and Term Newborns.

INTRODUCTION: Alteration in the glucose homeostasis is still the major cause of morbidity and mortality in the newborns. Intrauterine undernutrition plays an important role in causing adult insulin resistance and diabetes but the exact cause is still unknown. AIM: To estimate the plasma glucose, serum insulin and cortisol levels at birth in newborns at different gestational age. MATERIALS AND METHODS: The present cross-sectional study conducted from December 2014 to June 2015 included 58 newborns enrolled as per the inclusion criteria and further categorized into Group I (very preterm; n=19; gestational age < 32 weeks), Group II (late preterm; n=20; gestational age between 32-37 weeks) and Group III (full term; n=19; gestational age >37 weeks) newborns. Venous Cord Blood (VCB) was collected and plasma glucose was analysed by GOD-POD (Glucose Oxidase-Peroxidase) method in auto analyser whereas serum insulin and cortisol were analysed by ELISA (Enzyme Linked Immunosorbent Assay). HOMA2-IR (Homeostatic Model Assessment) calculator was used to assess insulin resistance. All parametric data was expressed as mean±SD and analysed using ANOVA with Tukey's as the Post-Hoc test. Correlation analysis was done using Pearson's correlation co-efficient with scatter plot as the graphical representation. RESULTS: Significantly increased insulin and HOMA2-IR levels were found in group I (13.7±4.7µIU/mL and 1.6±0.58 respectively) when compared to group II (8.3±2.9µIU/mL and 0.93±0.2 respectively) and group III (8.3±2.1µIU/mL and 1.03±0.26 respectively). A positive correlation between cortisol levels and gestational age (r = 0.6, n = 58, p < 0.001) and a negative correlation between insulin and gestational age (r = -0.654, n = 58, p < 0.001) was observed in the study population. CONCLUSION: Increased levels of insulin and HOMA2-IR as seen in the very preterm newborns signify the predisposition of these newborns to development of diabetes in later stages of life. The inverse association of cortisol and insulin with gestational age suggests that cortisol could also be responsible for impaired ß cell function and insulin sensitivity.

Evaluation of Ischemia-Modified Albumin, Malondialdehyde, and Advanced Oxidative Protein Products as Markers of Vascular Injury in Diabetic Nephropathy.

AIM: This study aimed at evaluation of ischemia-modified albumin (IMA), malondialdehyde (MDA), and advanced oxidative protein products (AOPP) as markers of vascular injury in diabetic nephropathy (DN) with derivation of cutoff values for the same. MATERIALS AND METHODS: Study population comprised 60 diabetes patients and 30 controls, with diabetes patients further categorized into three groups based on urine albumin/creatinine ratio (UACR) of <30 mg/g (diabetes without microalbuminuria), 30-300 mg/g (early DN), and >300 mg/g of creatinine (overt DN). Serum IMA, MDA, and AOPP were estimated by enzyme-linked immunosorbent assay; HbA1c, serum creatinine, urine albumin, and urine creatinine were estimated using automated analyzers. Statistical analysis was done using analysis of variance, Pearson's correlation coefficient, and receiver-operating characteristic curve. RESULTS: A statistically significant difference was found in the levels of IMA among patients with early DN (154 ng/mL), diabetes without nephropathy (109.4 ng/mL), and healthy controls (45.7 ng/mL), with highest levels in early DN cases. Similar increase was seen in AOPP as well. A significant correlation was observed between IMA and UACR in diabetes without nephropathy (r = 0.448). CONCLUSION: The present study postulates serum IMA as a novel biomarker for the assessment of disease progression in diabetes even before microalbuminuria, and a cutoff point ≥99 ng/mL can be used for detection of early DN.

Indices of Glucose Homeostasis in Cord Blood in Term and Preterm Newborns.

OBJECTIVE: According to the thrifty phenotype hypothesis, intrauterine malnutrition has a role in the etiology of type 2 diabetes. This study was planned to determine the early alterations in indices of glucose homeostasis (glucose, insulin, and cortisol) in term and preterm newborns and the correlations of glucose, insulin, and cortisol levels with insulin resistance indices. METHODS: A descriptive study comprising 35 term and 35 preterm newborns was carried out from December 2013 to June 2015. Venous cord blood was collected and plasma glucose was analyzed by the glucose oxidase-peroxidase method in an auto analyzer. Serum insulin and cortisol levels were assessed by the enzyme-linked immunosorbent assay. Homeostasis model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index and glucose insulin ratio were calculated to assess insulin resistance. The data on physical and metabolic parameters were analyzed using standard tests for statistical significance. RESULTS: In term newborns, mean glucose and cortisol levels (83.6±17.4 mg/dL and 11.88±5.78 µg/dL, respectively) were significantly higher than those in preterm infants (70.4±15.8 mg/dL and 8.9±4.6 µg/dL, respectively). Insulin and HOMA-IR levels were found higher in preterm newborns (10.8±4.8 µIU/mL and 1.52±0.66, respectively) than in term newborns (7.9±2.7 µIU/mL and 1.19±0.29, respectively). Insulin was found to positively correlate with HOMA-IR, whereas cortisol was negatively correlated with HOMA-IR in both term and preterm newborns. CONCLUSION: Higher insulin levels and HOMA-IR values in the cord blood of preterm newborns support the theory of intrauterine origin of metabolic diseases.

Assessment of oxidative stress and inflammation in prediabetes-A hospital based cross-sectional study.

BACKGROUND AND AIM: Prediabetes is associated with dysglycemia, obesity, inflammation and endothelial dysfunction, contributing towards the pathogenesis of cardiovascular diseases rendering them vulnerable for the same. The current study intended to explore the risk of cardiovascular disease (CVD) related with prediabetes by assessing oxidative stress and inflammation using serum interleukin-6 (IL-6), myeloperoxidase (MPO) and urine microalbumin (MA) and their correlation with fasting plasma glucose (FPG) and physical measurements. MATERIALS AND METHODS: Based on FPG values, 80 subjects were grouped into prediabetes and healthy controls. IL-6 and MPO were estimated in serum sample whereas MA was estimated in random urine sample. RESULTS: Prediabetes group had significantly increased (p<0.05) mean anthropometric measurements and IL-6, MPO and MA as compared to healthy controls. MPO had significant correlation with FPG (r-0.388) in the prediabetes group. IL-6 and MPO showed a positive correlation with body mass index (BMI (r-0.339, r-0.327)), waist circumference (WC (r-484, r-0.493)) and waist-to-hip ratio (WHR (r-0.430, r-0.493)) while MA did not correlate with FPG and anthropometric measurements. CONCLUSION: This study suggests that prediabetes is associated with central adiposity, inflammation and oxidative stress predisposing them to an increased risk for CVD.

Reticulum vs Inclusions: A Learning Experience in Haemoglobin H Disease.

Haemoglobin H disease, also known as the alpha-thalassaemia is characterized by the presence of HbH inclusions in red blood cells, detectable on supra-vital stain. We present a case of a previously asymptomatic 31-year-old male, who insidiously developed anaemia and had prominent splenomegaly. Peripheral smear examination revealed microcytic hypochromic anaemia with numerous spherocytes and moderate polychromasia. In reticulocyte preparation with Brilliant cresyl blue, HbH inclusions were mistakenly identified as granulofilamentous reticulum of reticulocytes, giving a spuriously high reticulocyte percentage. After the literature review, repeat assessment was performed and with the aid of high performance liquid chromatography result, it was possible to delineate the HbH inclusions.

Microalbuminuria - A better marker in hypertensive disorders of pregnancy.

To assess the role of microalbuminuria in pre-eclampsia (PE) as a diagnostic marker, we studied 40 PE cases and 40 normotensive controls at 24 ± 4 weeks of gestation in women 20-35 years of age. The patients with PE had significant microalbuminuria in comparison with the controls, in addition to deranged renal function tests. The receiver operating characteristic curve showed that microalbuminuria had the highest sensitivity (100%) and good specificity (77.6%). Microalbuminuria had the highest area under the curve (0.869) for both diagnosis of PE and renal function assessment. Microalbuminuria also had a good correlation with systolic blood pressure in the cases with mild grades of renal dysfunction. Microalbuminuria is a specific marker in PE and it also helps to assess the renal function status. Therefore, microalbuminuria may be used in the early diagnosis and management of PE patients in order to reduce the immediate and long-term complications.