Effects of Oxidant-Antioxidant and Vitamin D Levels on Clinical and Laboratory Data in Children With Fatty Liver Disease.

Background and Aims Fatty liver increases oxidative stress and may trigger antioxidant mechanisms. We aimed to compare the levels of vitamin D, which has antioxidant properties, as well as total oxidant status (TOS), total antioxidant status (TAS), and catalase between patients with nonalcoholic fatty liver (NAFL) and the control group. Methods We compared vitamin D, TOS, TAS, catalase levels, and other biochemical parameters between pediatric patients with ultrasonographically detected NAFL and an age-matched healthy control group. Results NAFL patients had a significantly lower vitamin D level (p < 0.001). The patient group also had significantly greater height, weight, body mass index (BMI) Z score, parathyroid hormone, triglyceride, glucose, antioxidant (TAS and catalase), and TOS levels compared to the controls (p ≥ 0.001). There was no significant difference between the obese and non-obese NAFL patients with respect to TAS, TOS, catalase levels, and other biochemical parameters (p < 0.05). There was a positive correlation between height, weight, BMI Z score, and hepatosteatosis grade, and TAS, TOS, and catalase levels, and a negative correlation with vitamin D level. We also found a negative correlation between vitamin D level and TOS and catalase level. Conclusions Our study revealed lower levels of vitamin D and higher levels of oxidant-antioxidants including TOS, TAS, and catalase in patients with NAFL.

Effects of Helicobacter Pylori Infection on Serology and Intestinal Mucosal Changes in Pediatric Patients With Celiac Disease: A Retrospective Cohort Study.

Introduction Helicobacter pylori (HP) and celiac disease (CD) can cause similar mucosal damage to the duodenal mucosa. For this reason, the relationship between these two diseases has been the subject of research recently. Our study aims to investigate the effects of HP infection on serology and pathology in pediatric patients with CD or potential celiac disease (PCD). Methods It is a retrospective cohort study conducted in the third-level education and research hospital between July 2017 and May 2019. The serological and pathological data of patients diagnosed with CD or PCD were compared statistically according to the presence of HP. Results An analysis of the histopathological data of the endoscopic biopsy samples showed Helicobacter pylori in eight (50%) of PCD patients and 37 (41.6%) of CD patients. No significant difference was found between the two groups (P=0.531). We found that dokutransglutaminas antibody level (DTG) and endomysium antibody level (EMA) serology decreased significantly after HP eradication therapy in HP (+) PCD (P=0.002, P<0.001). Intestinal metaplasia was not present in PCH. However, intestinal metaplasia was present in five patients (13.5%) with HP (+) CD and two patients (3.8%) with HP (-) CD. However, that difference was not statistically significant between the two groups (P=0.095). Conclusion Our study demonstrated that HP may augment CD's serology and serological improvement is possible after HP treatment particularly in HP (+) PCD. Therefore, we recommend re-perform diagnostic studies after HP treatment before commencing a gluten-free diet in HP (+) suspected CD cases.

Immune thrombocytopenia: epidemiological and clinical features of 216 patients in northwestern Turkey.

We evaluated the clinical features, treatment modalities, treatment responses, and prognosis of our patients with immune thrombocytopenia (ITP). Furthermore, we estimated the frequency of ITP in the Thrace region of Turkey. Two hundred sixteen patients diagnosed with ITP between 2000 and 2012 at our center were retrospectively evaluated. Patients' clinical features, treatments, and responses to treatment modalities were recorded. The mean annual incidence of ITP was 2.92/100,000 (95%CI: 1.57-4.27). The overall prevalence of ITP was 35.1/100,000 (95%CI: 30.3-39.8). The administration of first-line therapy resulted in complete remission (CR) in 76.5 % of patients and partial remission (PR) in 13.6 %. After 5 years, 33 % of patients who were responsive to first-line therapy were still in relapse-free remission. Of patients who were given second-line therapy, CR was obtained in 71.3 % and PR in 14.9 %. The duration of relapse-free remission was longer with splenectomy than with steroids (p < 0.001). Five years after splenectomy, 62 % of patients were in relapse-free remission; contrarily, this was lower with steroids (36 % at 5 years). The annual incidence and prevalence of ITP in northwestern Turkey was similar to data from western countries-at the lower limit for some countries. Effective treatment strategies seem to be steroids as first-line therapy and splenectomy in refractory cases.

The relationship between leptin level and oxidative status parameters in hemodialysis patients.

Both serum leptin level and oxidative stress are increased in hemodialysis (HD) patients. In the present study, we aimed to investigate whether there is association between oxidative status and leptin level in HD patients. Thirty-five HD patients and 25 healthy controls were enrolled in the present study. Serum leptin level, total peroxide (TP) level, total antioxidant capacity (TAC), and oxidative stress index (OSI) were determined. Serum leptin level, TP level, and OSI were significantly higher in HD patients than controls (all P < 0.001) while TAC was lower (P < 0.001). In HD patients, serum leptin level was significantly correlated with TP level and OSI (r = 0.372, P < 0.001 and r = 0.409, P < 0.001, respectively). The correlation of serum leptin level with TP level and OSI remained statistically significant after adjusting for age, gender, and body-fat percentage (r = 0.446, P < 0.001 and r = 0.463, P < 0.001, respectively). Hyperleptinemia seems to be associated with increased oxidative stress in HD patients, and this association may provide better understanding about the disorders related to either elevated serum leptin levels and/or increased oxidative stress in HD patients.

PON1 status in haemodialysis patients and the impact of hepatitis C infection.

OBJECTIVES: Paraoxonase-1 (PON1) activity has been reported to decrease in both haemodialysis patients and patients with HCV infection. We aimed to investigate paraoxonase and arylesterase activities, and lipid hydroperoxide levels (LOOH) in haemodialysis patients with or without hepatitis C infection, and to find out whether PON1 activity is affected further by the presence of HCV infection in HD patients. DESIGN AND METHODS: Twenty HCV (+) haemodialysis patients, 26 HCV (-) haemodialysis patients, and 26 controls were enrolled. Paraoxonase and arylesterase activities were measured spectrophotometrically. LOOH levels were measured by ferrous oxidation with xylenol orange assay. RESULTS: Haemodialysis patients with or without HCV infection had lower paraoxonase and arylesterase activities than controls (all p<0.001), while higher LOOH levels (both p<0.001). Paraoxonase and arylesterase activities, and LOOH levels were comparable between haemodialysis patients with or without HCV infection (p>0.05). Significant inverse correlation was observed between paraoxonase or arylesterase activities, and LOOH levels (p<0.05, beta=-0.319 and p<0.05, beta=-0.348, respectively). CONCLUSION: We concluded that PON1 activity significantly decreases in both haemodialysis patients with or without HCV infection. Nevertheless, PON1 activity is not affected further by the presence of HCV infection in haemodialysis patients.

Oxidative stress in hepatitis C infected end-stage renal disease subjects.

BACKGROUND: Both uremia and hepatitis C infection is associated with increased oxidative stress. In the present study, we aimed to find out whether hepatitis C infection has any impact on oxidative stress in hemodialysis subjects. METHODS: Sixteen hepatitis C (+) hemodialysis subjects, 24 hepatitis C negative hemodialysis subjects and 24 healthy subjects were included. Total antioxidant capacity, total peroxide level and oxidative stress index were determined in all subjects. RESULTS: Total antioxidant capacity was significantly higher in controls than hemodialysis subjects with or without hepatitis C infection (all p < 0.05/3), while total peroxide level and oxidative stress index were significantly lower (all p < 0.05/3). Hepatitis C (-) hemodialysis subjects had higher total antioxidant capacity compared to hepatitis C (+) hemodialysis subjects (all p < 0.05/3). Total peroxide level and oxidative stress index was comparable between hemodialysis subjects with or without hepatitis C infection (p > 0.05/3). CONCLUSION: Oxidative stress is increased in both hepatitis C (+) and hepatitis C (-) hemodialysis subjects. However, hepatitis C infection seems to not cause any additional increase in oxidative stress in hemodialysis subjects and it may be partly due to protective effect of dialysis treatment on hepatitis C infection.

The association of circulating leptin level with peripheral DNA damage in hemodialysis subjects.

OBJECTIVES: Hemodialysis subjects have been shown to have both elevated serum leptin and peripheral DNA damage level, and leptin has been suggested to induce apoptotic features. Thus, in the present study, we aimed at finding out if there is any relationship between serum leptin level and peripheral DNA damage in hemodialysis subjects. DESIGN AND METHODS: Forty hemodialysis subjects and 21 controls were included in the present study. Serum leptin level and peripheral DNA damage were assayed in all subjects enrolled in the study. Comet assay was used in determining DNA damage in peripheral lymphocyte. RESULTS: Both serum leptin level and peripheral DNA damage were significantly higher in hemodialysis subjects than control (P<0.05 and P<0.001, respectively). Female subjects had significantly higher serum leptin level than male subjects in both hemodialysis and control group (both P<0.05). Significant correlation was observed between serum leptin level, and gender and body fat mass in both hemodialysis (P<0.05, beta=-0.637 and P<0.05, beta=0.386, respectively) and control group (P<0.05, beta=-0.569 and P<0.05, beta=-0.460, respectively). In hemodialysis subjects, peripheral DNA damage was significantly correlated with serum leptin level (P<0.05, beta=0.508). CONCLUSION: In end-stage renal disease subjects, elevated serum leptin level seems to be associated with peripheral DNA damage and thus, may, in part, have a role in the development of DNA damage associated disorders.

Assessment of peripheral DNA damage by alkaline comet assay in maintenance hemodialysis subjects with hepatitis C infection.

Despite the high prevalence of hepatitis C infection among hemodialysis subjects, there is no information concerning the DNA damage of hepatitis C (+) hemodialysis subjects. We aimed to find out if there is any additional effect of hepatitis C infection on peripheral DNA damage in maintenance hemodialysis subjects. Fifteen hepatitis C (+) and 22 hepatitis C (-) hemodialysis subjects, 21 hepatitis C subjects without renal disease, and 22 healthy controls were enrolled. Peripheral DNA damage was assayed using alkaline comet assay. Median DNA damage levels of the study groups were as follows: hepatitis C (+) maintenance hemodialysis subjects, 88 (0-232); hepatitis C (-) maintenance hemodialysis subjects, 58 (0-228); hepatitis C (+) subjects without renal disease, 112 (44-252); controls, 26 (0-72). DNA damage level was significantly higher among hepatitis C (+) subjects without renal disease than hepatitis C (-) maintenance hemodialysis subjects and healthy controls (both p<0.05/6). Both maintenance hemodialysis subjects with and without HCV infection had significantly higher DNA damage level than healthy controls (both p<0.05/6). DNA damage level was comparable between hepatitis C (+) subjects without renal disease and HCV (+) hemodialysis subjects, and between hemodialysis subjects with and without hepatitis C infection (all p>0.05/6). Linear regression analysis revealed that hepatitis C infection was the only independent factor in predicting the peripheral DNA damage (p<0.05, beta=0.395). Each one of end-stage renal disease and hepatitis C infection significantly increases DNA damage level. However, in hemodialysis subjects, hepatitis C infection does not cause significant additional increase in DNA damage level, and it may be partly due to protective effect of hemodialysis on hepatitis C infection.