Association of serum carotenoids with high molecular weight adiponectin and inflammation markers among Japanese subjects

BackgroundSeveral studies have reported that serum concentrations of carotenoids and adiponectin are inversely associated with the risk for cardiovascular disease (CVD). However, no studies have investigated the association between serum concentrations of adiponectin and carotenoids in the general population.MethodsWe investigated cross-sectionally whether serum carotenoids are associated with serum high molecular weight (HMW) adiponectin and some inflammatory markers in 437 Japanese subjects (116 men and 321 women) who attended a health examination.ResultsIn multiple linear regression analysis adjusted for confounding factors, serum β-carotene concentrations were significantly associated with serum HMW adiponectin concentrations in both sexes (standardized β coefficient = 0.197, p = 0.036 for men; standardized β coefficient = 0.146, p = 0.012 for women). Serum α-carotene and β-carotene concentrations were significantly associated with serum C-reactive protein (CRP) concentrations in men. In women, there were significant negative associations between serum carotenoids concentrations and serum interleukin-6 (IL-6) concentrations. Additional adjustment for serum concentrations of IL-6 or CRP did not significantly affect the association between carotenoids and HMW adiponectin in non-smoking men as well as in women.ConclusionSerum β-carotene concentrations were positively associated with serum HMW adiponectin concentrations even after adjustment for possible confounding factors including inflammatory markers.     

Circulating osteoprotegerin is increased in the metabolic syndrome and associates with subclinical atherosclerosis and coronary arterial calcification

ContextThe relationship between osteoprotegerin (OPG) a glycoprotein related to bone metabolism and the metabolic syndrome (MS) has not been established.ObjectiveThe aim of this study is to evaluate OPG concentration in patients with MS and its association with subclinical atherosclerosis and coronary arterial calcification (CAC).Materials/methodsThe study included 238 asymptomatic patients. MS was diagnosed according to the NCEP/ATPIII guidelines. OPG was measured by ELISA. All subjects underwent ultrasonography of the common carotid arteries to measure intima-media thickness (IMT) and evaluate the presence of atheroma plaques. In a subgroup (n = 39) CAC was quantified by ECG-triggered cardiac computed tomography. Adipose tissue was excised from 25 patients and OPG expression by RT-PCR and immunohistochemistry was studied.ResultsPatients with the MS (n = 60) had higher OPG than patients without (n = 178) (p < 0.05). OPG correlated with IMT (r = 0.2, p = 0.005) and patients with atheroma plaques had higher OPG (p = 0.008) and also those with coronary artery calcification (p < 0.05).OPG expression was confirmed in adipose tissue (n = 12) and the expression was significantly higher in patients with MS than in those without (p = 0.003).ConclusionsThis study shows that OPG may potentially be a biomarker for cardiovascular risk/damage in the MS and identifies adipose tissue as a potential source of OPG.     

The relationship between the levels of gonadotropic hormones and OPG,leptin, TGF-β1 and TGF-β2 in Chinese adult women

BackgroundThe relationship between the levels of gonadotropic hormones and bone metabolism-related cytokines in Chinese women is unclear. We investigated the relationship between FSH and LH and OPG, leptin, TGF-β1, and TGF-β2 in Chinese women.MethodsA cross-sectional study of 694 Chinese women, aged 20 to 82 y was conducted. Levels of serum FSH, LH, OPG, leptin, TGF-β1, and TGF-β2 were determined.ResultsIn premenopausal females, serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels seemly showed no correlation with the cytokine levels. In perimenopausal females, serum FSH and LH levels showed significant positive correlation with osteoprotegerin (OPG) and transforming growth factor-β2 (TGF-β2) levels (r = 0.286 to 0.405, all P = 0.000), whereas they showed negative correlation with TGF-β1 levels (r = ? 0.413 and ? 0.354, all P = 0.000). In postmenopausal females, FSH and LH levels showed positive correlation with OPG levels (r = 0.247 and 0.241, all P = 0.000), negative correlation with leptin and TGF-β1 levels (r = ? 0.234 to ? 0.319, all P = 0.000), and no correlation with TGF-β2 levels. Multiple linear regression stepwise analysis revealed the following results. In premenopausal females, 2.0% and 1.5% of the changes in LH could be explained by OPG and leptin, respectively, while 1.9% of the changes in OPG could be explained by LH. In perimenopausal females, the determinants of OPG and TGF-β1 on FSH were 10.9% and 17.0%, respectively, and the determinants of OPG, TGF-β1 and TGF-β2 on LH were 4.5%, 4.9% and 16.4%, respectively. The determinants of FSH and LH on OPG were 14.5% and 2.5%, respectively. The determinant of FSH on TGF-β1 was 4.5%, while the determinant of LH on TGF-β2 was 16.4%. In postmenopausal females, the determinants of leptin and OPG on FSH were 10.2% and 2.8%, respectively, and the determinants of OPG and TGF-β1 on LH were 5.8% and 2.3%, respectively. The determinant of FSH on OPG, leptin and TGF-β1 were 6.1%, 3.4% and 9.2%.ConclusionsThese results indicate that age-related gonadotropic hormone levels are associated with changes in OPG, TGF-β1, TGF-β2 and leptin, and change with menopausal status.     

Influence of pre-analytical and analytical factors on osteoprotegerin measurements

IntroductionOsteoprotegerin (OPG), an osteoclastogenesis inhibitor implicated in bone remodelling, has emerged as a potential biomarker for cardiovascular disease. In order to implement OPG determination in the clinical laboratory, it is crucial to identify the most appropriate specimen type, preparation and measurement conditions. The present study focuses on identifying the pre-analytical variables that may influence OPG measurements.MethodsSerum and plasma (in EDTA, heparin and citrate) were collected from 45 healthy volunteers (men (n = 21, 46.7%), women (n = 24, 53.3%)). OPG was analysed by ELISA. The influence of the centrifugation speed, the number of freeze–thaw cycles, delay in sample processing, thermo-stability and endogenous interfering agents (haemolysis, triglycerides, bilirubin, cholesterol and RANKL) were studied.ResultsOPG concentrations were significantly lower (p < 0.0001) in serum (1015 ± 357 pg/mL) than in all plasma samples (1314 ± 448 pg/mL in EDTA, 1209 ± 417 pg/mL in heparin and 1260 ± 498 pg/mL in citrate).Increasing centrifugation speed (200 g to 3000 g) did not change serum OPG concentration (p = 0.88). However, OPG concentration significantly increased when centrifuged serum samples were stored at 48 h at room temperature (p < 0.0001). Repeated freeze–thaw cycles did not modify OPG levels until 4 cycles (p < 0.0001). Increasing time before processing the samples (2 h and 6 h) raised OPG concentrations both at room temperature (p < 0.0001) or 4 °C (p < 0.001).Positive concentration-dependent interference of triglycerides was found in the analysed pooled samples; however, OPG concentrations were falsely diminished with haemoglobin interference. Bilirubin, cholesterol and RANKL did not interfere with OPG measurements.     

Hip fracture and anthropometric variations: Dominance among trochanteric soft tissue thickness,body height and body weight during sideways fall

BackgroundHip fracture depends on various anthropometric parameters such as trochanteric soft tissue thickness, body height and body weight. The objective was to evaluate the responses to the variations in anthropometric parameters during sideways fall, and to identify the most dominant parameter among them.MethodSeven finite element models were developed having anthropometric variations in trochanteric soft tissue thickness (5–26 mm), body height (1.70–1.88 m), and body weight (63–93.37 kg). These were simulated for sideways fall with ANSYS-LS-DYNA® code.FindingsSignificant effect of trochanteric soft tissue thickness variation was found on ‘normalized peak impact force with respect to the body weight’ (p = 0.004, r² = 0.808) and strain ratio (p = 0.083, r² = 0.829). But, variation in body height was found to be less significant on normalized peak impact force (p = 0.478, r² = 0.105) and strain ratio (p = 0.292, r² = 0.217). Same was true for the variation in body weight on normalized peak impact force (p = 0.075, r² = 0.456) and strain ratio (p = 0.857, r² = 0.007). The risk factor for fracture was also well correlated to the strain ratio for the inter-trochanteric zone (p < 0.0007, r² = 0.917) where the most fractures are clinically observed to happen.InterpretationsTrochanteric soft tissue thickness was found likely to be the most dominant parameter over body height and body weight, signifying that a slimmer elderly person, taller or shorter, with less trochanteric soft tissue thickness should be advised to take preventive measures against hip fracture under sideways fall.     

Serum adipocyte fatty acid binding proteins and adiponectin in patients with coronary artery disease: The significance of A-FABP/adiponectin ratio

BackgroundAdipocyte fatty acid binding protein (A-FABP) and adiponectin have been shown to play important roles in atherosclerosis. We investigated serum A-FABP, adiponectin and A-FABP/adiponectin ratio in patients with coronary artery disease (CAD).MethodsA total of 340 subjects who underwent coronary angiography (CAG) were classified into CAD group (n = 211) and non-CAD group (n = 129) according to the CAG. Serum A-FABP and adiponectin concentrations were determined by enzyme-linked immunosorbent assays.ResultsCAD patients tend to have higher A-FABP concentrations than non-CAD subjects, the difference is significant only between female CAD patients and controls [22.8 (18.6–25.7) ng/ml vs 18.1 (15.6–21.8) ng/ml, P = 0.008]. Serum A-FABP concentration was independently associated with Gensini scores in female subjects (P = 0.018). CAD patients have significant higher serum A-FABP/adiponectin ratio [1.51 ± 0.05 vs 0.89 ± 0.03 ng/μg, P < 0.01] than controls in both genders.ConclusionsSerum A-FABP is associated with CAD more closely in female than in male. The A-FABP/adiponectin ratio may be a more useful indicator for CAD than A-FABP or adiponectin alone.     

Sperm head defects and disturbances in spermatozoal chromatin and DNA integrities in idiopathic infertile subjects: Association with cigarette smoking

ObjectivesTo evaluate sperm chromatin and DNA integrities in idiopathic infertile men and determine the possible association(s) of cigarette smoking on oxidative stress markers, antioxidant capacity and semen quality.Subjects and methodsSemen samples from men referring to the andrology laboratory were categorized into 3 groups: fertile non-smokers (n = 16), infertile non-smokers (n = 36), and infertile smokers (n = 34). Semen analysis was performed according to WHO criteria. The percentage of sperm DNA fragmentation index (%DFI) and the percentage of sperm with abnormally high DNA stainability (HDS%; immature spermatozoa) were determined by SCSA using the metachromatic properties of acridine orange. Lipid peroxidation, superoxide dismutase (SOD), catalase (CAT) and reduced glutathione (GSH) levels in seminal plasma and spermatozoa were measured by spectrophotometric assays.ResultsThe classical semen parameters were negatively correlated with lipid peroxidation in spermatozoa; motility and morphology were negatively correlated with %DFI (p < 0.05). HDS% was also negatively correlated with above markers except for morphology (r = ? 0.352, p = 0.081). DFI% and HDS% were significantly higher in the infertile smokers group than in infertile non-smokers (p = 0.032; p = 0.001 respectively). Cigarette smoking was significantly associated with DFI%, HDS%, TBARS and the fraction of “round-headed” sperm (r = 0.796, p = 0.0001; r = 0.371, p = 0.033; r = 0.606, r = 0.591, p = 0.001 respectively), and decreased SOD levels (r = ? 0.545).ConclusionDFI%, HDS% and round-head sperms are increased in idiopathic infertile men; this increase is associated with cigarette smoking. These defects may be attributed to increased oxidative stress and insufficient scavenging antioxidant enzymes in the seminal fluid of infertile patients.     

Analytical evaluation of a high-molecular-weight (HMW) adiponectin chemiluminescent enzyme immunoassay

BackgroundThe measurement of high-molecular-weight (HMW) adiponectin concentration provides valuable clinical information. However, the conventional ELISA method requires complicated and lengthy assay procedures to obtain assay results.MethodsWe prepared new assay reagents based on chemiluminescent enzyme immunoassay (CLEIA) on a fully-automated analyzer system using the same IH7 monoclonal antibody as for ELISA as solid phase and detection antibodies (CLEIA/cartridge-type and CLEIA/bottle-type).ResultsThe assay range of both CLEIA reagents were from 0.20 to 15.00 μg/ml, and lower limit of detection and quantification were lower than 0.0928 and 0.1346 μg/ml in CLEIA/cartridge-type and in CLEIA/bottle-type reagents, respectively. A good correlation was observed between both reagents (y = 1.000x + 0.120). The imprecision test as % of coefficient variation in both reagents were less than 3.3% and recovery test showed the range from 100% to 109%. No or little interference of blood components was observed in both reagents. HMW adiponectin concentration measured by CLEIA reagents was approximately half that measured by the previous ELISA because of reevaluation using freshly and highly purified HMW adiponectin standard.ConclusionThe newly prepared CLEIA reagents are robust and adequate and can be used for the measurement of HMW adiponectin in the clinical laboratory.     

Relationship of proprotein convertase subtilisin-kexin type 9 levels with resistin in lean and obese subjects

ObjectivesProprotein convertase subtilisin-kexin type 9 (PCSK9), a key regulator of low density lipoprotein receptor expression, has recently been reported to be upregulated by resistin in HepG2 cells and human primary hepatocytes. Whether this translates into a positive relationship of plasma PCSK9 with resistin levels in humans with varying degrees of obesity is unknown.Design and methodsWe assessed the extent to which plasma PCSK9 levels are determined by resistin in individuals with varying degrees of obesity.ResultsIn 80 subjects (35 women; no diabetes mellitus) with body mass index ranging from 19.4 to 40.4 kg/m², plasma PCSK9 levels were not positively related to resistin (r = ? 0.161, p = 0.154). Despite positive correlations of non-high density lipoprotein cholesterol (r = 0.378, p < 0.001), low density lipoprotein (r = 0.292, p < 0.01) and apolipoprotein B (apoB) (r = 0.266, p < 0.05) with PCSK9, none of these apolipoprotein (apo) B-containing lipoprotein measures was positively related to resistin (p > 0.10 for all). In subjects with BMI < 25.0 kg/m² (n = 38), PCSK9 was even inversely related to resistin (r = ? 0.322, p = 0.049), and this relationship remained present after controlling for either leptin (p = 0.027) or insulin resistance (P = 0.031). In subjects with BMI ≥ 25.0 kg/m² (n = 42), PCSK9 was unrelated to resistin (r = ? 0.064, p = 0.69).ConclusionsThis study demonstrates that there is no positive association of plasma PCSK9 with resistin in lean and moderately obese individuals. Our data question whether circulating resistin is a physiologically important determinant of higher PCSK9 levels.     

Relation between riboflavin,flavin mononucleotide and flavin adenine dinucleotide concentrations in plasma and red cells in patients with critical illness

BackgroundThere is some evidence that the relationship between plasma and red cell vitamin B2 concentrations is perturbed in the critically ill patient. The aim of the present study was to examine the longitudinal interrelationships between riboflavin, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD) in plasma and red cells in patients with critical illness.MethodsRiboflavin, FMN and FAD concentrations were measured, by HPLC, in plasma and red cells in healthy subjects (n = 119) and in critically ill patients (n = 125) on admission and on follow-up.ResultsOn admission, compared with the controls, critically ill patients had significantly higher plasma riboflavin and FMN concentrations (p < 0.001) and lower median plasma FAD concentrations (p < 0.001). In the red cell, FAD concentrations were significantly lower in critically ill patients (p < 0.001). In healthy subjects, plasma riboflavin was directly associated with both plasma FMN (r_s = 0.55, p < 0.001) and plasma FAD (r_s = 0.49, p < 0.001). Red cell riboflavin was directly associated with red cell FMN (r_s = 0.52, p < 0.001) but not red cell FAD. In the critically ill patients, plasma riboflavin was not significantly associated with either plasma FMN or FAD. Red cell riboflavin was directly associated with red cell FMN (r_s = 0.79, p < 0.001) and red cell FAD (r_s = 0.72, p < 0.001). Longitudinal measurements (n = 60) were similar.ConclusionsThe relationship between plasma riboflavin, FMN and FAD was significantly perturbed in critical illness. This effect was less pronounced in red cells. Therefore, red cell FAD concentrations are more likely to be a reliable measure of status in the critically ill patient.     

Analysis of the measurement properties of the Brazilian-Portuguese version of the Tampa Scale for Kinesiophobia-11 in patients with fibromyalgia

ObjectiveTo analyze the measurement properties of the Brazilian-Portuguese version of the Tampa Scale for Kinesiophobia-11 in patients with fibromyalgia.MethodsAssessment was made at three time points: baseline (n = 130) and 15 days (n = 54) and eight weeks after baseline (n = 51). Data collected at baseline were used to assess internal consistency, criterion and construct validity, and ceiling and floor effects. Data collected at baseline and 15 days after baseline were used to assess reliability and measurement error, and data collected before and after an eight-week exercise-based physical therapy intervention were used to assess interpretability of change scores.ResultsThe Tampa Scale for Kinesiophobia-11 showed adequate internal consistency (Cronbach's alpha = 0.77; alpha if item deleted: 0.74–0.77), substantial reliability (intraclass correlation coefficient_2,1 = 0.85; 95% confidence interval: 0.75, 0.90), good measurement error (standard error of measurement: 2.65 points), and a minimal detectable change (90% confidence) of 6.16 points. For validity, the Tampa Scale for Kinesiophobia-11 showed a positive and good correlation with the original Tampa Scale for Kinesiophobia (r = 0.84, p < 0.01), positive and moderate correlation with the Pain Catastrophizing Scale (r = 0.55, p < 0.01), positive and weak correlation with the Numerical Pain Rating Scale (r = 0.25, p < 0.01), positive and moderate correlation with the Beck Depression Inventory (r = 0.39, p < 0.01), and no correlation with the Patient-Specific Functional Scale (r = 0.11, p = 0.23). Kinesiophobia, pain, function, catastrophizing, and depression statistically improved after the eight-week intervention (p < 0.01).ConclusionThe Tampa Scale for Kinesiophobia-11 is consistent, reliable, and appropriate to assess fear of movement in patients with fibromyalgia in the clinical context. Responsiveness of the Tampa Scale for Kinesiophobia-11 should be tested in future studies.     

Gender-specific effect of Pro12Ala polymorphism in peroxisome proliferator-activated receptor γ-2 gene on obesity risk and leptin levels in a Tunisian population

ObjectivesThis study was undertaken to investigate the impact of the Pro12Ala (rs1801282) polymorphism of the peroxisome proliferator-activated receptor γ-2 (PPARγ-2) gene on obesity or body mass index (BMI) and plasma leptin, insulin, adiponectin and lipid levels in a sample of the Tunisian population.Design and MethodsThe study included 387 obese patients and 288 control subjects. The Pro12Ala genotype was determined by polymerase chain reaction followed by a digestion with the restriction of endonuclease BstUI.ResultsIn the whole population, there is no significant difference in genotype frequencies of the Pro12Ala polymorphism between obese patients and controls. However, separate analysis by gender revealed that obese men (but not women) had significantly higher frequency of Pro/Ala genotypes compared to controls (12.2% vs. 4.1%; χ² = 6.76, p = 0.009). In comparison to Pro/Pro homozygotes, Ala-allele bearers had a significantly higher risk of obesity [OR (95% CI) = 3.26 (1.28–8.33)]. When obese subjects were stratified according to type 2 diabetes status, the association with obesity was only significant in obese non-diabetic patients [OR (95% CI) = 3.74 (1.43–9.74), p =  0.007]. Additionally, obese male patients carrying the Ala-allele had significantly higher body mass index (p =  0.007) and plasma leptin levels (p =  0.023) compared to those homozygous for Pro-allele. The significant effect of Pro12Ala polymorphism on plasma leptin levels disappeared after adjustment for age and BMI.ConclusionThe present study provides evidence that the Pro12Ala polymorphism of the PPARγ-2 gene is associated with obesity in non-diabetic men from Tunisian origin.     

Butyrylcholinesterase activity and mortality risk in hemodialysis patients: Comparison to hsCRP and albumin

ObjectiveTo test the prediction power of butyrylcholinesterase (BuChE) activity for mortality risk in hemodialysis patients during 12 months follow-up, and made comparison to hsCRP and albumin.Materials and methodsThe study enrolled 62 patients, aged 31–79 years. Serum BuChE, high-sensitivity C-reactive protein (hsCRP) and albumin were measured after 1, 3, 9 and 12 months of dialysis. The Kaplan–Meier survival curves were employed in mortality prediction.ResultsBuChE was positively associated with serum albumin (r = 0.318; p = 0.012) and inversely related to hsCRP (r = ? 0.358; p = 0.004). The highest mortality was in the lowest quartile of basal albumin (< 38.4 g/L; p = 0.027), hsCRP concentrations > 8 mg/L (p = 0.005), and BuChE activity in the lowest tercile of basal values (< 5.92 kU/L; p = 0.0041).ConclusionOur results suggest that low BuChE activity may be a nonspecific risk factor for mortality in patients who are on hemodialysis.     

Pro-inflammatory and atherogenic circulating factors in non-alcoholic fatty liver disease associated to metabolic syndrome

BackgroundIt is not elucidated if liver fat deposits associated to metabolic syndrome (MS) aggravate the atherogenic state. We evaluated, in MS patients, if the presence of non-alcoholic hepatic steatosis (HS) determines differences in inflammatory markers and VLDL characteristics.MethodsSeventy-five patients with MS were divided into 2 groups depending on the presence or absence of HS, assessed by ultrasound. Lipid profile, free fatty acids (FFA), VLDL composition, adiponectin, tumor necrosis factor-alpha (TNF-α), high sensitivity C-reactive protein (hs-CRP), and soluble adhesion molecules (sVCAM-1 and sICAM-1) were measured.ResultsHS patients presented increased triglycerides levels, HOMA-IR and FFA. Patients with HS showed a reduction in adiponectin (p = 0.04) and increase in hs-CRP (p = 0.02), independently of insulin-resistance (IR). FFA correlated positively with TNF-α (p = 0.04) and inversely with adiponectin (p = 0.01). hs-CRP correlated with all inflammatory markers, independently of IR: TNF-α (r = 0.34, p = 0.02), sVCAM-1 (r = 0.29 p = 0.03), sICAM-1 (r = 0.56, p = 0.01), adiponectin (r = ?0.34, p = 0.04). HS patients presented higher VLDL mass and number of particles. Adiponectin correlated with VLDL cholesterol content (r = ?0.47, p = 0.04), independently of IR. VLDL, once secreted, would suffer from changes, becoming more atherogenic.ConclusionsSimple HS would play an important role increasing cardiovascular risk, independently of IR. hs-CRP may represent a useful biomarker of this condition.     

A cross-sectional study of the relationships between illness insight,internalized stigma,and suicide risk in individuals with schizophrenia

BackgroundSuicide is the major cause of premature death among individuals with schizophrenia. Ironically, one factor that heightens suicide risk is insight into mental illness. Little is known, however, about how insight contributes to suicidality. Recent evidence suggests that negative outcomes related to insight might depend on whether or not the individual accepts the stigmatizing beliefs about the mental illness.ObjectiveThe present study examined the interactive effects of insight and internalized stigma on suicide risk in individuals with schizophrenia. We hypothesized that insight into mental illness and internalized stigma would increase suicide risk and that internalized stigma would moderate the effect of insight on suicide risk.Design and participantsA cross-sectional design was used in this study. A convenience sample of 200 individuals with schizophrenia was recruited from an outpatient clinic in the Eastern catchment area in Alexandria, Egypt.MethodsEligible study participants were individuals with an illness duration not exceeding ten years, currently in outpatient treatment and follow-up, and post-acute or in a stable phase of their disorder. Individuals provided signed consent to participate and were interviewed to assess suicide risk, insight, internalized stigma of mental illness and depression.ResultsSlightly more than 38% of the study participants were classified as having a severe suicide risk. As predicted, suicide risk was positively associated with insight (r = .55, p < .001), internalized stigma (r = .79, p < .001), and depression (r = .78, p < .001). However, the influence of insight was not significant after controlling for covariates in the regression model (β = ?.02, ns). Internalized stigma and depression independently predicted suicide risk, explaining 74% of variance in suicide risk, F_change (6, 191) = 11.54, p < .001. Greater insight was significantly linked to increased levels of internalized stigma (r = .59, p < .001) and depression (r = .61, p < .001). Internalized stigma did not moderate the influence of insight on suicide risk.ConclusionThe present study draws attention to the robust influence of internalized stigma in increasing suicide risk and suggests clinical approaches for managing internalized stigma and suicide risk among individuals with schizophrenia.     

Correlation of endothelin 1 plasma levels with plasma antioxidant capacity in elderly patients treated for hypertension

Experimental studies confirmed that reactive oxygen species increase endothelin-1 (ET-1) synthesis, and modulate ET-1 signaling pathway resulting in vasoconstriction and vascular remodeling.The aim of this study was to evaluate the relationship between plasma ET-1 concentration and antioxidant status in patients with essential hypertension and type 2 diabetes mellitus.Methods78 hypertensive patients, 53.8% diabetic, mean age 72.1 ± 7.07 were examined. The plasma concentration of glucose, creatinine, uric acid, bilirubin, cholesterol, insulin, HbA1c and ET-1 were measured. Antioxidant status was assessed by Ferric Reducing Ability of Plasma (FRAP), vitamin C concentration and erythrocyte superoxide dismutase (SOD) activity.ResultsWith diabetes ET-1 concentration was higher (1.35 ± 0.51 vs 1.12 ± 0.46 pg/mL, p = 0.04). The negative correlations between ET-1 concentration and FRAP (r = ? 0.50, p < 0.0001), vitamin C (r = ? 0.296, p = 0.01) and SOD (r = ? 0.44, p = 0.001) were found. Concentration of ET-1 correlated positively with SBP (r = 0.33, p = 0.005) but not with DBP. The relationship between DBP and ET-1 only in subjects with DBP > 110 mm Hg and FRAP < 0.40 mmol/L was found. In multiple regression analysis plasma ET-1 levels were associated independently with FRAP (beta = ? 0.583, p = 0.003) and plasma vitamin C (beta = ? 0.407, p = 0.04).ConclusionsIn hypertensive and diabetic patients higher plasma endothelin-1 level was independently associated with lower plasma antioxidant status measured by FRAP and decreased vitamin C concentration, which may be a result of increased oxidative stress in these diseases.     

Effect of caregiver gender,age, and feedback prompts on chest compression rate and depth

BackgroundQuality of chest compressions (CC) is an important determinant of resuscitation outcome for cardiac arrest patients.PurposeTo characterize the quality of CC performed by hospital personnel, evaluate for predictors of CC performance, and determine the effects of audiovisual feedback on CC performance.MethodsSeven hundred and fifty four individuals participated in a CPR quality improvement challenge at 30 US hospitals. Participants performed 2 min of CC on a manikin with an accelerometer-based system for measuring both rate (CC/min) and depth (in.) of CC (AED Plus:ZOLL Medical). Real-time audiovisual feedback was disabled. A subset of participants performed a second trial of CC with the audiovisual feedback prompts activated.ResultsMean depth of CC was below AHA minimum guidelines (<1.5 in.) for 34% (1.30 ± 0.14 in.) and above maximum guidelines (>2.0 in.) for 12% of participants (2.20 ± 0.22 in.). Depth of CC was greater for male vs. female (p < 0.001) and younger vs. older (p = 0.009) but did not differ between ACLS, BCLS, and non-certified participants (p = 0.6). Predictors of CC depth included CC rate (r_part = ?0.34, p < 0.0001), gender (r_part = 0.13, p = 0.001), and age (r_part = ?0.09, p = 0.02).Mean depth of CC increased, mean rate decreased, and variance in CC depth and rate declined when feedback was used (p ≤ 0.0001 vs. without feedback). The percentage of CC performed within AHA guidelines (1.5–2 in.) improved from 15 to 78% with feedback.ConclusionsThe quality of CC performed by personnel at US hospitals as judged by their performance on a manikin is often suboptimal. Quality of CC can be improved with use of CPR feedback technologies.     

Oxidative stress and myeloperoxidase activity during bacterial meningitis: Effects of febrile episodes and the BBB permeability

ObjectiveTo investigate participation of extracellular myeloperoxidase (MPO) in oxidative stress during different courses of the bacterial meningitis (BM).Materials and methodsWe sequentially assessed WBC count, blood-brain barrier (BBB) permeability, serum and cerebrospinal fluid (CSF) lipid peroxidation (LPO), MPO and antioxidative activity (AOA) in proven pediatric BM.ResultsBM patients exhibited increased systemic and local LPO and MPO, and reduced AOA, which was exaggerated in the febrile episodes. Serum MPO and LPO products were related to the BBB permeability at the baseline. CSF hydroperoxide level was influenced by the BBB permeability, CSF albumin concentration, and serum hydroperoxide (r = 0.502; p < 0.001, and r = 0.611; p < 0.001, and r = 0.358; p < 0.001, respectively). CSF hydroperoxide and MPO correlated in complicated cases during the study.ConclusionsThese results suggest that CSF LPO and MPO were closely related in BM, had different courses if febrile episodes had occurred, but were partly influenced by the BBB permeability.     

Predictive value of osteocalcin in bone metastatic differentiated thyroid carcinoma

ObjectivesTo evaluate the diagnostic value of serum osteocalcin in the detection of bone metastases from differentiated thyroid carcinoma (DTC).Design and methodsSerum samples from DTC patients with (DTC BM+, n = 19) or without bone metastases (DTC BM?, n = 19), and matched healthy volunteers (n = 30) were tested for serum osteocalcin with electrochemiluminescent immunoassay.ResultsOsteocalcin was higher in DTC BM+ than in DTC BM? patients (+ 35.8%, p = 0.002), acting as an independent risk factor for bone metastases (R² = 0.142, p = 0.039). The sensitivity was 78.9% and the specificity was 63.2% at a cut-off value of 11.2 μg/L.ConclusionsSerial measurements of osteocalcin could be useful in the detection of bone metastases from DTC.     

Mutation -538 T/C in bone morphogenetic protein 4 do not increase the risk in sickle-cell disease with orthopedic complications but strongly associated with increased LDH and uric acid level in Indian patients from Chhattisgarh and Jharkhand states

BackgroundBone morphogenetic protein (BMP) are involved in the various orthopedic complications such as avascular necrosis, osteonecrosis and bone turnover, therefore genes coding for proteins, like BMP4, can be potential candidate for studying orthopedic disorders.MethodsA case–control study was conducted to examine the association between SNP T538C of BMP4 and orthopedic complications in sickling patients by employing PCR-RFLP.ResultsA total of 200 cases and 172 control groups were studied from Indian population. T538C SNP has not been implicated in disease and doesn't increase the risk (OR = 0.89, OR = 0.68). We observed no significant association between the T538C polymorphism and case group in the studied population. However, we observed significantly increased uric acid and LDH level in homowild (TT), heteromutant (TC) and homomutant (CC) in case group compared to control group ( all p = 0.0001) and (p = 0.0001, p = 0.0001, p = 0.015 and p = 0.0001, p = 0.0001, p = 0.0001 respectively) in the studied population.ConclusionsThe T/C polymorphism in BMP4 is not associated with case group and in view of present observation, we suggest that evaluation of LDH and uric acid level and its association with polymorphisms in the BMP4 may be considered to be reliable molecular and biochemical markers, and possess promising rational for diagnostic potential in clinical cases.