Increased Serum Osteocalcin Levels in Patients with Lactase Deficiency

Serum levels of osteocalcin, a noncollagenous bone matrix protein, have been found to be a specific biochemical parameter of bone formation. In the literature in subjects with osteoporosis, an increased incidence of lactase deficiency has been described. We therefore determined the serum levels of osteocalcin in 10 patients with lactase deficiency and in 20 control subjects by radioimmunoassay. The patients with lactase deficiency were dietary treated and had a very low daily calcium intake. Serum osteocalcin levels were significantly higher in the patients with lactase deficiency than in the control subjects. In contrast, serum levels of parathyroid hormone, alkaline phosphatase, calcium, and phosphorus were not statistically different in the two groups. Our data suggest an increased rate of bone turnover in patients with lactase deficiency on a low calcium diet; possibly calcium supplementation is indicated in dietary-treated patients with lactase deficiency.     

Serum Electrolyte Levels and Outcomes in Patients Hospitalized with Hepatic Encephalopathy

Introduction and aims. Serum electrolyte derangements are common in patients with decompensated cirrhosis hospitalized for hepatic encephalopathy. There are limited data describing the association between electrolyte levels and outcomes in hepatic encephalopathy. We assessed the association between initial serum electrolyte values and outcomes in patients with hepatic encephalopathy.Material and methods. A total of 385 consecutive patients hospitalized with encephalopathy were included in the study. Baseline electrolyte levels (sodium, potassium, chloride, bicarbonate, calcium and phosphorus) were measured at the time of admission and assessed for association with outcomes, which included survival, admission to the intensive care unit, requirement for mechanical ventilation, and length of hospital stay. P-values ≤ 0.0083 were considered significant after adjustment for multiple testing.Results. In unadjusted analysis, significant associations were identified regarding both bicarbonate and phosphorus (admission to intensive care unit), and calcium (mechanical ventilation); however these findings weakened and no longer approached statistical significance when adjusting for confounding variables. No other significant associations between serum electrolyte measurements and outcomes were observed.Conclusions. Our findings suggest that in patients hospitalized with encephalopathy, serum electrolyte measurements are not strong predictors of patient outcome.     

Increased Serum Levels of Eotaxin in Patients with Inflammatory Bowel Disease

Background: The CC-chemokines eotaxin and eotaxin-2, produced by epithelial and phagocytic cells, are potent and selective chemoattractants for eosinophils and basophils. The eosinophil is a potent inflammatory cell thought to play an important role in the pathogenesis of inflammatory bowel disease (IBD). In this study we investigated the serum concentrations of eotaxin and eotaxin-2 in patients with Crohn disease and ulcerative colitis. Methods: Thirty-one patients with Crohn disease, 35 patients with ulcerative colitis and 41 control patients were studied. Eotaxin and eotaxin-2 serum levels were measured with solid phase sandwich enzyme-linked immunosorbent assays. Results:     

Immunological Characterization of the 7-S Domain of Type IV Collagens

Antisera were raised against the long and short form of mouse and human 7-S collagen and against type IV collagens solubilized by acid extraction or limited digestion with pepsin. All the antisera showed strong binding for 7-S collagen in radioimmunoassays demonstrating that the 7-S domain which serves as a crosslinking region of type IV collagen is the most immunogenic portion of the molecule. Cross-reaction studies and analysis of fragments showed a complex antigenic structure including some determinants common to the long and short form of 7-S collagen and others unique for the long form.Purified antibodies against 7-S collagen reacted in indirect immunofluorescence with almost all basement membranes of the body indicating that the 7-S domain is a common structural element of type IV collagens.     

Increased Resistin Serum Concentrations in Patients with Type 1 Diabetes Mellitus

Objective: Adiponectin, leptin, and resistin are adipokines which play a significant role in the regulation of lipid and carbohydrate metabolism in patients with type 2 diabetes, while little is known about their role in type 1 diabetes mellitus (T1DM). The aim of this study was to measure serum adiponectin, leptin, and resistin levels and to investigate their relationships with some parameters in patients with T1DM and healthy controls.Methods: Fifty children and adolescents with T1DM (21 boys and 29 girls) and 33 healthy control subjects (18 boys and 15 girls) participated in the study. All subjects were patients followed in the Pediatric Endocrinology and Metabolism Unit of Gaziantep University Faculty of Medicine. None of the subjects had hypertension, obesity, hyperlipidemia, anemia, or infection. Adiponectin, leptin, and resistin levels were analyzed with ELISA.Results: There were no statistically significant differences related with age, sex, pubertal status, or body mass index distribution between the diabetic and control groups. Resistin levels were significantly higher in the diabetic group compared to controls (5.26±3.15 ng/mL vs. 3.50±1.26 ng/mL; p<0.01).Conclusion: Of the three investigated adipokines, only resistin was associated with T1DM. Resistin may play a role in the process of inflammation and also in the pathophysiology of T1DM. Conflict of interest:None declared.     

血清Ⅳ型胶原在良恶性肝肿瘤鉴别中的价值

对５８例肝癌，２９良性肝肿瘤，１３例其他恶性肿瘤和３０名正常对照者例用一步夹心酶免疫法测定了血清Ⅳ型胶原水平。结果显示，肝癌组血清Ⅳ－Ｃ显著高于良性肝肿瘤，其它恶性肿瘤及正常对照组；血清Ⅳ－Ｃ对良，恶性肝肿瘤鉴别诊断的准确率为９０．８０％，对原发性肝癌的敏感性及特异性分别为９１．４８％和８９．６５％，敏感性优于血清     

Relationship Between Renal Hemodynamics and Urinary Type IV Collagen in Patients with Essential Hypertension

Urinary type IV collagen excretion (uT4C) in diabetic patients is higher than in normal subjects. In this study, we investigated the relationship between uT4C and renal hemodynamics in 42 patients with essential hypertension. The renal resistive index (RI) is calculated from blood flow velocities measured using pulsed-wave in interlobar arteries. There was a significant correlation between uT4C to creatinine ratio (uT4C/uCr) and age, hemoglobin A1c (HbA1c), and RI. A stepwise regression analysis showed that RI was independently associated with uT4C/uCr. These results indicated that uT4C may be a marker of renovascular stiffness due to glomerulosclerosis in patients with essential hypertension.     

Increased Serum Levels of Vascular Endothelial Growth Factor in Patients with Inflammatory Bowel Disease

Background: Vascular endothelial growth factor (VEGF) is a potent angiogenic, vascular permeability-enhancing, and calcium-dependent enzyme-modulating cytokine with overexpression in various pathologic disorders, including granulomatous inflammation, tissue repair, delayed hypersensitivity reactions, rheumatoid arthritis, and tissue ischemia. The present study investigates the role of VEGF in chronic inflammatory bowel disease. Methods: Thirty-one patients with Crohn's disease, 15 patients with ulcerative colitis, and 9 healthy volunteers were studied. VEGF serum levels were measured with a solid-phase enzyme-linked immunosorbent assay. Results: Significantly increased VEGF serum levels were observed in both active Crohn's disease and active ulcerative colitis when compared with healthy controls. Patients with active Crohn's disease and active ulcerative colitis showed significantly higher VEGF serum levels than patients with quiescent disease. No difference was observed between inactive disease and healthy controls. In addition, strongly increased VEGF serum levels were found in patients with Crohn's disease with fistulas in the absence of clinical, endoscopic, histologic, and laboratory findings of disease activity. Conclusions: Significantly increased VEGF serum levels were observed in patients with active Crohn's disease and ulcerative colitis, which suggests that VEGF has an important role in chronic inflammatory bowel disease. Its possible association with fistulas has yet to be determined.     

Significance of Elevated Levels of Collagen Type IV and Hyaluronic Acid in Gastric Juice and Serum in Gastric Cancer and Precancerous Lesion

Background and Aims  

Collagen type IV and hyaluronic acid (HA) are the major components of basement membrane and extracellular matrix, respectively. Cathepsin D is an aspartyl lysosomal protease involved in the degradation of the basement membrane and extracellular matrix. The aim of this study is to investigate the clinical significance of collagen type IV and hyaluronic acid in gastric juice and serum in diagnosis of gastric cancer and the degrading effect of cathepsin D on collagen type IV and HA.     

Increased Turnover of Gc-Globulin in Patients with Hepatic Encephalopathy

Background: A low serum level (_&lt;100 mg/L) of the actin-scavenger Gc-globulin is a prognostic marker of non-survival in fulminant hepatic failure (FHF). It is unknown whether decreased production or increased consumption (or both) is responsible for the low Gc-globulin levels. Methods: Ten patients with FHF and four patients with acute or chronic liver disease (AOCLD) with hepatic encephalopathy (HE) grades II-IV were included. Eight patients with cirrhosis (chronic liver disease, CLD) without HE served as controls. Total, free, and actin-bound Gc-globulin were measured in samples from an artery, a central vein, and a hepatic vein. In 12 patients (9 FHF, 3 AOCLD), concentrations were measured before and after high volume plasmapheresis (HVP). Results     

Increased Hepatic Oxidative DNA Damage in Patients with Hepatocellular Carcinoma

Since oxidative DNA damage plays a role in experimental carcinogen-induced cancers, the purpose of the present study was to determine if hepatic oxidative DNA damage was increased in patients with HCC compared to patients with benign hepatic tumors or hepatic metastases (non-HCC) or to patients with end-stage alcoholic liver disease undergoing liver transplantation. Oxidative DNA damage was assessed by 8-hydroxy-2`-deoxyguanosine (8-OH-dG). Results showed that peritumoral 8-OH-dG was markedly increased in HCC (N= 51) (180 ± 74 vs 32 ± 58-OH-dG/10⁶dG for tumor, P < 0.005) in contrast to patients with non-HCC (N = 17), in whom the peritumoral 8-OH-dG did not differ from that in tumor (39 ± 7 vs. 31 ± 108-OH-dG/10⁶dG). Oxidative DNA damage can be both mutagenic and carcinogenic; our data suggested it will be important in future studies to determine the chronology of this type of liver injury relative to hepatocarcinogenesis.     

Thrombopoietin (TPO) Levels in Hepatic Patients with Thrombocytopenia

Thrombocytopenia is a common problem complicating the course of liver disease. One of the postulated mechanisms in chronic liver disease is impaired production of the hormone, thrombopoietin (TPO). The aim of present study was to evaluate the role of TPO on the occurrence of thrombocytopenia. Serum TPO levels was determined by ELISA in 40 patients with liver disease (11 seropositive with hepatitis C; 10 with mixed liver cirrhosis; 19 with bilharzial hepatic fibrosis), plus 14 normal healthy subjects as a control group. The sTPO levels were unevenly distributed among the liver disease subgroups being the highest in the group with HCV (median 1232.0, range 154.7-2042.0 pg/ml) followed by the mixed cirrhosis group (556.5; 342.0-1497.0 pg/ml) and lowest among the bilharzial hepatic fibrosis group (130.0; 22.0-204.0 pg/ml) ( P <0.01). While sTPO levels in HCV and cirrhotic group were significantly higher when compared to the control group (97.0; 19.0-377.0 pg/ml), those in the Bilharzial hepatic fibrosis group were not significantly elevated ( P > 0.05). There is significant negative correlation between sTPO levels and spleen size ( R =?0.3, P =0.043); but there was no correlation with platelet count ( R =0.09, P >0.05). In addition, sTPO levels were significantly higher in patients with platelet counts ≥60×10 9 /l as compared to those with platelet counts <60×10 9 /l ( P =0.04). Using the receiver operating curve (ROC) at sTPO cut off value ≥ vs. < 368 ng/ml, most of HCV and cirrhotic patients had higher sTPO levels (81.8 and 80.0%, respectively), while all Bilharzial hepatic fibrosis group (100%) had lower sTPO levels. In conclusion, sTPO levels had no role in the occurrence of thrombocytopenia in liver disease patients and other factors appear to be more important. It also appears that the mechanism controlling sTPO levels might be different in cirrhotic patients compared to Bilharzial hepatic fibrosis patients.     

高血压患者血清Ⅲ型胶原与动脉僵硬度

目的 探讨高血压患者中Ⅲ型胶原合成与动脉僵硬度改变之间的关系.方法 对入选的住院高血压病患者158例进行血清Ⅲ型胶原前多肽(PⅢNP)和生化指标包括血脂、空腹餐后血糖、血清高敏C反应蛋白(hsCRP)的测定,并测定以下动脉僵硬度指标:大动脉弹性指数(C1)、小动脉弹性指数(C2)、颈-股动脉脉搏波传导速度(PWVcf).应用统计学方法分析所选生化指标、血清PⅢNP与动脉僵硬度指标的之间的相关性.结果 (1)单因素分析结果显示:PWVcf与血清PⅢNP呈正相关(r=0.167, P＜0.05),血清PⅢNP与患者性别、年龄、高血压患病年数、血脂、血糖等无相关性(P＞0.05).PWVcf还与年龄、高血压病程、收缩压(SBP)、合并糖尿病、空腹和餐后血糖相关;C1、C2与血清PⅢNP无关,而与患者性别、年龄、SBP明显相关;(2)多元线性回归分析结果显示:PWVcf仍与患者血清PⅢNP水平有关(P＜0.05),与年龄、SBP之间有显著相关性.结论 动脉管壁Ⅲ型胶原的沉积增加可能在大动脉功能异常中发挥作用,且其作用并非由于增龄所致,但其对小动脉顺应性影响较小.     

Improvement of Serum Aminotransferase Levels after Phlebotomy in Patients with Chronic Active Hepatitis C and Excess Hepatic Iron

Objectives: Iron metabolism may be altered in patients with chronic active hepatitis C. In an attempt to evaluate whether excess iron contributes to liver injury, we used phlebotomy for removal of iron from patients with chronic hepatitis C. Methods: All 10 patients had histochemically detectable iron In the liver and underwent an initial period of weekly or monthly phlebotomy of 200 or 400 ml. A serum ferritin level of 10 ng/ml or less was chosen as the endpoint, and maintenance phlebotomy was performed if the level rebounded. Results: The treatment reduced mean serum alanine aminotransferase activity from 152 ± 49 to 55 ± 32 IU/L; this level became normal in five of the 10 patients. Anti-HCV antibodies could be detected in all patients throughout the study. Histologic abnormalities of the liver were unchanged except for disappearance of iron deposits from seven of the patients studied. Conclusions: Our findings suggest that iron removal may be beneflcial for patients with chronic active hepatitis C and histochemical iron in the liver.     

高血压患者血清Ⅲ型胶原与动脉僵硬度

目的探讨高血压患者中Ⅲ型胶原合成与动脉僵硬度改变之间的关系。方法对入选的住院高血压病患者158例进行血清Ⅲ型胶原前多肽(PⅢNP)和生化指标包括血脂、空腹餐后血糖、血清高敏C反应蛋白(hsCRP)的测定,并测定以下动脉僵硬度指标:大动脉弹性指数(C1)、小动脉弹性指数(C2)、颈-股动脉脉搏波传导速度(PWVcf)。应用统计学方法分析所选生化指标、血清PⅢNP与动脉僵硬度指标的之间的相关性。结果(1)单因素分析结果显示:PWVcf与血清PⅢNP呈正相关(r=0.167,P<0.05),血清PⅢNP与患者性别、年龄、高血压患病年数、血脂、血糖等无相关性(P>0.05)。PWVcf还与年龄、高血压病程、收缩压(SBP)、合并糖尿病、空腹和餐后血糖相关;C1、C2与血清PⅢNP无关,而与患者性别、年龄、SBP明显相关;(2)多元线性回归分析结果显示:PWVcf仍与患者血清PⅢNP水平有关(P<0.05),与年龄、SBP之间有显著相关性。结论动脉管壁Ⅲ型胶原的沉积增加可能在大动脉功能异常中发挥作用,且其作用并非由于增龄所致,但其对小动脉顺应性影响较小。     

Serum Interleukin-33 Levels in Patients with Gastric Cancer

Background  

Interleukin-33 (IL-33) is a novel member of the IL-1 family of cytokines, and it is closely related to IL-18, one of the best characterized members of the IL-1 family. It’s been demonstrated that elevated levels of IL-18 are involved in a wide variety of tumors, especially in gastric cancer.     

Serum Urotensin II Levels in Patients with Non-Dipper Hypertension

Hypertension terms “dipper” and “non-dipper” are propounded by the change that occurs during ambulatory blood pressure (BP) monitoring. The purpose of this study is to present whether the serum urotensin II levels are different in patients with dipper and non-dipper hypertension and to put forward the effects causing this difference, if there are any. Patients recently diagnosed with hypertension were included in the study. With ambulatory BP monitoring, 81 patients with high BP were divided into two groups, dipper (n = 40) and non-dipper (n = 41). Serum urotensin II levels were analyzed by ELISA method. Serum urotensin II levels were higher in patients with non-dipper hypertension than in patients with dipper hypertension (204 [106–533] vs. 140 [96–309], P = .004). There was a positive correlation between total systolic BP and serum urotensin II levels (r = 0.408 and P = .009), but the relation in the non-dipper hypertension group was not significant (r = 0.194 and P = .2). In conclusion, serum urotensin II levels were higher in non-dipper HT patients than dipper HT patients. This higher urotensin II level might be responsible for poor prognoses.