Is Waist-height Ratio Associated with Thyroid Antibody Levels in Children with Obesity?

Objective:Obesity is known to affect thyroid function. Recently, waist-height ratio (WHtR) has been considered as a useful marker of subclinical hypothyroidism in obese cases, but its relation with thyroid autoimmunity still remains unclear. We evaluated the effect of body fat mass, WHtR, and metabolic parameters on thyroid autoantibody levels in children with obesity.Methods:This was a cross-sectional study carried out with an obese [n=56, male/female (M/F): 29/26] and a healthy group (n=38, M/F: 19/19). All subjects underwent anthropometric measurements, laboratory investigations for thyroid function tests, thyroid peroxidase (TPO-ab) and thyroglobulin-antibodies (Tg-ab), transaminases, blood glucose, insulin levels, and lipids after overnight fasting; homeostatic model assessment for insulin resistance (HOMA-IR) was calculated for assessment of insulin resistance. Fat mass was estimated by multiple frequency bioimpedance analysis in the obese group, which was further divided into two subgroups according to the median of WHtR. All parameters were compared between the groups/subgroups.Results:In the obese group, weight, height, body mass index (BMI), free triiodothyronine, thyrotropin, TPO-ab, insulin, low density lipoprotein-cholesterol, total cholesterol, alanine aminotransferase levels, and HOMA-IR were significantly higher than the controls group (p<0.05 for all). Median of WHtR was 0.6 in the obese group. In the “WHtR >0.6” subgroup (n=28), weight, BMI, fat mass, TPO-ab, Tg-ab, insulin and triglyceride levels were higher than WHtR ≤0.6 subgroup (p<0.05). A positive correlation was obtained between Tg-ab and WHtR (rho=0.28, p=0.041).Conclusion:Euthyroid children with obesity and a WHtR >0.6 are likely to have higher thyroid antibody levels, and Tg-ab levels have a positive correlation with WHtR, which reveals an association of central adiposity with thyroid autoantibody levels in these cases.     

TLR9 Polymorphisms Are Associated with Altered IFN-�� Levels in Children with Cerebral Malaria

Toll-like receptor (TLR) polymorphisms have been associated with disease severity in malaria infection, but mechanisms for this association have not been characterized. The TLR2, 4, and 9 single nucleotide polymorphism (SNP) frequencies and serum interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) levels were assessed in Ugandan children with cerebral malaria (CM, N = 65) and uncomplicated malaria (UM, N = 52). The TLR9 C allele at −1237 and G allele at 1174 were strongly linked, and among children with CM, those with the C allele at −1237 or the G allele at 1174 had higher levels of IFN-γ than those without these alleles (P = 0.03 and 0.008, respectively). The TLR9 SNPs were not associated with altered IFN-γ levels in children with UM or altered TNF-α levels in either group. We present the first human data that TLR SNPs are associated with altered cytokine production in parasitic infection.     

Serum Vitamin A and β-Carotene Levels in Children with Asthma

Background. Low serum levels of dietary antioxidants are associated with allergic diseases including asthma. Vitamin A and carotenoids are dietary antioxidants that are likely to play an important role against airway inflammation. Methods. This study included 433 asthmatic schoolchildren and 537 healthy control subjects, between 6 and 18 years of age. Serum β-carotene, vitamin A, cholesterol, and triglycerides levels were studied in all subjects. Results. Serum vitamin A concentration was significantly lower in asthmatic subjects than in healthy control subjects (19.4 ± 1.1 mg/dL vs. 28.9 ± 0.86 mg/dL) (p < 0.001). There were no significant differences in the levels of β-carotene, cholesterol, and triglycerides between the two groups. Conclusion. Reduction of vitamin A in asthmatic children may have etiological implications for the disease.     

Reduction of Serum Melatonin Levels in HIV-1-Infected Individuals’ Parallel Disease Progression: Correlation with Serum Interleukin-12 Levels

Abstract. Background: During the natural history of human immunodeficiency virus type I (HIV-1) infection, an impairment of interleukin-12 (IL-12) production precedes a switch from a T-helper 1 (Th1) to a T-helper 2 (Th2) stage of cellular immunity. Melatonin, the main hormone produced by the pineal gland, seems to promote a Th1 response by increasing the production of IL-12 in vitro. The aim of this study was to measure and correlate serum levels of melatonin and IL-12 in a cohort of HIV-1-infected individuals. Patients and Methods: 77 anti-HIV-1-positive subjects were enrolled: 20 were in CDC stage A, 25 in CDC stage B and 32 in CDC stage C. 30 healthy HIV-1-seronegative subjects were recruited as controls. IL-12 and melatonin concentrations were quantitated in serum samples. Results: Mean levels of serum melatonin were significantly lower in HIV-1-infected individuals in comparison with controls (p < 0.001). Within the HIV-1-seropositive group, mean melatonin and IL-12 concentrations were significantly lower in patients in CDC stage C, as compared with patients in CDC stages B and A (p < 0.01). Conclusion: During the natural history of HIV-1 disease, serum melatonin levels are progressively reduced. This reduction may be related to the impairment of Th1 immunoresponses.     

A Novel Variant with Positive Natural Selection Influenced Hb A2 Levels in Chinese Individuals with β-Thalassemia

β-Thalassemia (β-thal) is the most common inherited hemolytic anemia worldwide. Elevated Hb A₂ is a mark of β-thal carriers. The aim of this study was to identify the pathogenic variants associated with the Hb A₂ levels. One thousand and thirty β-thal carriers were recruited for this study. Using positive natural expression quantitative trait loci (eQTL) analysis, a significant variant was selected. Genotyping for the rs231841 polymorphism was performed by the Sequenom MassARRAY IPLEX platform. All genetic association analyses were performed with the PLINK program. The linear regression analysis showed that rs231841 in the intron region of the potassium voltage-gated channel subfamily Q member 1 (KCNQ1) gene on chromosome 11p15 was significantly associated with Hb A₂ levels. The presence of the C allele was associated with elevated Hb A₂ levels. Our results suggest that rs231841 on the KCNQ1 gene with positive natural selection is related to Hb A₂ levels in Chinese β-thal carriers, and KCNQ1 is probably associated with the expression of the β-like globin gene cluster.     

Relationship between Serum Uric Acid Levels and Kidney Arteriole Resistance in Patients with Type 2 Diabetes Associated with Hypertension

Some more reports have been showed that goutalways could be seen in those patients who weresuffering from primary hypertension, obesity, dyslipi-dosis, diabetes mellitus and insulin resistance. Endo-thial cells are the predominant site of the enzymexanthine oxidase and uric acid production deposition[1].Serum uric acid levels reflect the degree of xanthinoxidase activation[2]. Xanthine oxidase is known tocontri-bute to free oxygen radical generation, and ther-eby could contribute to impaired v…     

Changes of Plasma Levels of Brain Natriuretic Peptide in Patients with Chronic Heart Failure

In the situation of chronic heart failure, over activation of sympathetic nervous system and rennin- angiotensin-aldosterone system (RAAS) can induceadverse effects. But at the same time, some peptide factors such as natriuretic peptides can counteract wi…     

Levels of circulating intercellular adhesion molecule-1 in patients with Behçet's disease

The purpose of this study was to investigate the possible relationship between circulating intercellular adhesion molecule-1 (cICAM-1) plasma levels and Beh?et's disease. Plasma levels of cICAM-1 were measured in 44 patients with Beh?et's disease and in 30 healthy controls. cICAM-1 levels were higher in patients with Beh?et's disease than in the controls (P=0.001). The difference was more marked between patients with active Beh?et's disease and controls (P < 0.001). cICAM-1 levels were also higher in patients with active Beh?et's disease than in those with inactive disease (P<0.001). cICAM-1 seems to be related to disease activity in Beh?et's disease. It may be useful in assessing disease activity in Beh?et's disease, as well as in monitoring response to treatment.     

Levels of soluble E-selectin in patients with active Behçet’s disease

Behçets disease is a systemic vasculitis of unknown aetiology. Endothelial cell injury plays an important role in the pathogenesis and immunopathology of Behçets disease. E-selectin is expressed by activated endothelial cells. Because the selectin adhesion molecules are shed from activated cells, soluble forms of these proteins can be used as activation markers of endothelium (E-selectin). The pathogenesis of Behçets disease (BD) is closely related to endothelial cells, leucocyte functions and immunity. The aim of this study was to investigate circulating E-selectin adhesion molecules, which are known to play a significant part in the immune response especially by regulating interaction of the leucocytes with endothelium in BD. Plasma E-selectin concentrations were evaluated in 23 patients with BD and 20 healthy control subjects. The disease activity was evaluated by clinical manifestations (oral aphthous ulcer, genital ulceration, positive pathergy test, skin lesions, eye involvement, thrombophlebitis and arthritis) and by laboratory investigations [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)]. The patients were newly or previously diagnosed cases not taking any drug for BD. Levels of E-selectin were measured with commercially available sandwich enzyme-linked immunosorbent assay (ELISA) kits using human sE-selectin (cat. no: BMS 205). Plasma E-selectin concentrations of patients and controls were compared with the Mann-Whitney U test. Statistical significance was assigned to p values lower than 0.05. Serum levels (mean±SD) of soluble E-selectin (sE-selectin) were significantly higher in 23 patients with BD than in 20 healthy controls (53.2±18.2 ng/ml vs 33.8±7.5 ng/ml, p<0.0001). A statistically significant positive correlation was observed between sE-selectin levels and CRP and ESR in patients with BD (r=0.78, p<0.001 and r=0.56, p<0.01, respectively). Increases in the E-selectin in BD may be a direct consequence of the leucocyte and endothelium activations observed during the disease process. The noninvasive investigations can be used as biochemical markers for inflammation. This may provide additional information regarding disease activity along with the traditional indices such as ESR and CRP.     

Levels of growth differentiation factor-15 are high and correlate with clinical severity in transfusion-independent patients with β thalassemia intermedia

Transfusion-independent patients with β thalassemia intermedia (TI) experience a variety of clinical complications attributed to the underlying ineffective erythropoiesis and subsequent anemia, hemolysis, and iron overload. Growth differentiation factor-15 (GDF-15) was recently investigated as a marker of ineffective erythropoiesis in several anemias. In this work, we evaluated GDF-15 levels in 55 patients with TI. The mean GDF-15 level was 25,197.8 ± 16,208.9 pg/ml which is lower than values reported for patients with thalassemia major, yet considerably higher than those reported in patients with other congenital and acquired anemias. GDF-15 levels were significantly higher in splenectomized compared to non-splenectomized patients and correlated with anemia, markers of iron overload, and a pre-defined clinical severity score. Further studies are needed to determine the practical utility of GDF-15 measurement and its potential to reflect the severity of the clinical course in TI patients.     

Association of Serum TGF-β1 Levels with Different Clinical Phenotypes of Cystic Fibrosis Exacerbation

Purpose

Cystic Fibrosis (CF) is a multi-organ genetic disorder and Transforming Growth Factor (TGF-β1) is a modifier gene which modulates lung pathology in CF. There is great phenotypic variability among CF patients who even have similar genotype. The aim of the present study was to associate the serum levels of TGF-β1 with several clinical phenotypes of CF.

Methods

The diagnosed cases of CF were recruited and the blood sample was withdrawn at different time points: during exacerbation (n = 26), non-exacerbation (n = 9) and after antibiotic therapy (n = 11). The concentration of the total TGF-β1 in serum was measured with commercial ELISA kit. The ΔF508 mutation was assessed by the Amplification Refractory Mutation System (ARMS-PCR).

Results

The levels of TGF-β1 were increased in exacerbation phase (119.89 ± 29.64 ng/mL), infection with P. aeruginosa (121.8 ± 28.83 ng/mL) and in subjects with ΔF508 mutation (139.2 ± 19.59 ng/mL). The levels of TGF-β1 in CF patients with Allergic Bronchopulmonary Aspergillosis (ABPA) (109.97 ± 27.71 ng/mL) were decreased as compared to CF patients without ABPA (123.55 ± 30.20 ng/mL). It was observed that the serum levels of TGF-β1 were decreased significantly after antibiotic therapy (p < 0.05).

Conclusions

The present study has determined that the serum levels of TGF-β1 vary with the type of infections, ΔF508 CFTR mutation, presence of ABPA and response to therapy.

     

Levels of plasma des-γ-carboxy protein C and prothrombin in patients with liver diseases

AIM:To study the plasma des-γ-carboxy protein C activity,antigen and prothrombin levels in patients with liver diseasesand their clinical significance.METHODS:Plasma protein C activity(PC:C)was detectedby chromogenic assay and antigen(PC:Ag)and des-γ-carboxyprotein C(DCPC)were detected by ELISA.Total prothrombinand unabsorbed prothrombin in plasma were detected byecarin chromogenic assay.RESULTS:Compared with the control,the levels of PC:Cand PC:Ag in patients with hepatocellular carcinoma(HCC)and liver cirrhosis(LC)were lower(PC:C:104.65±23.0%,62.50±24.89%,56.75±20.14%,PC:Ag:5.31±1.63 μg/mL,2.28±1.15 μg/mL,2.43±0.79 μg/mL,P<0.05).The levelsof PC:Ag in patients with acute viral hepatitis(AVH)alsowas lower(2.98±0.91 μg/mL,P<0.01),but PC:C was closeto the control(93.76±30.49%,P>0.05).The levels of DCPC inpatients with HCC were remarkably higher(0.69±0.29 μg/mL,1.18±0.63 μg/mL,0.45±0.21 μg/mL,P<0.05)and its averagewas up to 50% of total PC:Ag.But those of DCPC in patientswith AVH were not significantly different from the control.The levels of total prothrombin were lower in patients withLC,but higher in patients with HCC.The levels of unabsorbedprothrombin were predominantly higher than those of othergroups.CONCLUSION:PC:C and PC:Ag in patients with liverdiseases(except PC:C in AVH)were lower.The totalprothrombin was lower in patients with LC.The higherlevel of unabsorbed prothrombin may be used as a scanningmarker for HCC.DCPC may be used as a complementarymarker in the diagnosis of HCC.     

Levels of plasma des-γ-carboxy protein C and prothrombin in patients with liver diseases

AIM: To study the plasma des-γ-carboxy protein C activity, antigen and prothrombin levels in patients with liver diseases and their clinical significance. METHODS: Plasma protein C activity (PC:C) was detected by chromogenic assay and antigen (PC:Ag) and des-γ-carboxy protein C (DCPC) were detected by ELISA. Total prothrombin and unabsorbed prothrombin in plasma were detected by ecarin chromogenic assay. RESULTS: Compared with the control, the levels of PC:C and PC:Ag in patients with hepatocellular carcinoma (HCC) and liver cirrhosis (LC) were lower (PCC: 104.65&#177;23.0%,62.50&#177;24.89%, 56.75&#177;20.14%, PC:Ag: 5.31&#177;1.63 μg/mL, 2.28&#177;1.15 μg/mL, 2.43&#177;0.79 μg/mL, P&lt;0.05). The levels of PC:Ag in patients with acute viral hepatitis (AVH) also was lower (2.98&#177;0.91 μg/mL, P&lt;0.01), but PC:C was close to the control (93.76&#177;30.49%, P&gt;0.05). The levels of DCPC in patients with HCC were remarkably higher (0.69&#177;0.29 μg/mL,1.18&#177;0.63 μg/mL, 0.45&#177;0.21 μg/mL, P&lt;0.05) and its averagewas up to 50% of total PC:Ag. But those of DCPC in patients with AVH were not significantly different from the control. The levels of total prothrombin were lower in patients with LC, but higher in patients with HCC. The levels of unabsorbed prothrombin were predominantly higher than those of other groups. CONCLUSION: PC:C and PC:Ag in patients with liverdiseases (except PC:C in AVH) were lower. The total prothrombin was lower in patients with LC. The higher level of unabsorbed prothrombin may be used as a scanning marker for HCC. DCPC may be used as a complementary marker in the diagnosis of HCC.     

Nutritional Status Impairments in HIV-Infected Patients Are Associated with Increased TNF-α and IL-6 Serum Levels but Not with Viral Load

Background: Cytokines may alter metabolic pathways and contribute to malnutrition among human immunodefiency virus (HIV)-positive individuals. Patients and Methods: Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), soluble IL-2 receptors (sIL-2R), β₂-microglobulin serum levels and plasma viral load of 45 HIV-positive patients were determined and correlated to nutritinal status impairment. Patients were grouped by CD4 counts into categories I (< 200/μl), II (200–499/μl), III (≥ 500/μl). There were 15 healthy controls. A nutritional grading system, based on anthropometric and laboratory data, was devised. Scores ranged from 0 to 5 (eutrophic to malnutrition). Results: AIDS patients' cytokines and immune marker levels were significantly higher than those of the controls, but not always higher than those of other categories. AIDS patients had higher nutritional deficit grades than category III (p < 0.05) or the controls (p < 0.02) which, except for viral load, correlated with the parameters studied. Conclusion: Nutritional status impairments in HIV-positive individuals were associated with immune activation but not with viral load. Received: June 27, 2000 · Revision accepted: June 30, 2001     

Interleukin–8 Serum Levels at Fever Onset in Patients with Neutropenia Predict Early Medical Complications

Abstract Background: Previous studies have shown that interleukin–8 serum levels in febrile neutropenic patients are significantly higher in patients with gram–negative bacteremia than in patients with other causes of fever and may indicate unfavorable outcomes. We assessed the value of interleukin–8 serum levels at fever onset to predict clinical complications in order to confirm these earlier findings. Patients and Methods: In a prospective observational study of adult patients receiving cancer chemotherapy, serum samples obtained at the onset of 147 febrile neutropenic episodes were measured by an immunoluminescence assay. Results: Complicated courses of fever including severe sepsis or septic shock, respiratory insufficiency or death were observed in 13 episodes (9%); in six episodes complications had developed within 1 week after fever onset and five of them were associated with bloodstream infections. At an interleukin–8 cutoff level of 1,000 pg/ml, these early complications were predicted with a sensitivity of 83%, a specificity of 97%, a positive predictive value of 50%, and a negative predictive value of 99%, respectively. Conclusion: Interleukin–8 levels at fever onset may be used for the prediction of early medical complications associated with bacteremia and can help identify patients who might benefit from intensive care admission. This paper is dedicated to the founders of the Walter Marget Foundation, D. Adam and F. Daschner, in gratitude for their support of the training in infectious diseases.     

A Case of Buerger’s Disease Associated with High Levels of Lipoprotein(a)

We describe a 35-year-old man affected by Buerger’s disease in association with very high levels of lipoprotein(a). Received: 9 June 1998 / Accepted: 9 June 1998