Inflammatory marker levels in obese adolescents with glucose intolerance: increased chitotriosidase activity

ObjectivesExistance of low grade persistent inflammation in obese children may increase the risk of metabolic and cardiovascular events. The aim was to determine whether glucose intolerance has an influence on inflammatory markers in obese adolescents.Designs and methods45 obese adolescents (mean BMI: 30.34 ± 5.42 kg/m²) were grouped as normal or impaired glucose tolerance. IL-6 and CRP levels were analyzed by commercially available kits. Chitotriosidase activity was measured by a fluorescence method and neopterin levels were determined by ELISA. Data were expressed as mean ± SD.ResultsIL-6 and CRP levels were similar in the two groups. Serum neopterin levels were not different between the groups. The chitotriosidase activity was significantly higher in the IGT group than NGT (124.33 ± 51.97 μmol/L/h vs 84.50 ± 53.99 μmol/L/h, p = 0.04).ConclusionSerum chitotriosidase activity is increased in obese adolescents with impaired glucose tolerance.     

Sensitivity of Erythrocyte Sedimentation Rate and C-reactive Protein for the Exclusion of Septic Arthritis in Emergency Department Patients

BackgroundPrevious studies in post-operative orthopedic and pediatric patients suggest that erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) testing may be helpful in ruling out septic arthritis. However, these tests have not been evaluated in a population of adult Emergency Department (ED) patients.Study ObjectiveDetermine the sensitivity of ESR and CRP in patients with septic arthritis.MethodsRetrospective analysis of ED patients with septic arthritis from 2003 to 2008. Eligible patients had an International Classification of Diseases - Ninth Revision diagnosis of pyogenic arthritis (711.0x) plus: positive synovial fluid culture, positive synovial Gram stain, or operative irrigation. Patients were excluded if no ESR or CRP was performed within 24 h. Sensitivity of ESR and CRP at various cutoffs was calculated with 95% confidence intervals (CI).ResultsWe identified 167 patients with septic arthritis. We included 143 (86%) who had ESR (n = 140, 84%) or CRP (n = 96, 57%) performed. Mean age was 49 (± 22) years, and 85 (59%) were male. Race was: 125 (87%) white, 4 (3%) black, and 12 (8%) Hispanic. Thirty-five (24%) had infection of prosthetic joints. Synovial cultures were positive in 102 (71%). Sensitivity of ESR was: 98% (95% CI 94–100%) using a cutoff of ≥ 10 mm/h (n = 134) and 94% (95% CI 88–97%) using a cutoff of ≥ 15 mm/h (n = 131). The sensitivity of CRP was 92% (95% CI 84–96%) using a cutoff of ≥ 20 mg/L (n = 88).ConclusionESR and CRP have sensitivities of > 90% for septic arthritis, but only when low thresholds are used. Further study is required to determine the clinical usefulness of ESR and CRP testing.     

Is serum transthyretin a reliable marker of nutritional status in patients with end-stage renal disease?

ObjectiveTo test the value of serum transthyretin (TTR) concentration as a nutritional marker in renal patients.MethodsThe study included 115 renal patients, out of which 35 are on conservative treatment, 50 on hemodialysis and 30 renal transplant recipients, and 31 healthy control subjects. Serum TTR, albumin, transferrin, C-reactive protein (CRP) and α1 anti trypsine (AAT) were assessed by immunoturbidimetry, and vitamin A by HPLC. Linear regression models were applied to test the association between serum TTR and body mass index (BMI).ResultsSerum TTR concentrations were normal, but serum vitamin A, CRP and AAT concentrations were significantly higher in patients. In renal patients, serum TTR was positively and independently related to BMI and was significantly lower in malnourished than well-nourished patients (367 ± 91 vs. 417 ± 130 mg/L; p = 0.05). The risk of serum TTR < 300 mg/L was higher in malnourished patients [OR, 4.82 (1.78–13.2); p = 0.001].ConclusionSerum TTR concentrations were at normal range in renal patients despite evidence of malnutrition and inflammation. However, they were related to BMI and were significantly lowered in malnourished patients. Thus, serum TTR would reflect nutritional status in renal patients. However, the cutoff of malnutrition should be raised to 300 mg/L.     

Serum Fetuin-A and Pentraxin3 in hemodialysis and renal transplant patients

ObjectiveThe aim of the present study was to evaluate of Fetuin-A and Pentraxin3 (PTX3) as the main factors for vascular calcification and inflammation in hemodialysis (HD) and renal transplant (RT) patients.MethodSerum was obtained from 45 stable chronic HD patients and 44 stable RT recipients. Biochemical factors, intact Parathormone, high-sensitive C-reactive protein (hsCRP), Fetuin-A and PTX3 levels were determined by standard methods.ResultsIn the RT recipients PTX3 level was significantly higher than the HD patients [5.78(1.09–20.36) ng/mL vs. 1.65(0.24–7.89) ng/mL, p ≤ 0.001]. Serum Fetuin-A concentration was significantly higher in the HD compared to RT group [43.39(27.75–81.48) ng/mL vs. 38.76(22.26–89.07) ng/mL, p = 0.020]. hsCRP level was also higher in the HD than the RT group [2.90(0.1–8.50) mg/L vs. 1.1(0.1–7.9) mg/L, p = 0.003].ConclusionAlthough our study shows that serum PTX3 is increased and Fetuin-A is decreased after successful RT, their direct role on atherosclerosis needs further studies in the future.     

Procalcitonin and C-reactive protein levels as diagnostic tools in febrile patients admitted to a General Internal Medicine ward

Objective: We study the extent to which procalcitonin (Pro-CT) and/or C-reactive protein (CRP) may be helpful in the early triage of febrile patients admitted to a general internal medicine ward.Methods: This is a prospective, observational study on 62 admitted patients in whom a temperature > 38 °C had been observed the day before inclusion.Results: Neither Pro-CT nor CRP was able to discriminate infectious (or bacterial) diseases from the other etiologies as a group, with an area under the ROC curve of 0.63 (95% CI 0.47–0.79, p = 0.15) for Pro-CT and 0.61, (95CI 0.44–0.78, p = 0.23) for CRP.Sensitivity and specificity for Pro-CT varied between 0.59 and 0.67 for a cut-off point of 0.2 ng/mL and 0.03 and 1 for a cut-off point of 10.0 ng/mL.However, in subgroup analysis, Pro-CT was able to discriminate between infectious and inflammatory diseases (Welch two sample t-test t = 2.39, df = 44.3, p = 0.021).     

Procalcitonin measurement for detection of serious bacterial infection in febrile children: comparison between two automated immunoassays

ObjectivesTo assess the concordance of procalcitonin values at 3 cut-off ranges in a cohort of pediatric samples presenting with fever without source, using two different automated immunoassays.Design and methods65 frozen samples from children presenting with fever without source were thawed, tested on both Kryptor and VIDAS systems, and compared using a regression analysis, a Bland–Altman difference plot, and analysis of concordance at the clinically relevant cut-off points.ResultsKryptor and VIDAS PCT results correlated remarkably well (r = 0.952), with no significant difference in the frequency distribution over the 3 cut-off ranges (p = 0.1384). The strength of the agreement was good (κ = 0.759) with an overall concordance of 84.6%.ConclusionCorrelation and concordance of PCT values measured by both systems were good. This finding allows clinical implementation of both techniques with the same nominal PCT cut-off values for detection of serious bacterial infection in children presenting with fever without source.     

The ratio of serum leptin to adiponectin provides adjunctive information to the risk of metabolic syndrome beyond the homeostasis model assessment insulin resistance: the Korean Genomic Rural Cohort Study

BackgroundLeptin and adiponectin are adipokines, shown to have opposing functions for fat metabolism and development of metabolic syndrome. We determined if the ratio of serum leptin to adiponectin (L/A ratio) adjunctively contributes to the risk of metabolic syndrome beyond the homeostasis model assessment of insulin resistance (HOMA-IR).MethodsThis study included 1532 men and 1856 women, aged 40–70 y assessed in the Korean Genomic Rural Cohort Study from 2005 to 2008. The serum concentrations of adiponectin and leptin were measured by radioimmunoassay. Area under the receiver operating characteristic curve (AUROC) analyses were used to describe the ability of L/A ratio and HOMA-IR to differentiate between subjects with and without metabolic syndrome.ResultsThere were no significant differences in the ability of L/A ratio and HOMA-IR to predict metabolic syndrome (AUROC of L/A ratio vs. HOMA-IR, 0.771 vs. 0.774, p = 0.8006 for men; 0.677 vs. 0.691, p = 0.3088 for women). There was a significant adjunctive contribution by the L/A ratio, beyond that of HOMA-IR, to the risk of metabolic syndrome in men (p < 0.0001 with 0.028 increased AUROC) and women (p = 0.025 with 0.017 increased AUROC).ConclusionsThe L/A ratio provides significant adjunctive information to the risk of metabolic syndrome beyond HOMA-IR alone. The L/A ratio could be a good surrogate marker to assess metabolic syndrome.     

Urinary calcium response to high dose vitamin D3 with calcium supplementation in patients with multiple sclerosis

ObjectiveTo characterize the effect of vitamin D₃ intake on urinary calcium:creatinine ratios across predefined ranges of serum 25(OH)D.DesignPatients with multiple sclerosis (n = 25) received escalating doses of vitamin D₃ (4000–40,000 IU/d) with calcium (1200 mg/d).ResultsUrinary calcium:creatinine was driven by increased 25(OH)D when concentrations were < 75 nmol/L (r = 0.424, p = 0.009) and > 200 nmol/L (r = 0.281, p = 0.01), but no relationship existed when 25(OH)D concentrations were 76–200 nmol/L.ConclusionsA “safe”, physiological range of 25(OH)D concentrations is 75–200 nmol/L.     

Assessment of inflammatory markers in patients with community-acquired pneumonia — Influence of antimicrobial pre-treatment: Results from the German competence network CAPNETZ

BackgroundThere is almost no data about the influence of antimicrobial pre-treatment (APT) on levels of inflammatory markers in community acquired pneumonia (CAP). The aim of this study was to investigate the influence of APT on inflammatory markers in CAP.Methods991 hospitalized patients (64.3 ± 17.6 years, 61% male) with CAP were enrolled. In all patients procalcitonin (PCT), C-reactive protein (CRP), and leukocyte count (WBC) were determined. Patients were followed-up for 28 days for survival.Results232 patients (23.4%) had APT, 759 had no APT. Patients without APT had significantly higher levels of PCT and WBC but not of CRP compared to those with APT. In patients without APT, survivors compared to non-survivors had lower values of PCT (0.20 ng/mL; 0.02–169.10 vs. 0.83 ng/mL; 0.04–516.30, p < 0.0001), WBC (12.4 × 10⁹/L; 1.3–49.9 vs. 14.9 × 10⁹/L; 3.7–34.5, p = 0.047) and CRP (107.0 mg/mL; 0.3–567.0 vs. 143.5 mg/mL; 5.0–589.0, p = 0.006). However, in patients with APT, the values of PCT, WBC and CRP were not significantly different in survivors and non-survivors. Cox regression analysis confirmed that PCT, CRP and WBC were predictive for 28 day mortality in patients without APT but not in those with APT.ConclusionsPCT and WBC but not CRP levels are higher in patients without APT compared to those with APT. PCT, CRP and WBC are predictive for 28 days mortality exclusively in patients without APT. Interpretation of inflammatory parameters has to take into account possible APT.     

Comparison of high performance liquid chromatography, radio immunoassay and electrochemiluminescence immunoassay for quantification of serum 25 hydroxy vitamin D

ObjectiveTo compare the performance of radioimmunoassay (RIA) with high-performance liquid chromatography (HPLC) and electrochemiluminescence (ECLIA) for the quantification of vitamin D (25OHD).MethodsHPLC method for the determination of 25OHD in human biological samples was developed and compared in terms of accuracy and precision with a commercially available RIA assay. Performance of RIA assay with ECLIA technology for 25OHD analysis was further compared.ResultsMedian 25OHD levels with HPLC vs. RIA were 50.1 nmol/L (IQ = 17.7–199.4 nmol/L) and 51.1 nmol/L (IQ = 12.5–187.2 nmol/L) respectively, whereas median 25OHD concentration with RIA vs. ECLIA was 32.4 nmol/L (9.98–199.7 nmol/L) and 29.9 nmol/L (4.9–214.6 nmol/L), respectively. Comparison data for HPLC vs. RIA showed RIA = ? 1.13 + 1.01 (HPLC) (RMSE = 11.2 nmol/L) and for RIA vs. ECLIA revealed, ECLIA = 3.21 + 0.9 (RIA) (RMSE9.6 nmol/L).ConclusionAcceptable correlation was observed among HPLC and RIA and also with RIA and ECLIA in quantification of 25OHD.     

Small dense LDL cholesterol is a robust therapeutic marker of statin treatment in patients with acute coronary syndrome and metabolic syndrome

BackgroundSmall dense low-density lipoprotein (sd-LDL) is an atherogenic LDL subfraction and often increased in metabolic syndrome (MetS). This study aimed to determine whether sd-LDL cholesterol (sd-LDL-C) is a therapeutic marker of statin treatment in patients with acute coronary syndrome (ACS) and MetS.MethodsWe examined 71 patients with ACS and 50 non-ACS subjects with normal coronary arteries (controls). The patients with ACS were treated with life-style modifications (n = 36) or those plus 20 mg atorvastatin daily (n = 35) for 6 months. We measured sd-LDL-C by a novel detergent-based homogenous assay and calculated buoyant LDL-C (b-LDL-C).ResultsThe patients with ACS had higher sd-LDL-C than did the controls (30 ± 14 vs. 22 ± 8 mg/dl, p < 0.001). Furthermore, sd-LDL-C was higher in the patients with ACS and MetS (n = 31) than in those without MetS (n = 40) (35 ± 17 vs. 27 ± 11 mg/dl, p < 0.05). Atorvastatin reduced LDL-C and sd-LDL-C by 31% (102 ± 23 to 70 ± 28 mg/dl, p < 0.0001) and 24% (29 ± 15 to 22 ± 13 mg/dl, p < 0.01). The reduction in sd-LDL-C by atorvastatin was 5.5-fold greater in the patients with ACS and MetS than in those without MetS (p < 0.001). Contrary, that in b-LDL-C was similar between the groups.Conclusionssd-LDL-C is a superior therapeutic marker of statin treatment in patients with ACS and MetS.     

Prediction of the neurological outcome with intrathecal high mobility group box 1 and S100B in cardiac arrest victims: a pilot study

ObjectivesTo investigate whether high mobility group box 1 (HMGB1) and S100B in cerebrospinal fluid (CSF) and the serum predict the neurological outcome in patients resuscitated from out-of-hospital cardiac arrest (OHCA).Materials and methodsThis study was designed as a prospective observational study. Twenty-five patients, who received standard cardiopulmonary resuscitation and post-resuscitation intensive care, were enrolled in this study. The patients were divided into two groups according to Glasgow-Pittsburgh Cerebral Performance categories (CPCs) at 6 months after return of spontaneous circulation (ROSC), Group G (n = 7, CPC 1 or 2) and Group P (n = 18, CPC ≥ 3). Their blood samples were taken at 6, 24, and 48 h after ROSC. The patients, whose CSF was sampled at 48 h, were also divided into either sub-Group G (n = 6) or sub-Group P (n = 8) at 6 months after ROSC.ResultsHMGB1 and S100B in CSF in sub-Group P were significantly higher than those in sub-Group G (HMGB1, <1.0 vs. 12.4 ng/ml, P = 0.009; S100B, 2.68 vs. 84.2 ng/ml, P = 0.007, respectively). HMGB1 in CSF was strongly correlated with S100B (σ = 0.81, P = 0.001). HMGB1 was elevated in serum at 6 h and normalized within 48 h after ROSC without any significant differences between the two groups. Serum S100B in Group P was significantly higher than that in Group G at each time point.ConclusionsThe significant elevations of HMGB1 and S100B in CSF, and S100B in serum are associated with the neurologically poor outcome in OHCA patients.     

CLSI EP17-A protocol: a useful tool for better understanding the low end performance of total prostate-specific antigen assays

BackgroundClinical Laboratory and Standards Institute (CLSI) published EP17-A guideline, recommending new definitions for low end performances: Limit of Blank (LoB), Limit of Detection (LoD) and Limit of Quantitation (LoQ). The aim of this study was to determine LoB, LoD and LoQ by applying EP17-A to Hybritech and World Health Organization (WHO) calibrated Access Total PSA assays, and verify the correlation between results generated by the same reagent with both calibrations, particularly at low end concentrations.MethodsAccording to EP17-A, serum pools of anonymous routine patient samples residuals were analyzed on a UniCelDxI800 with the chemiluminescent Access®Hybritech®TotalPSA assay.ResultsLoB: 0.0046 μg/L Hybritech, 0.005 μg/L WHO calibration; LoD: 0.014 μg/L Hybritech, 0.015 μg/L WHO; LoQ at 20% coefficient of variation (CV%) 0.0414 μg/L Hybritech, 0.034 μg/L WHO. Regression Hybritech y = 0.2398× + 4.2017 (R² = 0.9515); WHO y = 0.2248× + 3.4335 (R² = 0.9596) with no statistical difference. Comparison between Hybritech and WHO at low PSA levels indicated an excellent Pearson's and intraclass correlation (r = 0.999, p < 0.001; ICC = 0.974, p < 0.001).ConclusionsOur results show that the Access Total PSA assay is suitable for prostate cancer recurrence and PSA velocity evaluation; Hybritech and WHO calibrated values can both be used for clinical purposes even at low levels.     

Evaluation of a gel-permeation high-performance liquid chromatography for determining triglyceride levels in serum major lipoproteins, compared with the ultracentrifugation/precipitation method

ObjectivesTo evaluate the gel permeation high-performance liquid chromatography (GP-HPLC) method for determination of triglyceride (TG) levels in low-density lipoprotein (LDL) and high-density lipoprotein (HDL).Design and methodsThe GP-HPLC and the ultracentrifugation(UC)/precipitation methods were used and compared.ResultsThere was no significant difference in measured levels of LDL-triglyceride between the two methods, but the HDL-triglyceride levels measured by the GP-HPLC technique were significantly higher than the UC/precipitation one (145 ± 47 mg/L and 121 ± 45 mg/L respectively, n = 38, p < 0.0001).ConclusionsA GP-HPLC technique provides LDL-TG levels comparable to those obtained by the UC/precipitation method.     

Development of a score based on urinalysis to improve the management of urinary tract infection in children

BackgroundThe need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management.MethodsWe evaluated the sensitivity, specificity, negative and positive predictive value of automated microscopy IRIS iQ200 combined with the dipstick analyses in children with suspected UTI. Multivariable logistic regression analysis was used to identify the set of variables that best predict positive culture results and develop a numerical risk score.ResultsOf 474 consecutive urine samples retrospectively analyzed, 69 were positive at urine culture with prevalence of infection of 14.6%. Parameters significantly associated with the presence of infection in multivariable analysis were age < 1 year (p < 0.001), leukocyte esterase ≥ 15 × 10^6/L (p < 0.001), number of small particles (ASP) ≥ 5500 × 10^6/L (p < 0.001) and bacteria ≥ 3 × 10^6/L (p = 0.01). The derived score ranged from 0 to 10, with higher values indicating higher risk of UTI. The area under the score ROC curve was 79% (95% CI 0.72–0.85), and was better than those of the individual urinary chemical and microscopic analyses.ConclusionsThis routine method could improve the management of UTI in children by early identifying patients with low probability of infection, for whom antibiotic treatment can be withheld until the results of urine culture become available.     

Interleukin-23 serum levels in patients affected by peripheral arterial disease

ObjectivesTo clarify whether interleukin (IL)-23 is involved in peripheral arterial disease (PAD).Design and methodsWe evaluated IL-23 serum levels, in 29 patients suffering from lower extremity PAD and in 30 healthy subjects.ResultsIL-23 serum levels were higher during the three times (T0, T1 and T2) compared to the control group, although only statistically significant for T0 and T2: T0 (15.83 ± 22.08 vs. 8.08 ± 8.62 pg ml, p = 0.026), T1 (16.10 ± 23.71 vs. 8.08 ± 8.62 pg/ml, p = 0.101), T2 (15.06 ± 16.72 vs. 8.08 ± 8.62 pg/ml, p = 0.005).ConclusionFor the first time, our data gives us reason to believe there is an involvement of IL-23 in PAD.     

Associations Among Hypogonadism,C-Reactive Protein,Symptom Burden,and Survival in Male Cancer Patients with Cachexia: A Preliminary Report

ContextCachexia is characterized by muscle wasting, anorexia, and elevated inflammatory markers. In patients without cancer, hypogonadism is associated with lower lean body mass, increased symptom burden, and decreased survival. Hypogonadism in cancer cachexia could exacerbate symptoms, facilitate a proinflammatory state, and decrease survival.ObjectivesTo explore the relationships among these factors, a retrospective study of male cancer patients was conducted.MethodsThe charts of 98 consecutive male patients referred to a cachexia clinic at a comprehensive cancer center were reviewed. All patients reported weight loss of >5% within the preceding six months; the median age was 60 years. Fifty-seven (58%) had serum C-reactive protein (CRP), and 68 (69%) had total testosterone evaluated. Symptoms were evaluated by the Edmonton Symptom Assessment Scale.ResultsMedian CRP was 20 mg/L, and median testosterone level was 185 ng/dL (6.42 nmol/L) (normal ≥240 ng/dL or 8.36 nmol/L). There was an inverse correlation between testosterone and CRP levels (P < 0.01). Lower testosterone was associated with increased dyspnea and insomnia (P < 0.05). Poor appetite and insomnia (P < 0.05) correlated with elevated CRP. Survival of patients with testosterone levels ≤185 ng/dL (6.42 nmol/L) was decreased compared with that of those with levels >185 ng/dL (13 vs. 62 weeks, P = 0.004). Patients with CRP levels >10 mg/L had decreased survival compared with those with levels ≤10 mg/L (15 vs. 46 weeks, P = 0.01). The combination of hypogonadism and elevated CRP was associated with poorer prognosis. Elevated CRP levels were associated with increased symptom burden and decreased survival. Low testosterone was associated with decreased survival and correlated inversely with CRP levels, dyspnea, and insomnia.ConclusionOur preliminary results suggest that testosterone and CRP may be additive or synergistic as markers for survival in male patients and could be useful in future prognostic models.     

Plasma ceruloplasmin as a biomarker for obesity: a proteomic approach

ObjectivesThis study aimed to investigate new biomarkers of obesity particularly in relation with inflammation-associated proteins using protein differential display techniques.Design and methodsComparison of protein expression in plasma between non-obese (n = 109, body mass index, BMI < 25 kg/m²) and obese (n = 32, BMI ≥ 25 kg/m²) groups was carried out using two-dimensional gel electrophoresis (2-DE) analysis. ELISA was also performed for validation.ResultsAmong six differentially expressed protein spots, ceruloplasmin (Cp) and fibrinogen were over-expressed in obese group. Plasma Cp levels were significantly higher in obese group than non-obese group (34.0 ± 8.6 vs. 41.3 ± 12.7 mg/dL, p < 0.001) and positively correlated with age (r = 0.253, p < 0.005), BMI (r = 0.265, p < 0.001) and hsCRP (r = 0.385, p < 0.001). In stepwise multiple linear regression analysis, plasma Cp along with hsCRP were found predictors for obesity (adjusted β-coefficient = 0.266, p < 0.01).ConclusionElevated plasma Cp levels were significantly associated with obesity, which may be suggested to be a marker of obesity.     

Decreased serum brain-derived neurotrophic factor concentration in young nonobese subjects with low insulin sensitivity

ObjectiveInsulin resistance and type 2 diabetes are associated with an increased risk of neurodegenerative diseases. Decreased brain-derived neurotrophic factor (BDNF) levels might play a role in the pathogenesis of neuropsychiatric disorders. The aim of our study was to estimate serum BDNF concentration in nonobese women divided into subgroups according to their insulin sensitivity.Design and methodsWe studied 46 young, healthy, nonobese women. Insulin sensitivity was estimated with the euglycemic–hyperinsulinemic clamp technique. Then, participants were divided into subgroups of high (mean, 12.79 ± 2.01 mg/kg fat-free mass/min) and low insulin sensitivity (mean, 7.33 ± 1.66 mg/kg fat-free mass/min).ResultsWe observed decreased serum BDNF concentration in women with low insulin sensitivity in comparison to high insulin sensitivity group (3306.11 ± 603.10 vs 4141.91 ± 755.37 pg/mL, p = 0.001). Serum BDNF was positively related to insulin sensitivity (r = 0.43, p = 0.003). This correlation remained significant after adjustment for other estimated parameters.ConclusionsSerum BDNF is decreased in young nonobese women with low insulin sensitivity. Early detection and prevention of insulin resistance might be useful in the prevention of neurodegenerative disorders.     

An oxidative stress score as a combined measure of the pro-oxidant and anti-oxidant counterparts in patients with coronary artery disease

Oxidative stress plays a key role in the pathogenesis and development of atherosclerosis.AimTo evaluate the relationship between a novel oxidative stress index (reflecting both oxidative and anti-oxidant counterparts) with traditional cardiovascular risk factors and C-reactive protein (CRP) in coronary artery disease (CAD).Methods100 angiographically proven CAD and 70 control subjects (mean age: 65 ± 10 years, 110 males), underwent a global cardiovascular risk assessment and serum CRP and oxidative stress estimation. The Oxidative-INDEX was calculated after automated evaluation of serum hydroperoxides and total anti-oxidant capacity (D-ROM and OXY-adsorbent Test, Diacron, Italy) subtracting the OXY standardized variable from the ROM standardized variable.ResultsThe Oxidative-INDEX was higher in CAD with respect to control subjects (p < 0.001). A stepwise elevation in the Oxidative-INDEX levels was found depending on the number of affected vessels (p < 0.001). Oxidative stress was elevated according to the presence of diabetes (p < 0.001), smoking habit (p < 0.01), and hypercholesterolemia (p < 0.05). Oxidative-INDEX significantly correlated with aging (p ≤ 0.05) and CRP (p < 0.001). The Oxidative-INDEX increased with the number of cardiovascular risk factors (p < 0.001).After adjustment for traditional CV risk factors, the multivariate logistic regression analysis indicated the Oxidative-INDEX concentration as an independent factor for CAD (odds ratio = 1.4, confidence intervals = 1.1–1.9, p < 0.05).ConclusionOxidative stress represents a shared molecular pathway in atherosclerotic-related conditions, and its estimation by the automated Oxidative-INDEX could represent a valuable tool and a promising target in the prevention, diagnosis and treatment of CAD in the clinical setting.