Daria Pašalić
Department of Medical Chemistry, Biochemistry and Clinical Chemistry
Zagreb University School of Medicine
Šalata ul 2.
10 000 Zagreb, Croatia
Phone +385 (1) 4590 205; +385 (1) 4566 940
E-mail: dariapasalic [at] gmail [dot] com

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The importance of the clinical state for successful collection of sweat sample in children
Matica J, Aralica M
Clinical Hospital Centre Rijeka, Clinical Department of Laboratory Diagnostics, Rijeka, Croatia
Corresponding author: jasminka [dot] matica [at] ri [dot] t-com [dot] hr
Background: The sweat test is the "gold standard" for diagnosis of cystic fibrosis. Patient's physiological and clinical states are important factors for successful collection of sufficient quantity of sweat after pilocarpine iontophoresis. Aim of the study was to investigate clinical state of children regarding successful sweat collection.
Materials and methods: The questionnaire composed of seven questions was presented to parents or nurses accompanying tested children prior the sweat testing. The questions were shaped as statements describing the clinical state of the child (dehydration, fasting, elevated body temperature, acute illness, edema and skin lesions). Regarding presence or absence of listed clinical symptoms answers were considered as favorable (1 point) or unfavorable (0 points). A total sum (clinical state score, ranged 0-7) was introduced as measure of clinical state. The participants were divided into two groups according to the quantity of collected sweat (sufficient and non-sufficient). Results were presented as median (range) and Mann-Whitney test was used to calculate the difference in clinical state score between groups.
Results: There were 117 participants; 90 children (age 30 (1-196) months) in sufficient sweat quantity (SSQ) group and 27 (age 25 (1-208) months) in non-sufficient sweat quantity (NSSQ) group. The SSQ group had clinical state score 5 (3-7), and NSSQ group had 5 (3-6) but there was significant difference in clinical state score between groups (P = 0.006).
Conclusion: Study pointed out the importance of favourable clinical status of children undergoing sweat testing. Preanalytical phase regarding proper patient's preparation is crucial for successful collecting of the sweat.
Relationship between gamma-glutamyltransferase levels with alcohol consumption in a young population
Abreu R, Leitão M, Almeida A, Bellém F, Cardoso V, Pinto A
Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL), Clinical Analyses and Public health, Lisbon, Portugal
Corresponding author: mcleitao [at] estesl [dot] ipl [dot] pt
Background: Excessive alcohol consumption is a worldwide increasingly problem, particularly in young people. The present study aimed to evaluate changes of gamma-glutamyltransferase (ΥGT) activity, caused by alcohol, in a young population.
Materials and methods: The sample consisted of 149 individuals, 108 females and 41 males, aged between 18 and 25 years. We used a questionnaire to collect personal data and socio-economic habits of alcohol. It was also collected blood samples by venipuncture to determine ΥGT activity. The study focused on the variables "age", "sex", "ΥGT activity value," and "level of alcohol consumption". Statistical analysis included descriptive and inferential methodologies.
Results and conclusions: Gender mean values of ΥGT activity were significantly different, being of 23.03 U / L in men and 16 U / L in women. For "level of alcohol consumption" the mean values of ΥGT were 16.49 U / L in abstinent, 18.10 U / L in moderate drinkers and 22.12 U / L in abusive consumers, but with differences not statistically significant. We concluded that alcohol consumption didn’t change significantly ΥGT activity values in the studied sample. Shall be considered in further studies, the inclusion of other factors, which may be associated with liver damage from alcohol, as obesity or genetic predisposition.
Prealbumin: nutritional marker in intensive care patients?
Cachapuz I (1), Lobo L (2), Noronha M (2), Lopes E (1), Amaro A (3), Granja C (3), Alves V (1)
(1) Pedro Hispano Hospital; Matosinhos Local Health Care Unit, Clinical Pathology Service, Oporto, Portugal
(2) Pedro Hispano Hospital; Matosinhos Local Health Care Unit, Nutrition Service, Oporto, Portugal
(3) Pedro Hispano Hospital; Matosinhos Local Health Care Unit, Intensive Care Medicine Service, Oporto, Portugal
Corresponding author: cachapuz [dot] isabel [at] gmail [dot] com
Background: The prevalence of malnutrition in critically ill patients lies around 40%. Due to the acute severe disease, it is particularly difficult to assess these patients’ nutritional state. The aim of this study was to evaluate the validity of prealbumin (PA) as a nutritional marker in intensive care patients.
Material and methods: Exploratory study in 46 patients of the Intensive Care Unit (ICU) from the Unidade Local de Saúde de Matosinhos. For each patient PA (immunoturbidimetry) and nitrogen balance (NB) were calculated. We studied the association of these variables with: (1) severity indicator (APACHE II: Acute Physiology and Chronic Health Disease and SAPS II: Simplified Acute Physiology Score II), (2) length of stay and (3) ICU mortality. Statistical analysis was performed with SPSS (vs 18). Results: From the 46 patients (M:33/F:13), 24% died in the ICU. SAPSII and APACHE indexes present a statistically significant correlation (r = 0.819; P < 0.01]. PA is not correlated to NB but it is positively correlated to absolute NB (r = 0.269; P < 0.05). PA has no statistically significant correlations with length of stay and severity indexes. The T test does not reveal statistically significant difference in PA and NB values when the patient was discharged or died in the ICU.
Conclusions: Results reveal no statistical evidence for associating PA with NB. According to some bibliographic references, acute inflammatory processes can interfere in prealbumin results. Further studies are required to confirm the usefulness of PA as a biochemical marker for the evaluation of the nutritional state in critically ill patients.
Plasma homocysteine and cerebrospinal fluid biomarkers in patients with Alzheimer’s disease
PetekTarnikI (1), Katušić Hećmović S (2), MalnarM (2), TrkanjecZ (3), BukovecMegla Ž (1)
(1) University Hospital Centre "Sestre Milosrdnice", Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, Zagreb, Croatia
(2) Ruđer Bošković Institute, Division of Molecular Medicine, Zagreb, Croatia
(3) University Hospital Centre "Sestre Milosrdnice", Department of Neurology, Zagreb, Croatia
Corresponding author: iva [dot] petek [dot] tarnik [at] kbcsm [dot] hr
Background: Alzheimer’s disease (AD) is progressive neurodegenerative disorder characterized by formation of senile plaque and neurofibrillary tangles in the brain. There are no adequate therapies and no tests that would enable accurate diagnosis of AD. In this pilot study we investigated the role of plasma homocysteine levels as vascular risk factor and levels of proteins Aβ42, total-tau and p181-tau in cerebrospinal fluid (CSF) in development of AD.
Materials and methods: We analyzed plasma and CSF samples of clinically assesed AD individuals (N = 9, mean age 73 years), healthy age-matched individuals (N = 8, mean age 63 years) and demented patients with no certain diagnosis (N = 8, mean age 69 years). Plasma homocysteine levels were determined by HPLC-FD method. The CSF levels of Aβ42, total-tau and p181-tau were determined using ELISA assay, and total-tau/Aβ42 and p181-tau/Aβ42 ratios were calculated.
Results: We found high levels of plasma homocysteine in group with AD, so levels of homocysteine differed significantly between non-demented and AD group. We also identified that low Aβ42 and high total-tau or high p181-tau levels are characteristic CSF profile for probable Alzheimer’s disease. All CSF biomarkers and their ratios differed significantly between non-demented and AD group and t-tau/Aβ42 ratio suggested that these biomarkers may be used for differential and early diagnosis of probable Alzheimer’s disease.
Conclusions: Our pilot study supports CSF proteins and t-tau/Aβ42 levels as early biomarkers of Alzheimer's disease, also suggesting that homocysteine is a significant vascular risk factor for AD.
One-step whole blood fluorometric emission scan method for diagnosis of cutaneous porphyrias
Kurt I, Ozturk O, Sertoglu E, Tapan S, El-Fawaer S, Bilgi C
Gulhane School of Medicine, Department of Medical Biochemistry, Porphyrin Unit, Ankara, Turkey
Corresponding author: erdimsertoglu [at] gmail [dot] com
Porphyrias are caused by enzyme defects in hem biosynthesis leading to overproduction of porphyrins and their precursor. Although, spectrofluorometric screening of plasma is useful in symptomatic phase of cutaneous porphyrias, it is insufficient in cases with increased erythrocyte protoporphyrin. We developed a simple fluorometric method, based on Lamola (1975), which determine zinc and free protoporphyrin in whole blood. Fluorometric measurements were performed with Perkin-Elmer LS55 spectrofluorometer. Zinc protoporphyrin were obtained from Frontier Scientific. EDTA-whole blood was used as sample. In fluorometric measurement, fluorescence emission peaks' height at 594 nm ve 625 nm were assessed by taking direct fluorescence intensity after Allen correction. It has been approved that emission peaks at 594 and 625 nm belong to ZPP and free protoporfirine (FEP), respectively by adding ZPP and FEP sequentially. In practice, emission scan was performed between 500-700 nm wavelength at 428 nm exitation wavelength in fluorometer from 1/400 diluted hemolysate, which was prepared with 0.1 M Tris-HCl buffer (pH = 8.0) containing 0.2 % tween-20. The height of the peak at 594 nm, which belongs to ZPP, was compared with calibration graph and results were expressed as ZPP µmol/L and ZPP/hem (µmol/mol). The intra-day and between days coefficient of variations were 3.3% and 3.6 % respectively. Reference range of 125 healthy individuals between 20-72 years of age was found 16.0-57.0 µmol/mol. Whole blood fluorescence emission scan allows semi-quantitative assessment of whole blood erythrocyte protoporphyrin levels. It can be used initial test with plasma fluorescence emission scan for the diagnosis of cutaneous porphyrias.
Impact of inflammation on high density lipoprotein function in polycystic ovary patient
Gidwani S (1), Phelan N (2), Mcgowan A (2), Gibney J (2), Young I (3), McEneny J (3)
(1) Royal Victoria Hospital, Belfast Trust, Clinical Biochemistry, Belfast, United Kingdom
(2) Adelaide and Meath Hospital, Department of Diabetes and Endocrinology, Dublin, Ireland
(3) Queens University Belfast, Centre for Public Health, Belfast, United Kingdom
Corresponding author: gidwanianand [at] hotmail [dot] com
Background: Polycystic ovarian syndrome (PCOS) is a common endocrine disorder. It is associated with decreased high density lipoprotein (HDL) levels and low grade inflammation, which both contribute to atherosclerosis development. HDL particles undergo continual remodelling, which can be influenced by inflammation and affect HDL function. This study aims to evaluate the impact of inflammation on HDL function in PCOS.
Materials and methods: PCOS subjects (N = 100) were matched for BMI and percent body fat with control subjects (N = 100). HDL was subfractionated into HDL2 and 3 by rapid ultracentrifugation. The inflammatory molecule serum amyloid A (SAA) was measured in serum and HDL2 and 3 by an ELISA procedure. The protein concentration of HDL2 and 3 was measured by a colorimetric assay. The activities of phospholipid transfer protein (PLTP) and cholesterol ester transfer protein (CETP) in HDL2 and 3 were measured by fluorimetric assays.
Results: Compared to the control subjects, SAA was increased in serum and HDL2 and 3 in the PCOS subjects (serum, 30952 ± 22003 vs. 25051 ± 18353 μg/L; HDL2, 6.57 ± 4.04 vs. 5.13 ± 3.6 μg/mg protein; HDL3, 3.64 ± 2.53 vs. 2.60 ± 2.2 μg/mg protein; P < 0.05 for all comparisons). Furthermore, PLTP activity was increased in HDL3 in PCOS subjects (HDL3, 7.84 ± 2.5 vs. 6.90 ± 1.74 nmol/mg protein; P < 0.05). No difference was noted in the activity of PLTP in HDL2 or CETP in HDL2 and 3.
Conclusions: This is the first study to show that PCOS, independent of obesity, lead to inflammatory changes within HDL2 and 3 and functional changes in HDL3-PLTP. Overall, these changes would influence the remodelling and function of HDL, which would decrease their antiatherogenic properties and enhance atherosclerosis development/progression.
Optimum cut-off value of salivary melatonin to discriminate between ADHD children and a control group
Gorriz-PintadoS (1), Pitarch-CastellanoI (2), Orts-CostaJA (1), Puertas-CuestaFJ (3)
(1) HospitalUniversitariodelaRibera, AnálisisClínicos, Alzira (Valencia), Spain
(2) Hospital Universitario de la Ribera, Pediatría, Alzira (Valencia), Spain
(3) Hospital Universitario de la Ribera, Neurofisología, Alzira (Valencia), Spain
Corresponding author: sigorriz [at] hospital-ribera [dot] com
Background: Altered patterns of melatonin circadian rhythm have been described in sleep disturbances, neurological, psychiatric and immunological conditions. Attention Deficit Hyperactivity Disorder (ADHD) is the most commonly psychiatric disorder in children. The aim of this study is to determine if there is an alteration of the melatonin secretion pattern in ADHD children and therefore if it can be helpful for its diagnostic.
Materials and methods: Salivary samples, timed at 180 minutes before and 60 minutes after going to sleep, were collected from 46 healthy and 91 ADHD children. Quantitative determination of melatonin was performed by a direct non-extraction ELISA assay using DSX analyzer. Data were analyzed by ROC curves using SPSS 15.0 statistical analysis package.
Results: Melatonin mean values found at -180 and + 60 for the healthy and ADHD groups were: 1.8, 41.0; and 4.3, 27.3 pg/mL, respectively. In the healthy group, Dim Light Melatonin Onset increase (Δ DMLO) was 39.2 ± 24.4 (SD) pg/mL, 1.7 times higher than in the diagnosed group, 23.0 ± 15.9 (SD) pg/mL. The area under the ROC curve found was 0.71 (95%:0.612-0.806).Taking into account several cut-offs, we have considered 28 pg/mL as the optimum value, with 70% specificity and 63% sensitivity.
Conclusion: Δ DLMO values lesser or equal to the cut-off value may be suggestive of ADHD since this condition is related with a deficit in the secretion of melatonin. Therefore, Δ DLMO could be helpful in the diagnosis of ADHD and would be considered in the decision-making process.
Dim Light Melatonin Onset assessed with only two timed salivary samples
Orts-Costa J (1), Pitarch-Castellano I (2), Tárrega-Roig E (1), Puertas-Cuesta F (3)
(1) Hospital Universitario de la Ribera, Análisis Clínicos, Alzira (Valencia), Spain
(2) Hospital Universitario de la Ribera, Pediatría, Alzira (Valencia), Spain
(3) Hospital Universitario de la Ribera, Neurofisología, Alzira (Valencia), Spain
Corresponding author: jaorts [at] hospital-ribera [dot] com
Background: Dim Light Melatonin Onset (DLMO) is the single most accurate marker for assessing the circadian pacemaker. The salivary melatonin measurement is a reliable alternative to blood samplings, being particularly suitable for children because it offers a non-invasive and stress-free collection. Altered patterns of melatonin circadian rhythm have been described not only in sleep disturbances but also in neurological conditions. We assessed if taking only two timed samples is enough to show an alteration in the DMLO pattern. For this purpose, we have determined DLMO in healthy and affected by Attention Deficit Hyperactivity Disorder (ADHD) children.
Materials and methods: Salivary samples, timed at: 3 (-3), 2 (-2) hours before, during (0), and 1 hour after (+1) going to sleep, were collected from 46 healthy children and from 91 ADHD children diagnosed. Specific instructions for specimen collection were given. Suitable samples were centrifuged 10 min to remove particulate material and frozen at -70 ºC until analysis. Quantitative determination of melatonin in saliva was performed by a direct non-extraction ELISA assay on a DSX analyzer. Statistical analysis was performed by SPPS 15.0.
Results: Mean values at different times expressed as pg/mL were, in healthy children: 1.9, 3.0, 9.0, 27.2 and 41.0; in ADHD children were: 4.3, 5.1, 11.7, 20.8, 27.1; both in 3,2,1,0, and +1 hours, respectively. The greatest difference among different timed samples was found between -3 and +1 hours.
Conclusion: DLMO pattern assessment could be simplified by considering only two timed samples at -3 and +1 hours, making easier in this way the sampling taking process.
Thrombocyte serotonin and serum cholesterol concentration in depressed patients
Ruljancic N (1), Mihanovic M (2), Cepelak I (3)
(1) Psychiatric Hospital "Sveti Ivan", Department of Laboratory Diagnostics, Zagreb, Croatia
(2) Psychiatric Hospital "Sveti Ivan", Department of Psychiatry, Zagreb, Croatia
(3) Pharmaceutical-Biochemical Faculty, University of Zagreb, Department of Medical Biochemistry and Hematology, Zagreb, Croatia
Corresponding author: n_ruljancic [at] yahoo [dot] com
Introduction: Numerous studies have confirmed the connection of reduced serum cholesterol and thrombocyte serotonin concentration with suicidal behaviour in psychiatric patients.
Materials and methods: In accordance to ICD-10, 55 depressed patients with suicide attempt and 77 depressed patients with no suicide attempt were separated in two subgroups; F32.2 and F33.2. Control group was presented by the healthy blood donors. The fasting serum cholesterol concentration was established using standard enzymatic method, while the thrombocyte serotonin concentration was determined by ELISA method.
Results: The ANOVA test (N = 228, F = 8.26, P < 0.001) found significant difference of cholesterol concentration, with lowest concentration in the group of depressed patients with attempted suicide, diagnoses F32.2 (P = 0.031) and F33.2 (P = 0.011), compared to the group of depressed patients without attempted suicides. Upon gender stratification, the significance remained for the female patients (ANOVA, N = 125, F = 6.06, P = 0.003). The thrombocyte serotonin was found to be significantly different in all groups (SNK post hoc test, P < 0.05, N = 187, F = 37.69, P < 0.001), with the lowest thrombocyte serotonin in the group of depressed patients with no suicide attempt (F32.2), compared to the same diagnosis with suicide attempt (MW-test, P = 0.018). The same significance was found for the group of female (ANOVA, N = 103, F = 11.81, P < 0.001) and male patients (ANOVA, N = 84, F = 30.40, P < 0.001).
Conclusion: In the group of depressed patients with attempted suicide, lower serum cholesterol values have been confirmed. In the group of depressed patients with no suicide attempt, lower values of thrombocyte serotonin have been confirmed, presumably as the response to the psychopharmacological therapy.
Effect of melatonin administration on lipid peroxide and antioxidant levels in tissues of SHR
Kitagawa A (1), Ohta Y (2)
(1) Shigakkan University, Department of Nutrition, Faculty of Wellness, Ohbu, Japan
(2) Fujita Health University, Department of Chemistry, School of Medicine, Toyoake, Japan
Corresponding author: kitagawa [at] fujita-hu [dot] ac [dot] jp
Background: Spontaneously hypertensive rats (SHR) show the symptom of metabolic syndrome and hypertension. Melatonin (MT) with antioxidant properties is known to inhibit hypertension in SHR. However, there are few reports on the antioxidant effect of MT in SHR. Therefore, we examined the effect of MT administration on lipid peroxide and antioxidant levels in the liver, kidney and heart of SHR.
Material and methods: Five-week-old male SHR and Kyoto Wistar rats (WKY) were fed MF diet. MT (1 or 10 mg/kg body weight) was orally administered to SHR once every morning for two weeks, starting at four-week feeding. Systolic blood pressure (SBP) was measured before sacrifice. Livers, kidneys, and hearts were used for measurements of lipid peroxide (LPO), ascorbic acid (AA), and reduced glutathione (GSH).
Results and conclusion: Hepatic, renal, and cardiac LPO contents and SBP were higher in SHR than in WKY. MT administration reduced these LPO contents and SBP in SHR. There were no differences in hepatic, renal, and cardiac GSH contents between SHR and WKY. MT administration did not affect these tissue GSH contents in SHR. Hepatic and cardiac AA contents were higher in SHR than in WKY. Renal AA content was less in SHR than in WKY. MT administered to SHR elevated the liver and renal AA contents and reduced the cardiac AA content. These results indicate that MT administered to SHR attenuates increased blood pressure and hepatic, renal, and cardiac LPO contents, although the administered MT has different effects on the changes in tissue AA contents.
Adipocyte fatty acid binding protein and cardiovascular risk in women with overweight/obesity
SypniewskaG (1), Mankowska-CylA (1), BergmannK (1), RajewskiP (2)
(1) Collegium Medicum Nicolaus Copernicus University, Dept. of Laboratory Medicine, Bydgoszcz, Poland
(2) E. Warminski City Hospital, Department of Internal Diseases, Bydgoszcz, Poland
Corresponding author: grazynaodes [at] interia [dot] pl
Background: Fatty acid-binding protein (A-FABP) derived from adipocytes and macrophages has been suggested a biomarker for obesity and metabolic syndrome. We evaluated the association of A-FABP with proatherogenic profile and insulin resistance in young non-diabetic overweight/obese women.
Materials and methods: A-FABP, hsCRP, adiponectin, lipids and apolipoproteins were measured in blood samples obtained from 104 women aged 25-40 yrs, BMI ≥ 25 kg/m2 and age-matched healthy controls (N = 76; BMI < 25kg/m2).
Results: In overweight/obese women (BMI 32.6 ± 6.1 kg/m2) serum A-FABP correlated positively and more strongly with hsCRP (P < 0.001) than with anti-inflammatory indicators like adiponectin, HDL-C, ApoA1 (negative correlation). A-FABP was associated with BMI, HOMA-IR, insulin (P < 0.003) and atherogenic profile indices, especially ApoB/ApoA1, TC/HDL-C, TG/HDL-C (P < 0.003). In the study group A-FABP, but neither adiponectin nor BMI, was an independent predictor of ApoB (β = 0.96; P = 0.03), ApoA1 (β = 0.68; P = 0.02), ApoB/ApoA1 (β = 1.21; P = 0.01) and TG/HDL-C (β = 0.71; P = 0.004). A-FABP compared to adiponectin was of very good diagnostic accuracy for discrimination of women with atherogenic risk profile and insulin resistance (CRP ≥ 1 mg/L; TG/HDL-C ≥ 3). AUC for A-FABP and adiponectin were 0.80 vs. 0.59 (P < 0.003) and 0.88 vs. 0.73 (P < 0.08), respectively. A-FABP compared to adiponectin was of excellent accuracy (AUC = 0.96 vs. 0.67; P < 0.001) at a cut-off value 16 ng/mL for discrimination of women with increased BMI and atherogenic risk profile with an odds ratio of 11.2 (95% CI 3.7-34.2), 7.1 (1.9-27.2), 6.7 (2.6-17.2) for having elevated TG/HDL-C, apoB, CRP.
Conclusions: In young non-diabetic overweight/obese women serum A-FABP seems to be a very good predictor of atherogenic risk profile and insulin resistance.
Determining the concentration of the hormone leptin and ghrelin in the treatment of obese people
PosavecL (1), KrpanR (1), Nikolić M (2), Mirošević G (3), BukovecMegla Ž (1), Stančić V (4)
(1) University Hospital Centre “Sestre milosrdnice”, Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, Zagreb, Croatia
(2) University Hospital Centre “Sestre milosrdnice”, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Zagreb, Croatia
(3) University Hospital Centre “Sestre milosrdnice”, Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Internal Medicine, Zagreb, Croatia
(4) University Hospital Centre “Sestre milosrdnice”, Division of Hematology, Department of Internal Medicine, Zagreb, Croatia
Corresponding author: ljubica [dot] posavec [at] kbcsm [dot] hr
Background: Obesity is the excessive accumulation of adipose tissue in the body, and is expressed as body mass index (BMI). By definition of the World Health Organization, a BMI ≥ 30 kg/m² is considered to be obesity. Objective of this study was to examine the concentration changes of hormones leptin and ghrelin before and after six months of treatment of obesity, depending on the body weight loss and grade of obesity.
Materials and methods: The study enrolled 44 patients treated with intragastric balloon, and 36 operated patients. Leptin concentrations, the so-called satiety hormone, were measured by EIA method (Biosource) and ghrelin concentrations, the so-called hunger hormone, were measured by RIA method (Biosource).
Results: Patients treated with intragastric balloon had higher initial concentrations of ghrelin (median 954 pg/mL) in comparison to surgical patients (median 777 pg/ml); P < 0.001, as expected given their initial body weight (114 to 128.5 kg). Initial leptin concentrations of patients with intragastric balloon were also higher (median 26.9 ng/mL) compared to surgical patients (median 15.2 ng/mL); P < 0.001. However, lower concentrations of leptin in surgical patients results from previously induced weight loss.
Conclusions: The concentration of leptin decreases with weight loss, regardless of the method of treating obesity, whereas ghrelin is negatively correlated with body weight. The concentrations of the hormone leptin and ghrelin through six months of treatment are statistically significantly different. Higher initial values of ghrelin indicate to greater weight loss of patients treated with "sleeve" resection of the stomach and gastric band.
Elevation of urinary porphyrins after prolonged sedation with Propofol. Fact or interference?
Castillo Perez C (1), Illana Camara F (1), Torrejon M (1), Velasco G (2), Ferrero J (2), Arroyo M (1)
(1) Hospital Clinico San Carlos, Laboratory Medicine, Madrid, Spain
(2) Hospital Clinico San Carlos, Cardiovascular Intensive Care Unit, Madrid, Spain
Corresponding author: carloscp2 [at] hotmail [dot] com
Background: Porphyries are a group of metabolic diseases caused by the deficiency of an enzyme involved in heme synthesis. Certain drugs may precipitate a porphyric crisis. One anesthetic considered safe for using in these patients is Propofol. However, porphyrin elevation has been described after a prolonged sedation with Propofol in some studies.
Material and methods: We measured 24 hours urinary porphyrin excretion in 4 patients sedated with Propofol for at least 24 hours and after Propofol withdrawal. The method used for the porphyrin determination was reverse phase HPLC with fluorescence detection and a column C18 as stationary phase. Interference studies were performed using β-glucuronidase and sulfatase type H-1 enzymes.
Results: An increase in total urinary porphyrin excretion as well as an increase in hexaporphyrin and uroporphyrin was found after Propofol sedation. Progressive normalization of urinary porphyrins was found after anesthetic withdrawal. No differences were found after using of glucuronidase and sulfatase enzymes.
Conclusions: Prolonged Propofol sedation caused an increase in the total urinary porphyrins, uroporphyrin and hexaporphyrin and it does not seem to be mediated by urinary propofol excretion metabolites. More studies are needed to elucidate the origin of this increase.
Glutathione peroxidase and reduced glutathione levels depend on aging
Cinar E, Bilgin R, Yalcin SM
University of Cukurova, Arts & Science Faculty, Chemistry Department (Biochemistry Division), Adana, Turkey
Corresponding author: rbilgin [at] cu [dot] edu [dot] tr
Free oxygen radicals have been proposed as important causative agents of aging. Aging is characterized by a progressive change in biochemical an functions in various tissues and organs in an individual. Clear reasons for this decline is unkown, but it has been suggested that increased oxidative stress, energy metabolism, immune system can take an important role. Free radical theory of aging predicts and its modern version, the oxidative stress theory of aging, the production of reactive oxygen species with increasing age and antioxidant stress deterioration of the delicate balance between antioxdant system may lead to a change in the cellular environment In this study, we determined erythrocyte glutathıone peroxidase and reduced glutathione levels to evaluate the effect of aging in healthy subjects of different ages. For this purpose, 84 healthy subjects divided in four groups as 2-12; 13-24; 25-40; 41-69 of age were investigated. Glutathione peroxidase levels were not found statistically significant in among the all age groups. On the other hand, reduced glutathione levels were found statistically significant difference in these age groups 13-24 and 25-41 (P < 0.05).
Acute intermittent porphyria induced by valproate: a clinical case.
Garcia Moreira V, Fernandez Leivas A, Garcia Alonso S, Martinez Gago M, Laborda Gonzalez B, Fernandez Rodriguez E
Hospital de Cabueñes, Servicio de Analisis Clinicos, Gijon, Spain
Corresponding author: eloyfr [at] gmail [dot] com
Background: Acute intermittent porphyria (AIP) is an autosomal dominant inherited disease caused by a decreased activity of hydroxymethylbilane sintase (HMBS)/porphobilinogen deaminase (PBGD), an enzyme in the heme biosynthetic pathway. Clinically is characterized as acute neurovisceral attacks, often precipitated by exogenous factors such as drugs, hormones, and alcohol.
Case: A 46-year-old woman presented to our hospital with unprovoked complex partial seizures post-stroke. She was treated with levetiracetam/valproate/atorvastatin. A month later, she was admitted with psycomotor agitation. Levetiracetam was suspended. She continued with abdominal pain, nervousness, insomnia and generalized tremor. Most notable of the laboratory analysis was: ALT 55 U/L and AST 56 U/L. Other general determinations were normal. Porphyrins analysis were subsequently requested: ALA 75.5 mg/24h (0-7.5), PBG 54.25 mg/24h (0-2.5), total porphyrins 514.9 mcg/24h (0-150), mainly due to uroporphyrins 191.9 mcg/24h (0-25) and pentacarboxiporphyrins 26.6 mcg/24h (0-5). Fecal porphyrins were normal. Treatment with valproate was suspended. In the study of the erythrocyte HMBS activity, values were normal. The genetic study of HMBS gene revealed that the patient was a heterozygous carrier of a deletion in exon12:c.669-698del30(p.Glu223-Leu232del). The three children of the patient were genetically analyzed. Two were also carriers of the mutation. Patient was referred to a specialized porphyrias unit for monitoring and currently remains asymptomatic.
Conclusion: Valproate and most antiepileptic drugs are unsafe because they have demonstrated porphyrinogenicity. The detection of asymptomatic carriers of the mutation can help avoid and treat early crises, often underdiagnosed for their specificity clinic. As we see, although porphyria usually is not considered in the differential diagnosis of hypertransaminasemia, it could be a cause.