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Daria Pašalić
Editor-in-Chief
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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P05-1

Vrkić N1, Mujagić R2, LaškajR3, Topić E1, Honović L2, Jurasović J4. PO5-1: Association of Cu/Zn-superoxide dismutase activity in serum with iron and copper status in liver diseases. Biochemia Medica 2009;19(Suppl 1):S124.
1University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
2Medical Biochemistry Laboratory, Pula General Hospital, Pula, Croatia
3Medical-biochemistry laboratory, University Hospital for Infectious Diseases Dr. Fran Mihaljević, Zagreb, Croatia
Corresponding author:renat [dot] mujagic [at] pu [dot] t-com [dot] hr
 
Abstract
 
Background: Status of iron, copper and zinc could be adversely affected by inflammation. Furthermore, extracellular Cu/Zn-superoxide dismutase (SOD) in the blood plasma is directly associated with the status of numerous essential trace elements such as copper and zinc. The aim of this study was to evaluate the association between SOD and copper, zinc and iron status in inflammatory liver diseases.
Materials and methods: A total of 33 patients with inflammatory liver disease have been included in the study. C-reactive protein, total/free copper (Cu/fCu), zinc (Zn), ceruloplasmin (CPm) concentration, ceruloplasmin activity (CPa) and SOD activity, and finally biochemical indicators of iron status such as total iron (Fe), non-transferrin bound iron (NTBI) and transferrin (Tf) have been analyzed in serum by routine analytical methods.
Results: There were significant positive correlations between logarithmically transformed CRP and ratios Cu/Zn (rP = 0.740, P < 0.001) and fCu/Zn (rP = 0.644, P < 0.001); and inverse correlation between CRP and square root transformed NTBI (rP = -0.421, P = 0.036) in the examined group (N = 24). Furthermore, there were significant positive correlations of SOD with NTBI (rP = 0.640, P < 0.001), CPm (rP = 0.394, P = 0.023), CPa (rP = 0.375, P = 0.032), and with Cu (rP = 0.366, P = 0.036) in the expanded group of patients (N = 33).
Conclusion: Indicatively, there was a significant correlation between SOD and non-transferrin iron, however, there was no correlation between SOD and total serum iron in liver disease patients. High SOD activity accompanied with high non-transferrin iron concentration in liver diseases could provoke prooxidative effects depending on generation of additional hydrogen peroxide by dismutation reaction and subsequently hydroxyl radical generation by Fenton chemistry. These preliminary results suggest that simultaneously increase of SOD and NTBI could be an important trigger for liver disease progression.
 
P05-2
Fišić E1, Bilić-Zulle L1,2, Šupak Smolčić V1. PO5-2: Prognostic values of IL-6, IL-18 and sTNFr in early assessment of acute pancreatitis. Biochemia Medica 2009;19(Suppl 1):S125.
1Department of laboratory diagnostics, Rijeka Clinical Hospital Centre, Croatia
2Department of Medical Informatics, Rijeka University School of Medicine, Rijeka, Croatia
Corresponding author:elizabeta [dot] fisic [at] ri [dot] t-com [dot] hr
 
Abstract
 
Background: Early assessment of severity in acute pancreatitis (AP) is very important for the patients who are at risk for development of systemic complications. Generally used prognostic scoring systems are only of moderate value for disease severity assessment. The aim of the study was to evaluate interleukine-6 (IL-6), interleukine-18 (IL-18) and soluble tumor necrosis factor-receptor (sTNFr) for early assessment of disease severity.
Participants and methods: Cytokines were analyzed by ELISA method from serum taken routinely from 150 patients (median and range of age 63 (20-91) years; 47% males) immediately after hospital admission. Severity criteria were noted for each patient using APACHE II and Ranson scoring system. Systemic complications were classified by Atlanta criteria and were developed in 19% of patients.
Results: The serum values (median) of IL-6, IL-18 and sTNFr in complicated versus non-complicated AP were as follows: 104, 230, 2220 pg/ml vs. 20, 202, 1520 pg/ml (P = 0.001; 0.411 and 0.004). ROC analyses was performed and the area under curve (AUC) were calculated for serum IL-6 AUC = 0.41; cut-off 37.9 and for sTNFr AUC = 0.69; cut-off 1552 pg/ml. AUC for APACHE and Ranson scoring system were 0.63 and 0.75 with cut-off 9 and 4 respectively.
Conclusions: Results reveal that IL-6 is the best parameter out of three observed for early assessment of complicated acute pancreatitis, sTNFr is also good enough, but IL-18 has no significant value. The results suggested that pancreatitis classified as complicated in a large number of patients could be better predicted using Ranson scoring system that APACHE II.
P05-3
Mujagić R1, Vrkić N2, ObuljenJ3, U@ović-FrakinI4, Ferenec-Ružić D2, PizentA5. PO5-3: Biochemical indicators of copper status and the calculation of free copper concentration. Biochemia Medica 2009;19(Suppl 1):S126.
1Medical Biochemistry Laboratory, Pula General Hospital, Pula, Croatia
2University Department of Chemistry, Sestre Milosrdnice University Hospital, Zagreb, Croatia
3Department of laboratory diagnostics, Zagreb Children’s hospital, Zagreb, Croatia
4Department of Transfusiology, Zadar General Hospital, Zadar, Croatia
5Analytical Toxicology and Mineral Metabolism Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
Corresponding author:renat [dot] mujagic [at] pu [dot] t-com [dot] hr
 
Abstract
 
Background: High copper concentration favors the increase of oxidative stress. Nevertheless, in the physiological levels copper is essential for optimal function of the antioxidative defense system in the human body. Homeostasis of copper has been regulated by liver (ceruloplasmin synthesis). Besides its copper transport function in the blood plasma, ceruloplasmin has substantial physiological role according to its oxydoreductase activity which is responsible to support the iron transition from ferric to ferrous ion. A reduction of ceruloplasmin activity could be reflected on the increase of oxidative stress, which favors the development of numerous complications in patients with diagnosed liver disease.
Materials and methods: Blood samples (N = 33) had been collected from the patients with liver disease. At the request of the physician, serum samples were analyzed for standard biochemical indicators of copper status: copper concentration (Cu) and ceruloplasmin mass concentration (CPm). Additional biochemical indicators of copper status were determined in the residual samples: ceruloplasmin ferroxidase activity (CPa), and copper/zinc-superoxide dismutase activity (SOD). Furthermore, free copper concentrations (Cuf) were calculated by using the widely accepted empirical equation that corresponds to copper fraction which is not bound to ceruloplasmin: Cuf [μmol/L] = Cu [μmol/L] - 47.2 [μmol/g] x CPm [g/L].
Results: There were statistically significant correlations between Cu and CPm (rP = 0.865, P < 0.001), CPa (rP = 0.780, P < 0.001) and SOD (rP = 0.366, P = 0.036), and furthermore, between Cuf and CPm (rP = 0.529, P = 0.002), and CPa (rP = 0.489, P = 0.004). Expected statistical correlations were found among the measured indirect biochemical indicators of copper status (CPm, CPa, SOD) with emphasis on the high significant correlation between CPm and CPa (rP = 0.890, P < 0.001).
Conclusion: Simultaneous determination of standard and additional functional biochemical indicators of copper status such as CPa and calculated parameters (Cu/CPm, Cu/CPa, CPa/CPm, Cuf) allows a complete insight into overall metabolism and status of copper in the liver diseases.
P05-4
Colić CvrljeV1, Juričić Lj2, KocmanB1, HumarI2, ŠurinaB1, Sertić J2. PO5-4: The first liver and pancreas transplantation in a cystic fibrosis patient in Croatia. Biochemia Medica 2009;19(Suppl 1):S127.
1Merkur University Hospital, Zagreb, Croatia
2Clinical Institute for Laboratory Diagnosis, Zagreb University Hospital, Zagreb, Croatia
Corresponding author:jadranka [dot] sertic [at] kbc-zagreb [dot] hr
 
Abstract
 
Background: Extended lifespan of cystic fibrosis (CF) patients has led to increased incidence of extrapulmonary complications which include liver cirrhosis, pancreatic insufficiency, diabetes and exocrine disorders as significant causes of morbidity and mortality. Liver transplantation is the method of choice in patients with developed cirrhosis, and multiorgan transplantation involving both liver and pancreas is also not infrequent.
Case report: Based on CFTR genotyping results, the patient was at the age of 10 years found to be a homozygous carrier of delta F508 mutation, which confirmed the diagnosis of CF. Genotyping comprised 32 mutation analysis using PCR and capillary electrophoresis methods. Complications developed in the patient, resulting in pancreatic insufficiency and decompensated liver cirrhosis, so he underwent simultaneous pancreas and liver transplantation at the age of 20 years. Pancreas and liver transplants of the same donor were used. Immunosuppressive therapy includes peroral tacrolimus and mycophenolate mophetic.
Results: Patient‘s recovery was normal, with normal liver function test results, and insulin independent glucose and HbA1c results. No pancreatic enzyme supplementation was needed and the patient was on normal diet. No rejection episode and no signs of relapse were observed two years posttransplant so that we may conclude that the first successful pancreas and liver transplant in a CF patient in Croatia resulted in improved life of the patient.
Conclusion: Simultaneous pancreas and liver transplantation in a CF patient allowed normalization of glucose levels and usual diet in a patient requiring liver transplantation and is certainly a method of choice for CF patients.
P05-5
Aralica M, Matica J, Barbarić I, Severinski S, Štifter S. PO5-5: A prevalence of celiac disease in the group of diabetic children in North-Adriatic part of Croatia. Biochemia Medica 2009;19(Suppl 1):S128.
Rijeka Clinical Hospital Centre, Croatia
Corresponding author:merica [dot] aralica [at] ri [dot] t-com [dot] hr
 
Abstract
 
Objective: Celiac disease (CD) is one of the most common chronic diseases in childhood. A prevalence of CD is higher in children with type 1 DM then in the general population and shows a regional variability. IgA anti-tissue transglutaminase (anti-tTG) assay is recommended for diagnosis of CD but duodenal biopsy is the gold standard. In this study we evaluated the prevalence of CD in the group of diabetic children in North-Adriatic part of Croatia.
Materials and methods: We tested 80 children (39 boys, 41 girls; age range 1-18 years, median 12 years). Serum IgA anti-tTG was measured by ELISA kit. There was no case of IgA deficiency in study group. Histological assessment was done on small bowel biopsy.
Results: IgA anti-tTG was positive in 13.7% children (11/80). In that group median duration of type 1 DM was one month (range 2 days-8 years). Biopsy specimens were examined in five of eleven serological positive children. According to the modified Marsh criteria in our group two children had type I, two had type II and one child had type IIIa histological changes in duodenal biopsy.
Conclusions: The high percent of CD serological positive children with type 1 DM observed in our study suggests a need of serological screening for CD. In our study group median duration of type 1 DM was short and in accordance with moderate reduction of duodenal mucosa in histological findings. It suggests an importance of early CD diagnostic in diabetic children in order to prevent small bowel function decline.
P05-6
Fišić E1, Bilić-Zulle L1,2, Šupak Smolčić V1. PO5-6: The prognostic value of serum C-reactive proteine and elastase in acute pancreatitis. Biochemia Medica 2009;19(Suppl 1):S129.
1Department of laboratora diagnostics, Rijeka Clinical Hospital Centre, Croatia
2Department of Medical Informatics, Rijeka University School of Medicine, Rijeka, Croatia
Corresponding author:elizabeta [dot] fisic [at] ri [dot] t-com [dot] hr
 
Abstract
 
Introduction: The early prognostic evaluation of acute pancreatitis (AP) is a key step in the appropriate management of the disease, and it helps to avoid the risk for development of systemic complications. The aim of the study was to evaluate the prognostic value of serum levels of CRP and E1 for AP in the clinical setting.
Participants and methods: E1 were analyzed by ELISA method, CRP by immunoturbidimetry in serum taken routinely from 150 patients (median and range of age 63 (20-91) years; 47% males) at the first and the third day after hospital admission. Severity criteria were noted for each patient using APACHE II scoring system. Systemic complications were classified by Atlanta criteria and were developed in 19% of patients.
Results: The serum levels of CRP and E1 at the first day of hospital admission were not significantly different between patients without or with complications: 14.4 vs 15 mg/L; P = 0.954 and 5.7 vs 7.5 ng/L; P = 0.249. Serum levels of the third day after admission were significantly different between groups, CRP were 85 vs 216 mg/L; P = 0.002 and E1 1.7 vs 2.5 ng/L; P = 0.001. ROC analyses was performed and the area under curve (AUC) were calculated for serum values measured the third day: for CRP AUC = 0.69, with cut-off of 214 mg/L and for E1 AUC = 0.70 with cut-off of 1.5 ng/L.
Conclusion: Serum concentrations of CRP and E1 measured the third day after hospital admission are valuable prognostic parameter for prediction of complications of AP.