The relationship between elevated plasma zonulin levels and Hashimoto's thyroiditis.

BACKGROUND: Hashimoto thyroiditis (HT) is one of the most prevalent autoimmune diseases. The intestine microbiota is strongly associated with autoimmune diseases. Zonulin, a modulator of tight junctions that controls the selective permeability of the intestine can induce an elevation in gut permeability. We aimed to investigate the association of plasma zonulin levels with HT. METHODS: We compared 77 HT patients with 66 age-gender and BMI-matched healthy individuals in the case of plasma zonulin levels. Plasma zonulin levels were measured by ELISA. The statistical analyses were performed using Student's t-test and chi-square tests. The predictive power was investigated using univariate and multivariate logistic regression analysis. RESULTS: We found that the increase in plasma zonulin levels in the HT group was statistically significant compared to the control group (p < 0.001). The regression analysis showed that urea, anti-thyroid peroxidase, aspartate aminotransferase, thyroid-stimulating hormone, free T3, and serum zonulin levels were found to be associated with HT in both univariate and multivariate models (p < 0.05). DISCUSSION: Zonulin is a possible biomarker candidate that may link intestinal permeability with the etiology of autoimmune diseases.

The predictors of catheter-related bloodstream infections in patients undergoing hemodialysis: A single center experience.

BACKGROUND: Here we aimed to investigate the predictors of catheter-related bloodstream infections (CRBSI) in patients with acute kidney injury or chronic kidney disease who required renal replacement therapy through a non-tunneled hemodialysis catheter. METHODS: A total of 111 patients who received non-tunneled hemodialysis catheters were retrospectively evaluated. Patients were divided into two groups; those who developed CRBSI and those who did not. Patient's demographic data, laboratory results at admission, information regarding catheter infections, and culture results were obtained from electronic medical records. RESULTS: The mean age of the patients was 64 ± 16 years, and 51 of them were male. CRBSI occurred in 14 patients (12.6%). Admission serum albumin level (OR: 0.119, 95% CI: 0.019-0.756, p = 0.024), admission mean platelet volume (OR: 2.207, 95% CI: 1.188-4.100, p = 0.012) and catheter duration (OR: 1.580, 95% CI: 1.210-2.064, p = 0.001) were independent predictors for the CRBSI development. ROC curve analysis demonstrated that a catheter duration of 22 days was predictive for presence of CRBSI (78% sensitivity, 76% specificity, AUC: 0.825, 95% CI: 0.724-0.925, p < 0.001). CONCLUSIONS: Prolonged catheter duration, low serum albumin, and high mean platelet volume independently predict the development of CRBSI in patients undergoing hemodialysis for acute kidney injury or chronic kidney disease.

Maternal serum preptin levels in the pathogenesis and diagnosis of Gestational diabetes mellitus.

Background: Gestational diabetes mellitus (GDM) is a metabolic disorder that occurs during pregnancy that increases both maternal and fetal mortality and morbidity. It was investigated whether there is a change in circulating levels of preptin, a new peptide secreted from pancreatic beta cells, due to GDM in pregnant women. The relationship between serum preptin levels with insulin and other metabolic parameters was also evaluated in these subjects. Methods: Eighty-five patients diagnosed as GDM and 89 healthy pregnant women with 75 mg oral glucose tolerance test (OGTT) was assessed in terms of serum preptin levels. Results: The serum preptin levels of the GDM group were significantly higher than those of the control group (p=0.001; p < 0.01). For the cutoff value of preptin measurement of 335.3 ng/L, the sensitivity was 97.65%, specificity was 87.64%, positive predictive value was 88.3% and negative predictive value was 97.5%. The risk of developing the disease is 294.273 times higher in patients with preptin level of 335.3 and above. Conclusions: We think that the reason for the increase in serum preptin levels in GDM is probably the response to glucose. The current results indicate that preptin plays an important role in elucidating the pathology of GDM. In addition, the search for a practical marker for the diagnosis of GDM suggests that the measurement of preptin level is promising.

Plasma Zonulin Levels as a Non-Invasive Biomarker of Intestinal Permeability in Women with Gestational Diabetes Mellitus.

OBJECTIVE: We aimed to compare the levels of plasma zonulin, a non-invasive biomarker of increased intestinal permeability, between pregnant subjects, with and without gestational diabetes mellitus (GDM), at 24⁻28 gestational weeks. The eighty-five consecutive pregnant subjects that presented to our hospital's obstetrics outpatient clinic and were diagnosed with GDM, for the first time by an oral glucose tolerance test (OGTT), formed the GDM group; 90 consecutive subjects that were not diagnosed with GDM by OGTT, formed the control group. The diagnosis of GDM was made by an OGTT performed between the 24th and 28th weeks of gestation, and in compliance with the American Diabetes Association (ADA) criteria. Plasma zonulin levels were measured by the enzyme-linked immunosorbent assay (ELISA) methods. The Plasma zonulin level was significantly higher in the GDM group than the control group (p < 0.001). A correlation analysis showed that plasma zonulin level was positively correlated to body mass index (BMI), creatinine, fasting plasma glucose, baseline, first hour, and two hours glucose levels and the OGTT, hemoglobin A1C (HbA1C), homeostatic model assessment for insulin resistance (HOMA-IR), and alanine aminotransferase (ALT) levels. Our findings suggest that zonulin may be a non-invasive biomarker involved in the pathogenesis of GDM. Further large-scale studies are needed on this subject.