The diagnostic value of non-invasive tests for the evaluation of liver fibrosis in chronic hepatitis B patients.

BACKGROUND: Liver biopsy, which is considered the gold standard for the evaluation of hepatic fibrosis in patients with chronic hepatitis B (CHB), has certain limitations. The aim of this study was to investigate the diagnostic performance of non-invasive markers of hepatic fibrosis as potential alternatives to liver biopsy. METHODS: The medical records of 221 patients with a diagnosis of CHB who underwent a liver biopsy were reviewed. Indirect indicators of fibrosis were calculated for each patient based on previously described formulas [Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), age-platelet index (API), cirrhosis discriminant score (CDS), AST-platelet ratio index (APRI), Forns index, FIB-4, Pohl score, AAR-platelet score (AARP), fibro-quotient (FibroQ), AST/platelet/Gammaglutamyl transpeptidase (GGT)/Alphafetoprotein (AFP) (APGA) index, Platelet/Age/Phosphatase (ALP)/AFP/AST (PAPAS) index, Lok's model, Goteborg University Cirrhosis Index (GUCI)]. Diagnostic adequacy of these indices was evaluated by receiver operating characteristic curve analysis. RESULTS: Area under the receiver operating characteristic curves for the FIB-4, Forns, GUCI, APRI, PAPAS, APGA and FibroQ indices were 0.701, 0.680, 0.670, 0.670, 0.639, 0.638 and 0.588, respectively. The AAR, API, CDS and AARP indices, Pohl score and Lok's model were all deemed diagnostically inadequate. FIB-4 had the best diagnostic adequacy whereas AAR had the worst. CONCLUSIONS: Our results suggest that out of the 13 indices evaluated, only FIB-4 index may be useful in estimating the extent of fibrosis in patients with CHB. There is a need for more comprehensive prospective studies to help determine the diagnostic value of non-invasive tests for liver fibrosis.

Evaluating MEFV mutation frequency in Turkish familial Mediterranean fever suspected patients and gender correlation: a retrospective study.

Familial Mediterranean fever (FMF) is the most frequent hereditary inflammatory disease. FMF causes different clinical manifestations in different ethnic groups and countries. In this study, we retrospectively reviewed the records of 1,152 FMF suspected patients (673 female and 479 male) from November 2006 to December 2010. A commercial kit assay for the identification of MEFV (Mediterranean fever) gene mutations based on PCR and reverse-hybridization was used to investigate 12 mutations of the MEFV gene. 52.17% of 1,152 FMF suspected patients had MEFV mutation and 45.25% of them were male. The rate of MEFV mutation among male and female patients were 56.78 and 48.88%, respectively. These results were statistically significant and might support the suggestion that FMF had much more penetrance in male patients (P = 0.009). Not any significant difference was observed between the male and female patients in terms of heterozygote and homozygote mutation carriage rate (P = 0.071). Also not any significant difference was observed between the male and female patients in terms of compound heterozygote mutation carriage rate (P = 0.058).

Liver enzymes, mean platelet volume, and red cell distribution width in gestational diabetes.

AIM: To investigate the value of measuring liver enzymes, red cell distribution width (RDW), and mean platelet volume (MPV) in predicting the development of gestational diabetes mellitus (GDM). MATERIALS AND METHODS: The medical records of all pregnant women followed by the obstetrics clinic between January 2010 and November 2012 were systematically evaluated, and patients with a diagnosis of GDM were identified. A total of 68 patients with GDM and 61 healthy controls were included in the study. Results of relevant laboratory parameters were recorded. RESULTS: Out of all the parameters evaluated, mean values for platelet distribution width (PDW) and mean activities of alanine transaminase (ALT) and gamma-glutamyl transferase (GGT) were significantly higher in the GDM group compared to healthy controls (P = 0.003, P = 0.015, and P = 0.021, respectively), whereas mean plateletcrit (PCT) levels were significantly lower in the GDM group (P = 0.002). No significant difference was observed between groups in terms of MPV, RDW, platelet count, and aspartate transaminase levels. CONCLUSION: Our study results suggest that ALT, GGT, PCT, and PDW may be useful as predictors of impending GDM.

The effect of magnesium sulfate treatment on serum cardiac troponin I levels in preeclamptic women.

AIM: To investigate serum cardiac troponin I levels before and after magnesium sulfate treatment in preeclamptic pregnant women. MATERIALS AND METHODS: Fifty-five pregnant women were included in the prospectively planned study. Study group patients (n = 25) were pregnant women hospitalized with a preeclampsia diagnosis while the control group (n = 30) were pregnant women with no medical or obstetric problem who had been attending the antenatal clinic. Serum cardiac troponin I levels were compared in the normal pregnant women and in preeclamptic pregnant women. These levels were also compared in the preeclamptic women before and after magnesium sulfate treatment. Mann-Whitney U-test was used for statistical analysis. RESULTS: Groups were similar with respect to age, gravity, parity, and gestational age. The median serum cardiac troponin I levels in preeclamptic patients was 0.20 ng/ml (0.02-4.53) before treatment and 0.09 ng/ml (0.02-3.91) after treatment, while it was 0.02 ng/ml (0.0-0.05) in the control group. The serum cardiac troponin I level in the preeclamptic group was significantly high (P < 0.01), and pretreatment values in this group were significantly higher compared with post-treatment values (P < 0.01) CONCLUSION: Cardiac troponin I is a sensitive parameter for indicating minor myocardial damage which may occur in preeclampsia and for evaluating the efficiency of magnesium sulfate treatment.