Is Serum Angiotensin-Converting Enzyme Level Useful For Determining Necroinflammatory Activity In Chronic Hepatitis B Infection?

AIM: The purpose of this study was to investigate the relationship between the findings from liver biopsy and the serum angiotensin-converting enzyme (ACE) level to determine whether ACE might serve as a potential noninvasive sign of necroinflammatory activity in patients with Chronic Hepatitis B (CHB) infection. METHODS: A total of 54 CHB patients referred for liver biopsy were enrolled in the study. Serum ACE levels were determined photometrically with a kinetic test. RESULTS: The aspartate aminotransferase (AST), alanine aminotransferase (ALT), hepatitis B virus-deoxyribonucleic acid (HBV-DNA), histological activity index (HAI), and white blood cell counts were higher in patients with severe fibrosis, while albumin levels were low. The serum ACE levels showed a statistically significant correlation with HBV-DNA, HAI score, and ALT-AST levels. DISCUSSION: In this study, a statistically significant relation between serum ACE levels and HAI scores was observed. This represents the first analysis to compare necroinflammation of the liver and serum ACE levels. There may be some explanations that the suppression of hepatocyte growth factor (HGF) by Angiotensin II and increased inflammatory damage might be a reason for the correlation between HAI and ACE. Serum ACE levels, HBV-DNA levels, and serum transaminase levels might be used together as noninvasive markers for the prediction of necroinflammation in CHB patients.

Mean platelet volume in a patient with male hypogonadotropic hypogonadism: the relationship between low testosterone, metabolic syndrome, impaired fasting glucose and cardiovascular risk.

Isolated male hypogonadotropic hypogonadism (IHH) can be congenital or acquired. Mean platelet volume (MPV), determinant of platelet function, is an independent risk factor for cardiovascular disease (CVD). The aim of this study was to evaluate MPV values in male IHH and the relationships between MPV, low testosterone levels, metabolic syndrome, impaired fasting glucose (IFG) and cardiovascular risk. Thirty-one patients with untreated, normosmic, isolated, male IHH (mean age 22.5 ± 7.58 years) and 30 age and BMI-matched healthy individuals (mean 22.51 ± 4.94 years) were included in the study. All hormonal analyses were done by chemiluminesance assay. All study participants were evaluated by biochemical and platelet parameters. MPV were significantly higher in IHH than controls (8.6 ± 0.65 and 7.6 ± 0.54 fl, respectively; P = 0.000). MPV had a positive correlation between metabolic syndrome (r = 0.444; P = 0000), IFG (r = 0.371; P = 0.04), insulin (r = 0.820; P = 0.02), homeostasis model assessment (HOMA)-IR (r = 0.822; P = 0.0023) and BMI (r = 0.373; P = 0.012). MPV had a negative correlation between total testosterone (r =  -0.586; P = 0.0000), free testosterone (r =  -0.634; P = 0.0000), luteinizing hormone (r =  -0.471; P = 0.0000) and FSH (r =  -0.434; P = 0.0000). Although control patients did not have metabolic syndrome and IFG, IHH patients had metabolic syndrome and IFG significantly more often (P < 0.001, P = 0.003, respectively). Age, metabolic syndrome, IFG, BMI, fasting glucose, insulin, CRP and HOMA-IR were independent predictive factors of MPV in the multiple regression analysis. These results suggest that men with IHH are susceptible to increased platelet activation and increased MPV values that contribute to an increased risk of cardiovascular complications. From this study, it has been observed that IHH with low testosterone may be a feature of the metabolic syndrome, IFG, increased MPV levels and cardiovascular risk in young adult males.