The neutrophil-lymphocyte ratio and its relationship with insulin resistance in obesity

Background/aim: In this study, our aim was to investigate the neutrophil/lymphocyte (N/L) ratio, variations in leukocytes and leukocyte subtypes, and the relationship between N/L ratio and insulin resistance (IR) in obesity. Materials and methods: Ninety-six patients and 40 healthy controls were included in this study. Patients' blood glucose levels, insulin levels, and hemogram parameters upon 8 h of fasting were determined. Body mass index (BMI) and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) values were calculated. Results: Neutrophil numbers were found to be higher among obese patients with IR than among non-IR obese patients. The N/L ratio was, moreover, found to be higher among obese patients with IR when compared to non-IR obese patients. A positive correlation was found between insulin resistance and both neutrophil and WBC counts. Positive correlations were also found between insulin levels and the N/L ratio, WBC counts, and neutrophil counts Conclusion: In our study, leukocyte numbers and subtypes were determined to be higher among obese individuals than among healthy individuals. The N/L ratio was increased significantly only among obese patients with IR. Further studies are needed in order to better demonstrate the relationship between the N/L ratio and IR/inflammation.

Renal function improves with the treatment of hypothyroidism.

BACKGROUND: It has been known that thyroid hormones may affect renal function. In this study, we aimed to investigate the effect of levothyroxine replacement on renal function in hypothyroid patients before and after treatment. METHODS: We retrospectively investigated free T3 (fT3), free T4 (fT4), TSH, creatinine, and eGFR measurements during both hypothyroid and euthyroid states of hypothyroid patients. The eGFR was calculated using the simplified Modification of Diet in Renal Disease formula. RESULTS: fT3, fT4, and eGFR measurements increased, meanwhile creatinine and TSH levels decreased significantly after euthyroidism was achieved with levothyroxine treatment (p < 0.0001 for all). The correlation analyses revealed that ∆creatinine and ∆TSH levels were significantly correlated before and after levothyroxine treatment (r: 0.288, p < 0.0001). ∆eGFR and ∆TSH levels were significantly correlated before and after LT4 treatment (r: -0.272, p < 0.0001). CONCLUSION: In this study, we evaluated creatinine and eGFR levels in patients with hypothyroidism and found out that renal function improved in most patients after euthyroidism was achieved. In some patients, above-normal creatinine levels completely returned to normal once the patients became euthyroid.

Effect of Food-Simulating Liquids on the Mechanical Properties of 3D-Printed Provisional Restoration Materials.

PURPOSE: To evaluate the effect of food-simulating liquids (FSLs) on the mechanical properties of provisional restoration materials fabricated by 3D printing, milling, and traditional fabricating methods. MATERIALS AND METHODS: The bar specimens were fabricated with traditional, milling, and 3D-printing methods according to ISO 10477 specifications. Each group of specimens was randomly subdivided into four groups to be immersed in various FSLs: distilled water (control group), n-heptane, 50% ethyl alcohol, and 0.02 mol/L citric acid for 7 days at room temperature (n = 19 per group). The Knoop hardness (KHN) was evaluated, and the specimens were subjected to a three-point bending (3PB) test to evaluate flexural strength (FS) and flexural modulus (FM). One-way ANOVA and Tukey tests were used to analyze the data. RESULTS: Fabrication methods had a significant effect on the mechanical properties of the materials being tested. FSLs had no effect on the FS and FM of materials being tested. The 50% ethyl alcohol solution significantly decreased the hardness of traditional group specimens, and the n-heptane and 50% ethyl alcohol solutions increased the hardness of the 3D-printed specimens significantly (P ≤ .05). Scanning electron microscopy (SEM) revealed that while traditional and milling group specimens showed a ductile fracture type, 3D-printed specimens showed a brittle fracture type. CONCLUSIONS: Production methods affected the mechanical properties of provisional restoration materials. Immersion in 50% ethyl alcohol solution decreased the KHN of the traditional specimens. FSLs had no negative effect on the mechanical properties of the milled and 3D-printed specimens.

Association of neutrophil-to-lymphocyte ratio and microalbuminuria in patients with normal eGFR.

AIMS: The aim of this study was to evaluate the association between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and microalbuminuria in patients with normal estimated glomerular filtration rate (eGFR). METHODS: 174 patients who had eGFR ≥ 60 mL/min/1.73 m2 were studied. Patients were divided into two groups according to the urinary albumin excretion as microalbuminuric group (n = 105) and normoalbuminuric group (n = 69). NLR and PLR levels were calculated. RESULTS: NLR was significantly higher (p < 0.05) in microalbuminuric patients (1.91 ± 0.70) compared with normoalbuminuric patients (1.63 ± 0.53). A positive correlation was found between urine albumin excretion and NLR in the whole study group (r = 0.214, p < 0.005). CONCLUSIONS: Higher NLR levels were found in microalbuminuric patients with normal eGFR. Also a significant positive correlation was observed between albuminuria and NLR.

Propylthiouracil-related Toxic Hepatitis: Impact of Silent Cases.

Liver is the main organ which can metabolize many drugs or chemical agents. Toxic events developed by drugs are one of the most common causes of liver damage. Toxic hepatitis can be encountered in different clinical situations, such as acute hepatitis, fulminant hepatitis chronic hepatitis or cirrhosis. We aimed to report a case of asymptomatic toxic hepatitis in a patient taking propylthiouracil (PTU). A 38 years old female patient admitted to hospital complained of fatigue. She had no special medical history except Graves' disease. She had been taking PTU 300 mg/day for 1 month. She had no history of another medication, eating mushroom, alcohol consumption, traveling, family history of liver disease. Her physical examination was normal. Laboratory analysis revealed that alanine aminotransferase-543 U/L, aspartate aminotransferase-227 U/L, gamma glutamyl transferase-66 U/L and alkaline phosphatase-136 U/L. Serum levels of bilirubin and albumin, INR, complete blood count and thyroid function tests were all normal. She had normal liver function test (LFT) before using PTU. Propylthiouracil was discontinued and she was given methimazole. She was examined for the etiology of abnormal LFT, but no specific etiology could be recorded. She was thought to have toxic hepatitis related to PTU. In her follow-up LFT has turned to normal level (Table 1). HOW TO CITE THIS ARTICLE: Eser M, Basyigit S, Eser M, Nazligul Y. Propylthiouracil-related Toxic Hepatitis: Impact of Silent Cases. Euroasian J Hepato-Gastroenterol 2015;5(2):134-135.