INCREASED SERUM LEVELS OF UREA AND CREATININE ARE SURROGATE MARKERS FOR DISRUPTION OF RETINAL PHOTORECEPTOR EXTERNAL LIMITING MEMBRANE AND INNER SEGMENT ELLIPSOID ZONE IN TYPE 2 DIABETES MELLITUS.

PURPOSE: To evaluate the role of serum urea and creatinine as surrogate markers for disruption of retinal photoreceptor external limiting membrane (ELM) and inner segment ellipsoid zone (EZ) in Type 2 diabetic retinopathy (DR) using spectral-domain optical coherence tomography, for the first time. METHODS: One hundred and seventeen consecutive cases of Type 2 diabetes mellitus (diabetes without retinopathy [No DR; n = 39], nonproliferative diabetic retinopathy [NPDR; n = 39], proliferative diabetic retinopathy [PDR; n = 39]) and 40 healthy control subjects were included. Serum levels of urea and creatinine were assessed using standard protocol. Spectral-domain optical coherence tomography was used to grade the disruption of ELM and EZ as follows: Grade 0, no disruption of ELM and EZ; Grade 1, ELM disrupted, EZ intact; Grade 2, ELM and EZ disrupted. Data were analyzed statistically. RESULTS: Increase in serum levels of urea (F = 22.93) and creatinine (F = 15.82) and increased grades of disruption of ELM and EZ (γ = 116.3) were observed with increased severity of DR (P < 0.001). Increase in serum levels of urea (F = 10.45) and creatinine (F = 6.89) was observed with increased grades of disruption of ELM and EZ (P = 0.001). CONCLUSION: Serum levels of urea and creatinine are surrogate markers for disruption of retinal photoreceptor ELM and EZ on spectral-domain optical coherence tomography in DR.

Diet, obesity, and prostate health: are we missing the link?

Prostate problems, such as benign prostatic hyperplasia, prostatic intra-epithelial neoplasia, prostatitis, and prostate cancer have been recognized as problems largely related to androgens and genetic factors. They affect a large fraction of the elderly population, contributing significantly to morbidity and mortality. Estrogen has also now been recognized as one of the important regulators of prostate growth. Diet, general health, and obesity were disregarded as the causative or complicating factors until very recently. Increasing episodes of prostate problems, complications in overweight/obese individuals, or both have attracted attention toward these contemporary risk factors. Prostate problems are reportedly less frequent or less severe in areas in which a plant-based diet is predominant. Consumption of certain fatty acids, particularly of animal origin, has been correlated with increased prostate problems. As adipose tissue is increasingly being regarded as hormonally active tissue, high body fat and obesity need in-depth exploration to understand the associated risk of prostate problems. Adipose tissue is now known to affect circulating levels of several bioactive messengers and therefore could affect the risk of developing prostate problems in addition to several other well-recognized health problems. Nevertheless, increased plasma volume, excess tissue growth, and fat deposition could affect resection and number of biopsies required, thus adding further complications because of a delayed diagnosis. In short, evidence is gathering to support the influence of diet and obesity on prostate health. In this review article, we have tried to make this connection more apparent using supporting published data.

Association between circulating leptin and insulin resistance, the lipid profile, and metabolic risk factors in North Indian adult women.

Leptin plays an important role in the regulation of body weight and operates by inhibiting food intake and stimulating energy expenditure. The purpose of the present study was to ascertain the relationship between serum leptin levels and the lipid profile, insulin resistance, and metabolic risk factors in North Indian adult women. In a transactional case-control study of 390 women, subjects were 186 women with metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) guidelines and 204 healthy control women without metabolic syndrome, all of whom were between 20-40 years of age. Circulating leptin levels were determined by sandwich enzyme-linked immunosorbent assay, insulin resistance was determined by homeostasis model assessment for insulin resistance (HOMA-IR), and the lipid profile was determined using an enzymatic method. Results indicated that circulating leptin (13.38 ± 9.00 vs. 8.16 ± 6.31 ng/mL, p < 0.001), HOMA-IR (2.68 ± 2.05 vs. 1.72 ± 1.20, p < 0.001), the lipid profile, and other metabolic risk factors (waist circumference, waist-to-hip ratio, body mass index, and fasting plasma insulin) were significantly higher in women with metabolic syndrome than in women without the syndrome (p < 0.001). Further, in women with metabolic syndrome serum leptin was significantly (p < 0.05 or p < 0.001) and positively correlated with HOMA-IR (p = 0.000) and other metabolic risk factors but negatively correlated with fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol. Circulating leptin was found to be significantly associated with hyperlipidemia, insulin resistance, and other metabolic risk factors in North Indian adult women.

Correlation of serum vascular endothelial growth factor with clinicopathological parameters in cervical cancer.

Angiogenesis plays an important role in cervical cancer progression. Currently among several factors known to promote angiogenesis, vascular endothelial growth factor (VEGF) is most important. To evaluate the effect of treatment on VEGF levels and their correlation with other predictive factors, pre-and post treatment levels of VEGF were estimated in cervical cancer patients. 110 cases of frank cancer and 50 controls were enrolled for the present study: 18 in Stage I, 32 in Stage II, 48 in Stage III, and 12 in Stage IV. Serum VEGF levels were estimated by ELISA in patients on the day of recruitment and post treatment follow-up at a fixed time interval of 6-8 weeks. VEGF levels were highly significant among patients as compared to controls (p = 0.001). The pre-treatment VEGF levels among different stages of the disease were marginally insignificant (p = 0.07). However, they were significantly different for (i) various grades (p < 0.001), (ii) tumor size (p = 0.026), and (iii) smoking habits (p = 0.018). Post treatment levels were highly significant, as compared to pre-treatment values (p = 0.001). The pre-treatment and post-treatment VEGF levels were associated with (i) disease stage (p = 0.002), (ii) grade (p = 0.001), and (iii) tumor size (p = 0.001). In conclusion, VEGF is a potent angiogenic factor and can be considered as an effective prognostic marker in cervical cancer.