Serum insulin-like growth factor-1 levels in patients with pseudoexfoliation syndrome and glaucoma.

Insulin-like growth factor-1 (IGF-1) is altered in several neurodegenerative diseases, the association between serum IGF-1 levels and glaucoma has not been evaluated. This study was designed to evaluate whether serum IGF-1 levels are different in patients with Pseudoexfoliation (PEX) with or without glaucoma. The study was conducted with 110 participants aged 65 years or older who were divided into three groups: group 1, patients with PEX syndrome; group 2, patients with PEX glaucoma; and group 3, participants without PEX or glaucoma. All participants underwent full ophthalmological examination and a detailed medical history was recorded. Patients with known neurodegenerative diseases other than PEX glaucoma were excluded. Serum IGF-1 levels were measured by automated chemiluminescent assay. Groups 1, 2, and 3 included 35, 34, and 41 patients, respectively; there were no differences regarding age, gender, or systemic disease status. There were also no statistically significant differences between the groups in terms of IGF-1 levels, which were 91.7 ± 39.1, 101.1 ± 40.2, and 107.2 ± 43.8 ng/ml for groups 1, 2, and 3, respectively (p = 0.276). Serum IGF-1 levels were similar by gender, the presence of systemic disease, status of diabetes mellitus, and laterality of the PEX material. There was no correlation between the cup-to-disk ratios and IGF-1 levels (r = -0.214, p = 0.223). IGF-1 levels in the circulation did not differ in the presence of PEX syndrome with or without glaucoma. This may indicate that the neurodegenerative process is local rather than systemic.

First data on the biological variation and quality specifications for plasma ammonia concentrations in healthy subjects.

BACKGROUND: Most of the factors causing preanalytical and analytical variation in ammonia measurement have been identified. Biological variation data for ammonia is still lacking. We therefore estimated the components of biological variation (within-subject=CVI and between-subject=CVG), reference change value (RCV) and quality specifications for ammonia in a group of healthy individuals using fresh and frozen plasma samples. METHODS: Blood samples from 20 healthy subjects were collected in K2EDTA tubes daily over a period of 4 consecutive days from each subject. Each plasma sample was split into two aliquots; one was immediately analyzed as the samples were collected and the other was stored -80 °C until testing at the end of the collection period and analyzed at once in one analytical run. All samples were analyzed in duplicate. Estimations were calculated according to Fraser and Harris methods. RESULTS: CVI value for fresh samples (13.78%) was significantly lower than that in frozen samples (18.91%) (p<0.001). However, there was no statistically significant difference in CVG values between fresh (16.91%) and frozen (18.43%) samples (p=0.570). The index of individuality did not exceed 1.4 for fresh and frozen samples. The estimated RCVs were high for both fresh and frozen samples (43.37% and 56.85%, respectively). Quality specifications were established. CONCLUSIONS: The present study for the first time described the components of biological variation for ammonia in healthy individuals. These data regarding biological variation of ammonia could be useful for a better evaluation of ammonia test results in clinical interpretation and for determining quality specifications based on biological variation.

Evaluation of the Tosoh G8 Analyzer and Comparison with the Trinity Biotech Premier Hb9210 Analyzer for the Measurement of HbA1c.

BACKGROUND: The aim of our study was to assess the analytical performance of the Tosoh HLC-723G8 automated analyzer and to compare it with the Trinity Biotech Premier Hb9210 analyzer for the measurement of hemoglobin A1c (HbA1c). METHODS: A total of 101 patients with pre-diabetes or diabetes mellitus were included in the study. HbA1c, was measured by both an ion-exchange high-performance liquid chromatography (IE-HPLC) method and a boronate affinity chromatography method. Statistical analysis was performed using Deming regression. Bland-Altman plots were used to calculate mean difference (bias). RESULTS: The CV% values of IE-HPLC and boronate affinity methods for within run and between days were lower than 2.0%. High correlation was found (y = 1.0045x + 0.2111; r = 0.9941) between the two methods. The method shows no interference from carbamylated hemoglobin. CONCLUSIONS: Both systems showed acceptable performance and are suitable for clinical application in the analysis of HbA1c. However, laboratories should be aware of the limitations of their methods and the availability of more accurate and precise HbA1c, determination methods.

Vitamin D Levels of Anesthesia Personnel, Office Workers and Outdoor Workers in Ankara, Turkey.

BACKGROUND: Vitamin D deficiency or insufficiency is a highly prevalent condition worldwide. Anesthesia providers or support personnel working in operating rooms might be considered at increased risk of vitamin D deficiency. There is a small amount of information about 25(OH)D levels in people who work mainly indoors as an operating room. This study aimed to investigate whether there was a higher vitamin D insufficiency or deficiency rate among anesthesia personnel working indoors when compared with personnel working in an office or outdoors in Ankara, Turkey (39 degrees North, 32 degrees East). METHODS: This study consisted of 125 volunteer anesthesia personnel and 60 subjects as control groups (30 outdoor workers and 30 office workers). All of the individuals completed a questionnaire. Serum levels of total 25(OH)D were measured by a chemiluminescent immunoassay method. RESULTS: 74.4% of anesthesia personnel and 76.6% of control group 1 (outdoor workers) and 76.6% of control group 2 (office workers) had serum 25(OH)D concentrations < 10 ng/mL. 20.8% of anesthesia personnel and 23.4% of control group 1 and 23.4% of control group 2 had serum 25(OH)D concentrations levels 10 - 20 ng/mL. 4.8% of anesthesia personnel had serum 25(OH)D concentration levels 21 - 30 ng/mL. There was no significant difference in the mean serum 25(OH)D level between the groups (Anesthesia group: 8.98 ± 4.89 ng/mL, Control group 1: 8.18 ± 2.39 ng/mL, Control group 2: 8.37 ± 3.01 ng/mL) (p > 0.05). CONCLUSIONS: To our knowledge the present study is the first study to investigate the comparison of vitamin D levels of anesthesia personnel with outdoor and office workers. Our findings alarmingly emphasize that vitamin D deficiency is very common at the end of winter in Ankara, regardless of being anesthesia personnel in operating room or a worker in office or an outdoor worker. Vitamin D supplementation may be suggested in all groups in Ankara.

Serum vaspin and adiponectin levels in patients with prolactinoma.

BACKGROUND: Studies investigating serum vaspin and adiponectin levels in patients with prolactinoma are inconclusive. The aim of this study was to evaluate serum vaspin and adiponectin levels in patients with prolactinoma and healthy controls. METHODS: A total of 42 prolactinoma patients (Group 1, 21 patients; Group 2, 21 patients) and 30 healthy controls were enrolled in the study. Group 1 consisted of newly diagnosed patients who were never treated or had not received a dopamine agonist (DA) within 6 months prior to screening. Group 2 consisted of prolactinoma patients who were on DA treatment for at least 6 months at the time of screening. The control group (group 3) consisted of healthy controls. RESULTS: Patients with prolactinoma had higher homeostasis model assessment of insulin resistance and lower quantitative insulin sensitivity check index values in comparison to healthy controls (p < 0.001 for both). Serum levels of adiponectin and vaspin were also significantly lower in prolactinoma patients when compared to the control group (p < 0.01 and p < 0.001, respectively). Following adjustment for confounding factors, the respective odds ratios for prolactinoma in patients in the lower subgroup compared with those in the higher subgroup for adiponectin and vaspin were 2.733 (0.621-12.035; p > 0.05) and 5.041 (1.191-21.339; p < 0.05). CONCLUSION: This is the first study to demonstrate the presence of low vaspin levels in patients with prolactinomas. Further studies are needed to help establish the roles of vaspin and adiponectin in prolactinoma patients.

The role of serum vitamin D levels in vitiligo.

INTRODUCTION: Vitiligo is a common acquired pigmentary skin disorder. Vitamin D is responsible for skin pigmentation, increases tyrosinase activity and melanogenesis, and exhibits immunoregulatory functions. Low levels of vitamin D are associated with many autoimmune diseases, including systemic lupus, diabetes mellitus, rheumatoid arthritis, multiple sclerosis and alopecia areata. Few reports have evaluated serum vitamin D levels in vitiligo patients, and their results are conflicting. AIM: To evaluate serum vitamin D levels of vitiligo patients and compare the results with controls. MATERIAL AND METHODS: In total, 50 vitiligo patients and 47 controls were enrolled in the study. Vitamin D levels were measured from blood samples. Group comparisons were performed using appropriate statistical methods. RESULTS: The patients had lower serum vitamin D levels than the controls, but this difference was not significant (p = 0.570). CONCLUSIONS: It remains unknown whether vitamin D deficiency causes vitiligo. Larger controlled studies are required to prove whether low circulating vitamin D is a causative factor in vitiligo.

Evaluation of Cardiac Markers in Children Undergoing Hematopoietic Stem Cell Transplantation.

BACKGROUND: Early life-threatening cardiotoxicity and cardiac death have been reported after hematopoietic stem cell transplantation (HSCT). The purpose of the current study was to evaluate cardiac toxicity of conventional chemotherapy followed by HSCT with cardiac markers: heart-type fatty acid binding protein (H-FABP), glycogen phosphorylase BB (GPBB), high sensitive C reactive protein (hsCRP) cardiac troponin I, (cTnI), creatine kinase MB (CK-MB mass) and myoglobin. METHODS: A total of 20 children who underwent HSCT for malignant and non-malignant diseases were included in this study. Blood samples were collected from all patients in 0th, 7th and 21st day for evaluating these cardiac biomarkers. The patients' echocardiography was assessment before and after one-month of HSCT. RESULTS: Serum 21st H-FABP level was significantly higher when compared with the 0th day H-FABP level (P < 0.05) . 7th day hsCRP level was significantly higher than 0th and 21st day levels (P < 0.05). Interestingly, 7th day GPBB level was significantly lower than 0th and 21st day levels (P < 0.05). Myoglobin, CK-MB mass and cTnI biomarkers remained within the reference range in all patients. CONCLUSIONS: This study showed that H-FABP and hsCRP both seem to be promising markers for evaluation of cardiotoxicity in HSCT process and probably superior to GPBB, cTnI, CK-MB mass and myoglobin.

Assessing the Relationship Between Serum Ghrelin Levels and Metabolic Parameters and Autoimmunity in Patients with Euthyroid Hashimoto's Thyroiditis.

OBJECTIVE: Hashimoto's thyroiditis (HT) may affect metabolic parameters and increase predisposition to obesity. In this study, we aimed to assess the relationships among serum ghrelin concentrations, metabolic parameters, and thyroid autoimmunity in euthyroid HT patients. METHODS: The study included 48 euthyroid HT patients and 41 age- and sex-matched healthy controls. We assessed serum ghrelin, free triiodothyronine (T3), free thyroxine (T4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (anti-TPO), thyroglobulin antibody (anti-Tg), fasting blood glucose (FBG), insulin, lipid levels, and homeostasis model assessment insulin resistance (HOMA-IR) in all subjects. RESULTS: Sex distribution, mean age, and body mass index (BMI) were similar in HT patients and controls (female/male, 42/6 vs. 33/8, 46.8 ± 14.7 vs. 45 ± 12.5 years, 28.5 ± 6.1 vs. 28.4 ± 4.9 kg/m2, respectively; P>.05 for all). The mean waist circumference (WC) of the HT group was significantly higher than that of the control group (100.6 ± 14.6 vs. 93.2 ± 13.2 cm, P = .015). While FBG, low-density lipoprotein cholesterol (LDL-C), and triglyceride levels in the HT group were significantly higher than in the control group, insulin levels and HOMA-IR were similar. Ghrelin levels were lower in HT patients compared to controls (416.9 ± 224.4 and 689.9 ± 191.6 pg/mL, respectively; P<.001). Ghrelin levels were similar in patients with low and high anti-TPO titers. Negative correlations were observed between ghrelin levels and BMI, WC, and anti-TPO levels. Regression analysis revealed that HT was the most important predictor of ghrelin levels. CONCLUSION: Euthyroid HT is associated with a decrease in plasma ghrelin levels. Altered body fat distribution and increased anti-TPO levels do not seem to be directly involved in lower ghrelin levels in euthyroid HT patients.

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).

Thymosin beta 4 is associated with collateral development in coronary artery disease.

OBJECTIVES: Thymosin beta 4 (Tß4) plays an essential role in cardiac vessel development and is currently being developed as a therapeutic agent for the treatment of coronary artery disease (CAD) in some experimental studies. Thus, we aimed to investigate the association of serum Tß4 levels and collateral formation in patients presenting with severely stenotic CAD. METHODS: Thirteen patients with poor collateral development and 16 age- and sex-matched patients with good collateral development who had ≥ 95% stenosis in at least one major coronary artery on coronary angiogram (CAG) were enrolled in the study. The Gensini score was calculated for each patient by using CAG results. Collateral development was classified according to the Cohen-Rentrop method. Serum Tß4 levels were measured with enzyme-linked immune sorbent assay. RESULTS: There were no statistically significant differences between the two groups in regard to clinical and laboratory characteristics of the patients except for Tß4 levels. The Tß4 levels in the well-collateralized study group were found to be significantly higher than those of the poorly collateralized study group and serum Tß4 levels were positively correlated with the collateral development. CONCLUSIONS: Our findings suggest that serum Tß4 levels are significantly associated with the collateral development in severe CAD.

The protective effect of erdosteine on radiocontrast induced nephrotoxicity in rats.

Acute renal failure resulting from radiocontrast-induced nephrotoxicity (RIN) is suggested to occur via medullary ischemia coupled with the generation of free radicals and oxidative injury to tubular cells. The aim of the present study was to assess the effects of erdosteine on prevention of RIN. Thirty-three Wistar-albino rats were divided into five groups: control (group 1, n = 6), radiocontrast media (group 2, n = 6), erdosteine (group 3, n = 7), erdosteine four doses before radiocontrast application (group 4, n = 7) and erdosteine one dose at the same day with radiocontrast application (group 5, n = 7). RIN was induced by administration of intravenous high osmolar contrast media amidotrizoate (6 mL/kg). Total RNA was extracted from the kidney, and the expression levels of Lipocalin 2 (Lcn2) and secreted phosphoprotein 1 (Spp1) genes were evaluated by real time reverse transcription polymerase chain reaction (real-time RT-PCR). Total antioxidant status (TAS) and total oxidant status (TOS) were measured in kidney homogenates and serum samples. Serum creatinine, BUN (Blood Urea Nitrogen) and cystatin-C levels were measured from serum samples. The kidneys were evaluated histopathologically. The expression levels of Spp1 and Lcn2 genes in group 2 were significantly higher than groups 1, 3, 4, and 5. The expression levels of Spp1 and Lcn2 genes in group 4 were four and two times lower than group 5, respectively. Kidney TOS levels in group 2 were significantly higher than groups 1, 3, 4, and 5. Kidney TAS levels in group 3 were higher than group 2. Kidney oxidative stress index (OSI) levels in group 2 were significantly higher than groups 4 and 5. All rats in contrast media group developed tubular necrosis, proteinaceous casts, medullary congestion although these changes were significantly reduced in groups 4 and 5. This study demonstrated that multiple doses of erdosteine before application may have higher protective effects against RIN.

Thymosin beta4 levels after successful primary percutaneous coronary intervention for acute myocardial infarction.

OBJECTIVES: Thymosin beta4 (Tß4) has been shown to have an important role in healing of damaged tissues and promoting cardiomyocyte survival in acute coronary syndromes. We evaluated endogenous Tß4 levels in patients presenting with ST-elevation acute myocardial infarction (STEMI) before and after successful primary percutaneous coronary intervention (PCI). STUDY DESIGN: The study included 24 consecutive patients (7 females, 17 males; mean age 55.0±10.9 years) who underwent successful primary PCI for STEMI and 24 age- and sex-matched healthy controls (13 females, 11 males; mean age 57.5±11.7 years) with angiographically normal coronary arteries. To determine Tß4 levels, blood samples were obtained from STEMI patients on admission and 48 hours after successful PCI, and from controls immediately after coronary angiography. RESULTS: Compared to controls, baseline levels of high-density lipoprotein cholesterol (46.2±8.9 vs. 34.2±7.2 mg/dl, p<0.001) and Tß4 (2.9±1.5 vs. 1.5±1.0 µg/ml, p<0.001) were significantly lower, and white blood cell counts (7.6±2.2 vs. 11.4±3.0 10³/µl, p<0.001) were significantly higher in the STEMI group. After 48 hours of PCI, the mean Tß4 level increased significantly to 2.3±0.8 µg/ml (p<0.001) and became similar to that of the control group (p=0.068). There was a significant negative correlation between serum Tß4 and white blood cell count (r=-0.347, p=0.016). CONCLUSION: Considering the significant increase in serum Tß4 levels following successful primary PCI in patients with STEMI, Tß4 may prove to be a new marker in the assessment of reperfusion success in addition to those used currently.

Association of serum fetuin-A with valvular calcium concentration in rheumatic mitral valve disease.

BACKGROUND AND AIM OF THE STUDY: Fetuin-A is an acute-phase glycoprotein that inhibits ectopic calcification. The study aim was to assess serum fetuin-A levels in patients with rheumatic mitral valve disease (RMVD), and to evaluate the association of fetuin-A with the extent of mitral valve calcification, determined either echocardiographically or by the measurement of calcium and phosphorus concentrations in the resected valve tissues. METHODS: The study group comprised 21 patients (14 females, seven males; mean age 48 +/- 12.4 years) with RMVD, who were scheduled for mitral valve replacement surgery, while 30 age- and gender-matched healthy subjects (17 females, 13 males; mean age 43.6 +/- 11.1 years) served as a control group. Baseline serum fetuin-A levels were measured using ELISA, and high-sensitivity C-reactive protein (hs-CRP) levels using immunonepholometry. A Wilkins score was calculated using transesophageal echocardiography, and the resected valve tissues were analyzed for concentrations of calcium and phosphorus. RESULTS: Serum fetuin-A levels were lower and hs-CRP levels higher in the study group than in controls (300.4 +/- 92.5 microg/ml versus 352.6 +/- 55.3 microg/ml, p = 0.028; and 1.9 +/- 1.2 mg/dl versus 0.3 +/- 0.2 mg/dl, p < 0.0001, respectively). An inverse correlation was found between serum fetuin-A and hs-CRP levels (r = -0.690, p = 0.001). A significant association of either serum fetuin-A or hs-CRP was also found to occur with calcium concentration in the mitral valve tissue (r = -0.684, p = 0.001, and r = 0.510, p = 0.018, respectively), but not with the Wilkins calcium score. Serum fetuin-A and phosphorus concentrations in the MV tissue were independent predictors of calcium concentration in the MV tissue. CONCLUSION: Serum fetuin-A, which is significantly decreased in patients with RMVD, is an independent predictor of calcium concentration in the mitral valve tissue.

Frequency of mutated allele CYP2D6*4 in the Turkish ankylosing spondylitis patients and healthy controls.

The aim of this study was to determine the frequency of mutated allele CYP2D6*4 in the Turkish ankylosing spondylitis (AS) patients and healthy controls. Hundred unrelated AS patients who were diagnosed and treated in the Physical Medicine and Rehabilitation Clinic of Ankara Numune Research and Training Hospital and 52 healthy control subjects were included in the study. The wild-type allele of CYP2D6 and the mutated allele CYP2D6*4 were detected by polymerase chain reaction and a subsequent hybridization reaction. CYP2D6*4 allele was not detected in 72 subjects (72%) of the AS patients. Among the remaining 28 patients, 7 (7%) were carriers of two *4 alleles, being homozygous for CYP2D6. Twenty-one patients (21%) were carriers of one *4 allele, being heterozygous for CYP2D6*4. Among the healthy control subjects (n = 52), 23% were heterozygous and 2% were homozygous for CYP2D6*4 polymorphism. The frequency of the CYP2D6*4 allele was 0.175 in the AS patients (100 patients; 200 alleles). The frequency of the CYP2D6*4 allele was 0.134 in control group (52 control subjects; 104 alleles). The odds ratios for development of the AS for the presence of one or two CYP2D6*4 alleles with no CYP2D6*4 alleles as baseline were calculated. No significant risk of AS development was observed for individuals with one or two CYP2D6*4 alleles. Findings of this study showed no significant association between CYP2D6*4 allele and AS in our population. Further studies with larger scaled groups should be performed.

Plasma homocysteine concentrations and serum lipid profile as atherosclerotic risk factors in subclinical hypothyroidism.

BACKGROUND AND OBJECTIVES: Because subclinical thyroid dysfunction may be a risk factor for cardiovascular disease, we evaluated the atherosclerosis tendency in subclinical hypothyroid (SCH) patients. PATIENTS AND METHODS: Fifty-three subclinical hypothyroid patients (serum thyrotropin [TSH] concentrations >4.12 mU/L) were compared with a control group of 50 euthyroid subjects whose age, sex and body mass indices were similar to the patient group. We tested whether serum TSH concentrations were correlated with plasma total homocysteine concentration (tHcy), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and triglycerides (TG). RESULTS: There was a significant statistical difference between the patient and control groups for normal free T4 (1.02+/-0.17 vs. 0.86+/-0.13, P<.001), TSH (1.64+/-1.02 vs. 6.62+/-2.61, P<.001), TC (185+/-39 vs. 206 +/- 42, P=.01), TG (103+/-54 vs. 132+/-85, P=.04), LDL-C (114+/-33 vs. 127+/-36, P=.04), and TC/HDL-C (3.81+/-106 vs. 4.19+/-1.02, P=.04), respectively. No statistically significant difference was found between the two groups for HDL-C, VLDLC, LDL-C/HDL-C, and tHcy. Serum TSH was significantly correlated with plasma tHcy (r=0.55; P=.001), TC (r=0.52; P=.001), LDL-C (r=0.49; P=.001), TC/HDL-C (r=0.38; P=.002) and LDL-C/HDL-C (r=0.36; P=.004) across all participants. CONCLUSION: Our study suggests that the atherogenicity of SCH is not mediated by hyperhomocysteinemia. Associated hyperlipidemia may explain the observed increased risk of coronary artery disease in patients with SCH.

Concentrations of prealbumin and some appetite-controlling hormones in pregnancies associated with hyperemesis gravidarium.

Background Hyperemesis gravidarum, which affects 0.3-2.3% of pregnancies, is defined as excessive vomiting during pregnancy and usually starts in week 4 or 5 of gestation. Symptoms include weight loss, dehydration, ketonaemia, ketonuria, fasting acidosis, alkalosis due to hydrochloric acid loss and hypokalaemia and its exact cause is unknown. The present study was undertaken to investigate the relationship between prealbumin, ghrelin, nesfatin-1 and obestatin concentrations in pregnancies associated with hyperemesis gravidarum. Methods A total of 40 pregnant females with hyperemesis gravidarum and 38 pregnant females without hyperemesis gravidarum as controls were included in this study. Serum concentrations of prealbumin, ghrelin, obestatin and nesfatin-1 were measured. Results There were no significant differences in age, gestational week, gravidity and parity between the two groups. Body mass index was significantly lower in cases than in controls. Serum ghrelin and prealbumin concentrations were significantly lower in cases than in controls ( P <0.05 and P < 0.001, respectively). There was no significant difference in serum concentrations of obestatin and nesfatin-1 between the two groups. There was no significant association between body mass index and serum ghrelin, nesfatin-1, obestatin or prealbumin concentrations in patients with hyperemesis gravidarum. Conclusions Decreased serum concentrations of ghrelin and prealbumin in patients with hyperemesis gravidarum are independent of body mass index. Based on our results, we believe that ghrelin may be considered to play a role in the aetiopathogenesis of hyperemesis gravidarum and that hyperemesis gravidarum may result in disruption of the relationship between nesfatin-1 and ghrelin. In addition, we believe that the measurement of serum prealbumin may be used for assessing nutritional status in pregnancy.

Greater Efficiency Observed 12 Months Post-Implementation of an Automatic Tube Sorting and Registration System in a Core Laboratory.

BACKGROUND: Sample classification and registration have been recognized as important and time-consuming processes in laboratories. There is increasing pressure on laboratories to automate processes due to intense workload and reduce manual procedures and errors. The aim of the present study was to evaluate the positive effects of an automatic tube registration and sorting system on specimen processing. METHODS: An automatic tube registration and sorting system (HCTS2000 MK2, m-u-t AG, Wedel, Germany) was evaluated. Turnaround time (TAT), rate of sample rejection and unrealized tests were examined 12 months pre- and post-implementation of the automatic tube sorting and registration system. RESULTS: The mean TAT of routine chemistry immunoassay, complete blood cell count (CBC) and coagulation samples were significantly improved (P<0.001). The number of rejected samples and unrealized tests was insignificantly decreased post-implementation of the system (0.4% to 0.2% and 4.5% to 1.4%, respectively) (P>0.05). CONCLUSIONS: By reducing delays and errors in the preanalytical processing and sorting of samples, significant improvements in specimen processing were observed after implementation of the system. These results suggest that an automatic tube registration and sorting system may also be used to improve specimen processing in a higher-volume core laboratory.

Endocan and Non-Dipping Circadian Pattern in Newly Diagnosed Essential Hypertension.

BACKGROUND AND OBJECTIVES: Non-dipper hypertension is frequently accompanied by endothelial dysfunction and activation. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. This study aims to investigate the association between circadian blood pressure (BP) pattern and plasma endocan levels together with high-sensitivity C-reactive protein (hsCRP) in patients with newly diagnosed untreated hypertension. SUBJECTS AND METHODS: Twenty-four hour ambulatory blood pressure monitoring was recorded in 35 dipper, 35 non-dipper hypertensives and 35 healthy controls. Endocan levels were measured by enzyme-linked immunosorbent assay. Serum levels of hsCRP were also recorded. RESULTS: Despite similar daytime and 24-hour average BP values between dippers and non-dippers, statistically significant high nocturnal BP was accompanied by a non-dipping pattern (Systolic BP: 132±9 vs. 147±11 mmHg; Distolic BP: 80±7 vs. 91±9 mmHg, respectively, p<0.001 for both). Non-dipper patients demonstrated higher endocan levels compared to dippers and normotensives (367 (193-844) pg/mL, 254 (182-512) pg/mL and 237 (141-314) pg/ml, respectively, p<0.001). HsCRP levels were significantly higher in non-dippers than the other groups (p=0.013). In a multivariate logistic regression analysis, endocan (p=0.021) and hsCRP (p=0.044) were independently associated with a non-dipping pattern. CONCLUSION: Elevated endocan levels were found in non-dipper groups. Endocan and hsCRP were found to be independently associated with a non-dipping pattern. We suggest that elevated levels of endocan in non-dipper hypertensive patients might be associated with a longer duration of exposure to high BP. These results point to the possible future role of endocan in selection of hypertensive patients at higher risk or target organ damage.

Human Endothelial Cell-Specific Molecule-1 (Endocan) and Coronary Artery Disease and Microvascular Angina.

Endothelial cell-specific molecule-1 (endocan) is an immunoinflammatory marker linked to endothelial activation and dysfunction. We investigated the relationship between obstructive coronary artery disease (CAD), microvascular angina (MVA), and plasma levels of endocan. We included 53 healthy individuals as controls, 40 MVA patients, and 120 patients with obstructive CAD. The severity of CAD was assessed by the Gensini and SYNergy between percutaneous coronary intervention with TAXUS and Cardiac Surgery (SYNTAX) scores. Endocan levels were 382.7 (313.8-470.2) pg/mL in patients with obstructive CAD; 324.3 (277.1-460.7) pg/mL in MVA group, and 268.0 (226.4-336.5) pg/mL (P < .001) in controls. Endocan levels in obstructive CAD and MVA groups were similar but both were significantly higher than for the control group (P < .001 and P = .002, respectively). In subgroup analysis, similar to the hypertensive subgroup results, endocan was still an independent predictor of presence of obstructive CAD in normotensives (odds ratio = 1.005, 95% confidence interval = 1.001-1.010, P = .024). There was also an independent positive correlation between endocan levels and SYNTAX score both in the hypertensives (ß = 0.414, t = 3.21, P = .002) and in the normotensives (ß = .301, t = 2.23, P = .031). In conclusion, endocan could be a common predictor of the endothelium-dependent inflammatory processes, rather than related with specific risk factors.

Evaluation of the analytical performance of Unicel DXI 800 for the Total 25 (OH) Vitamin D measurements.

OBJECTIVES: We assessed the analytical performance of newly developed Access 25(OH) Vitamin D Total assay with Beckman Coulter Unicel DXI 800 and evaluated the agreement between a reference method liquid chromatography/tandem mass spectrometry (LC-MS/MS) and a chemiluminescence method (LIAISON, DiaSorin). DESIGN AND METHODS: 160 serum samples were included. Deming Regression analysis and Bland-Altman plots were used. The concordance correlation coefficient (CCC) was used to assess the degree of agreement between assays and the reference method. RESULTS: The CV% values of Unicel DXI 800 for within-run, between-run and between-day were lower than 6%. When compared to LC-MS/MS, the Access 25(OH) Vitamin D Total assay demonstrated an R value of 0.9444 (intercept -0.089, slope 0.951), with an average bias of -2.9%, and the LIAISON 25(OH) Vitamin D Total assay an R value of 0.9405 (intercept -0605, slope 0.924), with an average bias of -13.6%. In comparison with the LIAISON 25(OH) Vitamin D Total assay, the Access 25(OH) Vitamin D Total assay demonstrated an R value of 0.9498 (intercept 0.528, slope 1.029), with an average bias of 1.2%. The agreement with the LC-MS/MS method, based on values of the CCC, was moderate for the Unicel DXI 800 and LIAISON method (0.95, 0.94 respectively). CONCLUSIONS: The new, automated Access 25(OH) Vitamin D Total assay showed an acceptable correlation with LC-MS/MS and LIAISON. Both methods moderately achieved to classify the patients according to their vitamin D status. However, we need further standardization of vitamin D assays to enhance the accuracy and comparability.