The impact of obesity to antioxidant defense parameters in adolescents with increased cardiovascular risk.

BACKGROUND: The goal of this study was to assess the oxidative stress status through the values of antioxidant defense parameters: superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR) and total antioxidant status (TAS), as well as cardiovascular risk factors (total cholesterol, LDL-cholesterol, VLDL-cholesterol, non-HDL-cholesterol and triglycerides), anthropometric parameters (Body mass index-BMI, waist circumference-WC, hipp circumferemce-HC, waist-to-hipp ratio-WHR and inflammatory markers (high sensitive C-reactive protein) in a group of obese adolescents. METHODS: A total of 238 students of both sexes, age of 22.32 ± 1.85 yr. were included in the study. According to the values of BMI lower and higher than 25 kg/m2 and WC higher and lower than 94 cm (males)/80 cm (females) the tested group of students was divided into 2 subgroups: Group 1 (increased risk for CVD) and Group 2 (lower risk for CVD). RESULTS: Significantly reduced SOD and GPx with increased GR, TAS, inflammatory and lipoprotein parameters were obtained in Group 1 compared to Group 2. Significant positive association of hsCRP (OR:1.41; 95%CI 1.08-1.83; P=0.007), TAS (OR:827.2; 95%CI 19.27-35498; P=0.007) and GR (OR:1.13; 95%CI 1.05-1.21; P=0.002) and negative association of GPx (OR:0.97; 95%CI 0.94-1.003; P=0.043) and HDL-cholesterol (OR:0.41; 95%CI 0.176-0.963; P=0.0014) with cardiovascular risk factors were found in obese students. According to the ROC analysis GR>44.8 U/L, TAS>1.35 mmol/L, hsCRP>1.71 mg/L and HDL-cholesterol <1.13 mmol/L have sufficient predictive ability for cardiovascular disease in obese students. CONCLUSIONS: Significant association of antioxidant defense parameters with anthropometric, lipid and inflammatory markers in obese students with increased cardiovascular risk suggest that screening of these parameters is necessary and highly recommended.

The Association Between Periodontal Inflammation and Labor Triggers (Elevated Cytokine Levels) in Preterm Birth: A Cross-Sectional Study.

BACKGROUND: Periodontitis is considered to be a risk factor for preterm birth. Mechanisms have been proposed for this pathologic relation, but the exact pathologic pattern remains unclear. Therefore, the objective of the present study is to evaluate levels of four major labor triggers, prostaglandin E2 (PGE2), interleukin (IL)-1ß, IL-6, and tumor necrosis factor (TNF)-α, in gingival crevicular fluid (GCF) and serum samples between women with preterm birth (PTB) and full-term birth (FTB) and correlate them with periodontal parameters. METHODS: PGE2, IL-1ß, IL-6, and TNF-α levels were estimated using enzyme-linked immunosorbent assays in GCF and serum samples collected 24 to 48 hours after labor from 120 women (60 FTB, 60 PTB). RESULTS: Women with PTB exhibited significantly more periodontitis, worse periodontal parameters, and increased GCF levels of IL-6 and PGE2 compared with the FTB group; there were no significant differences in serum levels of measured markers. GCF levels of IL-1ß, IL-6, and PGE2 and serum levels of TNF-α and PGE2 were significantly higher in women with periodontitis compared with periodontally healthy women. Serum levels of PGE2 were positively correlated with probing depth (PD) and clinical attachment level (CAL) as well as with GCF levels of TNF-α in women with PTB. CONCLUSIONS: Women with PTB demonstrated worse periodontal parameters and significantly increased GCF levels of IL-6 and PGE2 compared with those with FTB. Based on significant correlations among serum PGE2 and PD, CAL, and GCF TNF-α in PTB, periodontitis may cause an overall increase of labor triggers and hence contribute to preterm labor onset.

The utility of human epididymal protein 4, cancer antigen 125, and risk for malignancy algorithm in ovarian cancer and endometriosis.

BACKGROUND: In women with pelvic mass, cancer antigen 125 (CA125) had not achieved satisfactory sensitivity and specificity in the detection of ovarian cancer, particularly in patients with underlying endometriosis. The aim of this study was to determine the diagnostic potential of human epididymal protein 4 (HE4), the combination of HE4+CA125, and the Risk of Ovarian Malignancy Algorithm (ROMA) for patients with pelvic mass, particularly in differentiating endometriosis from carcinoma. METHODS: A prospective cross-sectional study was conducted at the Clinic for Gynecology and Obstetrics, Clinical Center of Serbia. Serum samples were obtained preoperatively from 108 women undergoing surgery for pelvic mass; 29 of them had ovarian carcinoma, and 79 had a nonmalignant ovarian disease (39 with benign tumor, 20 with endometriosis, 20 healthy controls). Sera were analyzed for the levels of HE4 and CA125 and were then compared with the final pathologic results. The diagnostic performance of HE4 and CA125 was estimated using receiver operating characteristic curve and area under the receiver operating characteristic curve. RESULTS: The level of HE4 and CA125 was significantly higher among the patients with malignant tumors, compared with patients with nonmalignant disease. At the predefined specificity of 95%, HE4 and CA125 showed sensitivity of 65.5% and 58.6%, respectively, whereas the combination of HE4+CA125 reached 68.9% at the same specificity. Importantly, the level of HE4 did not differ significantly between the patients with endometriosis and with other nonmalignant diseases (which was not the case with CA125). Risk of Ovarian Malignancy Algorithm classified 96% of benign premenopausal cases as at low risk for ovarian cancer. CONCLUSIONS: HE4 showed satisfactory capability of distinguishing endometriosis from ovarian cancer, which CA125 lacked. The Risk of Ovarian Malignancy Algorithm score proved to be useful in excluding malignant diagnosis in premenopausal women.

[Chromosomal aberrations as etiological factors of intrauterine growth retardation].

BACKGROUND/AIM: Intrauterine growth retardation (IUGR) is a pathological condition of pregnancy characterised by birth weight below the 10th centile. A number of fetal, placental and maternal causes can lead to IUGR; although, in most cases no specific causes can be identified. The aim of this study was to determine the part of chromosomal abnormalities in IUGR etiology. METHODS: Fetal blood karyotype taken by cordocentesis from 168 fetuses with diagnosed IUGR was analyzed. RESULTS: Chromosomal rearrangements both numerical and structural were detected in 14 cases (12.2%). Two cases were triploid. Patau syndrome, Edwards syndrome and Down syndrome were found in two cases each. There was one case of trisomy 7 (47, XY, +7) and one case of trisomy 16 (47, XX, +16); one translocation, 46, XY, t (2; 14)(q23; q32) and a deletion 46, XYdel (12) (p12) as well as two cases of sex chromosomes abnormalities, 45, X (Turner syndrome) and 47, XYY. CONCLUSION: These findings suggest that a consistent number of symmetrical IUGR cases (about 12%) can be associated with chromosomal rearrangements. Chromosomal aberrations that cause IUGR are heterogeneous, aberration of autosomes, mostly autosomal trisomies, being the most common.

Systemic humoral anti-Helicobacter pylori immune response in patients with gastric malignancies and benign gastroduodenal disease.

BACKGROUND/AIMS: Helicobacter pylori elicits a strong local and systemic humoral immune response, but it is not able to eliminate bacteria. Immune response may be important for the course of infection that may lead to different gastroduodenal disease. In order to investigate differences in systemic humoral immune response between patients with different gastroduodenal diseases, we conducted clinical and serological studies. METHODOLOGY: From 1999 to 2001 we enrolled 80 patients with dyspeptic symptoms: 26 with gastritis, 12 with duodenal ulcer, 29 with gastric cancer and 13 with gastric lymphoma. In all patients during diagnostic work-up we performed ELISA test with Helicobacter pylori-specific IgG and IgA. We investigated difference in stimulation of different immunoglobulin classes in patients with different gastroduodenal diseases, particularly benign and malignant. We estimated significance of differences with Mann-Whitney and Fisher exact probability test. RESULTS: All patients enrolled in the study were seropositive. Patients with gastritis had statistically significant higher level of IgG than patients with gastric cancer (p=0.0001), and gastric lymphoma (p=0.006). Patients with duodenal ulcer had statistically significant higher level of IgG than patients with gastric cancer (p=0.02), and gastric lymphoma (p=0.046). IgA level was significantly higher in patients with gastritis than in patients with gastric cancer (p=0.03). IgA>IgG ratio was significantly more frequent in patients with gastric cancer and gastric lymphoma than in patients with gastritis and duodenal ulcer (p=0.0002). CONCLUSIONS: Result of our study suggested that Helicobacter pylori elicits different systemic humoral immune response in patients with gastritis and duodenal ulcer than in patients with gastric cancer and gastric lymphoma at least in intensity of stimulation of different immunoglobulin classes.