Prooxidant-antioxidant balance, advanced oxidation protein products and lipid peroxidation in Serbian patients with Parkinson's disease.

BACKGROUND: Biomarkers of oxidative stress are relevant in the evaluation of the disease status and prooxidant-antioxidant balance, advanced oxidation protein products and lipid peroxidation products (malondialdehyde and 4-hydroxynonenal) are being extensively evaluated regarding their relationship with clinical presentation and disease severity. AIM OF THE STUDY: The aim of this study was to evaluate the levels of the above-mentioned parameters in plasma of 39 men and 17 women with Parkinson's disease, originated from the Republic of Serbia and their relation to clinicopathological characteristics (gender, age at examination, duration of the disease, and Hoehn and Yahr score) and oxidative status. RESULTS: The incidence of disease was 2:1 towards males. The investigated oxidative parameters were gender and Hoehn and Yahr related. Significant association of higher Hoehn and Yahr scores was observed for malondialdehyde (p = 0.01) and prooxidant-antioxidant balance (p = 0.02). Relation between oxidant-antioxidant status was further supported by observed positive correlation between 4-hydroxynonenal (p = 0.04) and prooxidant-antioxidant balance (p = 0.03). Finally, the multivariate analysis indicated that prooxidant-antioxidant balance and malondialdehyde were partially determined by gender (10.6% and 7.6%) and Hoehn and Yahr scores (13.6% and 18.8%), while Hoehn and Yahr scores contributed to the variance of advanced oxidation protein products with 13.2%. CONCLUSION: Our results indicate the higher level of oxidative stress (oxidant-antioxidant imbalance) and possible relation of several markers with gender and disease stage in patients with Parkinson's disease. The analyzed markers could be used to specify the severity of oxidative stress; however, their potential value should be analyzed in further studies.

Direct Estimation of Reference Intervals for Thyroid Parameters in the Republic of Srpska.

BACKGROUND: The aim of this study was to determine the reference values for thyrotropin (TSH), thyroid hormones (total and free thyroxine, T4 and fT4; total and free triiodothyronine, T3 and fT3), thyroglobulin (Tg) and thyroid antibodies (thyroid peroxidase, TPOAb and thyroglobulin antibody, TgAb) in the population of the Republic of Srpska. METHODS: A total of 250 euthyroid subjects were enrolled in this study. A direct method for choosing reference subjects was used to establish reference intervals. The hormones and thyroid antibodies were measured by an electrochemiluminescence immunoassay method (ECLIA, Roche Diagnostics, Mannheim, Germany). We calculated the reference intervals by MedCalc, version 12.1.4.0 (MedCalc software, Belgium) as recommended by the IFCC (CLSI C28-A3). RESULTS: Using guidelines recommended by the National Academy of Clinical Biochemistry (NACB) and based on standard statistical approaches, the reference intervals derived for TSH, fT4, T4, fT3, T3 were 0.75-5.32 mIU/L, 12.29-20.03 pmol/L, 73.49-126,30 nmol/L, 4.11-6.32 pmol/L, 1.15-2.32 nmol/L and for Tg, TPOAb, TgAb were 3.63-26.00 µg/L, <18.02 mIU/L, < 98.00 mIU/L, respectively. We found a significant difference (p<0.05) in TSH and fT3 values between different age groups as well as in T4, fT4 and fT3 values between ge nder groups. CONCLUSIONS: The established reference values for the population of the Republic of Srpska were significantly different from the values recommended by the manufacturer of reagents (Roche Diagnostics). Our results showed that a laboratory needs to establish its own reference values in order to set up a proper diagnosis, as well as to treat patients successfully.

Prooxidant-antioxidant balance, hsTnI and hsCRP: mortality prediction in haemodialysis patients, two-year follow-up.

Oxidative stress and inflammation are highly intertwined pathophysiological processes. We analyzed the markers of these processes and high-sensitive troponin I (hsTnI) for mortality prediction in patients on haemodialysis. This study enrolled a total of 62 patients on regular haemodialysis. The patients were monitored for two years, and the observed outcomes were all-cause and cardiovascular mortality. Blood samples were taken before one dialysis session for analysis of the baseline concentrations of prooxidant-antioxidant balance (PAB), total antioxidant status (TAS), total oxidative status (TOS), hsTnI, hsCRP and resistin. The overall all-cause mortality was 37.1% and CVD mortality 16.1%. By univariate and multivariate logistic regression, our findings suggest that good predictors of all-cause mortality include hsCRP and PAB (p < .05) and of CVD mortality hsCRP (p < .05) and hsTnI (p < .001). To evaluate the relationship between the combined parameter measurements and all-cause/CVD mortality risk, patients were divided into three groups according to their PAB, hsCRP and hsTnI concentrations. The cutoffs for hsCRP and hsTnI and the median for PAB were used. Kaplan-Meier survival curves pointed out that the highest mortality risk of all-cause mortality was in the group with hsCRP levels above the cutoff and PAB levels above the median (p < .001). The highest risk of CVD mortality was found in the group with hsCRP and hsTnI levels above the cutoff levels (p = .001). Our data suggest that hsCRP and PAB are very good predictors of all-cause mortality. For CVD complications and mortality prediction in HD patients, the most sensitive parameters appear to be hsTnI and hsCRP.

Total bilirubin in young men and women: association with risk markers for cardiovascular diseases.

OBJECTIVE: The aim of this study was to investigate whether high bilirubin concentration is a protective factor in cardiovascular disease (CAD) and how it correlates with parameters of oxidative stress in young males and females. METHODS: The study comprised 628 healthy subjects of both genders, 18-22years of age. In fasting sera the concentration of total bilirubin (Tbil), parameters of cardiovascular risk and oxidative stress were determined. The results were analyzed by appropriate statistical methods. RESULTS: We found no gender differences in body mass index (BMI), blood pressure and lipid profile between subjects with low and high Tbil level. Men with high Tbil had higher concentrations of albumin and uric acid (p<0.001) and lower of oxLDL (<0.05), while women had higher albumin (p<0.05) and lower TBARS (p<0.05). Significant positive correlation in men was found between Tbil, uric acid and albumin, while for glucose and TBARS this association was negative. In female significant positive correlation was between Tbil, HDL-C, fibrinogen, albumin and uric acid and negative between Tbil and TBARS. The high concentration of Tbil in men was independently associated with uric acid (p<0.05) and oxLDL (p<0.001), while in women it was independently associated with TBARS (p<0.05). After adjustment for traditional lipid parameters the predictive power of high bilirubin in men remained for uric acid (p<0.001) and TBARS in women (p<0.05). CONCLUSION: These findings jointly support the concept that bilirubin via its antioxidant potential has a protective effect against cardiovascular disease in young male and female.

High uric acid and low superoxide dismutase as possible predictors of all-cause and cardiovascular mortality in hemodialysis patients.

PURPOSE: We investigated the role of serum uric acid (sUA) and superoxide dismutase (SOD) as predictive factors for mortality in hemodialysis (HD) patients. METHODS: SOD, butyrylcholinesterase, and malondialdehyde were estimated spectrophotometrically and the other parameters by standard procedures. High-sensitive C-reactive protein was assayed by a sandwich ELISA method. RESULTS: sUA among survivors (112.1 ± 13.82 µmol/L) was significantly lower than in deceased (160.8 ± 16.81 µmol/L, p < 0.001), while SOD was higher in survivors (31.8 ± 6.61 kU/L) than among deceased (20.2 ± 3.03, p < 0.05). Kaplan-Meier survival curves showed the greatest mortality risk in the highest tertile of basal sUA concentration (≥ 127.11 µmol/L, p < 0.001), and for SOD in the lowest tertile (≤ 23.83 kU/L, p < 0.05). CONCLUSION: Our results suggest that high sUA and low SOD may predict all-cause and cardiovascular mortality in HD patients.

Butyrylcholinesterase activity in young men and women: association with cardiovascular risk factors.

OBJECTIVE: We investigated the relationship between butyrylcholinesterase (BuChE) and cardiovascular risk factors in young male and female. DESIGN AND METHODS: The study comprised 1512 healthy subjects, 18-25 years of age. In fasting sera the concentrations of BuChE and cardiovascular risk factors were estimated. RESULTS: Analysis of variance indicated significant increase in body mass index (BMI), total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL) (p<0.05) and albumin (p<0.001) with BuChE activity increment in males. In females glucose and albumin (p<0.05) increased with BuChE activity. Negative but not significant correlation between BuChE and high-density lipoprotein cholesterol (HDL-C) was detected for both genders. CONCLUSION: The tendency towards overweight in young male could explain our results on BMI as an independent risk factor for higher BuChE in young male. Glucose as an independent risk factor for higher BuChE activity in females indicates that BuChE may be a predictor of diabetes.

Butyrylcholinesterase activity and mortality risk in hemodialysis patients: comparison to hsCRP and albumin.

OBJECTIVE: To test the prediction power of butyrylcholinesterase (BuChE) activity for mortality risk in hemodialysis patients during 12 months follow-up, and made comparison to hsCRP and albumin. MATERIALS AND METHODS: The study enrolled 62 patients, aged 31-79 years. Serum BuChE, high-sensitivity C-reactive protein (hsCRP) and albumin were measured after 1, 3, 9 and 12 months of dialysis. The Kaplan-Meier survival curves were employed in mortality prediction. RESULTS: BuChE was positively associated with serum albumin (r=0.318; p=0.012) and inversely related to hsCRP (r=-0.358; p=0.004). The highest mortality was in the lowest quartile of basal albumin (<38.4 g/L; p=0.027), hsCRP concentrations >8 mg/L (p=0.005), and BuChE activity in the lowest tercile of basal values (<5.92 kU/L; p=0.0041). CONCLUSION: Our results suggest that low BuChE activity may be a nonspecific risk factor for mortality in patients who are on hemodialysis.