Analysis of serum homocysteine in the laboratory practice - comparison of the direct chemiluminescence immunoassay and high performance liquid chromatography coupled with fluorescent detection.

INTRODUCTION: Effective diagnosis of cardiovascular diseases requires the right tools to be used enabling selective and sensitive analysis of their biomarkers. One of them is homocysteine (Hcy), nowadays determined by immunoassays and chromatographic methods. This study aims to compare the results obtained by direct chemiluminescence immunoassay (CLIA) and high performance liquid chromatography with fluorescent detection (HPLC-FD) using commercial kits. MATERIALS AND METHODS: Homocysteine concentration was determined in serum samples obtained from 101 individuals, using Atellica IM HCY (Siemens Healthineers, Erlangen, Germany) and HCY in plasma/serum - HPLC-FD (Chromsystems Instruments & Chemicals GmbH, Gräfelfing, Germany) tests validated for routine analysis. The latter was applied as a reference method. The comparability and agreement between the tested methods were evaluated using the Passing-Bablok (PB) regression analysis and the Bland-Altman (BA) method of the differences analysis. RESULTS: Studies showed that CLIA gives higher Hcy concentrations (15.7 ± 4.14 µmol/L). Passing-Bablok regression analysis of the results obtained with CLIA (y) compared with HPLC-FD (x) yielded an intercept of 0.22 (95%CI: - 2.16 to 2.46) and slope of 1.58 (95%CI: 1.33 to 1.87). Bland-Altman analysis demonstrated a systematic positive bias for CLIA of 5.85 ± 2.77 µmol/L. CONCLUSIONS: Methods disagreement precludes their interchangeability. Lower Hcy values by HPLC-FD result from its greater selectivity. High performance liquid chromatography with fluorescent detection should be considered as preferential method for analysing Hcy in blood serum as well as the recommended reference method for routine clinical analysis. This fact, however, imposes the need to establish new reference ranges.

Diagnostic strategies for SARS-CoV-2 infection / Diagnostyka zakazen SARS-CoV-2.

COVID-19 pandemic highlighted the importance of laboratory diagnostics to reduce the spread of SARSCoV-2 and to treat patients with severe coronaviral disease. The situation required a rapid development of molecular and serological tests to enable mass screening, testing of high-risk groups, and establishing epidemiological data. Knowledge of diagnostic methods is continuously evolving, so it is crucial to understand the nature of the tests and to be able to interpret their results. This review discusses the current literature on diagnostic methods, prognostic markers, diagnostic recommendations, choice of the appropriate test, type of biological material, and interpretation of results depending on test sensitivity and disease duration. Also, the percentage of positive results in the selected countries at two distant time points of the epidemic was analyzed. Further development of diagnostic techniques and incorporation of new technologies can provide more accurate and faster tools for control the epidemic.

Myeloperoxidase level and inflammatory markers and lipid and lipoprotein parameters in stable coronary artery disease.

BACKGROUND: Myeloperoxidase (MPO) impairing endothelial functions. We investigated whether increasing concentration of myeloperoxidase (MPO) and inflammatory markers induce progression and incident acute coronary syndrome (ACS) in stable coronary artery disease (SCAD) patients. Therefore, the concentration of MPO, lipids, lipoproteins (apo(apolipoprotein) AI, apoB, lipoprotein associated phospholipase A2 (LpPLA2) level), inflammatory markers (high sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α), interleukine-6 (IL-6) concentration) were examined. METHODS: This study concerned 67 SCAD patients divided into groups: all patients, patients with MPO < 200 ng/ml, MPO 200-300 ng/ml, MPO > 300 ng/ml concentration and 15 controls. ApoAI, apoB and hsCRP levels were examined using the immunonephelometric method, and MPO, LpPLA2, IL-6, TNF-α concentration was performed by using Quantikine ELISA kit R&D Systems. RESULTS: In the all patients, and in group with MPO 200-300 ng/ml TC, LDL-C, nonHDL-C, LpPLA2 concentration and TC/HDL-C, LDL-C/HDL-C ratios were insignificant, and significantly higher concentration of TG, apoB, MPO, inflammatory markers and TG/HDL-C, MPO/apoAI, MPO/HDL-C ratios but HDL-C, apoAI level and HDL-C/apoAI ratio were significantly reduced. In the group of patients with MPO < 200 ng/ml, level of TC, LDL-C, nonHDL-C, apoAI, apoAII, LpPLA2 and MPO and LDL-C/HDL-C ratio were in-significant, HDL-C was decreased but apoB, TG, inflammatory markers, apoB/apoAI, TG/HDL-C, MPO/apoAI, MPO/HDL-C ratio were significantly increased. In the group of patients with MPO > 300 ng/ml concentration of TC, LDL-C, nonHDL-C, apoAII, LpPLA2 and LDL-C/HDL-C ratios were not significant, but HDL-C and apoAI concentrations were significantly decreased. The concentrations of TG, apoB, MPO and inflammatory markers and TG/HDL-C, MPO/apoAI, MPO/HDL-C ratios were significantly increased compared to the controls. The apoAI concentration was significantly decreased and the concentration of MPO and hsCRP as well as MPO/apoAI and MPO/HDL-C ratios were significantly higher as compared to the group of patients with MPO < 200 ng/ml. Spearman's correlation test showed a positive correlation between MPO concentration and MPO/apoAI and MPO/HDL-C ratios in all patients and MPO < 200 ng/ml, MPO 200-300 ng/ml. The patients with MPO > 300 ng/ml showed a positive correlation between the concentration of MPO and the level of hsCRP and IL-6, and a negative correlation between MPO/apoAI ratio and the concentration of HDL-C, apoAI and apoAII. CONCLUSION: The results suggest that moderate dyslipidemia and dyslipoproteinemia deepening of inflammation, and inflammation slowly induce increase MPO concentration which decrease apoAI and HDL-C level and disturb HDLs function. The increasing MPO level and MPO/HDL-C, MPO/apoAI ratios can differentiate the SCAD patients at the risk of acute coronary syndrome (ACAD) and stroke.

γ-amino butyric acid (GABA) level as an overall survival risk factor in breast cancer.

INTRODUCTION: The γ-amino butyric acid (GABA) plays important role in the proliferation and migration of cancer cells. The aim of the study was to evaluate the level of GABA in breast cancer, in relation to clinical and epidemiological data. MATERIAL AND METHODS: The study was conducted on 89 patients with breast cancer in stage I-II. GABA level was assessed using spectrofluorometric method in tumour homogenates. Immunoexpression of E-cadherin was evaluated histologically on paraffin fixed specimens. Overall and disease-free survival was assessed for a 15-year interval period. RESULTS: Median overall survival was significantly longer (127.2 months) in patients with a high level of GABA (>89.3 µg/1), compared with a group with a low level of the amino acid (106.4 months). Disease-free survival was insignificantly different - 99 and 109 months, respectively. A significantly longer overall survival (131.2 months) was seen among patients with a high level of GABA and positive E-cadherin immunoexpression, compared with a group characterized by a low level of GABA and lack of E-cadherin immunorectivity (98.1 months). The co-existence of negative immunoexpression of E-cadherin and low GABA concentration resulted in a six-fold increase in the risk of death (HR=6.03). CONCLUSIONS: GABA has a significant prognostic value in breast cancer. Co-existence of a low level of GABA and loss of E-cadherin immune-expression seems to be a new, independent, and negative prognostic marker of the neoplasm.

Levels of renalase and advanced oxidation protein products with regard to catecholamines in haemodialysed patients.

INTRODUCTION: The main mediators of the sympathetic nervous system in the effectors part are catecholamines (CA). An increased sympathetic nerve activity observed in chronic kidney disease (CKD), is due to a raised level of CA in plasma. Renalase is a protein secreted by the kidneys, composed of 342 amino acids, which is able to metabolize the circulating CA and possibly play an important role in the regulation of sympathetic tone and blood pressure. Also, oxidative stress, defined as a disruption of the equilibrium between the generation of oxidants, is a crucial factor in the development of the inflammatory syndrome associated with CKD. The advanced oxidation protein products (AOPP) represent exquisite markers of phagocyte-derived oxidative stress. OBJECTIVE: The aim of the study was to investigate the concentration of renalase and explore the associations between AOPP with regards to CA in haemodialysis (HD) patients. MATERIAL AND METHODS: The study was conducted among 50 residents of the municipality and neighbouring villages in the province of Lublin, central-eastern Poland. RESULTS: In the studied patients, it was found that an average concentration of renalase was 44.8 ± 6.5 µg/mL, whereas of AOPP plasma levels - 57.5 ± 21.5 µmol/L. The results demonstrated the correlation between levels of renalase and AOPP in the HD patients. Indeed, elevated levels of renalase and AOPP in HD may be due to the presence of uremic toxins in blood. The concentration of urea affects the plasma concentrations of AOPP and renalase causing a direct relationship between renalase and AOPP. However, there is no clear relationship between renalase and circulating catecholamines in HD patients.

Relationship between microRNA-146a expression and plasma renalase levels in hemodialyzed patients.

BACKGROUND: microRNA (miRNA) belongs to the non-coding RNAs family responsible for the regulation of gene expression. Renalase is a protein composed of 342 amino acids, secreted by the kidneys and possibly plays an important role in the regulation of sympathetic tone and blood pressure. The aim of the present study was to investigate plasma renalase concentration, and explore the relationship between miRNA-146a-5p expression and plasma renalase levels in hemodialyzed patients. METHODS: The study population comprised 55 subjects who succumbed to various cardiac events, 27 women and 28 men, aged 65-70 years. The total RNA including miRNA fraction was isolated using QiagenmiRNEasy Serum/Plasma kit according to the manufacturer's protocol. The isolated miRNAs were analyzed using a quantitative polymerase chain reaction (qRT-PCR) technique. The plasma renalase levels were measured using a commercial ELISA kit. RESULTS: In the group of patients with high levels of renalase, higher miRNA-146a expression was found, compared with those with low concentration of renalase. Patients with simultaneous low miRNA-146a expression and high level of renalase were confirmed to deliver a significantly longer survival time compared with other patients. CONCLUSIONS: miRNA-146a and plasma renalase levels were estimated as independent prognostic factors of hemodialyzed patients' survival time. Patients with low miRNA-146a expression demonstrated a significantly longer survival time in contrast to the patients with a high expression level of miRNA-146a. Moreover, a significantly longer survival time was found in patients with high renalase activity compared with patients with low activity of the enzyme.

Fibroblast growth factor 21 - a key player in cardiovascular disorders?

Fibroblast growth factor 21 (FGF21) is a newly discovered adipokine, synthesized by several organs, mostly by the liver, which was introduced as a potent metabolic regulator and insulin-sensitizing factor. Numerous animal studies have demonstrated that FGF21 improves glucose and lipids metabolism and exerts anti-inflammatory effects. However, data obtained from human studies have shown contradictory results, in which circulating FGF21 levels were often elevated in obesity, dyslipidemia, type 2 diabetes (DM2) and other conditions connected with insulin resistance. This increase in basal FGF21 concentrations observed in patients with obesity and other conditions related to insulin resistance was being explained as a compensatory response to the underlying metabolic disturbances or tissue resistance to FGF21 action. Furthermore, the results of clinical trials have shown that increased FGF21 concentrations were associated with increased cardiovascular (CV) risk and had a prognostic value in CV outcomes. In recent years, it has been reported that FGF21 may exert cardioprotective effects. This mini-review aims to summarize the current state of knowledge about the role of FGF21 in CV disorders, and discuss the molecular mechanism underlying the anti-atherogenic properties of this compound.

Role of circulating microRNA in hemodialyzed patients.

MicroRNA (miRNA) belongs to the family of non-coding RNAs, which posttranscriptionally regulate gene function. Moreover, accumulating evidence points to an essential role of miRNAs in development and monitoring of kidney disease, though the role of particular miRNAs in patients undergoing hemodialysis is still unclear. This might have consequences. It is possible that measuring a single miRNA in hemodialyzed patients may not provide adequate information about development of many pathological processes. The goal of this review is to highlight the current knowledge in the field of miRNAs, with a special emphasis on their circulation in hemodialyzed patients.

Plasma and erythrocyte relationship of catecholamines in hemodialysis patients.

The function of the autonomic nervous system is based on reciprocal interaction between the sympathetic and parasympathetic parts, most frequently in the form of antagonistic action on target organs. The main mediators of the sympathetic nervous system in the effectors part are catecholamines (CA), which are involved in various physiological processes. Moreover, CA also has a profound effect on the kidneys, being factors that impact on renal haemodynamics, and have been reported to be altered in pathological disorders, e.g. extracellular volume expression, hypertension and cardiovascular complications. The increased sympathetic nerve activity, at least in part, can explain the raised in plasma CA observed in chronic kidney diseases. Furthermore, plasma CA levels in ureamic patients cannot be considered a reliable index of sympathetic activity, due to existence of many factors which may affect their values. In addition, CA released into the circulation, as one of many substances, may penetrate across the cellular membranes of erytrocytes (RBC). Taking these observations together, the aim of the presented study was to investigate for the first time the plasma and erythrocyte relationship of catecholamines in haemodialysis. The studies were performed among 37 haemodialysed patients who were inhabitants of the Lublin commune. Plasma and intracellular concentration of CA were measured prior to and following haemodialysis by high performance liquid chromatography with electrochemical detection. The results suggest that RBC are able to accumulate CA at the stage of terminal renal failure; in addition, the levels of adrenaline and dopamine in RBC depend on the accumulation of urea in plasma. It was also found that the dynamic changes in concentration of RBC adrenaline are an independent predictor of mortality in haemodialysis patients.

Relationship between renalase and N-terminal pro-B-type natriuretic peptide (NT pro-BNP) in haemodialysis patients.

INTRODUCTION: Our knowledge in the field of cause of deaths in dialysis patients is rapidly expanding, yet we still do not fully understand how renalase regulates the processes of cardiovascular disease developing in end-stage renal disease. Increased sympathetic nerve activity observed in chronic kidney diseases due to raised catecholamines in plasma results from the absence of renalase. Renalase synthesized and secreted by the kidneys participate in the regulation of sympathetic tone and blood pressure. A family of natriuretic peptides has been identified - NT pro-BNP - which seems to be the best predictor of clinical outcome and marker of extracellular fluid overload, as well as predicting mortality, irrespective of renal function. OBJECTIVE: The aim of the presented study was to investigate renalase concentration and investigate associations between NT-proBNP, as well as analyzed parameters in haemodialysis patients. MATERIALS AND METHOD: The study was conducted among residents of the municipality and neighbouring villages in the province of Lublin, central-eastern Poland. 49 male subjects on haemodialysis, aged 65.3 ± 14.2 years, median time on haemodialysis: 37.5 months, were included. All study subjects underwent haemodialysis 3 times a week. The mean concentration of renalase in the entire study population was 126.59 ± 32.63 ng/mL. The circulating levels of NT-proBNP was 813.64 ± 706.96 pg/mL. A significant inverse correlation was found between NT-proBNP and renalase plasma levels (R = -0.3, P = 0.03). CONCLUSIONS: Inverse correlation between NT-proBNP and renalase plasma levels in haemodialysis patients were due to impaired kidney function, accompanied by increased sympathetic nerve activity, which have an impact on the development of hypertension and cardiovascular complications.

Polycystic ovary syndrome: clinical implication in perimenopause.

Polycystic ovary syndrome (PCOS), a hyperandrogenic disorder, is the commonest endocrinopathy in premenopausal women. This syndrome is associated with fertility problems, clinical manifestations of hyperandrogenism and metabolic disturbances, particularly insulin resistance and obesity. There is a great body of evidence that patients with PCOS present multiple cardiovascular risk factors and cluster components of metabolic syndrome from early ages. The presence of comorbidities such as abdominal obesity, insulin resistance, type 2 diabetes, hypertension places these females at an increased risk of future cardiovascular events. However, the extent to which PCOS components are present in perimenopausal women and the degree to which PCOS increases various risk factors in addition to the known risk of the perimenopausal period have not been fully determined. The perimenopausal period per se is associated with weight gain and an increased cardiovascular risk, which may be additionally aggravated by the presence of metabolic disturbances connected with PCOS. The phenotype of PCOS may improve with aging and it is still uncertain whether the presence of PCOS significantly increases the cardiovascular risk later in women's life. Most recent data suggest that the prevalence of cardiovascular diseases and the related long-term consequences in females with PCOS seem to be lower than expected. This manuscript reviews long-term consequences of PCOS and considers their clinical implications in perimenopause.

Association between lipids, lipoproteins composition of HDL particles and triglyceride-rich lipoproteins, and LCAT and CETP activity in post-renal transplant patients.

High-density lipoprotein (HDL) remodeling within the plasma compartment and the association between lecithin-cholesterol acyltransferase (LCAT) and cholesterol ester transfer protein (CETP) activity, and lipid, lipoprotein concentrations and composition were investigated. The aim was to examine the high sensitivity of C-reactive protein (hsCRP), lipid, apolipoprotein B (apoB), apoAI, total apoAII, apoAIInonB, apoB-containing apoAII (apoB:AII), total apoCIII, apoCIIInonB, apoB-containing apoCIII (apoB:CIII) concentration and LCAT and CETP activity to gain an insight into the association between them and LCAT and CETP, 57 post-renal transplant (Tx) patients with and without statin therapy and in 15 healthy subjects. Tx patients had moderate hypertriglyceridemia, hypercholesterolemia, and dyslipoproteinemia, disturbed triglyceride-rich lipoproteins (TRLs) and HDL composition, decreased LCAT, and slightly increased hsCRP but no CETP activity. Spearman's correlation test showed the association between lipids and lipoproteins and LCAT or CETP, and multiple ridge stepwise forward regression showed that immunosuppressive therapy in Tx patients can disturb HDL and TRLs composition. The results suggest that inhibition or activation of LCAT is due, in part, to HDL-associated lipoprotein. Lipoprotein composition of apoAI, apoAIInonB, and apoCIIInonB in HDL particle and apoB:AII TRLs can contribute to decrease LCAT mass in Tx patients. Tx patients without statin and with lower triglycerides but higher HDL cholesterol concentration and disturbed lipoprotein composition of ApoAI and apoAII in HDL particle can decrease LCAT, increase LDL cholesterol, aggravate renal graft, and accelerate atherosclerosis and chronic heart diseases.

Level of glycation gap in a healthy subject.

INTRODUCTION: The discordance between glycated hemoglobin (HbA(1C)) and fructosamine (FA) estimations in the assessment of glycemia is often encountered. A number of mechanisms might explain such discordance, but whether or not they are consistent is uncertain. Nevertheless, the fact that there is a discrepancy in HbA(1C) and mean blood glucose cannot be ignored in the monitoring of glycemic control. To address the discrepancy between HbA(1C) and mean blood glucose, Robert Cohen proposed the measurement of glycation gap (GG). Recently, the 'Glycation Gap' (GG) has been defined as the difference between the measured HbA(1C). GG has improved the quality of the monitoring of glycemic control, especially for those patients whose HbA(1C) levels do not truly reflect the mean blood glucose levels. OBJECTIVE: The aims of the statistical analyses were to estimate GG values in a healthy subject. The research was conducted among the inhabitants of the Zwierzyniec commune and nearby villages. MATERIAL AND METHODS: The study population consisted of 93 subjects: 63 women and 30 men, between the ages of 18-79. Measurements of HbA(1C) and FA in the 93 people were used to calculate GG, defined as the difference between measured HbA(1C) and HbA(1C) predicted from FA, based on the population regression of HbA(1C) on FA. CONCLUSIONS: In considering the values GG in the study group, particular significance should be attributed to a progressive increase of GG with advancing age. Elderly people who are at risk of developing diabetes, or who have already developed the disease, may not exhibit the classic symptoms expected. Age-related changes can mean that some symptoms will be masked, or more dificult to spot. It is worth pointing out that HbA(1C) together with GG must be taken into account in the correct interpretation of the glycation processes.

Association between moderately oxidized low-density lipoprotein and high-density lipoprotein particle subclass distribution in hemodialyzed and post-renal transplant patients.

Disturbances in the metabolism of lipoprotein profiles and oxidative stress in hemodialyzed (HD) and post-renal transplant (Tx) patients are proatherogenic, but elevated concentrations of plasma high-density lipoprotein (HDL) reduce the risk of cardiovascular disease. We investigated the concentrations of lipid, lipoprotein, HDL particle, oxidized low-density lipoprotein (ox-LDL) and anti-ox-LDL, and paraoxonase-1 (PON-1) activity in HD (n=33) and Tx (n=71) patients who were non-smokers without active inflammatory disease, liver disease, diabetes, or malignancy. HD patients had moderate hypertriglyceridemia, normocholesterolemia, low HDL-C, apolipoprotein A-I (apoA-I) and HDL particle concentrations as well as PON-1 activity, and increased ox-LDL and anti-ox-LDL levels. Tx patients had hypertriglyceridemia, hypercholesterolemia, moderately decreased HDL-C and HDL particle concentrations and PON-1 activity, and moderately increased ox-LDL and anti-ox-LDL levels as compared to the reference, but ox-LDL and anti-ox-LDL levels and PON-1 activity were more disturbed in HD patients. However, in both patient groups, lipid and lipoprotein ratios (total cholesterol (TC)/HDL-C, LDL-C/HDL-C, triglyceride (TG)/HDL-C, HDL-C/non-HDL-C, apoA-I/apoB, HDL-C/apoA-I, TG/HDL) were atherogenic. The Spearman's rank coefficient test showed that the concentration of ox-LDL correlated positively with HDL particle level (R=0.363, P=0.004), and negatively with TC (R=-0.306, P=0.012), LDL-C (R=-0.283, P=0.020), and non-HDL-C (R=-0.263, P=0.030) levels in Tx patients. Multiple stepwise forward regression analysis in Tx patients demonstrated that ox-LDL concentration, as an independent variable, was associated significantly positively with HDL particle level. The results indicated that ox-LDL and decreased PON-1 activity in Tx patients may give rise to more mildly-oxidized HDLs, which are less stable, easily undergo metabolic remodeling, generate a greater number of smaller pre-ß-HDL particles, and thus accelerate reverse cholesterol transport, which may be beneficial for Tx patients. Further studies are necessary to confirm this.

[Evaluation of metabolic control in patients with type 2 diabetes]. / Ocena wyrównania metabolicznego u chorych na cukrzyce typu 2.

INTRODUCTION: The most objective way of evaluating metabolic control in diabetic patients is using reliable laboratory tests. The laboratory examinations show the effectiveness of the management and compliance. The aim of the study was to observe metabolic control in patients with type 2 diabetes mellitus with the use of routinely available laboratory tests. MATERIAL AND METHODS: The laboratory study was performed on 50 patients with type 2 diabetes mellitus supervised by a diabetologist in a Specialistic Diabetic Outpatient Clinic. Biochemical parameters such as fasting glucose, random glucose, HbA(1c), lipids, creatinine, albuminuria were checked twice with average intervals between the examinations of 14 months. RESULTS: The results of the two examinations showed elevated average levels of fasting glucose, random glucose and HbA(1c). The values of lipid profile and albuminuria exceeded the Polish Diabetes Association targets. Only the average HDL-C concentration reached the target in both examinations. Among the examined patients only 14% achieved the targets for all the parameters while 4% showed no equalization of the parameters. Good glycemic control with HbA(1c) < 6.5% was obtained in 36% of the patients. Accepted glycemic control with HbA(1c) between 6.5% and 8% was observed in 38% of the patients. Poor glycemic control with HbA(1c) > 8% concerned 26% of the patients. Diabetic nephropathy was diagnosed in 24% of the patients. CONCLUSIONS: The results of the study have proved that diabetes mellitus management is not effective and does not achieve the PDA targets. Consequently, it does not lead to good metabolic control and contributes to complications.

Evaluation of concentrations of FGF-21 - a new adipocytokine in type 2 diabetes.

INTRODUCTION: Fibroblast growth factor 21 FGF-21 is a newly discovered adipocytokine which may play a vital role in improvement of insulin sensitivity and pathogenesis of type 2 diabetes. The aim of the study was to assess FGF-21 concentrations in the serum of patients with type 2 diabetes, in comparison to a control group, and evaluate the possible relationships between the studied cytokine and selected clinical and biochemical parameters MATERIAL AND METHODS: The study was conducted in 64 patients with type 2 diabetes, 28 women and 36 men aged 47-70 (median age 61.5), with a median duration of diabetes of 8.5 years. In fasting serum samples, concentrations of glucose, insulin, lipids profile parameters, creatinine, C-reactive protein (CRP), fibrinogen, HbA(1c), adiponectin, and FGF-21 were determined. The control group comprised 20 healthy persons matched for age to the study group, with no disturbances in carbohydrate metabolism: 14 women and 8 men. RESULTS: We found significant differences concerning the medians of body mass index (BMI) 32.4 kg/m(2) v. 24.1 kg/m(2), p < 0.001; waist circumference 114 cm v. 81 cm, p < 0.001; HDL cholesterol 42.5 mg/dl v. 62.5 mg/dl, p < 0.001; triglyceride (TG) 152 mg/dl v. 99 mg/dl, p < 0.01 in the studied group, in comparison with the control group, respectively. In patients with diabetes, median FGF-21 concentration was 239.9 pg/ml and was significantly greater in comparison to the control group: 112.6 pg/ml p < 0.01. Median adiponectin concentration in patients with type 2 diabetes was significantly lower in comparison to the control group, 7.5 ng/ml v. 9.95 ng/ml, p < 0.05. Significant correlations between FGF-21 concentrations and adiponectin (r = -0.24, p < 0.05), weight (r = 0.27, p < 0.05), glucose (r = 0.27, p < 0.05), HDL cholesterol (r = -0.26, p < 0.05), TG (r = 0.27, p < 005), and estimated glomerular filtration rate (eGFR) (r = -0.28, p < 0.05) were observed. No significant correlations between FGF-21 and parameters of metabolic control, markers of inflammatory status, and insulin resistance, or the presence of vascular complications of diabetes, were noticed. CONCLUSIONS: On the basis of the conducted studies it can be concluded that the greater FGF-21 concentration observed in the examined group of patients with type 2 diabetes may result from a compensatory reaction to metabolic disturbances or tissue resistance to this cytokine. The negative correlation between FGF-21 and eGFR suggests renal elimination of the examined compound. (Pol J Endocrinol 2010; 61 (1): 50-54).

Sialic acid content in erythrocyte membranes of patients on chronic hemodialysis.

INTRODUCTION: Sialic acids (SA) located in erythrocyte membranes (EM) play an important role in the survival of circulating red blood cells. OBJECTIVES: The aim of the present study was to evaluate the SA content in EM obtained from patients on chronic hemodialysis (HD) and to examine the relationships between SA and hematological parameters. Moreover, the effects of HD, treatment with human recombinant erythropoetin (epoetin), and some biochemical and hematological parameters were analyzed. PATIENTS AND METHODS: The total protein (TP) and total sialic acids (TSA), together with SA bound with proteins (PBSA) and lipids (LBSA), were determined in EM of 72 HD patients and compared with the control group of healthy individuals (CG; n=25). The adequacy of HD, weekly epoetin doses, mean arterial pressure (MAP), comorbidity score, serum levels of albumin, intact parathyroid hormone (iPTH), low-density lipoprotein cholesterol (LDL-cholesterol) were estimated in patients. RESULTS: Compared to the CG, HD patients had higher levels of TSA (p < 0.001), PBSA (p < 0.001), LBSA (p <0.001) and decreased TP levels (p < 0.001). The TP (p < 0.045) and PBSA (p < 0.05) levels were higher in patients with diabetic nephropathy than in non-diabetic HD patients. In HD patients there were correlations between TSA, PBSA in EM and some hematologial parameters. There were no relationships between the TSA, PB content in EM and variables such as HD, epoetin treatment, MAP comorbidity score, albumin, iPTH, and LDL-cholesterol. CONCLUSIONS: The results of the current study demonstrated there are significantly higher levels of TSA, PBSA, LBSA and lower TP levels in EM obtained from HD patients compared to healthy subjects. Comorbidity score, epoetin and HD treatment, MAP, iPTH, albumin and LDL cholesterol had no influence on SA levels in EM of patients.

Disturbed lipids, lipoproteins and triglyceride-rich lipoproteins as well as fasting and nonfasting non-high-density lipoprotein cholesterol in post-renal transplant patients.

Serum levels of lipids and lipoproteins were determined in 98 post-renal transplant fasting patients, and lipids and non-high density lipoprotein-cholesterol (non-HDL-C) and lipid ratios in the same post-renal transplant non-fasting patients were compared. The reference group was 87 healthy subjects. All patients were divided into two groups: patients with dyslipidemia (n = 69) and patients with normolipidemic (n = 29). The post-renal transplant patients (TX) with dyslipidemia had a significantly increased concentration of triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), non-HDL-C, apoB, and TRL and lipid ratios, and decreased HDL-C level and lipoprotein ratios. The lipids, lipoproteins, and lipoprotein ratios were significantly beneficial in TX patients with normolipidemic than in those with dyslipidemia. However, TRL concentration and lipid ratios were significantly increased and apoAI/apoCIII significantly decreased as compared to the reference group. The TX patients with dyslipidemia showed a significant correlation between TG and apoB:CIII (r = 0.562, p < 0.001) and apoCIII (r = 0.380, p < 0.004), but those with normolipidemic showed a significant correlation only between TG and apoCIII (r = 0.564, p < 0.008). Regression and Bland-Altman analyses showed excellent correlation between fasting and nonfasting non-HDL-C levels (r = 0.987, R(2) + 0.987) in TX patients both with dyslipidemia and normolipidemic. We think the finding that nonfasting labs that are reliable for non-HDL-C as well as total cholesterol is important, as fasting labs are not always available. Disturbances of lipids, lipoproteins, and TRLs depend not only on the kind of treatment, but due to multiple factors can accelerate cardiovascular complications in post-renal transplant patients with dyslipidemia and also with normolipidemic. Further studies concerning this problem should be completed.

[Analysis of some risk factors of coronary artery calcification in peritoneal dialysis patients]. / Badanie niektórych czynników ryzyka kalcyfikacji naczyn wiencowych u pacjentów leczonych dializa otrzewnowa.

Cardiovascular disease (CVD) is a major cause of death in peritoneal dialysed patients (PD-pts). Coronary artery calcification (CAC) is likely to affect the development of CVD. Purpose of our study was to evaluate coronary artery calcification and risk factors of this calcification in PD-pts. We studied 62 patients (38 F, 24 M) undergoing peritoneal dialysis (PD). Coronary calcification was examined by ECG-gated multidetector CT (Light Speed Ultra) using Agatson (AG) and volumetric (V) methods. Patients were divided into 3 groups depending on mean value of estimated CAC: group A-no calcification, group B-CAC maximal value 400 mm3, group C-CAC value more than 400 mm3. As risk factors of CAC were evaluated: patients age, sex, dialysis duration, serum concentration of Ca, P, homocysteine CRP and fibrinogen, as well as, CaxP product, intact PTH; presence of diabetes or hypertension. Coronary artery calcification was detected in 68% of patients. In the whole observed population positive correlation between CAC determined by AG and V methods and CRP (r = 0.36, p < 0.05) as well as patients age (r = 0.5, p < 0.01) was observed. There was also positive correlation between CAC and fibrinogen concentration (AG CAC r = 0.58, p < 0.05; V CAC r = 0.72, p < 0.05). When compared group C with the groups A and B cardiovascular complications were in this group more frequent than in the last two: 4 patients from group C died because of cardiovascular complications.