Assessment of osteoprotegerin and RANKL levels and several cardiovascular risk scoring systems in acromegaly.

PURPOSE: The OPG/RANKL (osteoprotegerin/receptor activator of nuclear factor kappa-B) system, which plays a crucial role in bone metabolism, is also associated with vascular calcification. Acromegaly is characterized by excessive secretion of growth hormone and insulin-like growth factor, and studies have demonstrated an elevated risk of cardiovascular disease in individuals with acromegaly. In this study, our objective was to investigate the relationship between OPG/RANKL and various cardiovascular risk scoring systems. METHODS: We recruited 44 consecutive acromegaly patients and 41 healthy controls with a similar age and gender distribution for this study. RESULTS: While RANKL levels were significantly higher in the acromegaly group compared to the controls, OPG levels were not found to be significantly different between the two groups. Furthermore, within the acromegaly group, RANKL levels were significantly higher in patients with active acromegaly compared to those with controlled acromegaly. Osteoprotegerin levels showed a positive correlation with the Framingham risk score (FRS) in the acromegaly group. Linear regression analysis revealed an association of OPG with FRS (adjusted R2 value of 21.7%). CONCLUSION: OPG and RANKL may serve as potential markers for assessment of cardiovascular calcification and prediction of the cardiovascular risk status in acromegalic patients.

Stability of potassium, calcium and phosphorus electrolytes in three different tubes in patients with essential thrombocytosis.

Proper blood collection and timely analysis are vital steps for reliable results. This study aims to compare potassium(K), calcium(Ca), and phosphorus(P) concentrations in serum separator tube (SST), lithium heparin tube without gel (LiH), and lithium heparin tube with a barrier (Barricor)tubes in essential thrombocytosis(ET) patients. Additionally, we assessed short-term stability of these analytes at room temperature. K, Ca and P concentrations of blood taken from 40 ET patients into SST, LiH and Barricor tubes were measured at 0, 2, 4 and 8 h. We calculated the percentage difference and defined the maximum permissible difference (MPD) using the Biological Variation Database. Intertube comparisons were conducted using Passing-Bablok regression and Bland-Altman analysis. Comparing SST to LiH, the percentage difference values for all tests exceeded the MPD. When comparing Barricor to LiH, K and Ca tests were above MPD, except for P. At the 8th hour, LiH showed clinically significant changes in all three electrolytes. Barricor exhibited stability for K, Ca, and P for up to 8 h, with only Ca levels borderline higher than the MPD. Our study reveals clinically significant alterations in K, Ca, and P concentrations in SST compared to LiH tubes, and in K and Ca concentrations in Barricor compared to LiH tubes. While K, Ca and P concentrations were stable for up to 4 h at room temperature in all tube types tested, significant changes were observed in all electrolytes at 8 h in the LiH tube.

The relationship between elevated serum xenin and insulin resistance in women with polycystic ovary syndrome: a case-control study.

This study aims to determine whether serum xenin-25 levels are altered in women with polycystic ovary syndrome (PCOS). The study included 31 women diagnosed with PCOS according to the 2003 Rotterdam criteria and 30 healthy controls. The primary outcome was serum xenin-25 levels. Other variables evaluated were menstrual history, physical findings, Ferriman-Gallwey hirsutism score, blood pressure, transvaginal ultrasonography, fasting blood glucose, insulin, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, C-reactive protein, follicle stimulating hormone, luteinizing hormone, estradiol, total testosterone, dehydroepiandrosterone sulfate, and day-21 progesterone. Median (min-max) values of xenin-25 were 45.50 pg/mL (7.10-656.40) and 9.85 pg/mL (7.00-564.40) for cases and controls, respectively, demonstrating a significant difference (Z = 2.803, p = .007). The ROC curve for xenin-25 predicting the PCOS risk had an area under the curve of 0.747. The optimal cutoff value of xenin-25 for detecting PCOS was calculated as ≥32.60 pg/mL with sensitivity, specificity values of 61.3% and 86.7%, respectively. A logistic regression model including xenin-25, FSH, Ferriman-Gallwey score, and Menstrual cycle frequency demonstrated the independent relationship of xenin-25 on PCOS (p < .05). This study demonstrated that xenin-25 may contribute to the diagnosis of PCOS. Further studies are needed to fully elucidate the effects of xenin-25 in the pathogenesis of PCOS.

Asprosin: a novel peptide hormone related to insulin resistance in women with polycystic ovary syndrome.

Asprosin associated with insulin resistance is a newly discovered peptide hormone. The peptide promotes hepatic glucose production. Polycystic ovary syndrome (PCOS) is a metabolic disorder. Insulin resistance plays a vital role in the pathogenesis of the disease. The aim of this study was to discover the association between insulin resistance and asprosin in women with PCOS. We recruited 78 subjects with PCOS and 78 age-matched and body mass index (BMI)-matched controls into this cross-sectional study. Circulating asprosin levels were validated using ELISA method. We also determined metabolic and hormonal parameters of the involved subjects. We found that circulating asprosin levels were elevated in women with PCOS with respect to controls. Asprosin levels showed a positive correlation with insulin resistance, BMI, and free androgen index (FAI). Moreover, subjects with the highest tertile of asprosin levels represented increased odds of having PCOS as compared to those subjects with the lowest tertile asprosin levels. Increased asprosin levels resulted to high possibility of having PCOS risk associated with insulin resistance.

The low levels of bone morphogenic protein-4 and its antagonist noggin in type 2 diabetes.

OBJECTIVE: Bone morphogenic protein-4 (BMP-4) is a proinflammatory cytokine which is controlled by BMP-4 antagonists. Our aim was to investigate the levels of BMP-4 and its antagonists, noggin and matrix Gla protein (MGP), in prediabetes and diabetes. DESIGN: One hundred and forty-two type 2 diabetic, 32 prediabetic, and 58 control subjects participated in this cross-sectional study. BMP-4, noggin, and MGP were measured with the ELISA method. RESULTS: There was a significant difference between the three groups in relation to sex, hypertension, fasting plasma glucose, HbA1c, lipid profiles, and diastolic blood pressure (p < 0.05). BMP-4 levels were significantly lower in the diabetic group compared to the control group (108.5 and 127.5 ng/mL, respectively, p < 0.001 diabetes vs. control). Noggin levels were significantly lower in the diabetic group compared to the prediabetic and control groups (10.5, 11.5, and 12.0 ng/mL, as median, respectively, p < 0.001; diabetes vs. control, p = 0.002; diabetes vs. prediabetes). BMP-4 was associated significantly with noggin in the entire study population (ß coefficient = 0.796, p < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve was 0.708 (95% CI 0.551-0.864, p = 0.011) for BMP-4 levels. The optimal cutoff value of BMP-4 for detecting albuminuria was 118.5 ng/mL for which sensitivity was 71.4% and specificity was 66.4%. CONCLUSIONS: BMP-4 and noggin levels were lower in the diabetic group. High BMP-4 levels were significantly associated with albuminuria. Further studies are warranted to determine the role of BMP-4 in the pathogenic processes underlying albuminuria and hyperglycemia in patients with type 2 diabetes.

Matrix metalloproteinase-9, 10, and stress hyperglycaemia in acute kidney injury.

BACKGROUND: This study investigated the effect of matrix metalloproteinase (MMP)-9 and 10, and stress hyperglycaemia on the necessity of emergency renal replacement therapy (RRT) and mortality in nondiabetic geriatric patients with acute kidney injury (AKI). MATERIALS AND METHODS: The present observational and longitudinal study included 101 nondiabetic geriatric patients (age >65 years) with AKI. The serum levels of MMP-9 and MMP-10 were evaluated in these patients. Serum glucose level >140 mg/dL at the time of admission was accepted as stress hyperglycaemia. RESULTS: The average age of patients was 81 ± 7.1 years. Stress hyperglycaemia was diagnosed in 34.6% of the cases; the majority of these cases were patients with high-serum urea, CRP, and chronic kidney disease. The average levels of MMP-9 and MMP-10 were found to be 199 ± 38 and 16.5 ± 7.5 ng/mL, respectively. Thirty-one cases (30.6%) mortality during hospitalization and 20 cases (20%) underwent emergency RRT. Multiregression analysis showed the serum urea (P < .001) and stress hyperglycaemia (P = .03) to be independently associated with mortality. Also, serum urea (P = .01), potassium level (P = .03), and MMP-10 levels (P = .03) were independently associated with the necessity of the emergency RRT. The MMP-9 levels exhibited no relation with the necessity of emergency RRT and mortality. CONCLUSION: Stress hyperglycaemia is a common condition among nondiabetic geriatric patients with AKI and is related to mortality. Serum MMP-10 levels serve as an important predictor of the necessity of emergency RRT in these patients.

Relationship Between Serum Macrophage Migration Inhibitory Factor Level and Insulin Resistance, High-Sensitivity C-Reactive Protein and Visceral Fat Mass in Prediabetes.

BACKGROUND: Growing evidence suggest that macrophage migration inhibitory factor (MIF) plays a vital role in glucose metabolism. We aimed to ascertain whether MIF levels are altered in subjects with prediabetes and also to determine the relationship between MIF and metabolic parameters as well as visceral fat mass. MATERIAL AND METHODS: This cross-sectional study included 40 subjects with prediabetes and 40 age-, body mass index (BMI)- and sex-matched subjects with normal glucose tolerance. Circulating MIF levels were measured using enzyme-linked immunosorbent assay. Metabolic parameters of recruited subjects were evaluated. Visceral fat mass was measured using bioelectrical impedance method. RESULTS: Circulating MIF levels were found to be elevated in subjects with prediabetes compared to controls (26.46 ± 16.98 versus 17.44 ± 11.80 ng/mL, P = 0.007). MIF positively correlated with BMI, visceral fat mass and indirect indices of homeostasis model assessment of insulin resistance. In linear regression model, an independent association was found between MIF levels and metabolic parameters, including BMI, visceral fat mass and homeostasis model assessment of insulin resistance. Multivariate logistic regression analyses revealed that the odds ratio for prediabetes was higher in subjects in the highest quartile of MIF compared to those in the lowest quartile, after adjusting for potential confounders. CONCLUSIONS: Increased MIF levels are associated with the elevation of prediabetic risk.

Increased serum neuregulin 4 levels in women with polycystic ovary syndrome: A case-control study.

Neuregulin 4 (NRG4) is an adipokine that is synthesized in many tissues and has been shown to be associated with the development of obesity and metabolic disorders in animals and humans. The aim of this study is to investigate the relationship between serum NRG4 levels and various metabolic parameters in women with PCOS. This cross-sectional study included 40 women with PCOS and 40 age- and BMI-matched controls without PCOS. NRG4, fasting blood glucose (FBG), insulin, hs-CRP, LDL-C, HDL-C, SHBG, DHEA-SO4 and total-testosterone levels were measured in all the participants. HOMA-IR was used to calculate the insulin resistance. Serum NRG4 levels were higher in women with PCOS than in healthy women (24.89 ± 9.32 [ng/mL] vs. 18.98 ± 6.40 [ng/mL], p = 0.002). FBG, LDL-C, HDL-C, LH, SHBG, FAI, DHEA-SO4, insulin, hs-CRP, HOMA-IR and total-testosterone levels were significantly higher in women with PCOS than controls. Circulating NRG4 levels were positively correlated with HOMA-IR, insulin and hs-CRP for both groups. There was a positive correlation between NRG4 and FBG in the PCOS group. HOMA-IR and hs-CRP were associated with NRG4. The high concentration of circulating NRG4 in PCOS may be associated with insulin resistance and low-grade chronic inflammation.