The relationship between serum leptin, insulin-like growth factor-1, and insulin-like growth factor binding protein-3 levels and clinical parameters in primary fibromyalgia patients.

OBJECTIVE: The aim of this study was to investigate the levels of leptin, growth hormone, insulin-like growth factor-1, and insulin-like growth factor binding protein-3 and their relations with clinical parameters in patients with primary fibromyalgia and healthy controls. METHODS: Our study was performed on 30 female patients with primary fibromyalgia and 30 healthy controls. The levels of insulin-like growth factor-1 and insulin-like growth factor binding protein-3 were measured by a two-site immunoradiometric assay. The serum level of leptin was measured by the ELISA kit. RESULTS: The serum level of leptin was significantly higher, but the serum levels of insulin-like growth factor-1 were significantly lower in patients with fibromyalgia syndrome than healthy controls (p<0.001). The leptin level was positively correlated with the Visual Analog Scale, Fibromyalgia Impact Questionnaire score, Beck Depression Inventory score, tender point count, age, and duration of disease (p<0.001), but it was negatively correlated with insulin-like growth factor-1 (p<0.001). The insulin-like growth factor-1 level was negatively correlated with age, Visual Analog Scale, Fibromyalgia Impact Questionnaire and Beck Depression Inventory scores, duration of disease, and tender point count (p<0.001). CONCLUSION: Our results indicate that high levels of serum leptin and low levels of serum insulin-like growth factor-1 may play a role in the physiopathogenesis of fibromyalgia and may be related to some symptoms.

Serum paraoxonase activities, nitric oxide, and malondialdehyde levels are altered in patients with primary fibromyalgia syndrome.

BACKGROUND: Fibromyalgia patients who are exposed to extreme oxidative stress may face more severe clinical features or oxidative stress may be increased by the severity of the disease. AIM: The purpose of these investigation were to determine serum paraoxonase activities (PON-1) and nitric oxide (NO) activities and malondialdehyde (MDA) level in fibromyalgia and whether there were any associations between these enzymes activities, MDA level, and clinical parameters. METHODS: The study groups were consisted of 30 primer fibromyalgia patients and 30 healthy subjects. Clinical findings, pain severity, functional disability, general health status, anxiety, and depression assessed, and serum PON-1 activity, MDA, and NO levels were measured. RESULTS: The primer fibromyalgia group had significantly higher MDA, low density lipoprotein-cholesterol (LDL-C), and decreased PON-1 activity, NO, and high density lipoprotein-cholesterol (HDL-C) with respect to controls. The paraoxonase activity was negatively correlated with MDA, LDL-C, Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire score (FIQ score), tender point score, age, and BDI score, while positively correlated with NO and HDL-C. MDA level was positively correlated with VAS, FIQ score, tender point score, age, and negatively correlated with NO level. CONCLUSION: These results suggest that FMS patients have an alteration in levels of MDA, NO, and PON-1 activities. We think that impaired oxidant/antioxidant status may affect the symptoms of the disease. Also, they may be of importance in the complex physiopathologic mechanism behind the development of FMS.

Maternal neuropeptide galanin levels in pregnancies with intra-uterine growth restriction (IUGR): neurohormonal regulation of fetal weight.

AIM: Galanin is a neuroendocrine peptide with diverse biological actions in humans. Here, we evaluated plasma galanin levels in pregnant women with intrauterine growth restriction (IUGR) to elucidate the mechanism underlying the causal link between regulatory neuropeptides and IUGR. MATERIAL AND METHODS: This prospective case-control study evaluated 40 IUGR pregnancies and 35 healthy body mass index (BMI) and age-matched second and third-trimester pregnant women at Istanbul Teaching and Research Hospital. Serums galanin levels were determined using an enzyme-linked immunosorbent assay (ELISA) kit according to the manufacturer's procedure. RESULTS: Median serum galanin levels were lower in the IUGR group (9.59 pg/ml) than in the control group (12.1 pg/ml), although statically insignificant. Galanin levels were significantly higher in the control group with a BMI ≥ 30 than in those with a BMI < 30; the IUGR group exhibited no significant difference. Galanin levels were higher in the control group premature births than in term pregnancies; the difference was insignificant in the IUGR group. Thus, IUGR minimally impacts circulating maternal galanin levels, indicating that while galanin might affect IUGR pathogenesis, it negligibly contributes to disease progression. CONCLUSION: The lack of correlation between galanin levels and maternal BMI and preterm pregnancies suggests a blunted neuropeptide response to hormonal stimulus in IUGR pregnancies, compared with the positive association with maternal BMI and negative association with healthy preterm pregnancies.

Kisspeptin: a potential therapeutic target in patients with unexplained infertility?

BACKGROUND: Kisspeptin has recently emerged as a key regulator of the reproductive axis in women. Kisspeptin, acting centrally via the kisspeptin receptor, stimulates the secretion of the gonadotrophin-releasing hormone (GnRH). AIMS: To investigate serum kisspeptin levels in infertility patients for its clinical utilisation in management and understanding of the pathophysiology of infertility in a wide array of patients. METHODS: This prospective case-control study analysis involved 92 primary infertile women with PCOS, diminished ovarian reserve (DOR), unexplained infertility (UEI), and male factor infertility between 20 and 42 years of age. Serum samples were collected between the second and fifth day of the menstrual cycle. The kisspeptin level was determined using a human kisspeptin ELISA kit according to the manufacturer's procedure. RESULTS: The median value of serum kisspeptin in the PCOS infertility group was significantly higher than that in the UEI group (p = 0.011). There was a statistically significant (p = 0.015, r = -0.182) negative weak correlation found between serum kisspeptin levels and age. The optimal cutoff value obtained to differentiate the UEI from others (PCOS infertility + DOR + male factor infertility) according to the serum kisspeptin level was 214.3 ng/L with a sensitivity of 55% and specificity of 80.9%. CONCLUSIONS: Understanding the role of kisspeptin may lead to its use as a biomarker in infertility diagnosis in UEI patients and might guide the use of kisspeptin analogues in selected patients for infertility management.

Maternal Serum Levels of Zinc, Copper, and Thiols in Preeclampsia Patients: a Case-Control Study.

Preeclampsia is one of the leading causes of maternal mortality-morbidity, and environmental factors act as the main driving force for the development of disease in genetically lean women. Trace element levels (zinc, copper) and thiol state (total, native thiol) may affect involved risk factors and play a role in the pathogenesis. The objective of our study is to assess trace element and thiol levels in patient and control groups. A total number of 88 pregnant women (in their third trimester) included 43 preeclampsia patients and 45 normotensive pregnant women as controls. The main findings of this study were the significantly elevated copper levels and decreased thiol levels (native and total thiols) in the patient group compared to controls (p < 0.05). Disulfide levels were not statistically different between the groups (p > 0.05). In patients, the predictive cutoff value of copper was 224 µg/dL and was 1.19 for the copper/native thiol ratio. Zinc levels were not statistically different between the two groups. Correlation analysis revealed no relationship between zinc-copper and zinc-total thiol levels in patients, while a positive correlation was evident in controls (zinc-copper, p < 0.05, r = 0.425, and zinc-total thiol levels, p < 0.05, r = 0.642). Patients had marginally high ALT and AST values in the normal range, and a significant difference was found between the two groups (p < 0.05). According to these results, elevated copper levels and decreased thiol levels may have a value for early prediction. The mechanisms that may be responsible for the altered element and thiol status have been discussed here in the context of oxidative stress.

ST2 and galectin-3 as novel biomarkers for the prediction of future cardiovascular disease risk in preeclampsia.

The aim of this study was to investigate known cardiovascular disease (CVD) risk biomarkers galectin-3 (Gal-3) and human stromelysin-2 (ST2) levels in preeclampsia (PE) and normotensive pregnancies. A case-control study was conducted in a teaching and research hospital. We performed data analysis involving 45 pregnant women with PE and gestational week (GW) matched 35 normotensive pregnant women. The Gal-3 and ST2 levels were determined by using ELISA kit. Gal-3 values did not differ statistically between PE and control groups (535.1 ng/mL vs. 615.2 ng/mL) (p> .05). ST2 value in the PE group was statistically significantly lower than the control group (33.3 pg/mL vs. PE, 54.5 pg/mL, p ˂ .05). >34 GW patients (late-onset PE) had statistically significantly lower Gal-3 values than the ≤34 GW patients (early-onset PE) (507.1 ng/mL vs. 769.6 ng/mL, p ˂ .05). Late-onset PE patients had significantly lower ST2 values than early-onset patients (26.4 pg/mL vs. 57.9 pg/mL, p ˂ .05). We assume that low Gal-3 values in early-onset PE show a higher risk of cardiac fibrosis although both early and late-onset PE patients had an increased CVD risk later in life. We found the superiority of ST2 levels to Gal-3 levels in PE pregnancies for CVD risk assessment.Impact StatementWhat is already known about this subject? Preeclampsia (PE) in pregnancy is a known risk factor for future cardiovascular disease (CVD) and is also associated with increased mortality from ischaemic heart disease later in life. Studies that investigate patients with a higher risk for CVD in PE pregnancies are lacking.What do the results of this study add? We found different levels of two novel cardiac markers with PE and normotensive pregnancies, and also with early and late-onset PE pregnancies.What are the implications of these findings for clinical practice and/or further research? Different adaptive responses from patients during PE pregnancies via altered levels of cardiac markers could help clinicians to identify women with a higher risk of CVD.

Novel metabolic marker Afamin: A predictive factor for Large-for-Gestational-Age (LGA) fetus estimation in pregnancies with gestational diabetes mellitus?

OBJECTIVE: Gestational diabetes mellitus (GDM) affects both maternal and fetal/infant outcomes during and after pregnancy. The reason for the high incidence of large-for-gestational-age (LGA) infants in GDM patients despite close monitorization of glucose levels with early detection of the disease remains unclear to date. Our study aims to investigate the levels of the third-trimester novel marker afamin in GDM versus non-GDM pregnancies in terms of glycemic control status and their utility in the prediction of LGA fetuses. MATERIAL AND METHODS: This prospective case-control study analysis involved 49 pregnant women with GDM diagnosed using the 75-g oral glucose tolerance test (75-g OGTT) and 40 randomly selected women with a similar body mass index (BMI) and gestational age (GA). Blood samples were collected in the third trimester of pregnancy. The afamin level was determined using a human afamin ELISA kit according to the manufacturer's procedure. RESULTS: There was no significant difference found in BMI or GA of patients. Third-trimester afamin levels were 93.91 mg/L and 83.87 mg/L in the GDM and non-GDM groups, respectively (p=0.625). Afamin values of patients were not correlated with age, BMI, GA, HgA1c, 75-g OGTT fasting and 75-g OGTT 1-hour, or 75-g OGTT 2-hour values (p>0.05). GDM patients with LGA fetuses had significantly higher afamin values than patients with appropriate-for-gestational-age (AGA) fetuses (120.8 mg/L versus 91.26 mg/L, respectively). Between GDM patients with either LGA or AGA fetuses, there was no statistically significant difference found for age, BMI, GAs, insulin dose, 75-g OGTT results, or HgA1c values. CONCLUSION: Our findings conclude that novel marker afamin levels could predict the risk of LGA infants independently of glycemic control status and provide insight into the pathogenesis of LGA fetuses, thus helping to reduce the risk of associated complications.

Biochemical and Histopathological Investigation of Resveratrol, Gliclazide, and Losartan Protective Effects on Renal Damage in a Diabetic Rat Model.

OBJECTIVE: To compare the protective effects of resveratrol, gliclazide, and losartan, at biochemical and histopathological levels, on the rat kidney with experimentally induced type 1 diabetes. STUDY DESIGN: A total of 35 adult male Wistar rats were divided into control, diabetic, diabetic gliclazide, diabetic resveratrol, and diabetic losartan groups. For biochemical analysis, based on one of the kidneys, superoxide dismutase, malondialdehyde, and catalase were used for measurement. The other kidney was stained for histochemical and immunohistochemical markers and examined by light microscopy. RESULTS: Nephropathy due to diabetes was developed at the end of the third week in the diabetic group: in the glomeruli, contraction from Bowman distance, diffuse mesangial matrix increasing and tubular dilation, and cytoplasmic vacuolar changes were observed. In tubulointerstitial areas, some tubular structures, an increased expression of VEGF was observed. CONCLUSION: As a result, in diabetic rats, the effects of gliclazide, resveratrol, and losartan cure were equivalent to each other according to the parameters which were followed. Resveratrol, gliclazide, and losartan significantly protected renal glomeruli and the proximal and distal tubules.

Leptin levels and lipoprotein profiles in patients with cholelithiasis.

OBJECTIVE: To determine the relationships between serum leptin and levels of lipoprotein(a) [Lp(a)], apolipoprotein A-1 (ApoA-1) and apolipoprotein B (ApoB) in patients with cholelithiasis. METHODS: Patients with ultrasound-confirmed cholelithiasis and controls frequency-matched for age, sex, body mass index, fasting blood glucose and haemoglobin A1c levels were recruited. Fasting blood samples from all study participants were assayed for glucose, haemoglobin A1c, total cholesterol, high density lipoprotein-cholesterol (HDL-C) and triglyceride. Serum Lp(a), ApoA-1 and ApoB levels were measured using nephelometric assays; serum leptin was measured using an enzyme-linked immunosorbent assay. RESULTS: A total of 90 patients with cholelithiasis and 50 controls were included in the study. Serum levels of leptin, Lp(a), total cholesterol, triglyceride and ApoB were significantly increased, and levels of ApoA-1 and HDL-C were significantly decreased, in patients with cholelithiasis compared with controls. Serum leptin in patients with cholelithiasis were significantly positively correlated with Lp(a) and ApoB and negatively correlated with ApoA-1. CONCLUSIONS: Patients with cholelithiasis have higher leptin levels and an altered lipoprotein profile compared with controls, with increased leptin levels being associated with increased Lp(a) and ApoB levels, and decreased ApoA-1 levels, in those with cholelithiasis.

Evaluation of paraoxonase, malondialdehyde, and lipoprotein levels in patients with asymptomatic cholelithiasis.

BACKGROUND/AIM: To compare lipoprotein and malondialdehyde levels and paraoxonase-1 activity between subjects with asymptomatic cholelithiasis and controls. PATIENTS AND METHODS: Eighty subjects with asymptomatic cholelithiasis (55 women, 25 men, mean age: 51, SD 14 years) and 40 control subjects without cholelithiasis (25 women, 25 men, mean age: 51, SD 12 years) were enrolled to the study. Serum paraoxonase activity, lipoproteins, and malondialdehyde were measured. RESULTS: In the cholelithiasis group, serum total cholesterol, low-density lipoprotein cholesterol, and malondialdehyde were significantly higher and high-density lipoprotein cholesterol (HDL-C) and paraoxonase-1 were significantly lower than the controls. In cholelithiasis patients with serum glucose level>100 mg/dL, body mass index, serum total cholesterol, triglyceride (TG), and malondialdehyde levels were significantly higher than cholelithiasis patients with serum glucose level<100 mg/dL. Paraoxonase-1 activity was significantly lower in patients with serum glucose level>100 mg/dL. In cholelithiasis patients with TG>150 mg/dL, mean age, body mass index, glucose, total cholesterol, and malondialdehyde were significantly higher than in cholelithiasis patients with TG<150 mg/dL. In cholelithiasis subgroup with TG>150 mg/dL, HDL-C level and paraoxonase-1 activity were lower than in the cholelithiasis subgroup with TG<150 mg/dL. All of the above comparisons were statistically significant (P<0.05). CONCLUSIONS: Patients with asymptomatic cholelithiasis have evidence of increased lipid peroxidation and decreased antioxidant capacity. Patients with asymptomatic cholelithiasis with components of the metabolic syndrome have more lipid peroxidation and less antioxidant capacity than patients with asymptomatic cholelithiasis but without the components of the metabolic syndrome.

Evaluation of leptin and insulin resistance in patients with cholelithiasis.

The association between insulin resistance, lipoproteins and leptin was evaluated in cholelithiasis. The study group included 55 women (68.8%) and 25 men (31.3%) with a mean age and SD of 50.56 +/- 14.28 yrs. The control group included 25 women (62.5%) and 15 men (37.5%) with a mean age of 50.93 +/- 11.73 yrs. Serum leptin levels were measured by the enzyme immunoassay method. HOMA-IR was determined by using fasting glucose and insulin levels. Insulin, total cholesterol (TC), LDL-C, HOMA-IR (p < 0.01) and leptin (p < 0.001) were significantly higher in the cholelithiasis group, compared to the controls. In patients with a HOMA-IR >2.2, age, body mass index (BMI), glucose, insulin, triglycerides (TG), TC and leptin levels were higher than in patients with a HOMA-IR < 2.2. In patients with glucose levels >100 mg/dl, mean BMI, HOMA-IR, insulin, TG, TC and leptin levels were significantly higher than in patients with glucose levels <100 mg/dl. In patients with TG levels >150 mg/dl, mean age, BMI, glucose, insulin, TC, leptin and HOMA-IR were significantly higher than in patients with TG levels < 150 mg/dl. In patients with BMI > 25 kg/m2, mean age, glucose, insulin, TG, TC, leptin, HOMA-IR were significantly higher than in patients with BMI < 25. In cholelithiasis group, there was a positive correlation between leptin and age, BMI, glucose, insulin, TG, TC, LDL-C or HOMA-IR. In conclusion, we found a positive association between increased leptin levels and abnormal lipoprotein metabolism in cholelithiasis. Cholelithiasis subjects with insulin resistance showed higher cardiometabolic risk factors than those without it.

Serum IL-6 level may have role in the pathophysiology of unexplained infertility.

PROBLEM: The aim of this study was to compare the serum levels of interleukin (IL)-6 of women with unexplained infertility with fertile subjects. METHOD OF STUDY: Serum IL-6, and tumor necrosis factor-alpha (TNF-alpha) levels of 45 infertile and 44 fertile women on day 3 of menstrual cycle were assessed and compared for this prospective controlled study. RESULTS: The mean serum IL-6 level was significantly higher in women with unexplained infertility, compared with fertile women (5.71 +/- 1.81 and 4.31 +/- 1.79, P < 0.001, Student's t-test). There was no significant difference in TNF-alpha level among the groups. CONCLUSION: Significant difference in serum IL-6 levels between unexplained infertile and fertile women suggests that this cytokine may be involved in pathophysiology of unexplained infertility.

The effect of dietary supplementation of Nigella sativa L. on serum lipid profile in rats.

OBJECTIVE: To investigate the effect of oral treatment of Wistar albino rats with different doses of Nigella sativa L. (NS) powdered seeds on the levels of serum lipids. METHODS: This study was performed in the Medical Science Application and Research Center of Dicle University, Diyarbakir, Turkey, from February 2003 to December 2008. A total of 75 Wistar albino male rats, 60 of them with NS supplementation and 15 animals acting as controls, were included in the study. The NS groups were divided into 4 main groups of 15 each. Four doses of NS were used (100, 200, 400, and 600 mg/kg/day). Each dose group was further divided into 3 duration subgroups of 5 rats each, the feeding of NS seeds continued for one, 2, and 4 weeks. Control animals were divided into 3 main groups of 5 rats each. The rats were sacrificed at one, 2, and 4 weeks after feeding. Lipid parameters were measured. RESULTS: Rats treated with the 400mg dose for one week's duration showed a significant increase in high-density lipoprotein-cholesterol levels. There was a significant decrease in low density lipoprotein-cholesterol levels after one week for 400 and 600 mg doses, and all doses after 2 weeks and 4 weeks for 200 and 600 mg doses when compared to control groups. There was a significant decrease in very low-density lipoprotein-cholesterol levels after one week for 200, 400, and 600 mg doses, and all doses for 2 and 4 weeks. A 400 mg dose for 2 weeks, and all doses for 4 weeks caused a significant decrease in triglyceride levels. There was a significant decrease of total cholesterol levels in all doses after 4 weeks of NS feeding. CONCLUSION: These results indicate that NS may ameliorate the alteration in the lipid levels caused by diseases or toxic agents.

Effect of oxidative stress on antioxidant enzyme activities, homocysteine and lipoproteins in chronic kidney disease.

BACKGROUND: Our aim was to determine the association of paraoxonase (PON1), superoxide dismutase (SOD) and catalase (CAT) activities and malondialdehyde (MDA) concentration, with lipoprotein and homocysteine (Hcy) concentrations in chronic kidney disease (CKD). METHODS: We examined 60 patients with CKD (35 men and 25 women), aged 52.7 -/+ 3.1 years, and 60 age-, sex- and body mass index (BMI)-matched control subjects. Serum PON1 activity, levels of lipoproteins, Hcy and MDA were evaluated; SOD and CAT activities in erythrocytes were also investigated. RESULTS: Levels of MDA, lipoprotein (a) (Lp(a)) and Hcy were significantly higher, while PON1 activity was lower in CKD than in controls (p<0.001). There were no significant differences between the patients and controls in the SOD and CAT activities (p>0.05). Levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (ApoA-I) were lower in CKD than in controls (p<0.001), whereas total cholesterol (T-Chol) and triglyceride (TG) levels showed no significant difference between the groups. Levels of apolipoprotein B (ApoB) and low-density lipoprotein cholesterol (LDL-C) were higher in CKD than in controls (p<0.001). In CKD, PON1 activities were correlated with levels of Hcy, MDA, HDL-C, Lp(a) and ApoA-I. A significant positive correlation was found between levels of Hcy and Lp(a). CONCLUSIONS: The results of this work suggest that patients with CKD exhibit an oxidant-antioxidant imbalance which is closely related to high levels of atherosclerotic risk factors.

Serum leptin level in women with unexplained infertility.

INTRODUCTION: The aim of this study was to compare serum levels of leptin in women with unexplained infertility with fertile subjects. MATERIAL AND METHOD: Serum leptin levels of 27 infertile and 30 fertile women on day 3 of the menstrual cycle were assessed and compared in this prospective age and body mass index (BMI) comparable controlled study. RESULTS: The mean age in the infertile group was 29.3 (range, 23-38), while this figure was 28.9 (range, 19-39) in the fertile group; the mean BMIs were 24.5 (range, 20.6-27.8) and 25.0 (range, 21.8-28.7), respectively. The mean serum leptin level was significantly higher in women with unexplained infertility compared with fertile subjects. Considering normal weight subjects, mean serum leptin levels were increased significantly in the unexplained infertile group compared with the fertile group (7.2 (range, 4.3-10.4) versus 3.5 (range, 1.9-6.2)ng/ml, respectively; p<0.0001, Mann-Whitney U-test). The significant increase in serum leptin levels was observed also in overweight patients (6.8 (range, 1.3-5.2) versus 3.3 (range, 4.2-8.9)ng/ml, respectively; p<0.0001, Mann-Whitney U-test). CONCLUSION: A significant difference in serum leptin levels between unexplained infertile and fertile women suggests that this cytokine may be involved in pathophysiology of unexplained infertility.

Relationships between leptin, insulin, IGF-1 and IGFBP-3 in children with energy malnutrition.

OBJECTIVES: Leptin has a key role in energy homeostasis and there may be a link between leptin and insulin-like growth factor-1 (IGF-1) system. The aim of this study was to analyze the relationships between long-lasting insufficient caloric intake (marasmus), leptin and IGF-1 system. DESIGN AND METHODS: The study group consisted of 30 marasmic children and control group included 28 healthy children. After an overnight fasting; leptin, insulin, IGF-1 and IGFBP-3 levels were measured. RESULTS: Marasmic children had significantly lower body weight, height, mid-arm circumference (MAC), skinfold thickness, mean serum leptin, insulin, IGF-1 and IGFBP-3 levels compared with healthy subjects (P<0.05). Serum IGF-1 and IGFBP-3 levels were significantly correlated with insulin, MAC and height Z score in patients (P<0.05). In controls, significant positive correlations were found between BMI, IGF-1 and leptin (P<0.05). CONCLUSIONS: Energy malnutrition is characterized by the important decreases in the leptin, insulin, IGF-1 and IGFBP-3 levels. Understanding details of these changes may lead to new therapeutic approaches in disease states associated with malnutrition.

Oxidative stress, inflammation and early cardiovascular damage in children with chronic renal failure.

The relationship between inflammation, oxidant stress and cardiovascular damage in children with chronic renal failure (CRF) has not previously been investigated. The aim of this study was to investigate markers of oxidative stress, inflammation and early cardiovascular abnormalities. Therefore, erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities; blood glutathione (GSH) and serum malondialdehyde (MDA) levels; C-reactive protein (CRP) and proinflammatory cytokines (IL-6, TNF-alpha,); and left ventricular masses (LVM) and intima media thicknesses (IMT) were measured in children with CRF. A total of 29 children with CRF (19 nondialysis, 10 peritoneal dialysis) were included. The control group consisted of 25 healthy subjects. CRF children had significantly increased IL-6, TNF-alpha, CRP and MDA concentrations and decreased SOD, CAT and GSH levels compared with controls (P<0.05). Nondialysis and peritoneal dialysis subgroups had similar oxidative stress and inflammation biomarkers (P>0.05). Erythrocyte CAT was positively correlated with CRP, TNF-alpha, and IL2-R in the study group. Positive correlations were found between cytokine concentrations, CRP and urea/creatinine levels. Significantly increased LVM and IMT values were found in CRF children (P<0.05). In conclusion, increased oxidant stress and inflammation together with early cardiovascular damage were found in CRF children. Further studies with more patients are needed to verify these results.

Paraoxonase, anti-oxidant response and oxidative stress in children with chronic renal failure.

Increased oxidative stress is believed to contribute to an increased risk of cardiovascular disease in uraemia. In children with chronic renal failure (CRF), an anti-oxidant enzyme, paraoxonase (PON), that inhibits oxidation of LDL-cholesterol, has not been previously investigated. In this study we aimed to investigate PON activity, total anti-oxidant response (TAR), total peroxide (TPX), oxidative stress index (OSI) and some pro-oxidant cytokines in 29 children with CRF [mean age 10.2+/-3.5 years; 19 pre-dialysis, ten on continuous ambulatory peritoneal dialysis (CAPD)] and in 25 control subjects. Children with CRF had lower PON and TAR and higher TPX and OSI values than did controls (P<0.05). Except for lower TAR and serum albumin levels of the CAPD subgroup (P<0.05), other parameters were similar in non-dialysis and CAPD patients (P>0.05). Patients had significant positive correlation between TAR and serum albumin (P<0.05). Serum urea had significant positive correlation with TPX and OSI (P<0.05). Increased oxidative stress and decreased anti-oxidants measured by serum PON activity and TAR were found in children with CRF. We can hypothesize, on the basis of statistical correlations, that low levels of serum albumin and high levels of uraemic metabolites might be responsible for increased oxidative stress in children with CRF. Further studies with larger sample sizes are needed to verify these results.