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Owing to limited usefulness of Rheumatoid Factor and anti-CCP in rheumatoid arthritis, there is a need to identify a more sensitive and specific biomarker to detect rheumatoid arthritis (RA), particularly seronegative RA cases. Tenascin-C is an extracellular matrix glycoprotein, which has been implicated in the pathophysiology of RA. The objective of our study was to evaluate the diagnostic utility of serum Tenascin-C in seropositive and seronegative rheumatoid arthritis patients. We conducted a cross-sectional case control study. Sixty patients who fulfilled the ACR 2010 criteria for rheumatoid arthritis were included in the study. Thirty patients were found to be positive for RF and/or anti-CCP and 30 were negative for both RF and anti-CCP. Thirty age and gender-matched healthy subjects were taken as controls. Serum Tenascin-C was measured by quantitative sandwich enzyme immunoassay technique. The mean serum concentration of Tenascin-C in controls, seronegative and seropositive cases was 0.66 ng/ml, 20.54 ng/ml and 23.42 ng/ml, respectively. Tenascin-C levels were significantly higher in RA cases compared to controls (p < 0.0001). There was no significant difference in Tenascin-C between seropositive and seronegative cases (p = 0.603). ROC curve analysis showed a sensitivity of 96.6% and specificity of 100% with AUC of 0.98 at 2.21 ng/ml as cut-off value for diagnosing RA. Tenascin-C is elevated in both seronegative and seropositive RA, which indicates that it can be used as a sensitive marker for RA. The addition of Tenascin-C to the existing RF and anti-CCP may help in identifying a large number of patients with RA, particularly seronegative rheumatoid arthritis cases.
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Background Heart failure is a complex cardiovascular disease with a variety of etiologies and heterogeneity. The N-terminal pro-B-type natriuretic peptide (NT-proBNP) value has limited usefulness in diagnosing heart failure with preserved ejection fraction (HFpEF). Aim The aim of the present study is to evaluate serum Galectin-3 as a diagnostic biomarker in patients with HFpEF and to compare Galectin-3 with NT-proBNP levels. Materials and Methods A cross-sectional case-control study including 63 cases of heart failure with ejection fraction ≥50% confirmed by echocardiography. NT-proBNP levels in serum were measured by electrochemiluminescence immunoassay and Galectin-3 levels in serum were measured by using an enzyme-linked-immunosorbent serologic assay kit. Results The median levels of serum Galectin-3 and NT-proBNP in patients were significantly higher than those of controls (26.59 vs. 5.27 and 927 vs. 49.3, p < 0.0001). A positive correlation was observed between serum levels of Galection-3 and NT-ProBNP ( r : 0.21, p = 0.048). At cut-off values of 10.1 ng/mL and 160 pg/mL, serum Galectin-3 has 77.78% sensitivity, 95% specificity with an area under the curve (AUC) of 0.93, and serum NT-proBNP has 71.43% sensitivity, 100% specificity with an AUC of 0.87, respectively, for diagnosing HFpEF. The comparison of receiver operating characteristics curves showed that Galectin-3 has better AUC compared with NT-proBNP in diagnosing HFpEF. Serum Galectin-3 showed a positive correlation with NT-proBNP and lipid parameters. Conclusion Galectin-3 with higher sensitivity and AUC can be used as a valuable biomarker for the diagnosis of HFpEF. Simultaneous testing of both Galectin-3 and NT-proBNP can further improve the detection of patients with HFpEF.
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BACKGROUND: Diabetic nephropathy is a major complication with high morbidity and mortality, and leads to end stage renal disease (ESRD). Type IV collagen is the main component of the glomerular basement membrane (GBM) and the extracellular matrix. The thickening of the GBM is due to accumulation of type IV collagen and alterations in its structure and composition. AIM: The aim of this study was to evaluate the association of plasma and urine type IV collagen with albuminuria status and to determine the clinical implications of type IV collagen as a marker in the early stage of diabetic nephropathy. MATERIALS AND METHODS: A total of 150 type 2 diabetes mellitus patients with more than 5 year diabetic duration in the age group of 35 to 60 years were selected for this study and 50 age and sex matched healthy individuals were selected as control group. Type IV collagen (Plasma and urine), Insulin were analyzed by ELISA method and micro albumin was analyzed by turbilatex method. Routine investigations fasting plasma glucose, post prandial glucose, lipid profile parameters, serum urea and creatinine were analyzed by using Auto analyzer. RESULTS: The plasma and urinary type IV collagen levels were significantly higher in the normoalbuminuric group with diabetes than in the control group, and increased with increasing severity of albuminuria among diabetics. Both plasma and urine type IV collagen levels showed positive correlation with albumin creatinine ratio (ACR) and regression analysis showed significant influence with ACR and also positive significant correlation of ACR with FPG, PPG, HbA1C, HOMA-IR, negative correlation with HDL cholesterol was observed. CONCLUSION: Plasma and urinary type IV collagen can be helpful in the prediction of the subsequent development of albuminuria in type 2 diabetic patients.
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The present study was performed, to analyse the inter-relationship among trace elements: Iron, copper and zinc in pregnancy. Eighty-four pregnant women were compared with 30 age matched nonpregnant healthy controls. Fasting blood samples were analysed for heamoglobin, iron, copper and zinc. On the basis of Hb concentration (<10g/dl) and iron levels(<50microg/dl), the pregnant women were sub-grouped as anaemic, non-anaemic, Iron deficient anaemic and non-iron deficient anaemic. The level of copper was found to be significantly higher in iron deficiency anaemia, when compared to non-iron deficiency anaemia (p<0.05), and in non-anaemic pregnant women, compared to non-anaemic non-pregnant women (controls).The level of zinc is also significantly lower in Iron deficiency anaemic pregnancy, when compared to the other groups. There is evidence of influence of pregnancy, on the level of trace elements in blood. This could be a result of competitive inhibition in the absorption of trace elements in the intestine, or an effect of hormonal changes (insulin, oestrogen), during pregnancy. A judicious supplementation of micronutrients, during pregnancy, especially in iron deficiency anaemia, is essential.
