Vitamin D status and premature adrenarche.

BACKGROUND: Vitamin D, an important factor in calcium-phosphate homeostasis, has recently been suggested to play an important role in the pathogenesis of numerous chronic conditions such as hyperandrogenism. The aim of this study was to investigate the relationship between vitamin D status and premature adrenarche (PA). METHODS: A total of 71 girls with PA and 52 healthy girls, as the control group, were recruited. Axillary and/or pubic hair development before the age of 8 years was defined as PA. Bone age and anthropometric measures including height, weight, and body mass index (BMI) were obtained. 25-Hydroxyvitamin D (25(OH)D), fasting plasma glucose and insulin were measured. Vitamin D insufficiency was defined as <20 ng/mL. RESULTS: The PA patients had older bone age, higher BMI standard deviation score, homeostasis model of assessment-insulin resistance (HOMA-IR), and androgen but lower 25(OH)D than the control group. HOMA-IR and dehydroepiandrosterone sulfate were also higher in PA patients with vitamin D insufficiency compared with those with normal vitamin D. There was a negative correlation between 25(OH)D and HOMA-IR. CONCLUSION: Low vitamin D is associated with PA; and insulin resistance may be a factor in this association.

RANKL/Osteoprotegerin System and Bone Turnover in Hashimoto Thyroiditis.

Hypothyroidism is associated with changes in bone metabolism. The impact of hypothyroidism and the associated autoimmunity on the mediators of bone turnover in Hashimoto's thyroiditis (HT) is not known. In this study, we assessed the levels of OPG, RANKL, and IL-6 along with markers of bone formation as osteocalcin (OC) and markers of bone resorption as type 1 collagen C telopeptide (CTX) and tartrate-resistant acid phosphatase isoform 5b (TRAcP 5b) in 30 hypothyroid and 30 euthyroid premenopausal HT patients and 20 healthy premenopausal controls. We found that TRAcP 5b (p = 0.006), CTX (p = 0.01), OC (p = 0.017), and IL-6 (p < 0.001) levels were lower in the hypothyroid group compared to euthyroid HT patients and controls. OPG levels were higher (p < 0.001) and RANKL levels were lower (p = 0.021) in hypothyroid and euthyroid HT patients compared to controls. TSH was negatively correlated with IL-6 (rho = -0.434, p < 0.001), OC (rho = -0.313, p = 0.006), TRAcP 5b (rho = -0.335, p = 0.003), and positively correlated with OPG (rho = 0.248, p = 0.029). RANKL/OPG ratio was independently associated with the presence of HT. In conclusion, bone turnover is slowed down by hypothyroidism in premenopausal patients with HT. Thyroid autoimmunity might have a unique impact on OPG/RANKL levels apart from the resultant hypothyroidism.

CFH Y402H and VEGF Polymorphisms and Anti-VEGF Treatment Response in Exudative Age-Related Macular Degeneration.

PURPOSE: The aim of this study was to evaluate the prevalence of single nucleotide polymorphisms (SNPs) in complement factor H (CFH) Y402H and VEGF rs2146323 and rs699947 in exudative age-related macular degeneration (AMD) and their relationship with intravitreal anti-VEGF treatment response. METHODS: A total of 109 exudative AMD patients and 70 controls were included. Patients were classified as 'good responders' and 'nonresponders' based on the changes in best corrected visual acuity, central foveal thickness, lesion size, and the persistence of retinal hemorrhage after three dosages of anti-VEGF. We examined CFH, VEGF rs2146323 and rs699947 SNPs, and plasma interleukin-6 (IL-6) levels in both groups. RESULTS: In total, 42 patients (38.5%) and 11 controls (15.7%) had homozygote wild genotype TT (p = 0.002). The variant C allele frequency was 45% in controls and 31.7% in patients (p = 0.011). A and C allele frequencies for VEGF rs699947 and rs2416323 were similar between the control and patient groups (p = 0.947, p = 0.378). Both SNPs were similar in responders and nonresponders. No significant difference was detected between plasma IL-6 levels of the control and AMD groups (p = 0.594), but the levels were higher in good responders than nonresponders (p < 0.001). CONCLUSION: CFH Y402H SNP might be protective for AMD in the Turkish population. VEGF rs2146323 and rs699947 SNPs have no relationship to exudative AMD formation, and none of these seem to have any effect on anti-VEGF response.

Association between Plasma Endothelin-1, Transforming Growth Factor-ß, Fibroblast Growth Factor, and Nitric Oxide Levels and Liver Injury in Hematopoietic Stem Cell Transplantation Recipients with Persistent Iron Overload after Transplantation.

Graft-versus-host disease, iron overload, and infections are the major causes of liver dysfunction in allogeneic hematopoietic stem cell transplantation (AHSCT) recipients. We investigated the relationship between serum iron parameters and the levels of transforming growth factor-ß (TGF-ß), fibroblast growth factor (FGF), endothelin-1 (ET-1), and nitric oxide (NO) as predictors of chronic liver injury in 54 AHSCT recipients who survived at least a year after transplantation. Serum samples from patients were obtained for the evaluation of ET-1, TGF-ß, FGF, NO, and nontransferrin bound iron at the first year follow-up visit using commercially available ELISA kits. Patients were categorized depending on serum ferritin and transferrin saturation levels. The parameters were compared between the groups, and survival analysis was also performed. Most of the AHSCT recipients (81.5%) were in complete remission during the study. After a median follow-up time of 73 months (range, 13 to 109 months), 72.2% of the patients were alive. Mean serum levels of ET-1, NO, TGF-ß, and FGF were 81.54 ± 21.62 µmol/mL, 31.82 ± 26.42 µmol/mL, 2.56 ± 0.77 ng/mL, and 50.31 ± 32.69 pg/mL, respectively. Nineteen patients (35.2% of the cohort) had serum ferritin levels higher than 1000 ng/mL. Mean serum levels of ET-1, NO, TGF-ß, and FGF were similar in patients with serum ferritin levels below or above 1000 ng/mL (P > .05). Serum ferritin levels were positively correlated with serum alanine aminotransferase (r = .284, P = .042) and γ-glutamyl transferase (r = .271, P = .05) levels and were negatively correlated with serum albumin levels (r = .295, P = .034). There was a significant positive correlation between serum transferrin saturation and alanine aminotransferase levels (r = .305, P = .03). Serum ET-1 level was positively correlated with alkaline phosphatase levels (r = .304, P = .026). In univariate Cox regression analysis serum levels of iron parameters, ET-1, NO, TGF-ß, and FGF did not have an impact on overall survival (P > .05). The probability of progression-free survival was also similar in patients with ferritin levels above or below 1000 ng/mL (P = .275). The probability of survival was similar in patients with transferrin saturation ≥70% and <70% (P > .05). Serum iron parameters showed a positive correlation with liver injury. However, there was no correlation between fibrogenic cytokines and liver transaminases. Our results suggest that iron overload at least with the current levels of ferritin might have a relatively benign course. Prospective randomized trials will guide the actual role of iron chelation in the post-transplantation setting.

Relationship between serum vitamin D levels and angiographic severity and extent of coronary artery disease.

BACKGROUND: Vitamin D is known for its effect in calcium and bone homeostasis. There is an increasing evidence for health benefits accomplished by activated vitamin D that go beyond these classical functions. Previous studies have suggested that lower vitamin D levels are associated with increased cardiovascular disease risk. Therefore, we aimed to evaluate relationship between vitamin D levels and extent and severity of coronary artery disease. MATERIALS AND METHODS: A total of 746 patients in whom coronary angiography was performed between August 2012 and July 2013 were enrolled in this study. Serum vitamin D levels were measured, and patients were grouped according to their serum vitamin D levels (vitamin D <20 ng/mL (n = 602) Group 1 versus >20 ng/dL (n = 144) Group 2). Gensini score system was used to evaluate the association between serum vitamin D levels and severity and extent of coronary artery disease. RESULTS: There was no significant difference between the groups in terms of baseline characteristics and demographic characteristics. Mean serum vitamin D levels of all patient cohort was 15.54 ± 7.46 ng/mL. Group 1 and Group 2 had an average serum vitamin D levels of 12.6 ± 3.3 ng/mL and 27.5 ± 7.8 ng/mL, respectively. Gensini score for all cohort was 26.25 ± 34.32. Group 1 had an average Gensini score of 26.4 ± 35.7; on the other hand, Gensini score was 25.5 ± 27.5 in Group 2 (P = 0.097). CONCLUSIONS: This study failed to demonstrate significant relationship between serum vitamin D levels and the severity and extent of coronary artery disease. Further studies with more participation and homogenous groups with comparable individual and environmental features are needed to evaluate the association of serum vitamin D levels and cardiovascular diseases.

Role of serum toll-like receptors 2 and 4 in non-alcoholic steatohepatitis and liver fibrosis.

BACKGROUND AND AIM: Non-alcoholic fatty liver disease is a common cause of chronic liver disease, including non-alcoholic steatohepatitis (NASH). Our aim was to investigate whether serum toll-like receptors 2 and 4 (TLR2 and TLR4) levels are correlated with NASH and able to predict liver fibrosis, as well as to compare these markers with other non-invasive fibrosis scores (aspartate aminotransferase [AST] to alanine aminotransferase ratio, AST to platelet ratio index, fibrosis index, fibrosis 4, and fibrosis cirrhosis index). METHODS: Serum samples were obtained from consecutive biopsy proven NASH patients and healthy controls. Serum TLR2 and TLR4 were measured using ELISA. Stage of fibrosis was evaluated using the Brunt Criteria. The different non-invasive fibrosis scores were compared using areas under the curve. RESULTS: Fifty-seven patients with NASH and 57 healthy individuals were enrolled in the study. Serum TLR2 levels were not significantly different between the healthy controls and NASH patients. The medians were 3.88 ng/mL ± 0.29 versus 3.81 ng/mL ± 0.32, respectively (P = 0.587). In comparing the levels of TLR4 between groups, the medians were 1.05 ng/mL ± 0.13 versus 1.46 ng/mL ± 0.27, respectively (P < 0.001). In NASH patients, the levels of serum TLR4 increased with the stage of fibrosis: TLR4 medians were F0:1.01, F1:1.46, F2:2.14, F3:3.74, F4:5.83 (P < 0.001). TLR4 produced AUCs for ≥ F1, ≥ F2, and ≥ F3 of 0.862, 0.810, and 0.905, respectively (P < 0.001). TLR4 levels were more predictive than other non-invasive fibrosis scores in liver fibrosis. CONCLUSION: Serum TLR4 levels but not TLR2 were elevated in NASH patients in comparison with healthy controls. And in NASH patients, serum TLR4 levels both correlated with and were able to predict liver fibrosis.

The Relationship between Pre-Infarction Angina and Serum Sphingosine-1-Phosphate Levels.

BACKGROUND: Pre-infarction angina reduces myocardial infarct size by preventing the myocardium from being subjected to ischemia reperfusion (I/R) injury. Ischemic preconditioning is the proposed mechanism for this effect. Sphingosine 1 phosphate (S1P) activates ischemic preconditioning pathways and may play a role in the presence of cardioprotective effects of pre-infarction angina. Therefore, we evaluated the relationship between pre-infarction angina and serum S1P levels. METHODS: Between May 2011 and January 2012, 79 patients with acute myocardial infarction were included in the study. In addition to taking routine medical histories, all of the patients were questioned as to whether or not they had pre-infarction angina. We determined patients serum levels of S1P at admission and discharge, and peak creatine kinase MB and troponin levels were also measured in the pre-infarction angina positive and negative groups. RESULTS: Of the 79 patients included in the study, 36 had pre-infarction angina and 43 had not. Baseline characteristics were similar between the groups. The median level of serum S1P in patients with pre-infarction angina was significantly higher than in those without pre-infarction angina both at admission and discharge [0.54 (0.14-1.35) vs. 0.26 (0.12-0.62) p = 0.014/0.51 (0.20-1.81) vs. 0.30 (0.13-0.68) p = 0.010]. Serum high sensitive troponin levels were significantly lower in patients with pre-infarction angina [0.97 (0.39-3.07) vs. 2.56 (0.9-6.51) p = 0.034]. Serum S1P levels both at admission and discharge tended to be higher in patients with more angina episodes, but the differences between these subgroups were not statistically significant. CONCLUSIONS: Patients who experienced pre-infarction angina had higher serum S1P levels than patients without pre-infarction angina. This study supported our hypothesis that the cardioprotective effects of pre-infarction angina may in part be mediated by S1P. KEY WORDS: Ischemic preconditioning; Pre-infarction angina; Sphingosine 1 phosphate.

Circulating insulin and leptin in women with and without premenstrual disphoric disorder in the menstrual cycle.

Premenstrual dysphoric disorder (PMDD) is a syndrome related with mood and appetite changes during the late luteal phase. Leptin and insulin are the hormones related to appetite, and leptin may have a role in reproductive functions and mood. Our aim was to determine whether there are differences in serum leptin and insulin levels between women with and without PMDD during the follicular and luteal phases. In this study, 20 women with PMDD and 18 women without PMDD were included. Fasting blood glucose, insulin, leptin, progesterone levels and HOMA-IR were measured in the follicular and luteal phases separately. Repeated-measures analysis of variance revealed significant interactions for serum leptin, insulin and HOMA-IR levels between the diagnosis of PMDD and menstrual phases (F = 5.4, p = 0.025; F = 5.4, p = 0.026; and F = 4.7, p = 0.036, respectively). A significant correlation was found between progesterone and insulin levels in subjects without PMDD in the luteal phase (r = 0.58, p = 0.01). Whether the alterations in serum leptin and insulin are related with the changes of appetite and mood in PMDD or secondary to other factors should be clarified.

Serum liver fatty acid binding protein shows good correlation with liver histology in NASH.

BACKGROUND/AIMS: Simple, reproducible and non-invasive tests that can be used to determine the severity of non-alcoholic steatohepatitis (NASH) are needed. Liver-type fatty acid binding protein (L-FABP) plays a key role in the fatty acid metabolism of the liver. We aimed to determine whether serum L-FABP levels in patients with NASH were different from those in healthy controls, and if so, whether this was associated with the degree of fibrosis, steatosis and inflammatory activity. METHODOLOGY: Forty-seven patients with histologically confirmed NASH and 41 healthy controls were included in the study. Serum L-FABP levels were measured in all participants. RESULTS: Mean L-FABP levels were significantly higher in patients with NASH compared to the control group (2703.19±1603.47 vs. 1684.58±860.19, p<0.001). Serum L-FABP levels showed a significant positive correlation with NAS score (p=0.03, r=0.312), the degree of fibrosis (p=0.02, r=0.324) and inflammation (p=0.03, r=0.312), BMI (p=0.05, r=0.303), serum ALT (p=0.01, r=0.28), AST (p=0.04, r=0.315), and triglyceride levels (p=0.03, r=0.328). CONCLUSIONS: Serum L-FABP levels are elevated in NASH and this elevation is positively correlated with the degree of fibrosis and inflammation. L-FABP levels may aid as a non-invasive marker in determining the severity of fibrosis and inflammation in patients with NASH.

Relationship between plasma asymmetric dimethylarginine level and autonomic dysfunction in diabetic patients.

OBJECTIVES: We aimed to investigate the relationship between plasma asymmetric dimethylarginine (ADMA) levels and heart rate variability (HRV) in diabetic patients. STUDY DESIGN: The study included 100 patients (44 men, 56 women) with type 2 diabetes mellitus. The patients were divided into two groups based on the use of oral antidiabetics (n=67; mean age 54.6±7.8 years) or insulin (n=33; mean age 51.6±8.8 years). Plasma ADMA levels were measured and HRV parameters were calculated from 24-hour Holter EKG recordings. The findings were compared with those of a control group consisting of 42 nondiabetic individuals (mean age 52.8±6.2 years). RESULTS: Compared to the control group, plasma ADMA levels were significantly higher (p=0.007) and all HRV parameters were significantly reduced in both diabetic groups. However, ADMA levels and HRV parameters were similar in the two diabetic groups (p>0.05). Correlation analysis showed no significant relationship between plasma ADMA levels and HRV parameters. CONCLUSION: Our findings show that plasma ADMA levels are increased and HRV is reduced in diabetic patients, indicating that these patients have both endothelial dysfunction and autonomic dysfunction, but plasma ADMA levels cannot be used to evaluate autonomic dysfunction.

Assessment of salivary stress and pain biomarkers and their relation to self-reported pain intensity during orthodontic tooth movement: a longitudinal and prospective study.

PURPOSE: The aim of this prospective study was to evaluate the relationship between pain intensity and concentrations of salivary pain and stress biomarkers during orthodontic tooth movement. METHODS: Eighteen patients (8 males, 10 females; mean age 14.57 ± 2.39 years) who needed orthodontic treatment with maxillary premolar extraction and segmental canine distalization participated in this study. Baseline samples were collected (T1), and orthodontic attachments were placed to maxillary first molars, second premolars, and canines. Then extractions were performed. After 1­month follow-up, canine distalization started with a segmental wire (T2). Concentrations of salivary α­amylase (sAA), cortisol, secretory immunoglobulin A (sIgA) and chromogranin A (CgA) were examined at T1, T2, and on days 4 (T3), 7 (T4), 14 (T5), and 30 (T6) after starting retraction. Participants also scored their pain on a visual analogue scale (VAS). Pain catastrophizing behavior and dental anxiety levels of the participants were evaluated by the Pain Catastrophizing Scale (PCS) and Corah's Dental Anxiety Scale (C-DAS), respectively. Repeated measure ANOVA, Mann-Whitney U test and Spearman's rank correlation coefficient analysis were used for statistical evaluations (p < 0.05). RESULTS: The maximum values for sAA were seen at T1. Males had higher sAA levels than females with statistical differences at T1, T3, and T4. No significant differences for cortisol, sIgA, and CgA concentrations were observed. The highest mean VAS score was recorded at T3. No correlations were detected between any salivary biomarkers, VAS, C­DAS, and PCS scores. CONCLUSIONS: The stress of starting orthodontic treatment increased sAA levels more than the pain that was experienced during orthodontic tooth movement. Being male was a predictor of higher sAA concentrations. Orthodontic tooth movement did not cause significant alterations in salivary pain and stress biomarkers.

The effects of vitamin C administration, acute food deprivation, and acute food intake on vitamin C levels in different brain areas of guinea pigs.

Vitamin C is crucial for the brain. We aimed to investigate the effects of vitamin C administration following 24 hours of acute food deprivation and 24 hours of acute food intake on changes in vitamin C levels in different brain areas of guinea pigs. Vitamin C was administered as a single intraperitoneal dose (500 mg kg(-1) body weight) both before acute food deprivation and before acute food intake. At the end of our study, we measured the vitamin C levels in cerebral cortex lobes, brain stem structures, hypophysis, hypothalamus, cerebellum, hippocampus, and amygdala. Vitamin C levels in the frontal and parietal lobes were found to be significantly higher in animals pretreated with vitamin C prior to 24 hours of food deprivation (p < 0.05). Temporal lobe vitamin C level was significantly lower in animals that were subjected to 24 hours of acute food intake following 24 hours of food deprivation (p < 0.05). Increased vitamin C levels were observed in the occipital lobe of all animals that received vitamin C administration (p < 0.05). Vitamin C levels in the brain stem structures such as mesencephalon and pons were significantly decreased in animals pretreated with vitamin C before normal feeding (p < 0.05). Vitamin C level in the hypothalamus was significantly increased after 24 hours of food deprivation (p < 0.05). In conclusion, different areas of the brain may differ in terms of vitamin C content during nutritional changes with or without vitamin C pretreatment, such as 24 hours of food deprivation or 24 hours of food intake following 24 hours of food deprivation. These differences may be attributed to several functions of vitamin C which may occur under these circumstances.

Relationship Among Denture Status, Remaining Teeth Number, and Malnutrition in Patients With Chronic Kidney Disease.

The purpose of the present study was to evaluate the relationship among the denture status, number of remaining teeth, and malnutrition in patients with chronic kidney disease (CKD). Seventy-three patients (43 men/30 women) who required hemodialysis were included in the study. Weight and height, Kt/V, urea reduction ratio, midweek interdialytic weight gain, ultrafiltration volume, and erythropoietin dosage were determined for all patients. Laboratory measurements and predialysis blood samples for biomarkers were collected within the monthly routine tests. Dental examination focused on the denture status and total number of remaining teeth. Denture status were classified into two groups as prosthesis group (patients have prosthesis) and no prosthesis group (patients do not have any kind of prosthesis). And also, patients were assigned to one of four categories based on the number of remaining natural teeth: (i) edentulous, (ii) 1-7 teeth, (iii) 8-19 teeth, and (iv) >20 teeth. The data were statistically analyzed (a = 0.05). Body mass index values were increased in the prosthesis patients. Serum albumin levels of the CKD patients were under the reference value (3.8 g/dL) both in prosthesis and no prosthesis groups. Patients who have eight and more teeth showed higher serum albumin levels, and patients who had 1-7 teeth showed lower serum albumin levels in prosthesis group. CKD patients' nutritional habits were affected by denture status (having prosthesis or not). The number of the remaining teeth in prosthesis group affected the serum albumin levels of CKD patients.

Could drug burden be associated with severe periodontitis in patients receiving haemodialysis?

BACKGROUND: Periodontitis increases the risk of cardiovascular disease in the general population by triggering systemic inflammation. AIM: To investigate the relationship between systemic inflammation and periodontitis, and clarify any association between severe periodontitis and the medications used by patients receiving haemodialysis. DESIGN: A cross-sectional study. PARTICIPANTS: The study was undertaken with 56 patients receiving haemodialysis. MEASUREMENTS: Demographic and laboratory data and prescribed drugs regularly used by patients were recorded from hospital records. During the dialysis session, a validated Xerostomia Inventory score was completed. A complete dental/periodontal examination was also undertaken on all patients by the same periodontist. RESULTS: In the study population, stage I periodontitis was determined in 41%, stage II periodontitis in 17%, stage III periodontitis in 21%, and stage IV periodontitis in 21%. Male gender, hypertension, coronary artery disease, ß antagonists, calcium channel blockers, sodium polystyrene sulphonate, teeth brushing less than twice a day and high sensitive C-reactive protein > 8 mg/l were significantly associated with severe periodontitis. CONCLUSION: Drugs, including ß antagonists, calcium channel blockers, polystyrene sulphonate, co-morbid conditions and poor or insufficient oral care could facilitate an increase in the severity of periodontitis in patients receiving haemodialysis. Severe periodontitis also seems to be associated with cardiovascular disease and inflammation in patients with chronic renal disease.

Low Copeptin Levels in Patients With Intradialytic Hypotension.

Intradialytic hypotension (IDH) is related to high morbidity and mortality. There is evidence that arginine-vasopressin (AVP) responses could play a role. Copeptin is a reliable biomarker of AVP. In this study, copeptin, aldosterone, epinephrine, and norepinephrine levels in patients with IDH were evaluated throughout a hemodialysis (HD) session and compared with the control group. The study includes 15 patients who were normotensive during HD and 15 patients with IDH with a minimum HD vintage of 1 year. Blood samples were collected before the initiation of an HD session (T0 ), in the mid-session for control group, 30 min after mean arterial pressure drop for IDH patients (T1 ), and at the end of the session (T2 ). Groups had similar demographic features and health parameters, interdialytic weight gains, and ultrafiltration amounts. The IDH group had a mean arterial pressure decline of 39.9 (±6.4) mm Hg. Copeptin levels of the control group increased an average of 79.9 (±97.5) pmol/L at T1 and an additional 24.8 (±33.9) pmol/L at T2 . In the IDH group, copeptin level increases at T1 and T2 were 3.2 (±5.5) pmol/L and 34 (±44.6) pmol/L, respectively. Copeptin levels of the IDH group were significantly lower at T1 (P < 0.001) and at the T0 -T2 interval than control group (P = 0.05). In the control group, aldosterone levels distinctly decreased, and in the IDH group, aldosterone levels were elevated (P < 0.001). Small changes were detected in epinephrine and norepinephrine levels for both groups but did not reach significance (P = 0.6 and P = 0.3, respectively). Lower copeptin level alterations suggest inadequate AVP responses in patients with IDH.

Oral Candida Colonization as a Risk Factor for Chronic Inflammation and Atherosclerosis in Hemodialysis Patients.

The purpose of this study was to determine the prevalence of oral Candida spp. in HD patients and to investigate its relation with systemic inflammation and atherosclerosis. Microbiological samples were taken from buccal mucosa, palate, and dental prosthesis with a cotton swab. High-sensitivity CRP (hsCRP) and IL-6 were measured as inflammation markers. A total of 69 patients (58% male and median age 62 years) were enrolled in this study; 53.6% of total patients had oral Candida colonization. HsCRP and IL-6 levels were found to be significantly higher in the oral Candida colonization positive group than in the Candida colonization negative group (P = 0.002 and P = 0.01, respectively). HDL levels were significantly lower in the Candida colonization positive group (P = 0.03). Peripheral artery disease (P = 0.05) and oral Candida colonization (P = 0.002) were significantly associated with inflammation. In addition to conventional risk factors such as age (P = 0.03), diabetes (P = 0.001), and peripheral artery disease (P = 0.002), oral Candida colonization is associated with coronary artery disease (P = 0.04). Oral Candida colonization might be associated with chronic inflammation and development of atherosclerosis in HD patients.

Tau and S100B proteins as biochemical markers of bilirubin-induced neurotoxicity in term neonates.

We investigated the relationship between total serum bilirubin and serum Tau and S100B protein levels, and predicted a cutoff level of bilirubin-induced neurotoxicity in term newborns. Total serum bilirubin, serum Tau, and S100B levels were measured in 92 jaundiced term newborns. A neurologic examination, electroencephalogram, brainstem auditory-evoked response, and otoacoustic emission were performed in the infants on admission and at age 3 months. Serum Tau (r = 0.921, P < 0.001) and S100B (r = 0.927, P < 0.001) levels were correlated with total serum bilirubin levels in all infants. Serum Tau and S100B protein levels remained at a steady level up to a total serum bilirubin level of 19.1 mg/dL, and then demonstrated a significant increase. Mean total serum bilirubin, serum Tau, and S100B levels of infants who manifested auditory neuropathy, neurologic abnormalities, or electroencephalogram abnormalities were significantly higher than in infants without these abnormalities (P < 0.05). Clinical and laboratory findings of bilirubin-induced neurotoxicity developed after a total serum bilirubin level of 22 mg/dL was reached. Serum levels of Tau and S100B proteins in jaundiced term newborns were strongly correlated with early-phase bilirubin encephalopathy.

Prevalence of ZnT8 Antibody in Turkish Children and Adolescents with New Onset Type 1 Diabetes

OBJECTIVE: Zinc transporter 8 protein (ZnT8A) is a transmembrane protein which functions to transfer zinc to insulin vesicles. Antibodies formed against ZnT8A (ZnT8A) are regarded as an independent autoimmunity demonstrator in type 1 diabetes (T1D). The aim of this study was to investigate the prevalence of ZnT8A in Turkish children with new onset T1D. METHOD: Eighty four patients between 1-18 years of age diagnosed with T1D between February 2015-March 2016 and the control group consisting of 50 healthy children without any autoimmune diseases were included in the study. Serum samples for ZnT8A testing were taken from the patient group within a week of diagnosis. A ZnT8A enzyme-linked immunosorbent assay was used in the analyses. RESULTS: ZnT8A positivity was detected in 58% of the patients with new onset T1D and 8% of the control group. ZnT8A were demonstrated in 5 of 11 patients with negative results for classical diabetes antibodies [insulinoma antigen-2 antibody (IA-2A), glutamic acid decarboxylase (GAD) or insulin autoantibodies]. No association was found between ZnT8A positivity and age, gender, presence or degree of ketoacidosis at presentation, hemoglobin A1c, insulin or C-peptide concentration, or the presence of either thyroid or celiac antibodies. CONCLUSION: ZnT8A prevalence in children with T1D in Turkey was compatible with the literature. The ratio of patients who are clinically considered to have T1D but have negative routine diabetes auto-antibodies were observed to decrease nearly by 50% when ZnT8 antibodies were added to the panel. ZnT8 measurement should be more widespread for clarifying the etiology in T1D.

Elevated PAPP-A levels in lean patients with polycystic ovary syndrome.

OBJECTIVES: This study aimed to evaluate the serum concentrations of PAPP-A (pregnancy associated placental protein-A), a biomarker which is associated with cardiovascular disease, in patients with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS: A total of 62 women with PCOS, and 68 age and body mass index (BMI) matched controls were eligible for the study. Hirsutism scores, hormonal and metabolic profile as well as PAPP-A levels were assessed in each subject. RESULTS: Women with PCOS and controls yielded similar median serum levels of PAPP-A (1.7 ng/ml versus 1.8 ng/ml, respectively, p = 0.328). However, when patients were compared based on BMI; subgroup analyses found that among women with BMI<27 kg/m2, patients with PCOS exhibited higher PAPP-A levels than controls (2.1 ng/ml versus 1.8 ng/ml, respectively, p = 0.018). When women with PCOS were evaluated in their own based on BMI, lean PCOS women showed higher levels of PAPP-A (2.1 ng/ml versus 1.5 ng/ml, p = 0.002). PAPP-A levels were negatively correlated with age (p = 0.031, r = -0.189), BMI (p = 0.002, r = -0.265) and triglyceride levels (p < 0.001, r = -0.3). CONCLUSION: The data of the present study suggested that PAPP-A might be a clinical indicator in PCOS, in which the risks of metabolic syndrome and cardiovascular event are increased. Especially a group of young patients with BMI <27 kg/m2 might benefit from the cardiovascular risk evaluation using PAPP-A, supplying prognostic information for high risk in the development of cardiovascular disease.

The effects of resveratrol on ovarian hyperstimulation syndrome in a rat model.

OBJECTIVE: The aim of the present study was to investigate effects of resveratrol (RSV) over ovarian hyperstimulation syndrome (OHSS) in rat model. MATERIALS AND METHODS: 24 female Wistar rats (22 days old) were divided into four groups. Group 1 (control group; n = 6) received 0.1 ml intraperitoneal (IP) saline from days 22-26; group 2 (mild-stimulated group; n = 6) received 10 IU pregnant mare serum gonadotropin (PMSG) on day 24 and 10 IU of hCG 48 h later (day 26); group 3 (OHSS group; n = 6) was given 10 IU of PMSG for 4 consecutive days from day 22 and 30 IU hCG on the fifth day to induce OHSS; group 4 (OHSS + RSV group; n = 6) was treated the same as group 3, but received 60 mg/kg RSV 2 h before PMSG injection for 4 consecutive days and 2 h before the hCG injection on the fifth day. RESULTS: Weight gain was highest in the OHSS group. Ovarian weights were lower in the treatment group than OHSS group. Peritoneal fluid VEGF levels were lower for RSV group compared to group 2 and 3. Total VEGF immunoreactivity was higher in OHSS group than group 1, 2 and 4. CONCLUSION: These results indicate that RSV is beneficial for prevention of OHSS by reducing the increases in body and ovarian weight and VEGF activity. These effects may be mediated by anti-inflammatory, anti-oxidant and anti-angiogenic capacity of RSV.