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Background: Chronic kidney disease (CKD) is a worldwide public health problem and a major cause of suffering and having a reduced quality of life for those affected. Objective: We aimed to study the changes in red blood cell indices and mineral bone metabolism in hemodialysis patients and to explore the correlation between these studied parameters. Patients and Methods: This is a case control study included 55 adult patients with end stage renal disease on maintenance hemodialysis as well as 55 healthy individuals as a control group. All participants were subjected to laboratory investigations included complete blood count and serum levels of creatinine, urea, total calcium, albumin, phosphate and intact parathyroid hormone (iPTH). Results: Our study showed that hemoglobin (Hb), hematocrit and red blood cell count were significantly reduced in the hemodialysis patients (P<0.001 for all). Regarding mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration, no significant differences were found between the hemodialysis patients and the control group (P= 0.362, 0.116, 0.22, respectively). In the hemodialysis group, the albumin-corrected serum calcium level was significantly lower while the serum phosphate and iPTH levels were significantly higher compared to the control group (P<0.001 for all). Hb was inversely correlated with serum iPTH (r=-0.359, P=0.007) and serum phosphate (r=-0.570, P<0.001) in the hemodialysis group and was inversely correlated with serum phosphate (r=-0.495, P<0.001) in the control group. Conclusion:Hemodialysis patients are at high risk of anemia, hypocalcemia, hyperphosphatemia and hyperparathyroidism. In hemodialysis patients, an association was found between anemia and each of hyperphosphatemia and hyperparathyroidism.

Background: Patients with type 2 diabetes mellitus (T2DM) are at increased risk of atherosclerosis. The early recognition of atherosclerosis at its subclinical stages can slow or prevent progression to atherosclerotic diseases, including coronary artery disease, cerebrovascular disease, and peripheral arterial disease. Objective: Identification of the relationship between T2DM and subclinical atherosclerosis and to explore factors that can be associated with a high risk of subclinical atherosclerosis. Patients and Methods: We recruited 75 participants among whom 50 T2DM while 25 were controls. Patients with T2DM were subdivided into two equal groups, well-controlled and uncontrolled. After complete history and examination, investigations including fasting and 2-hour postprandial blood glucose, high sensitive C-reactive protein (hs-CRP), and serum triglyceride (TG) levels were obtained. All participants underwent duplex ultrasound that was used to measure carotid intima-media thickness (cIMT) as a biomarker of subclinical atherosclerosis. Results: Uncontrolled diabetics had increased cIMT than well-controlled diabetics and well-controlled diabetics had increased cIMT than non-diabetics. There was a highly significant positive correlation between cIMT and duration of diabetes in both well-controlled and uncontrolled diabetic groups. In the uncontrolled diabetic group only, there was a highly significant positive correlation between cIMT and each of hs-CRP and TG levels. Conclusion:The risk of subclinical atherosclerosis is higher in type 2 diabetic patients especially in those with uncontrolled diabetes. In uncontrolled diabetics, subclinical atherosclerosis is associated with hypertriglyceridemia and elevated hs-CRP level.

The pathogenesis of diabetic nephropathy (DN) is still incompletely understood. Few studies have linked the cellular inflammatory markers, interleukin 6 (IL-6) and highly sensitive C-reactive protein (hs-CRP), to the development of DN. AimWe aimed to explore the link among IL-6, hs-CRP, and grades of DN in both types of diabetes mellitus (DM). Settings and designWe carried out a case-control study on participants selected from the outpatient clinic of Internal Medicine Department. Patients and methodsWe worked on 91 participants, comprising 78 patients and 13 controls. The patient group was further subdivided into two subgroups: subgroup I [39 patients type 1 DM (T1DM)] and subgroup II [39 patients type 2 DM (T2DM)]. Each subgroup was categorized according to the urinary albumin excretion rate into three divisions: A (<20 μg/min), B (20-200 μg/min), and C (>200 μg/min). We applied history taking, clinical examination, routine investigation, and IL-6 with hs-CRP testing to all participants. Statistical analysisWe used Shapiro-Wilk test, χ 2 test, Student's t test, one-way analysis of variance, Kruskal-Wallis test, least significant difference test, and Pearson's correlation coefficient for data analysis. ResultsDespite the significant difference of laboratory data between patient and control groups, least significant difference analysis revealed a nonsignificant difference between patients with T1DM and those with T2DM. On the level of the in-groups analysis, the most significant key players were hs-CRP and IL-6 among the three urinary albumin excretion rate categories of patients with T1DM and T2DM, with P values less than 0.01. ConclusionsWe concluded that IL-6 and hs-CRP might be used as sensitive markers for the development of DN.

Background Coronary artery disease (CAD) represents the leading cause of death worldwide. Animal and human studies have demonstrated that silent information regulator 1 (SIRT1) is involved in a wide range of physiological and pathological processes. This study aimed to measure the plasma level of SIRT1 in patients with CAD and explore its correlation with cardiovascular risk factors. Results Plasma SIRT1 was significantly lower in patients with chronic coronary syndrome (CCS) than in those in the control group and was significantly lower in patients with both acute myocardial infarction and unstable angina than in those in the control group and with CCS. Moreover, plasma SIRT1 was positively correlated with platelet count and negatively correlated with cholesterol and triglyceride levels. Conclusions The plasma level of SIRT1 is lower in patients with CAD compared to control and it could be a possible marker for this disease. Multi-center studies with follow-up measurements are recommended for further investigation.