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Aims and objectives: Pregnancy associated plasma protein-A (PAPP-A), a metalloproteinase plays apivotal role in the pathogenesis of atherosclerosis. Recent studies have reported that elevated levels of PAPP-A, signal the onset of acute coronary syndrome (ACS). We, therefore, proposed to study the analytical competence of PAPP-A in patients admitted to the emergency department with chest pain and finally diagnosed as ACS. Methods and results:Pregnancy associated plasma protein-A was measured using enzyme-linked immunosorbent assay (ELISA) in 485 patients admitted to emergency care unit, of which 89 patients were diagnosed as Non-cardiac chest pain (NCCP). Elevated levels of PAPP-A were observed in patients diagnosed as ACS on comparison with the controls. Receiver operator characteristic (ROC) curve analysis showed PAPP-A to be a good discriminator between ischaemic and nonischaemic patients. The area under the curve was found to be 0.904, 95% CI (0.874-0.929) with 90% sensitivity and 85% specificity (P < 0.0001). The cut-off value from the ROC curve was 0.55 μg/ mL above which PAPP-A was considered to be positive. Conclusion:Pregnancy associated plasma protein-A seems to be a promising biomarker for identification and risk stratification for patients with ACS.

In an analysis of the possible association of endothelial constitutive nitric oxide synthase (ecNOS) gene polymorphism and plasma nitric oxide levels in patients with acute coronary syndrome, we investigated 106 patients with the syndrome and 100 healthy controls. Genotype was determined using the polymerase chain reaction; plasma nitric oxide levels were found using ELISA. The genotype frequencies for the a/b polymorphism in the control group were 77% for bb, 19% for ab, and 4% for aa. In the patients, genotype frequencies were 55% bb, 34% ab, and 11% aa. The allele frequencies were 28% a and 72% b among the patients and 13% a and 87% b among control subjects. Our findings showed a significant association of the ecNOS gene polymorphism with acute coronary syndrome in the South Indian population.

There is a rising trend in the prevalence of insulin resistance among obese, overweight children and adolescents. The serum insulin and its correlation with biochemical, clinical and anthropometric parameters were evaluated in 185 children and adolescents (59 control, 52 obese, 49 overweight, 25 congenital heart disease) of age group 10-17 years. The levels of serum insulin were measured by ELISA. Serum insulin levels were found to be significantly increased in children who were obese, overweight and had congenital heart disease, than controls. Serum insulin levels positively correlated with BMI, WHR, and serum C-peptide, serum leptin, total cholesterol, triglycerides, LDL-cholesterol, systolic and diastolic blood pressure. Fasting glucose levels were found to be negatively correlated with serum insulin levels. HDL-cholesterol levels were non-significant among the study groups. We identified nine obese children (five girls and four boys) with the features of metabolic syndrome and 69% of obese and overweight children were identified with insulin resistance. Insulin resistance was strongly associated with metabolic syndrome and its components, especially with central obesity and hypertriglyceridemia.

Background: It is well established that patients with type 2 diabetes mellitus are at increased risk for chronic kidney and cardiovascular diseases. Diagnosis of diabetic nephropathy and cardiovascular diseases at an early stage in patients with type 2 diabetes mellitus is difficult. Therefore, biomarker for estimation of renal function was chosen. Aims and Objectives: To evaluate serum cystatin C and its correlation with biochemical, clinical, and anthropometric parameters in patients with type 2 diabetes and healthy controls. Materials and Methods: The levels of serum cystatin C were evaluated in 100 subjects (50 with type 2 diabetes and 50 controls) of age group 40-70 years and were measured using particle-enhanced immunonephelometry. Results: The levels of serum cystatin C were found to be significantly increased in patients with diabetes mellitus (0.97 ± 0.19 mg/L; P < 0.01) than healthy controls (0.84 ± 0.1 mg/L). In this study, it was found that few diabetes patients with normoalbuminuria with elevated levels of serum cystatin C and cystatin C-based estimated glomerular filtration rate (eGFR). The levels of serum cystatin C correlated positively with eGFR, serum creatinine, and systolic blood pressure and showed negative correlation with estimated creatinine clearance and no association with body mass index, waist-to-hip ratio, and diastolic blood pressure. Conclusion: Measurement of the levels of serum cystatin C is a useful, practical, noninvasive technique for the evaluation of renal involvement and might be related with a risk for cardiovascular events in patients without nephropathy in the course of diabetes, especially in patients with normoalbuminuria.