High serum free fatty acid (FFA) levels are associated with metabolic syndrome (MS). This study aimed to assess the association of fasting serum FFAs with nonalcoholic fatty liver disease (NAFLD) in a Chinese population. A total of 840 subjects fulfilled the diagnostic criteria of NAFLD and 331 healthy control participants were enrolled in this cross-sectional study. Fasting serum FFA levels and other clinical and laboratory parameters were measured. NAFLD patients had significantly higher serum FFA levels than controls (P < 0.001). Serum FFA levels were significantly and positively correlated with parameters of MS, inflammation indexes, and markers of hepatocellular damage. Elevated serum FFA levels were found in NAFLD subjects with individual components of MS (obesity, hypertriglyceridaemia, and hyperglycaemia). Stepwise regression showed that serum FFA levels were an independent factor predicting advanced fibrosis (FIB-4 ≥ 1.3) in NAFLD patients. Serum FFA levels correlated with NAFLD and could be used as an indicator for predicting advanced fibrosis in NAFLD patients.
Although the outcome of colorectal cancer (CRC) patients has improved significantly with the recent implementation of annual screening programs, reliable prognostic biomarkers are still needed due to the disease heterogeneity. Increasing pieces of evidence revealed an association between immune signature and CRC prognosis. Thus, we aim to build a robust immune-related gene pairs (IRGPs) signature that can estimate prognosis for CRC. Gene expression profiles and clinical information of CRC patients were collected from six public cohorts, divided into training cohort (n = 565) and five independent validation cohorts (n = 572, 290, 90 177 and 68, respectively). Within 1534 immune genes, a 19 IRGPs signature consisting of 36 unique genes was constructed which was significantly associated with the survival. In the validation cohorts, the IRGPs signature significantly stratified patients into highvs low-risk groups in terms of prognosis across and within subpopulations with early stages disease and was prognostic in univariate and multivariate analyses. Several biological processes, including response to bacterium, were enriched among genes in the IRGPs signature. Macrophage M2 and mast cells were significantly higher in the high-risk risk group compared with the low-risk group. The IRGPs signature achieved a higher accuracy than commercialized multigene signatures for estimation of survival. When integrated with clinical factors such as sex and stage, the composite clinical and IRGPs signature showed improved prognostic accuracy relative to IRGPs signatures alone. In short, we developed a robust IRGPs signature for estimating prognosis in CRC, including early-stage disease, providing new insights into the identification of CRC patients with a high risk of mortality. ARTICLE HISTORY
ObjectiveThis study was designed to examine the relationship between shortened activated partial thromboplastin time (APTT) and increased fibrinogen values with diabetes mellitus.MethodsAPTT, prothrombin time (PT), fibrinogen, fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) levels were measured in 1,300 patients. Patients were divided into three groups according to their HbA1c and FPG levels.ResultsWhen participants were grouped according to their HbA1c levels, we found significantly shorter APTT values (26.9±5.6 s) and increased fibrinogen levels (3.1, 1.9–6.3 g/L) in the diabetes group when compared with the other two groups. When participants were grouped according to their FPG levels, we found significantly shorter APTT values (26.9±6.2 s) and increased fibrinogen levels (3.1, 1.8–6.2 g/L) in the diabetes group when compared with the euglycemic group.ConclusionsShorter APTT and increased fibrinogen levels might be useful hemostatic markers in patients with diabetes and in patients at high risk for diabetes.
ObjectiveIn patients with chronic hepatitis B virus (HBV) infection, it is not known whether altered serum iron markers are directly because of the infection or the associated liver injury. We determined the serum iron status of patients with chronic HBV infection, and investigated whether it is HBV infection or HBV-related liver injury that likely causes abnormal serum iron markers in chronic HBV infection.Materials and methodsFor a retrospective study, chronic HBV-infected patients (80 patients with cirrhosis and 76 patients without cirrhosis) and 58 healthy controls were enrolled. Serum alanine transaminase levels were measured to ascertain liver damage. Indicators of iron status included serum iron, ferritin, and transferrin.ResultsCompared with noncirrhotic patients and healthy controls, the serum transferrin of cirrhotic patients was lower and the serum iron and ferritin values were higher (P<0.001, all). In cirrhotic patients, the serum iron and ferritin levels correlated positively with serum alanine transaminase levels and the transferrin levels were inversely related to both end-stage liver disease scores and iron levels (all P<0.01).ConclusionSerum iron markers tended to be aberrant in chronic HBV-infected patients with cirrhosis. The liver injury associated with HBV infection, but not chronic HBV infection directly, is likely the main cause for iron metabolism disorder.
Objective Infection with hepatitis B virus (HBV) remains a major cause of liver cirrhosis (LC) in China. Recent reports suggest that the lymphocyte-to-monocyte ratio (LMR) is a potential biomarker for predicting clinical outcomes. In our study, we investigated if LMR can be used as a prognostic marker of mortality in patients with HBV-related LC. Design A retrospective cohort study. Setting HBV-infected patients with LC and patients with chronic hepatitis B infection (CHB) from the Department of Infectious Disease were enrolled and 240 healthy individuals were recruited from the healthcare centre at the First Affiliated Hospital of Zhejiang University. Participants 479 HBV-infected patients with LC, 134 patients with CHB and 240 healthy individuals were enrolled. Primary and secondary outcome measures The receiver operating characteristic (ROC) curve and multivariable logistic regression analysis after adjusting for total protein, albumin, total bilirubin and the model for end-stage liver disease (MELD) score were used to evaluate the power of LMR for predicting 1 year mortality in patients with LC. Results The LMR was statistically lower in patients with LC. The MELD score and mortality were statistically higher in patients with LC compared with the CHB and control groups. The area under the ROC curve, cut-off values, sensitivity and specificity of LMR for predicting mortality LC in the training cohort were 0.817 (95% CI 0.746 to 0.888; p<0.001), 2.10, 82.6 and 78.8%, and these data were confirmed in the validation cohort. The multivariate logistic regression analysis showed that LMR was an independent predictive factor of mortality in LC (OR 2.370, 95% CI (1.070 to 5.249); p=0.033). Conclusions Our results strongly suggest that low LMR can be considered as an independent biomarker for predicting mortality in patients with LC.
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