Summary Background: One of the leading causes of terminal renal failure is diabetic nephropathy. The aim of this study was to determine the relationship between homocysteine levels and the biomarkers of renal function, inflammation and oxidative stress, as well as the incidence of macrovascular complications in patients with diabetic nephropathy. Methods: Sixty-four patients with diabetic nephropathy were included in this study. They were divided according to their homocysteine levels into two groups: hyperhomocysteinemic (HHcy, n=47) and normohomocysteinemic patients (NHCy, n=17). The re sults were compared to a control group (n=20) with normal renal function and without diabetes. Besides homocysteine, cystatine C, creatinine, urea, albuminuria, creatinine clearance, lipid status parameters, apolipoprotein A-I and B, lipo protein (a), CRP, fibrinogen, oxidative LDL were determined using appropriate methods. The incidence of macro vascular diabetic complications was also determined. Results: The results indicate that the level of renal dysfunction is greater in HHcy than in NHcy patients (p<0.05). In HHcy patients levels of oxLDL were also higher compared to NHcy patients (119.3±140.4 vs. 71.4±50.8 ng/mL, disp< 0.05) as well as fibrinogen levels (4.3±1.3 vs. 3.7±0.8 g/L, p<0.05). The in cidence of macrovascular complications is more frequent in HHcy than in NHcy patients (55.3. vs. 35.3 %, p>0.05), and in patients with macroalbuminuria compared to patients with microalbuminuria (65% vs. 39%, p<0.05). Conclusions: It can be concluded that HHcy is significantly present in patients with diabetic nephropathy, especially if there is greater reduction of renal function. Besides that, significantly higher concentrations of inflammatory (fibrinogen) and oxidative stress (oxLDL) markers were present in HHcy patients with diabetic nephropathy compared to NHcy patients.Therefore in diabetic nephropathy patients it is useful to regularly monitor the levels of homocysteine, as well as inflammatory and markers of oxidative stress.
identifikacije i le~enja asimp tomatskih osoba s visokim rizikom za razvoj koronarne bolesti srca (KBS) u praksi se koriste razli~iti bodovni sistemi za procenu rizika. Cilj ovog istra`ivanja je da se izvr{i upore|ivanje SCORE bodovnog sistema preporu~enog za na{u sredinu sa ostala dva naj~e{}e kori{}ena bodovna sistema za pro ce nu 10-godi{njeg rizika za KBS: Framinghamskog i PROCAM sistema, kao i njihovih modifikacija. Od 220 pregledanih ispitanika oba pola, upu}enih u Ambulantu za pre venciju ateroskleroze Klini~kog centra Vojvodine prvenstveno radi le~enja lipidskog poreme}aja, 110 je uklju~eno u na{u studiju i pra}eno godinu dana. Prilikom prvog pregleda, osoba s niskim rizikom je bilo od 15% prema skoru Framingham Weibull do 78% prema skoru PRO -CAM, srednjim od 12% prema PROCAM NS do 45% prema Framingham Weibullu, a visokim od 8% prema PRO -CAM-u do 40% prema Framigham Weibullu. Posle godinu dana le~enja, u kategoriji niskog rizika bilo je od 30% prema Framingham Weibullu do 88% prema PROCAM-u, srednjeg od 10% prema PROCAM-u do 36% prema Framingham Weibullu, a visokog od 2% pre ma PROCAM-u do 25% prema Framingham Weibullu. Kako su lipidski pa rametri zna~ajni kriterijumi svih bodovnih siste ma za pr ocenu rizika od KBS, ustanovljeno je o~ekivano signifi kan tno sni `enje broja ispitanika u kategoriji visokog, a po ve }anje u kategoriji niskog rizika posle godinu dana le ~enja lipidskog poreme}aja, procenjivano prema svim ispi tivanim bodovnim sistemima.Klju~ne re~i: koronarna bolest srca, faktori rizika, pro cena rizika, hiperlipidemija Summary: Atherosclerosis is a multifactorial disease with risk factors that have multiple effects. In the identification and treatment of asymptomatic indi viduals at high risk for developing coronary heart disease (CHD) diffe rent risk scoring schemes are used in everyday routine. The aim of this study was to compare SCORE recommended for our country with two other most frequently used risk schemes for 10-year CHD risk evaluation: Framingham and PROCAM as well as their modifications. From 220 examined subjects of both sexes, who were treated mainly for lipid metabolism disorder at the Dispensary for Atherosclerosis Prevention, Centre for Labor atory Medicine, Clinical Centre of Vojvodina, 110 subjects were included in our study and agreed to a one-year follow-up. At first check-up, 15% had low risk according to Framin gham Weibull and 78% according to PROCAM, intermediate 12% according to PROCAM NS up
Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac DiseaseContemporary guidelines for the first-line diagnosis of celiac disease recommend determination of IgA anti-tissue transglutaminase antibodies or IgA antiendomysial antibodies, as well as total serum IgA antibodies. The aim of our study was to assess the validity and clinical significance of serological testing for IgA anti-tissue transglutaminase antibodies in the diagnosis of celiac disease, and to investigate the presence of malabsorption symptoms in celiac patients. IgA anti-tissue transglutaminase antibody testing was performed in 50 subjects with clinically suspected celiac disease (21 men and 29 women). All subjects underwent endoscopy with small intestine biopsy. Celiac disease was confirmed by histopathological findings in four subjects, whereas the IgA anti-tissue transglutaminase test was positive in three subjects. The IgA anti-tissue transglutaminase test showed sensitivity of 75% and specificity of 100%. There were significant differences between men with biopsy-confirmed and excluded celiac disease in the erythrocyte parameters MCV (96.5±7.7 vs. 78.6 ±11.3; p<0.05), MCH (36.9±4.6 vs. 25.9±4.9; p<0.01), and MCHC (382.5±16.3 vs. 326.9±19.1; p<0.005), as well as in the levels of total protein (47.5 ±16.3 vs. 68.3 ± 7.6; p<0.01) and albumins (24.6±9.5 vs. 42.1 ± 6.9; p<0.01). In addition, HDL-cholesterol levels were significantly lower in men with biopsy-confirmed celiac disease (0.42.±0.12 vs. 0.90±0.30; p<0.05). Our results show a high correlation between IgA anti-tissue transglutaminase testing and endoscopy with biopsy as the gold diagnostic standard.
Kratak sadr`aj: Podaci o proaterogenim promenama lipidskog statusa u sklopu hroni~ne Helicobacter pylori (HP) infekcije su kontradiktorni. Cilj istra`ivanja bio je da se ispitaju razlike u nekim lipidskim parametrima izme|u 55 osoba oba pola s hroni~nom HP infekcijom (IgG >50 U/mL i IgA <20 U/mL) i 55 HP seronegativnih osoba (IgG i IgA <20 U/mL) oba pola. Serumske koncentracije ukupnog holesterola (TC) (p<0,001), triglicerida (TG) (p<0,05), LDL-holesterola (LDL-C) (p<0,02), non-HDL-holesterola (non-HDL-C), apolipoproteina (apo) B (p<0,001), Lp(a) i HDL-holesterola (HDL-C) bile su vi{e kod HP seropozitivnih u odnosu na seronegativne osobe, dok gotovo da nije bilo razlika u nivoima apo A-I. Kod HP seropozitivnih osoba, u~estalost patolo{kih TC (p<0,001), TG (p<0,05), LDL-C (p<0,01), non-HDL-C (p<0,01), apo B (p<0,02) i Lp(a) vrednosti bila je vi{a u odnosu na seronegativne. Ustanovljena je negativna korelacija serum skih titara HP IgG antitela s TC, LDL-C (p<0,05), non-HDL-C, apo B i Lp(a), a pozitivna s TG, HDL-C i apo A-I nivoima. Rezultati su sli~ni za oba pola. Na{i rezultati idu u prilog hipotezi da bi hroni~na HP infekcija mogla da modifikuje lipidske parametre na proate rogeni na~in.Klju~ne re~i: ateroskleroza, Helicobacter pylori, lipidi, aterogeni rizik Summary: Data on proatherogenic lipid profile alterations due to chronic Helicobacter pylori (HP) infection are contradictory. Aim of this study was to examine the differences in some lipid parameters between 55 subjects of both gender with a chronic HP infection (IgG>50 U/mL and IgA <20 U/mL) and 55 gender matched HP seronegative subjects (IgG and IgA <20 U/mL). Total cholesterol (TC) (p<0.001), triglycerides (TG) (p<0.05), LDL-cholesterol (LDL-C) (p<0.02), non-HDL-cholesterol (non-HDL-C), apolipoprotein (apo) B (p<0.001), Lp(a) and HDL-cholesterol (HDL-C) serum levels were higher in HP seropositive than in seronegative subjects, while there were almost no differences in apo A-I. In HP seropositive subjects, the frequency of pathological TC (p<0.001), TG (p<0.05), LDL-C (p<0.01), non-HDL-C (p<0.01), apo B (p<0.02) and Lp(a) serum levels was higher compared to seronegative. Serum HP IgG titers correlated negatively with TC, LDL-C (p<0.05), non-HDL-C, apo B and Lp(a) levels, and positively with TG, HDL-C and apo A-I levels. Results are similar for both genders. Our results confirm the hypothesis that a chronic HP infection could modify the lipid profile in a proatherogenic way.
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