Visfatin is not associated with inflammatory markers in patients on hemodialysis

BACKGROUND

Cardiovascular events are a major cause of death in patients with end-stage renal disease. Endothelial dysfunction represents a key event in atherosclerosis development and has been implicated in the pathophysiology of different forms of cardiovascular disease, including chronic kidney disease. In recent years, visfatin, a ubiquitous adipokine, has been described as a potent marker of endothelial inflammation and dysfunction. The aim of the study was to investigate the association of visfatin with well-known markers of inflammation and endothelial dysfunction.

METHODS

Serum and plasma samples from 66 patients (40 males and 26 females) treated by hemodialysis were analysed for visfatin, fibrinogen, CRP, PAI-1 levels. Visfatin was determined by ELISA method while CRP, fibrinogen and PAL-1 were obtained by standard laboratory methods.

RESULTS

We observed statistically significant correlation between visfatin level and fibrinogen (r = 0.51; p = 0.008) and the time on dialysis in female patients (r = 0.70; p < 0.001). PAI-1 and CRP did not correlate with visfatin in males nor in females.

CONCLUSIONS

Visfatin is correlated with time on dialysis and with fibrinogen only in female dialysis patients. To confirm this, further studies are needed with a higher number of patients.

Biochemia medica appoints research integrity editor

Biochemia Medica has just established the Research integrity editor who will act as the Editorial team member responsible for all matters related to the various aspects of scientific misconduct. The major reason for this is the increasing number of various types of scientific misconduct in manuscripts submitted to our Journal. Research integrity editor will: a) strive to continuously raise awareness for research and publication integrity issues; b) educate our authors, reviewers and readers, by providing educational articles on various topics related to responsible research and writing; c) aim to prevent unethical research and publication practices; and d) responsibly deal with research and publication misconduct attempts in accordance with internationally accepted policies and recommendations. This initiative provides firm evidence of our commitment and respect for publishing ethical and responsible research. By this we hope to further increase the scientific quality of the journal content as well as the quality of the editorial work.

ABCC8 polymorphisms are associated with triglyceride concentration in type 2 diabetics on sulfonylurea therapy

BACKGROUND

The failure of therapy with oral hypoglycemic drugs leads to not only poorly regulated glycemic status, but also dyslipidemia and increased body weight and body mass index (BMI). Sulfonylureas act as insulin secretagogues by binding to the sulfonylurea receptor (SUR-1) encoded by the gene ABCC8. The aim of this study was to explore whether there is an association of ABCC8 polymorphisms SUR1 exon 16 (-3C/T), SUR-1 exon 31 (Arg1273Arg), and SUR-1 exon 33 (S1369A) with lipid concentration and BMI in type 2 diabetics on sulfonylurea therapy.

MATERIALS AND METHODS

This study included 251 unrelated type 2 diabetics on sulfonylurea therapy. Height and weight were measured for BMI calculation. All polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism methods. Lipid concentrations and BMI were measured at inclusion into the study and after 6 months of follow-up.

RESULTS

Wild-type allele carriers for the SUR-1 exon 31 polymorphism (Arg1273Arg) had a significantly higher triglyceride (TG) concentration when compared with the carriers of two variant alleles (p=0.023). Polymorphic allele carriers of the SUR-1 exon 16 (-3C/T) polymorphism were more frequent in the subgroup of patients with the TG concentration increase after 6 months (p for genotype and allelic differences: 0.024 and 0.015, respectively).

CONCLUSION

ABCC8 polymorphisms in exon 16 and 31 are associated with the TG concentration in type 2 diabetics on sulfonylurea therapy.

Biochemia Medica indexed in Medline

Biochemia Medica has been approved for inclusion in PubMed/Medline bibliographic database, from the first issue published in 2011 year. We believe that this outstanding achievement comes as acknowledgment for many past efforts and some recent developments of the journal Editorial Board, such as recent launch of a new web page, online manuscript submission system and the implementation of the revised policy on the Statement of Conflict of Interest. We will continue our committed work to maintain the timeliness of publication, publication ethics and research integrity, and further improve the quality of content as well as the quality of the editorial work and production of the Journal. We sincerely hope that inclusion of our Journal in PubMed will enable us to increase its international visibility and the number of high-quality submissions.

Practical recommendations for statistical analysis and data presentation in Biochemia Medica journal

The aim of this article is to highlight practical recommendations based on our experience as reviewers and journal editors and refer to some most common mistakes in manuscripts submitted to Biochemia Medica. One of the most important parts of the article is the Abstract. Authors quite often forget that Abstract is sometimes the first (and only) part of the article read by the readers. The article Abstract must therefore be comprehensive and provide key results of your work. Problematic part of the article, also often neglected by authors is the subheading Statistical analysis, within Materials and methods, where authors must explain which statistical tests were used in their data analysis and the rationale for using those tests. They also need to make sure that all tests used are listed under Statistical analysis section, as well as that all tests listed are indeed used in the study. When writing Results section there are several key points to keep in mind, such as: are results presented with adequate precision and accurately; is descriptive analysis appropriate; is the measure of confidence provided for all estimates; if necessary and applicable, are correct statistical tests used for analysis; is P value provided for all tests, etc. Especially important is not to make any conclusions on the causal relationship unless the study is an experiment or clinical trial. We believe that the use of the proposed checklist might increase the quality of the submitted work and speed up the peer-review and publication process for published articles.

Preanalytical phase--a continuous challenge for laboratory professionals

Preanalytical phase is the most vulnerable part of the total testing process and is considered to be among the greatest challenges to the laboratory professionals. However, preanalytical activities, management of unsuitable specimens and reporting policies are not fully standardized, nor harmonized worldwide. Several standards related to blood sampling and sample transportation and handling are available, but compliance to those guidelines is low, especially outside the laboratory and if blood sampling is done without the direct supervision of the laboratory staff. Furthermore, for some most critical procedures within the preanalytical phase, internationally accepted guidelines and recommendations as well as related quality measures are unfortunately unavailable. There is large heterogeneity in the criteria for sample rejection, the different strategies by which unacceptable samples are managed, processed and test results reported worldwide. Management of unacceptable specimens warrants therefore immediate harmonization. Alongside the challenging and long road of patient safety, preanalytical phase offers room for improvement, and Editors at Biochemia Medica Journal definitely hope to continue providing a respective mean for reporting studies on different preanalytical phase topics. With pleasure and delight we invite potential future authors to submit their articles examining the quality of various preanalytical activities to Biochemia Medica. We will keep nurturing this topic as our prominent feature and by this we hope to be able to deliver valid evidence for some future guidelines and recommendations.

Biochemia Medica introduces the revised policy on statement of conflict of Interest

Biochemia Medica announces that from this issue Journal will be publishing the Statement on Conflict of Interest for Authors for all article types in printed as well as in electronic form of the Journal. This way Journal wishes to provide its readers the opportunity to unambiguously judge the quality and reliability of the data presentation and potential competing interests that could have biased the quality of the presented work in any way. This decision was made because we believe that scientific journals have an ultimate responsibility to provide unbiased scientific articles to its readership. We also believe that if any potential source of bias exists, it is the responsibility of the journal to disclose this information, since this might influence the judging the manuscript by editors, reviewers and readers. Therefore, when submitting their work in the future, author are kindly invited to make sure that they have carefully considered and disclosed all potential sources of competing interests that might have influenced their work. We hope that in such way we can help build a better future for the evidence based scientific research, on an international level.

Clinical chemistry and laboratory medicine in Croatia: regulation of the profession

Heterogeneity exists across Europe in the definition of the profession of clinical chemistry and laboratory medicine and also in academic background of specialists in this discipline. This article provides an overview of the standards of education and training of laboratory professionals and quality regulations in Croatia. Clinical chemistry in Croatia is almost exclusively practiced by medical biochemists. Although term Medical biochemist often relates to medical doctors in other European countries, in Croatia medical biochemists are not medical doctors, but university degree professionals who are qualified scientifically. Practicing the medical biochemistry is regulated by The Health Care Law, The Law of the Medical Biochemistry Profession and The Law of the State and Private Health Insurance. According to the law, only medical biochemists are entitled to run and work in the medical biochemistry laboratory. University degree is earned after the 5 years of the studies. Register for medical biochemists is kept by the Croatian Chamber of Medical Biochemists. Licensing is mandatory, valid for 6 years and regulated by the government (Law on the Health Care, 1993). Vocational training for medical biochemists lasts 44 months and is regulated by the national regulatory document issued by the Ministry of Health. Accreditation is not mandatory and is provided by an independent, non-commercial national accreditation body. The profession has interdisciplinary character and a level of required competence and skills comparable to other European countries.

Preanalytical quality improvement: from dream to reality

Abstract Laboratory diagnostics (i.e., the total testing process) develops conventionally through a virtual loop, originally referred to as "the brain to brain cycle" by George Lundberg. Throughout this complex cycle, there is an inherent possibility that a mistake might occur. According to reliable data, preanalytical errors still account for nearly 60%-70% of all problems occurring in laboratory diagnostics, most of them attributable to mishandling procedures during collection, handling, preparing or storing the specimens. Although most of these would be "intercepted" before inappropriate reactions are taken, in nearly one fifth of the cases they can produce inappropriate investigations and unjustifiable increase in costs, while generating inappropriate clinical decisions and causing some unfortunate circumstances. Several steps have already been undertaken to increase awareness and establish a governance of this frequently overlooked aspect of the total testing process. Standardization and monitoring preanalytical variables is of foremost importance and is associated with the most efficient and well-organized laboratories, resulting in reduced operational costs and increased revenues. As such, this article is aimed at providing readers with significant updates on the total quality management of the preanalytical phase to endeavour further improvement for patient safety throughout this phase of the total testing process.

Insulin receptor H1085H C>T and insulin receptor substrate 1 G972R polymorphisms and prostate cancer risk: a pilot study

BACKGROUND

In recent years, numerous studies have focused their attention on genes that are part of the insulin/insulin-like growth factor 1 signaling pathway, such as the insulin receptor (INSR) and the insulin receptor substrate 1 (IRS1) genes.

AIM

We aimed to examine the association of INSR H1085H C>T and IRS1 G972R polymorphisms with prostate cancer (PC). We also aimed to examine possible association with cancer severity assessed by Gleason score.

MATERIALS AND METHODS

We have studied 180 consecutive patients referred for PC screening. The genotyping of two polymorphisms (INSR H1085H C>T and IRS1 G972R) was performed by the polymerase chain reaction-restriction fragment length polymorphism method.

RESULTS

There was no difference in genotype (p=0.794) or allelic (p=0.621) frequency of the IRS1 G972R polymorphism between PC (n=119) and control (n=61) groups. However, a significant difference was found in INSR H1085H C>T polymorphism genotype and allelic distribution. Carriers of the polymorphic allele (C/T+T/T) were more frequent in control group patients than in the PC group (54.10% vs. 37.82%; p=0.040; odds ratio [95% confidence interval]=0.52 [0.28-0.96]). The IRS1 and INSR polymorphism distribution did not differ in subgroups according to Gleason score.

CONCLUSION

INSR H1085H C>T polymorphism seems to be associated with PC risk, whereas IRS1 G972R is not. However, because of the limited power of this study, there is a possibility that some modest effects of the IRS1 G972R polymorphism on PC risk went undetected. Neither polymorphism is associated with the degree of PC malignancy.

The prevalence of preanalytical errors in a Croatian ISO 15189 accredited laboratory

BACKGROUND

The preanalytical phase is the most common source of laboratory errors. The goal of this descriptive study was to analyze the prevalence and type of preanalytical errors in relation to the site of sample collection (inpatient vs. outpatient) and the type of laboratory unit (hematology and coagulation vs. biochemistry). For the biochemistry unit, the data were also analyzed relative to the type of the analysis (stat vs. routine).

METHODS

We retrospectively analyzed the sample and test request form error rate for a 1-year period, from January to December 2008.

RESULTS

The frequency of the sample errors differed significantly between the emergency and routine biochemistry unit (0.69% vs. 2.14%; p<0.0001), and between inpatients and outpatients (1.12% vs. 1.36%; p=0.0006). Hemolysis was the most frequent sample error, accounting for 65% of all unsuitable specimens in the emergency biochemistry unit. The total sample error rate did not differ between hematology and coagulation vs. the biochemistry unit. The frequency of test request form errors differed significantly with respect to the sample collection site (p<0.0001), laboratory unit (p<0.0001) and type of the analysis (p<0.0001). Errors in the test request form were least frequent in the outpatient unit (2.98%) and most frequent in the routine biochemistry unit (65.94%).

CONCLUSIONS

Sample and test request form errors in our laboratory are occurring with a frequency comparable to that reported by others. Continuous educational action is needed for all stakeholders involved in laboratory testing to improve the quality of the preanalytical phase of the total testing process.

Methodological issues of genetic association studies

Genetic association studies explore the association between genetic polymorphisms and a certain trait, disease or predisposition to disease. It has long been acknowledged that many genetic association studies fail to replicate their initial positive findings. This raises concern about the methodological quality of these reports. Case-control genetic association studies often suffer from various methodological flaws in study design and data analysis, and are often reported poorly. Flawed methodology and poor reporting leads to distorted results and incorrect conclusions. Many journals have adopted guidelines for reporting genetic association studies. In this review, some major methodological determinants of genetic association studies will be discussed.

Comparison of visual vs. automated detection of lipemic, icteric and hemolyzed specimens: can we rely on a human eye?

BACKGROUND

Results from hemolyzed, icteric, and lipemic samples may be inaccurate and can lead to medical errors. These preanalytical interferences may be detected using visual or automated assessment. Visual inspection is time consuming, highly subjective and not standardized. Our aim was to assess the comparability of automated spectrophotometric detection and visual inspection of lipemic, icteric and hemolyzed samples.

METHODS

This study was performed on 1727 routine biochemistry serum samples. Automated detection was performed using the Olympus AU2700 analyzer. We assessed: 1) comparability of visual and automated detection of lipemic, icteric and hemolyzed samples, 2) precision of automated detection, and 3) inter-observer variability for visual inspection.

RESULTS

Weighted kappa coefficients for comparability of visual and automated detection were: 0.555, 0.529 and 0.638, for lipemic, icteric and hemolyzed samples, respectively. The precision for automated detection was high for all interferences, with the exception of samples being only slightly lipemic. The best overall agreement between observers was present in assessing lipemia (mean weighted kappa=0.698), whereas the lowest degree of agreement was observed in assessing icterus (mean weighted kappa=0.476).

CONCLUSIONS

Visual inspection of lipemic, icteric and hemolyzed samples is highly unreliable and should be replaced by automated systems that report serum indices.