Comparison of the predictive value of plateletcrit with various other blood parameters in gestational diabetes development

Gestational diabetes is the most encountered metabolic disease in pregnancy and affects both the mother and fetus adversely. Low-grade subchronic inflammation is associated with gestational diabetes development. Platelets (PLT) play role in blood coagulation and inflammatory process. We aimed to compare the various platelet indices in patients with GDM and healthy pregnant controls and to determine whether PLT indices are useful in Gestational diabetes diagnosis. The present study was performed at the Zonguldak Bulent Ecevit University, School of Medicine, Department of Obstetrics and Gynecology. Statistically significant relationships with plateletcrit, mean platelet volume, and platelet distribution width and patients with GDM were found (p < 0.001). Plateletcrit had higher sensitivity and specificity than other platelet indices. Although plateletcrit is a largely unknown or an underestimated parameter in complete blood count, it gives more precise information than platelet count and mean platelet volume. Platelet-related indices and their determination are inexpensive and routinely ordered markers, the significance of which is often ignored. They may be useful in screening for gestational diabetes as an adjunct to oral glucose tolerance test.

Serum ischemia-modified albumin and malondialdehyde levels and superoxide dismutase activity in patients with fibromyalgia

BACKGROUND

The aim of the study was to determine serum ischemia modified albumin and malondialdehyde levels as markers of oxidative stress and serum superoxide dismutase activity as a marker of antioxidant defense and their associations with clinical outcomes in patients with fibromyalgia.

METHODS

59 patients with fibromyalgia and 38 age and gender matched healthy controls were included in the study. The diagnosis of fibromyalgia was based on the classification criteria declared by American College of Rheumatology in 1990. All patients underwent the clinical assessment, consisting of evaluation for tender point count, visual analogue scale for pain, fibromyalgia impact questionnaire, multidimensional assessment of fatigue, Beck anxiety inventory, Beck depression inventory, and the health assessment questionnaire. Serum levels of ischemia modified albumin, malondialdehyde, and superoxide dismutase activities were measured using colorimetric methods.

RESULTS

Malondialdehyde levels of fibromyalgia patients were significantly higher than they were in the control group. Ischemia modified albumin levels in the fibromyalgia group were not significantly different from the control values. There was no significant correlation between ischemia modified albumin and malondialdehyde and clinical measures with the exception that malondialdehyde levels positively correlated with health assessment questionnaire scores.

CONCLUSIONS

We concluded that increased malondialdehyde levels in patients with fibromyalgia could be considered as a sign of increased oxidative stress. Ischemia modified albumin values were not in concordance with malondialdehyde levels and could not be considered as an oxidative stress marker in the follow-up of fibromyalgia. Further studies are needed to investigate IMA levels in newly diagnosed fibromyalgia patients.

Serum uric acid may predict development of progressive acute kidney injury after open heart surgery

OBJECTIVES

Acute kidney injury (AKI) is a common complication of cardiac surgery developing in 25-35% cases. Recently, neutrophil gelatinase-associated lipocalin (NGAL) was shown to predict AKI development earlier than serum creatinine. Some studies demonstrated the predictive role of post-operative serum uric acid (SUA) as an early marker of AKI. We aimed to study the role of serum and urine NGAL as well as SUA to predict progression of AKI.

DESIGN AND METHODS

This is a prospective observational study of patients undergoing cardiac surgery. Blood and urine samples for measurement of uric acid, serum and urine NGAL levels were collected prior to cardiac surgery (0 h), and in the time course at 2nd and 24th hours after surgery. Patients who developed AKI were divided into two subgroups as progressing and non-progressing AKI.

RESULTS

Sixty patients (42 males, 18 females) were included. After cardiac surgery, 40 patients developed AKI, 20 of whom non-progressing AKI, and 20 progressing AKI. All of the markers significantly increased in AKI patients. A receiver operator characteristics (ROC) curve analysis showed higher predictive ability of SUA for progressing AKI compared with serum and urine NGAL. When compared markers obtained at the second hour after surgery, UA had significantly large AUC than NGAL to predict AKI developed at 24 and 48 h, particularly in patients, who require renal replacement therapy (RRT).

CONCLUSION

Uric acid seems to predict the progression of AKI and RRT requirement in patients underwent cardiac surgery better than NGAL.

Neuroinflammation in the fetus exposed to maternal obsessive-compulsive disorder during pregnancy: a comparative study on cord blood tumor necrosis factor-alpha levels

OBJECTIVE

The relationship between maternal psychiatric disorders and fetal neurodevelopment is unclear. Obsessive-compulsive disorder (OCD) is relatively frequent during pregnancy. The study aimed to investigate whether maternal OCD during pregnancy affects fetal circulating tumor necrosis factor-alpha (TNF-α) levels, an important pro-inflammatory cytokine, by comparing cord blood TNF-α levels in newborn infants of women with and without OCD.

METHODS

The study sample included 7 women with OCD and 30 healthy women. OCD and other psychiatric diagnoses were screened by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The blood sample for the determination of TNF-α level was obtained from the umbilical cord during delivery.

RESULTS

Cord blood TNF-α levels in newborn infants exposed to maternal OCD were significantly higher compared to non-exposed infants. Maternal anxiety symptom level was found to positively correlate with cord blood TNF-α levels in newborn infants of women with OCD.

CONCLUSION

The study results imply that maternal OCD during pregnancy may lead to neuroinflammation in the developing fetal brain through higher levels of circulating TNF-α.

Maternal generalized anxiety disorder during pregnancy and fetal brain development: a comparative study on cord blood brain-derived neurotrophic factor levels

OBJECTIVES

The study aimed to investigate whether maternal GAD during pregnancy affects fetal circulating brain-derived neurotrophic factor (BDNF), which plays important roles in neuronal development, by comparing cord blood BDNF levels in newborn infants of women with and without GAD.

METHODS

Study sample included 19 women with GAD and 25 women without any psychiatric disorder. GAD and other psychiatric diagnoses were screened by means of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The blood sample for the determination of BDNF level was obtained from the umbilical cord during delivery.

RESULTS

Cord blood BDNF levels in newborn infants of healthy women were approximately two-fold compared to newborn infants of women with GAD, and the difference was statistically significant. The duration of GAD during pregnancy was the only variable correlating with cord blood BDNF levels.

CONCLUSIONS

The study results imply that prolonged maternal GAD during pregnancy may negatively influence neurodevelopment of the fetus through lower levels of circulating BDNF.

The relationship between oxidative stress, inflammation, and atherosclerosis in renal transplant and end-stage renal disease patients

OBJECTIVES

Cardiovascular risk is increased in the early stages of chronic kidney disease (CKD) and is also found to be ongoing in renal transplant (Rtx) patients. As a sign of atherosclerosis, increased carotid intima-media thickness (CIMT) has been widely accepted as a strong predictor of cardiovascular disease (CVD) and mortality in the end-stage renal disease (ESRD) patients. Ischemia-modified albumin (IMA), pentraxin-3 (PTX-3), and neutrophil-to-lymphocyte ratio (NLR) were introduced as oxidative stress and inflammatory biomarkers in ESRD. The role of Rtx in terms of atherogenesis, oxidative stress, and inflammation is still unclear. We aimed to investigate the relationship between IMA, PTX-3, NLR, and CIMT in Rtx patients without overt CVD and to compare these results with those obtained from healthy subjects and ESRD patients receiving hemodialysis (HD) and peritoneal dialysis (PD).

DESIGN AND METHODS

Cross-sectional analysis in which CIMT measurements, NLR, and serum PTX-3 and IMA levels were assessed in 18 Rtx patients (10 females; mean age: 40.0 ± 13.3 years), 16 PD patients (7 females; 40.2 ± 12.9 years), 14 HD patients (8 females; 46.6 ± 10.7 years), and 19 healthy subjects (9 females; 36.9 ± 8.9 years).

RESULTS

IMA, PTX-3, and high-sensitive C-reactive protein (hs-CRP) levels, NLR, and CIMT of Rtx patients were found to be significantly higher compared with healthy subjects ( p = 0.04, p < 0.0001, p < 0.005, p = 0.005, and p = 0.005, respectively). IMA level was positively correlated with hs-CRP and PTX-3 levels, NLR, and CIMT when all participants were included (r = 0.338, p = 0.005; r = 0.485, p < 0.0001; r = 0.304, p = 0.013; and r = 0.499, p < 0.0001, respectively).

CONCLUSION

There has been ongoing inflammation, oxidative stress, and atherosclerosis in Rtx patients.