Clinical Biochemical Parameters Research Articles

Antitoxic effect of Veratrilla baillonii on the acute toxicity in mice induced by Aconitum brachypodum, one of the genus Aconitum

Ethnopharmacological relevanceAconitum brachypodum Diels (Family Ranunculaceae) is well known for both its good therapy and high toxicity in Yunnan and Sichuan provinces in China. Noticeably, Veratrilla baillonii Franch (Family Gentianaceae), an ethnodrug used by Naxi and Lisu nationalities in Yunnan Province, has been widely considered to possess antitoxic effects on Aconitum plants in herbal therapy and folklore medicines. Materials and methodsThe present study was conducted to determine the detoxic activities of the water decoction of Veratrilla baillonii Franch (WVBF) on the the chloroform fraction of Aconitum brachypodum Diels (CFA) induced acute toxicity in mice. The physiological (symptoms, body weight, etc.) as well as pathological and clinical biochemistry parameters were assessed and used as the markers for the toxicity. 1H nuclear magnetic resonance (NMR) based metabolic approach was adopted to further discuss the mechanism. ResultsThe acute poisoning effects of CFA on mice were observed at doses of 20–62.5mgkg−1, resulting in an oral median lethal dose (LD50) of 41.3mgkg−1. Histologically, distinct degenerative changes of the heart, liver and kidney were observed. The biochemistry parameters in the serum as well as metabolites in heart and brain were also altered. However, WVBF (25–200mg/kg) attenuated all the acute toxicity and pathological changes, properly regulated the biochemistry parameters, and reversed the concentration alterations for some metabolites in the heart and brain of mice induced by 40mg/kg of CFA to a certain extent. ConclusionsWVBF significantly reduced the onset of the CFA toxicity. This study may contribute to further understanding of the toxicological and pharmacological profiles of Aconitum brachypodum and the detoxic property of Veratrilla baillonii.

Factors associated with no apparent coronary artery disease in patients with type 2 diabetes mellitus for more than 10 years of duration: a case control study.

BackgroundType 2 diabetes mellitus is an important risk factor in the development of coronary artery disease (CAD) and is often associated with severe disease. However, this risk is not uniform, some patients remain free of CAD even after many years of treatment for diabetes. The present study was aimed to identify the factors that are associated with a favorable CAD profile.MethodsA case–control study of 76 patients with type 2 diabetes mellitus who were on treatment for more than 10 years duration and undergoing a coronary angiogram for the evaluation of clinically suspected CAD at a tertiary care hospital were recruited for the study. The presence and absence of significant CAD was determined after a coronary angiogram. Clinical history, and anthropometric and biochemical parameters were analyzed. Insulin resistance was determined by the Homeostasis Model Assessment. Multiple logistic regressions were done to find out the factors associated for a favorable CAD profile.ResultsThe difference in HOMA-IR (2.37 ± 0.69 VS 3.77 ± 1.64, p < 0.001) and urine microalbumin (24.15 ± 32.16 VS 82.72 ± 117.70, p = 0.004) were found to be statistically significant among those who did not have CAD when compared to those who had CAD. The difference in lipid profile, HbA1C, fasting blood sugar, BMI, waist hip ratio, waist and hip circumference was not significant. The adjusted odds ratio for insulin resistance less than 2.5 (OR 9.09, 95 % CI 1.91–41.83, p = 0.005), females (OR 7.91, 95 % CI 1.55–40.38, p = 0.013) and microalbumin <20 mg/l (OR 4.57, 95 % CI 1.17–17.85, p = 0.029) were independently associated with normal coronaries. The adjusted odds ratio for lipid profile, BMI, blood pressure and HbA1C were not significant.ConclusionsHOMA-IR less than 2.5, microalbuminuria less than 20 mg/l and females are the factors appear to be associated with no apparent CAD.

The Relationship Between Suicide Attempts and Menstrual Cycles in the Emergency Department and the Sociodemographic and Clinical Characteristics of These Patients

Aim: Suicidal behavior is defined as choosing death in the conflict between life and death. The aim of this study is to investigate the suspected relationship between suicide attempts and menstrual cycles and to evaluate the sociodemographic and clinical characteristics of the non-pregnant female patients of reproductive age who have presented to our hospital after attempting suicide. Materials and Methods: In this study, 102 female patients (aging 16–45 years) of reproductive age with regular menstrual cycles who presented to the emergency department because of suicide attempts were enrolled. The study was designed as prospective, cross-sectional, and descriptive. The patients’ sociodemographic, clinical, and laboratory biochemical parameters were recorded. For the purposes of this study, 100 healthy women who fulfilled the criteria formed the control group and underwent the same procedures as the patient group. Results: Among the patients who presented to the hospital after attempting suicide, 64 (62.7%) were in their menstrual period, six (5.9%) were outside their menstrual period during the follicular phase, five (4.9%) were at the mid-cycle peak, and 27 (26.4%) were at the luteal phase, as determined on the basis of the date of their last menstrual period and their blood hormone levels. Conclusion: The majority of suicide attempts by women occurred during their menstrual period when the estradiol and progesterone levels are at their lowest. (JAEM 2015 DOI: 10.5152/jaem.2015.91069)

Superoxide Dismutase Activity, Hydrogen Peroxide Steady-State Concentration, and Bactericidal and Phagocytic Activities Against Moraxella bovis, in Neutrophils Isolated from Copper-Deficient Bovines.

Copper (Cu) deficiency increases occurrence of certain infectious diseases in animals, including infectious keratoconjunctivitis in bovines, a bacterial ocular inflammation caused by Moraxella bovis. Neutrophil leukocytes constitute the first phagocytic cells to arrive at infection sites for bacterial neutralization. The objective of this work was to evaluate whether the functionality of neutrophils against M. bovis is impaired in experimentally induced Cu deficiency in bovines using high molybdenum and sulfur levels in the diet. The Cu tissue values and the periocular achromotrichia observed in +Mo animals showed that the clinic phase of Cu deficiency was reached in this group. Instead, +Cu animals have not evidenced clinical signs or biochemical parameters of hypocuprosis. On the basis of our observations, we concluded that Cu deficiency has no effect on phagocytic and bactericidal activities of neutrophils against M. bovis. However, superoxide dismutase activity and peroxide hydrogen generation were significantly different between groups. Therefore, additional research to explain these results is merited to fully characterize the consequences of Cu status on the risk for infections under field conditions.

Non-clinical safety assessment of gadoterate meglumine (Dotarem®) in neonatal and juvenile rats

The purpose of this study was to assess the safety of gadoterate meglumine, a gadolinium-based contrast agent used in magnetic resonance imaging, in neonatal and juvenile rats. Rats received a single intravenous administration on postnatal day (PND) 10 or 6 administrations (from PND 10 to 30), at doses of 0, 0.6, 1.25, and 2.5 mmol/kg/administration, i.e. equivalent to approximately 1, 2 and 4-times the usual human dose. The animals were sacrificed at the end of the treatment period or after a 60-day treatment-free period. No mortality and no significant treatment-related effect on clinical signs, macroscopic and histopathological findings, development, behavior, sexual maturation and hematology parameters were observed. Minor non-adverse changes were observed in clinical biochemistry and urinary parameters. Based on AUC0–t, gadoterate meglumine was more rapidly eliminated at PND 30 vs. PND 10, reflecting maturation of kidney function. At the end of the treatment period, Gd was measurable in all organs sampled after single or repeated dosing and levels were dose-dependent as expected, the highest ones being found in kidneys. The total Gd concentrations were similar in all the organs following a single or repeated dosing. At the end of the treatment-free period, only traces of gadolinium were quantifiable, almost exclusively in kidneys, reflecting the excretory function of this organ. In conclusion, single or repeated administration of gadoterate meglumine to juvenile rats was well tolerated.

Acute and Sub-acute Oral Toxicity of Hydroethanolic Root Extract of Annona stenophylla Engl. and Diels in Sprague Dawley Rats

The acute and sub-acute oral toxicity of the hydroethanolic root extract of Annona stenophylla Engl. and Diels in Sprague Dawley rats was determined by administering the crude extract daily in the range 250–2000 mg/kg body weight and the animals examined for physical, histopathological and clinical biochemistry changes. There were no behavioural changes or deaths in the acute toxicity tests up to 2000 mg/kg b. wt over 14 days. There were no major changes in the clinical biochemistry parameters measured: Alanine aminotransferase (ALT), Aspartate amino transferase (AST), Alkaline phosphatase (ALP), Gamma-glutamyl transferase (GGT), glucose, creatinine and total bilirubin (p>0.05) and in the histopathological tissue sections of the pancreas and liver compared with the control rats in the sub-acute tests over 28 days. The present report supports the traditional medicinal use and relative safety of A. stenophylla in the treatment of multiple ailments including its antidiabetic potential.

Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study

Clinical management of Ebola virus disease remains challenging. Routine laboratory analytics are often unavailable in the outbreak setting, and few data exist for the associated haematological and biochemical abnormalities. We aimed to assess laboratory and clinical data from patients with Ebola virus disease to better inform clinical management algorithms, improve understanding of key variables associated with outcome, and provide insight into the pathophysiology of Ebola virus disease. We recruited all patients, alive on arrival, with confirmed Ebola virus disease who were admitted to the Kerry Town Ebola treatment centre in Sierra Leone. At admission, all patients had clinical presentation recorded and blood taken for Ebola confirmation using reverse-transcriptase-PCR (RT-PCR) and for haematological and biochemical analysis. We studied the association between these and clinical outcome. The primary outcome was discharge from the Ebola treatment centre. 150 patients were admitted to the treatment centre between Dec 8, 2014, and Jan 9, 2015. The mean age of patients was 26 years (SD 14·7). Case fatality rate was 37% (55/150). Most patients presented with stage 2 (gastrointestinal involvement, 72/118 [61%]) and stage 3 (severe or complicated, 12/118 [10%]) disease. Acute kidney injury was common (52/104 [50%]), as were abnormal serum potassium (32/97 [33%]), severe hepatitis (54/92 [59%]), and raised C-reactive protein (21/100 [21%]). Haematological abnormalities were common, including raised haematocrit (15/100 [15%]), thrombocytopenia (47/104 [45%]), and granulocytosis (44/104 [42%]). Severe acute kidney injury, low RT-PCR cycle threshold (<20 cycles), and severe hepatitis were independently associated with mortality. Ebola virus disease is associated with a high prevalence of haematological and biochemical abnormalities, even in mild disease and in the absence of gastrointestinal symptoms. Clinical care that targets hypovolaemia, electrolyte disturbance, and acute kidney injury is likely to reduce historically high case fatality rates. None.

Raising the standard for clinical care of patients with Ebola virus disease

Raising the standard for clinical care of patients with Ebola virus disease

Molecular Characterization and Biochemical and Histopathological Aspects of the Parasitism of Haemoproteus spp. in Southern Caracaras (Caracara plancus).

Haemoproteid species have a wide global distribution, and they have been described in falcon species in several parts of the world. However, few studies in South America have focused on these birds. Haemoproteus spp. infections have been reported as the causative agents of serious histopathological changes, which can lead to the death of the host. Thus, this study aimed to molecularly and phylogenetically characterize Haemoproteus spp. in Caracara plancus, to characterize aspects of parasitism through clinical analysis and biochemical parameters, and to describe the histopathology of infection. To examine these aspects, 5 southern caracaras were examined clinically, and blood samples were collected. Blood smears were subsequently utilized in parasitemia calculations, PCR amplification, and serum biochemical investigations. Histological sections of the liver, kidneys, spleen, and heart were examined to check for possible histopathological changes. The birds showed clinical signs such as pallor and prostration that are consistent with Haemoproteus spp. infection. Moreover, the examination of the blood smears revealed 0.07% parasitemia in young gametocytes only. The PCR and sequencing results confirmed that the parasites belonged to Haemoproteus spp. The activity of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes, albumin, total serum proteins, and enzymatic urea were first described in C. plancus and serve as reference for future studies of bird species parasitized by Haemoproteus spp. Histopathology results showed signs of injury that were consistent with haemosporidian infection in the tissues of the analyzed organs. The present study is preliminary, and additional studies of Haemoproteus spp. infections in other bird species are needed to better understand the relationship between parasites and hosts, because despite the low parasitemia recorded, biochemical and histopathological changes in various organs were observed.

Evaluation of the safety profile and antioxidant activity of fatty hydroxamic acid from underutilized seed oil of Cyperus esculentus

ObjectiveTo evaluate the safety profile and antioxidant activity of fatty hydroxamic acid (FHA) from the seed oil of Cyperus esculentus (C. esculentus). MethodsFHA was synthesized from the seed oil of C. esculentus via a two-step reaction system. The FHA was later subjected to antioxidant activity test using 2, 2-diphenyl-1-picyrl hydrazyl assay. Additionally, adult male Wistar rats were randomly assigned to four groups of five rats each and were orally administered with FHA at 0, 5, 15 and 50 mg/kg for seven days. Clinical observations and serum biochemical parameters were assessed to monitor treatment–related adverse effects in the rats. ResultsFourier transform infrared spectra showed that FHA was synthesised from the seed oil of C. esculentus. The antioxidant property of FHA increased as the concentration reduced below 0.05 μg/mL. Result of oral administration of FHA revealed no adverse effect levels at the dose of 5 mg/kg/day. However, the adverse effects seen in rats receiving 15 mg/kg/day (the least observed adverse effect level) were significant increase in alkaline phosphatase activity, triglycerides, and creatinine levels. Moderate hyperalbuminemia and hypoalbuminemia resulted in an increased albumin/globulin ratio. These effects might be the result of a physiological response to exposure to a very high level of FHA which is not part of the normal diet, and are most likely not toxicologically relevant. ConclusionsC. esculentus has been presented as a potential source of feed stock for the synthesis of a relatively cheap and non toxic FHA which has antioxidant and free-radical scavenging activity.

Glycemic control and weight outcomes after initiation of continuous subcutaneous insulin infusion therapy

IntroductionThe continuous subcutaneous insulin infusion (CSII) is an alternative to multiple daily injections therapy in type 1 diabetes and its use is increasingly common due to the beneficial effects on glucose control. AimsTo analyze clinical features and biochemical parameters of patients on CSII therapy. Type of studyLongitudinal retrospective. SettingOutpatient clinic.Population: Type 1 diabetic patients using insulin infusion pump in our department. MethodsWe evaluated outcomes regarding the following set points: immediately before initiation of CSII therapy, 12 months after inclusion and in the last appointmentHH. For statistical analysis, we used non-parametric tests and linear regression analysis. We considered significant a value of p≤0.05. ResultsWe studied 63 patients (24 men; 39 women) with a mean pre-CSII HbA1c of 8.2%±1.43; mean age at the time of placement of 32.7±10.94 years; and mean follow up time after placement of 2.1±1.92 years. There was a statistically significant reduction of HbA1c during follow-up (HbA1c 12 months: 7.2% [6.6–7.8] p=0.001; HbA1c at the end of follow-up: 7.4% [6.6–7.9] p=0,001). There was no significant variation of weight or total daily insulin dose. We registered a negative correlation between the last HbA1c before CSII and the reduction in HbA1c until the end of the follow-up period (ρ=−0.644 p=0.000). The median reduction in HbA1c was higher in women (W: –1.10 [−2.20––0.40] vs M: −0.10 [−0.80–0.40]; p=0.002). Female gender was a predictive factor of better results with CSII, even after adjustment to the last HbA1c before the initiation of therapy. ConclusionsIn our sample, the last HbA1c before the beginning of CSII was the most powerful predictive factor of the reduction of HbA1c during follow up. Women had better results than men. There was no significant variation of weight and total daily insulin dose during follow up.

Utility of Gallium-68 DOTANOC PET/CT in the localization of Tumour-induced osteomalacia.

Tumour-induced osteomalacia (TIO) is a rare disorder characterized by hypophosphataemic osteomalacia caused by small mesenchymal tumours secreting fibroblast growth factor 23 (FGF 23). The most difficult part in the management of these patients is the localization of tumours causing TIO. We describe the utility of Gallium (Ga)-68 DOTANOC PET/CT in the localization of tumours causing TIO. The study was conducted in a single tertiary referral university teaching hospital in India. Ten patients with TIO who underwent Ga-68 DOTANOC PET/CT from the time period 2009 to 2014 were included in this study. Their detailed clinical history, biochemical parameters, imaging modalities, surgical interventions, histopathology and outcomes were reviewed. Ga-68 DOTANOC PET/CT could correctly localize the tumours in TIO in 9 of the 10 cases in which it was performed. Complete resection of the tumour led to full clinical recovery in six of the ten patients; two patients who had partial resection and one patient who underwent radiofrequency ablation showed partial remission. One patient in whom Ga-68 DOTANOC PET/CT was positive in vertebral body with a low standardized uptake value (SUV) did not show up the tumour on surgery. We conclude that Ga-68 DOTANOC PET/CT can be used as the first imaging modality in patients diagnosed with TIO. The extremely good outcome following the resection of these small otherwise undiagnosed tumours far outweighs its cost even in resource limited settings.

Prevalence and predictors of high-on treatment platelet reactivity with ticagrelor in ACS patients undergoing stent implantation

BackgroundResidual high-on treatment platelet reactivity (HRPR) predicts outcomes and major cardiovascular events. Ticagrelor has provided pharmacological and clinical evidence of more predictable and more potent antiplatelet effect as compared to clopidogrel. However, so far, few data have investigated the prevalence and predictors of HRPR in unselected patients treated with ticagrelor, that is therefore the aim of the current study. Methods and resultsOur population is represented by 195 patients undergoing coronary stenting for ACS and receiving ASA and ticagrelor. Platelet function was assessed by multiplate impedance aggregometry (MEA) between 1 and 3months after stenting. Main clinical features and biochemistry parameters were collected. HRPR for ticagrelor was defined for aggregation>417 AUC after MEA-ADP stimulation. A total of 26 patients, (13.3%), displayed HRPR with ticagrelor. Older age (≥70years, p=0.002), hypertension (p=0.02) previous myocardial infarction (p=0.04), therapy with nitrates and beta-blockers (p=0.02), diuretics (p=0.03) and fasting glycaemia (p=0.05) were associated to HRPR with ticagrelor. By multivariate analysis, age≥70years (OR [95%CI]=4.6[1.55–13.8], p=0.006), concomitant therapy with beta-blockers (OR [95%CI]=3.2[1.06–9.6], p=0.04) and platelets count (OR[95%CI]=1.0007 [1–1.016], p=0.05) were identified as independent predictors of HRPR with ticagrelor. ConclusionThe present study firstly demonstrates that the occurrence of HRPR in patients treated with ticagrelor is not so futile, as it was observed in 13% of patients treated with ticagrelor. Older age, beta-blockers administration and platelets count are independent predictors of HRPR with ticagrelor.

Post-transplant Hyperuricemıa as a Cardıovascular Risk Factor

PurposeUric acid is known to impair endothelial cell function and to stimulate the development of renal interstitial fibrosis. The aim of this study was to evaluate the association between first-year hyperuricemia with graft dysfunction and the development of cardiovascular risk disorders in renal transplant recipients. MethodsOne hundred kidney transplant recipients (31 female, 45.9 ± 9.6 post-transplantation months) with normal graft functions were enrolled. The clinical biochemical parameters in the first post-transplantation year were retrospectively recorded and searched for the predictive value in yearly determined graft function and association with cross-sectionally analyzed cardiovascular parameters, including body composition analyses, ambulatory blood pressure monitoring data, and pulse wave velocity. Hyperuricemia was defined as an uric acid level of ≥ 6.5 mg/dL that persisted for at least 2 consecutive tests. ResultsOne year after transplantation, 37% of subjects had hyperuricemia. According to cross-sectional data, sagittal abdominal diameter (P = .002) and hip circumferences (P = .013) were significantly higher in hyperuricemic patients than in normouricemic ones. Hyperuricemic patients had higher fat (P = .014) and muscle mass (P = .016) than normouremic patients. Hyperuricemic patients had significantly higher mean systolic BP (P = .044) than normouremic patients. Hyperuricemic patients had significantly higher pulse wave velocity levels (P = .0001) and left ventricular mass index (P = .044) than normouremic patients. The yearly decline in estimated glomerular filtration rate levels was significantly higher in hyperuricemic patients (P = .0001) than in normouricemic ones. ConclusionPost-transplantation hyperuricemia is associated with hypertension, arterial stiffness, and dyslipidemia; it should be accepted not only as a marker for renal allograft dysfunction but also as a cardiovascular risk factor in renal transplant recipients.

Deoxynivalenol in chicken feed alters the vaccinal immune response and clinical biochemical serum parameters but not the intestinal and carcass characteristics.

This study was conducted to investigate the impacts of deoxynivalenol (DON) feeding either alone or in combination with a microbial feed additive (MFA) on the immune response to a viral vaccine and serum clinical chemical parameters. Forty 1-day-old boiler chicks were weighed and randomly divided into four groups, 10 birds in each group: (i) control group fed with basal diet; (ii) DON group fed with basal diet artificially contaminated with 10 mg DON/kg feed; (iii) DON + MFA group fed with basal diet contaminated with 10 mg DON/kg feed and supplemented with 2.5 kg of MFA/ton feed; and (iv) MFA group fed with basal diet supplemented with 2.5 kg of MFA/ton feed. At 35 days of age, birds were slaughtered and blood was collected for investigating the antibody titre against infectious bronchitis virus (IBV) and clinical chemical parameters. The results showed that DON reduced (p = 0.032) the titre against IBV, decreased (p = 0.005) the level of alanine transaminase (ALT) (4.2 ± 0.5 U/l) compared with control birds (6.4 ± 0.5 U/l), increased (p = 0.002) the serum cholesterol concentration (144 ± 6 mg/dl) compared with their control counterparts (123 ± 5 mg/dl) and increased (p = 0.074) the amount of circulating triglycerides (62.25 ± 7.50 mg/dl) compared with controls (39.55 ± 4.74). These results indicate that dietary DON altered the humoral immune response to viral vaccine and affected the serum clinical biochemistry. However, DON in combination with MFA did not affect serum IBV titre. Taken together, DON in the feed of broilers produced an impairment of the success of IBV vaccine and affected the health of birds.

Clinical outcome, biochemical and therapeutic follow-up in 14 Austrian patients with Long-Chain 3-Hydroxy Acyl CoA Dehydrogenase Deficiency (LCHADD).

BackgroundLCHADD is a long-fatty acid oxidation disorder with immediate symptoms and long-term complications. We evaluated data on clinical status, biochemical parameters, therapeutic regimens and outcome of Austrian LCHADD patients.Study designClinical and outcome data including history, diagnosis, short- and long-term manifestations, growth, psychomotor development, hospitalizations, therapy of 14 Austrian patients with LCHADD were evaluated. Biochemically, we evaluated creatine kinase (CK) and acyl carnitine profiles.ResultsAll LCHADD patients are homozygous for the common mutation. Three are siblings. Diagnosis was first established biochemically. Nine/14 (64%) were prematures, with IRDS occurring in six. In nine (64%), diagnosis was established through newborn screening, the remaining five (36%) were diagnosed clinically. Four pregnancies were complicated by HELLP syndrome, one by preeclampsia. In two, intrauterine growth retardation and placental insufficiency were reported. Five were diagnosed with hepatopathy at some point, seven with cardiomyopathy and eight with retinopathy, clinically relevant only in one patient. Polyneuropathy is only present in one. Three patients have a PEG, one is regularly fed via NG-tube. Growth is normal in all, as well as psychomotor development, except for two extremely premature girls. In 11 patients, 165 episodes with elevated creatine kinase concentrations were observed with 6-31 (median 14) per patient; three have shown no elevated CK concentrations. Median total carnitine on therapy was 19 μmol/l (range 11-61). For 14 patients, there have been 181 hospitalizations (median 9 per patient), comprising 1337 in-patient-days. All centres adhere to treatment with a fat-defined diet; patients have between 15% and 40% of their energy intake from fat (median 29%), out of which between 20% and 80% are medium-chain triglycerides (MCT) (median 62%). Four patients have been treated with heptanoate (C7).ConclusionOur data show LCHADD outcome can be favourable. Growth and psychomotor development is normal, except in two prematures. Frequency of CK measurements decreases with age, correlating with a decreasing number of hospitalizations. About 50% develop complications affecting different organ systems. There is no relevant difference between the patients treated in the respective centers. Concluding from single case reports, anaplerotic therapy with heptanoate should be further evaluated.

Top-down lipidomics of low density lipoprotein reveal altered lipid profiles in advanced chronic kidney disease

This study compared the molecular lipidomic profile of LDL in patients with nondiabetic advanced renal disease and no evidence of CVD to that of age-matched controls, with the hypothesis that it would reveal proatherogenic lipid alterations. LDL was isolated from 10 normocholesterolemic patients with stage 4/5 renal disease and 10 controls, and lipids were analyzed by accurate mass LC/MS. Top-down lipidomics analysis and manual examination of the data identified 352 lipid species, and automated comparative analysis demonstrated alterations in lipid profile in disease. The total lipid and cholesterol content was unchanged, but levels of triacylglycerides and N-acyltaurines were significantly increased, while phosphatidylcholines, plasmenyl ethanolamines, sulfatides, ceramides, and cholesterol sulfate were significantly decreased in chronic kidney disease (CKD) patients. Chemometric analysis of individual lipid species showed very good discrimination of control and disease sample despite the small cohorts and identified individual unsaturated phospholipids and triglycerides mainly responsible for the discrimination. These findings illustrate the point that although the clinical biochemistry parameters may not appear abnormal, there may be important underlying lipidomic changes that contribute to disease pathology. The lipidomic profile of CKD LDL offers potential for new biomarkers and novel insights into lipid metabolism and cardiovascular risk in this disease.

Predictors of survival in children with methymalonic acidemia with homocystinuria in Beijing, China: a prospective cohort study.

(i) To determine whether clinical features and biochemical parameters help to predict survival of methylmalonic acidemia with homocystinuria; (ii) To find the cutoff values of biochemical parameters for predicting survival of methylmalonic acidemia with homocystinuria. A prospective cohort study. A pediatric tertiary hospital in Beijing; all patients were followed until death or June 2013. 45 pediatric patients diagnosed with methylmalonic acidemia with homocystinuria between 2006 and 2012. The data of clinical characteristics and pretreatment biochemical parameters were collected. The Cox regression analysis was performed to identify independent risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The best cutoff values for these independent factors were determined by the receiver characteristic curve. Newborn onset (OR=6.856, 95%CI=2.241-20.976, P=0.001), high level of methylmalonic acid in urine (OR=1.022, 95%CI=1.011-1.033, P<0.001), and high level of urea in serum (OR=1.083, 95%CI=1.027-1.141, P=0.003) were independent negative risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The cutoff values of maximum predictive accuracy of methylmalonic acid in urine and urea in serum were respectively 5.41 mmol/mmol creatinine and 7.80 mmol/L by receiver operating characteristic curve analysis. The patients of methylmalonic acidemia with homocystinuria tend to have an adverse outcome if they have newborn onsets. Elevated urea and urinary methylmalonic acid are predictors of adverse outcomes for the patients. They show similar effect for predicting severe adverse prognosis. The combination of methylmalonic acid in urine concentration and urea in serum concentration provided the most accurate predictive tool.

Clinical risk factors of prediabetes in Taiwanese women without substance uses (tobacco, alcohol, or areca nut).

Individuals with prediabetes (100-125mg/dL) and diabetes mellitus (DM) increase the risk of all-cause and cardiovascular disease (CVD) mortality. Since personal substance use such as cigarette smoking, alcohol drinking, and areca nut chewing may confound the true effect of clinical biochemistries on the risk of prediabetes, this study aims to examine the relationship between clinical biochemical parameters and the risk of prediabetes among Taiwanese without the habits of consuming tobacco, alcohol drinking, or areca nut. Women aged between 40 years and 64 years who came to one community teaching hospital between January 1, 2001 and December 31, 2008 for general health screening for the first time were studied. The general health screening is provided every 3 years gratis. The package of this health screening includes personal history, physical examination, and biochemical tests in serum and urine. In total, 8580 nonsmoking, nondrinking, and nonareca nut chewing women who did not have a history of DM were eligible for this study. Of these, 1861 (21.7%) out of 8580 women were prediabetic. Compared to women with normal fasting glucose (NFG), we found a dose-response relationship of the risk of prediabetes with age and body mass index (BMI) and total cholesterol, triglyceride, glutamic-pyruvic transaminase (GPT), and uric acid in serum. Women with hypertension or proteinuria (≥30mg/dL) had also an increased risk to have prediabetes. Besides age, the factors of BMI, hypertension, dyslipidemia, GPT, hyperuricemia, and proteinuria are the main risk factors for prediabetes in Taiwanese women without substance uses. A follow-up study is necessary to clarify the causality of these important biochemical parameters and prediabetes.

Omega‐3 fatty acid supplementation candidates can be selected using fatty acid profiling

The aim of this study was to evaluate the fatty acid (FA) profile in the plasma and erythrocyte membranes of apparently healthy men compared to male patients with various cardiovascular diseases (CVD). The plasma FA profiles were analyzed in five groups of subjects aged 37–57 years: groups 1 and 2 were male voluntary blood donors with a body mass index (BMI) 25.1 ± 1.6, (Group 1, N = 12) and a BMI 32.9 ± 4.5, (Group 2, N = 11) respectively, male patients with chronic heart failure due to dilated cardiomyopathy (Group 3, N = 10), chronic atrial fibrillation without heart failure or coronary heart disease (Group 4, N = 10) and patients after myocardial infarction (Group 5, N = 11). The FA profile in plasma and erythrocytes was measured by gas chromatography (GC) with flame ionization detection and basic plasma lipid parameters were then estimated. Deficiencies of eicosapentaenoic acid and docosahexaenoic acid were found in all the groups of CVD patients and in Group 2 (BMI 32.9 ± 4.5) of this Central European population. Unfavorable alterations in FA composition and clinical biochemistry parameters were found in patients with dilated cardiomyopathy (Group 3). Further, 75% of Group 1 (blood donors) had an average plasma PUFA level in the worst quartile for relative risk of cardiovascular events. Tailored n‐3 PUFA supplementation should be recommended not only for secondary prevention in patients suffering from CVD but also for primary prevention in overweight and obese persons with a proven deficiency.Practical applications: Plasma and erythrocyte membrane n‐3 polyunsaturated fatty acid (PUFA) levels are an important parameter of diet composition as well as a marker of cardiovascular risk. Regular sea fish intake or alternative supplementation with the n‐3 PUFA recommendation is in all probability insufficiently realized, particularly in inland countries. In addition to contemporary guidelines and practice, research is providing data on the use of FA analysis for revealing people with an n‐3 PUFA deficiency. This approach could benefit people suffering from CVD as well as for overweight and obese populations with demonstrated deficiency.Tailored n‐3 PUFA supplementation should be recommended not only for secondary prevention in patients suffering from CVD but also for primary prevention in overweight and obese persons with a proven deficiency.