Serum Calcium Concentrations Research Articles

Predictive Value Analysis of Serum sFlt-1 and PLGF Levels/Ratio in Preeclampsia

Background: This study is to explore the clinical significance of serum sFlt-1, and placental growth factor (PLGF) contents, as well as sFlt-1/PLGF ratio in predicting and diagnosing preeclampsia. Methods: Peripheral venous blood was collected from all pregnant women at 11–33+6 weeks for biomarker detection. Totally 105 patients with preeclampsia and 57 patients with severe preeclampsia were included. Serum sFlt-1 and PLGF levels were determined, and sFlt-1/PLGF ratio was calculated. Correlation between sFlt-1, PLGF, sFlt-1/PLGF ratio and serum total cholesterol, triglyceride, lactate dehydrogenase and calcium content levels were analyzed. receiver operating characteristic (ROC) analysis was used to evaluate values of sFlt-1, PLGF and sFlt-1/PLGF ratios in disease diagnosis and prediction. Results: Serum sFlt-1 content and sFlt-1/PLGF ratio in Preeclampsia (PE) patients were significantly higher than control. Serum sFlt-1 content and sFlt-1/PLGF ratio of the severe PE group were significantly higher than the PE group. Serum PLGF contents of the PE and severe PE group were significantly lower than control, and the difference in PLGF content between the severe and PE groups was not significant. There was a moderate correlation between the sFlt-1 content and the lactate dehydrogenase level. There was a low-level correlation between the sFlt-1/PLGF ratio and the lactate dehydrogenase level. The receiver ROC curve analysis showed that sFlt/PLGF had greater predictive value for preeclampsia, with a sensitivity of 98.1% and a specificity of 78.2%. Conclusions: Serum sFlt-1 level and sFlt-1/PlGF ratio have better predictive and diagnostic values, as well as better auxiliary efficiency for preeclampsia. The diagnostic efficiency of sFlt-1/PlGF ratio is better than sFlt-1 content alone.

Calcium serum concentration among pregnant women in a tertiary hospital and its satellite hospital in Medan, Indonesia

HIGHLIGHTS 1. Serum calcium concentration in pregnant women who took prenatal appointments in the general hospital and its satellite hospitals were evaluated.2. It was found that serum calcium concentration in those pregnant women who made the prenatal appointments were normal. ABSTRACT Objectives: This study aimed to evaluate serum calcium concentration in pregnant women who made prenatal appointments to Obstetric and Gynecologic Outpatient Clinics at Adam Malik General Hospital, Medan, Indonesia, and its satellite hospitals. Materials and Methods: This study was a descriptive study with a case series approach. The case series of the study included 35 pregnant women in their second or third trimester chosen by consecutive sampling method. Results: The mean calcium serum level of pregnant women in the second and third trimester was 9.12±0.49 mg/dl and 8.97±0.26 mg/dl, respectively. The mean calcium level of pregnant women aged <20, 20-35, and >35 years old were 9.0±0.28 mg/dl, 9.07±0.44 mg/dl, and 8.96±0.06 mg/dl, respectively. Conclusion: This study found that the mean calcium serum level of pregnant women who took prenatal appointments in Haji Adam Malik General Hospital, Medan, Indonesia, was normal.

Hypocalcemia: A key biomarker in hospitalized COVID-19 patients

BackgroundAt the end of 2019 a new respiratory syndrome emerged in China named Coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection. Considering the severity of the disease in adult subjects with one or more chronic pathologies, it was mandatory to find simple and effective biomarkers for negative prognosis of the disease easily available at the admission to the hospital. MethodsTo identify possible parameters showing association with the outcome in COVID-19 patients with pre-existing chronic diseases, blood biochemical profiles of 511 patients, enrolled from March to June 2020, were retrospectively evaluated. The pathological conditions taken into consideration were diabetes, arterial hypertension, chronic kidney disease, cardiovascular diseases, chronic obstructive pulmonary disease, obesity, and cancer. All the data were collected upon admission to the emergency room (ER) during the indicated period. ResultsWe observed that serum and ionized calcium were prevalently altered in our cohort. We determined that hypocalcemia was a major parameter associated with mechanical ventilation and poor prognosis, correlating also with the presence of comorbidities such as cardiovascular diseases, chronic kidney disease, and cancer. In addition, we found a positive correlation between hypocalcemia and clinical complications during hospitalizations. ConclusionsOur results strengthen the relevance of serum calcium concentration as a useful prognostic biomarker in hospitalized COVID-19 patients.

IMPLEMENTATION NUTRIGENOMIC OF VITAMIN D IN PERIODONTITIS

Background: Nutrition is a significant risk factor for the incidence of periodontal disease. Nutrients acting on the human genome, either directly or indirectly, can change the expression and structure of genes. One of the micronutrients associated with periodontitis is vitamin D. Vitamin D has an important role in bone and calcium metabolism and regulates serum calcium and phosphate concentrations at normal limits. Purpose: To discuss the nutritional vitamin D as an essential micronutrient in preventing and accelerating healing in periodontitis. Review: Searched two databases from article publication to April 2021, resulting in a total of 66 hits, from which seven relevant articles were selected. VDR signaling can build transcription of genes encoding proactive cytokines, bypassing the cyclo-oxygenase-2 (COX-2) and prostaglandin pathway, and can inhibit matrix metalloproteinase production. The protective mechanism of vitamin D against periodontitis occurs through two biological pathways, namely anti-microbial and anti-inflammatory pathways. The anti-microbial effect of vitamin D results from the binding of 1,25(OH)2D3 with VDR which then induces cAMP, b-def-2 and b-def-3 peptides by macrophages, monocytes, gingival epithelium and periodontal ligament epithelium. The anti-inflammatory effect occurs through decreased production of proinflammatory cytokines. Conclusion: All the signaling effects of VDR can reduce bacteria induced in the inflammatory cytokines so that personalized vitamin D supplementation with an adjusted dose as needed can be used in preventing periodontitis or accelerating the healing of periodontitis.

O108 Central adiposity influences serum calcium concentrations and increases risk of kidney stone disease

Abstract Introduction Serum calcium (SCa) and adiposity are associated with kidney stone disease (KSD). We used conventional and genetic epidemiological approaches to further understanding of these relationships. Methods Waist-hip ratio (WHR), a marker of central adiposity, SCa and KSD data were analysed by adjusted linear regression using UK Biobank participants. Univariable, multivariable and mediation Mendelian randomisation (MR) were undertaken using 316 and 246 genetic instruments for WHR and SCa, respectively. Results Observational analyses of 3,466 KSD cases and 489,944 controls showed that participants of normal BMI (20–25kg/m2) but in the fifth quintile for WHR have greater risk of incident KSD compared to the first quintile (HR=1.39 (95%CI=1.18–1.63)). After adjustment for sex, age, serum vitamin D, and phosphate, higher WHR was positively associated with SCa (ß=0.04, 95%=CI 0.04–0.05, P<0.001). Univariable MR demonstrated that relative risk of KSD increases with increasing WHR and SCa; 1 standard deviation (SD) increases relative risk by 46% (95%CI=1.27–1.67, P=5.9e-8) and 63% (95%CI=1.37–1.93, P=2.0E-8), respectively. A 1 SD increase in WHR increases SCa by 0.11mmol/L (95%CI=0.07–0.14, P=1.8e-8). Multivariable MR revealed that SCa and WHR independently increase KSD relative risk (OR=1.71, 95%CI=1.49–1.96, P<0.001 and OR=1.41, 95%CI=1.17–1.69, P<0.001 respectively). Mediation MR established that 14% of the effect of WHR on KSD risk is mediated via alterations in SCa. Conclusion Central adiposity is causally linked to KSD, partly by raising SCa. Mechanisms by which central adiposity increases KSD risk, independent of and via SCa, remain to be revealed and may identify novel therapeutic methods for KSD. Take-home message Central adiposity and serum calcium are independent, causal risk factors for kidney stone disease. One mechanism by which central obesity increases risk of kidney stone disease is by influencing serum calcium concentrations.

Effects of phosvitin phosphopeptide-Ca complex prepared by efficient enzymatic hydrolysis on calcium absorption and bone deposition of mice

Phosvitin (PV) was treated with high-temperature, mild pressure (HTMP), and enzyme combination, and then phosvitin phosphopeptides-calcium (PPP-Ca) complexes were prepared. The low-calcium specific pathogen free-Kunming (SPF-KM) mice were used to determine the effect of PPP-Ca complexes on intestinal calcium absorption and their utilization for bone formation. The serum calcium content was the highest with the HTMP-Enz-PPP-Ca treatment (2.19 mmol/L), and it significantly down-regulated the abnormal elevation of serum alkaline phosphatase (AKP) caused by calcium deficiency. The low-calcium control group had the lowest calcium deposited to the femur (80.41 mg/g) and the lowest femur bone mineral density (BMD) (0.17 g/cm3), while HTMP-Enz-PPP-Ca significantly improved bone calcium content (94.33 mg/g) and BMD (0.29 g/cm3). The micro-computed tomography (MCT) images showed that the femur with the normal control, PV-Ca, and HTMP-Enz-PPP-Ca treatments had a more compact, complete, and thicker trabecular network than the low-calcium and CaCl2 treatments. These results indicated that the organic calcium (HTMP-Enz-PPP-Ca) promoted calcium absorption and bone deposition, and the effect of HTMP-Enz-PPP-Ca was better than the inorganic CaCl2.

Comparative analysis of haematological, biochemical and nutritional parameters of Dezhou donkey with healthy and weak foals (Equus asinus)

The study was conducted to compare the haematological, biochemical and nutritional parameters between healthy foals (HF) and weak foals (WF, malformation, lameness and drooping ears), and between the corresponding female donkeys to provide a reference for the assessment of healthy status. A total of 34 donkeys with HF (DHF) and 34 with WF (DWF) were selected. Compared to HF, WF had higher leukocyte, neutrophil, platelets (PLT) and the percentage of neutrophil, and their corresponding female donkeys showed the similar tendency; WF had lower birth weight and body measurements. The concentrations of serum urea, total protein, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC), low-density lipoprotein cholesterol, β-hydroxybutyric acid (BHBA) and non-esterified fatty acid (NEFA) were increased in WF compared with HF, whereas serum glucose (GLU) was decreased. The concentrations of serum urea, total protein, AST, alkaline phosphatase (ALP), BHBA, NEFA, calcium and phosphorus were increased in DWF compared with DHF, whereas serum albumin (ALB), GLU, kalium, chromium, iron, manganese, lead and zinc were decreased. The hair concentrations of minerals had the same tendency as well, but calcium concentration of hair was opposite. There were significant correlations of kalium, copper, iron and zinc contents between serum and hair. In plasma, the contents of threonine, glutamic acid, alanine, arginine in DWF were greater than DHF, whereas valine content was lower. In conclusion, there were significant differences in some haematological, biochemical and nutritional parameters, which suggested that the malnutrition of the corresponding female donkeys was probably responsible for malformation, lameness and drooping ears of foals. Highlights Weak foals (WF) had higher leukocyte and neutrophil count, platelets (PLT) and the percentage of neutrophil than healthy foals (HF), and their corresponding female donkeys showed the similar tendency. WF had higher concentrations than HF in serum urea, total protein, aspartate aminotransferase (AST), alkaline phosphatase (ALP), β-hydroxybutyric acid (BHBA), non-esterified fatty acid (NEFA), but had lower concentration in serum glucose (GLU), and their corresponding female donkeys showed the similar tendency. Donkeys with WF had higher concentrations of threonine, glutamic acid, alanine, arginine in plasma than donkeys with HF, but lower concentrations of valine in plasma and some mineral elements in serum and hair.

Effects of phytase supplementation of high-plant-protein diets on growth, phosphorus utilization, antioxidant, and digestion in red swamp crayfish (Procambarus clarkii)

Fish meal is increasingly being replaced by plant protein raw materials, meanwhile, it brings phytic acid, which combines with phosphorus to form phytate phosphorus and leads to a low utilization rate of phosphorus in shrimp. To solve this problem, this study investigated the effects of phytase supplementation on growth performance, phosphorus utilization, antioxidants, and digestion in red swamp crayfish (Procambarus clarkii). Crayfish (initial mean weight: 8.69 ± 0.15 g, N = 324) were randomly divided into six groups each with three replicates of 18 individuals each, and hand-fed for 8 weeks with one of six experimental diets (50 and 490 g kg−1 animal and plant protein raw material, respectively): negative control (NC; 11.0 g kg−1 phosphorus), positive control (PC; 15 g kg−1 NaH2PO4 added to NC; 14.7 g kg−1 phosphorus), and phytase supplementation diets (P1–P4: 0.1, 0.2, 0.4, and 0.6 g kg−1 phytase added to NC, respectively). The feeding trial was performed in a micro-flow water culture system. P2 showed a significantly higher weight gain rate (WGR), specific growth rate, protein efficiency ratio, and protein retention efficiency (PRE) but showed the lowest feed conversion ratio (FCR) than other groups. Broken-line regression analyses using WGR, FCR, and PRE as evaluation indices showed that the optimal dietary phytase supplementation level was 0.233, 0.244, and 0.303 g kg−1, respectively. P2 showed the highest crude protein content of whole crayfish and abdominal muscle, and phosphorus deposition rate, which was significantly higher than that in NC and PC. P3 showed the highest calcium and phosphorus contents in whole crayfish and phosphorus content in abdominal muscle, and calcium and inorganic phosphorus content in serum, which were significantly higher than those in NC. P3 showed significantly lowest serum alkaline phosphatase, alanine aminotransferase, aspartate transaminase activities, malondialdehyde content in hepatopancreas, and highest catalase activity, which were significantly lower and higher, respectively, than those in NC and PC. In summary, the addition of 0.2–0.4 g kg−1 phytase significantly improves the growth performance, feed utilization, digestive enzyme activity, and antioxidant of P. clarkii, which has a similar effect to the direct addition of NaH2PO4 at 15 g kg−1 to the feed.

Effects of Calcium Lactate-Enriched Pumpkin on Calcium Status in Ovariectomized Rats.

This study aimed to evaluate the effects of enriched pumpkin on calcium status in ovariectomized rats. The study was conducted in sixty female Wistar rats, which were divided into six groups: a group fed a standard diet (C) and five ovariectomized groups fed a standard diet (OVX_C) or a diet with calcium lactate (CaL), with calcium lactate-enriched pumpkin (P_CaL), with calcium lactate and alendronate (CaL_B), or with calcium lactate-enriched pumpkin with alendronate (P_CaL_B). After 12 weeks of the intervention, the rats were sacrificed, and their blood and tissues were collected. The calcium concentrations in serum and in tissues were measured using flame atomic absorption spectrometry (AAS). Serum concentrations of procollagen type-1 amino-terminal propeptide (PINP), parathyroid hormone PTH, estrogen (ES), and osteocalcin (OC) were determined with enzyme-linked immunosorbent assay (ELISA). It was found that enriched pumpkin increased the calcium level in the kidneys (194.13 ± 41.01 mg) compared to the C (87.88 ± 12.42 mg) and OVX_C (79.29 ± 7.66 mg) groups. The addition of alendronate increased the calcium level in the femurs (267.63 ± 23.63 mg) and more than six times in the kidneys (541.33 ± 62.91 mg) compared to the OVX_C group (234.53 ± 21.67 mg and 87.88 ± 12.42 mg, respectively). We found that the CaL, P_CaL, and CaL_B groups had significantly lower PINP serum concentrations (4.45 ± 0.82 ng/mL, 4.14 ± 0.69 ng/mL, and 3.77 ± 0.33 ng/mL) and higher PTH serum levels (3.39 ± 0.54 ng/dL, 3.38 ± 0.57 ng/dL, and 3.47 ± 0.28 ng/dL) than the OVX_C group (4.69 ± 0.82 ng/mL and 2.59 ± 0.45 ng/dL, respectively). In conclusion, pumpkin enriched with calcium lactate affects calcium status and normalizes PINP and PTH serum levels in ovariectomized rats. Diet with enriched pumpkin and alendronate increase calcium concentration in the femur. Enriched pumpkin causes calcium to accumulate in the kidneys of ovariectomized rats; alendronate significantly exacerbates this effect.

Effects of Bisphosphonate on Osteocyte Proliferation and Bone Formation in Patients with Diabetic Osteoporosis.

Background Bisphosphonate is currently considered one of the drugs for the first-line treatment of osteoporosis because of its ability to inhibit bone resorption, but the molecular mechanism of its effect on osteocyte proliferation and bone formation of diabetic osteoporosis is still unclear. Objective To confirm the potential effect on of bisphosphonate on osteocyte proliferation and bone formation in patients having diabetic osteoporosis (DO). Methods Sixty DO patients admitted to our hospital from February 2019 to April 2021 were randomly selected and divided into the bisphosphonate group and the control group. The total incidence, incidence of hip fracture, efficacy, bone mineral density, osteocalcin, pain score, osteocyte proliferation, bone formation index, serum calcium, and phosphorus contents were compared between two groups. Results The curative effect of bisphosphonic acid group was better than that of control group, and the difference was statistically significant (P < 0.05). Compared with the control group, the bone mineral density and osteocalcin in the bisphosphonic acid group were significantly improved after treatment, and the pain score in the bisphosphonic acid group was significantly lower than that in the control group (P < 0.05). After intervention treatment, the OD and PINP values in the bisphosphonate group were significantly different from those in the control group (P < 0.05). After treatment, the contents of serum calcium and phosphorus in the bisphosphonic acid group were significantly higher than those in the control group (P < 0.05). The incidence of hip fracture, spinal fracture, and other fractures in the bisphosphonic acid group was significantly lower than that in the control group (P < 0.05). Conclusion The treatment of DO with bisphosphonate is capability of effectively improving bone cell proliferation and bone formation, further alleviating clinical symptoms and promoting the improvement of the disease.

Physiological Changes in Serum Calcium, Phosphate, Vitamin D, Parathyroid Hormone and Calcitonin During Pregnancy and Lactation in Randomised Population of Zaria Women.

Pregnancy and lactation are usual but stressful physiological conditions accompanied by changes in calcium and phosphate metabolism and their regulatory hormones which may lead to calcium-related disorders in pregnant women. This study aimedto evaluate the changes in serum levels of calcium, phosphate, vitamin D and their regulatory hormones in pregnant and lactating women in Zaria, Nigeria. A cross‑sectional descriptive study was conducted at Ahmadu Bello University Teaching Hospital, Zaria for three (3) months. Blood samples were collected, anthropometric measurements (weight, height and body mass index) of 179 women were taken. Serum calcium, phosphate, vitamin D, parathyroid hormone and calcitonin were determined using standard methods. Data were presented as mean ± SD, analysis was performed using one-way ANOVA and Pearson's correlation analysis. Values were considered significant at p ≤ 0.05. There was a significant decrease in serum calcium concentration (p < 0.01) during the third trimester of pregnancy and lactation. An increase in serum concentration of vitamin D, parathyroid hormone, and calcitonin in the 2nd trimester and a decrease during the third trimester and lactation although not statistically significant when compared with the control. There was a negative correlation between serum calcium concentration and gestational age (r = 0.255) while no correlation between gestational age and serum phosphate concentration. Changes in serum calcium, vitamin D, parathyroid hormone and calcitonin during pregnancy and lactation has been demonstrated suggesting a relationship between calcium metabolism and these hormones at some stages of pregnancy.

The Effect of Pre-Thyroidectomy Calcitriol Prophylaxis on Post-Thyroidectomy Hypocalcaemia in Children

Introduction: Transient or persistent hypoparathyroidism is one of the most well-known complications of total thyroidectomy and may lead to symptomatic hypocalcaemia. In children, treatment of post-thyroidectomy hypocalcaemia usually consists of postoperative calcium and/or vitamin D supplementation. In 2013, we implemented prophylactic pre-thyroidectomy calcitriol supplementation for all children undergoing total thyroidectomy at the Amsterdam UMC. The objective of this study was to evaluate the efficacy of this prophylactic calcitriol supplementation in preventing post-thyroidectomy hypocalcaemia in children. Methods: In a retrospective case study, we included all children (age <18 years), who underwent a total or completion thyroidectomy in the Amsterdam UMC, between 2000 and 2020. Patients were divided into two groups, patients with preoperative calcitriol supplementation and those without (controls). Hypocalcaemia was defined as total serum calcium concentration of <2.0 mmol/L. The primary outcome measure was the occurrence of hypocalcaemia in the first 72 h after surgery. Secondary outcome measures were occurrence of symptomatic hypocalcaemia, need for medical intervention within the first 72 h after surgery, and length of hospitalization. Results: A total of 51 patients were included; 26 with calcitriol prophylaxis and 25 controls. There was no significant difference in occurrence of hypocalcaemia (17/26 prophylaxis group; 18/25 control group). Median postoperative calcium concentrations in the first 72 h were significantly higher in the group with prophylaxis at 30–35 h (2.26 vs. 2.01 mmol/L) and 36–41 h (2.17 vs. 1.92 mmol/L). Occurrence of symptomatic hypocalcaemia, need for medical intervention, and length of hospitalization were not significantly different between the groups. Conclusion: Calcitriol prophylaxis resulted in somewhat higher postoperative calcium concentrations but did not reduce the occurrence of hypocalcaemia or affect clinical outcome measures such as occurrence of symptomatic hypocalcaemia and length of postoperative hospitalization.

Clinical and prognostic analysis of acute pulmonary thromboembolism in the elderly

Objective: To analyse the clinical characteristics and to explore the prognostic factors of acute pulmonary thromboembolism in the elderly. Methods: The medical records of inpatients with acute pulmonary thromboembolism discharged from Peking Union Medical College Hospital from January 1, 2012, to February 1, 2019 were retrospectively reviewed. The eligible patients were divided into elderly group (≥ 60 years old) and non-elderly group (<60 years old). The clinical symptoms, complications, laboratory results, pulmonary embolism severity index (PESI) and mortality were compared between the two groups. Mortality was further compared among elderly patients of different age groups. Cox regression analysis was used to analyze the risk factors of 7-day and 30-day death in elderly patients with pulmonary embolism. Results: A total of 503 patients with acute pulmonary embolism were included, including 279 cases in the elderly group and 224 cases in the non-elderly group. The incidence of cardiac arrest was higher in the elderly group compared with non-elderly group, while the incidence of chest pain and hemoptysis was less common in the elderly group. The proportions of comorbidities, including diabetes, hypertension, and coronary heart disease were higher in the elderly group while the proportion of autoimmune diseases was higher in the non-elderly group. In terms of prognosis, the PESI score and 7-day and 30-day mortality in the elderly group were higher than those in the non-elderly group. The mortality of elderly patients increased with age. Cox univariate regression analysis showed that infection, hypoalbuminemia, hypocalcemia, elevated cardiac troponin(cTnI), elevated N-terminal prohormone of brain natriuretic pepride(NT-proBNP) and PESI grade were associated with 30-day death. Multivariate Cox regression analysis showed that PESI grade and decreased serum calcium concentration were independent risk factors for 7-day death of pulmonary embolism in elderly patients. PESI grade, decreased serum calcium concentration and infection were independent risk factors for 30-day death. Conclusions: The mortality of elderly patients with pulmonary embolism was higher than that of non-elderly patients, and the mortality increased gradually with age. PESI grade, decreased serum calcium concentration and infection were independent risk factors for 30-day death of pulmonary embolism in elderly patients.

Low Serum Calcium Concentration in Patients With Systemic Lupus Erythematosus Accompanied by the Enhanced Peripheral Cellular Immunity

ObjectiveThis study aims to explore the relationship between serum calcium concentration and peripheral lymphocyte status/Th1/Th2 cytokine levels in SLE patients, and the effect of glucocorticoids (GCs) on the calcium concentration and immune cell activation.MethodsThe peripheral blood TBNK lymphocyte subsets and Th1/Th2 cytokines in SLE patients with low or normal serum calcium concentration and healthy people were analyzed and compared retrospectively. Peripheral white blood cells (PWBCs) from SLE patients or healthy people were stimulated with PMA or GCs in vitro to test their extracellular calcium concentration and CD8+ T cell activation.ResultsThe percentages of CD8+ T in SLE patients increased, but the increase of the number of CD8+ T cells only occurred in the SLE patients with low serum calcium concentration, and the number of CD45hiCD8+ T cells also increased, suggesting that SLE patients with hypocalcemia tend to possess an enhanced cellular immunity. The results of Th1/Th2 cytokines in peripheral blood showed that the levels of serum IL-2, IL-10, IL-6 and IFN-γ in SLE patients with hypocalcemia were significantly increased. Although the serum levels of TNF-α in SLE patients were –similar to that in healthy people, it was significantly higher than that in SLE patients with normal serum calcium. When comparing the results of Th1/Th2 cytokines in two times of one patient, the serum levels of TNF-α in SLE patients increased while serum calcium levels decreased. The in vitro experiments showed that the decrease of serum calcium concentration in SLE patients was affected by the immune cell activation and the application of GCs, but GCs did not promote the immune cell activation.ConclusionsLow serum calcium may make SLE patients in an enhanced cellular immune status and GCs aggravates the decrease of serum calcium levels but has no role on the immune cell activation. It suggests that hypocalcemia possibly promotes the disease activity of SLE patient, which should be paid attention to clinically.

Bıldırcın Rasyonlarına Sodyum Format İlavesinin Performans, Yumurta Kalite ve Serum Parametreleri Üzerine Etkisi

The current research was carried out to determine the effect of adding sodium formate at the level of 0, 5, and 10 g/kg to the diets on the performance, egg quality and some serum parameters in layer Japanese quails. In the experiment, a total of 84 female quails at the age of 20 weeks were randomly distributed to 3 treatment groups with 7 replicates. At the end of the experiment, the addition of sodium formate at different levels to the diet did not statistically affect performance and egg quality parameters. Compared with the control group, the supplementation of 10 g/kg sodium formate to the diet considerably decreased the serum glucose concentration, while the serum calcium concentration increased significantly. Furthermore, the administration of sodium formate to diet significantly decreased serum triglyceride and cholesterol concentrations. According to the results obtained from the study, it was determined that the addition of sodium formate to the diet was effective in reducing serum glucose, triglyceride and cholesterol concentrations and increasing serum calcium concentration without affecting the performance and egg quality parameters of laying quails, and this effect was more pronounced at 10 g/kg sodium formate level.

Establishing a predictive model of hypoparathyroidism after total thyroidectomy and central lymph node dissection for postoperative calcium supplementation selectively.

BackgroundThe core goal of this article is to find some meaningful risk factors that can affect the postoperative hypoparathyroidism of thyroid cancer, create an effective prediction model on this basis, and use it to selectively implement routine prophylactic calcium supplementation for patients after thyroid carcinoma surgery.MethodsThe clinicopathological characteristics of patients with papillary thyroid carcinoma (PTC) who underwent conventional bilateral total thyroidectomy (TT) + bilateral central lymph node dissection from January 2020 to August 2021 in the Affiliated Hospital of Nantong University were retrospectively analyzed. Firstly, this study analyzed the relationship between postoperative hypocalcemia and hypoparathyroidism. Then, we included many potential risk factors such as gender, age, body mass index (BMI), lateral lymph node dissection (LLND) and so on and also performed univariate and multivariate analysis of the independent risk factors for postoperative hypoparathyroidism in patients, and established a predictive scoring model.ResultsAmong the 401 patients with PTC, 50.1% developed postoperative hypoparathyroidism. There was significant difference in serum calcium concentration between normal parathyroid group and hypoparathyroidism group after thyroid carcinoma surgery. BMI <24 kg/m2, lateral lymph node dissection, multifocality, and extrathyroidal extension (ETE) were all identified as independent risk factors for postoperative hypoparathyroidism. Based on these independent risk factors, a nine-point risk scoring model was created to firstly assess the postoperative parathyroid function status of patients and then to determine whether routine prophylactic calcium supplementation is needed. Importantly, the area under the curve (AUC) of the risk scoring model is equal to 0.979.ConclusionsAt present, prophylactic calcium supplementation after thyroid carcinoma surgery is a controversial postoperative treatment. It should be selectively implemented for high-risk patients with hypoparathyroidism after surgery. Routine prophylactic calcium supplementation is recommended for PTC patients with a score greater than or equal to 5, although there are no clinical symptoms of postoperative hypocalcemia caused by hypoparathyroidism. However, prophylactic calcium supplementation is not recommended for patients with PTC with a score of less than 5; if the patient develops hypocalcemia at the later stage, therapeutic calcium supplementation can then be implemented.

Older adults with a higher frailty index tend to have electrolyte imbalances.

Frailty is a state of increased vulnerability to poor resolution of homeostasis after a stressor. We hypothesized that frail older adults would tend to have electrolyte imbalances because they should have many stressors together with fragile physiological systems. In this study, we aimed to determine whether older adults with higher Frailty Index scores have electrolyte imbalances and to establish which domains of the Frailty Index are correlated with electrolyte imbalances. A cross-sectional study. A total of 4204 older adults aged 70years or over who visited the Japanese National Center for Geriatrics and Gerontology. We calculated the 50-item Frailty Index with the following domains: comorbidities, cognitive function and mood, basic and instrumental activities of daily living, physical function, nutrition, and fall risks from physical weakness and comorbidities. Participants were categorized into four groups: a non-frail group (Frailty Index ≤0.2), mildly frail group (0.20<Frailty Index ≤0.3), moderately frail group (0.3<Frailty Index ≤0.4), and severely frail group (0.4<Frailty Index). Their serum sodium, potassium, calcium, and phosphorus concentrations were measured. A multiple regression model was used to explore the relationship of electrolyte imbalances with the Frailty Index and to determine which frailty domains are correlated with electrolyte imbalances. Compared with the non-frail group, the mildly and moderately frail groups tended to have hypernatremia and hypophosphatemia, whereas the severely frail group tended to have dysnatremia, hypokalemia, and hypophosphatemia. The estimated odds ratios increased by 15%-52% for each electrolyte imbalance as the Frailty Index increased by 0.1. The Frailty Index domains of cognitive function, activities of daily living, and nutrition were correlated with more than three kinds of electrolyte imbalances, the domains of physical function and fall risks from physical weakness were correlated with three kinds of electrolyte imbalances, and the domains of comorbidities and fall risks from comorbidities were correlated with two kinds of electrolyte imbalances. Older adults with higher Frailty Index scores tend to have electrolyte imbalances.

COMPARATIVE STUDY OF SERUM CALCIUM AND MAGNESIUM LEVELS IN WOMEN WITH PRE ECLAMPSIA AND NORMOTENSIVE PREGNANT WOMEN

Objectives: The objective of the study is to establish a relation between serum calcium and magnesium levels with severity of pre-eclampsia and to compare the levels with normotensive pregnant women. Materials And Methods: 200 women with pre-eclampsia and 200 normotensive pregnant women were included in this hospital based, cross sectional study; serum calcium and magnesium levels were measured and data was analysed. The serum calcium concentration wasResults: signicantly lower in pre-eclamptic cases as compared to normotensive controls. (7.903±0.292 Vs 9.227±0.598 mg/dl, p &lt; 0.001). Serum magnesium concentration was signicantly lower in severe preeclampsia cases as compared to mild preeclampsia. (7.67±0.32 Vs 7.991±0.22 mg/dl, p&lt;0.001). Measurements of serum calcium and magnesium among women at risk may be used toConclusion: predict onset and severity of pre-eclampsia.

The relationship between chronic kidney disease and denosumab-induced hypocalcemia in high-age osteoporotic patients.

A few studies have reported the safety of the treatment of elderly osteoporotic patients with chronic kidney disease (CKD) and the possibility of hypocalcemia. The aim of the present study was to examine the relationship between the incidence of hypocalcemia and the CKD stage in elderly osteoporotic patients treated with denosumab. This study was designed as a parallel-group comparison study between the denosumab-associated hypocalcemia (DAH) groups: the concentration of serum calcium was under 8.6mg/dl and the normal calcium (NC) groups: the concentration of serum calcium was over 8.6mg/dl. Fifty-two subjects over 70years old were enrolled in this study, with 16 patients classified into the DAH group and 36 patients assigned to the NC group. All patients were further classified into two subgroups according to their age, into an around 75years group to clarify the relevance of old age and an around 85years group and also into a mild CKD group and a moderate CKD group by based on estimated glomerular filtration (eGFR). Serum calcium concentration, tartrate-resistant acid phosphatase (TRACP-5b), and type 1 procollagen N terminal propeptide (P1NP) were measured, and adverse drug reactions were evaluated. The eGFR and serum calcium were significantly lower in the DAH group than in the NC group in the starting phase. Moreover, TRACP-5b was significantly higher in the DAH group than in the NC group in the starting phase. There were no significant differences in P1NP. The incidence of hypocalcemia was significantly higher in the around 85 groups than in the around 75 groups. The frequency of hypocalcemia was also significantly higher in the severe CKD group than in the mild CKD group. Advanced age combined with low eGFR and low serum Ca status appear to be associated with the incidence of hypocalcemia when using denosumab for the treatment of osteoporosis.

Associations between Genetically Proxied Inhibition of Lipid-Lowering Drug Targets and Serum Micronutrients among Individuals of European Descent: A Mendelian Randomization Study

BackgroundLimited and inconclusive data exist concerning the associations between lipid-lowering drugs and serum micronutrient concentrations. MethodsWe conducted Mendelian randomization (MR) analyses to explore the associations between lipid-lowering drug targets and serum micronutrients. Single-nucleotide polymorphisms in genes encoding molecular targets of LDL cholesterol-lowering therapies were selected as instrumental variables for 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR; target of statins), proprotein convertase subtilisin/kexin type 9 (PCSK9; target of PCSK9 inhibitors), and Niemann-Pick C1-Like 1 (NPC1L1; target of ezetimibe). Exposure data were extracted from a published genome-wide association study (GWAS) of lipids in 188,577 European individuals, with outcome data obtained from the Integrative Epidemiology Unit (IEU) GWAS database (https://gwas.mrcieu.ac.uk). Overall, age and sex information were not calculable from the summary-level GWAS data. MR analyses were performed using the inverse-variance weighted method and MR sensitivity analysis methods. ResultsWe found genetically proxied inhibition of HMGCR to lower iron (effect, –0.16; 95% CI: –0.27, –0.06; P value = 0.003), zinc (effect, –0.83; 95% CI: –1.36, –0.31; P value = 0.002), magnesium (effect, –0.17; 95% CI: –0.27, –0.06; P value = 0.003), potassium (effect, –0.17; 95% CI: –0.27, –0.06; P value = 0.002), genetically proxied inhibition of NPC1L1 to increase calcium (effect, 0.28; 95% CI: 0.10, 0.46; P value = 0.003), retinol (effect, 0.25; 95% CI: 0.07, 0.44; P value = 0.01), and genetically proxied inhibition of PCSK9 to increase vitamin D (effect, 0.10; 95% CI: 0.07, 0.12; P value = 1.8 × 10–19). These associations were robust in MR sensitivity analyses. However, the associations between genetically proxied inhibition of HMGCR and NPC1L1 and the micronutrients were not consistent in multiple comparisons. ConclusionsOur results provide evidence that statin use may lower serum concentrations of iron, zinc, magnesium, and potassium, PCSK9 inhibitors may increase serum vitamin D, and ezetimibe may increase serum calcium and retinol concentrations.