Serum Total Albumin Research Articles

Electrophoretic Pattern of Serum Proteins in Pregnancy: A Cross-sectional Study

Introduction: Nutritional status during pregnancy is a determining factor for maternal and neonatal health outcomes. Protein is an essential nutrient for foetal development. If pregnancy is associated with an improper diet leading to protein deficiency, the prospects for maternal and foetal outcomes may be catastrophic. An electrophoretic study of serum protein patterns in pregnancy can help identify pregnancy-specific protein markers and facilitate the monitoring of feto-maternal health. Aim: The aim of this study is to assess serum protein levels and their fractions (albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, and gamma globulin) using gel electrophoresis in healthy pregnant women attending an antenatal clinic. Materials and Methods: This cross-sectional study was conducted in the Department of Medical Biochemistry in collaboration with the Department of Obstetrics and Gynecology at Sultania Zanana Hospital, associated with Gandhi Medical College, Bhopal, Madhya Pradesh, India, between January 2021 and February 2021. Fifty normal non-pregnant women of childbearing age and 50 normal pregnant women in the first trimester of pregnancy attending an antenatal clinic were enrolled and followed-up through the second and third trimesters for investigations. Serum total protein, albumin, and globulin levels were estimated using a fully automated chemistry analyser, and the electrophoretic patterns of serum protein fractions were analysed using an automated gel electrophoresis apparatus. EpiInfo statistical software was used for the statistical analysis of data, with p<0.05 considered the statistical significance level. Results: The serum total protein level in non-pregnant women was 6.36±0.40 g/dL, while in pregnant women, it was 8.01±0.40 g/dL, 8.00±0.42 g/dL, and 6.36±0.43 g/dL in the first (T1), second (T2), and third (T3) trimesters, respectively. The serum albumin level was 3.90±0.30 g/dL in non-pregnant women, while in pregnant women it was 4.24±0.38 g/dL, 4.58±0.34 g/dL, and 3.87±0.36 g/dL in T1, T2, and T3, respectively. The globulin level in non-pregnant women was 2.46±0.28 g/dL, while in T1, T2, and T3 it was 3.86±0.22 g/dL, 3.42±0.20 g/dL, and 2.49±0.24 g/dL, respectively. A significant difference was found among the groups for serum total protein, serum albumin, and serum globulin. In non-pregnant women, the protein fractions- albumin, alpha-1 globulin, alpha-2 globulin, beta globulin, and gamma globulindid not show any deviation from normal levels. However, there was a decrease in albumin and beta globulin levels, along with an increase in alpha-2 globulin levels in the first trimester. An increase in beta globulin and a decrease in gamma globulin levels were observed in the second trimester. In the third trimester, all these fractions did not show any significant alterations, except for gamma globulin. Conclusion: Serum total protein, serum albumin, and serum globulin levels showed a significant difference. However, a slight increase in serum globulin levels compensated for the fall in albumin levels during pregnancy. Variations in the levels of beta globulin, alpha-2 globulin, and gamma globulin were observed during pregnancy, while, on the other hand, alpha-1 globulin did not show any alterations in pregnant women during the first, second, and third trimesters, although its level was higher in pregnant women compared to non-pregnant women.

Ameliorative effects of Lactobacillus against Aflatoxin B1.

Lactobacilli are probiotics with Aflatoxin (AF) detoxification ability, found in fermented products, GIT of animals and environment. Purpose of this study was to investigate the ability of broiler isolates of Lactobacillus against Aflatoxin B1 (AFB1). For this purpose, 5 isolates of Lactobacillus from broiler gut were incubated with 100 ppb AFB1 in aqueous environment and effect of different parameters (cell fractions, time, temperature, pH) on detoxification was determined by HPLC. The ameliorative effect of Lactobacillus salivarius (LS) against AFB1 was studied in broiler. The results revealed that LS (CR. 4) showed the best results (in vitro) as compared to other isolates (L. salivarius (CR. 3, CR, 4), L. agilis (CE. 2.1, CE. 3.1) and L. crispatus (CE. 28). Cell debris of CR. 4 showed significantly higher detoxification (P<0.05). Maximum amount of AFB1 was detoxified at 30°C (97%), pH 4.0 (99%) and 6 h (99.97%). In vivo study showed that AFB1 decreased weight gain (1,269 ± 0.04 gm/ bird), feed consumed (2,161 ± 0.08 gm/ bird), serum total protein (2.42 ± 0.34 gm/ dl), serum albumin (0.5 ± 0.2 2 gm/dl) and antibody titer (4.2 ± 0.83). Liver function enzymes were found (alanine transaminase (ALT): 32 ± 10.7 U/L) and aspartate transaminase (AST): 314.8 ± 27 U/L) elevated in AFB1 fed broilers. Treatment with 1% LS not only decreased the toxic effects of AFB1 (group D) but also improved the overall health of broilers due to its probiotic effects (p<0.05) as compared to control negative (group A). The detoxification ability of LS was better than commercial binder (CB) (0.2% Protmyc). It was concluded that detoxification of AFB1 by Lactobacillus was strain, temperature, pH and time dependent. LS has detoxification ability against AFB1 in vivo.

Hepatoprotective efficacy of Lagenaria siceraria seeds oil against experimentally carbon tetrachloride-induced toxicity.

The liver is crucial for maintaining normal metabolism in the body. Various substances, such as toxic chemicals, drugs, and alcohol, can damage hepatocyte cells, leading to metabolic imbalances. The experiment aimed to determine the efficacy of Lagenaria siceraria seed oil (LSS) as a hepatoprotective agent against acute hepatotoxicity triggered by carbon tetrachloride (CCl4). A total of 20 rats were randomly separated into four groups. The control group: rats received 2 ml of distilled water orally, followed by 1.25 ml of olive oil intraperitoneally (i.p.) after 30 minutes. CCL4 group: rats were given a single intraperitoneal dose of 1.25 ml/kg b.w. of CCl4 in a 1:1 mixture with olive oil. Silymarin group: received 100 mg of silymarin per kg of b.w. diluted in 2 ml of distilled water orally, followed by CCl4 treatment after 30 minutes. LSS oil group: received LSS oil at 3g/kg b.w. orally, followed by CCl4 treatment after 30 minutes. Blood samples were collected to assess liver enzymes (AST, ALT, and ALP), proteins and bilirubin fractions, and redox status (catalase, reduced glutathione (GSH), and malondialdehyde (MDA)) were assessed in hepatic tissues. Changes in liver histopathological examination were also evaluated. In CCl4-treated rats, there was a significant increase in serum liver marker enzyme activity (ALP, AST, and ALT) along with a significant elevation (p < 0.05) in total bilirubin, indirect bilirubin, and direct bilirubin compared to the control rats. However, all these parameters decreased in the CCl4+ Silymarin and CCl4+LSS groups compared to CCl4-treated rats. There was a significant decline in total protein level and serum albumin in all experimental groups compared to the control, while globulin levels significantly increased in all experimental groups. There was a significant (p < 0.05) reduction in the level of GSH and catalase, with an increase in MDA level in CCl4 rats compared to other rats. Histopathological investigation of the LSS-treated group showed a hepatoprotective effect against CCl4. The study revealed that LSS oil has antioxidant activity against CCl4-induced toxicity.

Efficacy of sulodexide in treating idiopathic membranous nephropathy among Chinese patients: a meta-analysis.

To evaluate the efficacy of Sulodexide in treating idiopathic membranous nephropathy (IMN) in the Chinese population. We systematically reviewed all eligible randomized clinical trials (RCTs) conducted in China that investigated the effects of Sulodexide on IMN. Three RCTs published between 2013 and 2022 were included, encompassing a total of 146 patients. The primary outcomes evaluated were changes in urine total protein (UTP), serum albumin (ALB), cholesterol (CHOL), and fibrinogen (FIB) levels. Statistically significant differences were observed in the Sulodexide treatment group compared to the control group for the following parameters: reduction in UTP and CHOL, increase in ALB, and reduction in FIB levels. Sulodexide, when combined with conventional therapy, effectively reduces UTP and CHOL levels, decreases FIB levels, and increases ALB in Chinese patients with IMN.

Exploring systemic inflammation in children with chronic kidney disease: correlates of interleukin 6.

Systemic inflammation (SI) is linked to chronic kidney disease (CKD) progression and multiple complications. Data regarding SI biomarkers in pediatric patients are scarce. This case-control and cross-sectional study investigates the correlation of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), total iron binding capacity (TIBC) and serum albumin to serum interleukin-6 (IL-6). NLR and PLR were measured in 53 patients (median age: 12.9years), including 17 on dialysis and 36 with a median glomerular filtration rate of 39ml/min/1.73m2, and in 25 age and sex-matched healthy controls. Iron profile, serum albumin and IL-6 were measured in the patient group. IL-6 levels > 3rd quartile were classified as high. Patients presented higher NLR and PLR and particularly those on dialysis (p < 0.001 and p = 0.001). We observed a significant correlation between natural logarithm (ln) of IL-6 (lnIL-6) and NLR (rs = 0.344, p = 0.014), serum albumin (rs = -0.350, p = 0.011) and TIBC (rs = -0.345, p = 0.012) after adjustment for CKD stage, while the correlation between lnIL-6 and PLR was not significant (rs = 0.206, p = 0.151). Combination of NLR, serum albumin and TIBC predicted high IL-6 (13 patients) with an AUC of 0.771 (95% CI 0.608-0.943). Pairing of NLR ≥ 1.7 and TIBC ≤ 300μg/dL exhibited the highest sensitivity (76.9%), while incorporating serum albumin ≤ 3.8g/dL along with them achieved the highest specificity (95%) for detecting high IL-6 levels. Both NLR and PLR levels increase in CKD, especially in patients on chronic dialysis. NLR, rather than PLR, along with TIBC and serum albumin, are associated with IL-6 in pediatric CKD.

Sub-lethal impacts of lead poisoning on blood biochemistry, immune function and delta-aminolevulinic acid dehydratase (δ-ALAD) activity in Cape (Gyps coprotheres) and white-backed (G. africanus) Vulture chicks

Although the prevalence of lead poisoning in southern Africa's Gyps vultures is now well-established, its finer physiological effects on these endangered species remain poorly characterised. We evaluated the sub-lethal impact of acute lead exposure on Cape and White-backed Vulture chicks from two breeding colonies in South Africa, by analysing its possible effects on key blood biochemistry parameters, immune function, packed cell volume and δ-aminolevulinic acid dehydratase (δ-ALAD) activity. All 37 White-backed Vulture nestlings sampled displayed elevated lead levels (>10 μg/dL), and seven had blood [Pb] >100 μg/dL. Eight of 28 Cape Vulture nestlings sampled had blood [Pb] exceeding background exposure, with one showing blood [Pb] >100 μg/dL. Delta-aminolevulinic acid dehydratase (δ-ALAD) activity was significantly and negatively related to blood [Pb] in nestlings from both species, with 50% inhibition of the enzyme predicted to occur at blood [Pb] = 52.8 μg/dL (White-backed Vulture) and 18.8 μg/dL (Cape Vulture). Although no significant relationship was found between % packed cell volume (PCV) and blood [Pb], the relatively lower mean PCV of 32.9% in White-backed Vulture chicks, combined with normal serum protein values, is likely indicative of depression or haemolytic anaemia. The leukogram was consistent in both species, although the presence of immature heterophils suggested an inflammatory response in White-backed Vulture chicks with blood [Pb] >100 μg/dL. Values for cholesterol, triglycerides, total serum protein, albumin, globulin, albumin/globulin ratio, alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) were consistent with values previously reported. Calcium and phosphorus concentrations suggested no adverse effects on bone metabolism. A significant decrease in urea: uric acid (U:UA) ratio at blood [Pb] >100 μg/dL in White-backed Vulture chicks, brought about by a decrease in urea production, raises the possibility of hepatic abnormality. These results suggest that δ-ALAD activity may serve as a sensitive biomarker of lead toxicity in both species, while highlighting the need to better understand the significant variability in sensitivity that is observed, even between closely related members of the same genus.

The impact of home enteral nutrition planned with the use of indirect calorimetry on the nutritional status and body composition of cancer patients

BackgroundStudies show that malnutrition is common among cancer patients, ranging from about 20% to more than 70%. It is known that malnutrition that is not managed properly worsens the course of the disease, prolongs the hospital stay, and impacts the quality of life and treatment toxicities. Malnutrition has many negative effects, therefore individualization and optimization of nutritional support is crucial for the patient's health. This study aimed to assess the impact of home enteral nutrition (HEN) planned with the use of indirect calorimetry on the nutritional status and body composition of cancer patients. MethodsThis prospective, observational study included 28 patients with cancer recruited at the Nutrition Clinic of Department of General, Gastroenterologic and Oncologic Surgery, of the Medical University of Warsaw from December 2021 to December 2022. All patients were supported with HEN setup based on individual caloric needs for 3 months. We evaluated nutritional status, body composition, and biochemical markers of malnutrition. ResultsFor 67.9 % of patients, using the equations rather than indirect calorimetry would underestimate energy needs. Individualized HEN resulted in weight loss stops in 46.4 % of patients. The average change in body mass in the study group was positive and was equal to 0.46 ± 6.73 kg. No significant differences were found when comparing the mid-arm circumference (MAC) and triceps skinfold thickness (SFT) before and after inclusion in HEN, although, as in the case of body mass SFT showed an upward trend. Moreover, the percentage of patients with insufficient total protein (TP) and serum albumin concentrations decreased. This difference was statistically significant for albumin. The Nutritional Risk Index (NRI) was also significantly higher. The analysis of body composition also showed a decrease in the percentage of patients with reduced fat-free mass (FFM), body cell mass (BCM), and phase angle (PhA) value. ConclusionsThe results of our research highlight the significance of well-planned nutritional care for cancer patients. Utilizing HEN and individualized approaches can effectively preserve body mass, composition, and nutritional status while minimizing safety risks, ultimately improving quality of life. Indirect calorimetry if available can be helpful to optimize nutrition care for patients with cancer in HEN.

The Effect of Phototherapy on Various Biochemical Parameters in Neonatal Hyperbilirubinemia

Phototherapy (PT) is the current modality of choice for treatment of unconjugated hyperbilirubinemia. The effects of PT onvarious biochemical parameters including serum calcium, bilirubin profile, serum total protein, albumin, urea, creatinine,serum electrolytes in neonates are a concern in current times. Like any other treatment, PT also has its own side effects.This hospital-based, prospective, comparative observational study was conducted with the objective to assess the level ofvarious biochemical parameters like serum calcium, serum sodium, serum potassium, serum chloride, serum urea and serumcreatinine, serum total protein and serum albumin in addition to serum bilirubin before PT and after completion of 48 hoursof PT in full-term neonates with unconjugated hyperbilirubinemia at a tertiary care center. On comparing biochemicalparameters, a statistically significant difference in parameters such as bilirubin, urea, creatinine, sodium, potassium, chloride,calcium, total protein and albumin was observed after PT. On the other hand, there was a statistically nonsignificant differencein corrected calcium (p = 0.945).

Serum albumin levels as a useful complementary marker for erectile dysfunction in ulcerative colitis: A cross-sectional study.

Recently, a close association between ulcerative colitis (UC) and erectile dysfunction (ED) was reported. An inverse relationship between serum albumin and ED is found in patients with chronic disease. However, the association between serum albumin levels and ED in patients with UC is unclear. This study aims to investigate this issue in Japanese patients with UC. One hundred and thirty-six Japanese male UC patients were enrolled in this study. Information on serum albumin levels and medications for UC from medical records, Sexual Health Inventory for Men (SHIM) score information from self-administered questionnaires and information on the severity of UC from physician reports were obtained from medical records, self-administered questionnaires, and reports from physicians. The participants were divided into tertiles based on the total protein, serum globulin, serum albumin, aspartate aminotransferase, and C-reactive protein levels. The definition of ED and severe ED was SHIM score < 22 and SHIM score < 8, respectively. The association between these serum markers and ED was assessed by multivariate logistic regression. The prevalence of severe ED in the low, moderate, and high albumin groups was 66.0%, 51.0%, and 28.3%, respectively. After adjusting for confounding factors, the low albumin group was independently and positively associated with severe ED (adjusted odds ratio: 2.74, 95% confidence interval: 1.03-7.48, p for trend =0.044). No association between other marker and ED was found. Serum albumin was independently inversely associated with severe ED in Japanese patients with UC. Hypoalbuminemia might be a useful complementary marker for assessing the prevalence and severity of ED in UC patients.

A study of plasma proteins (serum total protein, serum albumin), and thyroid function in children with protein-energy malnutrition

Background: The study's objective was to evaluate and compare total serum protein, serum albumin, and thyroid hormones in children with PEM (protein-energy malnutrition) and healthy controls. Methods: In this cross-sectional study, 100 children with PEM served as cases, while an equal number of age and gender-matched healthy children served as controls. 4 ml of venous blood were taken (3 ml in a plain vial and 1 ml in an EDTA vial) and immediately submitted for further investigation. SPSS software (version 25) was used to analyze the data. A p value of ≤0.05 was considered statistically significant. Results: PEM children have lower serum total protein, albumin level, total T3 (TT3), and total T4 (TT4) levels compared to healthy controls (p&lt;0.0001). Mean TSH levels in cases and controls were nearly similar. There was no significant difference between serum TSH concentrations in PEM children and the controls. Grade I PEM had the highest mean total protein, serum albumin, T3, and T4 levels, followed by grades II, III, and IV. When mean total protein, serum albumin, T3, and T4 levels of each grade of PEM were compared to controls, mean total protein, serum albumin, T3, and T4 levels were substantially lower in each grade of PEM (p&lt;0.0001). Conclusions: PEM children have low serum total protein and albumin levels. This is probably due to decreased oral intake of proteins and reduced biosynthesis. Serum TT3 and TT4 levels are lower in children with PEM than in healthy controls, which is most likely due to reduction in circulating plasma proteins.

Elevated circulating CD19+CD24hiCD38hi B cells display pro-inflammatory phenotype in idiopathic membranous nephropathy

CD19+CD24hiCD38hi regulatory B cells exert immunosuppressive functions by producing IL-10, but their role in idiopathic membranous nephropathy (IMN) remains elusive. Here, we investigated the frequency and functional changes of circulating CD19+CD24hiCD38hi B cells and evaluated the correlation of CD19+CD24hiCD38hi B cells with clinical features and T helper cell subsets in IMN patients. Compared with healthy controls (HCs), IMN patients showed an increased frequency of CD19+CD24hiCD38hi B cells, but a significant reduction in the percentage of CD19+CD24hiCD38hi B cells was observed 4 weeks after cyclophosphamide treatment. The frequency of CD19+CD24hiCD38hi B cells was positively correlated with the levels of 24h urinary protein, but negatively correlated with serum total protein and serum albumin, respectively. CD19+CD24hiCD38hi B cells in IMN patients displayed a skewed pro-inflammatory cytokine profile with a higher level of IL-6 and IL-12, but a lower concentration of IL-10 than their healthy counterparts. Accompanied by upregulation of Th2 and Th17 cells in IMN patients, the percentage of CD19+CD24hiCD38hi B cell subset was positively associated with Th17 cell frequency. In conclusion, CD19+CD24hiCD38hi B cells were expanded but functionally impaired in IMN patients. Their altered pro-inflammatory cytokine profile may contribute to the pathogenesis of IMN.

Assessment of the Haematological and Biochemical Effects of Himalayan Herb Urtica dioica Leaves Diets Fed Amur Carp, Cyprinus carpio haematopterus

The various properties of Urtica dioica (Stinging nettle) supplemented feeds were evaluated in amur carp (Cyprinus carpio haematopterus). Four iso-protein and iso-energy diets were prepared by using different dietary levels of U. dioica i.e., 0.5 g (T1), 0.75 g (T2), and 1.0 g/kg (T3) respectively, and the treatment TC (control) consist of the basal diet with 0% of U. dioica. The phytochemical analyses of U. dioica revealed the presence of flavonoids (25.39 μg/mL), alkaloids (30.21 μg/mL), tannin (2.97 μg/mL), terpenoid (6.15 μg/mL), glycosides (10.12 μg/mL), phenolic (25.16 μg/mL) and saponin was absent. The best result of growth parameters such as net weight gain (415±0.55 g), net length gain (4.20±0.04 cm), weight gain percent (85.65±0.40%), specific growth rate (0.30±0.01%), gross conversion efficiency (0.229±0.01%), feed conversion ratio (4.37±0.13) and condition factor (1.53±0.01) were recorded in treatment T3 in comparison with the other treatments. No mortality was observed in all the treatments resulting in a 100% survival rate. The haematological parameters (like haemoglobin level, total erythrocyte count, total leukocyte count, etc.) and serum biochemical parameters (including total serum protein, albumin, and globulin) showed better results in treatment T3.

Dietary supplementation of Nile tilapia (Oreochromis niloticus) diets with bay laurel (Laurus nobilis): alleviation of oxidative stress and amelioration of immune response, serum biochemistry, and resistance against Aeromonas hydrophila.

Herbal plants can enhance immunity and alleviate oxidative stress in fish. Therefore, the present work was performed to evaluate the effects of bay laurel (Laurus nobilis) on growth, immunity, antioxidant activities, disease resistance, and hematology in Nile tilapia (Oreochromis niloticus). A total of 225 Nile tilapia fingerlings (average weight 15.36 ± 0.04g) were divided into five treatment groups and fed with bay laurel at 0, 10, 15, 20, and 25g/kg diet for 90days. A completely randomized design with three replications was applied. The significantly (p < 0.05) improved weight growth (WG), food conversion ratio (FCR), average daily growth (ADG), protein efficiency ratio (PER), and survival rate were observed in fish fed with bay laurel-supplemented diet at the rate of 15g/kg. Significantly improved red blood cells (RBCs) count, white blood cells (WBCs), hemoglobin (Hb), and significantly declined alanine aminotransaminase (ALT) and aspartate transaminase (AST) were found in the same diet-fed group. The immune response parameters such as nitro blue tetrazolium (NBT), lysozyme activity, phagocytic activity, total serum protein, serum albumin, serum globulin, and albumin-globulin ratio were found significantly improved at 15g/kg bay laurel supplemented diet. The improved antioxidant response (catalase, glutathione peroxidase, malondialdehyde, total antioxidant activity) was also observed in the same diet-fed group. Relative percent survival after the fish challenged against Aeromonas hydrophila was significantly (p < 0.05) different. Overall, bay laurel supplementation at a 15g/kg diet improved the nutritional physiology and immunity and, therefore, could be a potential growth-promoting feed additive for aquaculture development.

Profile of Amoebic vs Pyogenic Liver Abscess and Comparison of Demographical, Clinical, and Laboratory Profiles of these Patients From a Tertiary Care Center in Northern India

Amoebic liver abscess (ALA) and pyogenic liver abscesses (PLA) are the most common causes of liver abscess in developing and developed countries, respectively. Although incidence of liver abscess is low, but mortality is high amongst the patients due to delayed diagnosis. The study was done to find out the prevalence of amoebic and PLA among patients of liver abscess. The clinical, personal, and demographical details were also evaluated to find out the risk factor(s) associated with ALA and PLA, respectively. A retrospective study was conducted to find the prevalence of amoebic and PLA. Clinical, demographic, personal details were evaluated from hospital records. Laboratory parameters such as total leucocyte count, platelets, bilirubin, ESR (Erythrocyte Sedimentation Rate), hemoglobin, glycosylated hemoglobin (HbA1c), alkaline phosphate (ALP), Aspartate aminotransferase (SGOT/AST), Alanine aminotransferase (SGPT/ALT), serum albumin, bilirubin levels, and procalcitonin were recorded. The Ultrasonography (USG) findings regarding the size, location, volume, and number of abscesses were also analyzed. Total of 107 patients of liver abscess were evaluated, and 61.6% of patients were of amoebic etiology, and 25.3% were of pyogenic etiology. Males of 20-60 years of age were predominantly affected with right upper quadrant pain and fever as the most common presentations. ALA patients were found to have solitary abscess in the right lobe involving 6th and 7th segments, with decreased hemoglobin, hyperbilirubinemia, elevated ALP and SGOT, with normal SGPT, and addiction to alcohol. PLA patients had increased HbA1c, increased PCT values, low serum albumin levels, and low platelet-to-white blood cellvalues. The most common bacteria causing PLA was Escherichia coli (n= 8) followed by Enterobacter cloacae (n= 5). Mortality was seen in 6 patients. Liver abscess is found to have relatively high mortality and morbidity. Therefore, early diagnosis is the only method to prevent mortality and morbidity in these patients. Since the presentation is very nonspecific, evaluation of certain risk factors and laboratory parameters can aid in the diagnosis.

Interaction of low-level dietary supplementation of Chlorella vulgaris Beijerinck, 1890, and feeding duration on growth hormone, growth performance and serum biochemistry of red hybrid tilapia (Oreochromis mossambicus × Oreochromis niloticus).

Chlorella is one of the most widely accepted Chlorophyta used by many as livestock and aquaculture feed. Nonetheless, different studies on the overall performances of fish reported the unfavourable effect of high-level supplementations of Chlorella vulgaris. The current study determined the impact of low-level dietary supplementation of C. vulgaris alongside the different feeding durations and their interactions on the growth hormone (GH), growth performances, serum-biochemical indices, hepatic function and some immunological parameters of red hybrid tilapia. The fingerlings (mean weight: 14.25 ± 0.01 g, length: 13.5 ± 0.49 cm) were fed diets containing 0, 0.99%, 2.91% and 4.76% of C. vulgaris powder per kilogram dry diet for 90 days. GH, growth performance, serum-biochemical indices (total serum protein, albumin, globulin, glucose, aspartate aminotransferase and alanine aminotransferase) and some immunological (respiratory burst and lysozyme activities) parameters of the fish were examined after 30, 60 and 90 days of feeding. The results demonstrated that tilapia fed C. vulgaris-supplemented diets showed increased levels of respiratory burst, lysozyme, albumin and total protein, GH and growth performances (P < 0.05), and the effects were duration dependent. After the 90 days of feeding, there was no adverse effect on the hepatic function of the fish. Besides, low survivability was observed in the control group than in the group fed the experimental diets. The group fed the diet supplemented with 4.76% C. vulgaris had significantly higher (P < 0.05) lysozyme activity throughout the duration of the feeding experiment. These results indicate that C. vulgaris enhanced growth performances, GH concentration, serum-biochemistry and some immunological parameters of red hybrid tilapia.

#5655 NEUTROPHIL TO LYMPHOCYTE RATIO, TOTAL IRON BINDING CAPACITY, SERUM ALBUMIN AND SYSTEMIC INFLAMMATION IN CHILDREN WITH CHRONIC KIDNEY DISEASE

Abstract Background and Aims Chronic kidney disease (CKD) is widely linked to chronic inflammation, with a higher incidence in the advanced stages of the disease. Recognition of systemic inflammation may be useful for prompt diagnosis and management of various CKD related disorders and may open the door towards the development and application of anti-inflammatory strategy treatments. This case-control and cross-sectional study investigates the association of neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), total iron binding capacity (TIBC) and serum albumin with high serum interleukin-6 (IL-6) in children with chronic kidney disease (CKD). Method NLR and PLR were measured in 53 patients (median age: 12.9 years) and 25 healthy controls, stratified by age and sex. Lipid and iron profile, glucose tolerance parameters, serum albumin, uric acid and IL-6 were measured in the patient group. Results Compared to controls, NLR and PLR were higher in patients (p = 0.004 and p = 0.032 respectively), and particularly in those with CKD on dialysis (CKD 5D) (17 patients) (p&amp;lt;0.001 and p = 0.001). LnIL-6 was correlated to NLR (rs = 0.344, p = 0.014), albumin (rs = -0.350, p = 0.011) and TIBC (rs = -0.345, p = 0.012) after adjustment for CKD stage, while the correlation between lnIL-6 and PLR was not significant (rs = 0.206, p = 0.151). Patients with NLR ≥1.7, TIBC ≤300 μg/dl and albumin ≤3.8 g/dl presented a higher risk for increased IL-6 (15 patients) regardless CKD stage (OR 5.499, 95% CI 1.272-22.017, p = 0.016, OR 9.818, 95% CI 2.311-41.706, p = 0.002 and OR 7.543, 95% CI 1.891-30.083, p = 0.004). NLR ≥1.7 and TIBC≤ 300 μg/dl predicted high IL-6 with the highest sensitivity (73.3%), while NLR ≥1.7, TIBC≤ 300 μg/dl and serum albumin ≤ 3.8 g/dl with the highest specificity (97.4%). Conclusion Both NLR and PLR increase in pediatric CKD, especially in CKD 5D. NLR rather than PLR may serve as diagnostic marker of systemic inflammation in pediatric CKD, along with TIBC and serum albumin.

Elevated plasma interleukin 21 is associated with higher probability and severity of idiopathic membranous nephropathy

Abstract Objectives Interleukin 21 (IL-21) is a receptor participating in innate immunity and correlates with the activation of innate immune cells. We sought to investigate the role of plasma IL-21 in patients with idiopathic membranous nephropathy (IMN). Methods This was a cross-sectional and case-control study. We analyzed plasma IL-21 in patients with IMN, with other kidney diseases as the diseased controls (DCs), and the healthy controls (HCs), regarding their associations with the risk of having IMN and IMN severity. Results We enrolled 132, 22, and 38 patients with IMN, DC, and HC, respectively. Plasma IL-21 was significantly higher in those with IMN [9.42 (6.93, 12.60)] and DC [7.84 (2.90, 7.95)] compared with HC [5.60 (2.90, 7.10)] (p&lt;0.05). Plasma IL-21 was significantly higher in those with IMN stage III [10.36 (6.94, 20.88)] and II [9.75 (7.60, 14.27)] than those with IMN stage I [6.99 (3.91, 9.08)] (p&lt;0.05). Plasma IL-21 was significantly higher in those with a positive anti-phospholipase A2 receptor antibody (PLA2R) [9.60 (8.27, 12.93)] than those with a negative anti-PLA2R antibody [4.84 (2.90, 11.28)] (p&lt;0.05). Receiver operator characteristic curve analysis showed that a cutoff value of 7.665 pg/mL distinguished patients with IMN from HC and DC with a sensitivity and specificity of 68.94 and 89.47 %, respectively, and the area under the curve was 0.8184. A cutoff value of 7.830 pg/mL identified those with IMN stage II with a sensitivity and specificity of 74.03 and 89.47 %, respectively, with an area under the curve of 0.8718 (p&lt;0.001). Multivariate regression showed that plasma IL-21 was positively correlated with anti-PLA2R and 24 h urine protein, and negatively correlated with total protein and serum albumin. Conclusions Plasma IL-21 levels increased significantly in patients with IMN. IL-21 may therefore serve as a biomarker for IMN.

The effect of post-discharge oral nutritional supplements on outcomes after gastrointestinal surgery: A systematic review and meta-analysis

Malnutrition is a risk-factor for adverse postoperative outcomes. This systematic review and meta-analysis evaluated the impact of post-discharge oral nutritional supplements (ONS) on outcomes in patients undergoing gastrointestinal surgery. The Medline and Embase databases were searched for randomised clinical trials in patients undergoing gastrointestinal surgery who had received ONS for at least two weeks after discharge from hospital. The primary endpoint was weight change. Secondary endpoints included quality of life, total lymphocyte count, total serum protein and serum albumin. Analysis was performed using RevMan5.4 software. Fourteen studies with 2480 participants (1249 ONS/1231 controls) were included. Pooling of results revealed that a reduction in postoperative weight loss in patients taking ONS, when compared with control: overall weighted mean difference (WMD)-1.69kg, 95% CI -2.98 to-0.41, P=0.01. Serum albumin concentration was increased in the ONS group: WMD=1.06g/L, 95% CI 0.04 to 2.07, P=0.04. Haemoglobin was also increased: WMD= 2.91 g/L, 95% CI 0.58 to 5.25, P = 0.01. Total serum protein, total lymphocyte count, total cholesterol and quality of life did not differ between the groups. Patient compliance was relatively poor across the studies and there was variability in the composition of ONS, volume consumed and surgical procedures performed. There was a reduction in postoperative weight loss and an improvement in some biochemical parameters in patients receiving ONS after gastrointestinal surgery. Future RCTs with more consistent methodologies are needed to investigate the efficacy of ONS after discharge from hospital following gastrointestinal surgery.

ASSOCIATION OF MATERNAL SERUM TOTAL PROTEIN AND ALBUMIN LEVEL WITH BIRTH WEIGHT OF NEWBORN

Background: Low birth weight is a leading cause of Neonatal Mortality. Lack of Nutrients and less intake of Nutrients and minerals during pregnancy is associated with Low birth weight of newborn. To Evaluate the Ass Objective: ociation of Maternal serum Total protein and Albumin levels with birth weight of newborn. A Total of 75 Healthy Mothers of Newborns wi Methods: th Low Birth weight (Birth weight &lt;2.5 Kgs.) were selected as cases and 75 Healthy Mothers of Newborns with Normal Birth weight (Birth weight&gt;2.5 Kgs.) were selected as controls. Serum Total proteins and Serum Albumins were measured in all study subjects. Serum Total proteins were done by Biuret Method and Albumins by BCG Dye Method. Birth weight of Newborns were taken by Beam Balance Scale method at the time of Birth. The study found that the mean levels of Results: Serum Total protein and Serum Albumin in cases (Mothers having LBW newborns) were signicantly lower than the Controls (Mothers having NBW newborns). Mean Serum Total protein and Serum Albumin in cases were 4.98±0.57 gm/dL and 2.65±0.29 gm/dL respectively, while in controls 6.90±0.61gm/dL and 4.06±0.63 gm/dL respectively. Birth weight of newborns showed a posit Conclusion: ive, Signicant and strong Correlation with Maternal Serum Total Protein ('r' = 0.985, p&lt;0.0001) and Maternal Serum Albumin ('r' = 0.961, p&lt;0.0001)

ASSESSMENT OF NUTRITIONAL STATUS IN CHRONIC OBSTRUCTIVE AIRWAY DISEASE PATIENTS WITH RESPECT TO SEVERITY

Introduction: Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the world, represents an important public health challenge that is both preventable and treatable. Weight loss, muscle mass and fat mass depletion are common nutritional problems in COPD patients. To investigate the nutritional status of COPD patients with Objective: anthropometric parameters such as Body Mass Index (BMI), muscle mass, skin fold thickness, percentage of fat and Mini Nutritional Assessment (MNA), and biochemical parameters such as total protein and serum albumin. All the above parameters were then correlated with the severity of pulmonary dysfunction using a Pulmonary Function Test (PFT). Methodology: The present cross sectional study was conducted on 65 patients with stable COPD status, satisfying inclusion and exclusion criteria and admitted in hospitals attached to Bangalore Medical College &amp; Research Institute. Wit Result: h increasing severity of COPD a signicant decrease in BMI, skin fold thickness, muscle mass, percentage of fat, mean MNA score, hemoglobin, total protein, albumin and lipid were noted. Conclusion: Malnutrition worsens the severity of airway obstruction in COPD patients. Therefore, nutritional status should be evaluated and nutritional intake should be tailored individually for every COPD patient