Significant Differences In Albumin Research Articles

Beneficial Effect of Integrated Nutritional Interventions in Patients with Hematological Diseases Undergoing Hematopoietic Stem Cell Transplant

Introduction: The nutritional status of patients undergoing hematopoietic stem cell transplantation (HSCT) is critically important. This study aimed to assess the impact of comprehensive nutritional interventions on the well-being of individuals with hematological diseases who underwent HSCT. Methods: A total of 175 patients with hematological diseases who underwent HSCT were included, with 94 in the control group and 81 in the research group. Patients in the control group received standard nursing care, while those in the research group underwent integrated nutritional interventions. Nutritional status was evaluated using the mini nutritional assessment (MNA) and subjective global assessment (SGA), along with body measurements and serum levels of albumin, prealbumin, and hemoglobin. Results: There were no significant differences in the proportion of malnourished patients evaluated by MNA or SGA between the control and research groups at admission. However, at discharge and 3 months of post-discharge, fewer patients in the research group were malnourished compared to the control group, as assessed by both MNA and SGA. At admission, there were no significant differences in albumin, prealbumin, hemoglobin levels, weight, calf circumference (CC), triceps skinfold thickness (TSF), or subscapular skinfold thickness (SSF) between groups. However, at discharge and 3 months of post-discharge, the levels of these indicators significantly decreased compared to those upon admission. Levels of albumin, prealbumin, and hemoglobin, as well as weight, CC, TSF, and SSF, were significantly higher in the research group than in the control group at both discharge and 3 months of post-discharge. Conclusion: HSCT led to a decline in nutritional status among patients with hematological diseases, but integrated nutritional interventions effectively improved their nutritional status.

The Impact of Modern Bone Markers in Multiple Myeloma: Prospective Analyses Pre and Post-First Line Treatment.

Multiple myeloma, the disease characterized by the malignant proliferation of plasma cells that invades the bone marrow, produces osteolytic lesions and secretes monoclonal proteins. Several biomarkers have been shown to represent important tools in the pathogenesis of myeloma and offer insights into bone degradation and formation. The objectives of this current study were to assess the associations of modern biomarkers (TNF-α: tumor necrosis factor; IFN: Interferon; FreeRANKL: Free Receptor Activator for Nuclear Factor kappa B Ligand; RANKL: Receptor Activator for Nuclear Factor kappa B Ligand, Beta crosslaps, IL-6: Interleukin 6) with osteolytic lesions status after first-line treatment and to evaluate the correlations between modern and classical biomarkers (LDH: Lactate Dehydrogenase; VSH: Erythrocyte Sedimentation Rate; Hgb: Hemoglobin, Calcium, Albumin, B2microglobulin) stratified by osteolytic lesions status. A total of 35 patients diagnosed with multiple myeloma divided into two groups according to the osteolytic bone lesions, were studied: (1) unchanged status of osteolytic lesions and (2) changed status of osteolytic lesions. After fist-line treatment, we found a significant difference in Albumin (p = 0.0029) and Calcium levels (p = 0.0304), patients with a changed status in osteolytic lesions having higher values of Albumin and Calcium compared to those without changes in status of osteolytic lesions. After first-line treatment, decreased IL-6 values were significantly correlated with elevated values of Albumin (ρ = -0.96, p = 0.0005) in the patients with changed status of osteolytic lesions. Post-treatment values of IFN showed a significant positive correlation with Hemoglobin (ρ = 0.47, p = 0.0124), IL-6 (ρ = 0.55, p = 0.0026) and TNF-alpha values (ρ = 0.54, p = 0.0029). The results obtained from patients with unmodified lytic lesions identified a significant correlation between the biomarkers IL-6, Free RANKL, and IFN-beta with the classical marker LDH. This association highlights the involvement of these markers in promoting bone destruction and the development of osteolytic lesions.

Impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in adults with leukemia.

Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain. Therefore, these patients do not have high quality of life. According to the World Health Organization, the incidence of leukemia in China in 2020 was 5.1/100000, the mortality rate was 3.3/100000, and the prevalence rate was 16.7/100000. Therefore, it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients. To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients, thereby providing a basis for early diagnosis and treatment in clinical practice. A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an, Shaanxi Province, China, from August 2022 to December 2023. Patients with a score > 16 on the Chinese Classification of Mental Disorders (CCMD-3) and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group (n = 95), while 100 leukemia patients admitted during the same period were classified as the control group. Data were collected using Epidata 3.1 software, and comparisons were made between the two groups regarding general clinical data, the Piper Fatigue Scale (PFS), the Pittsburgh Sleep Quality Index (PSQI), the Numeric Rating Scale for pain assessment, laboratory indicators, and the occurrence of complications. In this survey, 120 leukemia patients with depression were preliminarily screened, 95 patients with subthreshold depression were ultimately selected as the subthreshold depression group, and 100 leukemia patients admitted during the same period were enrolled as the normal group. Comparison of basic clinical data between the two groups revealed no significant differences in age, sex, body mass index, cognitive function, or comorbidity with other chronic diseases. However, there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups (P < 0.05). Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups, but there were statistically significant differences in pain scores, PSQI scores, PFS scores, hemoglobin levels, and C-reactive protein levels (P < 0.05). Spearman's correlation analysis indicated that cancer-related fatigue was correlated with age, hemoglobin levels, C-reactive protein levels, pain, and regular exercise among leukemia patients with subthreshold depression. Multivariate regression analysis revealed that advanced age, combined radiotherapy, pain, and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression, while regular exercise was a protective factor against cancer-related fatigue. Follow-up comparisons revealed a significantly lower overall incidence of complications in the control group (4%) than in the depressive group (24.21%; P < 0.001). Leukemia patients with comorbid subthreshold depressive symptoms experience more severe cancer-related fatigue and a higher incidence of complications. These findings may be related to advanced age, combined radiotherapy, pain, and low hemoglobin levels, while regular exercise may effectively alleviate symptoms.

Effects of early enteral nutrition in patients with severe burns: A systematic review.

Nutritional problems in the early stages of severe burns are prominent and seriously affect the clinical outcomes of patients. Our aim is to analyze the effects of early enteral nutrition (EEN) in patients with severe burns. In this study, relevant articles were searched in 8 English and Chinese data, with a time limit from the creation of the database to June 2023. Two researchers independently completed the search, screening and quality assessment of the articles. We conducted a systematic review and meta-analysis of randomized controlled trials that examined EEN therapy in people with severe burns. We compared the effects of EEN and non-EEN therapy in severely burned patients. The outcomes were mortality, gastrointestinal complications, nutritional indicators, gastrointestinal hormones, sepsis, length of hospital stay and wound healing time. Categorical variables were expressed as OR and 95% CI was calculated, and continuous variables were expressed as MD and 95% CI was calculated. The protocol for this systematic review was registered in PROSPERO on May 12, 2023 (identifier CRD42023422895). Nineteen studies with a total of 1066 participants met the inclusion criteria. When comparing EEN therapy with non-EEN therapy, the experiment group had significantly lower mortality [OR = 0.39, 95% CI (0.20, 0.74), P = .004], lower wound healing time [MD = -10.77, 95% CI (-13.66,-7.88), P < .00001], fewer gastrointestinal complications [OR = 0.18, 95% CI (0.09, 0.36), P < .00001], lower rates of gastrointestinal hemorrhage [OR = 0.12, 95% CI (0.04, 0.36), P = .0001], lower rates of sepsis [OR = 0.40, 95% CI (0.24, 0.66), P = .0005], shorter length of hospital stay [MD = -12.08, 95% CI (-13.61, 9.19-10.56), P < .00001], and higher prealbumin levels [MD = 29.04, 95% CI (21.98, 36.10), P < .00001], higher total albumin levels [MD = 6.74, 95% CI (4.29, 9.19), P < .00001], and gastrin levels [MD = 15.93, 95% CI (10.12, 21.73), P < .00001]. However, there was no significant difference in albumin between the 2 groups [MD = 2.62, 95% CI (-0.30, 5.55), P = .08] or motilin levels [MD = 12.48, 95% CI (-43.59, 68.56), P = .66]. EEN plays an important role in the rehabilitation of patients with severe burns. EEN is beneficial to reduce complications and the length of hospital stay, maintain organ function, optimize the nutritional status of patients, promote wound healing, and improve the survival rate of patients.

Clinical value of prognostic nutritional index combined with C-reactive protein and albumin in early prediction of anastomotic leakage after radical gastric cancer surgery.

To evaluate the predictive value of the Prognostic Nutritional Index (PNI) combined with C-reactive protein (CRP) and albumin (ALB) for anastomotic leakage following radical gastric cancer surgery. A retrospective case-control study was conducted with 275 gastric cancer patients at the Second People's Hospital of Lanzhou City from September 2019 to October 2022. Patients were categorized into an anastomotic leakage group (n=31) or a non-leakage group. Clinical, surgical, and pathological data were analyzed using logistic regression to develop two risk models: a combined clinical-laboratory index (RISK1) and a separate laboratory index (RISK2). Model effectiveness was compared using Receiver Operating Characteristic (ROC) curves. Anastomotic leakage occurred in 11.27% of patients, predominantly in those with advanced TNM stages (P=0.006). Notably, higher operative times (P=0.049) and increased intraoperative bleeding (P=0.027) were associated with the leakage group. Significant differences in ALB, PNI, and CRP levels were observed between the groups. Both RISK1 and RISK2 identified ALB, CRP, PNI, operative time, and intraoperative bleeding as independent predictors of leakage, demonstrating high predictive accuracy (RISK1 AUC=0.937, RISK2 AUC=0.911), with no significant difference in performance between the models (P=0.245). The combination of ALB, CRP, and PNI effectively predicts the risk of anastomotic leakage in patients undergoing gastric cancer surgery. These biomarkers can significantly enhance postoperative management and improve patient outcomes.

Relationships among body weight, lipids and bone mass in elderly individuals with fractures: A case-control study.

The prevalence of osteoporosis and low bone mass is steadily rising each year. Low body weight is commonly linked to diminished bone mass and serves as a robust predictor of osteoporosis. Nonetheless, the connection between body mass index (BMI), bone mineral density, and lipid profiles among the elderly remains elusive. To examine the association between BMI and bone mass, explore the correlation between lipid profiles and bone mass, and delve into the interplay between lipid metabolism and bone health. The study included 520 patients aged ≥ 65 years (178 men and 342 women). Age, sex, weight, and height were recorded. Femoral neck bone mineral density and T scores were determined using a dual-energy X-ray absorptiometry scanner. Blood calcium (Ca), phosphorus (P), albumin (ALB), alkaline phosphatase (ALP), aspartate aminotransferase, alanine aminotransferase, triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels were measured. Patients were classified by sex (male and female), age (65-79 years and ≥ 80 years), and T score (normal bone mineral density, osteopenia and osteoporosis). Age, sex, BMI, and ALP and TG levels were independent risk factors for osteoporosis. For the 65-79- and ≥ 80-year-old groups, females presented lower T scores than males. Ca, P, ALB, ALP, TC, HDL and LDL levels were significantly different between men and women in the 65-79-year-old group. In addition, BMI and TG levels were significantly decreased in osteoporotic patients compared with patients with normal bone mass. TC levels declined in 65- to 79-year-old male and female osteoporosis patients. In the group of women aged ≥ 80 years, osteoporotic patients showed significantly increased ALP levels. Furthermore, we found positive correlations between BMI and TG levels in the male and female patient groups. However, we found no significant differences in ALB, Ca, P, HDL and LDL levels in osteoporotic patients compared to patients with normal bone mass. Osteoporotic patients showed significantly decreased BMI and TG levels compared with those with normal bone mass. BMI showed positive correlations with TG levels in male and female patients. These results indicate correlations between BMI and bone mass and between lipid profiles and bone mass.

Effects of Physical Exercise on Hepatic Biomarkers in Adult Individuals: A Systematic Review and Meta-Analysis

Objective: This study aimed to analyze the effects of physical exercise on hepatic biomarkers in adult individuals. Methods: We conducted a systematic review and meta-analysis following the PRISMA recommendations and registered in PROSPERO (CRD42022337749). MEDLINE (via PubMed), Scopus, SPORTDiscus, and Web of Science were searched, using the terms of the Medical Subject Headings (MeSH) “exercise”, “liver diseases”, and “biomarkers”. Results: Fourteen studies achieved eligibility with a total of 485 participants. Interventions ranged from 4 to 12 weeks, lasting 24 to 90 minutes per session, with 3 to 5 sessions per week. Interventions with aerobic and resistance exercises, with or without a vibration device and diet implementation, demonstrated a reduction in different hepatic biomarkers, such as aspartate transferase (AST), alanine transferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin (ALB), ferritin (Fe), and indirect bilirubin (Bil). The main results of the meta-analysis showed no significant difference in ALB, GGT, AST, and ALP. However, there was a significant difference in ALT (SMD: – 0.41; 95% CI: – 0.71 to -0.11; p = 0.008; I2 = 0%). Conclusion: Physical exercise (e.g., resistance training, aerobic training, high-intensity interval training) favored the reduction of AST, ALT, GGT, ALP, ALB, Fe, and Bil. This study pointed out that the regular practice of physical exercise can be an efficient and recommended strategy to minimize the deleterious effects of liver diseases. Keywords: exercise; liver disease; non-alcoholic fatty liver disease; biomarkers; resistance training; high-intensity interval training.

Evaluation of Neutrophil Percentage to Albumin Ratio as Predictor of Mortality in Patients with Covid-19

Background: Inflammatory acute respiratory syndrome (SARS) is caused by the COV-2 virus. Neutrophils have been implicated in the pathophysiology of the COVID-19 pandemic since its inception, particularly in individuals with advanced disease. This is confirmed by a large number of studies. Methods: The study included 200 patients, of whom 100 were in the critical group (group 1) and 100 were in the non-critical group (group 2). White blood cell (WBC) percentage, neutrophil count, albumin, and demographic information were recorded. Neutrophil percentage x 100 /Albumin (g/dl) was used to construct the neutrophil count to albumin ratio (NPAR). To determine whether the measure may be utilized as a predictor for mortality, the NPAR is then compared between groups 1 and 2, as well as between discharge and mortality groups. Results: Age and gender had no statistically significant differences in either group. There were no significant variations in the median (IQR) values of neutrophil count (89 vs 91.25), WBC (15.65 vs 14.9), and NPAR (41.3 vs 43.7) between the two groups. Significant differences in albumin (3.330.521 vs. 3.10.51) were identified between the critical and non-critical groups. Conclusion: According to our research, the COVID-19 patients' NPAR is a poor predictor of mortality. More study is still required to verify and elucidate the clinical implications of these findings. Keywords: Covid-19, Albumin, Neutrophil, Mortality, SARS

P395 Short-term clinical efficacy and safety of teduglutide for Crohn’s disease patients with short bowel syndrome

Abstract Background The short-term effects of teduglutide (TED) for short bowel syndrome with chronic intestinal failure (SBS–IF) in patients with Crohn’s disease (CD) remain unknown and real-world data have not been scarce. This study aimed to investigate the short-term efficacy and safety of TED in CD patients on parenteral support (PS) for SBS–IF. Methods We retrospectively investigated the medical records of CD patients with SBS–IF who initiated TED between January 2020 and October 2022 in Hyogo Medical University hospital. The primary outcomes were the change in PS volume and proportion of patients with a reduction of PS volume by ≥20% at week 4. Secondary outcomes were the changes in body mass index (BMI), estimated glomerular filtration rate (eGFR), albumin, hematocrit (Ht), PS calorie requirements, withdrawal from PS, and adverse events during the observation period. Results Of 605 CD patients, 23 who underwent home PS for SBS–IF were included in this study. Twenty patients continued TED throughout the observation period. The median PS duration was 11.6 (range 1.0-20.0) years and the observation period after starting TED was 48.0 (7.0-60.0) weeks. TED significantly reduced the PS volume from 17989(570-49000) mL/week to 14257(0-42000) mL/week at week 4 (p = 0.0013), and the PS volume decreased by ≥20% in 8 patients (40.0%) at week 4 and in 16 patients (80.0%) during the observation period after TED administration. The BMI significantly increased from 17.9 (12.9–23.9) kg/m2 before TED administration and 18.9 (14.6–25.4) kg/m2 after TED administration (p = 0.014). Although there were no significant differences in albumin (p = 0.53), eGFR (p = 0.66), and Ht (p = 0.089), the PS calorie /week was significantly decreased from 6581 (244–14000) kcal to 3747(0– 8820) kcal after TED administration (p = 0.0001). Ten patients (50.0%) experienced gastrointestinal stoma complications, including stoma swelling and/or prolapse during the observation period. Abdominal pain occurred in 7 cases (35.0%), catheter-related infection in five patients (25.0%), oedema in 4 patients (20.0%), nausea in 2 patients (10.0%), abdominal distension in 3 patients (15.0%), and upper respiratory tract infection in 1 patient (5.0%). All the symptoms were transient and tolerable. Although 3 patients discontinued TED due to nausea and abdominal pain and were excluded from this analysis, these symptoms improved after the discontinuation. Conclusion TED reduced PS volume at week 4 in CD patients with SBS–IF, and the BMI and the PS calorie requirement were improved during the observational period without serious adverse events.

NON-MEDICAL SWITCHING FROM INFLIXIMAB TO A BIOSIMILAR IN ADOLESCENTS AND YOUNG ADULTS WITH INFLAMMATORY BOWEL DISEASE

Abstract BACKGROUND Studies in adults with inflammatory bowel disease (IBD) have demonstrated that a one-time switch from the originator to a biosimilar has not resulted in loss of response, increased side effects, or antibody development. Data describing non-medical switching is limited in adolescents and young adults. The objective of this study was to evaluate clinical outcomes of one-time switches from the originator to a biosimilar in adolescents and young adults with IBD. METHODS Patients with IBD that underwent a non-medical switch from infliximab originator to a biosimilar were retrospectively reviewed. Demographic data, physician global assessments (PGA), and laboratory values (albumin, hemoglobin, sedimentation rate (ESR), c-reactive protein (CRP), anti-TNF level, and anti-TNF antibody level) were recorded up to one year prior to the switch and up to one year after the switch. Rates of continuation on the biosimilar was reported at 6 and 12 months post-switch. Linear mixed effect models with random intercepts accounting for within patient correlation were used to compare continuous lab values before and after switching. RESULTS A total of 53 patients completed a switch from infliximab originator to a biosimilar. The mean age at the time of the switch was 18 (+/- 2.86) years old. Fifty-three percent of those undergoing a switch were female, 74% had Crohn’s disease, and 96% were switched to the biosimilar infliximab-dyyb. At the time of the switch, 52 (98%) patients had quiescent disease activity based on PGA and 1 (2%) patient had mild disease. At follow up after receiving at least 2 biosimilar infusions, 51 (96%) patients had quiescent disease and 2 (4%) patients had mild disease based on the PGA. At 6 months post switch, 48 (90%) patients were still on the biosimilar. Three (6%) patients switched back to the originator due to worsening symptoms, one (2%) patient developed worsening psoriasis, and one (2%) patient had ongoing issues with IV access. Of the 33 patients who had a full 12 months of follow-up data, 91% (30/33) remained on the biosimilar, one patient switched back to the originator due to worsening symptoms, and two switched to adalimumab due to the development of psoriasis and an underlying social situation, respectively. There was no statistically significant difference in albumin, hemoglobin, ESR, CRP, or anti-TNF levels when comparing pre- and post- switch values. The mean anti-TNF level prior to the switch was 17.3 ug/ml (95% CI: 13.7 -19.0) and 15.1 ug/ml (95% CI: 12.5 - 17.8) after the switch. No patients developed anti-drug antibodies or infusion reactions. CONCLUSION A one-time non-medical switch to an infliximab biosimilar in an adolescent and young adult cohort had no significant effect on clinical remission rates, laboratory markers of inflammation, serious adverse events, anti-TNF levels, or anti-drug antibodies.

Efficacy of immunonutritional supplement after neoadjuvant chemotherapy in patients with esophageal cancer

BackgroundIn recent years, preoperative nutrition has received great attention, especially for patients who received surgical reconstruction of the digestive tract such as esophagectomy. Preoperative nutrition therapy was reported to accelerate the patient's postoperative recovery. In addition, immune suppression, nausea, and vomiting may lead to poor immune and nutritional status of patients with esophageal cancer who underwent neoadjuvant chemotherapy (NAC), which is not conducive to surgery. Therefore, preoperative nutritional treatment is necessary for patients with esophageal cancer who underwent NAC.MethodPatients with esophageal cancer who received NAC at Nanjing Jinling Hospital from January 2018 to September 2020 were retrospectively identified. Patients were divided into enteral immunonutrition (EIN) group (those who received a conventional diet and immunonutrition supplement, Peptisorb, Nutricia, 500 mL/day * 7 via oral intake), and control group (those who only received a conventional diet were divided into). The primary outcomes were immune and nutritional indicators changes, including immunoglobulin M (IgM), immunoglobulin A (IgA), immunoglobulin G (IgG), and albumin (ALB), which were measured at preoperative day (PRD) 7, PRD-1, postoperative day (POD) 1 and POD-7. The secondary outcomes were postoperative complications, adverse reactions, and length of hospital stay.ResultsA total of 124 eligible patients were included in the study, with 21 patients in EIN group. After 1:2 matching, significant difference in baseline characteristics between the two groups was not observed (EIN: n = 21, Control group: n = 42). Compared with the control group, the IgA is significantly increased in the EIN group at POD-7 (p = 0.017). However, we observed that the IgM level in the control group was significantly higher than those in the EIN group at POD-7 (p = 0.007). The incidence of pneumonia and total complications in the EIN group were significantly lower than those in control group (p = 0.024, p = 0.028, respectively). There is no significant difference in ALB and adverse reactions between two groups (p = 0.303, p = 0.108, respectively).ConclusionImmunonutritional supplement after NAC is an effective strategy to improve the postoperative immune status of esophageal cancer patients and could reduce the incidence of infectious complication. More well-designed prospective studies are needed to verify and update our finding.

Lower Plasma Albumin, Higher White Blood Cell Count and High-Sensitivity C-Reactive Protein are Associated with Femoral Artery Intima-Media Thickness Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus.

IntroductionLow albumin levels, high levels of high-sensitivity C-reactive protein (hs-CRP), and high white blood cell count were risk factors for changes in arterial intima-media thickness (IMT). Femoral artery IMT damages were one of the common peripheral artery type 2 diabetes. This study was conducted to determine the association between femoral artery IMT and plasma albumin, hs-CRP levels, and white blood cell count in newly diagnosed patients with type 2 diabetes mellitus (nT2D).Materials and MethodsFrom January 2015 to May 2020, 306 patients with nT2D were recruited for this cross-sectional descriptive study at Vietnam’s National Endocrinology Hospital. We measured IMT by Doppler ultrasound.ResultsThere was a statistically significant difference in albumin, hs-CRP levels, hs-CRP-to-albumin ratio, and white blood cell counts between three different IMT groups namely normal IMT, thick IMT, and atherosclerosis (p = 0.003, p = 0.001, p = 0.001 and p = 0.049, respectively). In the multivariate linear regression analysis, white blood cell count, and hs-CRP levels showed a significantly positive correlation to IMT (standardized B and p of 0.17, 0.015 and 0.163, 0.024, respectively), but albumin levels were a significantly negative correlation to IMT (standardized B = –0.151, p = 0.029). The multivariate logistic regression analysis showed that albumin (OR = 0.79, 95% CI 0.65–0.90, p = 0.018), hs-CRP (OR = 1.09, 95% CI 1.01–1.18, p = 0.026), and white blood cell count (OR = 1.36, 95% CI 1.03–1.81, p = 0.033) had correlation to atherosclerosis of femoral artery.ConclusionReduced plasma albumin, elevated hs-CRP, and white blood cell count associated with IMT increased the odds for atherosclerosis of femoral artery among nT2D.

Daily Soy–Catfish–Anchovy–Rice (SCAR) Porridge Increases 25(OH)D Serum Levels in Tuberculosis Patients with Vitamin D Receptor Gene Polymorphisms

BACKGROUND: The presence of vitamin D receptor (VDR) polymorphism and high levels of inflammatory markers are predisposing factors indicating disease progression and malnutrition. To meet nutritional needs in maintaining nutritional status in tuberculosis patients with VDR gene polymorphisms (TaqI or FokI), food that is easily absorbed and high in vitamin D, calcium, and protein is needed. This study was conducted to determine whether high vitamin D and calcium porridge called soy–catfish–anchovy–rice (SCAR) porridge would increase 25(OH)D serum levels and other parameters, including calcium, albumin, high-sensivity C-reactive protein (hs-CRP), and blood glucose serum levels.METHODS: The study was a parallel, open, clinical trial. There were 22 subjects in the intervention (I) group who received 50 g of SCAR porridge once per day along with dietary counseling, and 21 subjects in the control (C) group who only received dietary counseling. All subjects with TC and CC (TaqI) or TC and CC (FokI) genotype were included in this study. The intervention lasted for 14 days, and the parameters such as 25(OH)D, calcium, albumin, hs-CRP, and blood glucose serum levels were assessed before and after intervention between groups.RESULTS: All subjects in both groups completed the study. After 14 days of intervention, there was a significant increase in 25(OH)D (p=0.01) and decrease in hs-CRP (p=0.02) serum levels in the I group, and no change was observed in the C group. There was no significant difference in albumin and blood glucose serum levels.CONCLUSION: The results show that 50 g of SCAR porridge per day for 14 days is an effective supplementation that can increase 25(OH)D and decrease hs-CRP serum levels in tuberculosis patients with VDR gene polymorphism.KEYWORDS: vitamin D, hs-CRP, polymorphism, porridge

The Association between serum protein electrophoresis patterns and severity of patients infected with SARS-CoV-2 virus

Background:-The Coronavirus epidemic 2019 (COVID-19) is really a highly infectious sickness that is causing a huge danger to human life throughout the world. The induction of acute cytokine storm and immunosuppressive in COVID- 19 patients causes a rise in cytokines levels in the blood. Furthermore, the full extent of serum protein alterations in COVID-19 patients remains unclear. Patients and methods: -In a cross-sectional study, 80 SARS-CoV-2 virus-infected patients aged 18 to 80 were categorized according to severity of the infection and their serum protein electrophoresis assessment in relation to the severity of Covid-19. Results:-SPE for patients infected with the SARS-CoV-2 virus showed a significant difference in albumin, beta, and gamma and there was no significant relation with the α1 and α2 all in comparison between the subgroups themselves. Conclusion:-We conclude from the finding: albumin, beta, and gamma fractions showed a decrease in levels In conjunction with disease severity.

Hepatic steatosis precedes pregnancy in the BPH/5 preeclampsia‐like mouse model

BPH/5 mice represent a superimposed model of preeclampsia that spontaneously develop maternal and fetal characteristics of preeclamptic pregnancies. In women, the development of preeclampsia is associated with pre-existing dysregulation of lipid metabolism including hepatic steatosis. The study objective was tocharacterize the basal hepatic health of the female BPH/5 mouse to determine if hepatic steatosis precedes the preeclampsia-like syndrome. We hypothesized that non-pregnant female BPH/5 mice have an excess of hepatocellular lipid that promotes intrahepatic pro-inflammatory cytokine production. Blood and liver samples were collected from 8–10-week-old BPH/5 non-pregnant females (n=10) and 8–10-week-old C57Bl/6 non-pregnant females (n=6). Liver and body weight were recorded. Biochemical markers of hepatocellular function (albumin, ALT, BUN, and bilirubin) were quantified. Hepatic RNA was isolated, and qPCR was used to evaluate pro-inflammatory markers. H&E staining was used to evaluate hepatic histomorphology and lipid accumulation. There was no significant difference in albumin, ALT, BUN, or bilirubin between BPH/5 and C57Bl/6 mice. There was significantly higher hepatic CXCL-2, CXCL-10, IL-1ß, TLR2, and TLR7 mRNA expression in BPH/5 versus C57Bl/6 mice (p<0.05). There was a significantly greater liver weight in BPH/5 mice compared to C57Bl/6 mice (p=0.05). The histologic microsteatosis score was significantly increased in the BPH/5 mice (2.5) compared to C57Bl/6 mice (0.98, p=0.025). The BPH/5 mouse has basal hepatic steatosis and a pro-inflammatory hepatic phenotype that precedes pregnancy. Dysregulated lipid metabolism in the liver may contribute to the development of preeclampsia.

On gastric evacuation characteristics and suitable feeding frequency of &amp;lt;italic&amp;gt;Centropristis striata&amp;lt;/italic&amp;gt;

The experiments were carried out on juvenile <italic>Centropristis striata</italic>.The gastric evacuation rate(GER) and effects of different feeding frequencies on growth, survival rate, feed coefficient, nutrient composition and enzyme activity were studied. Results showed that when the water temperature was 22 ℃, the wet weight of stomach content decreased significantly in 4 h, then decreased slowly, and finally reached 0.Three mathematical models, including linear model, exponential model and square root model, were used to fit the gastric evacuation rate. The square root model was more suitable for quantitative description of gastric evacuation curve. The equation was <italic>Y</italic>^0.5 = 2.050-0.084<italic>t</italic>.Under water temperature 22-26 ℃, groups of different feeding frequencies were set:F1 (1 time·d^-1), F2 (2 times·d^-1), F3 (3 times·d^-1) and F4 (4 times·d^-1) . After 8 weeks of experiment, the final body weight, weight gain rate, specific growth rate and condition factor increased with the increasing feeding frequency, and there were significant differences between F1 and other groups (<italic>P</italic><0.05). With the increase of feeding frequency, feed coefficient initially decreased and then increased. The feed coefficient of F1 was the highest and that of F2 was the lowest, and there were significant differences between F1 and F2, as well as between F1,F2 and other groups (<italic>P</italic><0.05). With the increase of feeding frequency, water content, ash content, crude protein content, protein efficiency and protein production value of <italic>C</italic>. <italic>striata</italic> decreased, while crude fat showed an increasing trend, and differences among groups were significant (<italic>P</italic><0.05). There were significant differences in serum total protein between F1 and other groups (<italic>P</italic><0.05). There was no significant difference in albumin among groups (<italic>P</italic>>0.05); globulin of F2 was the highest; glucose and triglyceride content increased with the increase of feeding frequency; alanine aminotransferase content and aspartate aminotransferase content increased initially and then decreased with the increase of feeding frequency, and F3 was the highest. Considering the gastric evacuation rate, growth performance, feed coefficient, nutritional components and other indicators, under the experimental conditions, the suitable feeding frequency of juvenile <italic>Centropristis striata</italic> was F2 (2 times·d^-1), which could provide basis and reference for breeding production.

Correlation between lower extremity arterial disease and skeletal muscle mass in patients with type 2 diabetes mellitus.

ObjectivesTo evaluate skeletal muscle mass in patients with both type 2 diabetes mellitus (T2DM) and concomitant lower extremity arterial disease (LEAD) and determine the contribution of skeletal muscle mass to macrovascular diseases.MethodsIn total, 112 patients with T2DM were divided into the T2DM and T2DM + LEAD groups. Hepatic function, renal function, uric acid, blood glucose, and glycated hemoglobin (HbA1C) were measured. Dual-energy X-ray absorptiometry was used to measure visceral fat area and skeletal muscle mass index (SMI).ResultsWaist-to-hip ratio, uric acid, and body fat percentage were significantly higher in the T2DM+LEAD group than in the T2DM group; SMI was significantly lower in the T2DM+LEAD group than in the T2DM group. There were no significant differences in albumin, creatinine, fasting blood glucose, HbA1C, or blood lipids. Uric acid, SMI, and body fat percentage were significantly positively correlated with T2DM and concomitant LEAD. Logistic regression analyses suggested that SMI is an independent risk factor for LEAD in T2DM (odds ratio = 1.517; 95% confidence interval: 1.082–2.126).ConclusionsSkeletal muscle mass is lower in patients with T2DM and concomitant LEAD than in patients with T2DM who do not exhibit LEAD. SMI is an important risk factor for LEAD.

IL-18 and IL-35 in the serum of patients with sepsis thrombocytopenia and the clinical significance.

Expression levels of interleukin-18 (IL-18) and IL-35 in the serum of patients with sepsis and without thrombocytopenia and patients with sepsis thrombocytopenia (TCP) were detected to preliminarily investigate their clinical significance. One hundred and sixty-six patients admitted to Jinan Central Hospital Affiliated to Shandong University from July 2013 to September 2015 were retrospectively analysed. There were 96 patients with sepsis without thrombocytopenia in the sepsis group, and 70 patients with sepsis TCP in the sepsis TCP group. In the same period, 80 healthy subjects were selected as the control group. Fluorescent quantitative PCR was used for the detection the expression of mRNA levels of IL-18 and IL-35, and Enzyme-linked immunosorbent assay for the detection of the protein concentrations of IL-18 and IL-35 in the serum of peripheral blood. The correlation between IL-18, IL-35 and platelets was analyzed. There were significant differences in albumin, creatinine, total bilirubin and platelet count between the sepsis group and the sepsis TCP group (P<0.05); the expression levels of mRNA of IL-18 and IL-35 in a karyocyte in peripheral blood in the sepsis group and the sepsis TCP group were higher than those in the control group (P<0.05); the expression of mRNA of IL-18 and IL-35 in the sepsis TCP group was higher than those in the sepsis group (P<0.05). The concentration of IL-18 and IL-35 in the sepsis TCP group was higher than in the sepsis group (P<0.05); IL-18 and IL-35 were negatively correlated with platelets (r=−0.8749, −0.6228, P<0.001). There was a significant positive correlation between serum IL-18 and IL-35 in the control group, sepsis group, and sepsis TCP group (r=0.5124, 0.5718, 0.5511, P<0.001). IL-18 and IL-35 were negatively correlated with the reduced degree of platelets in patients with sepsis and are likely to play an important role in the pathogenetic process of sepsis TCP.

One Anastomosis Gastric Bypass Performed with a 150-cm Biliopancreatic Limb Delivers Weight Loss Outcomes Similar to Those with a 200-cm Biliopancreatic Limb at 18 -24 Months

It has been suggested that shortening the biliopancreatic limb (BPL) length with one anastomosis gastric bypass (OAGB) to 150cm would reduce the revision rates for malnutrition. But, it remains unclear if this would not compromise the efficacy of this procedure. We examined our prospectively maintained database to compare the outcomes of patients who had their OAGB performed with a 150-cm BPL with those performed with a 200-cm BPL. Medium-term weight loss data at 18-24months was available for 343/398 (86.1% follow-up) patients. Of these, 225 had undergone OAGB-200 and 118 had undergone OAGB-150. The mean preoperative weight and body mass index were 141.6 ± 32.8kg and 49.76 ± 8.6kg/m2, respectively, in the OAGB-200 group compared with 133.7 ± 24.5kg and 47.83 ± 7.2kg/m2, respectively, in the OAGB-150 group. There was no significant difference in albumin and haemoglobin levels in the two groups at 18-month follow-up. The mean excess weight loss was 75.0% ± 20.1 in the OAGB-200 group and 74.0% ± 22.0 in the OAGB-150 group (p = 0.6714). A total of 89.7% (n = 202) patients achieved an excess weight loss (EWL) of ≥ 50.0% in the OAGB-200 group compared with 85.5% (n = 103) in the OAGB-150 group (p value = 0.4754). The mean total weight loss was 36.1% ± 9.2 in the OAGB-200 group compared with 34.0% ± 9.8 in the OAGB-150 group (p value = 0.0598). OAGB performed with a BPL of 150cm delivers weight loss outcomes similar to that seen with a BPL of 200cm.

Reference range of clinical blood tests in physically independent patients of advanced age with groin hernia in a Japanese hospital

The present study was carried out to determine the reference ranges of 43 frequently used blood tests in daily practice for physically independent patients of advanced age. We identified all patients aged ≥20 years who underwent groin hernia repair at Itoigawa General Hospital in Niigata, Japan. The patients' characteristics, preoperative data and prescribed medications were obtained by reviewing the electronic medical records. Of 284 patients, 266 with independence in activities of daily life were included in the present study: 72 were assigned to the younger adult group (age 20-64 years), 86 were assigned to the older adult group (age 65-74 years) and 108 were assigned to the advanced age group (age ≥75 years). Patients in the advanced age group had a lower body mass index, less alcohol consumption, more hypertension, lower respiratory function and higher frequency of multidrug therapy. The multiple regression analysis showed significant differences in albumin, gamma-glutamyl transpeptidase, cholinesterase, estimated glomerular filtration rate, uric acid, triglyceride, calcium, phosphate, magnesium and peripheral blood cell counts between the advanced age group and the other two age groups. We identified age-dependent changes in several blood tests among physically independent adults. These results will help to guide accurate interpretation of laboratory results and properly manage patients in geriatric medicine. Geriatr Gerontol Int 2019; 19: 780-785.