Blood Uric Acid Concentrations Research Articles

Analysis of weight loss, metabolism, and anti-reflux effect of sleeve gastrectomy combined with fundoplication as treatment of obesity complicated by gastroesophageal reflux disease

Objective: To explore the weight-loss, metabolism, and anti-reflux effect of laparoscopic sleeve gastrectomy combined with fundoplication (SGFD) as treatment of obesity complicated by gastroesophageal reflux disease (GERD) with the aim of identifying the best treatment for such patients. Methods: This was a retrospective cohort study. Relevant clinical data of 140 patients with obesity (body mass index≥30 kg/m2) complicated by GERD (confirmed by preoperative GerdQ score, gastroscope, upper gastrointestinal radiography, 24-hour pH monitoring of esophagus, and high-resolution esophageal manometry) who had undergone bariatric surgery in the Minimally Invasive Surgery, Hernia and Abdominal Surgery Department of the People's Hospital of Xinjiang Uygur Autonomous Region from January 2019 to February 2023 were collected. The participants were allocated to the following groups according to surgical procedure performed: sleeve gastrectomy group (SG group, 92 cases) versus SGFD (SGFD group, 48 cases). SGFD, a new type of anti-reflux weight loss surgery that achieves both anti-reflux and weight loss effects by a procedure involving "cutting first and then folding", was developed by our team. In this study, our main aim was to compare and analyze differences in outcomes between the SG and SGFD groups in terms of weight loss and improvements in metabolism and reflux 3 and 6 months postoperatively. Results: The 140 patients comprised 50 men and 90 women of average age 36.0±9.6 years and preoperative body mass index (BMI) (38.5±6.5) kg/m2. The average preoperative GERD score was 10.2±1.6. There were no significant differences in baseline characteristics between the SGFD and SG groups (all P>0.05). There were also no significant differences in postoperative hospital stay, intraoperative blood loss, or postoperative complications between the two groups (all P>0.05). However, the operation time was longer in the SGFD than SG group (137.5±10.5 minutes vs. 105.3±12.6 minutes, t=-15.131, P<0.001). Compared with preoperative values, fasting blood glucose, cholesterol, body mass, BMI, and GERD score were all lower 3 months postoperatively (all P<0.05). Six months postoperatively, triglyceride, uric acid, and DeMeester score were lower in the SGFD than SG group; however, the lower esophageal sphincter resting pressure was higher in the SGFD group (all P<0.05). There were no significant differences in weight loss indexes (body mass, BMI, percentage of excess body mass loss) or metabolic indexes (fasting blood glucose, triglyceride, cholesterol, and uric acid concentrations) between the SG and SGFD groups 3 and 6 months postoperatively (all P>0.05). However, anti-reflux indexes (GerdQ score, DeMeester score, and lower esophageal sphincter resting pressure) were all significantly better in the SGFD than SG group 6 months postoperatively (all P<0.05). Conclusion: Obese patients with GERD get good weight loss, metabolism improvement and anti-reflux effect after SGFD. SGFD is a safe and feasible surgical method, and its anti-reflux effect is better than SG at the 6th month after operation, so it is feasible.

#828 Non-invasive determination of uric acid in blood during hemodialysis with an optical spent dialysate sensor

Abstract Background and Aims Kt/V urea is conventionally used hemodialysis (HD) adequacy marker, whereas many other uremic toxins with differing removal kinetics affect the mortality of end stage kidney disease (ESKD) patients. Among them, uric acid (UA) has been shown to cause cardiovascular mortality of ESKD patients. Recently, determination of UA concentration in blood with optical sensors during HD has been attempted by Lin et al in 2021 and Żyłka et al in 2023, but the accuracy has been relatively low. Moreover, Żyłka et al measured light absorption of spent dialysate at 573 nm to determine UA concentration, whereas previous research has shown that dialysate and UA have negligible light absorption in that region. The aim of this observational study was to predict concentration of UA with higher accuracy in ESKD patients’ blood during HD with various treatment settings by monitoring spent dialysate noninvasively with an optical sensor. Method Twenty-two ESKD patients on chronic HD were included into the study. Each patient received four 4 h long midweek HD sessions: one standard HD and three haemodiafiltration (HDF) sessions with different settings. Median (interquartile range) settings of the 1 HD session were: effective blood flow (Qb) = 199 (198-199) mL/min, dialysate flow (Qd) = 297 (297-298) mL/min, ultrafiltration rate (UF) = 13 (8-16) mL/min, dialyzer area 1.5 m2 and for the 3 HDF sessions: Qb = 298 (296-356) mL/min, Qd = 788 (489-792) mL/min, substitution fluid flow (Qsubs) = 96 (66-106) mL/min, UF = 11 (8-15) mL/min, dialyzer areas 1.8 m2 and 2.2 m2. Blood samples were collected before the start and at the end of each HD session from the arterial blood line and spent dialysate samples were collected 7, 60, 120, 180 and 240 min after the start from the outlet of the HD machine. Concentration of UA in spent dialysate and serum samples were determined with HPLC. An optical sensor (Optofluid Technologies OÜ, Tallinn, Estonia) was connected to the spent dialysate outlet of the HD machine and ultraviolet (UV) light absorption of spent dialysate was measured online in real time for each HD session. A linear interactions regression model was created using light absorbance at four different UV wavelengths to predict UA concentrations in collected spent dialysate samples. A curve of UA concentration for the whole HD session was determined based on the model and UV absorbance data measured with the optical sensor. Thereafter, UA concentration in spent dialysate at the start and at the end of each session (UAsensor hereinafter) was found from the concentration curve. The data of 88 HD sessions were equally divided into calibration and validation sets. Linear regression model was created using data of calibration set to predict concentration of UA (UApredicted) in blood as follows: UApredicted = a • UAsensor • $\frac{{{\rm{Qd}} + {\rm{\ Qsubs}} + {\rm{UF\ }}}}{{{\rm{Qb}}}}$, where “a” is the slope, UAsensor is the UA concentration in spent dialysate found from the concentration curve of the optical sensor, Qb is effective blood flow and Qd+Qsubs+UF is the total flow of spent dialysate. Subsequently, the accuracy of the model was evaluated on the calibration and validation data using Bland Altman analysis. Results UA concentrations in spent dialysate determined with HPLC and estimated with the optical sensor were strongly correlated (R2 = 0.992) and with comparable accuracy (BIAS±SE) (0.1 ± 3.84) µmol/L. Coefficient of determination 0.951 with the accuracy of 0.00 ± 31.43 µmol/L was achieved for calibration group, and coefficient of determination 0.962 with the accuracy of −7.64 ± 32.06 µmol/L was achieved for validation group between the UA concentration in blood determined with HPLC and corresponding values predicted by the optical sensor, respectively (Fig. 1). Conclusion Concentration of UA in dialysate and blood can be estimated noninvasively and accurately with the optical sensor in real time. This can be used to estimate removal efficiency and levels of UA during HD. In future, removal of other uremic toxins could be additionally monitored leading to a more personalized HD treatment.

ZnO Nanocages Decorated with Au@AgAu Yolk-Shell Nanomaterials for SERS-Based Detection of Hyperuricemia.

Surface-enhanced Raman scattering (SERS) is widely recognized as a highly sensitive technology for chemical detection and biological sensing. In SERS-based biomedical applications, developing highly efficient sensing platforms based on SERS plays a pivotal role in monitoring disease biomarker levels and facilitating the early detection of cancer biomarkers. Hyperuricemia, characterized by abnormally high concentrations of uric acid (UA) in the blood, was associated with a range of diseases, such as gouty arthritis, heart disease, and acute kidney injury. Recent reports have demonstrated the correlation between UA concentrations in blood and tears. In this work, we report the fabrication of SERS substrates utilizing ZnO nanocages and yolk-shell-structured plasmonic nanomaterials for the noninvasive detection of UA in tears. This innovative SERS substrate enables noninvasive and sensitive detection of UA to prevent hyperuricemia-related diseases.

Pathophysiology and Treatment of Gout Arthritis; including Gout Arthritis of Hip Joint: A Literature Review.

Gout is triggered by the accumulation of uric acid in the body, leading to hyperuricemia. Genetic, metabolic, and environmental factors can influence this condition. Excessive uric acid buildup results in the formation of monosodium urate (MSU) crystals, which precipitate in specific areas of the body, including the joints, where they can cause symptoms of gout. While the acute and chronic symptoms of gout have been well-documented, diagnosis of gout affecting the hip joint poses significant challenges. The global incidence of gout, the most prevalent form of inflammatory arthritis, is on the rise. Evaluation of the clinical signs, laboratory results, and imaging results is generally required for diagnosis of gout in cases where MSU crystals have not been detected. Hyperuricemia is considered a primary cause of arthritis symptoms, and comprehensive guidelines for treatment are available. Therefore, the choice of medication is straightforward, and moderate effectiveness of treatment has been demonstrated. Gout is a chronic disease, requiring lifelong uric acid-lowering medications, thus application of a treatment strategy based on the target blood uric acid concentration is necessary. Consequently, cases of gout will likely be observed more frequently by hip surgeons in clinical scenarios in the future. The objective of this review is to provide an overview of the pathophysiology of gout and subsequently examine recent advances in diagnostic methods and therapeutic agents based on an understanding of its underlying mechanisms. In addition, literature on gout-related issues affecting the hip joint, providing a useful reference for hip surgeons is examined.

Эффективность и безопасность разных режимов cахароснижающего лечения у лиц с синдромом раздраженного кишечника в сочетании с сахарным диабетом 2 типа

Among the disorders associated with type 2 diabetes mellitus, intestinal functional changes (irritable bowel syndrome — IBS) are an insufficiently studied problem. The purpose — a prospective study of the efficacy and safety of various hypoglycemic treatment regimens in patients with IBS and type 2 diabetes mellitus. Material and methods The study included 107 patients aged 48.9 ± 9.4 years with type 2 diabetes mellitus and clinical manifestations of IBS, who were divided into 4 groups depending on the prescribed hypoglycemic therapy: patients of group A received metformin, group B — a combination of metformin with saxagliptin, group C — a combination of metformin with liraglutide or exenatide, group D — combination of metformin with dapagliflozin. The duration of the study was not less than 5 months. Results. Treatment in all groups resulted in a significant decrease in the average values of HbA1c, fructosamine, insulin, C-peptide and the HOMA-IR index, an increase in the values of the NOMA-B index, p &lt; 0.05. A more significant absolute and relative decrease in the levels of HbA1c, insulin and HOMA-IR index was observed in groups C and D in comparison with groups A and B. The use of various classes of hypoglycemic drugs in people with IBS and type 2 diabetes mellitus was characterized by satisfactory tolerability and was associated with a significant decrease in clinical manifestations of constipation, diarrhea, abdominal pain, gastroesophageal reflux, and a positive effect on glycemic levels. The criteria for predicting the effectiveness and safety of hypoglycemic treatment in patients with a combination of IBS and type 2 diabetes mellitus were the diabetes duration &lt; 7 years, the values of HOMA-IR &lt;5 and NOMA-B ³ 60, the absence of smoking, the uric acid concentration in blood &lt; 350 mmol/ l, the absence of hypothyroidism and the choice of dapagliflozin as a component of hypoglycemic therapy.

KIDNEY ULTRASOUND PARAMETERS AND RENAL BLOOD BIOCHEMISTRY MARKERS IN POST-HEMORRHAGIC STROKE HYPERTENSIVE SURVIVORS

Introduction. Hemorrhagic stroke is a serious and devastating complication of arterial hypertension, which leads to increased mortality in survivors even after the early recovery period. Being other target organs for arterial hypertension, kidneys take part in blood pressure regulation. Investigation of their peculiarities in such patients may provide valuable data on possible reasons of poor long-term prognosis in this category of patients.&#x0D; The aim of the study: to compare kidney ultrasound parameters and renal blood biochemistry tests between the post-hemorrhagic stroke hypertensive subjects in a stable phase of recovery period and the patients with arterial hypertension who had no cerebrovascular and cardiovascular events.&#x0D; Materials and methods. There were 100 subjects enrolled into the study. They formed two investigatory groups: the main (n=64; age – 52,2±8,41 years, M±SD years) and the control (n=36; age – 51,8±5,92 years) one. Hypertensive patients of the main group developed hemorrhagic stroke – subarachnoid hemorrhage (SAH) (n=42) or intracerebral hemorrhage (ICH) (n=22) – ≥6 months prior to the examination conducted at this study. The control group consisted of patients with non-complicated arterial hypertension. In both groups of patients, the kidney ultrasound parameters and blood plasma urea, creatinine and uric acid concentration levels were determined. Estimated glomerular filtration rate (eGFR) was calculated.&#x0D; Results. The indices of kidney ultrasound parameters in the main group and the control group were the following ones, respectively: the pole-to-pole size of the right kidney was 9,96±1,05 and 11,63±1,26 cm, the same size of the left kidney – 10,39±0,93 and 11,95±1,23 cm, p&lt;0,01 for both pairs. Among the biochemistry blood plasma indices, uric acid concentration reached significant difference as well – 411,21±60,36 and 360,91±75,3 µmol/L in the relevant groups, respectively (p=0,04). On the other hand, eGFR did not show the difference between the study groups. The main group was characterized by a higher prevalence of kidney stone formation – OR 5,00 (95% CI, 1,83-13,65). The statistically significant higher incidence rate of calculus development was identified in two subgroups of the main group as well: for SAH – OR 3,08 (95% CI, 1,05-9,02), for ICH – OR 13,33 (95% CI, 3,69-48,15). When comparing to the control group, kidney cyst identification rate in the SAH subgroup referred to OR 3,08 (95% CI, 1,05-9,02), while kidney pelvis/calyces enlargement incidence rate was higher in the ICH subgroup OR 9,17 (95% CI, 2,15-39,06).&#x0D; Conclusions. The obtained data indicate the smaller pole-to-pole dimension of both kidneys in hypertensive subjects who suffered hemorrhagic stroke, accompanying higher incidence rate of kidney calculus formation in view of the increased blood plasma uric acid concentration. The same is typical for the SAH individuals subgroup but with the addition of prevalence of kidney cysts incidence rate. As for the ICH subgroup, in addition to the main group findings, pelvis/calyces enlargement is observed more frequently when comparing to the hypertensive only subjects.

Uric acid levels and risk of cognitive impairment: Dose-response meta-analysis of prospective cohort studies.

Studying the effects of uric acid levels on cognitive function and quantifying the dose-response relationship. Based on PubMed and Embase search terms, we identified prospective cohort studies that included blood uric acid as a risk factor and cognitive impairment as a result up to September 2022. We extracted pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs). Nine reports (including 488,915 participants and 5516 cognitive impairment cases) with median follow-up of 8.8-22 years were eligible for analyses. Compared with lowest category of blood uric acid concentration, the combined RR of cognitive impairment events in the highest classification was 0.81 (95% CI: 0.70-0.92, P < 0.001). Dose-response analysis of eight reports (including 484,297 participants and 5059 cognitive impairment cases) showed that there was no evidence of a curvilinear relationship between blood uric acid levels and cognitive impairment (P = 0.51 for nonlinear relationship). The summary RR of cognitive impairment for an increase of 1 mg/dL blood uric acid level was 0.98 (95% CI: 0.95-1.00; linear trend P = 0.07, I2 = 67.1%, heterogeneity P < 0.05). There was also a linear negative association between blood uric acid levels and cognitive impairment risk in the male subgroup analysis (RR = 0.97, 95% CI: 0.95-0.99, P < 0.05). Levels of blood uric acid are not related to risk of cognitive impairment. A subgroup analysis shows that the rise in blood uric acid levels in the male population is related to a decreased risk of cognitive impairment. These results need to be confirmed by further studies.

Risk factors for diabetic ketoacidosis in acute pancreatitis patients with type 2 diabetes

Background and purposeIn cinical, some acute pancreatitis patients with diabetes may have diabetic ketoacidosis (DKA). However, the risk factors for DKA in these patients remain unclear. The purpose of this study is to analyze the risk factors for DKA in acute pancreatitis patients with type 2 diabetes.Patients and methodsTwenty-five patients were included in this prospective single-centre study to analyze the incidence and risk factors for DKA in acute pancreatitis patients with type 2 diabetes.ResultsSeven of the twenty-five patients (28%) developed DKA within 48 h of admission. According to whether they had DKA, the twenty-five AP patients were divided into DKA group and non-DKA group. There were significant differences in age (P = 0.014), BMI (P = 0.034), poor previous blood glucose control (P < 0.001) and uric acid concentration (P = 0.041), but no statistically significant differences in sex (P = 0.597), number of drinkers (P = 0.407), number of smokers (P = 1.000), triglyceride level (P = 0.389) and total cholesterol concentration (P = 0.534) between the two groups. In both groups, 1 patients had severe pancreatitis, and the difference was no statistically significant (P = 0.490).ConclusionsThe incidence of DKA in AP patients with diabetes is high. Age, BMI, worse glycemic control and uric acid concentration may be predictors of DKA in AP patients with diabetes.

Mach–Zehnder interferometric analysis of planar polymer waveguide having an adlayer of WS2 for biosensing applications

Abstract To enhance the sensing performance of a four-layer planar polymer optical waveguide, an adlayer of tungsten disulfide material is introduced. Also, the proposed waveguide is used to demonstrate theoretically the detection of uric acid concentration in blood or urine. The heterostructure of two-dimensional WS2 offers excellent dry lubricity with respect to any other 2D substance, such as graphite or molybdenum disulfide. The proposed waveguide is analyzed using the common path Mach–Zehnder interferometric method. The dispersion characteristic i.e., the effective refractive indices and thickness of proposed waveguide is plotted for a particular wavelength range to optimize the thickness of film layer. The difference in propagation constant and output interference signal for changing the cover medium is calculated. Using the output interference signal, the phase sensitivity 213 degree/RIU is obtained in the proposed waveguide. The maximum obtained sensitivity, limit of detection and limit of quantification for uric acid concentration in the proposed waveguide structure is 6.86 × 10−2 degree mM−1, 0.061 mM and 0.203 mM, respectively.

The Impact of Kohlrabi Sprouts on Various Thyroid Parameters in Iodine Deficiency- and Sulfadimethoxine-Induced Hypothyroid Rats.

Brassica sprouts, as the rich source of dietary glucosinolates, may have a negative effect on thyroid function. In this study, kohlrabi sprouts diet, combined with two models of rat hypothyroidism, was tested. TSH, thyroid hormones and histopathology analysis were completed with the evaluation of immunological, biochemical, haematological parameters, cytosolic glutathione peroxidase, thioredoxin reductase in the thyroid, and plasma glutathione peroxidase. A thermographic analysis was also adapted to confirm thyroid dysfunction. The levels of TSH, fT3 and fT4, antioxidant enzyme (GPX) as well as histopathology parameters remained unchanged following kohlrabi sprouts ingestion, only TR activity significantly increased in response to the sprouts. In hypothyroid animals, sprouts diet did not prevent thyroid damage. In comparison with the rats with iodine deficiency, kohlrabi sprouts diet decreased TNF-α level. Neither addition of the sprouts to the diet, nor sulfadimethoxine and iodine deficiency, caused negative changes in red blood cell parameters, glucose and uric acid concentrations, or kidney function. However, such a dietary intervention resulted in reduced WBC levels, and adversely interfered with liver function in rats, most likely due to a higher dietary intake of glucosinolates. Moreover, the possible impact of the breed of the rats on the evaluated parameters was indicated.

Study on the analgesic, anti-inflammatory and hypouricemic effects of 50% ethanolic extract from Jasminum subtriplinerve Blume

Previous studies have reported in vitro antioxidant and inhibitory activity on xanthine oxidase of Jasminum subtriplinerve Blume, Oleaceae, which suggested the potential prevention of gout and supplementary treatment. This study evaluated analgesic, anti-inflammatory, and hypouricemic effects of the 50% ethanolic extract of J. subtriplinerve (EEJS) at the oral doses of 800 and 1200 mg/kg in mice. For acute oral toxicity, after oral administration of single doses of EEJS; mortality and toxic signs in male and female mice were noticed within 72 hours and 14 days. The analgesic effect was observed in acid acetic induced writhing in mouse model within 40 minutes. The anti-inflammatory effect was determined in mice-induced edema by 1% carrageenan. The hypouricemic effect was evaluated in mice with the peritoneal injection of potassium oxonate inducing acute and chronic hyperuricemia. The results showed that there was not any toxic sign in mice given orally at the maximum dose (Dmax) of 20 g EEJS/kg. At the dose of 800 and 1200 mg/kg, EEJS did exhibit analgesic effect until 40th minute. EEJS 1200 mg/kg expressed acute anti-inflammatory effect. EEJS had no acute hypouricemic effect at the oral doses of 800 and 1200 mg/kg. When given to mice with chronic hyperuricemia, 800 mg/kg EEJS reduced 30-44% blood uric acid concentration compared to pathological group. In conclusion, EEJS did not cause any toxic sign in mice at the Dmax of 20 g/kg. This extract had analgesic and chronic hypouricemic effects at the oral dose of 800 mg/kg in mice.

Association of dietary patterns with blood uric acid concentration and hyperuricemia in northern Chinese adults

BackgroundStudies have shown that a direct association exists between the diet and blood uric acid concentrations. However, works on the association of dietary patterns with blood uric acid concentrations and hyperuricemia remain limited. ObjectiveThis study aims to evaluate the association of dietary patterns with blood uric acid concentrations and hyperuricemia.MethodsThe relationship between dietary patterns and hyperuricemia was explored through a nutritional epidemiological survey in China (n = 4855). Three statistical methods, including principal component analysis, reduced rank regression (RRR), and partial least squares regression, were used to extract dietary patterns. General linear regression and logistic regression analyses were utilized to explore the relationship of dietary patterns with blood uric acid concentrations and hyperuricemia.ResultsAfter adjusting for potential confounding factors, the score for the plant-based dietary pattern was found to be negatively correlated with blood uric acid levels (β = − 3.225) and that for the animal dietary pattern was discovered to be directly correlated with blood uric acid levels (β = 3.645). The participants in the highest quartile of plant-based dietary pattern scores were at a low risk of hyperuricemia (OR = 0.699; 95% CI: 0.561–0.870, P < 0.05), whereas those in the highest quartile of animal dietary pattern scores were at a high risk of hyperuricemia (OR = 1.401; 95% CI: 1.129–1.739, P < 0.05). The participants in the third quartile of scores for the RRR dietary pattern, which was characterized by the relatively high intake of poultry, sugary beverages, and animal organs and the low intake of desserts and snacks, had a significantly higher risk of hyperuricemia than those in the first quartile of scores for the RRR dietary pattern (OR = 1.421; 95% CI: 1.146–1.763, P < 0.05).ConclusionsOur research indicated that plant-based dietary pattern analyzed by PCA was negatively associated with blood uric acid concentrations, while animal-based dietary pattern was directly associated with blood uric acid concentrations. The RRR dietary pattern may have the potential to induce elevations in blood uric acid concentrations.

A STUDY ON EFFECTIVENESS OF LEUKEPHERESIS IN PATIENTS WITH HYPERLEUKOCYTIC LEUKEMIAS

Background: Thrombosis is a common complication of hyperleukocytic leukemias. Purpose: To access features of leukostasis, effectiveness of leukopheresis in terms of reduction of WBC, and biochemistry indicators in hyperleukocytic leukemias. Patients and methods: An intervention study was carried out on 112 CML patients treated with leukopheresis in Hai Phong Vietnam - Czech friendship hospital from 7/2017 to 3/2019. Results: (1) Clinical symptoms of leukostatsis: (a) Percentage of symptoms: headache/dizziness: 38,0%; visual impairment/hearing loss: 2,0%; splenic pain/infarct: 12,0%; priapism: 2,0%; leukostasis related pulmonary distress syndrome: 2,0%; CNS hemorrhage: 2,0%. (2) Effectiveness of leukopheresis in term of reduction of WBC, and biochemistry indicators in hyperleukocytic leukemias: (a) WBC reduced significantly after leukopheresis and after 24 hours: CML: 304, 219 and 198 G/l; AML: 295, 206 and 194 G/l; ALL: 342, 207 and 185 G/l, respectively (with P&lt;0,01); (b) Cytoreduction effectiveness after leukopheresis in CML, AML and ALL after 24 hours are: 34,7%; 34,2% and 45,9% respectively. (3) Change of blood uric acid and LDH concentrations after leukopheresis: (a) Uric acid concentration reduced significantly for males and females after leukopheresis; (b) LDH concentration reduced significantly (CML: 3.129 and 1.892 U/l; AML: 2.589 and 1.491 U/l; ALL: 2.992 and 1712 U/l (P&lt;0,01) before and after leukopheresis, respectively (with P&lt;0,01). Conclusion: Leukopheresis is an effective supportive treatment for hyperleukocytic leukamias.

Clinical and Dietary Determinants of Ketosis During Long-Term Fasting in 1610 Subjects

ObjectivesThe health-promoting effects of fasting are increasingly documented. Long-term fasting according to the Buchinger Wilhelmi program (200 kcal/day, approximately 30 grams of carbohydrates) elicits various health-improving effects. The metabolic switch from glucose to fat oxidation is associated with an elevation in urine ketone concentrations (ketonuria). We hypothesised that inter-individual differences in ketonuria are due to variations in daily intake of carbohydrate facultative supplements. We further hypothesised that changes in ketonuria are linked to the beneficial effects of therapeutic fasting on an individual basis, and that these could be predicted from a person’s demographic data and metabolic status before they entered the fasting program. MethodsWe evaluated daily variations in carbohydrate intake and ketonuria in a group of 1610 subjects during a 4 to 21-day fasting period. Ketosis was estimated non-invasively in urine with Ketostix strips. Unsupervised hierarchical clustering of ketonuria was used to stratify patients as subgroups. Random Forest classification was performed using R package Caret. Differences in the effects of fasting between the different subgroups were model-predicted estimated marginal means. ResultsKetonuria was less intense in individuals who consumed honey and/or juice, which corresponded to a daily carbohydrate intake of approximately 30 grams. Participants with high ketonuria were younger, had lower blood urea concentrations, and lower HDL levels, before they entered the fasting program. Subjects excreting the largest amounts of ketones in their urine had a larger decrease in blood glucose levels, glycated haemoglobin (HbA1c) levels, body weight and waist circumference, and a larger increase in blood uric acid concentrations, in the group of patients. ConclusionsWe showed that even a low level carbohydrate intake influences ketonuria during long-term fasting. The course of ketonuria could be predicted based on a patient’s characteristics before they entered the fasting program. Individuals with the most intense ketonuria presented the most pronounced metabolic changes during long-term fasting. Altogether, our study paves the way to the establishment of personalised long-term fasting strategies. Funding SourcesThis study was funded by Amplius GmbH, Überlingen, Germany.

Anti-hangover and Anti-gout Effects of Asparagus Byproduct Extracts

Background: Given the reported pharmacological effects of rutin from asparagus stems and roots, here, we assessed the anti-hangover and anti-gout effects of asparagus stem and root extracts.<BR>Methods and Results: We found that rutin amount in ethanol extracts of asparagus stems was 10.15 ㎎/g, and in hydrothermal extracts of asparagus roots it was 3.28 ㎎/g. Alcohol dehydrogenase and aldehyde dehydrogenase activities in asparagus-stem extracts were 80% and 40% of those in the control group, respectively. Following hangover induction in rats using alcohol, an injection of 400 ㎎/㎏ body weight (BW) of the extract significantly reduced the blood alcohol concentration compared to that of the control group. Additionally, blood gamma-glutamyl transpeptidase (GGT), glutamic oxaloacetic transaminase (GOT), and glutamic pyruvic transaminase (GPT) concentrations measured 5 h after alcohol administration revealed that treatment with 400 ㎎/㎏ BW of extract significantly reduced GGT and GOT concentrations compared to the control group, whereas changes in GPT were not significant. Moreover, xanthine oxidase activity after treatment with hydrothermal extracts of asparagus roots was 44.01 ± 0.32%, showing 53.3% inhibition compared to the positive control (allopurinol; 82.50 ± 4.98%). To assess the anti-gout effect of hydrothermal extracts of asparagus roots, we induced gout in rats by intraperitoneal injection of potassium oxonate and measured blood uric acid, creatinine, and blood urea nitrogen concentrations at 3 h post-administration of the extract. The results showed a significant reduction in creatinine and uric acid levels in the treated group compared to the control.<BR>Conclusions: These findings demonstrated the potential of asparagus stem and root extracts as functional ingredients.

Impact of kidney size on the outcome of diabetic patients receiving hemodialysis.

IntroductionDiabetic patients normally have enlarged or normal-sized kidneys throughout their lifetime, but some diabetic uremic patients have small kidneys. It is uncertain if kidney size could have any negative impact on outcome in hemodialysis patients.MethodsThis longitudinal, observational cohort study recruited 301 diabetic hemodialysis patients in 2015, and followed until 2019. Patients were stratified into two subgroups according to their kidney sizes before dialysis, as small (n = 32) or enlarged or normal (n = 269). Baseline demographic, hematological, biochemical, nutritional, inflammatory and dialysis related data were collected for analysis.ResultsPatients with small kidney size were not only older (P<0.001) and had lower body mass index (P = 0.016), but had also higher blood uric acid concentration (P<0.001) compared with patients with enlarged or normal kidney size. All patients received adequate doses of hemodialysis since the Kt/V and urea reduction ratio was 1.7±0.3 and 0.7±0.1, respectively. Patients with small size kidneys received higher erythropoietin dose than patients with enlarged or normal kidney size (P = 0.031). At the end of analysis, 92 (30.6%) patients expired. Kaplan-Meier analysis revealed no survival difference between both groups (P = 0.753). In a multivariate logistic regression model, it was demonstrated that age (P<0.001), dialysis duration (P<0.001), as well as blood albumin (P = 0.012) and low-density lipoprotein (P = 0.009) concentrations were significantly correlated with mortality.ConclusionsSmall kidney size on starting hemodialysis was not related with an augmented risk for death in diabetic patients receiving hemodialysis. Further studies are necessary.

Role of Salvia officinalis Silver Nanoparticles in Attenuation Renal Damage in Rabbits Exposed to Methotrexate.

Nanomaterials are now considered in an extensive range of applications in various fields such as biotechnology and biomedicine. The present study aimed to investigate the protective role of Salvia officinalis Silver Nanoparticles (SOSNPs) as an anti-oxidant on nephrotic damage induced by methotrexate (MTX) in adult rabbits. Green silver nanoparticles were synthesized using alcoholic extract of Salvia officinalis (S. Officinalis) leaves and were characterized by UV-spectrophotometry and scanning electron microscope. The mixing of the plant extract of S. Officinalis with silver nitrate solution leads to the change of the reaction mixture color to yellowish within 1 h and dark brown after 8 h. For studying the protective role of SOSNPs, a total of 28 adult Wistar albino rabbits were divided into four groups and treated intramuscularly (twice per week) for 45 days as follows: T1: S. Officinalis (150 mg/kg B.W), T2: SOSNPs (150 mg/kg B.W); T3: MTX (0.25 mg/kg B.W) and SOSNPs (150 mg/kg B.W); T4: MTX (0.25 mg/kg B.W). Blood was collected at 0, 15, 30, and 45 days using retro-orbital sinus and cardiac puncture technique, and the serum factors including malondialdehyde (MDA), glutathione (GSH) in serum, creatinine, as well as blood urea nitrogen and uric acid concentrations were measured at the next step. The results indicated that MTX (T4) caused a case of oxidative stress by a significant decrease in GSH and MDA as well as an increase in serum creatinine, urea, and uric acid concentrations. On the other hand, the protective roles of S. Officinalis and SOSNPs given concurrently with MTX were clarified in T2 and T3 groups, where there was the alleviation of renal damage through the correction of the previously mentioned parameters as well as the correction of anti-oxidant status. Finally, the present study documented the anti-oxidant activity and renal protective effects of SOSNPs against the damaging effects of MTX in rabbits.

Impact of Pre-transport Feed Withdrawal on Welfare and Meat Characteristics of European Quails

The objective of this study was evaluate whether pretransport feed withdrawal affects welfare, carcass, and meat characteristics of European quails. A total of 120 European quails were used, with an initial age of 15 days. Bird feed was removed before transport to the slaughterhouse at the following times, which characterised the different treatments: zero hours, three hours, six hours, nine hours and twelve hours. The transport took 54 minutes to cover 27 kilometres to a commercial slaughterhouse. The birds were slaughtered at 41 days of age. During bleeding, blood samples were collected. Blood glucose, total protein, albumin, uric acid, and corticosterone concentrations were measured. The carcasses and meat characteristics were measured. Poultry body weight decreased and blood glucose concentrations increased with the increase in feed withdrawal time. The treatments did not affect carcass weights. Carcass yields after three hours fasting were similar to those in the six hours and nine hours groups, indicating that gastrointestinal tracts were empty after the third hour. Meat quality was negatively affected (pH, lightness, water holding capacity, cooking loss) by the increase in feed withdrawal time; integrated parameters that characterise dark, firm, dry meat. Pre transport feed withdrawal time should be three hours to empty the gastrointestinal tract and minimise losses in meat quality of European quails. It is necessary to adjust feed withdrawal so that it does not exceed this time, since there is no technical justification for supporting it.

Effects of Dietary Soybean (Glycine max) on Growth Performance, Haematology and Serum Biochemistry of African Carp (Labeo Cubie Ruppell 1832)

The effects of dietary replacements of fish meal with soybean meal on growth performance, heamatology and serum biochemistry in juvenile Labeo cubie were evaluated. Four hundred and fifty (450) apparently healthy juvenile Laboe cubie were distributed into one of fifteen 1000 L tanks divided into five groups and fed any of diets A (0% soybean meal); B (30% soybean meal); C (40% soybean meal); D (45% soybean meal) and diet E (75% soybean meal) for 56 days. At set time points day 7, 14, 28 and day 56, five fish were randomly selected per tank for growth assessments, heamatology and serum biochemical evaluations. Growth performance indices decreased significantly (p &lt; 0.05) along the gradient of soybean meal inclusion and the duration of feeding. The erythrocytes count increased significantly (p &lt; 0.05) at day 14 in fish fed soybean meal diets and decreased significantly (p &lt; 0.05) beginning at day 28 in fish fed soybean meal-based diets. The haematocrit of fish fed diets D and E were significantly (p &lt; 0.05) lower at day 28 compared to day 56. There were no significant variations in haemoglobin concentration and the leucocytes counts (p &gt; 0.05). The proteins, blood glucose and the transaminases increased significantly (p &lt; 0.05) along gradient of dietary inclusion and duration of feeding in the first 28 days while creatinine kinase activity, blood urea nitrogen and uric acid concentration remained significantly elevated (p &lt; 0.05) in fish fed the soybean meal-based diets. The results of the study show juvenile L. cubie may tolerate up to 40% dietary inclusion of soybean meal as replacement for fish meal.

CYSTATIN C AS A MARKER OF KIDNEY FUNCTION IN PATIENTS WITH DIABETES MELLITUS AND PURINE METABOLISM DISORDERS

Chronic kidney disease is a pressing issue for healthcare systems over the world; its prevalence has reached 13% in Western countries. In recent years, cystatin C has been proposed as a more reliable endogenous marker of renal function, especially for the diagnosis of initial changes in glomerular filtration rate. The aim of this study is to analyze the signs of chronic kidney disease in patients with type 2 diabetes mellitus depending on the level of uricemia by using cystatin C in real clinical practice. The study included 127 patients with type 2 diabetes mellitus (mean age = 60.0 years [52.0; 66.0]; sex ratio: 55 men/ 72 women) who received oral hypoglycemic therapy. All subjects, depending on the stage of diabetic nephropathy were divided into groups: group 1 (n=80) included patients with asymptomatic diabetic nephropathy (normoalbuminuria below 30 mg/day)); group 2 (n=22) involved patients with microalbuminuria (30-300 mg/day); group 3 (n=17) included patients with proteinuria; group 4 (n=8) comprised patients with chronic renal failure. Glomerular filtration rate was calculated according to the formulas of Chronic Kidney Disease Epidemiology Collaboration taking into account the concentration of cystatin C (Chronic Kidney Disease Epidemiology Collaboration cys), by Cockcroft-Gault and Modification of Diet in Renal Disease Study using a calculator of the National Institute of Diabetes and Digestive and Kidney Diseases. In patients with type 2 diabetes mellitus, the development of chronic kidney disease is also predetermined by the following comorbid conditions as hypertension, chronic pyelonephritis, hyperuricemia, and asymptomatic urolithiasis, along with diabetic nephropathy. Glomerular filtration rate values in patients with type 2 diabetes mellitus assessed by Chronic Kidney Disease Epidemiology Collaboration cys are more reliable than those assessed by using the formulas of Cockcroft-Gault and Modification of Diet in Renal Disease Study, especially at the limit level of glomerular filtration rate ˂60 ml/min/1.73m2. In patients with type 2 diabetes mellitus, the level of circulating cystatin C is associated with body mass index, waist circumference, blood uric acid concentration and albuminuria levels. The blood concentration of cystatin C in the patients with type 2 diabetes mellitus is determined by the blood concentration of creatine and uric acid.