Uric Research Articles

Integrated microbiome and metabolome analysis reveals the key role of taurohyocholate in the treatment of hyperuricemia with Lacticaseibacillus rhamnosus 2016SWU.05.0601

The incidence of hyperuricemia (HUA) is on the rise, posing a significant threat to human health. Several probiotics have shown potential in treating HUA; however, the critical role of intestinal metabolites in this therapy remains inadequately understood. Our study demonstrated that Lacticaseibacillus rhamnosus 2016SWU.05.0601 not only reduced the expression levels of xanthine dehydrogenase and the content and activity of xanthine oxidase in the liver but also regulated the uric acid transporters expression in the kidney, thereby attenuating HUA in mice. Additionally, L. rhamnosus 2016SWU.05.0601 modulated the gut microbiota and metabolite abundance in HUA mice. Correlation analysis revealed that the gut microbiota metabolite taurohyocholate played a vital role in the treatment of HUA by L. rhamnosus 2016SWU.05.0601, as confirmed in HUA cell models. Our research provides a significant theoretical basis for elucidating the mechanisms by which probiotics alleviate HUA and for developing functional ingredients for HUA treatment.

Serum Uric Acid Level and its Association with Severity in Acute Ischemic Stroke

Background: Cerebrovascular diseases (CVDs) are a major public health issue around the world. Elevated serum uric acid levels may predict an increased risk for cerebrovascular events particularly acute ischemic stroke. Aim of the study: The aim of our study was to assess the association between serum uric acid level and severity of acute ischemic stroke. Methods: This observational case control study was conducted at the department of Neurology and at the department of Medicine in Dhaka Medical College Hospital from July 2018 to June 2020. This study included 50 acute ischemic stroke patients and 50 age and gender matched healthy controls. Along with the routine investigations, estimation of serum uric acid was done in all participants. The severity of stroke was assessed as per national institutes of health stroke scale (NIHSS). After collection of all the required data, analysis was done by SPSS 23.0. Results: The mean age and distribution of the age in different age group were matched between case and control groups (p=0.607 and 0.763 respectively). The mean age of the ischemic stroke cases was 62.14±9.77 years. The mean NIHSS score of the patients was 16.34±10.34. Of all, 18% had minor stroke, 32% had moderate stroke, 20% had moderate to severe stroke and 30% had severe stroke. Among stroke patients 58% had elevated uric acid level and among controls 20% had raised uric acid in serum. The number of patients having elevated serum uric acid is statistically significantly higher in case group than control group (p<0.001). Multivariate regression analysis showed hypertension (OR 4.046; 95% CI 1.432–11.432; p=0.008), DM (OR 3.063; 95% CI 1.030-9.105; p=0.044), dyslipidemia (OR 3.031; 95% CI 1.062-8.654; p=0.038) and elevated serum uric acid level (OR 6.019, 95% CI 2.220–16.317; p<0.001) independently associated with acute ischemic stroke (p<0.05). Conclusion: This study shows elevated serum uric acid level significantly associated with severity of acute...........

The Relationship between Vascular Biomarkers (Serum Endocan and Endothelin-1), NT-proBNP, and Renal Function in Chronic Kidney Disease, IgA Nephropathy: A Cross-Sectional Study

IgA nephropathy (IgAN) is the most common primary glomerular disease. Endothelin-1 (ET-1) is one of the strongest vasoconstrictor materials in the blood. The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) is associated with renal function and poor outcomes in chronic kidney disease (CKD). Serum endocan is a biomarker associated with proinflammatory cytokines, and the increase in the serum level plays a critical role in inflammatory, proliferative, and neovascularization processes and is associated with poor cardiovascular outcomes in patients with CKD too. Identifying high-risk patients using biomarkers could help to optimize their treatment. Ninety patients with biopsy-confirmed IgAN were included in the study (50 males/40 females, mean age: 54.9 ± 14.4 years). Serum endocan, ET-1, and NT-proBNP were measured by enzyme-linked immunosorbent assay kits. Echocardiography was performed, and carotid-femoral pulse wave velocity (cfPWV) was measured by SphygmoCor in this cross-sectional study. Patients were divided into two groups based on serum endocan median level (cut-off: 44 ug/L). There was significantly higher aorta systolic blood pressure (SBPao) (p = 0.013), NT-proBNP (p = 0.028), albumin/creatinine ratio (p = 0.036), and uric acid (p = 0.045) in the case of the higher endocan group compared to the lower. There was also significantly higher SBPao (p = 0.037) and NT-proBNP (p = 0.038) in the case of higher endothelin-1 (ET-1) levels compared to the lower (cut-off: 231 pg/mL) group by the two-sample t-test. Then, we divided the patients into two groups based on the eGFR (CKD 1–2 vs. CKD 3–5). The levels of serum endocan, NT-proBNP, cfPWV, SBPao, left ventricular mass index (LVMI), uric acid, and albuminuria were significantly higher in the CKD 3–5 group compared to the CKD 1–2 group. The serum endocan and NT-proBNP levels were significantly higher in the diastolic dysfunction group (p = 0.047, p = 0.015). There was a significant increase in serum endocan levels (CKD 1 vs. CKD 5; p = 0.008) with decreasing renal function. In IgAN, vascular biomarkers (endocan, ET-1) may play a role in endothelial dysfunction through vascular damage and elevation of SBPao. Serum endocan, ET-1, and NT-proBNP biomarkers may help to identify IgAN patients at high risk.

Insight into the chemistry of Folin’s test for uric acid

Folin developed an analytical technique for uric acid spectroscopic determination. It is based on the interaction of uric acid with sodium tungstate in phosphoric acid. This produces an intense blue colour after alkalinization, whose concentration is measured. However, the structure of the organic product obtained was not mentioned. The present communication gives the references related to each reaction step, as well as information about the reaction products obtained in uric acid oxidations carried-out in acidic or in alkaline mediums. The reaction route is as follows: addition of tungstic acid to the C-C double bond, acidolysis of the organo-metallic ester, producing tungstic subacid and an epoxide. Oxirane opening to vicinal diol after reaction with water. Two carbinolamines result, which are broken by protonation at the nitrogen; carbonyl groups are formed at C-4 and C-5 with concomitant elimination of a urea molecule. This way alloxan monohydrate is formed. The blue products obtained are described.

Construction of a metabolism-malnutrition-inflammation prognostic risk score in patients with heart failure with preserved ejection fraction: a machine learning based Lasso-Cox model

BackgroundMetabolic disorder, malnutrition and inflammation are involved and interplayed in the mechanisms of heart failure with preserved ejection fraction (HFpEF). We aimed to construct a Metabolism-malnutrition-inflammation score (MIS) to predict the risk of death in patients with HFpEF.MethodsWe included patients diagnosed with HFpEF and without infective or systemic disease. 20 biomarkers were filtered by the Least absolute shrinkage and selection operator (Lasso)-Cox regression. 1000 times bootstrapping datasets were generated to select biomarkers that appeared above 95% frequency in repetitions to construct the MIS.ResultsAmong 1083 patients diagnosed with HFpEF, 342 patients (31.6%) died during a median follow-up period of 2.5 years. The MIS was finally constructed based on 6 biomarkers, they were albumin (ALB), red blood cell distribution width-standard deviation (RDW-SD), high-sensitivity C-reactive protein (hs-CRP), lymphocytes, triiodothyronine (T3) and uric acid (UA). Incorporating MIS into the basic predictive model significantly increased both discrimination (∆C-index = 0.034, 95% CI 0.013–0.050) and reclassification (IDI, 6.6%, 95% CI 4.0%-9.5%; NRI, 22.2% 95% CI 14.4%-30.2%) in predicting all-cause mortality. In the time-dependent receiver operating characteristic (ROC) analysis, the mean area under the curve (AUC) for the MIS was 0.778, 0.782 and 0.772 at 1, 3, and 5 years after discharge in the cross-validation sets. The MIS was independently associated with all-cause mortality (hazard ratio: 1.98, 95% CI [1.70–2.31], P < 0.001).ConclusionsA risk score derived from 6 commonly used inflammatory, nutritional, thyroid and uric acid metabolic biomarkers can effectively identify high-risk patients with HFpEF, providing potential individualized management strategies for patients with HFpEF.Graphical

RECENT ADVANCEMENT IN ELECTROCHEMICAL BIOSENSOR BASED ON REDOX ENZYME COMPOSITE MODIFIED ELECTRODE FOR THE DETECTION OF BIOMOLECULES

Recent developments in electrochemical biosensors have resulted in new applications in a variety of disciplines, such as clinical diagnosis, food processing quality control, and environmental monitoring. The electrochemical biosensor is a widely used sensing device that transmits an electrical signal from biological activities. Electrochemical biosensors have led to significant advancements in detecting various biomolecules such as uric acid, glucose, cholesterol, lactate, and DNA, including cancer biomarkers, viruses, and antibodies. An electrode is a vital part of this kind of sensor since it serves as a strong support for immobilizing biomolecules (enzyme, antibody, and nucleic acid) and allowing electron flow. Redox enzymes are the foundation of enzymatic electrochemical biosensors, which use oxidation or reduction reactions to detect a substrate, which is then converted into an electrical signal. Immobilizing enzymes onto solid supports is a common method to enhance the performance of an enzymatic electrochemical biosensor. However, there are some challenges, such as potential loss of enzyme activity, difficulties in maintaining enzyme stability, and issues related to the reproducibility and consistency of enzyme immobilization. This review covers all challenges in enzymatic electrochemical biosensors. Numerous new biosensor platforms are announced each year as researchers look for various electrode materials. Additionally, the researchers should familiarize themselves with the practical methods used in electrode production in order to build a successful biosensor. This review highlights current developments in modifying enzyme-immobilized biosensors for detection of different biomolecules. The article further describes methods of enzyme immobilization and various enzymes with different nanomaterials for the development of novel enzymatic electrochemical biosensors.

Antiinflammatory and Antioxidant Mediated Nephroprotection of Melatonin and Rosuvastatin in Carboplatin Induced Nephrotoxicity: An Experimental Study

Background: Platinum compounds like cisplatin, carboplatin used as anticancer drugs are known to cause nephrotoxicity. There is a need of drugs to prevent the drug induced nephrotoxicity. This experimental study was done to assess the nephroprotective role of rosuvastatin in carboplatin induced nephrotoxicity models and to compare it with melatonin. Methodology: A total of 36 albino rats were randomly divided into 6 groups (n=6). Group I was control group. In Groups II to VI nephrotoxicity was induced by intraperitoneal administration of a single dose of Carboplatin 128mg/kg on day 5. In Group II, no drug was administered. In group III and IV melatonin 5mg/kg and 10mg/kg was administered orally once a day for 10 days. In group V and VI, rosuvastatin 10mg/kg and 20mg/kg was administered orally once a day for 10 days. Blood was collected on day 0 for the baseline values and at an interval of 7 and 11 days for biochemical and antioxidant estimation. Kidneys were dissected at the end of study, weighed and renal tissue was subjected to histopathological analysis. Results: There was a significant decrease in urea, creatinine and uric acid in all the treatment groups. Also a significant decrease (p&lt;0.05) was seen in MDA levels in treatment groups as compared to the negative control. A non-significant decrease was observed in IL-18 levels in the treatment groups. Also, histopathology of kidney tissues showed that in treatment groups, there were less changes in interstitium and vessels. Conclusion: Melatonin and rosuvastatin has shown a nephroprotective effect in carboplatin induced nephrotoxicity in terms of improved renal function tests, reduced IL-18 showing anti-inflammatory action, antioxidant action by decreasing MDA and increasing GSH and by histopathological studies of kidney tissue

Prospective study investigating the influence of nutritional intervention on biochemical profiles in patients with recurrent urolithiasis.

Urolithiasis, commonly known as kidney stones, is a condition significantly impacted by dietary habits. The objective of this study is to evaluate the impact of a tailored dietary plan on the crystalluria and biological parameters of patients with different types of kidney stones over a 3-month period. We conducted a prospective study of 3 months. The study involved patients with recurrent nephrolithiasis. Alongside the medical consultation, a comprehensive dietary survey was performed to assess the patients' nutritional habits. Urinary parameters, including volume, calcium, oxalate, uric acid, and power of hydrogen (pH), were evaluated both before and after the dietary intervention. 69 patients were involved. There were 17 patients diagnosed with cystine lithiasis, 33 with oxalocalcic lithiasis and 19 with uric lithiasis. After 3 months, only 32 patients revisited for follow-up. There were significant changes (p = 0.002 and 0.04) in urine crystalluria for cystinic and uric lithiasis. For the urinary oxalate variation, there was a significant decrease from T1 (before dietary intervention) to T2 (after dietary intervention), with levels dropping from 0.289 ± 0.10 umol/l to 0.215 ± 0.079 umol/l (p = 0.02).Regarding urinary calcium (calciuria), there was a trend toward a decrease from T1 to T2, although the change was not statistically significant, with levels decreasing from 2.42 ± 1.68 umol/l to 2.14 ± 1.62 umol/l (p = 0.1). Our research underscores the favorable effects of a tailored and well-balanced diet on both the crystalluria and biological parameters of individuals with recurrent lithiasis.

Construction and comparative analysis of an early screening prediction model for fatty liver in elderly patients based on machine learning

Objective: To construct a prediction model for fatty liver disease (FLD) among elderly residents in community using machine learning (ML) algorithms and evaluate its effectiveness. Methods: The physical examination data of 4989 elderly people (aged over 60 years) in a street of Shanghai from 2019 to 2023 were collected. The subjects were divided into a training set and a testing set in a 7:3 ratio. Using feature selection and importance sorting methods, eight indicators were selected, including high-density lipoprotein cholesterol, body mass index, uric acid, triglycerides, albumin, red blood cell, white blood cell, and alanine aminotransferase. Six ML models, including Categorical Features Gradient Boosting, eXtreme Gradient Boosting, Light Gradient Boosting Machine, Random Forest, Decision Tree, and Logistic Regression, were constricted, and their predictive performances were compared via accuracy, precision, recall, F1 score, and Area Under Receiver Operating Characteristic Curve. Results: Among the six ML models, the Categorical Features Gradient Boosting model demonstrated the highest prediction accuracy of 0.74 for FLD in elderly community population, along with a precision of 0.70, a recall of 0.73, a F1 score of 0.71, and an area under the curve of 0.74. Conclusions: In the context of rapid development of artificial intelligence, a community-based elderly FLD prediction model constructed using ML algorithms aid family general practitioners in the early diagnosis, early treatment, and health management of local FLD patients.

The Impact of The Preventive Role of Star Anise on The Toxicity of Benzopyrene Compound in The Liver and Kidney Tissues and Biochemical Parameters in Male Rats

Objective: This study, conducted at the University of Anbar's College of Pure Science, evaluated the protective effects of star anise against benzopyrene (B[a]P)-induced liver and kidney damage in 30 male white Swiss rats (Sprague Dawley), aged 3-4 months and weighing between 170-210 g. Materials and methods: The rats were divided into six groups: Control (G1), B[a]P (G2), Star Anise 125 mg/kg bw (G3), Star Anise 120 mg/kg bw + B[a]P (G4), Star Anise 125 mg/kg bw + B[a]P (G5), and Star Anise 130 mg/kg bw + B[a]P (G6). Results:Biochemical analyses showed that B[a]P exposure significantly elevated liver enzymes (ALP, AST, ALT, GGT) and kidney markers (uric acid, creatinine), indicating hepatic and renal damage. Treatment with star anise, especially 130 mg/kg bw significantly reversed these elevated levels because it protected against the injury. Histopathology showed that the liver and kidney were severely damaged in the B[a]P group and in the star-anise-treated group, normal tissue architecture was well preserved only in high doses of star anise treatment. Conclusion:These outcomes suggest the use of star anise as a hepatoprotective as well as a nephroprotective agent, and this needs to be further strengthened by understanding its mechanisms and long-term effectiveness.

Comparative Analysis of The Effectiveness of Antihypertensive Therapy Including Spironolactone and Eplerenone in Patients With Essential Hypertension and Atrial Fibrillation.

To perform a comparative analysis of the efficacy of antihypertensive therapy (AHT) containing spironolactone or eplerenone in patients with essential arterial hypertension (AH) and atrial fibrillation (AF). The study included 99 male and female patients with essential AH complicated by permanent AF, who were receiving the outpatient treatment at the National Specialized Scientific and Practical Medical Center of Cardiology (Tashkent). The patients aged 61.3±9.5 years, the mean duration of AH was 12.9±8.3 years. All patients were divided into two groups: Group 1, patients who completed a 6-month combination AHT containing spironolactone (n=51); Group 2, patients who completed a 6-month combination AHT containing eplerenone (n=48). AF was diagnosed by electrocardiogram (ECG) and/or 24-hour ECG monitoring according to standard diagnostic criteria. The ECG study was performed in compliance with the American Society of Echocardiography Guidelines in M- and B-modes. The degree of structural vascular alterations was determined by the intima-media thickness of the common carotid artery by duplex scanning and microalbuminuria in morning urine. The concentrations of sex hormones were measured by the enzyme immunoassay. The serum concentrations of lipids, glucose, creatinine, and uric acid were measured by the enzymatic method. The glomerular filtration rate (GFR) was calculated with the EPI formula. Results of all studies were considered statistically significant at p&lt;0.05. The proportion of patients who achieved the target diastolic blood pressure (BP) values was significantly greater in the eplerenone-containing treatment group than in the spironolactone-containing treatment group: 87.8% vs. 67.5% (p=0.043). The proportion of patients who simultaneously achieved the target systolic and diastolic BP values was slightly greater in the eplerenone-containing treatment group than in the spironolactone-containing group (100% vs. 92.1%, p=0.060). The best cardioprotective efficacy was observed in the group of combination AHT containing eplerenone. Specifically, in Group 2, the left ventricular ejection fraction (LVEF) was significantly improved compared to Group 1: from 55.4±10.6% at baseline to 52.6±9.1% in Group 1 (p&gt;0.05) and from 54.8±8.8% at baseline to 58.2±6.4% in Group 2 (p&lt;0.02). Only in Group 2, the left atrial volume index (LAVI) was significantly decreased compared to Group 1. Thus, in Group 1, the LAVI changed from 42.2±15.1 ml/m2 at baseline to 40.4±12.2 ml/m2 (p&gt;0.05) and in Group 2, from 41.2±15.3 ml/m2 at baseline to 37.3±13.5 ml/m2 after the treatment (p&lt;0.05); the ∆% LAVI in the eplerenone group was -5.9% vs. -0.36% in the spironolactone group. In men of Group 1, estradiol significantly increased from 13.9±12.6 pmol/l at baseline to 22.7±12.4 pmol/l (p&lt;0.001). The good antihypertensive efficacy of the 6-month combination therapy containing eplerenone was significantly superior to spironolactone in achieving the target BP values. The eplerenone-containing treatment significantly improved LVEF and decreased LAVI compared to the spironolactone-containing treatment. A trend towards a beneficial effect of the AHT containing eplerenone on concentrations of sex hormones was noted in both women and men.

Ultrasound viscoelastic imaging in the noninvasive quantitative assessment of chronic kidney disease

Background This study aims to evaluate the clinical application value of ultrasound viscoelastic imaging in noninvasive quantitative assessment of chronic kidney disease (CKD). Methods A total of 332 patients with CKD and 190 healthy adults as a control group were prospectively enrolled. Before kidney biopsy, ultrasound viscoelastic imaging was performed to measure the mean stiffness value (Emean), mean viscosity coefficient (Vmean), and mean dispersion coefficient (Dmean) of the renal. CKD patients were divided into three groups based on estimated glomerular filtration rate. The differences in clinic, pathology, ultrasound image parameters between the control and patient groups, or among different CKD groups were compared. The correlation between viscoelastic parameters and pathology were analyzed. Results Emean, Vmean, and Dmean in the control group were less than the CKD group (p < 0.05). In the identification of CKD from control groups, the area under curve of Vmean, Dmean, Emean, and combining the three parameters is 0.90, 0.79, 0.69, 0.91, respectively. Dmean and Vmean were increased with the decline of renal function (p < 0.05). Vmean and Dmean were positively correlated with white blood cell, urea, serum creatinine, and uric acid (p < 0.05). Vmean is positively correlated with interstitial fibrosis and inflammatory cell infiltration grades (p < 0.001). Conclusions Ultrasound viscoelastic imaging has advantages in noninvasive quantitative identification and evaluating renal function of CKD. Emean > 6.61 kPa, Vmean > 1.86 Pa·s, or Dmean > 7.51 m/s/kHz may suggest renal dysfunction. Combining Vmean, Dmean, and Emean can improve the efficiency of identifying CKD.

Salivary Metabolites in Breast Cancer and Fibroadenomas: Focus on Menopausal Status and BMI.

to study the influence of the menopause factor and body mass index (BMI) on the biochemical composition of saliva and to evaluate the applicability of metabolic markers of saliva for the diagnosis of breast cancer. The case-control study involved 1438 people (breast cancer, n = 543; fibroadenomas, n = 597; control, n = 298). A comprehensive study of the biochemical composition of saliva was carried out using 36 parameters. When comparing the salivary biochemical composition in breast cancer, fibroadenomas, and controls, it is necessary to take into account the menopausal status, as well as BMI (less than 25 or more) for the group of patients with preserved menstrual function. A complex of biochemical parameters has been identified that change in saliva during breast cancer, regardless of menopause and BMI (total protein, urea, uric acid, NO, α-amino acids, GGT), as well as specific parameters that must be taken into account when analyzing individual subgroups (imidazole compounds, LDH, catalase, α-amylase). During the study of a separate group of patients with leaf-shaped (phyllodes) tumors, we found similarities with breast cancer in the changes in some biochemical parameters that can be attributed to metabolites of malignant growth (protein, α-amino acids, calcium, NO, pyruvate, peroxidase, α-amylase). We demonstrated changes in a wide range of salivary biochemical parameters depending on the presence of fibroadenomas and breast cancer. From the point of view of clinical practice, this may be useful information for monitoring the condition of patients with fibroadenomas, which are difficult to unambiguously classify based on instrumental diagnostics alone.

SHOPI (Sosialisasi Pencegahan Hipertensi): Building Community Resilience Against Hypertension in Banyuwangi, Indonesia

This community service was aimed at increasing knowledge to preventhypertension by utilizing the role of mother cadres of PKK, which stands for Pemberdayaandan Kesejahteraan Keluarga, a hamlet/village-level association focusing on family welfareand empowerment. These cadres are representatives of neighborhood associations (RT/Rukun Tetangga) in the village area. This community empowerment was held throughcounseling lectures. This activity was carried out in 2022; the data, which were theparticipants’ responses, were collected using pretest and post-test questionnaires. Thesampling was carried out using accidental sampling with a cross-sectional design. Thisactivity targeted 30 PKK mothers as representatives from each neighborhood in KarangrejoVillage, Banyuwangi Regency. This empowerment increased the knowledge of the targetcommunity regarding the prevention of hypertension by 22.7 points. The average score ofthe participants’ pretest was 52.26, and that of the post-test was 74.96. This is in line withstudies that found that community service activities carried out using the roles of cadresand the elderly showed optimal results in increasing the target communities’ knowledge inthe operation of tensimeters and measuring blood sugar, uric acid, and cholesterol as wellas increasing knowledge of cadres and the elderly in hypertension management, and dietarymanagement of hypertension. The SHOPI Project (Education on Hypertension Prevention)effectively enhances public awareness regarding hypertension prevention, with a focus onwomen from the PKK community in Karangrejo Village, Banyuwangi Regency.

A potential marker for increased LDL and hypertriglyceridemia risk

Background and objectives. Serum uric acid (SUA), traditionally associated with gout, is increasingly recognized for its potential role in cardiometabolic disorders, including dyslipidemia. Elevated SUA levels may influence lipid metabolism, thus enhancing cardiovascular disease risk. This study aims to explore the association between SUA levels, dyslipidemia, and related risk factors in a cohort of patients, contributing to a better understanding of their interplay and implications for cardiovascular health. Material and methods. We conducted a retrospective case series involving 30 participants selected from the outpatient Department of General Medicine. The study was approved by the Institutional Review Board, and informed consent was waived due to the retrospective design and use of de-identified data. Participants were aged 18 or older with available data on SUA, LDL cholesterol, and triglycerides, excluding those with a history of gout, renal impairment, or current use of urate-lowering medications. Data were analyzed using descriptive statistics, chi-square tests, and Mann-Whitney U tests, with significance set at p &lt;0.05. Results. The study population had a mean age of 54.7 ± 6.3 years and a mean BMI of 28.4 ± 2.4 kg/m². The mean SUA level was 6.9 ± 0.8 mg/dL, LDL cholesterol was 138 ± 13 mg/dL, and triglycerides were 162 ± 25 mg/dL. Dyslipidemia was present in 60% of the participants. Significant associations were found between hyperuricemia and dietary habits, family history of gout, CVD, and dyslipidemia, as well as the duration of hyperuricemia. Conclusion. Elevated SUA levels are significantly associated with dyslipidemia and other cardiovascular risk factors. The findings suggest the importance of managing SUA levels and lipid profiles concurrently to reduce cardiovascular risks. Further research is needed to explore the long-term cardiovascular outcomes of persistent hyperuricemia and dyslipidemia.

Serum uric acid level can predict asymptomatic brain metastasis at diagnosis in patients with small cell lung cancer

BackgroundThe aim of this study was to determine the relationship between serum uric acid level at diagnosis and asymptomatic brain metastasis in patients with extensive-stage small cell lung cancer.MethodsA total of 69 patients with extensive-stage small cell lung cancer without symptomatic brain metastases, whose serum uric acid level was measured at the time of diagnosis, were included in this retrospective cross-sectional study. The patients were divided into two groups as those with and without asymptomatic brain metastases. The Mann–Whitney U test was used for comparison between groups, and Spearman’s correlation test was used for correlation analysis. The cut-off level of serum uric acid level was analyzed, and sensitivity, specificity, and accuracy rates were determined for brain metastasis. Independent factors affecting asymptomatic brain metastasis were determined by multivariate Cox regression analysis.ResultsThe median serum uric acid level of all patients was 6.9 mg/dL. Twenty-two percent of patients had asymptomatic brain metastases, and serum uric acid levels were significantly higher in these patients (P = 0.0014). The cut-off value for serum uric acid level was calculated as 6.2 mg/dL. The sensitivity, specificity, and accuracy of this value for brain metastasis were 84%, 76%, and 78%, respectively. High serum uric acid level was an independent risk factor for asymptomatic brain metastasis (OR 3.446 95% CI 1.337–5.480; P = 0.005).ConclusionIn conclusion, a serum uric acid level of 6.2 mg/dL and above at the time of diagnosis may predict asymptomatic brain metastasis in patients.

Investigation of dual inhibition of antibacterial and antiarthritic drug candidates using combined approach including molecular dynamics, docking and quantum chemical methods

Emerging antibiotic resistance in bacteria threatens immune efficacy and increases susceptibility to bone degradation and arthritic disorders. In our current study, we utilized a three-layer in-silico screening approach, employing quantum chemical methods, molecular docking, and molecular dynamic methods to explore the novel drug candidates similar in structure to floroquinolone (ciprofloxacin). We investigated the interaction of novel similar compounds of ciprofloxacin with both a bacterial protein S. aureus TyrRS (1JIJ) and a protein associated with gout arthritis Neutrophil collagenase (3DPE). UTIs and gout are interconnected through the elevation of uric acid levels. We aimed to identify compounds with dual functionality: antibacterial activity against UTIs and antirheumatic properties. Our screening based on several methods, sorted out six promising ligands. Four of these (L1, L2, L3, and L6) demonstrated favorable hydrogen bonding with both proteins and were selected for further analysis. These ligands showed binding affinities of −8.3 to −9.1 kcal/mol with both proteins, indicating strong interaction potential. Notably, L6 exhibited highest binding energies of −9.10 and −9.01 kcal/mol with S. aureus TyrRS and Neutrophil collagenase respectively. Additionally, the pkCSM online database conducted ADMET analysis on all lead ligand suggested that L6 might exhibit the highest intestinal absorption and justified total clearance rate. Moreover, L6 showed a best predicted inhibition constant with both proteins. The average RMSF values for all complex systems, namely L1, L2, L3 and L6 are 0.43 Å, 0.57 Å, 0.55 Å, and 0.51 Å, respectively where the ligand residues show maximum stability. The smaller energy gap of 3.85 eV between the HOMO and LUMO of the optimized molecule L1 and L6 suggests that these are biologically active compound. All the selected four drugs show considerable stabilization energy ranging from 44.78 to 103.87 kcal/mol, which means all four compounds are chemically and physically stable. Overall, this research opens exciting avenues for the development of new therapeutic agents with dual functionalities for antibacterial and antiarthritic drug designing.

Subclinical carotid atherosclerosis in gouty patients: relation to musculoskeletal ultrasonographic findings and serum sclerostin level

Objectives. To detect subclinical carotid atherosclerosis in gout patients and its relation to musculoskeletal ultrasound (MSK US) manifestations and serum sclerostin (SCL) levels. Patients and methods. Thirty Egyptian gouty patients were classified into two groups: Group A included 15 patients with diagnostic MSK US manifestations of gout (double contour sign), and Group B included 15 patients without MSK US findings. MSK US was done for both knees and the first MTP joints. Carotid duplex ultrasonography was done to evaluate carotid intima-media-thickness (CIMT) and serum SCL level was measured in all patients by ELISA technique. Results. Gouty patients with MSK US findings had a significantly higher increase in serum SCL levels than those without MSK US findings (p &lt;0.01). Group A patients had a significantly greater CIMT than patients of group B (p &lt;0.01). Serum uric acid and SCL levels were found to be significantly positively correlated. The ROC curve revealed that the optimal SCL cutoff value for detecting positive MSK US findings in gout patients was &gt;25.05 ng/ml. At this level, there was a significant difference between the patients with a CIMT &gt;0.9 mm and the patients with a CIMT ≤0.9 mm (p &lt;0.05). Conclusions. Patients with MSK US manifestations of gout are more liable to have subclinical carotid atherosclerosis than patients without these manifestations. SCL at a certain level &gt;25.05 ng/ml in gout patients might predispose patients to radiographic findings of MSK US of gout and subclinical atherosclerosis.

Assessment of the renal function of patients with anorexia nervosa

BackgroundA decreased glomerular filtration rate (GFR), estimated using creatinine (Cr– eGFR), is often found at the initial presentation of anorexia nervosa (AN). Its pathophysiology has been explained mainly by dehydration, and chronic hypokalemia is also thought to be a cause. However, because we have often experienced cases of AN with decreased Cr-eGFR without these conditions, we must consider different etiologies. The focus of this paper is on low free triiodothyronine (FT3) syndrome. We also discuss the utility of eGFR, estimated using cystatin-C (CysC-eGFR), for these patients.MethodsThe data of 39 patients diagnosed with AN between January 2005 and December 2023 was available for study. The characteristics of patients at the lowest and highest body mass index standard deviation score (BMI-SDS) were examined. Data on the parameters Cr-eGFR, CysC-eGFR, dehydration markers, potassium (K), and hormonal data and BMI-SDS were assessed during the treatment course to evaluate the correlations in these parameters. Blood hematocrit, uric acid (UA), blood urine nitrogen (BUN) level, and urine specific gravity were adopted as dehydration markers; FT3, free thyroxine, thyroid stimulating hormone, and insulin-like growth factor were adopted as hormonal data. Cr-eGFR and simultaneously evaluated dehydration markers, K, or hormonal data were extracted and correlations associated with the changes in BMI-SDS were examined. Furthermore, Cr-eGFR and simultaneously assessed CysC-eGFR were compared.ResultsWhen the BMI-SDS was at the lowest value, low-FT3 syndrome was shown. Severe hypokalemia was not found in our study. A linear relation was not found between Cr-eGFR and BMI-SDS. A statistically significant correlation was found between Cr-eGFR and FT3 (p = 0.0025). Among the dehydration markers, statistically significant correlations were found between Cr-eGFR and BUN or UA. The difference between Cr-eGFR and CysC-eGFR was prominent, and CysC-eGFR showed much higher values.ConclusionsOur data indicates that low-FT3 syndrome and dehydration were related to the renal function of our patients with AN. Furthermore, our data suggest that caution is needed in the interpretation of kidney function evaluation when using CysC-eGFR in cases of AN.

FT-IR Spectroscopy Analysis of Kidney Stone Variability in Styria

Urolithiasis is a medically significant crystallization process affecting the urinary tract. Kidney stones exhibit considerable diversity as they form in complex environments containing various molecules and pathogens. Understanding the formation and occurrence of kidney stones is essential for developing strategies to prevent or reduce the invasiveness of treatments. In this study, we investigated over 300 cases of urolithiasis in Styria, Austria. The composition of the stones was evaluated using infrared spectroscopy and scanning electron microscopy. Most stones were found to be heterogeneous, predominantly composed of calcium oxalate, followed by calcium phosphate. Other components such as struvite, uric acid, and cystine were present to a lesser extent and were more likely to form homogeneous crystals. Analyzing the occurrence of these different stone types provides valuable insights into the formation processes of kidney stones and can aid in the prevention of urolithiasis in the future.