Uric Acid Values Research Articles

The Relationship of Gallestone Disease with Serum RBP4 Level, Vitamın D, Lipid Profile, Insulin Resistance and Uric Acid Levels

Abstract Aim The metabolic parameters associated with gallstones are the subject of numerous studies. RBP4, an adipokine, has been linked to various metabolic diseases; however, there is currently no study in the literature that clearly establishes its relationship with gallstone disease. Therefore, in our study, we aimed to evaluate the biochemical parameters associated with gallstone disease, primarily serum RBP4. Methods Between 2015 and 2016, abdominal ultrasound, serum biochemical tests, lipid profiles, uric acid, insulin, and fasting glucose values were available for 80 patients who presented to our hospital's gastroenterology clinic, were included in the study. RBP4 levels were analyzed in the serum samples obtained from the patients. Results Out of the 80 participants in the study, 42 had gallstones, while 38 did not. Among the biochemical parameters, no significant difference was found between the groups in terms of total cholesterol values (p= 0.483), LDL values (p=0.224), and TG values (p=0.764). A significant difference was observed between the two groups in terms of HDL values(p=0.017). No significant difference was found between the two groups in terms of serum uric acid (p=0.411), fasting glucose (p=0.214), fasting insulin, and HOMA-IR score (p=0.157), vitamin D levels (p=0.340). The mean±SD values of the studied serum RBP-4 levels in the participants were determined as 40.24±7.12 in the control group and 39.75±8.55 in the patient group. No statistically significant difference was found between the two groups (p=0.776). In correlation analyses; a significant positive correlation was found between RBP4 and vitamin D levels(r: 0.277, p= 0.013), total cholesterol (r: 0.268, p=0.016), triglycerides (r: 0.387, p

Patients With Type 2 Diabetes Mellitus and Early Diabetic Kidney Disease Exhibit Lower Computed Tomography-measured Skeletal Muscle Attenuation Values: A Propensity Score-matched Study

ObjectiveTo investigate the association between computed tomography (CT)-measured quality characteristics of skeletal muscle (SM) and early diagnosis of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). MethodsThis retrospective study included patients diagnosed with T2DM, with and without early DKD, between January 2019 and December 2021. To reduce potential bias, propensity score matching (PSM) was performed. The area and CT attenuation values for SM and different abdominal adipose depots were measured. After PSM, logistic and multiple linear regression analyse were performed to analyse risk factors for early DKD. ResultsA total of 267 patients were enrolled (mean age, 61.67 years ±10.87; 155 men) and divided into two groups: T2DM with early DKD (n=133); and T2DM without DKD (n=134). After PSM, 230 patients were matched (T2DM with early DKD [n=115]; and T2DM without DKD [n=115]), with no statistical differences in general characteristics between the two groups (P>0.05). In multivariate logistic regression analysis, high-density lipoprotein cholesterol (odds ratio [OR] 0.14; 95% confidence interval [CI] 0.04–0.49; P=0.002), uric acid (OR 1.01; 95% CI 1.00–1.01; P=0.006), and SM attenuation value (OR 0.94; 95% CI 0.90–0.98; P=0.003) were independent risk factors for early DKD. Multiple linear regression analysis revealed significant correlations between SM attenuation value and cystatin C (β=-0.39, P=0.004), urine albumin-to-creatinine ratio (β=-0.26, P=0.026), and estimated glomerular filtration rate (β=0.31 P=0.009) after adjustment for confounders. ConclusionT2DM patients with lower SM attenuation values may exhibit a higher risk for early DKD than those with higher values, which provides a potential imaging biomarker for early DKD diagnosis.

DEVELOPMENT AND INTERNAL VALIDATION OF A PREDICTION MODEL TO PREDICT THE PROBABILITY OF FUTURE RECURRENCE OF HYPERTENSION IN PATIENTS WITH HYPERTENSIVE DISORDERS OF PREGNANCY

Objective: This study aimed to obtain a clinical prediction model for the future recurrence of hypertension in women with a history of gestational hypertension or Preeclampsia-Eclampsia by analyzing the basic data and laboratory indicators in their pregnancy. Design and method: We retrieved hypertensive disorders of pregnancy (HDP) patients of the First Affiliated Hospital of Dalian Medical University and the Second Affiliated Hospital of Dalian Medical University from 2001 to June 2021. After telephone follow-up, a total of 605 pregnant women with previous HDP were followed up. The baseline data of the cases were followed by binary logistic regression analysis according to the follow-up hypertension outcome, Nomogram plotted according to independent risk factors, and the model discrimination was tested by operating characteristic curve (ROC), The reproducibility of the model was verified by internal validation on the development dataset (Bootstrap self-sampling method, internal cross-validation and Jackknife validation), verify the calibration of the model through the calibration curve (Hosmer-Lemeshow goodness of fit test), and Validation of clinical predictive value by Decision Curve Analysis (DCA). Results: data analysis showed that A total of 200 (33.06%) pregnant women with a previous history of HDP had recurrent hypertension during follow-up (median follow-up time was 5 years). The predictors in the Nomogram were the highest diastolic blood pressure (DBP) during pregnancy, the highest systolic blood pressure (DBP) during pregnancy, peak Alkaline phosphatase value, age at delivery, peak uric acid value, and positive urine protein, Contrary to the remaining 5 predictors, a low level of peak alkaline phosphatase value predicted a high risk of postpartum hypertension. the Area Under Curve (AUC) of ROC about the nomogram was 0.797, and a similar C-index was obtained in the internal validation, and this model show a high fitting degree in the calibration curve and show clinical predictive value. Conclusions: The results of this study can provide predictive indicators for women with HDP to suffer from hypertension after delivery, which can be used for clinical decision-making, and aid with follow-up blood pressure monitoring and the selection of primary prevention treatment groups.

Determination of Serum Biochemical Profile and Oxidant-Antioxidant Activities in Damascus Goats at Different Ages

This study aimed to research changes in biochemical profile and oxidant-antioxidant activities of Damascus goats of different ages. The 45 non-gravid Damascus goats of different ages were included in the research. They were divided into three groups of 15 goats according to age: goat kids ( - ≤ 6-months age), young goats (2-3-year age) and old goats (5-8-year age). Biochemical parameters and oxidant-antioxidant activities were determined in serum samples using commercial kits and colorimetric methods. The lowest serum urea, blood urea nitrogen, aspartate aminotransferase, total protein, albumin, globulin and magnesium levels were observed in goat kids (P < .05). Concentrations of glucose, inorganic phosphorus, non-esterified fatty acids, albumin/globulin and alanine aminotransferase decreased with age in the goats (P < .05). Serum total oxidant capacity, total antioxidants capacity and oxidative stress index levels were increased in goat kids compared to old goats (P < .05). Furthermore the highest serum glutathione and glutathione preoxidase activities were observed in young goats (P < .05). An increase was determined in concentrations of serum β-carotene and bilirubin in old goats compared to goat kids (P < .05). In contrast, serum catalase activity, arylesterase, ceruloplasmin and uric acid values did not differ between the groups. The results obtained on the biochemical profiles and oxidant-antioxidant activities of Damascus goats will contribute to monitoring this breed's age-related health and nutritional status and establishing reference values.

Relationship between serum uric acid and sarcopenia in geriatric heart failure patients with preserved ejection fraction

BackgroundHeart failure with preserved ejection fraction (HFpEF) presents a serious risk to human health. The increased prevalence of sarcopenia in the HFpEF population has a negative impact on patient prognosis. Uric acid (UA) is the byproduct of purine metabolism and is harmful to the cardiovascular system. This study aims to establish the potential relationship between sarcopenia and serum UA in HFpEF patients. MethodsData were obtained from 180 individuals (aged ≥60 years) with HFpEF admitted to the Geriatric Department of Jiangsu Province Hospital between January 2021 and December 2022. The UA values were grouped into 4 quartiles (Q1-Q4). Logistic generalized linear models and restricted cubic spline (RCS) regression were used to analyze the relationship between sarcopenia and UA. Subgroups based on gender were utilised for further analysis. ResultsAfter adjusting for covariates, odds ratios (ORs) and 95 % confidence intervals (CIs) for sarcopenia prevalence in the 2nd, 3rd, and 4th quartiles were 2.56 (0.57–12.65), 4.94 (1.10–24.49), and 6.95 (1.30–44.25), respectively, unlike the 1st quartile (P for trend = 0.022). The RCS plot demonstrated a positive linear relationship between serum UA levels and sarcopenia (P for non-linearity = 0.190). A sex-based subgroup analysis revealed a statistically significant relationship between UA and sarcopenia in males (P < 0.05). ConclusionsIn summary, the prevalence of sarcopenia is positively related to serum UA levels among the elderly diagnosed with HFpEF. Due to the cross-sectional nature of the study design, additional investigations are necessary to validate our findings and identify the optimal range for UA reduction.

E012 Burden and risk factors for cardiovascular involvement in connective tissue disease

Abstract Background/Aims Connective tissue diseases (CTD) are associated with several cardiovascular manifestations. Cardiovascular diseases (CVD) are significant cause of morbidity and premature death. The pathogenesis of CVD in CTD patients is incompletely understood and likely multifactorial. Traditional risk factors for atherosclerosis are common among patients with CTD as well as metabolic syndrome. Furthermore, diabetes, dyslipidaemia, hypertension, and obesity may all be exacerbated by connective tissue disease itself or treatment with glucocorticoids. The aim of this study was to assess the burden of CVD and the risk factors for the development of cardiovascular disease in patients with CTD. Methods This was a retrospective study from a single centre. We reviewed clinical records of CTD patients as determined by treating rheumatologist. This CTD cohort included patients with systemic lupus erythematosus (SLE), myositis, systemic sclerosis, Sjogren’s syndrome, mixed and undifferentiated connective tissue diseases. Data on demographic, clinical, laboratory parameters, cardiac investigations, treatment and outcome were collected from electronic patient records. CVD and traditional risk factors were defined using standard criteria. Results A total of 298 patients with CTD were included in the analysis. Mean age of the cohort was 61±17.7 years and majority were females (n = 240, 80.5%). Of the 298 patients, 64 had CVD (21.5%). Most common CVD was ischaemic heart disease (17 patients) followed by hypertension (12), arrhythmia (9), pulmonary arterial hypertension (7), valvular diseases (5), pericardial disease (3), cardiomyopathy (3), myocarditis (2), thromboembolism (3), aortic dissection (2) and coronary spasm (1). Patient with CTD who had CVD were older (72.5±12.2 years) compared to CTD patients who did not develop CVD (non-CVD group, 57.7±17.6 years). The duration of CTD was shorter in patients with CVD (88.9±41.7 months), compared to 106±84.3 months in non-CVD group. The risk factors such as smoking, diabetes and dyslipidaemia was higher in the CVD group. Comparing CVD vs non-CVD patients respectively, systolic BP (147.1±23.0 vs 133.6±18.3mmHg), diastolic BP (83.2 ± 16.3 vs 78.2 ± 11.2mmHg) and serum uric acid (321.8±97.4 vs 292±83.9mg/dL) values were higher and statistically significant (p &amp;lt; 0.05) in CVD group. Patients with CVD had longer exposure to steroids (50%) compared to non-CVD patients (31.6%). They required high dose steroids (9.4% vs 5.6% in non-CVD patients). Current and previous DMARD use was also higher in patients who had CVD (51.6% vs 44.9%). Conclusion This study has demonstrated high burden of cardiovascular disease in CTD patients. Traditional risk factors were more prevalent in the CVD group. DMARD’s and steroid use was also higher in the CVD group. Screening for cardiovascular diseases and disease control in CTD patients is paramount for better outcomes. Further analysis will be carried out for risk factors and relevant outcomes. Disclosure K.K. Garg: None. S. Sampath: None. A. Erinjogunola: None. B. Ting: None. H. Noori: None. G.M. Koduri: None.

Machine learning-enhanced drug testing for simultaneous morphine and methadone detection in urinary biofluids

The simultaneous identification of drugs has considerable difficulties due to the intricate interplay of analytes and the interference present in biological matrices. In this study, we introduce an innovative electrochemical sensor that overcomes these hurdles, enabling the precise and simultaneous determination of morphine (MOR), methadone (MET), and uric acid (UA) in urine samples. The sensor harnesses the strategically adapted carbon nanotubes (CNT) modified with graphitic carbon nitride (g-C3N4) nanosheets to ensure exceptional precision and sensitivity for the targeted analytes. Through systematic optimization of pivotal parameters, we attained accurate and quantitative measurements of the analytes within intricate matrices employing the fast Fourier transform (FFT) voltammetry technique. The sensor’s performance was validated using 17 training and 12 test solutions, employing the widely acclaimed machine learning method, partial least squares (PLS), for predictive modeling. The root mean square error of cross-validation (RMSECV) values for morphine, methadone, and uric acid were significantly low, measuring 0.1827 µM, 0.1951 µM, and 0.1584 µM, respectively, with corresponding root mean square error of prediction (RMSEP) values of 0.1925 µM, 0.2035 µM, and 0.1659 µM. These results showcased the robust resiliency and reliability of our predictive model. Our sensor’s efficacy in real urine samples was demonstrated by the narrow range of relative standard deviation (RSD) values, ranging from 3.71 to 5.26%, and recovery percentages from 96 to 106%. This performance underscores the potential of the sensor for practical and clinical applications, offering precise measurements even in complex and variable biological matrices. The successful integration of g-C3N4-CNT nanocomposites and the robust PLS method has driven the evolution of sophisticated electrochemical sensors, initiating a transformative era in drug analysis.

A nomogram clinical prediction model for predicting urinary infection stones: development and validation in a retrospective study.

This study aimed to develop a nomogram prediction model to predict the exact probability of urinary infection stones before surgery in order to better deal with the clinical problems caused by infection stones and take effective treatment measures. We retrospectively collected the clinical data of 390 patients who were diagnosed with urinary calculi by imaging examination and underwent postoperative stone analysis between August 2018 and August 2023. The patients were randomly divided into training group (n = 312) and validation group (n = 78) using the "caret" R package. The clinical data of the patients were evaluated. Univariate and multivariate logistic regression analysis were used to screen out the independent influencing factors and construct a nomogram prediction model. The receiver operating characteristic curve (ROC), calibration curves, and decision curve analysis (DCA) and clinical impact curves were used to evaluate the discrimination, accuracy, and clinical application efficacy of the prediction model. Gender, recurrence stones, blood uric acid value, urine pH, and urine bacterial culture (P < 0.05) were independent predictors of infection stones, and a nomogram prediction model ( https://zhaoyshenjh.shinyapps.io/DynNomInfectionStone/ ) was constructed using these five parameters. The area under the ROC curve of the training group was 0.901, 95% confidence interval (CI) (0.865-0.936), and the area under the ROC curve of the validation group was 0.960, 95% CI (0.921-0.998). The results of the calibration curve for the training group showed a mean absolute error of 0.015 and the Hosmer-Lemeshow test P > 0.05. DCA and clinical impact curves showed that when the threshold probability value of the model was between 0.01 and 0.85, it had the maximum net clinical benefit. The nomogram developed in this study has good clinical predictive value and clinical application efficiency can help with risk assessment and decision-making for infection stones in diagnosing and treating urolithiasis.

Evaluation of Renal Function Tests and Electrolytes in Iraqi Males with Repeated Smoking and Alcohol Abuse

Abstract Background: Wrong lifestyles such as smoking and drinking alcohol all lead to negative effects. Moreover, smoking is one of the most dangerous effects on people’s health, and it is considered one of the motives for slow suicide in humans, due to its consist deadly compounds and drinking alcohol has a dangerous effects too on people’s health. Objective: Is to estimate the variables at kidney function tests (uric acid, creatinine, and urea) and electrolytes like Na+, K+, and Cl−) in Iraqi male smokers. The major goal research is to check the variation on kidney function tests (uric acid, creatinine, and urea) and electrolytes like Na+, K+, and Cl−) in Iraqi alcoholic smokers males. Materials and Methods: This research carried out on 115 specimens of alcoholic smoker person’s sera bloods and nonalcoholic smoker persons from Iraqi males. Some kidney functions and electrolytes were determined included: uric acid, creatinine, and urea of kidney functions beside to sodium, potassium, and chloride of the electrolytes. Results: In this study, the results showed that affect smoking and alcohol consumption on kidney role was shown by the sera contents of urea, creatinine, uric acid, and urea values as it was observed that the sera contents of uric acid, creatinine, and urea were higher within alcoholic smokers persons compared with the blood specimens of the control group. The contents ranged of uric acid (5.99–9.25), creatinine (0.78–1.2), and urea contents were ranged between 26.3 and 30.03 of alcoholic smoker specimens. While the same markers in nonalcoholic smoker specimens (control group) were as following: uric acid (5.11), creatinine (0.69), and urea values (27.9) sequentially. Conclusion: There are a significant difference in serum Na+, K+, and Cl− in alcoholic smokers when compared to controls, also there are a significant difference in uric acid, urea, and creatinine levels.

Intersecting pathways: evaluating inflammatory markers and metabolism in chronic spontaneous urticaria with a multi-marker approach.

Chronic spontaneous urticaria (CSU) is an inflammatory skin disease with intricate mechanisms. This study comprehensively assessed markers from diverse metabolic pathways, including novel inflammatory indicators, to evaluate their potential for diagnosing and monitoring CSU. In the study involving 90 CSU patients and 90 healthy controls, the levels of albumin, high-density lipoprotein (HDL), fibrinogen, uric acid, D-dimer, C-reactive protein (CRP), and white blood cells (WBC) values were analyzed. The D-dimer/albumin ratio (DAR), fibrinogen/albumin ratio (FAR), and uric acid/HDL ratio (UHR), considered novel inflammatory markers, were calculated. The Urticaria Activity Score 7 (UAS7) was also calculated. Pearson chi-squared test, Mann-Whitney U test, Spearman correlation coefficient, and univariate logistic regression analysis were employed for data analysis. In the patient group, significant elevations were observed in DAR, FAR, fibrinogen, CRP, D-dimer, and UHR values. Additionally, albumin, HDL, and uric acid values exhibited significant decreases. HDL and albumin provided the most accurate results in the univariate logistic regression analysis. CRP had less accuracy, FAR exhibited greater accuracy than fibrinogen, and DAR demonstrated higher accuracy than D-dimer. There was no statistically significant correlation between the UAS7 and parameters. The considerable correlation of CRP with other parameters, except D-dimer, was also remarkable. Indicators from diverse metabolic pathways, including albumin, HDL, uric acid, fibrinogen, D-dimer, and CRP, can be valuable in assessing CSU. In particular, FAR and DAR are emerging as potential markers to consider in the assessment of CSU.

Evaluation of serum natural antioxidant levels in patients with schizophrenia, schizoaffective disorder, and bipolar disorder

Aims: Evidence for the role of oxidative stress in psychiatric disorders is growing. This study aimed to evaluate laboratory parameters related to oxidative stress, such as uric acid, albumin, and total bilirubin, which can be easily measured in serum in patients with schizophrenia, schizoaffective disorder, and bipolar disorder, and to compare them with healthy controls. Methods: The study included 221 patients diagnosed with schizophrenia, schizoaffective disorder, and bipolar disorder according to DSM-5 criteria and 104 healthy individuals. The patient and control groups were compared in terms of serum uric acid, albumin, and total bilirubin values. Results: A statistically significant difference was in uric acid levels among the schizophrenia group, schizoaffective disorder, bipolar disorder, and the control group (p&lt;0.001 for all). Similarly, significant differences were identified between the patient groups and the control group in terms of albumin levels (p= 0.002, p&lt;0.001, p&lt;0.001, p&lt;0.001, respectively). Total bilirubin levels also exhibited significant differences between schizophrenia and schizoaffective disorder, schizoaffective disorder and control group, and bipolar disorder and the control group (p&lt;0.04, p= 0.007, p= 0.044, respectively). Conclusion: Patients differed from controls in terms of serum natural antioxidants. The findings in our study support a causal relationship between schizophrenia, schizoaffective disorder, and bipolar disorder and uric acid, albumin, and total bilirubin.

Monocyte/High-Density Lipoprotein Ratio: An Indicator of Oxidative Stress and Disease Severity in Lichen Planus Patients

Aim: Although the etiopathogenesis of lichen planus is not clearly known, it has been noticed to be associated with various factors such as drugs, infections, autoimmune factors, genetic factors, and oxidative stress mechanisms. Oxidative stress is implicated in the pathogenesis of various diseases such as cancer and chronic inflammatory diseases. Complete blood count parameters can be utilized as oxidative stress diagnostic biomarkers for many diseases related to chronic inflammatory processes. In recent clinical studies, it has been shown that the monocyte/high-density lipoprotein (HDL) ratio (MHR) may be useful as a marker of oxidative stress in many chronic dermatoses. However, as far as we know, the relationship between oxidative stress and monocyte/HDL ratio in lichen planus cases has not been studied in the literature yet. Materials and Methods: The files of cases who were followed up with lichen planus in the dermatology clinic of a tertiary university hospital between February 2018 and July 2021 were reviewed retrospectively. There were 201 participants in the analysis, including 99 histopathologically and clinically verified LP cases and 102 age and sex-matched controls. Results: Monocyte values (p=0.16) and HDL levels (p=0.26) were not statistically different for both groups, but the MHR value (p=0.04) was detected to be statistically significantly higher in the lichen planus group than in the control group. In oral lichen planus cases, whilst the oral disease severity score and uric acid values were not correlated (p=0.11), the oral disease severity score was correlated with the CRP (p=0.03) and MHR (p=0.001) values. Conclusions: In the study, we found that MHR levels were significantly higher in lichen planus patients compared to the control group. Again, we detected that MHR had a better correlation with oral mucosa disease severity score than CRP. We suggest that MHR may be a potential index to assess disease activity in follow-up patients with lichen planus. Keywords: Lichen planus, oral mucosa, monocyte/high-density lipoprotein ratio

Serum Uric Acid Levels among Chinese Children: Reference Values and Association With Overweight/Obesity.

This study aimed to investigate the reference values for serum uric acid (SUA) levels and their association with overweight/obese in children. We conducted a retrospective analysis of 8522 participants, including 6227 normal weight children, aged 2 to 18 years in China. Among normal children, SUA levels increased with age, showing significant sex differences in children over 10 years. Age-specific and sex-specific 95% reference intervals for SUA levels were established. Furthermore, we observed that the percentage of overweight/obesity significantly increased as SUA quartiles rose. Elevated SUA levels were associated with a high odds ratio (OR) for overweight/obesity (OR = 4.45, 95% confidence interval = 3.33, 5.93). We propose that the 97.5th percentile is a suitable value for defining elevated SUA levels, and there is a positive correlation between SUA levels and the presence of overweight or obesity.

Postbiotic of Pediococcus acidilactici GQ01, a Novel Probiotic Strain Isolated from Natural Fermented Wolfberry, Attenuates Hyperuricaemia in Mice through Modulating Uric Acid Metabolism and Gut Microbiota.

Hyperuricaemia (HUA) is a disorder of purine metabolism, which manifests itself as an increase in uric acid production and a decrease in uric acid excretion, as well as a change in the structure of the intestinal microbiota. Most of the drugs currently used to treat HUA have significant side effects, and it is essential to find a treatment for HUA that is free of side effects. In this study, a novel strain, Pediococcus acidilactici GQ01, was screened from natural fermented wolfberry. The effects of both live bacteria GQ01 and its heat-killed G1PB postbiotic on HUA were investigated. The results showed that both probiotic GQ01 and G1PB postbiotics could effectively decrease blood uric acid, creatinine, and urea nitrogen levels in the HUA mice model. P. acidilactici GQ01 was more effective in inhibiting ADA activity, while G1PB postbiotics was more effective in inhibiting XOD activity. Meanwhile, GQ01 and G1PB were able to ameliorate liver and kidney tissue injury, upregulate the expression of ABCG2 in kidney and XOD gene in liver, downregulate the protein expression of URAT1 and GLUT9 in kidney, and therefore reduce the value of blood uric acid by decreasing the uric acid reabsorption and increasing the excretion of uric acid. Additionally, both probiotics and postbiotics could regulate the intestinal microbiota structure of HUA mice, so as to bring the dysfunctional intestinal composition back to normal. Furthermore, P. acidilactici GQ01 and G1PB postbiotics can increase the levels of acetic acid, propionic acid, and butyric acid in the intestinal tract, improve the intestinal function, and maintain the healthy homeostatic state of the intestinal tract. In summary, P. acidilactici GQ01 and its G1PB postbiotics may be developed as functional food or drug materials capable of treating HUA.

Predictive value of the serum uric acid to high-density lipoprotein cholesterol ratio for culprit plaques in patients with acute coronary syndrome

BackgroundHyperuricemia and low level of high-density lipoprotein cholesterol (HDL-C) are both risk factors for coronary artery disease (CAD). The uric acid to HDL-C ratio (UHR) has recently been identified as a new inflammatory and metabolic biomarker. However, the relationship between the UHR and coronary culprit plaques has not been fully investigated in patients with acute coronary syndrome (ACS).MethodsA total of 346 patients with ACS were enrolled in this study. Culprit lesion characteristics were assessed by optical coherence tomography (OCT). Logistic regression and linear correlation analyses were performed to assess the association between the UHR and culprit plaques. The predictive value of the UHR was investigated by receiver operating characteristic (ROC) curve analysis.ResultsThe percentages of typical culprit plaques, including ruptures, erosions and thrombi, were greater in the high-UHR subgroup than those in the low-UHR subgroup. A positive relationship was also found between the UHR and diameter stenosis (r = 0.160, P = 0.003) and between the UHR and area stenosis (r = 0.145, P = 0.007). The UHR was found to be independently associated with plaque rupture, erosion and thrombus. Furthermore, ROC analysis suggested that the UHR had a better predictive value than low-density lipoprotein cholesterol.ConclusionsAn elevated UHR level was independently related to the occurrence rate of culprit plaques. The UHR is a simple and easily acquired parameter for detecting culprit plaques in patients with ACS.

Prophylactic effects of Combretum molle boughs on changes in the hematological, biochemical, and histological parameters in dexamethasone-induced insulin-resistant rats

BackgroundCombretum molle (Combretaceae) is a plant used in Cameroon traditional medicine to treat diabetes mellitus. To our knowledge, no studies have been performed on the preventive effects of C. molle on change in hematological, biochemical, and histological parameters of insulin-resistant rats. The aim of the study was to evaluate the preventive effect of C. molle on changes in the hematological biochemical, and histological parameters of insulin-resistant rats. MethodsInsulin resistance was induced for 10 days by subcutaneous injection of dexamethasone (1 mg/kg), one hour after oral pretreatment of animals with distilled water, metformin (40 mg/kg), and C. molle extract (250 and 500 mg/kg). Hematological profile (red blood cells, white blood cells, platelets and their indices), biomarkers of renal and hepatic function, hepatic glycogen level, activity of hepatic enzymes of carbohydrate metabolism, and histological sections of kidney, liver and pancreas were assessed. ResultsC. molle extract (250 and 500 mg/kg) caused a significant decrease (p < 0.05 to p < 0.001) in white blood cells, platelets count, and the activities of fructose 6-diphosphatase, glucose-6-phosphate dehydrogenase, and transaminases. It also caused significant increase (p < 0.05 to p < 0.001) in red blood cells, hemoglobin, albumin, glycogen, urea, uric acid, and creatinine values, and fructose-1,6-diphospatase and glucokinase activity. Histological examination revealed regeneration of beta-cells of the pancreatic islets and preventive renal and hepatic tissues against damages caused by impact of dexamethasone. ConclusionC. molle extract protected insulin-resistant patients from hematological, biochemical, and histopathological changes, there by validating the merits of the use of this plant in traditional medicine to treat diabetes mellitus and its complications.

Uric acid in predicting the traumatic rhabdomyolysis induced acute kidney injury; a systematic review and meta-analysis

ObjectiveThe objective of this systematic review and meta-analysis was to assess the value of uric acid in predicting acute kidney injury caused by traumatic rhabdomyolysis.MethodsThe search was conducted in MEDLINE, Scopus, Embase and Web of Science until November 1, 2023. Based on the inclusion and exclusion criteria, the articles were included by two independent researchers. Data regarding study design, patient characteristics, number of patients with and without AKI, mean and SD of uric acid and prognostic characteristics of uric acid were extracted from relevant studies. STATA version 17.0 was used to compute pooled measures of standardized mean differences, odds ratios, and diagnostic accuracy. I2 and chi-square tests were used to assess heterogeneity between studies.ResultsWe found 689 non-redundant studies, 44 of them were potentially relevant. Six articles met the inclusion criteria and were included in the review. The results of the meta-analysis confirmed that there was a significant correlation between serum uric acid levels and the occurrence of AKI (SMD = 1.61, 95% CI = 0.69 to 2.54, I2 = 96.94%; p value = 0.001). There were no significant publication biases.ConclusionAccording to this meta-analysis, uric acid levels could be considered as a predictor of acute kidney injury following traumatic rhabdomyolysis.

Association of maternal serum uric acid levels with LBW/SGA: a large retrospective cohort study

BackgroundElevated maternal serum uric acid (UA) levels were associated with adverse perinatal outcomes. This study aimed to examine the association between UA and the risk of low birth weight (LBW) / small for gestational age (SGA).MethodsA cohort study of women delivered in Shanghai maternity hospital was included between 2017 and 2021. Electronic medical records were utilized to extract information and antenatal care records. The cut-off value of UA was 360 μmol/L. The outcome was LBW/SGA, with LBW defined as birth weight below 2500 g and SGA indicating birth weight below the 10th percentile of average weight for gestational age. The assessment of SGA was based on the Chinese standard curve for birth weight at various gestational ages. Univariate, multivariate logistic regression models, restricted cubic spline were used in this study, with adjustments made for confounding factors.ResultsSixty-nine thousand six hundred seventy-four live births and singleton pregnancies were included. The ratio of LBW/SGA was 3.3%/9%. Maternal UA levels were significantly negatively correlated with birth weight. High UA levels were associated with high risk of LBW/SGA, especially in third trimester. In BMI < 25 group, the risk of LBW increased to 2.35-fold (95%CI, 1.66–3.31) in hyperuricemic group (UA > 360 μmol/L). The SGA risk was 1.66-fold (95%CI, 1.37–2.00). Gestational hypertension (GH) with hyperuricemica increased the risk of LBW (aOR = 4.00, 95%CI, 2.01–7.93) and SGA (aOR = 2.63, 95%CI, 1.83–3.78). Preeclampsia (PE) with hyperuricemia increased the risk of LBW (aOR = 1.38, 95%CI, 0.63–3.03) and SGA (aOR = 1.81, 95%CI, 1.18–2.78). In delivery gestational week (DGW) ≥ 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.46-fold (95%CI, 1.62, 3.73) and the incidence of SGA increased to 1.52-fold (95%CI, 1.24, 1.87). In DGW < 37 group, if UA > 360 μmol/L, the incidence of LBW increased to 2.70-fold (95%CI, 1.92, 3.80) and the incidence of SGA increased to 2.13-fold(95%CI, 1.50, 3.02).ConclusionsThe study found an inverse correlation between UA levels and birth weight. High UA levels were associated with increased risk of LBW/SGA, particularly in third trimester. GH or PE complicated by hyperuricemia were found to have significantly higher risk of developing LBW/SGA. This relationship also existed in pregnant women with BMI < 25.

The usefulness of point-of-care ultrasound in dehydrated patients in a pediatric emergency department

BackgroundsDehydration is among the most common causes of Pediatric Emergency Department admission; however, no clinical signs, symptoms, or biomarkers have demonstrated sufficient sensitivity, specificity, or reliability to predict dehydration.MethodsWe conducted a prospective, monocentric, observational study at Giannina Gaslini Hospital, a tertiary care pediatric hospital. Our study aimed to compare inferior vena cava ultrasound measurement with volume depletion biomarkers to understand if point-of-care ultrasound could help grade, evaluate, and better manage dehydration in children presenting to the pediatric emergency department. We enrolled patients under the age of 14 who required blood tests in the suspect of dehydration; for each patient, we collected values of venous pH, natremia, bicarbonatemia, uric acid, chloremia, and blood urea nitrogen. For each patient, we performed two ultrasound scans to calculate the Inferior Vena Cava/Aorta area ratio and to assess the IVC collapsibility index; moreover, we described the presence of the “kiss sign” (100% IVC walls collapsing during the inspiratory phase).ResultsPatients with the “kiss sign” (25/65 patients, 38.5% of the total) showed worse blood tests, in particular, uric acid levels (p = 0.0003), bicarbonatemia (p = 0.001) and natriemia (p = 0.0003). Moreover, patients with the “kiss sign” showed a high frequency of ≥ 2 pathological blood tests (p = 0.0002). We found no statistical significant difference when comparing the IVC/Ao ratio and IVC-CI with the considered blood tests.ConclusionsThe “kiss sign” seems to be related to worse hydration state, whereas IVC/Ao and IVC-CI are not. In an emergency setting, where physicians must take diagnostic-therapeutic decisions quickly, the presence of the “kiss sign” in patients suspected to be dehydrated can be a helpful tool in their management.

Effect of Dapagliflozin on Serum Uric Acid Levels in Patients with Advanced Chronic Kidney Disease.

Objective Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are hypoglycemic agents, have been shown to be cardioprotective through a variety of mechanisms, and the effect of lowering uric acid (UA) levels may be one of the mechanisms. In the present retrospective study, we investigated the changes in serum UA levels in patients with chronic kidney disease (CKD) treated with SGLT2 inhibitors. Methods We included 31 patients with CKD who were newly started on dapagliflozin for renal protection and evaluated trends in various parameters, including serum UA levels and UA excretion from urine. Results The patients' median age was 71 years old, 20 patients were men, 7 patients had diabetes, and the median estimated glomerular filtration rate was 33.9 mL/min/1.73 m2 (CKD stage 3: 21 cases, stage 4: 10 cases). The differences in UA and fractional excretion of UA after three weeks and three months of prescription showed significantly decreased UA values and an increased fractional excretion of UA. Conclusion Our findings suggest that dapagliflozin can lower serum UA levels via increased UA excretion, even in patients with advanced CKD.