Venous Blood Samples Research Articles

Evaluation of lipid profile and hematological parameters among patients attending Ram Janaki Hospital, Janakpurdham

Background & Objectives: Hematological and lipid profiles play crucial roles in assessing healthconditions and monitoring physiological abnormalities. Hematological and lipid profiles serve as valuable tools in this context, providing insights into various health conditions. However, due to various factors like diet, socioeconomic status, and literacy, these profiles can differ significantly across populations. Therefore, we aimed to find out the hematological as well as biochemical parameters among the patients attending Ram Janaki Hospital, Janakpurdham.Materials and Methods: This hospital based study involved 140 patients attending the medicineOPD between September 2023 and February 2024. Anthropometric measurements, blood pressure,and BMI was calculated. Venous blood samples were collected. Hematological parameters wereassessed using a fully a utomated hematology analyzer, while lipid profiles were evaluated usingsemi analyzer Erba Chem 7 analyzer with ErbaDiagnostics kits. Data analysis was performedusing SPSS version 21.Results: The study population comprised an equal distribution of males and females. Males exhibitedhigher values in weight, height, BMI, and blood pressure as compared to females. Hematologicalanalysis revealed higher hemoglobin levels, red blood cell counts, and packed cell volume in males,while females showed higher total leukocyte counts. Lipid profile analysis indicated higher totalcholesterol and LDL levels in males, whereas females had higher HDL, triglyceride, and VLDLlevels. Conclusion: The finding highlights significant gender based differences in anthropometric,hematological, and biochemical parameters among patients in Janakpurdham. The findings emphasizethe importance of considering gender differences in clinical evaluations and treatment plans. Theobserved variations from international norms underscore the need for population specificreference ranges.

The relationship between the effect of panic attack and physiological parameters in some patients and animals lab

The effects of a panic attack were studied in some patients who do not have hereditary diseases "sudden onset" as well as using laboratory animal "rats" to examine the types of effects on some physiological parameters. compared with control. These attacks affect daily life and result from a complex interaction between environmental, neurological, and psychological factors. Venous blood samples were collected from people suffering from non-genetic diseases. Blood samples were also collected from experimental animals exposed to fear at intervals of 0, 3, 7, and 28 days to detect the relationship between environmental factors and some physiological factors. Statistical analysis was performed using the SPSS program. The results indicated an increase in the level of cholesterol, glucose, and C-reactive protein in people with non-genetic diseases compared to their decrease in the control group, in addition to an increase in the level of cholesterol and glucose and no effect on C-reactive protein in rats exposed to the impact of fear and low body weight. The results also show a significant increase in heart and breathing rates and a significant decrease in oxygen levels.

Evaluation of Prothrombin and Activated Partial Thromboplastin Time in Patients with Diabetes Mellitus

Diabetes mellitus (DM) is a metabolic disease accompanied by high blood glucose due to a defect in insulin secretion, insulin activity, or both. High blood glucose levels may lead to serious damage to some organs of the body, mainly blood vessels and nerves. Therefore, this study was conducted to evaluate prothrombin time (PT) and activated partial thromboplastin time (APTT) in diabetic patients. 100 venous blood samples were collected from diabetic patients attending the diabetes clinic in Sebha. Of them, 57 were males and 53 were females, and their ages ranged between 15-88 years. out of 100, 48 Were treated with insulin-regulating tablets and 52 Were treated with insulin injections. 34 blood samples were collected from healthy people (15 females and 19 males). They were used as a control group, aged between 14-55 years. 4 ml of venous blood was drawn, and 2 ml was placed in containers containing the anticoagulant sodium citrate to perform the PT and APTT. Place 2 ml of sample in tubes containing sodium fluoride anticoagulant to perform a fasting blood sugar (FBS). Place the tubes in a centrifuge at 3000 rpm to obtain plasma. The results showed the mean of PT in patients was (19.4 ± 3.6), the mean APTT was (35.9 ± 1.5) and the Mean FBS was (229.7 ± 80.39), whereas the mean PT, APTT, and FBS in control were (12.8 ± 1.6), (25.4 ± 2.1), and (91.9 ± 12.5) respectively. there was a significant increase of PT and APTT in patients compared to control (P<0.05), PT and FBS were higher in patients who used insulin injection with significant differences(P<0.05), while no significant differences were in APTT (P > 0.05). The present study observed a statistically significant increase in PT and APTT among patients compared to controls, it would be helpful to incorporate coagulation screening as a routine investigation for the better management of diabetic patients.

Beta Trace Protein as a Potential Biomarker for CSF-Venous Fistulas.

Accurately identifying patients with CSF-venous fistulas (CVF), one cause of spontaneous intracranial hypotension (SIH), is a diagnostic dilemma. This conundrum underscores the need for a CVF biomarker to help select who should undergo an invasive myelogram for further diagnostic workup. Beta trace protein (BTP) is the most abundant CNS derived protein in the CSF and therefore is a potential venous biomarker for CVF detection. The purpose of our study was to measure venous BTP levels as a potential CVF biomarker. We prospectively enrolled 14 patients with CVF and measured BTP in venous blood samples from the paraspinal veins near the CVF and compared those levels to the peripheral blood. Myelograms used initially to identify the CVF were evaluated for modality, CVF laterality, CVF level, and venous drainage pattern. Patient sex, patient age, and symptom duration were also collected. Brain MR images were reviewed for Bern scores. We also measured the peripheral blood BTP levels in 20 normal controls. In patients with CVF, the mean BTP level near the CVF was 54.5% higher (0.760 [SD 0.673] vs 0.492 [SD 0.095] mg/L; p = 0.069) compared to peripheral blood. Nine (64.3%) patients with CVF had a higher paraspinal BTP level than peripheral BTP level. The 20 control patients had a higher the mean peripheral BTP level 0.720 (SD 0.191) mg/L compared to patients with CVF (p<0.001). We found that venous blood at the site of CVF had higher BTP values compared to peripheral blood in the majority, but not all patients with CVF. This may reflect the intermittent leaking nature of CVF. Additionally, we found that patients with CVF had a lower peripheral blood BTP level compared to normal controls. BTP requires further evaluation as a potential CVF biomarker. SIH = Spontaneous Intracranial Hypotension; CVF = CSF-Venous Fistula; CTM = CT myelogram; DSM = Digital Subtraction Myelography; BTP = Beta Trace Protein.

Analytical and clinical validation of an LC-MS/MS method for carbamazepine, lamotrigine and levetiracetam in dried blood spots

ObjectivesTherapeutic drug monitoring is performed routinely in patients on anti-epileptic drugs (AEDs) for optimisation and individualisation of therapy. The dried blood spot (DBS) sampling technique is a suitable, more patient-friendly...

Mean Platelet Volume/Platelet Count Ratio and Dipper/Non-Dipper Hypertensive Patients.

There is an interaction between mean platelet volume (MPV), platelet count (PC), inflammation, and platelet reactivity. The present study evaluated the relationship between the MPV/PC ratio and blood pressure (BP) using 24h ambulatory BP monitoring (ABPM). A total of 720 patients (male: 291) were included in the study. Based on the ABPM outcomes, they were divided into two groups: dipper hypertensive (n = 350; male: 136) and non-dipper hypertensive (n = 370; male: 155). Peripheral venous blood samples obtained at admission were used for PC and MPV calculations. Both groups displayed identical clinical characteristics. Non-dipper hypertensives had a higher MPV/PC ratio than dipper hypertensives [0.044; (0.036-0.055); 0.036 (0.030-0.042); P < .001]. According to receiver operating characteristic (ROC) curve analysis, the optimal cut-off value of the MPV/PC ratio for predicting non-dipper patterns in hypertensive patients was 0.040 (area under the curve [AUC]: 0.726, P < .001). Sensitivity was 64.1% and specificity was 64.3%. The MPV/PC ratio may represent mechanisms involved in increasing cardiovascular risk in non-dipper hypertensives compared with dipper hypertensives.

Prevalence and management of iron deficiency anemia in pregnancy in a tertiary care hospital over a period of 2 years

Background and Objectives: Anemia in pregnancy is highly prevalent and can have a significant effect on both maternal and fetal outcome. The most prevalent kind of nutritional anemia that occurs during pregnancy is iron deficiency anemia. Even with the use of oral iron prevention during pregnancy, IDA remains a significant health concern for expectant mothers. The current study intends to examine the treatment response and prevalence of IDA in a pregnant population. Methods: This is a retrospective cohort study looking into the prevalence of iron deficiency anaemia amongst pregnant women who delivered in a Tertiary care Hospital for a period of 2 years (Feb2022- Jan2024). All patients who got prenatal care at our hospital had their hemoglobin levels regularly evaluated at booking and at 28 weeks and 36 weeks pregnant and more often as needs by either a venous or capillary blood sample, are included in the inclusion criteria. We use the mid-trimester hemoglobin level to identify patients who are anemic among our study volunteers. SPSS was used for analysis. Results- the prevalence of anemia was found to be 59.4% (N=297) mostly being Iron deficiency anemia. 6 patients were Thalassemia minor and 1 patient was Sickle cell carrier The most common age group was found to be 20-35 years in which 60.2% were anemic. Around 59% of anemic had tertiary form of education and parity 63% for 2-4. The most common category was mild anemia (82%), moderate in 15%. After 36 weeks the anemia levels were improved in all category only 12.4% had mild while no severe anemia was seen. But this was not statistically significant (p&gt;0.05). The incidence of PPH were 2.7% in treated anemic patients while 1.7% in anemic Conclusion: Anemia in Pregnancy is highly prevalent and if left untreated can have a significant effect on both Maternal and fetal outcome. Prevention, Health education on reproductive health from early childhood and Adolescent age is highly recommended.Eraly diagnosis and Prompt management of anaemia in Pregnant females by oral Iron or Iron infusion helps in a better outcome . Parenteral iron therapy should be used as soon as possible to enhance treatment outcomes. And also helps in avoiding the need for Blood transfusion.

Effects of Interrupting Prolonged Sitting with Light-Intensity Physical Activity on Inflammatory and Cardiometabolic Risk Markers in Young Adults with Overweight and Obesity: Secondary Outcome Analyses of the SED-ACT Randomized Controlled Crossover Trial.

Sedentary behavior (SB) is an essential risk factor for obesity, cardiovascular disease, and type 2 diabetes. Though certain levels of physical activity (PA) may attenuate the detrimental effects of SB, the inflammatory and cardiometabolic responses involved are still not fully understood. The focus of this secondary outcome analysis was to describe how light-intensity PA snacks (LIPASs, alternate sitting and standing, walking or standing continuously) compared with uninterrupted prolonged sitting affect inflammatory and cardiometabolic risk markers. Seventeen young adults with overweight and obesity participated in this study (eight females, 23.4 ± 3.3 years, body mass index (BMI) 29.7 ± 3.8 kg/m2, glycated hemoglobin A1C (HbA1c) 5.4 ± 0.3%, body fat 31.8 ± 8.2%). Participants were randomly assigned to the following conditions which were tested during an 8 h simulated workday: uninterrupted prolonged sitting (SIT), alternate sitting and standing (SIT-STAND, 2.5 h total standing time), continuous standing (STAND), and continuous walking (1.6 km/h; WALK). Each condition also included a standardized non-relativized breakfast and lunch. Venous blood samples were obtained in a fasted state at baseline (T0), 1 h after lunch (T1) and 8 h after baseline (T2). Inflammatory and cardiometabolic risk markers included interleukin-6 (IL-6), c-reactive protein (CRP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), visceral fat area (VFA), triglyceride-glucose (TyG) index, two lipid ratio measures, TG/HDL-C and TC/HDL-C, albumin, amylase (pancreatic), total protein, uric acid, and urea. We found significant changes in a broad range of certain inflammatory and cardiometabolic risk markers during the intervention phase for IL-6 (p = 0.014), TG (p = 0.012), TC (p = 0.017), HDL-C (p = 0.020), LDL-C (p = 0.021), albumin (p = 0.003), total protein (p = 0.021), and uric acid (p = 0.040) in favor of light-intensity walking compared with uninterrupted prolonged sitting, alternate sitting and standing, and continuous standing. We found no significant changes in CRP (p = 0.529), creatinine (p = 0.199), TyG (p = 0.331), and the lipid ratios TG/HDL-C (p = 0.793) and TC/HDL-C (p = 0.221) in response to the PA snack. During a simulated 8 h work environment replacement and interruption of prolonged sitting with light-intensity walking, significant positive effects on certain inflammatory and cardiometabolic risk markers were found in young adults with overweight and obesity.

Precision and accuracy of four handheld blood lactate analyzers across low to high exercise intensities

PurposeTo evaluate the precision and accuracy in measured blood lactate concentrations among four commonly used handheld lactate analyzers compared to two stationary analyzers.MethodsVenous blood samples were taken at exercise intensities ranging from low to high. The blood lactate concentration was measured simultaneously with four pairs of handheld lactate analyzers (two new units of each brand: Lactate Plus, Lactate Pro2, Lactate Scout 4, and TaiDoc TD-4289), and compared with two stationary analyzers (Biosen C-Line and YSI Sport 1500). Measurements were repeated for a range of blood lactate concentrations (measured with Biosen) from 0.88 to 4.89 mM with a median difference between measurements of 0.10 mM.ResultsThe mean relative differences to the Biosen analyzer were -\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$-$$\\end{document}7% (Plus), 7% (Pro), -\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$-$$\\end{document}10% (Scout), 42% (Tai), and -\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$-$$\\end{document}32% (Ysi). The residual standard errors after linear regression against Biosen were 0.18 mM (Plus), 0.20 mM (Pro), 0.22 mM (Scout), 0.15 mM (Tai), and 0.06 mM (Ysi). Accordingly, a blood lactate concentration of 3 mM measured with Biosen yielded 95% prediction intervals that were 0.72 mM (Plus), 0.80 mM (Pro), 0.87 mM (Scout), 0.60 mM (Tai), and 0.23 mM (Ysi) wide.ConclusionCompared to our two stationary analyzers, the precision of the four handheld lactate analyzers evaluated in this study was poor. Among the four, Tai was the most precise; however, this analyzer had low accuracy with a substantial mean difference to the reference analyzer.

Protocol of the Nutritional, Psychosocial, and Environmental Determinants of Neurodevelopment and Child Mental Health (COINCIDE) study

Background Over 250 million children are developing sub-optimally due to their exposure to early life adversities. While previous studies have examined the independent effects of nutritional status, psychosocial adversities, and environmental pollutants on children’s outcomes, little is known about their interaction and cumulative effects. Objectives This study aims to investigate the independent, interaction, and cumulative effects of nutritional, psychosocial, and environmental factors on children’s cognitive development and mental health in urban and rural India. It also seeks to explain pathways leading to inequities in child development outcomes at the individual, household, and neighbourhood levels. Methods A mixed-methods prospective cohort study will be conducted on 1600 caregiver-child dyads (child age 3–9 years) in urban and rural India. Nutritional status, psychosocial adversities, environmental pollutants, and child mental health outcomes will be assessed using parent-report questionnaires. Performance-based measures will be used to assess cognitive outcomes. Venous blood and urine samples will be used to measure nutritional and pesticide biomarkers in 500 children. Indoor air pollution will be monitored in 200 households twice, during two seasons. Multilevel regression, weighted quantile sum regression, and Bayesian kernel machine regression will assess the individual and combined effects of exposures on child outcomes. Thematic analysis of in-depth interviews and focus group discussions will explore pathways to early childhood development inequities. Discussion The data will be used to formulate a Theory of Change (ToC) to explain the biological, psychosocial, and environmental origins of children’s cognitive and mental health outcomes across the first decade of life in diverse Indian settings, which will then inform context-specific intervention targets for promoting children’s outcomes beyond the first 1000 days, potentially generalizable to similar under-resourced global settings. The COINCIDE research infrastructure will comprise a valuable global health resource, including prospective cohort data, validated study tools, and stored biological and environmental samples for future studies.

Diagnostic utility of the average peak LH levels measured during GnRH stimulation test.

Gonadotropin-releasing hormone (GnRH) test is the gold standard test to evaluate the hypothalamus-pituitary-gonadal (HPG) axis for the diagnosis of central precocious puberty (CPP). However, the diagnosis of cases with clinical features of CPP whilst have borderline peak luteinizing hormone (LH) remain challenges. We aimed to evaluate diagnostic performance of the average of LH levels measured during GnRH stimulation test. Cases with diagnosis of CPP and premature thelarche (PT) who had a GnRH stimulation test results were retrospectively reviewed. Anthropometric measurements (weight, height, and body mass index), age and sex-specific standard deviation scores, growth velocity, puberty stages, bone ages, serum FSH, LH, and estradiol levels were measured by electrochemiluminescence immunological method (ECLIA), and the GnRH stimulation test results, which performed by obtaining venous blood samples at basal, 20th, and 40th minutes for FSH and LH measurement, were recorded. A total of 76 girls (38 CPP, 38 PT) were included. We detected an average peak LH cut-off value of 4.25 IU/L with 94.7 % sensitivity and 97.4 % specificity, a 97.3 % positive predictive value, and a 94.9 % negative predictive value in GnRH test to differentiate cases with CPP from PT. This is the first study evaluating the diagnostic utility of the average of LH levels measured during GnRH stimulation test. We showed that the average of two LH measurements has a high diagnostic performance. Therefore, it can be used as a valid and reliable diagnostic tool for assessment of HPG axis activation, particularly for cases with a borderline peak LH level.

Training with reduced carbohydrate availability affects markers of bone resorption and formation in male academy soccer players from the English Premier League

PurposeTo test the hypothesis that training with reduced carbohydrate (CHO) availability increases bone resorption in adolescent soccer players.MethodsIn a randomised crossover design, ten male players (age: 17.4 ± 0.8 years) from an English Premier League academy completed an acute 90-min field-based training session (occurring between 10:30–12:00) in conditions of high (TRAIN HIGH; 1.5 g.kg−1, 60 g, 1.5 g.kg−1 and 1.5 g.kg−1 consumed at 08:00, during training, 12:30 and 13:30, respectively) or low CHO availability (TRAIN LOW; 0 g.kg−1). Participants also completed a non-exercise trial (REST) under identical dietary conditions to TRAIN LOW. Venous blood samples were obtained at 08:30, 10:30, 12:30 and 14:30 for assessment of bone resorption (βCTX), bone formation (PINP) and calcium metabolism (PTH and ACa).ResultsExternal training load did not differ (all P > 0.05) between TRAIN HIGH and TRAIN LOW, as evident for total distance (5.6 ± 0.8; 5.5 ± 0.1 km), average speed (81 ± 9; 85 ± 12 m.min−1) and high-speed running (350 ± 239; 270 ± 89 m). Area under the curve for both βCTX and PINP was significantly greater (P < 0.01 and P = 0.03) in TRAIN LOW versus TRAIN HIGH, whilst no differences in PTH or ACa (P = 0.11 and P = 0.89) were observed between all three trials.ConclusionCHO restriction before, during and after an acute soccer training session increased bone (re)modelling markers in academy players. Despite acute anabolic effects of bone formation, the long-term consequence of bone resorption may impair skeletal development and increase injury risk during growth and maturation.

Characteristics of the hemostatic system “P-selectin — von Willebrand factor — metalloprotease ADAMTS13” during childbirth

Introduction. The physiological task of the blood coagulation system during childbirth is to prevent excessive blood loss.Aim: to evaluate the quantitative and qualitative characteristics in the system P-selectin-von Willebrand factor (vWF)-metallo-protease ADAMTS13 during natural and uncomplicated childbirth in women with a physiological pregnancy.Materials and methods. The study included 40 pregnant women without somatic pathology, with a physiologically progressing pregnancy that ended with physiological birth (general group). Of these, 16 women had their first birth (group 1), 18 had their second birth (group 2) and 6 had their third birth (group 3). Venous blood sampling was performed at three points throughout the study: 1st point — the onset of labor, 2nd point — 2 hours after childbirth and 3rd point — 24 hours after child -birth. The control group consisted of 25 healthy non-pregnant women. The blood samples were examined for: vWF antigen (vWF:Ag), binding ability of vWF to platelet receptor GPIb (vWF:GPIb), binding ability of vWF to collagen type I (vWF:CBAI) and type III (vWF:CBAIII), antigen and activity ADAMTS13 (ADAMTS13:Ag and ADAMTS13:AC), antibodies to ADAMTS13 (ADAMTS13:AB) and P-selectin.Results. The medians of the studied vWF characteristics in the genera l group were statistically significantly higher compared to the control group at all study points, with the exception of the medians of the vWF:GPIb/vWF:Ag ratio, which in the general group were statistically significantly lower at all study points when compared with the control group. The median values of vWF:GPIb and vWF:Ag in women in the second group were statistically significantly higher at all points of the study, compared with similar indicators in both the first and third groups. The median values of ADAMTS13:AC and ADAMTS13:AB in the overall group were statistically significantly higher when compared with the control group at all study points. Median ADAMTS13:Ag and ADAMTS13:AC/ADAMTS13:Ag ratios were statistically significantly lower at all study points. Individual P-selectin values varied widely from 212.1 to 1398 ng/ml, but the medians of this indicator were statistically significantly higher in all study groups and at all study points compared to the control group.Conclusion. The increase in platelet-binding and collagen-binding abilities of vWF suggests that these adhesive properties of the hemostatic protein play an important role in preventing excessive bleeding during labor. Taking into account the decrease in the vWF:GPIb/vWF:Ag ratio compared to the control group, the adhesion of vWF to collagen is more important under these conditions. Despite the fact that ADAMTS13 concentration does not decrease, an actual twofold increase in its activity provides a sufficient antithrombotic effect. The interaction between vWF and ADAMTS13 under conditions of physiological labor does not lead to excessive formation and accumulation of high-affinity antibodies to ADAMTS13.

Factors affecting peripheral neuropathy induced by nanoparticle albumin-bound paclitaxel in patients with pancreatic cancer.

Chemotherapy-induced peripheral neuropathy (CIPN) is a major toxicity limiting the use of nab-paclitaxel (Nab-P) in treating patients with pancreatic cancer. The aim of this study was to identify the factors affecting CIPN using patient-reported outcome measures and the minimally invasive volumetric absorptive microsampling (VAMS) technique. The maximum concentrations of paclitaxel (Cmax) were measured from 81 VAMS samples collected from 44 participants with pancreatic cancer. The association between CIPN development and demographic, clinical and pharmacokinetic factors was determined using univariable and multivariable logistic regression. The association between CIPN severity and the factors was evaluated using Spearman's rank correlation. The impact of Cmax and the number of treatment cycles on the severity was assessed using multivariable linear regression. The development of CIPN was significantly associated with cumulative dose (odds ratio 1.005, 95% confidence interval [CI] 1.003-1.007), treatment cycles (3.47, 2.25-5.85), alkaline phosphate (0.992, 0.985-0.998) and age (1.092, 1.020-1.179), with an area under the receiver operating characteristic curve of 0.89 (95% CI 0.83-0.95). The severity of CIPN significantly worsened with increasing cumulative dose (coefficient 0.58, 95% CI 0.44-0.69), treatment cycles (0.57, 0.44-0.68) and age (0.18, 0.00-0.35). The severity of CIPN was predictable from treatment cycles (P = .0002) and Cmax (P = .01). The higher the cumulative dose of Nab-P, treatment cycles and age, the more frequently and severely do the patients experience CIPN. In predicting the severity of CIPN using Cmax, minimally invasive VAMS is a feasible alternative to venous blood sampling.

Correlation between the TyG-BMI index and carotid plaque characteristics in middle-aged and elderly patients with acute myocardial infarction.

The aim of this study is to investigate the correlation between the triglyceride-glucose-body mass index (TyG-BMI) and the characteristics of various carotid plaques in middle-aged and elderly patients with acute myocardial infarction (AMI). A retrospective study was conducted on 380 patients with AMI hospitalized in the Cardiology Department of Kaifeng Central Hospital. Based on carotid ultrasound results, patients were divided into the following two groups: the stable plaque group and the unstable plaque group. Additionally, a control group comprising 380 healthy individuals visiting the hospital's physical examination center during the same timeframe was established. Fasting venous blood samples were collected from all participants to measure blood glucose and triglyceride. The baseline TyG-BMI index was calculated using the formula Ln [fasting triglyceride (mg/dL)×fasting blood glucose (mg/dL)/2]×BMI. The correlation between different plaque groups and the TyG-BMI index was analyzed. The TyG-BMI index was significantly higher in the unstable plaque group compared to the stable plaque group, with values of 252.81±29.99 and 201.92±28.72, respectively (P = 0.034). Spearman's correlation analysis showed a positive correlation between the instability of carotid plaques and the TyG-BMI index in patients with AMI (r = 0.521, P = 0.003). Logistic regression analysis indicated that the TyG-BMI index was an important risk factor for unstable carotid plaques in patients with AMI (OR = 2.691, 95% CI: 1.169-4.123). The findings of this study suggest that an elevated TyG-BMI index significantly increases the risk of unstable carotid plaques in patients with AMI, making it an important risk factor for carotid plaque instability.

Circadian rhythm of brain-derived neurotrophic factor in serum and plasma.

The neurotrophic growth factor brain-derived neurotrophic factor (BDNF) plays a crucial role in various neurodegenerative and psychiatric diseases, such as Alzheimer's disease, schizophrenia and depression. BDNF has been proposed as a potential biomarker for diagnosis, prognosis and monitoring therapy. Understanding the factors influencing BDNF levels and whether they follow a circadian rhythm is essential for interpreting fluctuations in BDNF measurements. We aimed to investigate the circadian rhythm of BDNF by collecting multiple peripheral venous blood samples from young, healthy male participants at 12 different time points over 24h. In addition, vital parameters, cortisol and insulin like growth factor 1 (IGF1) were measured to explore potential regulatory mechanisms, interfering variables and their correlations with BDNF concentration. The findings revealed that plasma BDNF did not exhibit any significant fluctuations over 24h, suggesting the absence of a circadian rhythm. However, serum BDNF levels decreased during sleep. Furthermore, serum BDNF showed a positive correlation with heart rate but a negative correlation with IGF1. No significant correlation was observed between cortisol and BDNF or IGF1. Although plasma BDNF suggests steady-state conditions, the decline of serum BDNF during the nocturnal period could be attributed to physical inactivity and associated with reduced haemodynamic blood flow (heart rate reduction during sleep). The type of sample collection (peripheral venous cannula vs. blood sampling using a butterfly system) does not significantly affect the measured BDNF levels. The sample collection during the day did not significantly affect BDNF analysis, emphasizing the importance of considering activity levels rather than timing when designing standardized protocols for BDNF assessments.

The effect of an acute bout of exercise on circulating vitamin D metabolite concentrations: a randomised crossover study in healthy adults.

The effect of acute exercise on circulating concentrations of vitamin D metabolites is unclear. To address this knowledge gap, we examined the effect of a bout of treadmill-based exercise versus rest on circulating concentrations of 25(OH)D3, 25(OH)D2, 3-epi-25(OH)D3, 24,25(OH)2D3, 1,25(OH)2D3, and vitamin D2 and D3 in healthy men and women. Thirty-three healthy adults (14 females, 41 (15) years, body mass index 26.2 (3.7) kg/m2, 36.2 (9.2) ml/kg/min; mean (SD)) completed two laboratory visits involving 60min of moderate-intensity treadmill exercise (60% ) versus 60min of seated rest, both in an overnight fasted-state, as part of a randomised crossover design. Venous blood samples were drawn at baseline, immediately (0h), 1h and 24h after the exercise or rest-period. There was a significant time × trial interaction effect for total circulating 25(OH)D (P=0.0148), 25(OH)D3 (P=0.0127) and 1,25(OH)2D3 (P=0.0226). Immediately post-exercise, 25(OH)D, 25(OH)D3 and 1,25(OH)2D3 concentrations were significantly elevated compared to the control resting condition, and 1,25(OH) 2D3 remained significantly elevated 1 h later. Circulating albumin, vitamin D binding protein, calcium and parathyroid hormone were elevated immediately post-exercise. Thus, an acute bout of moderate intensity exercise transiently increases concentrations of circulating 25(OH)D and 1,25(OH)2D3 compared to resting conditions. KEY POINTS: Observational studies suggest that acute exercise might change circulating concentrations of vitamin D metabolites, but this has not been investigated using randomised crossover studies and using robust analytical procedures. In this study, we used a randomised crossover design to examine the effect of a bout of treadmill-based exercise (vs. rest) on circulating concentrations of a wide range of vitamin D metabolites in healthy humans. We show that an acute bout of moderate intensity exercise transiently increases concentrations of circulating 25(OH)D and 1,25(OH)2D3 compared to resting conditions. These findings indicate that regular exercise could lead to transient but regular windows of enhanced vitamin D biological action.

Abstract Mo031: Tissue deficiency and altered eicosanoids levels in rodent and human heart failure.

Introduction: The role of eicosanoids, especially epoxyeicosatrienoic acids (EETs), metabolites of arachidonic acid with cardio-renal activity, in heart failure (HF) remains unclear. Hypothesis: Altered eicosanoids turnover, both in rodent and human heart failure, is a part of the pathophysiology of HF and contributes to poor prognosis. Methods: We measured active EETs and their biologically inactive metabolites, dihydroxyeicosatrienoic acids (DHETs) in the left ventricle (LV) and renal tissue obtained from a rodent heart failure model induced by aortocaval fistula (ACF). We measured protein expression of CYP2C23 and CYP2J3 in the kidney cortex and LV tissue by Western blot analysis to evaluate EETs production and mRNA expression of soluble epoxide hydrolase (sEH), the enzyme responsible for the degradation of EETs to DHETs. In the translational part, firstly, we enrolled 50 patients with HF to measure plasma 14,15-epoxyeicosatrienoic acid (14,15-EET) and 14,15-dihydroxyicosatrienoic acid (14,15-DHET) levels using commercial ELISA kits and compared them with 25 age- and sex-matched controls. Secondly, 11 consecutive patients with HFrEF indicated to cardiac resynchronization therapy (CRT) were enrolled to measure plasmatic 14,15-EET and 14,15-DHET levels in venous, arterial, and coronary sinus (CS) blood samples and correlate them with N-terminal pro-B-type natriuretic peptide (NT-proBNP) from the same compartments. Results: ACF rats exhibited tissue deficiency of EETs in the LV and kidney compared to controls, probably mainly caused by increased EETs degradation by sEH (unchanged expressions of CYP2C23 and CYP2J3, increased mRNA of sEH and EETs/DHETs ratio). In humans, both of the measured eicosanoids were significantly higher in the HF group: 14,15-EET (91.3 ±25.7 vs. 64.95 ±35.4 ng/ml) and 14,15-DHET (10.58 ±2.06 vs. 9.07 ±1.60 ng/ml), p for both &lt; 0.001. HF patients with 14,15-EET levels less than 60 ng/ml had worse short term mortality compared to those above. In CS, NT-proBNP levels negatively correlated with plasmatic 14,15-EET levels (r = -0.63, p = 0.03) and positively with the DHET/EET ratio (r = 0.73, p = 0.02). Plasmatic 14,15-EET nor 14,15-DHET levels in measured compartments did not differ statistically (p = 0.21, p = 0,64, respectively). In individual patients, the levels of both eicosanoids correlated across all compartments. Conclusions: Tissue deficiency of active eicosanoids and their altered turnover may play an important role in HF pathophysiology.

Association of Circulating PCSK9 With Ischemia-Reperfusion Injury in Acute ST-Elevation Myocardial Infarction.

Beyond therapeutic implications, PCSK9 (proprotein convertase subtilisin/kexin 9) has emerged as a promising cardiovascular biomarker. The exact role of PCSK9 in the setting of acute ST-elevation myocardial infarction (STEMI) is incompletely understood. We aimed to investigate the association of PCSK9 with ischemia-reperfusion injury, visualized by cardiac magnetic resonance imaging, in patients with STEMI revascularized by primary percutaneous coronary intervention (PCI). In this prespecified substudy from the prospective MARINA-STEMI (NCT04113356) registry, we included 205 patients with STEMI. PCSK9 concentrations were measured from venous blood samples by an immunoassay 24 and 48 hours after PCI. The primary end point was defined as presence of intramyocardial hemorrhage according to cardiac magnetic resonance T2* mapping. Secondary imaging end points were the presence of microvascular obstruction (MVO) and infarct size. The clinical end point was the occurrence of major adverse cardiac events. We observed a significant increase in PCSK9 levels from 24 to 48 hours (268-304 ng/mL; P<0.001) after PCI. PCSK9 24 hours after PCI did not show any relation to intramyocardial hemorrhage, MVO, and infarct size (all P>0.05). PCSK9 concentrations 48 hours post-STEMI were higher in patients with intramyocardial hemorrhage (333 versus 287 ng/mL; P=0.004), MVO (320 versus 292 ng/mL; P=0.020), and large infarct size (323 versus 296 ng/mL; P=0.013). Furthermore, patients with increased PCSK9 levels >361 ng/mL at 48 hours were more likely to experience major adverse cardiac events (15% versus 8%; P=0.002) during a median follow-up of 12 months. In patients with STEMI, a significant increase in PCSK9 was observed from 24 to 48 hours after PCI. While PCSK9 levels after 24 hours were not related to myocardial or microvascular injury, PCSK9 after 48 hours was significantly associated with intramyocardial hemorrhage, MVO, and infarct size as well as worse subsequent clinical outcomes. URL: https://www.clinicaltrials.gov; Unique identifier; NCT04113356.

High-level performances following low altitude training and tapering in warm environments in elite racewalkers.

Current guidelines for prolonged altitude exposure suggest altitude levels ranging from 2000 to 2500m to optimize an increase in total hemoglobin mass (Hbmass). However, natural low altitude locations (<2000m) remain popular, highlighting the interest to investigate any possible benefit of low altitude camps for endurance athletes. Ten elite racewalkers (4 women and 6 men) underwent a 4-week "live high-train high" (LHTH) camp at an altitude of 1720m (PIO2=121mmHg; 20.1°C; 67% relative humidity [RH]), followed by a 3-week tapering phase (20m; PIO2=150mmHg; 28.3°C; 53% RH) in preparation for the World Athletics Championships (WC). Venous blood samples were withdrawn weekly during the entire observation period. In addition, blood volumes were determined weekly by carbon monoxide rebreathing during altitude exposure and 2weeks after return to sea level. High-level performances were achieved at the WC (five placings among the Top 10 WC races and three all-time career personal bests). A slight but significant increase in absolute (+1.7%, p=0.03) and relative Hbmass (+2.3%, p=0.02) was observed after 4-week LHTH. In addition, as usually observed during LHTH protocols, weekly training distance (+28%, p=0.02) and duration (+30%, p=0.04) significantly increased during altitude compared to the pre-LHTH period. Therefore, although direct causation cannot be inferred, these results suggest that the combination of increased training load at low altitudes with a subsequent tapering period in a warm environment is a suitable competition-preparation strategy for elite endurance athletes.