Arleta Malecha-Jędraszek

Significance of plasma chromogranin A determination in neuroendocrine tumour (NET) diagnosis.

The secretory nature of NETs implies the determination of the CgA concentration as a standard marker. The concentration of CgA in plasma correlates with the degree of histopathological differentiation, tumor stage, and is an essential prerequisite for therapy. A retrospective analysis of the results of the plasma CgA concentrations in relation to histopathological and clinical findings (type of NET according to the WHO classification, severity of disease based on the presence of metastases and clinical symptoms) as well as somatostatin receptor scintigraphy was performed in 41 patients with NET. The patients were treated in The Regional Oncology of Lublin from February 2005 to May 2008. Data from the literature and results of this study suggest the use of CgA in the diagnosis and prognosis of NET. Plasma CgA concentration analysed together with histopathological assessment of tumor and the clinical picture is a useful marker in the diagnosis of neuroendocrine tumours. High plasma CgA concentrations may indicate the presence of highly-differentiated NET (WDNEC), and also may indicate the presence of tumor metastasis. The highest CgA concentrations were observed in patients with neuroendocrine tumors associated with carcinoid symptoms and the presence of metastases to the liver.

The evaluation of 25(OH)D concentration in blood serum of chronic heart failure patients

Abstract This current study examined patients with severe chronic heart failure (CHF) in order to ascertain the held vitamin D, based on an assessment of calcidiol [25(OH)D] concentration. It also identified and evaluated possible correlations between 25(OH)D level and the concentration of total calcium, inorganic phosphates and creatinine concentration in their serum. Herein, venous blood samples were taken from 36 patients with CHF. Diagnosis was confirmed by echocardiographic, as well as by electrocardiographic examinations. In this work, the control group consisted of 41 randomly selected healthy individuals. The results of our study showed that CHF patients had significantly lower concentration of 25(OH)D, as well as total calcium and inorganic phosphates. Moreover, mean creatinine concentration was higher, in comparison to the control group, but did not exhibit statistical significance. As calcium-phosphate homeostasis is regulated by numerous factors, including PTH, neurohormonal factors and calcitriol (1,25(OH)2D), it is possible that vitamin D deficiency may play a significant role in the pathomechanism of CHF, and a lowered 25(OH)D level may be related to progression of the disease.

Serum leptin concentration in patients with type 2 diabetes

Abstract With the increasing importance of early type 2 diabetes (DM2) and obesity detection, it is useful to reevaluate leptin role in these conditions. Our study aimed at investigating circulating leptin concentrations in a group of patients with DM2, and at assessing in detail whether leptin concentrations correlate with selected biochemical, clinical parameters and markers of systemic inflammation in patients with DM2 and in healthy volunteers. In our work, we analysed samples and data drawn from 71 patients aged 61.4 ± 11.7 years, who have been diagnosed with type 2 diabetes, as well as from a healthy control group (HC) consisting of 51 healthy subjects with a mean age of 57.8 ± 13.7 years. Therein, the concentration of leptin in the DM2 patients was significantly higher than in the HC (p < 0.01), with median value of 16.59 (IQR 8.58-33.39) ng/ml in the DM2, vs median value of 6.66 (IQR 4.52-21.40) ng/ml in the HC. In the analysis of variance, higher leptin concentrations were revealed in the DM2 group as compared to the HC, and this figure remained significant after adjusting for gender and age (p < 0.001). Moreover, it was independent of HOMA-IR (p = 0.003). However, the differences in leptin levels between the groups disappeared when additional adjustments for anthropometric parameters (BMI, waist circumference) were applied (p = 0.088). Beyond the aforementioned, significant positive correlations were found in the DM 2 group between leptin level and CRP (r=0.256; p < 0.05) and IL-6 (r = 0.345; p < 0.01). Among the selected variables, only gender and BMI were included in the predictive model explaining the variability of leptin, and, in total, were responsible for 72.6% of the original variation of the studied adipocytokine. The results of this study have led to conclusion that leptin may participate in the complex pathogenesis of DM2 and be a predictor of the development of this disease. As higher concentrations of leptin coexist with obesity, and this situation correlates positively with markers of inflammation (CRP, IL-6), leptin level, hence, should be considered in the pathogenesis of DM2.

Selected markers of bone turnover in type 2 diabetic patients

Dia be tes mel li tus type 2 (DM2) is widely rec og nized se ri ous health prob lem among de vel oped and de vel op ing coun tries and it ap pears to be re lated to the changes from tra di tional pat terns of life to wards West ern life style. It is rec og nized as civi li za tion dis ease, which oc cur in epi demic pro por tions in mod ern so cie ties. Two im por tant ele ments con trib ute sig nifi cantly to the patho gene sis of DM2; tis sue in su lin re sis tance and pan cre atic β cell dys func tion. It is be lieved that in many cases DM2 is di ag nosed too late; when chronic com pli ca tions are al ready pres ent [5,19]. Vast ma jor ity of lit era ture show that dia be tes and re lated meta bolic dis tur bances can lead to sig nifi cant changes in bone me tabo lism [1,3,4,20,14]. Re gard less the dif fer ences in bone min eral den sity in pa tients with DM2 ab nor mali ties in bone for ma tion can be seen. De creased qual ity of the bone as well as im paired mi croand mac roar chi tec ture to gether with sus cep ti bil ity to falls re sult ing from the pres ence of chronic com pli ca tions leads to a greater in ci dence of frac tures in DM2 pa tients [3,14,10,24]. The mechanisms of bone alterations in DM2 are complex and still poorly understood. It depends on the number of protective factors on bone health, such as hyperinsulinemia, obesity, estrogens as well as factors accelerating bone resorption (e.g. hyperglycemia) [7,21, 24]. Therefore evaluation of bone metabolism in patients with DM2 undertaken in this study seems to be fully justified. In the present study we focused on the following bone markers CTx (C-terminal cross-linked telopeptide of the alpha chain of type I collagen) and OCN (osteocalcin). CTx levels reflect type I collagen degradation and indirectly represents bone resorption by the osteoclasts and loss of bone mass. OCN however is known as a highly specific marker of bone turnover rate and the activity of the osteoblasts [1,9,20,24]. The aim of this study was to Selected markers of bone turnover in type 2 diabetic patients