Mercedes González-Hita

Establishment of a cut‐point value of serum TNF‐α levels in the metabolic syndrome

Cardiovascular diseases and type 2 diabetes are the major causes of mortality in Mexico. Metabolic syndrome (MS) is a cluster of factors that increase the risk to develop such diseases. Previous studies have shown that MS is associated with high tumor necrosis factor (TNF‐α) levels. In fact, TNF‐α has been proposed to be a useful marker for clinical diagnosis of inflammation at an early stage. Therefore, we analyzed TNF‐α concentrations in Mexican individuals with or without MS and related these levels to the associated MS components. Clinical, anthropometric, and biochemical data were analyzed in 41 healthy and 39 MS individuals. Individuals were similarly grouped by age and gender.The serum TNF‐α levels measured bya highly sensitive enzyme‐linked immunosorbent assay (ELISA) kit were increased significantly in MS subjects compared with healthy individuals (P<0.001). The assay showed 78.1% sensitivity and 61.5% specificity with a cut‐point level of 1.36 pg/mL. TNF‐α levels higher than the cut‐point value were correlated with insulin resistance indices. These findings support the hypothesis that serum TNF‐α concentration could be a useful marker for early MS diagnosis. Nevertheless, we suggest the establishment of specific cut‐point values in each studied population to evaluate potential clinical applications. J. Clin. Lab. Anal. 23:51–56, 2009.

A cut-point value of uncarboxylated to carboxylated index is associated with glycemic status markers in type 2 diabetes.

Background The uncarboxylated osteocalcin (ucOC) has been described as a regulator of glucose metabolism in mice, and it is decreased in human type 2 diabetes mellitus (T2D). Although inversely correlated with serum glucose, insulin, and glycated hemoglobin, it is unclear if ucOC decrement is caused by diabetes or plays a role in the pathogenesis and/or progression of the disease. Whatever the case may be, diabetes affects osteoblast gene expression, and possibly the proportion of ucOC over carboxylated OC (cOC). The association of ucOC/cOC index with glycemic status markers in patients with T2D has not been described before. Objective The objective of this study was to assess the ucOC/cOC index and its relationship with glycemic status markers in patients with T2D. Methods The ucOC/cOC index was determined by the quotient of ucOC and cOC serum levels in 80 T2D patients and 160 healthy subjects. The relationship between the ucOC/cOC index and glycemic status markers was evaluated. Results The ucOC/cOC index was low and negatively correlated to fasting plasma glucose and homeostasis assessment-insulin resistance model in T2D patients. The odds ratio for T2D patients with an ucOC/cOC index below the cut-point obtained by receiver operating characteristic analysis was 12.64 (confidence interval, 5.75–27.77; P < 0.001). Conclusions A value of ucOC/cOC index less than 0.3 is associated with markers of poor metabolic control in patients with T2D.

Vitamin-D receptor gene polymorphisms (TaqI and ApaI) and circulating osteocalcin in type 2 diabetic patients and healthy subjects.

INTRODUCTION Vitamin D receptor (VDR) is encoded by the VDR gene. Several studies have supported that this gene is associated with diabetes. Heterodimer VDR/RXR functions as an enhancer of the BGLAP gene and increases the basal transcription rate of osteocalcin (OC) during osteoblast differentiation. OC is a regulator of glucose metabolism in mice. Moreover, OC level is decreased in patients with type 2 diabetes (T2D). Although inversely correlated with serum glucose insulin and glycated haemoglobin, it is unclear whether OC reduction is caused by diabetes or plays a role in the pathogenesis and/or progression of the disease. In this study we analysed the association between TaqI and ApaI VDR gene polymorphisms and OC serum concentration in T2D subjects. MATERIAL AND METHODS Patients underwent clinical and nutritional assessment. Genomic DNA was extracted from leucocytes using a standard salting-out procedure. The polymorphisms were genotyped by PCR-RFLP method. ELISA was used to measure OC and insulin concentrations. RESULTS Association between TT genotype of TaqI polymorphism and low levels of OC was observed only in the population with overweight and obesity. No association between TaqI and ApaI polymorphisms and T2D was observed (p > 0.05). Furthermore, in T2D subjects, no correlation between ApaI and TaqI genotypes and age, sex, Body Mass Index (BMI), glucose, or OC was observed. CONCLUSIONS The TT genotype of TaqI VDR gene polymorphism was correlated with low levels of OC in overweight and obese subjects. However, TaqI and ApaI VDR gene polymorphisms were not associated with T2D.

Niveles de referencia de osteocalcina en población sana de México

Introduction: Osteocalcin has been shown to have an inverse relationship with blood glucose, insulin resistance and adiposity. Objective: To determine osteocalcin normal serum concentration in Mexican healthy adults and compare it with values reported in other populations. Method: Carboxylated and undercarboxylated osteocalcin serum concentrations were determined in 100 healthy adults by means of enzyme immunoassay; osteocalcin total concentration was calculated. A descriptive comparison was made with other populations’ values reported in the literature. Results: Carboxylated and undercarboxylated osteocalcin median concentrations were 3.22 ng/mL and 1.61 ng/mL, respectively. Mean total osteocalcin was 7.40 ± 5.11 ng/mL. There was no significant difference between the osteocalcin values in our population and those of populations where similar quantification methods to ours were used. Conclusion: Osteocalcin total serum concentration mean in the analyzed population was 7.40 ng/mL. There are subtle variations between populations that are attributable to genetic and population factors; however, the quantification method was the only variable that was shown to significantly influence on osteocalcin levels in healthyespanolIntroduccion: Se ha demostrado que la osteocalcina tiene una relacion inversa con la glucemia, resistencia a la insulina y adiposidad. Objetivo: Determinar la concentracion serica normal de osteocalcina en adultos sanos mexicanos y compararlos con los reportados en otras poblaciones. Metodo: Se determino la concentracion serica de osteocalcina carboxilada y pobremente carboxilada en 100 adultos sanos mediante inmunoensayo enzimatico; se calculo la concentracion de osteocalcina total. Se hizo una comparacion descriptiva con valores de otras poblaciones reportadas en la literatura. Resultados: Las medianas de las concentraciones de osteocalcina carboxilada y pobremente carboxilada fueron 3.22 ng/mL y 1.61 ng/mL, respectivamente; la media de osteocalcina total fue 7.40 ± 5.11 ng/mL. No hubo diferencia significativa entre los valores de osteocalcina total en nuestra poblacion y los de poblaciones en las que se utilizaron metodos de cuantificacion similares al nuestro. Conclusion: La concentracion serica promedio de osteocalcina total en la poblacion analizada fue de 7.40 ng/mL. Las variaciones sutiles entre poblaciones son atribuibles a factores geneticos y poblacionales, sin embargo, el metodo de cuantificacion fue el unico que se comprobo influye significativamente en los niveles de osteocalcina en poblaciones sanas. EnglishIntroduction: Osteocalcin has been shown to have an inverse relationship with blood glucose, insulin resistance and adiposity. Objective: To determine osteocalcin normal serum concentration in Mexican healthy adults and compare it with values reported in other populations. Method: Carboxylated and undercarboxylated osteocalcin serum concentrations were determined in 100 healthy adults by means of enzyme immunoassay; osteocalcin total concentration was calculated. A descriptive comparison was made with other populations’ values reported in the literature. Results: Carboxylated and undercarboxylated osteocalcin median concentrations were 3.22 ng/mL and 1.61 ng/mL, respectively. Mean total osteocalcin was 7.40 ± 5.11 ng/mL. There was no significant difference between the osteocalcin values in our population and those of populations where similar quantification methods to ours were used. Conclusion: Osteocalcin total serum concentration mean in the analyzed population was 7.40 ng/mL. There are subtle variations between populations that are attributable to genetic and population factors; however, the quantification method was the only variable that was shown to significantly influence on osteocalcin levels in healthy populations

Giant Solitary Synovial Osteochondromatosis of The Knee in a YoungFemale

Introduction: Giant Synovial osteochondromatosis of Hoffa’s body is very uncommon. Although described as a benign disease, it can be destructive and can cause severe osteoarthritis and pain. Case report: We report an 18 year old female patient presented with a calcified mass inside the Hoffa’s body. Clinically, patient presented with eight-month history of progressively worsening left knee pain with associated swelling. The bony mass in the Hoffa’s body was evident on the X-ray. MRI showed synovial affectation. During the arthroscopy, all pathological synovial was removed and the bony mass was extirpated through a mini-arthrotomy. Diagnosis of a giant synovial osteochondromatosis was confirmed by histology and malignancy was ruled out. Five years after surgery the patient has been asymptomatic and motion range is complete. Conclusion: This case of primary synovial chondromatosis is interesting because it was presented in an age, gender and unusual location. At 5 years of postoperative follow-up the patient has had no recurrence and has showed excellent performance of the knee joint.