Mirjana Đerić

Cardiovascular Biomarkers in Chronic Kidney Disease

Cardiovascular Biomarkers in Chronic Kidney Disease Cardiovascular morbidity and mortality are markedly increased in chronic renal failure patients. Although it cannot be regarded as a cardiovascular disease risk equivalent, kidney dysfunction is considered an independent predictor of increased cardiovascular risk that increases with deteriorating kidney function. The association is a very complex one, and the term cardiorenal syndrome is now widely used. Cardiovascular disease in chronic kidney disease patients usually manifests as ischemic heart disease (in the form of angina, acute coronary syndrome or sudden cardiac death), cerebrovascular disease, peripheral vascular disease, and congestive heart failure. Vascular disease includes atherosclerosis and vascular calcifications, and cardiomyopathy comprises left ventricular hypertrophy, cardiac fibrosis and left ventricular systolic and diastolic dysfunction. In addition to the well-established traditional risk factors such as hypertension, hyperlipidemia, insulin resistance and diabetes mellitus, the association is supported by synergistic action of non-traditional risk factors such as excessive calcium-phosphorus load, hyperparathyroidism, anemia, hemodynamic overload, malnutrition, inflammation, hyperhomocysteinemia, altered nitric oxide synthase and increased oxidative stress. This paper summarizes the current understanding of the significance of specific uremic retention solutes, natriuretic peptides, biochemical markers of disorders in calcium-phosphorus homeostasis, systemic inflammation, oxidative stress, and dyslipidemia. Biohemijski Markeri Kardiovaskularnih Bolesti U Hroničnoj Bolesti Bubrega Kod pacijenata sa hroničnim oboljenjem bubrega, kardiovaskularni morbiditet i mortalitet su značajno povišeni. Iako se ne može smatrati ekvivalentom rizika za kardiovaskularne bolesti, veruje se da je bubrežna insuficijencija nezavisni prediktor povećanog kardiovaskularnog rizika i da se taj rizik povećava sa slabljenjem bubrežne funkcije. Ova udruženost je veoma kompleksna i danas se široko koristi termin kardiorenalni sindrom. Kardiovaskularna bolest u hroničnoj bolesti bubrega obično se ispoljava kao ishemijska bolest srca (u obliku angine, akutnog koronarnog sindroma ili nagle srčane smrti), cerebrovaskularna bolest, periferna vaskularna bolest i kongestivna bolest srca. Vaskularna bolest obuhvata aterosklerozu i vaskularne kalcifikacije, dok kardiomiopatija obuhvata hipertrofiju leve komore, kardijalnu fibrozu i sistolnu i dijastolnu disfunkciju leve komore. Pored dobro poznatih tradicionalnih faktora rizika kao što su hipertenzija, dislipidemija, insulinska rezistencija i diabetes mellitus, u osnovi ove udruženosti je i sinergističko delovanje netradicionalnih faktora rizika kao što su povećanje odnosa kalcijum-fosfor, hiperparatireoidizam, anemija, hemodinamsko opterećenje, pothranjenost, zapaljenje, hiperhomocisteinemija, izmenjena sinteza azot-monoksida i povećan oksidativni stres. U radu se razmatraju dosadašnja saznanja o značaju pojedinih uremijskih toksina, natriuretičkih peptida, biohemijskih markera poremećaja u homeostazi kalcijuma i fosfora, sistemske inflamacije, oksidativnog stresa i dislipidemije.

Determining the Relationship Between Homocysteinemia and Biomarkers of Inflammation, Oxidative Stress and Functional Kidney Status in Patients with Diabetic Nephropathy

Summary Background: One of the leading causes of terminal renal failure is diabetic nephropathy. The aim of this study was to determine the relationship between homocysteine levels and the biomarkers of renal function, inflammation and oxidative stress, as well as the incidence of macrovascular complications in patients with diabetic nephropathy. Methods: Sixty-four patients with diabetic nephropathy were included in this study. They were divided according to their homocysteine levels into two groups: hyperhomocysteinemic (HHcy, n=47) and normohomocysteinemic patients (NHCy, n=17). The re sults were compared to a control group (n=20) with normal renal function and without diabetes. Besides homocysteine, cystatine C, creatinine, urea, albuminuria, creatinine clearance, lipid status parameters, apolipoprotein A-I and B, lipo protein (a), CRP, fibrinogen, oxidative LDL were determined using appropriate methods. The incidence of macro vascular diabetic complications was also determined. Results: The results indicate that the level of renal dysfunction is greater in HHcy than in NHcy patients (p<0.05). In HHcy patients levels of oxLDL were also higher compared to NHcy patients (119.3±140.4 vs. 71.4±50.8 ng/mL, disp< 0.05) as well as fibrinogen levels (4.3±1.3 vs. 3.7±0.8 g/L, p<0.05). The in cidence of macrovascular complications is more frequent in HHcy than in NHcy patients (55.3. vs. 35.3 %, p>0.05), and in patients with macroalbuminuria compared to patients with microalbuminuria (65% vs. 39%, p<0.05). Conclusions: It can be concluded that HHcy is significantly present in patients with diabetic nephropathy, especially if there is greater reduction of renal function. Besides that, significantly higher concentrations of inflammatory (fibrinogen) and oxidative stress (oxLDL) markers were present in HHcy patients with diabetic nephropathy compared to NHcy patients.Therefore in diabetic nephropathy patients it is useful to regularly monitor the levels of homocysteine, as well as inflammatory and markers of oxidative stress. Kratak sadržaj Uvod: Dijabetesna nefropatija jedan je od vodećih uzroka terminalne bubrežne insuficijencije. Cilj ove studije bio je ispitivanje odnosa homocisteinemije i biomarkera bu bre`ne funkcije, inflamacije i oksidativnog stresa, kao i u~e stalosti makrovaskularnih komplikacija kod bolesnika sa dijabetesnom nefropatijom. Metode: U studiju je uklju~eno 64 ispitanika sa dijabetesnom nefropatijom koji su podeljeni u dve grupe u odnosu na homocisteinemiju: hi per homociste i nemi~ni (HHcy, n=47) i normohomo cistei ne mi~ni (NHcy, n=17). Odgovaraju}im metodama su pored nivoa homocisteina u krvi odre|ivani i nivoi cistatina C, kreatinina, uree, albuminurije, klirensa kreatinina, parametara lipidskog statusa, apolipoproteina A i B, lipoproteina(a), CRP, fibrinogena, oksidisanog LDL, kao i u~estalost makrovaskularnih komplikacija dijabetesne bo - lesti. Rezultati: Dobijeni rezultati upore|ivani su sa rezultatima kontrolne grupe ispitanika (n=20) sa urednom bubre`nom funkcijom, bez prisutne dijabetesne bolesti. Rezultati ukazuju da je stepen bubre`ne disfunkcije ve}i kod HHcy nego kod NHcy pacijenata (p<0,05). Tako|e, kod HHcy pacijenata nivo oxLDL je zna~ajno vi{i u odnosu na NHcy pacijente (119,3±140,4 vs. 71,4±50,8 ng/mL, p<0,05), kao i nivofibrinogena (4,3±1,3 vs. 3,7±0,8 g/L, p<0,05). Pojava makrovaskularnih komplikacija je u~estalija kod HHcy nego NHcy pacijenata (55,3% vs. 35,3%, p> 0,05), kao i kod pacijenata sa makroalbuminurijom u od nosu na pacijente sa mikroalbuminurijom (65% vs. 39%, p<0,05). Zakljućak: Na osnovu dobijenih rezultata mo`e se zaklju~iti da je HHcy u zna~ajnom stepenu prisutna kod bolesnika sa dijabetesnom nefropatijom, naro~ito ukoliko postoji izra `enija redukcija funk cio nalne rezerve bubrega. Osim toga, u odnosu na NHcy bo lesnike, kod HHcy bolesnika sa dijabetesnom nefropatijom zna~ajno su vi{e koncentracije inflamatornih (fibrinogena) i markera oksidativnog stresa u krvi (oxLDL). Stoga je kod bolesnika sa dijabetesnom nefropatijom po`eljno redovno pra}enje homocisteina u krvi, ali i inflamatornih markera, kao i markera oksidativnog stresa.

Evaluation of Coronary Risk Score Applications in 10-Year Coronary Heart Risk Estimation

Evaluation of Coronary Risk Score Applications in 10-Year Coronary Heart Risk Estimation Atherosclerosis is a multifactorial disease with risk factors that have multiple effects. In the identification and treatment of asymptomatic individuals at high risk for developing coronary heart disease (CHD) different risk scoring schemes are used in everyday routine. The aim of this study was to compare SCORE recommended for our country with two other most frequently used risk schemes for 10-year CHD risk evaluation: Framingham and PROCAM as well as their modifications. From 220 examined subjects of both sexes, who were treated mainly for lipid metabolism disorder at the Dispensary for Atherosclerosis Prevention, Centre for Laboratory Medicine, Clinical Centre of Vojvodina, 110 subjects were included in our study and agreed to a one-year follow-up. At first check-up, 15% had low risk according to Framingham Weibull and 78% according to PROCAM, intermediate 12% according to PROCAM NS up to 45% according to Framingham Weibull, and high 8% according to PROCAM up to 40% according to Framingham Weibull. After a one-year treatment 30% were in the low risk category according to Framingham Weibull and 88% according to PROCAM. Intermediate from 10% according to PROCAM to 36% according to Framingham Weibull, and high from 2% according to PROCAM to 25% according to Framingham Weibull. There is a significantly lower percentage of high risk individuals and a higher percentage of low risk individuals after one year of lipid disorder treatment. Ispitivanje Značaja Primene Bodovnih Sistema za Procenu Ukupnog 10-Godišnjeg Rizika za Koronarnu Bolest Srca S obzirom na to da je ateroskleroza multifaktorijalna bolest, u cilju identifikacije i lečenja asimptomatskih osoba s visokim rizikom za razvoj koronarne bolesti srca (KBS) u praksi se koriste različiti bodovni sistemi za procenu rizika. Cilj ovog istraživanja je da se izvrši upoređivanje SCORE bodovnog sistema preporučenog za našu sredinu sa ostala dva najčešće korišćena bodovna sistema za procenu 10-godišnjeg rizika za KBS: Framinghamskog i PROCAM sistema, kao i njihovih modifikacija. Od 220 pregledanih ispitanika oba pola, upućenih u Ambulantu za prevenciju ateroskleroze Kliničkog centra Vojvodine prvenstveno radi lečenja lipidskog poremećaja, 110 je uključeno u našu studiju i praćeno godinu dana. Prilikom prvog pregleda, osoba s niskim rizikom je bilo od 15% prema skoru Framingham Weibull do 78% prema skoru PROCAM, srednjim od 12% prema PROCAM NS do 45% prema Framingham Weibullu, a visokim od 8% prema PROCAM-u do 40% prema Framigham Weibullu. Posle godinu dana lečenja, u kategoriji niskog rizika bilo je od 30% prema Framingham Weibullu do 88% prema PROCAM-u, srednjeg od 10% prema PROCAM-u do 36% prema Framingham Weibullu, a visokog od 2% prema PROCAM-u do 25% prema Framingham Weibullu. Kako su lipidski parametri značajni kriterijumi svih bodovnih sistema za procenu rizika od KBS, ustanovljeno je očekivano signifikantno sniženje broja ispitanika u kategoriji visokog, a povećanje u kategoriji niskog rizika posle godinu dana lečenja lipidskog poremećaja, procenjivano prema svim ispitivanim bodovnim sistemima.

Biochemical Markers of Atherosclerosis

Biochemical Markers of Atherosclerosis This paper is a brief review of some lipid parameters and serum markers of inflammation in a view of their predictive relevance for the atherosclerotic disease. A discourse on the importance of measuring different lipids and lipoproteins, concentration of LDL particles and apolipoprotein levels is still underway. Also, the recommendations for apolipoprotein (a), phenotypization and other lipid markers have not yet been established. In recent years the recommendations imply simultaneous measuring of multiple markers and calculating the lipid index values such as lipid tetrad index (LTI), lipid pentad index (LPI) and atherogenic index of plasma (AIP). Several circulating markers of inflammation such as C-reactive protein, serum fibrinogen and elevated leukocyte number, are consistently associated with atherosclerosis. In spite of a lack of evidence on measuring the C-reactive protein in a wide population, the guidelines for its application in diagnostics and therapy of coronary heart disease were developed. Some proinflammatory cytokines, adhesion molecules and markers of leukocyte activation are promising markers, requiring, however, more detailed prospective evaluation. The question to be elucidated is if these inflammatory markers are directly involved in the pathogenic process. Biohemijski Markeri Ateroskleroze U ovom radu razmatrani su samo neki lipidni parametri i serumski markeri inflamacije u pogledu njihove prediktivne povezanosti s aterosklerotskom bolešću. Nastavlja se debata o značaju merenja različitih lipida i lipoproteina, uključujući koncentraciju LDL čestica i nivoe apolipoproteina. Takođe, nisu uspostavljene preporuke za apolipoprotein (a) fenotipizaciju i druge lipidne markere. Poslednjih godina preporučuje se simultano merenje nekoliko markera i izračunavanje lipidnih indeksa kao što su lipid tetrada index (LTI), lipid pentada index (LPI) i aterogeni indeks plazme (AIP). Nekoliko cirkulišućih markera inflamacije, npr. C-reaktivni protein, serumski fibrinogen i povišenje broja leukocita, dosledno su udruženi s aterosklerozom. Iako nema dokaza za korisnost merenja Creaktivnog proteina u široj zajednici, formirane su preporuke za njegovu upotrebu u dijagnostici i lečenju koronarne bolesti srca. Neki proinflamatorni citokini, adhezioni molekuli i markeri leukocitne aktivacije su obećavajući markeri, ali zaslužuju dalja prospektivna ispitivanja. Pitanje koje zahteva odgovor je i da li su ti inflamatorni markeri direktno uključeni u patogeni proces.

Serum Cystatin C in Estimating Glomerular Filtration Rate

Serum Cystatin C in Estimating Glomerular Filtration Rate Using serum cystatin C in estimating glomerular filtration rate (GFR) has in recent times been recommended. A number of simple formulas for calculating GFR have been derived specifically from serum cystatin C concentrations. The purpose of this study was to assess the significance of cystatin C and of the two most frequently applied of these formulas in estimating glomerular filtration rate compared to serum creatinine and its derived formulas for estimating glomerular filtration rate from creatinine concentrations. The study included 74 patients: 59 were in various stages of chronic renal insufficiency (divided into two subgroups: I with GFR ≥ 60 mL/min/1.73m2 and II with GFR<60 mL/min/1.73m2) and 15 on hemodialysis. A control group of 30 healthy participants was also included in the study. Serum values of cystatin C ranged from: 0.86 ± 0.16 mg/L in subgroup I, and 1.77 ± 0.79 mg/L in subgroup II, to 6.9 ± 1.83 mg/L in patients on hemodialysis. The correlation between the two formulas derived from cystatin C and the clearance of creatinine, as well as the Cockcroft and Gaults formula, was significant, while one of the formulas derived from cystatin C did not show a significant correlation with MDRD. It was concluded that serum cystatin C is a significant marker in estimating glomerular filtration rate, especially in the advanced stages of chronic renal insufficiency. Serumski Cistatin C U Proceni Jačine Glomerulske Filtracije U novije vreme preporučena je upotreba serumskog cistatina C u proceni jačine glomerulske filtracije (GFR). Upravo iz serumske koncentracije cistatina C je izvedeno nekoliko jednostavnih formula za izračunavanje GFR. Cilj ove studije je bio da proceni značaj cistatina C i dve najčešće primenjivane od tih formula u proceni jačine glomerulske filtracije u poređenju sa serumskim kreatininom i izvedenim formulama za procenu jačine glomerulske filtracije iz koncentracija kreatinina. U studiju je uključeno 74 ispitanika: 59 u različitim stadijumima hronične bubrežne insuficijencije (podeljenih u dve podgrupe: I sa GFR ≥ 60 mL/min/1,73m2 i II sa GFR< 60 mL/min/1,73m2) i 15 na hemodijalizi. U studiju je bila uključena i kontrolna grupa od 30 zdravih ispitanika. Serumske vrednosti cistatina C su se kretale: u podgrupi I 0,86 ± 0,16 mg/L, u podgrupi II 1,77 ± 0,79 mg/L i kod ispitanika na hemodijalizi 6,9 ± 1,83 mg/L. Korelacija između obe formule izvedene iz cistatina C i klirensa kreatinina kao i Kokroft-Gaultove formule bila je značajna, dok jedna od ovih formuli izvedenih iz cistatina C nije pokazala značajnu korelaciju sa MDRD. Može se zaključiti da je serumski cistatin C značajan parametar u proceni jačine glomerulske filtracije, naročito u odmaklim stadijumima hronične bubrežne insuficijencije.

Cystatin C, vascular biomarkers and measured glomerular filtration rate in patients with unresponsive hypertensive phenotype: a pilot study

Abstract Background: Biomarkers are commonly used to estimate the presence of subclinical cardiovascular disease (CVD) in patients with essential arterial hypertension (HT). In addition to known association between cystatin C and glomerular filtration rate (GFR), elucidating the association between cystatin C and vascular biomarkers (intima-media thickness of common carotid arteries (CCIMT), carotid plaque and renal artery resistance index (RRI)) in patients with unresponsive hypertensive phenotype could be of significant clinical interest. Methods: Participants (n = 200, median age 58 (52–64) years, 49% female) under treatment with antihypertensive drugs were stratified into two subgroups based on their blood pressure level as having responsive hypertension (RHT – compliant and responsive to treatment, n = 100), or nonresponsive (URHT – compliant but nonresponsive to treatment, n = 100). GFR was measured by isotopic (slope-intercept) method (99m Tc diethylene triamine penta-acetic acid – mGFR). Results: The URHT group had significantly higher median cystatin C serum concentration (p = 0.02) and CCIMT (p = 0.00) compared to the RHT group, with no significant difference in RRI (p = 0.51) and mGFR among subgroups [69.9 ± 28.2 vs 76.74 ± 23.61 ml/min/1.73m2, p = 0.27]. In the URHT group, cystatin C was found to be associated with CCIMT (p = 0.02), hsCRP (p = 0.01) and duration of HT (p = 0.02), independently of mGFR and age. Independent predictors of URHT phenotype were CCIMT (p= 0.02) and hsCRP (p= 0.04). Conclusion: In addition to GFR, cystatin C serum concentration is positively and independently associated with CCIMT in patient with URHT phenotype and subclinical CVD. Prospective larger studies should further investigate the clinical importance of this relationship.

Screening for Chronic Kidney Disease in Adult Males in Vojvodina: A Cross-Sectional Study

Summary Background: Chronic kidney disease (CKD) is one of the most significant global health problems accompanied by numerous complicatons, with constant increase in the number of affected people. This number is much higher in early phases of disease and patients are mostly asymptomatic, so early detection of CKD is crucial. The aim was examination of the prevalence of CKD in the general population of males in Vojvodina, based on estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR), and exploring the determinants and awareness of CKD. Methods: This cross-sectional study included 3060 male examinees from the general population, over 18 years of age, whose eGFR and ACR were calculated, first morning urine specimen examined, arterial blood pressure measured and body mass index calculated. Standard biochemistry methods determined creatinine, urea, uric acid and glucose serum concentrations as well as albumin and creatinine urine levels. Results: Prevalence of CKD in the adult male population is 7.9%, highest in men over 65 years of age (46.7%), while in the other age groups it is 3.6-12.6%. The largest number of examinees with a positive CKD marker suffer from arterial hypertension (HTA) and diabetes mellitus (DM). Only 1.3% of examinees with eGFR<60 ml/min/1.73 m2 and/or ACR≥ 3 mg/mmol had been aware of positive CKD biomarkers. Conclusions: Obtained results show the prevalence of CKD in adult males is 7.9%, HTA and DM are the most important CKD risk factors and the level of CKD awareness is extremely low (1.3%) indicating the necessity for introduction of early stage disease recognition measures, including raising CKD awareness.

Antiphospholipid Antibodies and Renal Impairment Parameters in Diabetic Nephropathy Preliminary Data

Objective: Antiphospholipid antibodies (aPL Abs) represented an independent factor that was associated with the occurrence and/or progression of nephropathy in patients with antiphospholipid syndrome, but their role in diabetic nephropathy is not elucidated. Therefore, we evaluated the association of aPL Abs with the renal impairment parameters in patients with diabetic nephropathy. Methods: Concentrations of analyzed antibodies were measured by enzyme-linked immunosorbent assay. Results: Cystatin C and anticardiolipin (aCL) antibodies of the immunoglobulin (Ig) G (r = .349, P = .004) and the IgM isotype (r = .316, P = .009) were in positive correlation. The IgG isotype of the aCL Abs was in positive correlation with creatinine (r = .252, P = .038), urea (r = .241, P = .048), and uric acid (r = .271, P = .025). The concentrations of the IgG isotype of the aCL Abs were significantly different between subgroups of patients with diabetic polyneuropathy and patients without this clinical finding (Mann-Whitney, P = .033). Conclusion: This is the first report on positive correlation between aCL Abs and renal impairment parameters. Larger studies are necessary for elucidation whether this association is involved in further progression of the disease.

Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac Disease

Diagnostic Accuracy of IGA Anti-Tissue Transglutaminase Antibody Testing in Celiac Disease Contemporary guidelines for the first-line diagnosis of celiac disease recommend determination of IgA anti-tissue transglutaminase antibodies or IgA antiendomysial antibodies, as well as total serum IgA antibodies. The aim of our study was to assess the validity and clinical significance of serological testing for IgA anti-tissue transglutaminase antibodies in the diagnosis of celiac disease, and to investigate the presence of malabsorption symptoms in celiac patients. IgA anti-tissue transglutaminase antibody testing was performed in 50 subjects with clinically suspected celiac disease (21 men and 29 women). All subjects underwent endoscopy with small intestine biopsy. Celiac disease was confirmed by histopathological findings in four subjects, whereas the IgA anti-tissue transglutaminase test was positive in three subjects. The IgA anti-tissue transglutaminase test showed sensitivity of 75% and specificity of 100%. There were significant differences between men with biopsy-confirmed and excluded celiac disease in the erythrocyte parameters MCV (96.5±7.7 vs. 78.6 ±11.3; p<0.05), MCH (36.9±4.6 vs. 25.9±4.9; p<0.01), and MCHC (382.5±16.3 vs. 326.9±19.1; p<0.005), as well as in the levels of total protein (47.5 ±16.3 vs. 68.3 ± 7.6; p<0.01) and albumins (24.6±9.5 vs. 42.1 ± 6.9; p<0.01). In addition, HDL-cholesterol levels were significantly lower in men with biopsy-confirmed celiac disease (0.42.±0.12 vs. 0.90±0.30; p<0.05). Our results show a high correlation between IgA anti-tissue transglutaminase testing and endoscopy with biopsy as the gold diagnostic standard. Dijagnostička Preciznost Određivanja IgA Antitela na Tkivnu Transglutaminazu u Celijačnoj Bolesti Savremeni vodiči u prvostepenoj dijagnostici celijačne bolesti preporučuju određivanje IgA antitela na tkivnu transglutaminazu ili IgA antiendomizijumskih antitela, kao i ukupnog nivoa serumskih IgA antitela. Cilj našeg istraživanja je bio da se proceni validnost i klinička značajnost serološkog testiranja IgA antitela na tkivnu transglutaminazu u dijagnostici celijačne bolesti, kao i da se ispita prisustvo simptoma malapsorpcije kod celijačnih bolesnika. IgA antitela na tkivnu transglutaminazu su određivana kod 50 bolesnika oba pola (21 muškarac i 29 žena) kod kojih je postojala klinička sumnja na celijačnu bolest. Endoskopski im je urađena biopsija tankog creva. Celijačna bolest je potvrđena patohistološkim nalazom bioptata kod 4 pacijenta dok su IgA antitela na tkivnu transglutaminazu bila pozitivna kod 3 ispitanika. U našoj grupi senzitivnost testa je bila 75%, a specifičnost 100%. Kod muškaraca, između onih kod kojih je dokazana celijačna bolest i onih kod kojih nije, signifikantne razlike su ustanovljene za eritrocitne parametre MCV (96,5±7,7 vs. 78,6±11,3; p<0,05), MCH (36,9±4,6 vs. 25,9±4,9; p<0,01) i MCHC (382,5±16,3 vs. 326,9±19,1; p<0,005) kao i za nivoe ukupnih proteina (47,5 ±16,3 vs. 68,3 ± 7,6; p<0,01) i albumina (24,6±9,5 vs. 42,1 ± 6,9; p<0,01). Nivo HDL-holesterola je takođe bio signifikantno niži kod muškaraca sa celijakijom (0,42±0,12 vs. 0,90±0,30; p<0,05). Naši rezultati pokazuju visoku korelaciju IgA antitela na tkivnu transglutaminazu sa zlatnim standardom (endoskopskom biopsijom).

The influence of chronic Helicobacter pylori infection on some serum lipid profile parameters, apolipoproteins A-I and B and Lp(a) lipoprotein.

The Influence of Chronic Helicobacter Pylori Infection on some Serum Lipid Profile Parameters, Apolipoproteins A-I and B and Lp(a) Lipoprotein Data on proatherogenic lipid profile alterations due to chronic Helicobacter pylori (HP) infection are contradictory. Aim of this study was to examine the differences in some lipid parameters between 55 subjects of both gender with a chronic HP infection (IgG>50 U/mL and IgA <20 U/mL) and 55 gender matched HP seronegative subjects (IgG and IgA <20 U/mL). Total cholesterol (TC) (p<0.001), triglycerides (TG) (p<0.05), LDL-cholesterol (LDL-C) (p<0.02), non-HDL-cholesterol (non-HDL-C), apolipoprotein (apo) B (p<0.001), Lp(a) and HDL-cholesterol (HDL-C) serum levels were higher in HP seropositive than in seronegative subjects, while there were almost no differences in apo A-I. In HP seropositive subjects, the frequency of pathological TC (p<0.001), TG (p<0.05), LDL-C (p<0.01), non-HDL-C (p<0.01), apo B (p<0.02) and Lp(a) serum levels was higher compared to seronegative. Serum HP IgG titers correlated negatively with TC, LDL-C (p<0.05), non-HDL-C, apo B and Lp(a) levels, and positively with TG, HDL-C and apo A-I levels. Results are similar for both genders. Our results confirm the hypothesis that a chronic HP infection could modify the lipid profile in a proatherogenic way. Uticaj Hronične Helicobacter Pylori Infekcije NA Neke Parametre Lipidskog Statusa, Apolipoproteine A-I I B I Lp(a) Lipoprotein Podaci o proaterogenim promenama lipidskog statusa u sklopu hronične Helicobacter pylori (HP) infekcije su kontradiktorni. Cilj istraživanja bio je da se ispitaju razlike u nekim lipidskim parametrima između 55 oso - ba oba pola s hroničnom HP infekcijom (IgG >50 U/mL i IgA <20 U/mL) i 55 HP seronegativnih osoba (IgG i IgA <20 U/mL) oba pola. Serumske koncentracije ukupnog holesterola (TC) (p<0,001), triglicerida (TG) (p<0,05), LDL-holesterola (LDL-C) (p<0,02), non-HDL-holesterola (non-HDL-C), apolipoproteina (apo) B (p<0,001), Lp(a) i HDL-holesterola (HDL-C) bile su više kod HP seropozitivnih u odnosu na seronegativne osobe, dok gotovo da nije bilo razlika u nivoima apo A-I. Kod HP seropozitivnih osoba, učestalost patoloških TC (p<0,001), TG (p<0,05), LDL-C (p<0,01), non-HDL-C (p<0,01), apo B (p<0,02) i Lp(a) vrednosti bila je viša u odnosu na seronegativne. Ustanovljena je negativna korelacija serumskih titara HP IgG antitela s TC, LDL-C (p<0,05), non-HDL-C, apo B i Lp(a), a pozitivna s TG, HDL-C i apo A-I nivoima. Rezultati su slični za oba pola. Naši rezultati idu u prilog hipotezi da bi hronična HP infekcija mogla da modifikuje lipidske parametre na proaterogeni način.