Turan Turhan

Association of Endocan, Ischemia-Modified Albumin, and hsCRP Levels With Endothelial Dysfunction in Type 2 Diabetes Mellitus

We investigated the relationship of ischemia-modified albumin (IMA) and high-sensitivity C-reactive protein (hsCRP) levels with direct (endocan) and indirect (carotid intima–media thickness [cIMT] and 24 hours urine protein excretion) endothelial dysfunction indicators in type 2 diabetes mellitus (T2DM). Patients with T2DM (n = 88) and 88 healthy individuals were included in the study. The median endocan (475.15 vs 216.37 pg/mL; P < .001, respectively) and hsCRP (10.74 vs 3.11 mg/L; P < .001, respectively) and the mean IMA (0.64 ± 0.12 vs 0.51 ± 0.12 absorbance units; P < .001, respectively) levels were higher in participants with endothelial dysfunction compared to those without endothelial dysfunction in T2DM. The 24-hour urine protein excretion and cIMT levels had a positive correlation with hsCRP (r = .357; P = .001 and r = .592; P < .001, respectively), IMA (r = .519; P < .001 and r = .495; P < .001, respectively) and endocan (r = .347; P = .001 and r = .583; P < .001, respectively) levels in the T2DM group. Stepwise multivariable logistic regression analysis, which included laboratory findings found to be associated with endothelial dysfunction, showed that endocan (odds ratio [OR] = 1.456; P = .004), hsCRP (OR = 1.298; P = .008), and IMA (OR = 2.270, P = .003) were independent risk factors. It was found that none of these markers were superior in terms of diagnostic discrimination for endothelial dysfunction. Endocan, IMA, and hsCRP levels were found to be associated with endothelial dysfunction in patients with T2DM.

A short guideline on chronic kidney disease for medical laboratory practice / Kronik böbrek hastalığında tıbbi laboratuvar uygulamaları için kısa kılavuz

Abstract Chronic kidney disease (CKD) is asymptomatic in the early stage. Kidney function might be lost 90% when the symptoms are overt. However, in case of early detection, progression of the disease can be prevented or delayed. If not detected it results in end stage renal disease. Therefore, the level of awareness about CKD should be increased. The role of medical laboratory is utmost important for the diagnosis and staging of CKD. In this paper, the main tasks of the laboratory specialists are described and the outlines are as follows. • Creatinine assays should be traceable to internationally recognised reference materials and methods, specifically isotope dilution mass spectrometry. • When reporting the creatinine result, eGFR should also be reported in adult (>18 years) population. A warning expression should be included in the report form if eGFR result is <60 mL/min/1.73 m2. • eGFR values should be expressed quantitatively up to 90 mL/min/1.73 m2 by CKD-EPI equation. Above 90 mL/ min/1.73 m2, eGFR values can be expressed quantitatively or >90 mL/min/1.73 m2. • eGFR equations of the adult population should not be used for pediatric population. Different equations utilizing also patient height should be used. The enzymatic creatinine assay should be preferred. eGFR based on cystatin C can be used for confirmation in the pediatric population. • Cystatin C measurements, at least when eGFR based on creatinine is not reliable and for confirmation should be encouraged. • Proteinuria or albuminuria values should be measured in spot samples and reported in proportion to creatinine. Özet Kronik böbrek hastalığı (KBH) erken dönemde asemptomatiktir. Semptomlar ortaya cıktığında böbrek fonksiyonu %90 oranında azalmış olabilir. Buna karşılık, eğer erken dönemde saptanırsa hastalığın ilerlemesi önlenebilir veya geciktirilebilir. Eğer saptanamazsa, KBH son dönem böbrek yetmezliği ile sonuclanır. Bu yüzden, KBH hakkında farkındalık artırılmalıdır. KBH tanısı ve derecelendirmesinde tıbbi laboratuvarın rolü son derece önemlidir. Bu derlemede, laboratuvar uzmanlarının temel görevleri tanımlandı. Bunlar anahatlarıyla aşağıda verilmektedir: • Kreatinin ölçümleri uluslararası gecerliliği olan referans materyallere ve izotop seyreltimi kütle spektrometri gibi referans yöntemlere göre izlenebilir olmalıdır. • Kreatinin sonuçları rapor edilirken, erişkin popülasyonda (>18 yaş) eGFR de verilmelidir. Eğer eGFR sonucu <60 mL/ min/1.73 m2 ise raporda bir uyarı ifadesi yer almalıdır. • eGFR sonucları CKD-EPI eşitliği ile 90 mL/min/1.73 m2’ye kadar kantitatif olarak verilmelidir; 90 mL/min/1.73 m2’nin üzerindeki değerler kantitatif olarak veya >90 mL/ min/1.73 m2 olarak ifade edilebilir. • Erişkin popülasyon eGFR değerleri pediyatrik popülasyon için kullanılmamalıdır. Pediyatrik popülasyon için hasta boyunu da içeren farklı eşitlikler kullanılmalıdır ve enzimatik kreatinin yöntemi tercih edilmelidir. Sistatin C’ye dayanan eGFR değeri pediyatrik popülasyonda doğrulama amaclı kullanılabilir. • eGFR’ye dayalı kreatinin sonucu güvenilir olmadığında ve doğrulama gerektiğinde sistatin C ölçümleri teşvik edilmelidir. • Proteinüri ve albüminüri değerleri rastgele örneklerde ölçülmeli ve kreatinine oranlanarak verilmelidir.

Association of oxidative stress marker ischemia modified albumin and polycystic ovary syndrome in adolescent and young girls

Abstract Objective The pathophysiologic features of polycystic ovary syndrome (PCOS) seem to be a combination of genetic predisposition and environmental factors. However, data regarding the exact effect of oxidative stress on PCOS is conflicting. This cross sectional and case-control study was designed to compare the serum ischemia modified albumin (IMA) levels in adolescent and young girls with and without PCOS. Methods A total of 41 non-obese adolescents and young girls (15–21 years) diagnosed as PCOS and 41 age and body mass index (BMI) matched controls were enrolled to study. The main features of PCOS and markers of chronic inflammation were determined together with serum IMA levels at the time of study enrollment. Results The C-reactive protein and neutrophil-to-lymphocyte ratio were within the normal ranges and also there were no significant difference between the two groups (p>0.05). Serum levels of IMA were significantly increased in adolescents with PCOS respect to healthy controls (0.44±0.12 versus 0.35±0.10 absorbance units, p<0.001). And also there was a significant positive correlation between serum IMA and BMI in all groups (r=0.274, p=0.013). Conclusion Serum IMA levels were higher in PCOS patients than in the healthy controls. This elevation may contribute to the increased cardiovascular diseases risk in PCOS patients.

The association of serum nesfatin-1 and ghrelin levels with metabolic syndrome in patients with schizophrenia

Nesfatin-1 and ghrelin are two hormones which has opposite effects and play role in food intake. This study was planned on the idea that both metabolic syndrome and psychiatric disorders are associated with nesfatin-1 and ghrelin. In this study, it was aimed to investigate the levels of ghrelin and nesfatin-1 in patients with schizophrenia, by taking confounding factor as the metabolic syndrome (MS). 55 patients with schizophrenia and 33 healthy controls were included in the study.11 out of the 55 patients (%20) has MS. Serum ghrelin and nesfatin-1 levels of schizophrenia patients with MS have been compared with both healthy controls and schizophrenia patients without MS. Patients with schizophrenia had significantly higher serum nesfatin-1 levels compared to healthy controls. But serum ghrelin levels was not different in both groups. Serum nesfatin-1 concentrations were significantly higher in the schizophrenia patients with MS (10.51-350.8pg/ml) with respect to the healthy control group (4.86-68.91pg/ml). There was no significant statistical difference between the three groups in terms of ghrelin levels. Our findings suggests that, MS presence also contributed to significantly high levels of nesfatin-1 level. Nesfatin-1 may have a part in a novel studies regarding the treatment of schizophrenia and its metabolic effects.

Evaluation of the analytical performance of the Beckman Coulter Unicel DXI 800 Access Total 25(OH) Vitamin D immunoassay

Abstract Background As vitamin D has recently been implicated in various diseases, vitamin D testing has gained a lot more significance. Vitamin D deficiency is quite prevalent, and detection of this condition is important. Several manufacturers have developed new automated immunoassays for this purpose. In this study, we aimed to evaluate the analytical performance of the Access Total 25(OH) Vitamin D immunoassay on the Beckman Coulter Unicel DXI 800 analyzer, through comparison with the reference method, liquid chromatography/tandem mass spectrometry (LC-MS/MS). Methods The study was conducted with 148 patient samples which were sent to Ankara Numune Training and Research Hospital for routine vitamin D testing. Every sample was analyzed with both Unicel DXI 800 immunoassay analyzer and LC-MS/MS. The concordance of the results was evaluated with Passing-Bablok regression analysis and Bland-Altman plot. Additionally, imprecision, interference, limit of blank (LOB), recovery, linearity and carry-over studies were performed for the Beckman Coulter Unicel DXI 800 analyzer. Results When compared to LC-MS/MS, the Access Total 25(OH) Vitamin D immunoassay on the Beckman Coulter Unicel DXI 800 analyzer had an R-value of 0.957 (intercept: −3.938, slope: 1.185) and a mean bias of 9.5%. The concordance correlation coefficient (CCC) between the two methods was 0.916. The intra-assay, inter-assay and total coefficient of variation (CV%) for the Unicel DXI 800 vitamin D immunoassay were 3.3%, 5.3% and 8.3%, respectively, at 31.7 ng/mL concentration, and 2.1%, 3.2% and 7%, respectively, at 66.8 ng/mL concentration. Conclusions The Access Total 25(OH) Vitamin D immunoassay method has acceptable analytical performance, and the results are in concordance with the LC-MS/MS results.

Visfatin and insulin levels and cigarette smoking are independent risk factors for hidradenitis suppurativa: a case–control study

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. HS has been associated with obesity, adipokine imbalance, dyslipidemia, pro-inflammation, and metabolic syndrome (MS). The aim of this study was to determine the association between HS, and serum visfatin levels (SVLs), small-dense low-density lipoprotein cholesterol (sdLDL-C), and ischemia-modified albumin (IMA), as well as the association between HS, and smoking, alcohol consumption, anthropometric measurements, blood pressures (BPs), fasting blood glucose (FBG) and lipids, inflammatory markers, homocysteine, uric acid (UA), serum insulin levels (SILs), insulin resistance (IR) and MS, so as to identify relevant risk factors for HS. This case–control study included 40 patients (M/F: 23/17) and 40 age- and gender-matched controls (M/F: 23/17). Demographic data, smoking status and alcohol consumption, personal and family medical history, previous and current treatments were noted. Anthropometric data, BPs, FBG and lipids, homocysteine, UA, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and high-sensitivity CRP (hs-CRP), hemoglobin A1c (HbA1c), SILs, SVLs, IMA and sdLDL-C were measured. Homeostasis model assessment for IR (HOMA-IR) was calculated. The associations were made by univariate and multivariate analyses. Univariate analysis showed that there was a significant association between HS and smoking, pack-years of smoking, weight, body mass index (BMI), waist circumference (WC), triglycerides (TGs), high-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, SILs, CRP, hs-CRP, homocysteine, UA, ESR, HOMA-IR, SVLs, and MS. After adjusting for BMI and smoking status, the SVLs, SILs, and hs-CRP levels remained higher in the patients than in the controls (P = 0.02, P = 0.01, and P = 0.02, respectively). Multivariate analysis showed that there was a significant association between HS, and the SVLs and SILs, and smoking. Each unit increase in the SVL (P = 0.003, 95% CI 1.16–2.11) and SIL (P = 0.03, 95% CI 1.01–1.17) increased the risk of HS 1.56- and 1.09-fold, respectively. Furthermore, smoking was associated with a 14.87-fold increase in the risk of HS (P = 0.001, 95% CI 2.82–78.56). This study indicates that HS patients have higher SVLs, SILs, and hs-CRP levels than healthy controls—independent of BMI and smoking status. The SVL and SILs and smoking were independent risk factors for HS.

Assessment of macroprolactinemia rate in a training and research hospital from Turkey

Abstract Objective: Macroprolactinemia detection is important to avoid unneccessary tests and overtreatment. High prolactin levels require routine screening and clinicians must be aware of macroprolactinemia frequency encountered with the method in use. In this study we aimed to determine the macroprolactinemia rate in our laboratory. Methods: Prolactin results of different patients analysed on two different immunoassay systems within two consecutive years were evaluated. Analyses were performed on Beckman Coulter UniCel® DxI800 and Roche Cobas® e601 immunoassay systems. Samples for macroprolactin analysis were precipitated using polyethylene glycol (PEG) 6000. Post-PEG recovery <40% was defined as positive, 40–60% as gray-zone and >60% as negative for macroprolactin. Results: For the samples analysed on DxI800 (n=14,958) hyperprolactinemia frequency was 8.1% (n=1208). One of 138 samples submitted for macroprolactin analysis was positive, while three of them were in the gray-zone. For the samples analysed on Cobas® e601 (n=14,040) hyperprolactinemia frequency was 13.9% (n=1954). Eighteen of 238 samples submitted for macroprolactin analysis were positive, while 21 of them were in the gray-zone. Conclusion: A difference was found between two immunoassay systems used in our laboratory in terms of macroprolactinemia rate. However, inability of simultaneous analyses on both systems, lack of evaluation with gel filtration chromatography, and heterophile antibody blocking tube were the limitations.

Comparison of vacuum and non-vacuum urine tubes for urinary sediment analysis

Abstract Urine collection systems with aspiration system for vacuum tubes are becoming increasingly common for urinalysis, especially for microscopic examination of the urine. In this study, we aimed to examine whether vacuum aspiration of the urine sample has any adverse effect on sediment analysis by comparing results from vacuum and non-vacuum urine tubes. The study included totally 213 urine samples obtained from inpatients and outpatients in our hospital. Urine samples were collected to containers with aspiration system for vacuum tubes. Each sample was aliquoted to both vacuum and non-vacuum urine tubes. Urinary sediment analysis was performed using manual microscope. Results were evaluated using chi-square test. Comparison of the sediment analysis results from vacuum and non-vacuum urine tubes showed that results were highly concordant for erythrocyte, leukocyte and epithelial cells (gamma values 1, 0.997, and 0.994, respectively; p < .001). Results were also concordant for urinary casts, crystals and yeast (kappa values 0.815, 0.945 and 1, respectively; p < .001). The results show that in urinary sediment analysis, vacuum aspiration has no adverse effect on the cellular components except on casts.