Journal of Medical Biochemistry最新文献

Background: This paper aimed to determine the prevalence of 25-hydroxy vitamin D (25(OH)D) deficiency in healthy adult patients who presented to our hospital in Istanbul province and to present the difference between vitamin 25(OH)D levels by gender, age group, season, and month.

Methods: The vitamin 25(OH)D levels of 9,778 adults who presented to our hospital's internal medicine checkup outpatient clinic between January 2022 and December 2023 were analyzed retrospectively. Individuals with chronic disorders were excluded from the study. The adult patients included in the study were divided into two groups by age (18-50 and 51-65 years). Serum 25(OH)D levels were measured using the electrochemiluminescence immunoassay method. A serum 25(OH)D level was considered deficient if below 20 ng/mL, insufficient if 20-30 ng/mL, and sufficient if above 30 ng/mL. The patients' 25(OH)D levels were investigated by age, gender, season, and month.

Results: After measurement, vitamin D levels were deficient in 57.2% of the patients (n=5,592), insufficient in 28.2% (n=2,756), and sufficient in 14.6% (n=1,430). The mean vitamin D level of the 18-50 age group was significantly lower than that of the group 51-65 age group (p=0.001; p<0.01). The vitamin D levels did not statistically significantly differ by gender (p=0.085, p>0.05). The mean vitamin D levels were 17.99±10.88 ng/mL in winter, 18.11±12.69 ng/mL in spring, 22.08±11.58 ng/mL in summer, and 21.67±10.82 ng/mL in fall. There were statistically significant differences according to the season and month of hospital presentation (p=0.001; p<0.01).

Conclusions: The prevalence of vitamin D deficiency (below 20 ng/mL) in healthy adults aged 18-65 years in Istanbul was 57.2%. That prevalence varied across seasons and months, indicating that sunlight was not used sufficiently. Vitamin D deficiency in Istanbul presents a major problem that needs to be remedied.

Background: Heart failure (HF) following acute myocardial infarction (AMI) is characterized by high mortality and disability rates, which highlights the need of timely and effective revascularization. Recent studies suggested the potential predictivity of biomarkers NT-proBNP, cTNT, PLR, NLR, and GDF-15 in cardiovascular events, but their value in HF patients post-AMI still require further verification. Therefore, the present study aimed to identify potent biomarkers for prognosticating the development of HF subsequent to AMI, and to devise early interception and therapeutic strategies.

Methods: A total of 170 patients with AMI were enrolled in this study, including 44 patients with post-AMI HF and 126 patients with post-AMI non-HF. We measured the serum biomarkers NT-proBNP, cTNT, PLR, NLR, and GDF-15 in all patients using enzyme-linked immunosorbent assay (ELISA). Subsequently, we performed t-tests to assess the predictive value of these biomarkers for post-AMI HF.

Results: In the group of HF patients, cTNT, NT-proBNP, GDF-15 and NLR was significantly higher than in the group without HF, but PLR was not. The AUC of NLR to predict HF after AMI was 0.632 (95%CI: 0.542-0.723), P=0.010, with a cut-off value of (3.86×109)/L, GDF-15 was 0.661 (95%CI: 0.560-0.763), P=0.002, with a cutoff value of 1.35 ng/mL, and NT-proBNP was 0.82 (95%CI: 0.723-0.876), P<0.001, with a cut-off value of 1444 pg/mL.

Conclusions: In five biomarkers, there is predictive value in NT-proBNP, NLR, GDF-15 for patients with HF after AMI.

Background: Traumatic coagulopathy (TIC) poses a significant challenge in the management of severe trauma cases. Early identification of TIC and its risk factors is vital for initiating timely interventions. The systemic immune inflammation index (SII), a composite marker of inflammation and immune response, alongside conventional coagulation indices, may hold promise in predicting TIC. Here, this study aimed to evaluate the predictive value of combining SII with coagulation indices for TIC in severe trauma patients, with the goal of enhancing early detection and guiding prompt therapeutic strategies.

Methods: The clinical data of patients with severe trauma treated in our hospital from January 2022 to December 2022 were retrospectively selected. According to the outcome of TIC, the patients were divided into TIC group (n = 50) and non-TIC group (n = 50). The general data, SII and individual indexes of the two groups were compared, and the influencing factors of TIC were analyzed by multivariate Logistics regression. ROC analysis of SII combined with blood coagulation index to predict traumatic coagulation in patients with severe trauma.

Results: There was no significant difference in general data between the two groups. SII in TIC group was significantly higher than that in non-TIC group. neutrophil count (NEU), platelet count (PLT), lymphocyte count (LYM), activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB) level, and D-Dimer (D-D) level in TIC group were higher than those in non-TIC group, while LYM, FIB was lower than that in non-TIC group. The logistic regression analysis showed that APTT, D-Dimer, FIB, PT, and SII were independent factors that significantly influenced TIC. The area under the curve of TIC in patients with severe trauma with SII combined with coagulation index was 0.883, and the standard error was 0.032 (95%CI:0.8195~0.9461). The best cut-off value was 0.65. The sensitivity and specificity were 80.3, 84.2 respectively.

Conclusions: SII combined with coagulation index has high predictive value for TIC in patients with severe trauma. By monitoring these indexes, we can more accurately predict the occurrence of TIC and take effective treatment measures in time.

Background: The study aims to assess the feasibility of using a combined approach of liver function indices and FibroScan measurements as a predictive tool for the early detection of anti-tuberculosis drug-induced liver injury (DILI) in patients with existing liver disease.

Methods: A retrospective cohort study was conducted, including adult tuberculosis patients with documented liver disease. Liver function was assessed using standard biochemical parameters, and FibroScan examinations were performed to determine liver stiffness measurement (LSM). Patients were monitored for clinical and biochemical signs of DILI throughout treatment. Logistic regression models and Receiver Operating Characteristic (ROC) curves were used for data analysis. Statistical significance was set at P<0.05.

Results: Patients who developed DILI showed significantly higher levels of ALT, AST, total bilirubin, GGT, and LSM, with strong positive correlations between these markers and DILI occurrence. Logistic regression analysis revealed elevated ALT, AST, TBIL, and GGT were strongly associated with an increased likelihood of DILI. The area under the ROC curves indicated excellent predictive accuracy of these parameters. A nomogram for predicting DILI based on the combined biomarkers was established.

Conclusions: The study demonstrates the feasibility of combining liver function indices and FibroScan measurements to predict anti-tuberculosis DILI. The results highlight the importance of baseline liver health assessment and offer promising implications for clinical practice, aiding in individualized risk estimation and therapeutic decision-making for patients with liver disease initiating anti-tuberculosis therapy. Further validation in larger cohorts is warranted to strengthen the predictive model.

Background: To investigate the impact of colchicine adjuvant therapy on disease control and serum levels of nucleotide-binding oligomerization domain-like receptor (NALP) 3, soluble intercellular adhesion molecule (sICAM)-1, matrix metalloproteinase (MMP)-9, and MMP13 in patients with coronary heart disease (CHD) complicated by acute gout attacks.

Methods: Ninety-two patients with CHD and acute gout attacks admitted to our hospital from October 2021 to January 2023 were randomly divided into an observation group and a control group, with 46 patients in each group. The control group received conventional treatment, while the observation group received colchicine adjuvant therapy on top of the control group's treatment for 7 days. Clinical efficacy in both groups was assessed. Before and after treatment, cardiac function indicators (left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular posterior wall thickness (LVPWT)), vascular endothelial function indicators (sICAM-1, endothelin-1 (ET-1), and vascular endothelial growth factor (VEGF)), inflammatory factors (NALP3, MMP-9, MMP-13) levels, changes in immune cell populations (CD3+ lymphocytes, CD3+CD4+ lymphocytes, CD3+CD8+ lymphocytes ratio, and CD3+CD4+/CD3+CD8+ ratio) were compared, and the incidence of adverse reactions was recorded. Three months after treatment, the occurrence of major adverse cardiovascular events was also recorded.

Results: The total effective rate in the observation group was significantly higher than that in the control group (93.48% vs 79.07%) (P<0.05). After treatment, the levels of NALP3, MMP-9, and MMP-13 in both groups decreased, with the observation group being lower than the control group (P<0.05). After treatment, LVPWT and LVEDD levels in the observation group were lower than those in the control group, and LVEF was higher (P<0.05). After treatment, the levels of ET-1 and sICAM-1 in the observation group were lower than those in the control group, and VEGF levels were higher (P<0.05). After treatment, the proportions of CD3+ lymphocytes, CD3+CD4+ lymphocytes, and CD3+CD4+/CD3+CD8+ ratio were significantly higher in the observation group than in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The occurrence of major adverse cardiovascular events in the observation group was lower than that in the control group (2.17% vs 13.04%).

Conclusions: Colchicine adjuvant therapy improves the efficacy of CHD patients with acute gout attacks, helps improve cardiac function and vascular endothelial function, reduces serum levels of NALP3, sICAM-1, MMP-9, and MMP-13, enhances patient immunity, and controls disease progression.

Background: Severe pneumonia complicated by myocardial damage is a serious condition in children, and early prediction and intervention are crucial for improving outcomes. To explore the clinical value of serum hyaluronic acid, procollagen III N-terminal propeptide, sST2, and cfDNA levels in predicting myocardial damage in children with severe pneumonia.

Methods: A case-control study was conducted on 140 children with severe pneumonia, divided into a control group (n=70) and a group with disease complicated by myocardial injury (n=70). Biomarker levels (hyaluronic acid, procollagen III, N-terminal propeptide levels, sST2, and cfDNA) were detected through biochemical analysis, and clinical outcomes were compared between the two groups.

Results: Logistic regression analysis identified hypoalbuminaemia, age <3 years, and elevated levels of serum hyaluronic acid, procollagen III N-terminal propeptide, sST2, and cfDNA as independent risk factors for myocardial damage. The AUC of these biomarkers in predicting myocardial injury ranged from 0.68 to 0.78, with sensitivities and specificities of 65-80%. The combined prediction AUC was 0.92, with a sensitivity of 87.6% and a specificity of 77%. The control group had lower serum NT-proBNP, CK, CK-MB, and C-reactive protein levels and better clinical outcomes than the myocardial injury group.

Conclusions: Serum hyaluronic acid, procollagen III, NTproBNP, sST2, and cfDNA significantly predict severe pneumonia complicated by myocardial damage. Nursing strategies based on these biomarkers can effectively improve treatment outcomes, demonstrating significant clinical application value.

Background: This study analyzed the risk factors of radiation-induced oral mucositis (RIOM) for nasopharyngeal carcinoma (NPC) and the correlation between epidermal growth factor (EGF), soluble myeloid cell expression trigger receptor-1 (sTREM-1), and disease severity.

Methods: A total of 124 patients with NPC who received radiotherapy from March 2013 to November 2016 were enrolled and divided into the study group (n=68) and the control group (n=56) regarding the presence of RIOM. The risk factors of RIOM were evaluated by multivariate logistic regression. According to the severity of RIOM, patients who developed RIOM were divided into mild and severe groups, and the correlation between EGF, sTREM-1 and the severity of RIOM was analyzed by linear regression. According to the 5-year survival of patients after treatment, they were divided into a poor prognosis group (death, recurrence, and distant metastasis) and a better prognosis group and the predictive value of the prognosis of patients was analyzed by the ROC curve.

Results: Age (>55 years), smoking, poor oral hygiene, and oral pH<7 were risk factors for RIOM, and the use of oral mucosal protective agents was a protective factor (P<0.05). In patients who developed RIOM, EGF levels decreased with increasing severity of RIOM, and sTREM-1 levels increased (P<0.05). The EGF level of patients was negatively correlated with the severity of RIOM. In addition, EGF levels in the poor prognosis group were lower than those in the better prognosis group, whereas sTREM-1 levels were higher than those in the better prognosis group (P<0.05). The AUC of the combined EGF and sTREM-1 levels test for predicting a patient's prognosis was greater than that of sTREM-1 alone (P<0.05).

Conclusions: In short, age (>55 years), smoking, poor oral hygiene, and oral PH<7 are risk factors for RIOM for NPC. The use of oral mucosal protective agents is a protective factor. EGF and sTREM-1 levels are associated with RIOM severity and indicate predictive values for patient outcomes. This study provides new ideas for mitigating the occurrence of RIOM after radiotherapy to treat NPC.

Background: This paper aimed to investigate the expression of CXCL12 and S100A12 in peripheral blood (PB) and synovial fluid (SF) of patients with knee osteoarthritis (OS) and to analyze the correlation between them and the severity of knee OS.

Methods: Sixty patients with knee OS treated in our hospital from January 2020 to December 2022 were selected as the experimental group, and 60 healthy knee joints with similar ages were selected as the control group. The fasting venous blood of 120 subjects was drawn in the early morning, and the SF was extracted during joint operation or sodium hyaluronate injection. Put the collected PB and SF in the refrigerator at -80 °C. The levels of CXCL12 and S100A12 in PB and SF were detected by enzyme-linked immunosorbent assay (Elisa).

Results: The correlation between the levels of CXCL12 and S100A12 in PB and SF and Kmurl L grade and WOMAC score. The levels of CXCL12 and S100A12 in PB and SF in the observation group were higher than those in the control group. There were significant differences in the levels of CXCL12 and S100A12 in PB and SF in the experimental group. The higher the Kmurl grade of knee OS, the higher the concentration of CXCL12 and S100A12 in PB and SF. The levels of CXCL12 and S100A12 in PB of knee OS were positively correlated with WOMAC score (r=0.767, 0.521, respectively, P<0.05); see Figure 1. The levels of CXCL12 and S100A12 in SF of knee OS were positively correlated with WOMAC score (r=0.663, 0.357 respectively, P<0.05). The levels of CXCL12 and S100A12 in PB and SF are positively correlated with the severity of knee OS.

Conclusions: The levels of CXCL12 and S100A12 in PB and SF can provide the basis for the evaluation and prognosis of knee OS.

Background: To investigate the clinical value of absorbable collagen suture in the treatment of oral implant restoration.

Methods: A prospective, randomized, single-blind trial was conducted in patients undergoing dental implant restoration in our hospital. The patients were divided into an absorbable group (incision closure with absorbable collagen suture) and a conventional group (incision closure with conventional suture). The incision healing time, postoperative pain degree, incision healing grade, patient satisfaction, and the levels of tumor necrosis factor-a (TNF-a), interleukin-8 (IL-8) and interleukin-6 (IL-6) in gingival crevicular fluid were compared between the two groups.

Results: The absorbable group had faster incision healing times and lower postoperative pain scores on days 1 and 2, all with significant differences (P<0.05). Wound healing in the absorbable group was notably better, with a Grade A healing rate of 96.88% and a Grade B healing rate of 3.13%. In contrast, the conventional group had a Grade A healing rate of 81.25%, a Grade B healing rate of 17.19%, and a Grade C healing rate of 1.56%. These differences favored the absorbable group significantly (P<0.05). Before surgery, there were no statistically significant differences in the levels of TNF-a, IL-6, and IL-8 in gingival crevicular fluid between the absorbable and conventional groups (P>0.05). However, 3 days after surgery, the absorbable group showed significantly lower levels of TNFa, IL-6, and IL-8 compared to the conventional group (P<0.05). Patient satisfaction rates for stability, aesthetics, chewing function, and pronunciation were similar between the two groups (P>0.05). However, patients in the absorbable group reported significantly higher comfort levels compared to those in the conventional group (P<0.05). Moreover, the complication rate in the absorbable group was significantly lower at 6.25% compared to 18.75% in the conventional group (P<0.05).

Conclusions: Absorbable collagen suture for oral implant prosthesis after suture, beneficial to wound healing and reduce postoperative pain and inflammation.

Background: To analyze the correlation of glucose transporter 4 (GLUT4), leptin receptor (LEPR), and tumour necrosis factor-a (TNF-α) with endometrial receptivity (ER) in patients with polycystic ovarian syndrome (PCOS)induced infertility to provide clinical evidence for future diagnosis and treatment of PCOS-induced infertility.

Methods: We prospectively enrolled 109 study subjects admitted to The Second Hospital Affiliated of Shandong University of Traditional Chinese Medicine from June 2020 to August 2023, including 42 patients with PCOS-induced infertility (research group), 35 nonpregnant patients with simple PCOS (control group), and 32 nonpregnant healthy women (normal group). GLUT4, LEPR, and TNF-α levels in the peripheral blood were detected in all participants, and their diagnostic value for PCOS in healthy women and PCOS-induced infertility in PCOS patients was analyzed. In addition, the endometrial thickness and endometrial blood flow pulsation index (PI) and resistance index (RI) of patients in the research group were measured. Furthermore, the correlation of GLUT4, LEPR, and TNF-α with ER was discussed.

Results: GLUT4 was lower in the research group compared with the control and normal groups, while LEPR and TNF-α were higher (P<0.05); the control group showed lower GLUT4 and higher LEPR and TNF-α levels than the normal group (P<0.05). The diagnostic sensitivity and specificity of GLUT4, LEPR, and TNF-α combined assay for PCOSinduced infertility in PCOS women were 88.57% and 75.00%, respectively, and those for PCOS in healthy women were 78.57% and 60.00%, respectively (P<0.05). In the research group, GLUT4 was positively correlated with endometrial thickness and negatively linked to RI and PI. At the same time, LEPR and TNF-α were negatively associated with endometrial thickness and positively correlated with RI and PI (P<0.05).

Conclusions: GLUT4, LEPR, and TNF-α are closely related to ER in patients with PCOS-induced infertility, and their combined detection can effectively evaluate the occurrence of PCOS and PCOS-induced infertility.