Journal of Medical Biochemistry最新文献

Background: This study explores the application of oxygen-driven salbutamol (SA) combined with methylprednisolone (MP) in bronchial asthma (BA) from the perspective of objective clinical markers, including serum inflammatory response, oxidative stress response, immunoglobulin, and pulmonary ventilation function.

Methods: A retrospective analysis was performed on 207 pediatric BA patients admitted to our hospital between January 2022 and January 2025. Of them, 114 children received MP combined with SA nebulization (control group), and 93 children received MP combined with oxygen-driven SA (observation group). The pulmonary ventilation function, inflammatory mediators (HIF-1a, IL-4, IL-6, IL-8 and TNF-a), stress response indicators (SOD, NO, ET-1 and MDA) and immunoglobulin (IgE, IgA, IgM and IgG) were detected and compared before and after treatment.

Results: Post-treatment, the observation group demonstrated superior pulmonary ventilation function and significantly lower levels of inflammatory mediators (HIF-1a, IL-4, IL-6, IL-8, and TNF-a) compared to the control group (P < 0.05). Regarding stress response, the SOD level in the observation group was higher after treatment, while the levels of NO, ET-1, and MDA were lower (P < 0.05). In addition, IgE was lower and IgA was higher in the observation group than in the control group after treatment (P < 0.05).

Conclusions: The combination of oxygen-driven SA and MP is more effective in mitigating inflammatory, stress responses and optimizing immune function in pediatric BA patients.

Background: Paraoxonase 1 (PON1) is a calcium-dependent esterase and exerts antioxidant and antiatherogenic properties. Advanced oxidation protein products (AOPP) are a group of carbonylated protein products showing oxidant-mediated protein damage. This study aimed to determine serum PON1 activities and AOPP concentrations in diabetic patients and to evaluate these parameters in terms of their relationships with diabetes mellitus (DM) and related factors.

Methods: A total of 93 patients diagnosed with type 2 DM and 30 healthy controls were enrolled in the study. Serum AOPP levels and PON1 activities were measured spectrophotometrically. Other biochemical parameters, including glucose, total cholesterol, HDL-C, LDL-C, triglycerides, HbA1c and clinical/demographic data, were measured in the routine blood chemistry laboratory and retrieved from patient files.

Results: Serum PON1 activity was significantly lower in patients with DM (31.6 [21.49-48.45] U/mL) compared to controls (41.08 [29.07-54.35] U/mL) (p= 0.028). Serum AOPP concentration was significantly higher in diabetic patients (584.6 [453.8-778.6] pmol/L) than in controls (173.9 [98.77-224.1] pmol/L) (p< 0.001). PON1 activity negatively correlated with AOPP concentration and positively with serum HDL-1 levels. AOPP concentration positively correlated with age, weight, HbA1c, glucose, total cholesterol, and LDL-C. A PON1 activity cut-off of ^25 U/mL predicted DM with a sensitivity of 36.56% and specificity of 90% (AUC: 0.634, p= 0.028). An AOPP concentration cut-off of >340 mmol/L predicted DM with a sensitivity of 89.25% and specificity of 93.33% (AUC: 0.965). Both PON1 (OR: 10.821, 95% CI: 1.959-59.778, p= 0.006) and AOPP (OR: 190.068, 95% CI: 20.102-1797.148, p< 0.001) were independently associated with DM after adjusting for age, sex, and weight.

Conclusions: AOPP and PON1 may play a significant role in the development and progression of DM. In particular, serum AOPP concentrations appear to be distinctive among patients with new-onset DM.

Background: Metformin, a biguanide primarily used for the treatment of type 2 diabetes mellitus, has attracted significant attention for its potential anti-ageing effects. As ageing becomes the primary risk factor for chronic diseases, interventions targeting fundamental ageing processes are gaining traction in biomedical research.

Methods: Accumulating evidence suggests that metformin exerts geroprotective effects through multiple interconnected pathways. These include activation of AMP-activated protein kinase (AMPK), inhibition of the mechanistic target of rapamycin (mTOR), attenuation of oxidative stress, modulation of mitochondrial biogenesis, and reduction of low-grade systemic inflammation. Together, these actions address key hallmarks of ageing such as cellular senescence, dysregulated nutrient sensing, and altered proteostasis.

Results: Animal studies have consistently shown that metformin extends both lifespan and healthspan. In humans, retrospective epidemiological data indicate reduced incidence of cancer, cardiovascular disease, and cognitive decline among metformin users. The TAME (Targeting Ageing with Metformin) trial represents the first large-scale attempt to assess ageing-related outcomes in a non-diabetic population formally. Despite promising data, uncertainties remain regarding optimal dosing, long-term safety, and applicability in healthy ageing populations. Furthermore, individual variability in response to metformin suggests the need for precision medicine approaches.

Conclusions: Metformin stands at the intersection of metabolic regulation and ageing biology. While not a panacea, its favourable safety profile and multi-targeted actions make it a leading candidate for repurposing as an anti-ageing therapy. Continued clinical validation is essential to translate these insights into practice.

Background: Effective glycemic management in type 2 diabetes remains challenging due to limited patient self-management and fragmented care. The National Standardized Metabolic Management Center (MMC)-assisted glycemic control assistant is a novel digital platform that integrates real-time monitoring, education, and treatment adjustment. This study evaluated its impact on biochemical markers and patient behaviors compared with routine care.

Methods: A retrospective study was conducted on 160 patients with type 2 diabetes, including 95 who received MMC-assisted digital management and 65 who received routine care. Key biochemical parametersfasting plasma glucose (FPG), 2-hour postprandial glucose (2hPG), and glycated hemoglobin (HbA1c)were measured using standardized enzymatic assays. Dietary behavior and diabetes self-management were also assessed using validated scales.

Results: At baseline, groups were comparable in clinical and behavioral characteristics. After intervention, the MMC group achieved greater improvements: FPG decreased by 10.1% (7.42± 2.43 vs. 8.30± 2.66 mmol/L, P= 0.032), 2hPG by 17.5% (10.23± 3.21 vs. 12.39± 3.50 mmol/L, P < 0 .0 0 1 ), and HbA1c by 9.0% (7.26 ± 2.05 % vs. 7.98± 2.34% , P = 0.041). Significant gains were also observed in dietary behavior and adherence to glucose monitoring, medication, and exercise.

Conclusions: The MMC-assisted glycemic control assistant enhances glycemic control and promotes healthier behaviors in type 2 diabetes. These findings support its clinical utility and highlight the potential for broader integration of digital tools into standardized chronic disease management.

Background: Originally classified among antiepileptic drugs, pregabalin has been prescribed for clinical conditions such as neuropathic pain, generalised anxiety disorder, and fibromyalgia. In recent years, accumulating evidence has highlighted its potential for misuse and abuse, particularly among individuals with a high prevalence of opioid dependence. This study aims to conduct a comprehensive bibliometric analysis of global research on pregabalin misuse and abuse, to identify key trends, influential contributors, and collaborative networks.

Methods: Bibliometric design was employed using data retrieved from the Web of Science Core Collection database. The search was conducted in February 2025, and relevant publications were identified based on predefined inclusion and exclusion criteria. A total of 449 eligible records were exported and compiled for analysis. The bibliometric analysis was carried out using the bibliometrix R package and its Web-based interface Biblioshiny, both operating within the RStudio environment.

Results: The analysis revealed a notable increase in scientific output on pregabalin misuse and dependence, particularly after 2010. The United States emerged as the most prolific and central country within the global collaboration network, followed by the United Kingdom, Germany, and France. Leading authors and institutions were concentrated in specific academic clusters. Keywords such as "abuse," "addiction," and "opioids" have shown an increasing trend since 2016.

Conclusions: This study highlights the growing academic interest in the misuse and abuse potential of pregabalin, particularly over the past decade. The findings reveal a centralised research structure, with significant contributions from high-capacity countries such as the United States, the United Kingdom, and Germany. Emerging participation from developing countries, including Türkiye, underscores a broadening global awareness of the issue. The results emphasise the importance of interdisciplinary collaboration, policies, and the critical role of clinical laboratories in monitoring pregabalin-related risks.

Background: This article analysed the relationship between serum advanced glycation end-products (AGEs), carnosinase-1 (CN-1) and diabetic nephropathy (DN) and diabetic retinopathy (DR).

Methods: 150 patients with type 2 diabetes mellitus (DM2) were grouped: DN and non-DN, DR and non-DR groups. Fasting venous blood was collected, and serum levels of AGEs and CN-1 were detected. Pearson's correlation (PC) test was adopted to analyse their correlation with DN and DR, and multivariate logistic regression (MLR) analysis was adopted.

Results: There were 48 DN cases, 102 non-DN cases, 20 DR cases, and 130 non-DR cases in 150 patients with DM2. As against the non-DN group, the serum levels of AGEs and CN-1 in the subjects with DN were markedly increased. Similarly, the serum levels of AGEs and CN-1 in subjects with DR were also significantly increased compared to the non-DR group. The results of correlation analysis revealed that the levels of serum AGEs and CN-1 were positively correlated with the occurrence of DN and DR. Serum AGEs and CN-1 levels were identified as independent risk factors (IRF) for DN and DR (all P< 0.05).

Conclusions: AGEs and CN-1 may become new targets for the diagnosis and treatment of diabetic microvascular complications.

Background: To investigate the associations of serum magnesium, total calcium, and ionized calcium levels with ICU mortality, addressing conflicting evidence on electrolyte imbalances in critically ill patients.

Methods: This retrospective cross-sectional study analyzed 16,249 adult ICU patients from 208 U.S. hospitals (2014-2015) using the eICU Collaborative Database. Serum magnesium, total calcium, and ionized calcium levels were measured within 24 hours of ICU admission. ICU mortality was the primary outcome. Multivariate logistic regression, adjusted for 15 confounders (e.g., age, sex, APACHE scores, comorbidities), and restricted cubic spline (RCS) models assessed linear and non-linear associations, with subgroup analyses by disease severity.

Results: In fully adjusted models, ionized calcium showed a significant non-linear association with ICU mortality (OR: 0.90 per 1 mmol/L increase, 95% CI: 0.83 - 0.97, P = 0.009). Piecewise regression identified a threshold at 1.2 mmol/L: below this, each 1 mmol/L increase reduced mortality risk by 14% (OR: 0.86, 95% CI: 0.79 -0.94, P = 0.001); above it, risk increased by 97% (OR: 1.97, 95% CI: 1.12 -3.49, P = 0.019). This protective effect was stronger in patients with lower APACHE II scores (P-interaction = 0.021). Magnesium (OR: 0.95, 95% CI: 0.79 -1.14, P = 0.594) and total calcium (OR: 1.02, 95% CI: 0.93 -1.11, P = 0.689) showed no significant associations.

Conclusions: Ionized calcium exhibits a U-shaped relationship with ICU mortality, with an optimal range near 1.2 mmol/L, particularly in less severe cases. These findings suggest prioritizing ionized calcium monitoring in ICU settings and warrant prospective validation.

Background: To observe the changes in bile acid synthase activity, conjugation enzyme gene and intestinal mucosal barrier function (D-LA, Zonulin, MFG-E8) in patients with type 2 diabetes mellitus (T2DM) after bariatric and metabolic surgery (BMS), and to provide an objective opinion on the clinical optimisation of BMS.

Methods: 127 patients with T2DM who had received BMS treatment at our hospital from October 2023 to August 2024 were included in the study, and weight loss glucose-lipid metabolism was detected before surgery and 6 months after surgery. Furthermore, the study quantified the expression levels of key enzymes involved in bile acid synthesis and conjugation (CYP7A1, CYP27A1, FXR, FGF19) and markers indicative of intestinal mucosal barrier function (D-LA, Zonulin, MFG-E8).

Results: After BMS, the patient's weight was significantly reduced, and glucolipid metabolism was significantly improved (P< 0.05). In addition, CYP7A1 was decreased, and FXR and FGF19 were elevated in patients after surgery (P < 0.05). Regarding the intestinal mucosal barrier function, D-LA and Zonulin were reduced in patients after surgery (P< 0.05). MFG-E8 was not significantly altered.

Conclusions: BMS can effectively improve glucose-lipid metabolism and reduce body weight in T2DM patients, and its mechanism is related to regulating bile acid metabolism and promoting the recovery of intestinal barrier function.

Background: This study aimed to develop and validate a novel risk prediction model for hepatorenal syndrome (HRS) in hepatic failure (HF) patients by integrating glucose-6-phosphate dehydrogenase (G6PD) activity with conventional hepatic and renal function biochemical parameters, thereby enhancing early HRS detection beyond the limitations of traditional indicators.

Methods: We performed a retrospective analysis of 264 HF patients (82 with HRS, 182 without HRS) hospitalized between July 2020 and July 2022. G6PD levels and standard hepatic/renal function biochemical parameters (ALT, AST, TBil, GGT, BUN, Scr, UA, and CysC) were assessed. Key predictors were identified via Least Absolute Shrinkage and Selection Operator (LASSO) regression, and a multivariate logistic regression model was developed. Model performance was evaluated using receiver operating characteristic (ROC) analysis, with internal validation conducted through a 70:30 training-validation split.

Results: HRS patients exhibited significantly lower G6PD activity than non-HRS HF controls (P < 0.05). While G6PD alone showed moderate predictive value (AUC = 0.742; sensitivity 59.76%, specificity 79.12%), the composite model integrating G6PD, GGT, UA, Scr, and CysC demonstrated markedly improved discrimination, achieving AUCs of 0.960 (95%CI: 0.931-0.990) in the training cohort and 0.957 (95%CI: 0.913-1.000) in the validation cohort with both sensitivity and specificity outperforming individual indicators. The derived risk equation was Combined testing Youden = -17.038 + -0.116 x G6PD + 0.102 x GGT + 0.016 x UA + 0.040 x Scr + 3.760 x CysC.

Conclusions: The integration of G6PD with hepatic and renal function biochemical parameters significantly enhances HRS risk stratification in HF patients. This validated tool offers superior sensitivity and specificity for the early identification of HRS.

Background: We attempted to clarify the diagnostic value of combined detection of neutrophil-to-lymphocyte ratio (NLR) and serum C-reactive protein (CRP) for migraine patients in the attack stage.

Methods: A total of 50 migraine patients in the attack stage undergoing treatment in our hospital from June 2023 to June 2024 were chosen as the observation group. Additionally, 50 healthy individuals undergoing physical examination in our hospital were chosen as the control group. We adopted questionnaires to obtain detailed demographic data, medical history, and disease characteristics of patients. The patients and healthy examinees received routine blood tests without prior medication within 3 hours after admission. The absolute values of neutrophils (N) and lymphocytes (L) were obtained, followed by calculation of the neutrophil-to-lymphocyte ratio (NLR). The serum C-reactive protein (CRP) level was measured using immuno-nephelometry. The diagnostic value of NLR and serum CRP for migraine was analysed using the receiver operating characteristic (ROC) curve.

Results: The serum CRP and NLR levels were significantly higher in the observation group compared with the control group (P< 0.05). In the observation group, serum CRP and NLR levels in patients with migraine with aura were comparable to those in patients without aura, with no significant difference (P> 0.05). Similarly, differences in serum CRP and NLR levels between patients with frequent migraine attacks and those with infrequent attacks were not statistically significant (P> 0.05). Serum CRP or NLR alone could be used to diagnose migraine patients in the attack stage, and there was no significant difference between them in diagnostic accuracy (P= 0.633). However, combined detection of serum CRP and NLR showed a significantly higher diagnostic value than either marker alone.

Conclusions: The inflammatory biomarkers serum CRP and NLR were markedly elevated in migraine patients during the attack stage. The combination of serum CRP and NLR has diagnostic value in identifying migraine attacks.