Biohemija i laboratorijska dijagnostika gojaznosti

Until now, a lot of research has been carried out which significantly helped in understanding and solving the problem of obesity. Despite this, there has been an upward in obesity trend at the global level. The role of laboratory diagnostics in the field of obesity is of great importance to doctors for establishing a diagnosis and monitoring the effects of therapy. Determining biochemical parameters also contributes to practical usefulness in the prevention of this disease, and prevention of consequent complications. Routinely available biochemical analyses are usually used to diagnose and monitor the effects of obesity therapy. The initial association related to laboratory analyses refers to parameters of lipid status, but there are a variety of routine laboratory parameters that can help in understanding and monitoring obesity from different angles. Timely and adequate management of obesity is also of interest from an economic aspect. For this reason, the topic of this research is to summarize the latest aspects of the concept of obesity, specifically from the point of view of biochemistry and laboratory diagnostics. Taking into account the complexity of this disease, it is important to point out the future perspectives and challenges that inevitably arise before both laboratory professionals and healthcare providers in general.Do sada je sprovedeno dosta istraživanja koja su značajno pomogla u sagledavanju i rešavanju problema gojaznosti. I pored toga, gojaznost ima trend porasta na globalnom nivou. Uloga laboratorijske dijagnostike u oblasti gojaznosti je od velikog značaja lekarima za postavljanje dijagnoze i praćenje efekata terapije. Određivanje biohemijskih parametara takođe doprinosi praktičnoj korisnosti u prevenciji ovog oboljenja, kao i predupređenju posledičnih komplikacija. Obično se za postavljanje dijagnoze i praćenje efekata terapije gojaznosti određuju rutinski dostupne biohemijske analize. Prvobitna asocijacija vezana za laboratorijske analize odnosi se na parametre lipidnog statusa, ali jako je veliki broj rutinskih analiza koje mogu pomoći u sagledavanju i praćenju gojaznosti iz različitih uglova. Dodatno, pravovremeno i adekvatno upravljanje gojaznošću je od interesa i sa ekonomskog aspekta. Iz tog razloga, tema ovog istraživanja je sumiranje najnovijih aspekata koncepta gojaznosti, posebno sa stanovišta biohemije i laboratorijske dijagnostike. Uzimajući u obzir složenost ove bolesti, važno je ukazati na buduće perspektive i izazove koji se neizbežno javljaju kako pred laboratorijskim stručnjacima, tako i pred zdravstvenim radnicima uopšte

Circulating Fatty Acids Associate with Metabolic Changes in Adolescents Living with Obesity

Fatty acids play a crucial role in obesity development and in the comorbidities of obesity in both adults and children. This study aimed to assess the impact of circulating fatty acids on biomarkers of metabolic health of adolescents living with obesity. Parameters such as blood lipids, redox status, and leukocyte telomere length (rLTL) were measured alongside the proportions of individual fatty acids. The Mann–Whitney U test revealed that individuals with obesity exhibited an unfavorable lipid and redox status compared to the control normal weight group. The group with obesity also had lower plasma n-3 polyunsaturated fatty acids (PUFAs) and a higher ratio of n-6 to n-3 PUFAs than the control group. They also had a shorter rLTL, indicating accelerated biological aging. There was an inverse association of rLTL and plasma n-6-to-n-3 PUFA ratio. Future studies should explore the impact of recommended nutrition plans and increased physical activity on these parameters to determine if these interventions can enhance the health and well-being of adolescents with obesity, knowing that early obesity can track into adulthood

Serbian gynecologists' and pharmacists' beliefs about emergency contraception

Emergency contraception (EC) in Serbia is available in two products: Levonorgestel, which has nonprescription status, and Ulipristal acetate, which is a prescription-only medicine. Considering their dispensing statuses, gynecologists and pharmacists are health care professionals (HCPs) with the widest impact on EC use. Yet little is known about their beliefs and practices regarding these medicines. We surveyed 166 gynecologists (during October 2012-October 2013) and 452 community pharmacists (during January-April 2014). Results showed significant differences between these two groups, suggesting that provision of EC to users may be inconsistent. Gynecologists were more convinced than pharmacists that EC would reduce the abortion rate (86% versus 53%, p lt .001). However, they were more concerned than pharmacists that easy access to EC would cause less regular contraceptive use (66% versus 29%, p lt .001) and risky sexual behaviors, including initiating sexual activity at a younger age (37% versus 19%, p lt .001) and having more sexual partners (33% versus 12%, p lt .001). Additionally, more pharmacists than gynecologists (12% versus 2%, p lt .001) said they would not provide EC to anyone under any circumstance, even to victims of sexual assault. These results indicated a need for reevaluating and establishing official guidelines for dispensing practices.This is peer-reviewed version of the following article: Milosavljevic, J.; Bogavac-Stanojevic, N.; Krajnovic, D.; Mitrovic-Jovanovic, A. Serbian Gynecologists’ and Pharmacists’ Beliefs about Emergency Contraception. Women Health 2017, 57 (4), 508–519. [https://doi.org/10.1080/03630242.2016.1176099

Oxidative stress and platelet activation during on-pump and off-pump coronary artery bypass grafting in patients with double grafted vessels

This study aimed to evaluate the oxidative stress status and two markers of platelet activation and reactivity in off-pump versus on-pump coronary artery bypass surgery. Study groups of 65 patients with double coronary artery bypass grafting were divided into cardiopulmonary bypass (CPB) and off-pump coronary artery bypass groups. In serial blood samples, lipid hydroperoxides (LOOH), serum paraoxonase (PON1), advanced oxidation protein products (AOPP), total sulfhydryl groups (tSHG) and red blood cell distribution width (RDW) to platelet (Plt) ratio (RPR) and mean platelet volume (MPV) to platelet (Plt) ratio (MPR) index were determined to compare the extent of oxidative stress and platelet activation. The MPR and RPR rose significantly in the post-operative period (P lt 0.001) in both groups. The increase was higher in the CPB group, but this difference reached borderline significance at 48 h post-operatively. The AOPP/tSHG index increased 6 h after surgery, preceded by a significant fall of the PON1/LOOH ratio, more evident in the CPB group. Multiple linear regression analysis showed explicit connection between these markers and surgery-related clinical conditions. Receiver operating characteristic analysis enabled estimation of the clinical accuracy of oxidative plus platelet-related indices in prediction of surgery caused complications (area under the curve for the model consisted of oxidative stress parameters and platelet activation indices was above 0.9, P lt 0.001). Results showed higher oxidative stress and undesirable platelet activation in the CPB group. Oxidative status markers and platelet activity indices showed good clinical accuracy to predict the development of possible surgical complications

Analysis of the Prognostic Potential of Schlafen 11, Programmed Death Ligand 1, and Redox Status in Colorectal Cancer Patients

The Schlafen 11 (SLFN11) protein has recently emerged as pivotal in DNA damage conditions, with predictive potential for tumor response to cytotoxic chemotherapies. Recent discoveries also showed that the programmed death ligand 1 (PD-L1) protein can be found on malignant cells, providing an immune evasion mechanism exploited by different tumors. Additionally, excessive generation of free radicals, redox imbalance, and consequential DNA damage can affect intestinal cell homeostasis and lead to neoplastic transformation. Therefore, our study aimed to investigate the significance of SLFN11 and PD-L1 proteins and redox status parameters as prognostic biomarkers in CRC patients. This study included a total of 155 CRC patients. SLFN11 and PD-L1 serum levels were measured with ELISA and evaluated based on redox status parameters, sociodemographic and clinical characteristics, and survival. The following redox status parameters were investigated: spectrophotometrically measured superoxide dismutase (SOD), sulfhydryl (SH) groups, advanced oxidation protein products (AOPP), malondialdehyde (MDA), pro-oxidant–antioxidant balance (PAB), and superoxide anion (O2•–). The prooxidative score, antioxidative score, and OXY-SCORE were also calculated. The results showed significantly shorter survival in patients with higher OXY-SCOREs and higher levels of serum SLFN11, while only histopathology-analysis-related factors showed significant prognostic value. OXY-SCORE and SLFN11 levels may harbor prognostic potential in CRC patients

Cardiovascular risk factors in 7-13 years old children from Vojvodina (Serbia)

Background: Atherosclerosis is a chronic inflammatory disease which starts early in life and depends on many factors, an important one being dyslipoproteinemia. According to several studies, atherosclerotic plaques or their precursors could be seen in children younger than 10 years. During later life, interaction with a sedentary way of life, as well as unhealthy nutrition, smoking, alcohol consumption, obesity and family history of cardiovascular disease cause the burden of atherosclerotic disease. Methods: Study included 624 children (316 boys, 308 girls), aged from 7-13 years. We analysed socio-demographic data (BMI, blood pressure, cardiovascular family history, smoking status), as well as lipid status with lipoprotein little a-Lp(a), and apolipoproteins: Apo AI, Apo B-100 for all children. This enabled us to calculate new atherogenic indices Tg/HDL-c, lipid tetrad index (LTI) and lipid pentad index (LPI). Cardiovascular risk for later life was estimated by using modified Risk Score for Young Individuals (RS), which divided the subjects according to the score level: low, medium and higher risk. Results: The older children (13 y) had better lipid status than the younger children, i.e. significantly lower total cholesterol, LDL-C, triglycerides and non-HDL-C concentration and significantly higher HDL-C concentration than the younger children and this was in accordance with the RS level. Children with a positive family history of CV disease had significantly higher Lp(a) concentration and blood pressure. LPI was significantly higher in children with a higher RS. Conclusions: The results of our work could be used for cardiovascular risk assessment in apparently healthy children to provide preventive measures which could control the change able risk factors

Biomarkeri prehipertenzije

Prehypertension, which was defined as a systolic blood pressure (SBP) between 120 and 139 mmHg or a diastolic blood pressure (DBP) between 80 and 89 mmHg is shown to be associated with a twofold higher risk of cardiovascular disease (CVD) in addition to a higher risk of developing hypertension. We examined the association between CVD biomarkers and prehypertension in 99 adults who were free of hypertension. We measured concentrations of lipid parameters, high sensitivity serum C-reactive protein, uric acid (UA), fibrinogen and colected demografic data. The SBP positively correlated with body mass index (BMI), waist-to-hip ratio (WHR), triglycerides and UA and negatively with high density lipoprotein cholesterol and apolipoprotein A-I concentrations. There was independent association of higher WHR with higher SBP (standardized coefficients β = 0.483; p=0.002). The ordinal regression analysis revealed that WHR (β = 9.380, p =0.004) and UA concentration (β = 0.006, p = 0.013) were predictors of higher blood pressure (BP). Higher BP in asymptomatic parsons is associated with abdominal obesity. Lifestyle modifications, especially WHR reduction, should be recommended to individuals with prehypertension. Therapy with positive effect on BP and UA concentration may improve CVD management. These should be further investigated in longitudinal population-based studies.Osobe sa sistolnim krvnim pritiskom (SKP) između 120 i 139 mm Hg i dijastolnim krvnim pritiskom (DKP) od 80 do 89 mm Hg ili sa prehipertenzijom imaju dva puta veću verovatnoću razvoja kardiovaskularnih bolesti (KVB) i veći rizik za razvoj hipertenzije. U ovoj studiji ispitivana je veza biomarkera KVB sa prehipertenzijom. U istraživanje je uključeno 99 normotenzivnih osoba. Određivane su koncentracije lipidnih parametara, visoko osetljivog C reaktivnog proteina, mokraćne kiseline (MK), fibrinogena i demografske karakteristike pacijenata. Utvrđena je pozitivna veza SKP sa indeksom telesne mase (ITM) i odnosom struka i kuka (indeks S/K) i negativna korelacija sa koncentracijama holesterola u lipoproteinima visoke gustine i apolipoproteina A-I. Takođe, visoke vrednosti indeksa S/K nezavisno od ostalih parametara doprinose povećanju SKP (standardizovani koeficijent β = 0.483; p=0.002). Veći indeks S/K (β = 9.380, p =0.004) i viša koncentracija MK (β = 0.006, p = 0.013) povećavaju verovatnoću pojave viših vrednosti krvnog pritiska (KP). Kod normotenzivnih osoba više vrednosti KP su u vezi sa abdominalnom gojaznošću, pa cilj preventivnih mera treba da bude smanjenje indeksa S/K. Buduće studije bi pored proučavanja efekata lekova na smanjenje KP, trebalo da ispitaju uticaj tih lekova na koncetraciju MK, u cilju nalaženja novih mogućnosti za smanjenje rizika za KVB

Analysis of redox status and HDL subclasses in patients with lymphoma and the associations with FDG-PET/CT findings

Newer research points to alterations in the plasma redox status and the HDL subclass distributions in cancer. We aimed to assess the redox status and the HDL subclass distributions, lipids, and inflammatory markers in lymphoma patients in order to determine whether they were correlated with changes in FDG-PET/CT scans. At the beginning of this study, redox status, HDL subclasses, lipids, and inflammation biomarkers were determined in 58 patients with lymphoma (Hodgkin lymphoma, n=11 and non-Hodgkin lymphoma, n=47), and these same measurements were reassessed during their ensuing treatment (in 25 patients). Initially, the total oxidation status (TOS), the prooxidant–antioxidant balance (PAB), the OS index (OSI), the total protein sulfhydryl groups (SH-groups), and the advanced oxidation protein products (AOPP) were significantly higher in lymphoma patients as compared to healthy subjects, but the total antioxidant status (TAS) was significantly reduced. The PAB had a strong correlation with the CRP and interleukin-6 (rho=0.726, p[removed

Oxidative Stress in Patients before and after On-Pump and Off-Pump Coronary Artery Bypass Grafting: Relationship with Syntax Score

Objective. Coronary artery bypass grafting (CABG) represents the significant source of increased oxidative stress (OS). We aimed to follow the OS status parameters (i.e., ischemia-modified albumin (IMA), malondialdehyde (MDA), superoxide anion, prooxidantantioxidant balance (PAB), total oxidant status (TOS), total antioxidant status (TAS), and superoxide-dismutase (SOD)) change through the predefined study times in two different surgical procedures, i.e., cardiopulmonary bypass (CPB) and off-pump coronary artery bypass grafting (OPCAB). Additionally, we aimed to investigate those OS status parameters in specific study times according to SYNTAX score (SS), an established angiographic score for evaluating the extensity and severity of coronary artery disease. Patients and Methods. A total of 107 patients that were planned to undergo CABG were included (i.e., 47 patients in OPCAB and 60 patients in CPB group). Blood samples were taken at 6 time intervals: before surgery (t1), immediately after intervention (t2), 6 h (t3), 24 h (t4), 48 h (t5), and 96 h after termination of the operation (t6). Results. IMA levels were higher in CPB than that in OPCAB baseline and rose in CPB group in t2 point. TOS decreased in both study groups, compared to baseline values, but without statistical significance. Superoxide anion and PAB significantly increased in t3-t6 study times, in both groups. MDA significantly increased only in CPB group in t5 and t6 interval. MDA was significantly higher in CPB group compared to OPCAB in t6 study point. CPB patients had significantly lower TAS compared to OPCAB patients at the beginning and in t2 and t3 study points. They also had significantly lower SOD activities compared to OPCAB, baseline, and in several study points. Moreover, TAS, SOD, and TAS/TOS ratio were significantly lower, whereas PAB and TOS/TAS were significantly higher in patients with high SS compared to corresponding groups. SOD activity, IMA, and TAS level were the best predictors of high SS. Conclusion. CPB patients were in more severe ischemia baseline than OPCAB group and IMA rose in CPB patients immediately after the surgery end, but not later. Also, the antioxidant status was significantly lower, whereas the prooxidant status was significantly higher in patients with high SS compared to corresponding groups. SOD activity, IMA, and TAS level were the best predictors of CAD (as determined with SS), showing that SOD and IMA had very good discriminatory capability towards higher SS status

Paraoxonase 1 low activity and SYNTAX score may predict postoperative complications after coronary artery surgery

OBJECTIVE: Coronary artery bypass grafting (CABG) seems to present a powerful trigger of oxidative stress (OS) and acute inflammatory response. This study aimed to estimate the effects of off-pump coronary artery bypass (OPCAB) grafting on the OS that is commonly observed in patients undergoing operation under cardiopulmonary bypass (CPB). Additionally, we aimed to examine the relationship between and paraoxonase 1 (PON1) activity and the degree of stenosis, severity and complexity of the atherosclerotic lesions, estimated by SYNTAX score (SS). PATIENTS AND METHODS: Study group of 107 patients scheduled for CABG were divided into CPB and OPCAB group. Blood samples for OS markers measurement were collected at six-time intervals: before skin incision (t1), immediately after surgery (t2), 6h (t3), 24h (t4), 48h (t5) and 96h after cessation of the operation and surgical trauma (t6). SS was calculated. RESULTS: A significant decrease in lipid hydroperoxides (LOOH) and advanced oxidation protein products (AOPP) levels after both types of surgeries were observed, whereas PON1 reduction was observed higher in the CPB than in the OPCAB group. A significant inverse correlation between SS values and PON1 activity, preoperatively and during the early postoperative hours after surgery [in t2, t3 time intervals (p<0.05 for all)] was found. ROC analysis showed that for CPB patients, Model with all OS parameters showed excellent accuracy (AUC=0.957, p<0.001) for prediction postoperative complications. CONCLUSIONS: Decrease in PON1 activity during the early post-operative phases was related to higher SS. This relationship was more convincing in CPB, compared with OPCAB patients. Moreover, integrated models of OS status parameters have the capability to predict the development of postoperative complications