Significance of serum levels of angiopoietin-2 and its relationship to Doppler ultrasonographic findings in rheumatoid arthritis patients

AbstractBackgroundAngiopoietin-2 (Ang-2) is connected to angiogenesis in synovial regions, but the significance of its levels in patients with rheumatoid arthritis (RA) is still unclear.Aim of the workTo evaluate the significance of serum levels of Ang-2 in patients with RA. Also, to determine Ang-2 relationship to the findings of joints Doppler ultrasonographic findings.Patients and methodsThis study included 40 patients with RA, and 25 matched healthy controls. All patients were subjected to assessment of pain using visual analogue scale (VAS), assessment of personal activity using the Health Assessment Questionnaire (HAQ) score, and calculation of disease activity score (DAS 28). Laboratory assays of complete blood count (CBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF) titre, and measurement of serum levels of Ang-2 by ELISA. Doppler ultrasonography (US) assessment for eight joints, with calculation of synovial thickness and total signal score (TSS), was done.ResultsSerum Ang-2 levels were significantly higher among patients (3191.3±594.9pg/ml) than controls (1771.7±103.1pg/ml) (p<0.001). Serum Ang-2 levels were significantly correlated with ESR, CRP, DAS28, and duration of morning stiffness (p<0.001, p<0.001, p<0.001, and p=0.025, respectively). There was a significant correlation between serum Ang-2 levels and findings of US, regarding joint synovial thickness, and TSS (p<0.001, for both).ConclusionPatients with RA had significantly higher levels of serum Ang-2 versus controls. In those patients, serum Ang-2 levels were significantly correlated with disease activity markers (ESR, CRP), DAS28, and duration of morning stiffness. Moreover, these levels were significantly correlated with synovial thickness, and TSS. The role of Ang-2 in RA pathogenesis might open the door to the development of new therapeutic strategies, particularly which target angiogenesis

Serum resistin in acute myocardial infarction patients with and without diabetes mellitus

Aim: Human resistin is an adipokine, which has been suggested to be an inflammatory marker, with possible links to atherosclerosis and coronary heart disease. Meanwhile, the relationship between serum resistin, insulin resistance, and type 2 diabetes mellitus (T2DM) is still controversial. Therefore, this study aimed to assess serum resistin in patients with acute ST-segment elevation myocardial infarction (STEMI), with and without T2DM. Patients and methods: A total of 55 subjects included in this study, were categorized into three groups: 20 non-diabetic patients with acute STEMI (group I), 20 diabetic patients with acute STEMI (group II), and 15 healthy age and gender-matched controls (group III). Levels of serum lipids, fasting blood glucose (FBG), insulin, troponin I, creatine kinase (CK), lactate dehydrogenase (LDH), and resistin, were estimated. Results: Serum total cholesterol, low density lipoprotein cholesterol (LDLc), FBG, troponin I, CK (total and MB), LDH, and resistin, were significantly higher in group II, than in group I and group III (p  0.05). However, in this patients’ group, serum resistin was not correlated with age, gender, body mass index (BMI), total cholesterol, FBG, insulin, CK, LDH, and the calculated homeostasis model for insulin resistance (HOMA-IR) (p > 0.05). As regards group I, serum resistin was not correlated to any of these studied parameters (p > 0.05). Conclusion: Serum resistin levels are elevated in patients with acute STEMI. This increase is more evident in patients with T2DM than those without T2DM, denoting higher degrees of inflammation. However, serum resistin is not correlated with age, gender, BMI, and insulin resistance. These data denote that serum resistin concentration might be used as a diagnostic biomarker for acute STEMI. In addition, optimization of the treatment of T2DM could improve cardioprotection

Role of serum glypican-3 in the diagnosis and differentiation of small hepatocellular carcinoma from hepatitis-C virus cirrhosis

Background: Serum alpha-fetoprotein (AFP) has insufficient sensitivity and specificity for detection of hepatocellular carcinoma (HCC). Recently, glypican-3 (GLP-3) was suggested as a new biomarker for the detection HCC. Objectives: To determine the role of serum GLP-3 levels in the early diagnosis and differentiation of small (3 cm or less in diameter) HCC from liver cirrhosis. Also, to correlate GLP-3 levels to clinico-laboratory data. Methods: The study included sixty patients; 30 of them with hepatitis C virus (HCV) cirrhosis, and 30 patients with proved HCC. In addition, 20 healthy subjects were included as a control group. Clinical and radiological features (abdominal ultrasonography and/or abdominal triphasic computed tomography) were recorded. Liver function tests, complete blood cell count, and serum AFP were measured. Serum GLP-3 values were determined by an ELISA technique. Results: Serum levels of GLP-3 were significantly elevated in patients with HCC compared with HCV cirrhosis group (p < 0.001). Also, these levels were significantly elevated in these two patients’ groups versus controls (p < 0.001). Also, serum GLP-3 levels with cut-off value of ⩾240 ug/L, had a higher sensitivity (100%) and same specificity (93.3%), than AFP with cut-off value of ⩾200 ng/ml, for detection of HCC. Moreover, GLP-3 levels showed a higher sensitivity than AFP (50% vs.41.7%), for detection of small HCC. The combined use of both markers (i.e. when either one of the two markers positive) improved the specificity to 88.9%. Regarding unicentric HCC, GLP-3 at cut-off value of ⩽580 ug/L had better specificity than AFP at cut-off value of ⩽765 ng/ml (57.1% vs. 42.9%). The combined use of both markers improved the sensitivity and specificity to 82.6% and 71.4%, respectively. Conclusion: Serum GLP-3 levels are higher in HCC versus HCV cirrhosis, which can differentiate HCC from liver cirrhosis. Also, serum GLP-3 is highly sensitive and specific for detecting HCC. Moreover, GLP-3 is more sensitive than AFP for the detection of small HCC. Furthermore, a combination of both serum markers yielded an improved specificity and both sensitivity and specificity for the diagnosis of small and unicentric HCC, respectively