Effect of ginkgo extract on eye microcirculation in patients with diabetes

Funding Information: This research is a part of international “Eureka“ project „Creation of the methodology for effects of natural antioxidants on the development of the Diabetes mellitus complications“ financially supported by the European Social Fund Agency, Lithuania according to the “Human Resource Development Action Program”, project No. VP1-3.1-SMM-06-V-01-003. Also we would like to thank Laboratory of Biochemistry of Riga Stradins University, Latvia for performing biochemical tests of blood plasma and for the residents of Endocrinological Clinic, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Lithuania for the help. Provision of capsules of Ex.Gb from “Aconitum” and placebo capsules from “Sanitas” is appreciated too.The prevalence of Diabetes mellitus has increased around the world in the last decade. Anyone with diabetes is at risk of diabetic eye complications. The aim of the study was to compare effects of standardized Ginkgo biloba (Ginkgo biloba L.) dry extract (Ex.Gb) with the placebo on the microcirculation lesions of the eye in randomized double-blind placebo-controlled trial. 44 patients with type 2 diabetes mellitus were randomized to Ex.Gb 160 mg per day or placebo, and were followed up for nine months. Dose of Ex.Gb was increased to 240 mg in next nine months. Total Antioxidant Status (TAS) of plasma was measured using the Trolox equivalent antioxidant capacity assay. Ophthalmologic examination was performed by the biomicroscopic method. Vascular, intravascular and perivascular alterations were evaluated, and total conjunctival index was calculated. Though the values of the total conjunctival index and its constituent decreased (P<0.05) during the study in Ex.Gb group, there were no significant differences between these parameters as compared with placebo group. Evaluation of plasma TAS showed gradually increment, although insignificant and very small, in Ex.Gb group. The significance of Ex.Gb on development of the alterations of eye microcirculation, especially in elder patients needs to be explored further.publishersversionPeer reviewe

Sensitivity and Specificity of Biochemical Tests for Diagnosis of Intrahepatic Cholestasis of Pregnancy

Background and aim: Intrahepatic cholestasis of pregnancy (ICP) is linked with increased risk of fetal complications. An accurate diagnostic test is needed to diagnose this disorder on time. We aimed to assess sensitivity and specificity of laboratory tests used for diagnosis of intrahepatic cholestasis of pregnancy and determine more reliable cut-off values of transaminases. Material and methods: Sixty one symptomatic patients with ICP and 29 healthy pregnant women were included in the retrospective analysis. Results: ICP patients had higher total bile acids (TBA) levels than healthy women (32 vs. 6; P < 0.0001) due to increase in cholic acid (CA) and chenodeoxycholic acid (CDCA). CA/CDCA ratio was significantly higher in ICP patients compared to healthy pregnant women (1.13 vs. 0.68; P < 0.00002). TBA, CA, CDCA and CA/CDCA ratio demonstrate the following sensitivity (94%, 96%, 89%, 71.9%) and specificity (63%, 63%, 59%, 79.3%, respectively) for ICP diagnosis. Lowering cut-off values for ALT (31 U/ L) and AST (30 U/L) resulted only in minimal increase of sensitivity to 92.2% vs. 90.1% for ALT and to 92.2%, vs. 90.6% for AST. Conclusion: The present study did not reveal any single specific and sensitive marker for reliable diagnosis of ICP. Establishment of lower cut-off values for transaminases activity might only minimally increase the accuracy of diagnosing ICP