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ABSTRACT: Authors present that serum pigment epithelium derived factor (PEDF) is an independent marker of metabolic syndrome in Caucasianpopulation. PEDF was measured with new ELISA sandwich test. J. Clin. Lab. Anal. 24:17-19, 2010. (c) 2010 Wiley-Liss, Inc.
Journal of Clinical Laboratory Analysis 01/2010; 24(1):17-9. · 1.38 Impact Factor
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ABSTRACT: Adipocyte-fatty acid binding protein (A-FABP) is a biomarker of adiposity and metabolic syndrome. The aim of our work was to investigate the effect of weight reduction on serum A-FABP value. In the study, we analyzed a group of 189 probands suffering from obesity (102 women and 87 men; aged 57.3+/-12 years) initially, after a 3-month low-fat diet and once again 3 months after the termination of the diet for serum A-FABP, insulin, glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Basal biomarker concentrations were typical of the metabolic syndrome, and moreover A-FABP correlated with Quicki and BMI. We observed a reduction in BMI in 145 subjects who were divided into two subgroups: A-with persistent BMI reduction even after 6 months, B-with BMI reduction after 3 months and its regress after 6 months. Individuals with rise or no BMI difference were signed as subgroup C. In subgroup A, A-FABP level increased and returned to the earlier level (42.3 vs 68.3 vs 37.1 microg/l) and correlated with the markers of the metabolic syndrome. In subgroup B, A-FABP level increased less significantly, however elevated A-FABP level persisted for 6 months (41.9 vs 53.6 vs 50.7 microg/l). Subgroup C (n=54) showed no difference in A-FABP after 3-month diet and after next 3 months. The A-FABP value correlated with the some components of the metabolic syndrome. In conclusion, we describe that serum A-FABP might be a prognostic marker of body weight loss suggesting a preventive therapeutic intervention.
Journal of Clinical Laboratory Analysis 10/2008; 22(5):380-2. · 1.38 Impact Factor
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ABSTRACT: Since fibroblast growth factor 19 (FGF-19) is a potent metabolic regulator that influences glucose and lipid homeostasis, our aim was to develop an ELISA assay for measuring FGF-19 in human serum and to investigate its concentrations in healthy volunteers and patients suffering from metabolic syndrome.
A sandwich ELISA method was developed for quantitative determination of human FGF-19 in serum samples. Blood pressure, waist circumference, FGF-21 serum levels, serum cholesterol, triacylglycerols, HDL-cholesterol, LDL-cholesterol, insulin, glucose, adiponectin, uric acid, creatinine, hs-CRP and calculated BMI and Quicki insulin sensitivity index were measured in 153 healthy volunteers and 66 persons with metabolic syndrome.
Neither sex nor age influenced FGF-19 serum concentration in the healthy volunteers. Probands with metabolic syndrome had 65 % lower FGF-19 serum values than the healthy ones (medians 158.6 versus 242.4 ng/L; p<0.01). FGF-19 correlated with glucose (r = -0.35, p<0.01), HDL (r = 0.24, p = 0.045), triacylglycerols (r = -0.19, p = 0.05) and with a number of other risk factors for metabolic syndrome (r = -0.28, p = 0.01). When adjusted to the concentrations of triacylglycerols, BMI and glucose, and finally to all data pertinent to FGF-19 (according to correlation analysis), our data indicate that FGF-19 is an independent marker of metabolic syndrome.
The present study demonstrates the analytical properties of the ELISA FGF-19 assay and its usefulness when studying the metabolic syndrome. Serum concentrations of FGF-19 could be new key predictors of metabolic syndrome and thereby even a new negative risk factor of atherosclerosis.
Scandinavian journal of clinical and laboratory investigation 07/2008; 68(6):501-7. · 1.38 Impact Factor
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ABSTRACT: Lipocalin-2 (also known as neutrophil gelatinase-associated lipocalin [NGAL]) has been described as a promising marker of metabolic syndrome associated with inflammation. The aim of our work was to develop an assay for the determination of lipocalin-2 in human serum and to investigate its levels in healthy volunteers and donors suffering from metabolic syndrome. We also conducted a pilot study on individuals with metabolic syndrome and on healthy probands and measured lipocalin-2 in these individuals. We developed and evaluated the sandwich ELISA method for the quantitative determination of human lipocalin-2 in serum samples. We measured blood pressure, waist circumference, serum cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, insulin, glucose, creatinine, hs-CRP, and adiponectin and calculated the BMI and Quicki insulin sensitivity index. In the study on 153 healthy volunteers, we showed that sex and age are not determinative for lipocalin-2 serum values. Furthermore, we tested 45 individuals with metabolic syndrome; values of lipocalin-2 did not differ (78.8 vs. 80.0 microg/l, p =0.56) from the data of healthy individuals from the first study. Neither group differed with regard to sex or age. Lipocalin-2 correlated with alanine aminotransferase (ALT) (r=-0.3, p<0.01) aspartate aminotransferase (AST) (r=-0.3, p<0.01), cholesterol (r=-0.21, p=0.047), creatinine (r=0.19, p=0.05), and high-sensitivity C-reactive protein (hs-CRP) (r=0.22, p=0.036). No significant correlation was found between serum lipocalin-2 and BMI, waist circumference, blood pressure, triglycerides, HDL, Quicki, or the number of metabolic syndrome components. When study patients with metabolic syndrome were further stratified according to the number of components of metabolic syndrome, serum concentrations of lipocalin-2 did not differ. The results presented demonstrate the analytical competence of the lipocalin-2 assay. However, we assumed that lipocalin-2 is not a routinely usable marker of metabolic syndrome or obesity. The association between serum lipocalin-2 and obesity or metabolic syndrome was not validated in our study.
Hormone and Metabolic Research 06/2008; 40(6):381-5. · 2.19 Impact Factor
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ABSTRACT: To develop an assay for the determination of ZAG in human serum, and to investigate its clinical relevance as a marker of metabolic syndrome.
A new sandwich ELISA was introduced and clinically tested.
ZAG serum level did not differentiate healthy subjects (27.4+/-8.3 mg/L; N=132) from patients with metabolic syndrome (24.9+/-8.1; N=92). ZAG correlated with glucose, creatinine and uric acid.
The immunoassay offers a new research tool for glucose metabolism.
Clinical Biochemistry 04/2008; 41(4-5):313-6. · 2.08 Impact Factor
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ABSTRACT: The aim of our work was to develop an assay for the determination of angiopoietin-like protein 4 (Angplt4) in human blood, and to investigate its levels in healthy volunteers and donors suffer from metabolic syndrome. We developed and evaluated the sandwich ELISA method for the quantitative determination of human Angplt4 in serum samples. We conducted also the pilot study on individuals with metabolic syndrome or familiar hypercholesterolemia and healthy probands and measured blood pressure, waist circumference, Angplt4 serum levels, serum cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, insulin, glucose, A-FABP and calculate BMI and QUICKI insulin sensitivity index. In the study on 30 healthy volunteers we demonstrated that sex or age is not the determinant for Angplt4 serum values. Furthermore, we tested 115 individuals with metabolic syndrome and found that probands with metabolic syndrome did not differ in Angplt4 values than healthy individuals from the first study (medians 8.7 vs. 8.1 ng/ml, p = 0.6). Individuals with metabolic syndrome did not differ in sex or age from healthy. Angplt4 values correlated with the HDL-cholesterol (r = -0.25; p < 0.01), FGF-21 (r = 0.23, p < 0.01), glucose (r = 0.17; p = 0.03), uric acid (r = 0.17; p = 0.49), lipocalin-2 (r = 0.23, p < 0.01), triacylglycerols (r = 0.25; p < 0.01) and number or characters of metabolic syndrome (r = 0.21; p < 0.01). No significant correlation was found between serum Angplt4 and BMI, WC or QUICKI. However, we performed stepwise regression and we found that Angplt4 was not an independent marker for metabolic syndrome. The patients from the metabolic syndrome group suffering diabetes mellitus (n = 83) did not differ in serum Angplt4 from the group of healthy patients, too. The pilot study supports the hypothesis about the role of Angplt4 as a new class of lipid metabolism modulator. Their values could be a new key predictors of metabolic syndrome. Further research is necessary to confirm our findings in individuals with dyslipidemia, obesity, coronary artery diseases and different medication in order to assess Angplt4 value as a risk predictor of accelerated atherosclerosis.
General Physiology and Biophysics 03/2008; 27(1):59-63. · 1.19 Impact Factor
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ABSTRACT: Glykogen Phosphorylase BB is considered a timely and specific marker of acute coronary syndrome. A kit for measuring Glykogen Phosphorylase BB in routine diagnosis has been released recently.
To test the utilisation of Glykogen Phosphorylase BB measurement in the diagnosis of acute coronary syndrome.
70 patients with suspected acute coronary syndrome were tested. A final diagnosis of acute coronary syndrome/non-coronary difficulties was made according to ESC/ACC/AHA criteria. Measurements of troponin I, myoglobin and GPBB in venous plasma (heparin-lithium) were taken for all probands on admission and two and six hours later.
Individuals with acute coronary syndrome (n = 52) had significantly higher levels of Glykogen Phosphorylase BB on admission and 2 hours after admission (21.9 vs 6.2; 18.7 vs 5.9 microg/l; p < 0.01). Levels of Glykogen Phosphorylase BB had a greater diagnostic effectiveness for the presence of acute coronary syndrome than levels of troponin I (threshold below ROC curve 0.89 vs. 0.78; 0.87 vs. 0.67). In the first two hours after admission, only levels of Glykogen Phosphorylase BB were included as independent variables in the regression model for the incidence of acute coronary syndrome (p < 0.05). When the group of patients with myocardial necrosis (n = 39; acute myocardial infarction without ST elevations on ECG; NSTEMI) is removed from the group with acute coronary syndrome, it was found that only GPBB and cTnl were independent variables in the regression model on initial testing and after two hours. After adjusting GPBB to cTnl, significantly higher levels of GPBB adjusted to troponin I were found in persons with NSTEMI (14.5 vs -48.0; p < 0.01).
Measurement of Glykogen Phosphorylase BB has excellent effectiveness independently of troponin in the first hours after the onset of acute coronary syndrome and should ensure the correct diagnosis of acute coronary syndrome in combination with troponin.
Vnitr̆ní lékar̆ství 11/2007; 53(11):1164-9.
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M Karpisek, D Stejskal,
H Kotolova,
P Kollar,
G Janoutova,
R Ochmanova,
L Cizek,
D Horakova,
R Ben Yahia,
R Lichnovska,
V Janout
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ABSTRACT: Adipocyte-fatty acid binding protein (A-FABP) is a circulating protein expressed in adipocytes and macrophages. Several recent studies demonstrated that A-FABP might be involved in the pathogenesis of metabolic syndrome, particularly in dyslipidaemia, insulin resistance and atherosclerosis. The aim of this study was to investigate the influence of atorvastatin treatment (20 mg day(-1) for 3 months) on serum A-FABP value in subjects with hyperlipidaemia.
Anthropometric and serum analyses were performed for body mass index, A-FABP, triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, uric acid, alanine aminotransferase (ALT), aspartate aminotransferase (AST), high sensitive C-reactive protein (hs-CRP), creatine kinase (CK) and glucose on 26 subjects (BMI 30.3 +/- 6.0, mean age 62 +/- 10 years) with hyperlipidaemia who met the criteria: total cholesterol > 5.2 mmol L(-1), LDL cholesterol > 3.3 mmol L(-1) and triglycerides < 3 mmol L(-1).
After the 3-month therapy, a significant reduction in total cholesterol (P < 0.001), LDL cholesterol (P < 0.001), glucose (P < 0.001), A-FABP (from 44.6 +/- 26.2 to 38.6 +/- 19.3 g L(-1), P < 0.01), uric acid (P < 0.05), AST (P < 0.05) and triglycerides (P < 0.05) values was observed. No difference was found in BMI, CK, ALT, hs-CRP, or HDL cholesterol values. A significant difference in the serum A-FABP value before and after the therapy remains after the correction for total cholesterol value (P < 0.001). A positive correlation between serum A-FABP and glucose was found (P < 0.05).
In conclusion, our study confirmed in vivo that atorvastatin reduces serum A-FABP by a pleiotropic mechanism and supports the hypothesis that A-FABP is involved in atherosclerotic actions.
European Journal of Clinical Investigation 09/2007; 37(8):637-42. · 3.02 Impact Factor
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ABSTRACT: The aim of our work was to develop an assay for the determination of angiopoietin-like protein 3 (Angptl3) in human blood, and investigate its levels in healthy volunteers and donors suffer from metabolic syndrome and familiar hypercholesterolemia. We developed and evaluated the sandwich ELISA method for the quantitative determination of human Angptl3 in serum samples. We conducted also the pilot study on individuals with metabolic syndrome or familiar hypercholesterolemia and healthy probands. The following parameters were measured: blood pressure, waist circumference, Angptl3 serum levels, serum cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, insulin, glucose, A-FABP, and BMI and Quicki insulin sensitivity index was calculated. In the study on 93 healthy volunteers we demonstrated that sex or age is not the determinant for Angptl3 serum values. Futhermore, 118 individuals with metabolic syndrome and 200 patients with familiar hypercholesterolemia were tested and it was found that probands with metabolic syndrome or familiar hypercholesterolemia had higher Angptl3 values than healthy individuals from the first study (medians 289.5 vs. 277.1 vs. 224.8 ng/ml, p < 0.01). All of groups did not differ in sex or age. Angptl3 values correlated with the systolic blood pressure, LDL and A-FABP (p < 0.05). No connection of Angptl3 with triglycerides was found (presumably influences of statins, fibrates via PPARs, etc). However, we performed stepwise regression and found A-FABP and Angptl3 serum values as the independent markers for metabolic syndrome presence only (F ratio 29, p < 0.01). Then we adjusted Angptl3 to A-FABP (reputable metabolic syndrome marker) and recognised that Angptl3 is the A-FABP-independent marker. The pilot study supports the hypothesis about the role of Angptl3 as a new class of lipid metabolism modulator. Their values could be a new key predictors of metabolic syndrome. Further research is necessary to confirm our findings in individuals with dyslipidemia, obesity, CAD and different medication in order to assess Angptl3 value as a risk predictor of accelerated atherosclerosis.
General Physiology and Biophysics 09/2007; 26(3):230-3. · 1.19 Impact Factor
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ABSTRACT: The aim of our work was to develop an assay for the determination of proguanylin in human blood, and investigate its levels in healthy volunteers and donors suffer from hypertension often accompanied by body sodium accumulation and plasma volume expansion. We developed and evaluated the sandwich ELISA method for the quantitative determination of human proguanylin in serum samples. We conducted also the pilot study on individuals with hypertension and oh healthy probands and measured proguanylin serum levels, serum and urine sodium and creatinine levels. In the study on 256 healthy volunteers we demonstrated that women have significantly higher values of proguanylin than men (medians 12.7 vs. 9.6 ng/ml, p < 0.01) and proguanylin values increased with age of individuals (p < 0.01). Futhermore, we tested 17 individuals with hypertension and found that probands with anamnesi of hypertension had higher proguanylin values than healthy individuals from the first study (medians 16.2 vs. 11.3 ng/ml, p < 0.01). Both of groups did not differ in sex or age. Proguanylin values correlated with the systolic blood pressure (r = 0.41, p < 0.01), sodium fraction excretion (r = 0.72, p < 0.01) and serum sodium (r = -0.39, p < 0.01). No significant correlation we found with serum proguanylin and creatinine. In the group of 9 healthy probands we demonstrated the existence of a diurnal rhythm of proguanylin with its maximum in the evening hours (between 6-10 p.m.). The pilot study supports the hypothesis about the role of proguanylin in sodium metabolism and its possible importance for hypertension disorder. Further research is necessary to confirm our findings in individuals with hypertension with different medication in order to assess proguanylin value as a risk predictor of accelerated hypertension, and to classify individuals with hypertension for variuos types of diuretic therapy.
General Physiology and Biophysics 04/2007; 26(1):62-5. · 1.19 Impact Factor
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ABSTRACT: Reg-1alpha plays a role in various types of tissue regeneration.
To evaluate serum Reg-1alpha for the diagnosis of metabolic syndrome.
14 non-obese, healthy subjects and 15 individuals with metabolic syndrome were studied. Anthropometric and laboratory analysis in sera (Body Mass Index--BMI, insulin, triglycerides, cholesterol, HDL-cholesterol, LDL-cholesterol, uric acid, aglucose, Quicki calculation, Reg-1alpha) were performed.
Reg-1alpha levels did not differ between subjects with metabolic syndrome and healthy subjects (means 597.7 vs. 631.1 ng/l, p < 0.01) and positively correlated only with fasting glucose (r = 0.34; p < 0.01) and age (r = 0.38; p < 0.01); Reg-1alpha correlated even after adjustment to age. Reg-lalpha concentrations did not differ in men and women.
Our study, for the first time, indicates that serum Reg-1alpha is not useful for the diagnosis of metabolic syndrome (Tab. 3, Ref. 7).
Bratislavske lekarske listy 01/2007; 108(3):138-40. · 0.40 Impact Factor
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ABSTRACT: Adipocyte fatty acid binding protein (A-FABP) has been suggested as playing an important role in the pathogenesis of metabolic syndrome. The aim of this study was to evaluate serum A-FABP as a marker of metabolic syndrome and to assess its predictive accuracy in a Caucasian population. Anthropometric and serum analyses were performed for body mass index (BMI), waist circumference, A-FABP, insulin, triglycerides, total cholesterol, high-density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c), uric acid, and glucose on 67 non-obese, healthy subjects and 71 subjects with metabolic syndrome. Quicki-quantitative insulin sensitivity check index, receiver operating characteristic curve (ROC-curve) and chi(2) analysis were completed. Compared with healthy controls, subjects with metabolic syndrome had a significantly higher A-FABP serum level (mean: 42.4 vs. 23.7 microg L(-1); P < 0.01). The A-FABP serum level correlated with fasting levels of insulin (r = 0.34; P < 0.01), glucose (r = 0.21; P = 0.01), triglycerides (r = 0.4; P < 0.01), BMI (r = 0.57; P < 0.01) and waist circumference (r = 0.51; P < 0.01), but negatively with HDL-c (r = -0.23; P < 0.01) and Quicki (r = -0.32; P < 0.01). The relationship was defined between serum A-FABP level and metabolic syndrome diagnosis with 40% sensitivity and 99% specificity at A-FABP level 16.4 microg L(-1). Serum A-FABP level might be an independent marker of metabolic syndrome in a Caucasian population.
European Journal of Clinical Investigation 09/2006; 36(9):621-5. · 3.02 Impact Factor
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ABSTRACT: Aspirin resistance appears to be an important prognostic factor in patients with coronary artery disease, yet there is no standardized method to measure it and limited data on its correlation to clinical outcomes.
In a prospective study we followed 103 patients (mean age 64 years) with acute coronary syndrome (ACS) without ST segment elevation who were treated with 100 mg of aspirin (ASA) daily. Optical platelet aggregometry using cationic propyl gallate (CPG) as an inductor was measured at ACS onset and after 3, 12, 24, 36, and 48 months. ASA responsiveness was defined both by the slope of the aggregation curve (<53%/min) and by spontaneous aggregation (<5%). The primary outcomes were the recurrence of ACS or stroke.
Patients with ACS exhibited a greater prevalence of ASA resistance (55%) than healthy volunteers (4%; p<0.01). ASA resistance occurred more often in patients with type 2 diabetes, hypertriacylglycerolemia, and decreased HDL levels, and in smokers (p<0.05). A single assessment of platelet aggregometry was sufficient to identify ASA-resistant patients. During the 4-year follow-up, the patients with ASA resistance had an 88% incidence of recurrent cardiovascular events versus 46% for the patients without ASA resistance (p<0.01). In the subgroup with recurrent cardiovascular (CV) events, significantly more patients were ASA-resistant than in the subgroup without recurrent CV events (72% vs. 8%, p<0.01).
ASA resistance measured by CPG-induced platelet aggregometry is more common among patients with ACS and some metabolic risk factors, and ASA-resistant patients have a significantly higher recurrence of cardiovascular events.
European Journal of Internal Medicine 09/2006; 17(5):349-54. · 2.00 Impact Factor
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ABSTRACT: Adiponectin is a fat tissue protein that plays a role in maintaining the homeostasis of glucose and lipids, along with counteracting a number of risk factors associated with atherosclerosis and obesity. In addition, adiponectin has an effect on insulin sensitivity. The aim of this work was to assess concentrations of adiponectin in predefined groups of individuals and to analyse the associations between adiponectin and other metabolic parameters.
The studied population comprised four groups of individuals, A-D. A--healthy controls, B--patients with impaired lipid metabolism, C--the obese, and D--patients with metabolic syndrome. When comparing the levels of adiponectin in groups of patients with impaired lipid metabolism (B), the obese (C), and patients with metabolic syndrome (D) with healthy controls (A), no statistically significant difference was observed between groups B and C and healthy individuals. In contrast, statistically significant difference was found when concentrations of adiponectin in patients with metabolic syndrome (D) were compared to those in healthy controls. Individuals with metabolic syndrome had the lowest levels of adiponectin - 5.3 mg/1 (men) and 5.6 mg/1 (women). The correlation coefficient for the association between adiponectin and HDL was R=0.57, for adiponectin and triglycerides R=-0.46, for adiponectin and BMI R=-0.37, for adiponectin and glycemia R=-0.34, for adiponectin and insulinemia R=-0.39, and for adiponectin and the QUICKI index R=0.44.
One possible method of the complex evaluation of the metabolic syndrome development and its metabolic consequences is the assessment of adiponectin levels. Low levels of adiponectin indicate the development of insulin resistance.
Casopís lékar̆ů c̆eských 02/2006; 145(11):861-4.
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ABSTRACT: In order to assess an impact of acute changes in blood volume on levels of B-type natriuretic peptides (BNP and NT-proBNP) 30 patients with a heart disease and chronic renal insufficiency on chronic dialysis program were assessed. An acute fluid restriction of 3750 ml on an average lead to decreased filling of the left heart ventricle (echocardiography revealed a reduced size of the left atrium, change in E/A parameters and deceleration time, and decreased end-diastolic volume of the left ventricle). Prior to dialysis normal levels of BNP (2.58 +/- 1.21 pg/ml) and elevated levels of NT-proBNP (193.2 +/- 117.7 pg/ml) had been indicated. Following dialysis a statistically significant decrease of BNP concentration in venous blood was proved, however it was "masked" by hemoconcentration. NT-proBNP level in venous blood remained unchanged. Correlation between BNP and NT-proBNP was not proved before dialysis nor after it. Correlation between BNP levels and echocardiographic parameters was not confirmed and a weak negative correlation with ejection fraction was proved in NT-proBNP. A BNP assessment could play an important role in the evaluation of acute changes in heart compensation. On the other way, NT-proBNP concentration is stable and is a long term marker of synchronisation of fluid circulation and function of the left ventricle. An importance of its assessment is probably rather prognostic.
Vnitr̆ní lékar̆ství 12/2004; 50(11):812-7.
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ABSTRACT: Commonly used laboratory markers of coronary damage in individuals with acute coronary syndrome (ACS) are not specific for myocardial ischemia and prove only irreversible myocardial damage. There have been concerns recently of a laboratory test able to distinguish sufficiently an individual with myocardial ischemia and typical IHD symptoms from patients without IHD. Since 1994 several works about cobalt binding capacity of albumin (ACB) have been published in which a unique diagnostic sensitivity and specificity of this test for estimations of the presence of myocardial ischemia has been described. In February 2003 this test was approved by FDA for making an early diagnosis of ACS. GOAL OF THE WORK: To verify a possibility to use ACB test for making an early diagnosis of ACS.
98 individuals, patients of the Department of Internal Medicine of the hospital in Sternberk, hospitalised for suspicion of ACS but not indicated for direct PTCA, have been examined. Respondents with ACS diagnosis were examined via coronarography. All the respondents were examined for cTnI, myoglobin, and ACB immediately at the admission (0) and 2, 6, and 12 hours after admission. Cobalt binding capacity of albumin has been given in absorbance units. The group of respondents was subsequently divided into subgroups according to presence of ACS and subgroups of respondents with/without AMI.
55 respondents (56%) have been diagnosed with ACS. 16 respondents (16%) from them suffered from non-Q AMI and 39 respondents (40%) suffered from unstable AP (UAP). 43 respondents (44%) suffered from noncoronary sternal pain. Patients with ACS had ACB values significantly higher at admission and 2 and 6 hours after admission compared to respondents without ACS (0: 0.62 +/- 0.17 vs. 0.4 +/- 0.11, 2: 0.61 +/- 0.13 vs. 0.44 +/- 0.12, 6: 0.58 +/- 0.16 vs. 0.45 +/- 0.1, p < 0.01). In ACB dynamics monitoring in defined groups of respondents no significant differences have been identified among ACB values of individual takings. There were no significant differences in ACB values 12 hours after admission (0.53 +/- 0.12 vs. 0.44 +/- 0.16) in cut-off absorbance ACB 0.5 the diagnostic sensitivity at admission was 69% and specificity 89%, 2 hours later 87% and 71% and 6 hours after admission 64% and 69%. 12 hours after admission ACB assessment has not been possible to be used for ACS diagnosing (AUC of 0.55). First 2 hours after admission ACB test was more specific and sensitive for diagnosing ACS compared to cTnI test (0: AUC 0.83 vs. 0.61, p = 0.015, 2: AUC 0.87 vs. 0.71, p = 0.04). However, ACB test could not be used in respondents with ACS to distinguish between acute myocardial infarction and unstable angina pectoris (UAP) (AUC: ACB-0 0.51, ACB-2 0.56, ACB-6 0.51, ACB-12 0.57).
ACB test is a quick, cheap and easy examination which is very specific and sensitive for early diagnosing of acute coronary syndrome without regard whether it is caused by UAP or AMI (up to 6 hours after admission) compared to commonly used markers. This test could significantly contribute to the next fate of a patient (diagnostic procedures, patient's prognosis).
Vnitr̆ní lékar̆ství 10/2004; 50(10):734-9.
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D Stejskal,
J Prosková,
B Lacnák,
D Horalík,
A Hamplová,
I Oral,
I Hrabovská,
R Ochmanová,
S Adamovská,
R Juráková,
G Ozanová,
J Juchelka,
O Kulísková,
H Pĕnkavová
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ABSTRACT: Recently resistance to an acetylsalicylic acid (ASA) administration has been a frequently mentioned problem. However, to identify ASA nonresponsive patients (ASA resistance) is difficult and common examination procedures can contain important preanalytic, analytic and postanalytic mistakes. Recently a possibility to use aggregometry after induction with cationic propyl gallate (CPG) has been discussed in this context; it's a robust, highly sensitive, and specific method for ASA resistance estimates. We asked ourselves following questions during our work:
a) Experience patients with acute coronary syndrome (ACS) ASA resistance more often than healthy volunteers?; b) Are aggregation values in both patients with different metabolic homeostasis disorders and patients with risk factors for atherosclerotic complications different?; c) Change results of measured aggregation induced by CPG in patients treated with identical ASA therapy during a several years long monitoring; respectively are patients assessed differently during the monitoring?; d) Is it possible to use one-shot aggregation assessment following CPG to estimate ASA resistance or is it necessary to repeat the examinations?; e) Is recurrence of ACS complications more frequent during two years of monitoring of patients with ACS history resistant to 100 mg doses of ASA per day?
103 patients of an average age 69 were assessed. All of them suffered from ACS without ST segment elevations and were treated conservatively; in addition to it all of them were treated with 100 mg ASA/day. They were assessed at the onset of ACS and after 3, 12 and 24 months. The examination consisted of taking patient history, clinical examination, BMI determination, laboratory test for cholesterol, HDL, LDL, triacylglycerols, and glucose, and of an aggregation of thrombocytes assessment under standard conditions (spontaneous and after CPG induction).
a) ASA resistance is more frequent in patients with ACS compared to healthy volunteers (45% to 6%, p < 0.001). b) Patients with type II DM, smokers, patients with low HDL cholesterol levels or high triacylglycerols levels are ASA resistant more often (< 0.05). c) Results of measured aggregation of thrombocytes don't change during administration of the identical dose of 100 mg ASA/day during 2 years of monitoring. Respondents usually are assessed identically during monitoring (responsive/ASA nonresponsive). d) ASA resistance can be estimated from one-shot aggregation assessment following induction with CPG. e) Two years after diagnosing the ASA resistance a percentage of cardiovascular complications recurrence is higher in patients with history of ACS (p < 0.001). One-shot assessments of the CPG induced thrombocytes aggregation and the spontaneous aggregation are sensitive in 81% of patients with ACS history and specific in 100% of patients at risk of recurrence of cardiovascular complications. If these results are confirmed it could lead to a change in interventions in patients with ASA resistance proved by this method.
Vnitr̆ní lékar̆ství 08/2004; 50(8):591-9.
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ABSTRACT: Recently in the literature information is found on estimation of natriuretic peptides in the differential diagnosis of dyspnoea. Because in the Czech Republic since the beginning of 2002 routine estimation of NT-proBNP is available (analyzer Elecsys 2010), the objective of our work was to find out whether it is possible to use in the everyday practice of a district hospital estimation of NT-proBNP to differentiate dyspnoea with affection of the heart muscle from other types of dyspnoea.
A group of 33 patients from the medical department of the Sternberk hospital was examined who attended on account of dyspnoea and lacked signs of acute coronary syndrome. All probands were diagnosed on the basis of defined criteria; according to the final diagnosis the patients were divided into three groups: group "LV" was formed by dyspnoic patients with organic affection of the left ventricle and signs of congestion in the lesser circulation, group "non-LV" was formed by patients where no organic affection of the left ventricle was found but other heart disease was present. Group "non-C" was formed by patients where a cardiac cause of dyspnoea was ruled out. In all patients on admission NT-proBNP was assessed.
33 probands were examined, 18 men and 15 women, mean age 74.5 years. 25 probands the dyspnoea was classified as dyspnoea with affection of one of the cardiac compartments [19 of them had signs of organic affection of the left ventricle (group "LV")]; in 6 probands no signs of organic left ventricular affection were found (group "Non-LV"). The remaining 8 patients had no signs of any disease of the heart muscle, valves, septa, endocardium and pericardium (group "Non-C). The baseline values of NTpro-BNP were closely associated with the NYHA classification (grade II--median 55.3 pmol/l (469 ng/l, grade III--median 399.3 pmol/l (3384 ng/l), grade IV--median 724.7 pmol/l (6294 ng/l), the differences were statistically significant, p < 0.05). The dyspnoic probands with concurrent affection of some cardiac compartment (groups "LV" and "Non-LV") had a NT-pro BNP concentration significantly higher than probands without affection of the heart (group "Non-C") (median 589.5 pmol (4996 ng/l as compared with 62.9 pmol/l (533 ng/l, p < 0.01). In the group of probands with heart disease probands with affections of the left ventricle (group "LV") had significantly higher NT-proBNP values than subjects without affection of the LV and without any heart disease (groups "Non-LV" and "Non-C") (median 670.6 pmol/l (5683 ng/l) as compared with 187.5 pmol/l (1589 ng/l), p < 0.01). In hospitalized probands after treatment along with improved cardiopulmonary compensation also a significant drop of NT pro-BNP occurred (median 303 pmol/l (3967.7 ng/l to 211 pmol/l (2561 ng/l), p < 0.05). When looking for associations between anamnestic, laboratory and clinical data we found that the value of NT-proBNP is associated with dyspnoea with cardiac affection (groups "LV" + "Non-LV", correlation coefficient 0.48), with the left ventricular ejection fraction (correlation coefficient 0.52) and the baseline NYHA classification (correlation coefficient 0.36). In the examined group we did not find an association between NT-proBNP and age, sex, diabetes mellitus, hypertension, the presence of atrial arrhythmias, aortal stenosis, or the width of the left atrium. When using as cut-off for NT-proBNP 59 pmol/l (500 ng/l), the sensitivity of NT-proBNP for dyspnoea with affection of the cardiac compartments was 92% and the specificity 67%.
Assessment of NT-proBNP is an important diagnostic acid in the differential diagnosis of dyspnoea.
Vnitr̆ní lékar̆ství 02/2003; 49(2):121-6.
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ABSTRACT: Aim of study was determine if a correlation exists between bone mass density and concentration of osteoprotegerin. We examined the group of 199 patients of mean age of 63 years. Of the group under study, 31 patients had normal bone density (T score > -1 and < 1) and 168 probands had osteopenia or osteoporosis (T < -1). Persons with normal BMD values had median values of OPG 60.8 ng/l, while patients with reduced bone density had median values of 73 ng/l OPG. Cut-off for reduction of bone density was 128 ng/l OPG. We demonstrated that OPG concentrations vary inversely with bone density values (correlation coefficient -0.31). These results suggest that determination of OPG could allow discrimination of individuals with normal bone density and those with reduced bone density.
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 01/2002; 145(2):75-6.
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ABSTRACT: Osteoprotegerin, RANK (Receptor Activator of Nuclear factor kappa B) and RANKL (Receptor Activator of Nuclear faktor kappa B ligand) became the aim of intensive research. RANK is considered as a hematopoietic surface receptor controlling osteoclastogenesis and calcium metabolism. RANKL may promote osteoresorption by induction of cathepsin K gene expression. The present paper summarizes the most significant data in osteoprotegerin, RANK and RANKL problems obtained.
Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 01/2002; 145(2):61-4.
