Matrix Gla protein (MGP) is a vitamin K dependent peptide which has an established role in suppression of vascular calcification. Recent studies have pointed to a possible link between ...immunomodulatory effect of MGP and inflammatory bowel disease (IBD).
To compare plasma levels of dephosphorylated and uncarboxylated MGP (dp-ucMGP) between IBD patients and controls.
This cross-sectional study was conducted on 70 patients with IBD (30 patients with ulcerative colitis and 40 patients with Crohn's disease) and 60 age and gender matching healthy controls. Plasma dp-ucMGP levels were analyzed from blood samples by CLIA method using IDS-iSYS InaKtif MGP (Immunodiagnostic Systems, Frankfurt, Germany) according to the manufacturer's instructions. fecal calprotectin (FC) levels were determined from stool samples by turbidimetric immunoassay method using Bühlmann fecal calprotectin turbo assay (Bühlmann Laboratories Aktiengesellschaft, Schonenbuch, Switzerland). Other parameters were analyzed according to the standard laboratory procedures.
Plasma levels of dp-ucMGP were significantly higher in patients with IBD compared to the healthy control group (629.83 ± 124.20 pmol/mL
546.7 ± 122.09 pmol/mL,
< 0.001), and there was no significant difference between patients with Crohn's disease and patients with ulcerative colitis (640.02 ± 131.88 pmol/mL
616.23 ± 113.92 pmol/mL,
= 0.432). Furthermore, a significant positive correlation of plasma dp-ucMGP levels was found with both FC levels (
= 0.396,
< 0.001) and high sensitivity C-reactive protein (hsCRP) levels (
= 0.477,
< 0.001). Moreover, in the total study population a significant positive correlation was found between dp-ucMGP with age (
= 0.210,
= 0.016) and waist circumference (r = 0.264,
= 0.002). Multiple linear regression analysis showed that dp-ucMGP levels retained significant association with FC (β ± SE, 0.06 ± 0.02,
= 0.003).
Study results support experimental data of MGP immunomodulatory IBD effect and indicate potential involvement in the pathophysiology of the disease, and possibly extraintestinal manifestations.
IntroductionLaboratory plays important part in screening, diagnosis, and management of thyroid disorders. The aim of this study was to estimate current laboratory preanalytical, analytical and ...postanalytical practices and policies in Croatia.
Materials and methodsWorking Group for Laboratory Endocrinology of the Croatian Society of Medical Biochemistry and Laboratory Medicine designed a questionnaire with 27 questions and statements regarding practices and protocols in measuring thyroid function tests. The survey was sent to 111 medical biochemistry laboratories participating in external quality assurance scheme for thyroid hormones organized by Croatian Centre for Quality Assessment in Laboratory Medicine. Data is presented as absolute numbers and proportions.
ResultsFifty-three participants returned the questionnaire. Response rate varied depending on question, yielding a total survey response rate of 46-48%. All respondents perform thyroid stimulating hormone (TSH). From all other thyroid tests, most performed is free thyroxine (37/53) and least TSH-stimulating immunoglobulin (1/53). Laboratories are using nine different immunoassay methods. One tenth of laboratories is verifying manufacturer’s declared limit of quantification for TSH and one third is verifying implemented reference intervals for all performed tests. Most of laboratories (91%) adopt the manufacturer’s reference interval for adult population. Reference intervals for TSH are reported with different percentiles (90, 95 or 99 percentiles).
ConclusionThis survey showed current practices and policies in Croatian laboratories regarding thyroid testing. The results identified some critical spots and will serve as a foundation in creating national guidelines in order to harmonize laboratory procedures in thyroid testing in Croatia.
The aim of the study was to examine basal hypothalamic-pituitary-adrenal (HPA) axis activity and to determine associations of various covariates (gender, sleep-wake rhythm, demographic, academic, ...life style and health-related characteristics) with altered daily salivary cortisol profiles in late adolescence.
The total analytic sample consisted of 903 Croatian secondary school students aged 18 - 21 years (median 19 years). Salivary cortisol was sampled at home at three time points over the course of one week and its concentrations were measured by using the enzyme immunoassay.
In comparison to males, female students had a higher cortisol awakening response (CAR) (median 4.69, IQR 10.46 and median 3.03, IQR 8.94, respectively; P < 0.001), a steeper ("healthier") diurnal cortisol slope (DCS) (median 0.51, IQR 0.55 and median 0.44, IQR 0.51, respectively; P = 0.001), and a greater area under curve with respect to ground (AUC
) (median 206.79, IQR 111.78 and median 191.46, IQR 104.18, respectively; P < 0.001). Those students who woke-up earlier and were awake longer, had a higher CAR (P < 0.001), a flatter ("less healthy") DCS (P < 0.001), and a greater AUCG (P < 0.001), than students who woke-up later and were awake shorter. Less consistent but still significant predictors of salivary cortisol indexes were age, school behaviour, friendship, diet healthiness and drug abuse.
Gender and sleep-wake up rhythm were major determinants of the altered daily salivary cortisol profiles in late adolescence. The predictive power of other covariates, although less clear, has a potential for identifying vulnerable subgroups such as male drug users and females without a best friend.
The aim of this nested study is to provide the reference intervals for already published measurements of salivary cortisol from the Croatian Adolescence Stress Study (CLASS).
A total of 969 ...individuals (372 males and 597 females) were included in the reference sample (age range: 18-21 years). Salivary cortisol concentrations were determined by the enzyme immunoassay (LUCIO-Medical ELISA Salivary Cortisol Kit, Nal von Minden, Germany) in the Department of Medical Laboratory Diagnostics, University Hospital Split. Nonparametric statistics were used for calculating the reference intervals (RIs) and 90% confidence intervals (90% CIs).
The lower limits of RIs determined by the direct method were higher in females (> 10%) than in males for the cortisol concentrations at awakening (SCC
), 30 to 45 after awakening (SCC
) and at bedtime (SCC
). The upper limits of RIs for the SCC
were higher (> 10%) in males than in females. Females also had higher upper limits of RIs for the cortisol awakening response (CAR) and the diurnal cortisol slope (DCS) and higher lower limits of RIs for the CAR and the area under the curve with respect to ground (AUC
). The lower limits of RIs for the DCS were higher in males than in females.
Obtained reference values open the arena for introducing salivary bioscience in Croatian clinical laboratory practice and provide important data for better understanding of gender differences in adaptation to stress during late adolescence.
The aim was to estimate association of the oxidative stress with the occurrence of age-related macular degeneration (AMD). The activities of erythrocyte antioxidant enzymes: superoxide dismutase ...(SOD), glutathione peroxidase (GPx) and catalase (CAT) and additionally serum total antioxidant status (TAS) were used as indicators of the oxidative stress level. 57 AMD patients (32 early and 25 late AMD) and 50 healthy, age and gender matched controls were included. GPx activity ( P < 0.001 ) and serum TAS ( P = 0.015 ) were significantly lower in AMD patients. The difference was not significant for SOD or CAT activities. Significant interaction between GPx and SOD was detected ( P = 0.003 ). At high levels of SOD activity (over 75th percentile), one standard deviation decrease in GPx increases the odds for AMD for six times (OR = 6.22; P < 0.001 ). ROC analysis revealed that combined values of GPx activity and TAS are significant determinants of AMD status. Accuracy, sensitivity, specificity, and positive and negative predictive values were 75%, 95%, 52%, 69%, and 90%, respectively. The study showed that low GPx activity and TAS are associated with AMD. SOD modulates the association of GPx and AMD. The results suggest that erythrocyte antioxidant enzymes activity and serum TAS could be promising markers for the prediction of AMD.
Abstract only
The bones of divers are subjected to stress from water pressure, from the forces generated when their muscles resist water pressure, and from weightlessness. Several previously ...published studies have shown conflicting results. The aim of this study was to determine bone mineral density (BMD) and biochemical markers of bone turnover in experienced SCUBA divers. In this study we included 10 experienced SCUBA divers with a mean age of 47±2.4 years (mean±SEM). The average number of diving years was 26.1 with 381 diving hours per year. The control group included 10 healthy man who were matched by age, weight, and height. The BMD of lumbar spine and hip regions was assessed by dual energy x‐ray absorptiometry and biochemical markers of bone turnover were measured. The BMD value for total lumbar spine in divers was 1.252±0.031 vs. 1.136±0.041 g/cm
2
in control group and for total hip was 1.172±0.047 vs. 1.102±0.041 g/cm
2
in control group. T scores were 1.54±0.28 vs. 0.42±0.37 and 1.05±0.27 vs. 0.45±0.28 for lumbar and hip regions, respectively. There were no significant differences in bone turnover markers between groups, except in sRANKL concentration (in divers group 1322±466 vs. 2316±1046 pmol/L in control group. In conclusion, our results show that middle aged, experienced divers have increased BMD and decreased sRANKL levels.
This study was supported by Croatian Ministry of Science, Education and Sports.
Abstract only
Weightlessness during prolonged water activities and bubble formation during decompression phase of SCUBA diving could influence bone structure of the diver. Previous research has ...reported controversial results in bone mineral density (BMD) in SCUBA divers, showing both decrease and no change in BMD. We hypothesized that middle aged experienced divers will present greater decrease in BMD than younger divers investigated in previous studies. We tested 11 SCUBA divers whose mean age was 46.2±2.3 years (mean±SEM). On average, they were involved in SCUBA diving for 26 years performing 363 hours of diving annually. BMD was measured at the levels of lumbar spine and hip regions using dual energy X‐ray absorptiometry. BMD value for total lumbar spine was 1.233±0.034 g/cm
2
, and for total hip was 1.150±0.048 g/cm
2
. T scores were 1.4±0.3 and 0.9±0.3 for lumbar and hip regions, respectively. Z scores, considering subjects age, were 1.6±0.3 and 1.2±0.3 for lumbar and hip regions, respectively. Parathyroid hormone, estradiol, and testosterone levels were within normal range in all subjects. In conclusion, our results show that middle aged, experienced divers have increased BMD. Such increase is especially evident in their lumbar region.
This study was supported by Croatian Ministry of Science, Education and Sports.
We present a case of T.M. admitted to University Department of Psychiatry, Split University Hospital Center, in Croatia, because of the acute psychotic reaction (F23.9). The patient's urine tested ...positive for methadone without a history of methadone ingestion. Urine drug screen was performed with the COBAS Integra Methadone II test kit (kinetic interaction of microparticles in solution /KIMS/ methodology) by Roche. Drugs that have been shown to cross-react with methadone feature a tricyclic structure with a sulfur and nitrogen atom in the middle ring, which is common for both quetiapine and methadone. Therefore, it is plausible that this structural similarity between quetiapine and methadone could underlie the cross-reactivity on methadone drug screen. Besides quetiapine, a number of routinely prescribed medications have been associated with triggering false-positive urine drug screen results. Verification of the test results with a different screening test or additional analytical tests should be performed to avoid adverse consequences for the patients.
The aim of the present study was to investigate whether greater splenic emptying or higher skeletal muscle deoxygenation amplitude (determined by near‐infrared spectroscopy, NIRS) contributes to ...higher V̇O2 max. during supine cycling. We hypothesized that the reduction in splenic volume, and subsequent manipulations of O2 delivery by blood ejected from the spleen, would not contribute to higher V̇O2max. during supine cycling, because this transient increase in circulating red blood cells (RBC’s) would be insufficient to increase the O2 storage capacity in the blood. Rather, O2 uptake during supine cycling in healthy subjects is expected to be limited, at least in part, by skeletal muscle bioenergetics. Here, fourteen healthy young individuals completed all study procedures. On three separate days they underwent a medical examination, supine V̇O2 max. test, and three step‐transitions from 20 W to a moderate‐intensity power output equivalent to V̇O2 uptake at 90% gas exchange threshold. During these step‐transitions, pulmonary V̇O2, NIRS of the vastus lateralis (VL), and cardiovascular responses (via Finapres) were measured continuously. In parallel, minute‐by‐minute ultrasound measurements of the spleen were performed. Blood samples were taken before and immediately after the step‐transition cycling. Mean V̇O2 max. was 46.5±6.5 mL·kg·min‐1. In response to supine step‐transition cycling, spleen volume was significantly reduced (by ~38%, p=.001). Both hematocrit and hemoglobin concentration increased by ~4%, after exercise cessation. There was no correlation between: i)spleen volume at rest, ii) changes in spleen volume (%), iii) hematocrit at rest and V̇O2 max. However, a linear, near‐significant correlation was observed between VL deoxygenation amplitude and V̇O2 max. Apparently, individuals with a higher V̇O2 max. are capable of greater O2 extraction from the superficial knee extensors, whereas in parallel, greater splenic emptying does not correlate with higher V̇O2 max, regardless of the subsequent release of erythrocytes. Therefore, it is reasonable to suggest that maximal O2 utilization during supine cycling in healthy young men is limited, in part, by skeletal muscle bioenergetics.
References
Holmström, PK, Karlsson Ö, Lindblom H, McGawley K, & Schagatay, EK. (2021). Enhanced splenic volume and contraction in elite endurance athletes. J Appl Physiol, 131(2), 474‐486, DOI: 10.1152/japplphysiol.01066.2020;
Zubac, D, Obad, A, Bosnjak, A, Zec, M, Ivancev, V, Valic, Z. (2021). Spleen emptying does not correlate with faster oxygen kinetics during a step‐transition supine cycling. Appl Physiol Nutr Metab. Accepted for publication in Jun 24. doi: 10.1139/apnm‐2021‐0294.2021.
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