International journal of Clinical Biochemistry and Research

5-12

Authors: Sunaiba M, Avinash S.S, Arunkumar K, Malathi M, Shivashankara A. R, Ashwini K

Introduction: AOPP (Advanced oxidation protein products) are the dityrosine containing protein cross linking products indicating the oxidised tyrosine residues of the plasma protein albumin, fibrinogen and lipoproteins. AOPP are elevated in oxidative stress and inflammation. Unlike AOPP the mAOPP estimation is not interfered by triglyeride levels. Objective: Analytical method comparison of AOPP with mAOPP. Materials and Methods: Measurement of AOPP involves the principle of spectrophotometric determination of oxidation of I- plasma AOPP under acidic condition by Witko Sarsat method. To remove the interference by the triglycerides especially seen in hypertriglyceridemia, the plasma was treated with lipid precipitating agent and the mAOPP were measured. In this study using pooled serum samples we compared the performance characteristics like precision, accuracy, linearity limit and reference range of AOPP assay with the mAOPP assay under our laboratory conditions as per CLIA guidelines of method validation. Results and Discussion: The intrarun, intraday, interday and overall precision of AOPP (4.25%, 5.18%, 3.89%, 5%) was better than that of mAOPP (5.76%, 5.5%, 5.8%, and 5.8%). But on linear regression, mAOPP = 0.5×AOPP + 9.8 chloramine T equivalents (r2-0.62; p < 0.001) and the AOPP was 18% higher than mAOPP. In eutriglyceridemia however, mAOPP = 0.7xAOPP + 4.8 chloramine T equivalents (r2 = 0.75; p < 0.001) and the AOPP was only 14.5% higher. Also the correlation (r = 0.74) of AOPP – mAOPP levels with TG showed that the difference was significantly higher (p < 0.001) in the persons with higher TG levels clearly establishing the overestimation of AOPP. Conclusion: Hence mAOPP may prove to be a better estimate of protein oxidation status and a better diagnostic and prognostic indicator compared to AOPP especially in hypertriglyceridemic patients.

18-21

Authors: Dinesh Kumar Sharma

Background: The present study concentrate to get significant association of serum uric acid levels with pre-eclampsia and PIH and also between serum uric acid and severity of disease. Material and Methods: 80 Patients diagnosed as having Pre-eclampsia and 80 controls with similar age group were studied after taking their consent. Blood samples were collected under aseptic precautions in plain vacutainer for serum uric acid estimations. Uric acid estimation was done by Uricase Peroxidase Method on Fully Automated Biochemistry Analyzer Miura 300. Results: The observed mean serum uric acid levels in preeclampsia was 7.52±0.77 mg/dl as compared to 3.70±0.94 mg/dl in controls.

27-32

Authors: Nishtha Saral, Mamta Rathore, V. D. Bohra, Madhuri Gupta

Background: β-Thalassemia results from a defect in β-globin chain production and ranges from clinically silent heterogeneous thalassemia minor to severe transfusion dependent homozygous thalassemia major. After approximately one year of transfusion, iron begins to deposit in parenchymal tissues, which might cause damage to the parenchyma and organ function impairment. So, iron overload may be develop liver, kidney, heart and endocrine abnormalities. Objectives: The aim of study was to correlate the early hepatic and renal complications in condition of β-thalassemia with serum iron and total iron binding capacity (TIBC) levels. Method: In study 50 β-thalassemia major patients were compared with 50 normal healthy subjects as controls. Fasting serum iron, TIBC, LFT and RFT were estimated using standard kit methods. Data were statistically evaluated by Student’s t-test and Pearson’s correlation coefficient (r). Result: A significant increase in the levels of serum iron and a significant decrease in TIBC in β-thalassemia patients were observed. Serum levels of liver enzymes (Aspartate transaminase, Alanine transaminase and alkaline phosphatase) were significantly higher in β-thalassemia patients as compared to controls. A significant decrease in total proteins and increase in serum bilirubin level was found in β-thalassemia patients. Serum urea and creatinine levels were significantly higher, but no change in levels of serum uric acid was found in β-thalassemia patients when compared to controls. There was significant negative correlation between serum iron and TIBC, total protein among patient group. Conclusion: Iron overload due to frequent transfusions in β-thalassemia results in abnormal organ function tests. Proper and timely screening of these parameters can help in early diagnosis & prevention of iron overload.

41-47

Authors: Viyatprajna Acharya, B D Toora

Background: Obesity is now occurring in pandemic proportions and has earned a new name as “Globesity” for it. Unlike earlier times developing countries too are facing the challenge of obesity and the modern epidemics have a common root cause tapering to obesity. Obesity during adolescent and young adulthood usually persists to adulthood in almost 50% cases and gives rise to early onset of type 2 diabetes mellitus, cardiovascular disorders and metabolic syndrome for which insulin resistance being the common link to all. Objective: The present study was taken up to study the prevalence of insulin resistance in apparently healthy young adult obese population and study its correlation with different cardiovascular risk factors like lipid profile and sdLDL-C. Material and Methods: In a randomized control study 106 apparently healthy young adults in the age group of 21-34 years were chosen from the community out of which 45 were obese and 61were age and gender matched non-obese controls. They were divided in obese and non-obese groups based on cut-off BMI of 25Kg/m2. Along with physical parameters fasting plasma glucose, lipid profile and routine biochemical parameters were assayed by standard kit methods and plasma insulin was measured by sandwich ELISA method. Different lipid ratios, atherogenic index and insulin resistance were calculated. Atherogenic index was calculated and insulin resistance was measured by HOMA-IR model and QUICKI index. Small dense LDL-C (sdLDL-C) was quantified by modified Tsutomu –Hirano method. Results: In the obese group BMI, waist circumference (WC) and waist-hip ratio (WHR) elevated significantly (p=0.0001) and TG, VLDL-C and sdLDL-C as well as atherogenic index elevated significantly (p<0.001).Significant Hyperinsulinaemia (p<0.0001) was found in the obese group and 50% of obese cases had hyperinsulinaemia. Insulin resistance calculated by HOMA-IR and QUICKI index was statistically significant (p<0.0001) in obese. Linear regression analysis showed sdLDL-C (R2=0.08, p=0.05 at 95% C.I.), hyperinsulinaemia (R2=0.089, p=0.054 at 95% C.I.) and insulin resistance (R2=0.099, p=0.03 at 95% C.I.) significantly dependent on WC and atherogenic index was significantly dependent on TG (R2=0.0036, p=0.05 at 95% C.I.) rather than any other lipid factors. On ROC analysis either method of insulin resistance showed equal efficacy (AUC for HOMA-IR= 80.3% and QUICKI = 80.14%; C.I. 95%) and atherogenic index turned out to be a better predictor than sdLDL-C (AUC for Atherogenic index= 76.14% and QUICKI = 71.46%). Conclusions: For Indian subpopulation WC and WHR should also be evaluated along with BMI. Insulin resistance should be identified early and interventional measures should be taken in terms of low carbohydrate protein-rich diet, physical exercise and insulin receptor sensitizers for a short-term. sdLDL-C rises earlier than total cholesterol and hence can be accepted as CVS risk predictor. Not many studies have been done in India on young adult health which is the group that can be targeted for early prevention of the modern epidemics like DM, Metabolic syndrome, CVS disorders and cancers.

54-58

Authors: Smita S. Swami, Sanjay C. Swami, Vinayak W. Patil, Anuradha M. Kanhere

Hypertension (HT) Type 2 diabetes mellitus (DM) are among the most common chronic non-communicable diseases and multifactorial disorders affecting both developed and developing countries, including India. Although DM and HT are not among the top leading causes of death, such as cancer and stroke, these two diseases draw attention from the public due to their increasing trends. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. When HT coexists with DM, the risk of CVD is increased by 75%, which further contributes to the overall morbidity and mortality of already high risk population. India contributes a lion’s share in the diabetic and hypertensive population. This needs to be tackled with proper awareness and proper government policies. The current review article throws light on comorbidity of HT and DM and its current scenario in India.

61-64

Authors: Dhiraj Trivedi, K Sankara Narayana

Background: Estimating the time since death is one of the prime objectives of conducting Medico-legal autopsies. The exact time of death can be known from hospital records, police investigation report etc. But at times, it is difficult to predict when such records are not available. Various methods have been experimented using biological fluids like blood, vitreous humor, synovial fluid, urine etc. to determine time lapse with varying degree of success. After somatic death, blood components undergo biochemical changes at every tissue. This principle can be utilized effectively to predict time since death in routine forensic practice where time of death is uncertain. Study purpose/Objectives: The present study was conducted to evaluate the relationship of postmortem blood glucose level with time elapsed from death on thirty-nine postmortem blood samples of time registered deaths of an adult occurred at our hospital. Methods: The 10 ml of jugular venous blood was collected from each autopsy case. Blood glucose level was estimated by glucometer. The results were correlated with time since death. Results and Mean Findings: Significant difference between blood glucose level before death (125.32 ± 489.29) and after death (56.73 ± 42.00) was observed. When the time interval since death (884.11 ± 489.29 min)were compared with difference in blood glucose level (68.59 ± 57.76mg/dl) shows high significance (p<0.0001). Similar significance (p<0.0001) were noted when the time interval since death were compared with rate of fall (0.103 ± 0.093 mg/dl min) of glucose level. Conclusions: Estimation of postmortem blood glucose level doesn’t provide any specific pattern of fall. Hence, it cannot be recommended for estimation of time since death as individual parameter.