scholarly journals D-thyroxine reduces lipoprotein(a) serum concentration in dialysis patients.

1998 ◽  
Vol 9 (1) ◽  
pp. 90-96
Author(s):  
C Bommer ◽  
E Werle ◽  
I Walter-Sack ◽  
C Keller ◽  
F Gehlen ◽  
...  
Keyword(s):  
Serum Concentration ◽  
Ldl Cholesterol ◽  
Clinical Symptoms ◽  
Hormone Secretion ◽  
Elevated Serum ◽  
Serum Levels ◽  
Controlled Study ◽  
Dialysis Patients ◽  
Lipoprotein A ◽  
Thyroxine Therapy

Uremia raises lipoprotein(a) (Lp(a)) serum concentration and the risk of arteriosclerosis in dialysis patients. The treatment of high Lp(a) levels is not satisfactory today. The decrease of Lp(a) in hypothyroid patients on L-T4 therapy raised the question of whether dextro-thyroxine (D-thyroxine) reduces not only serum cholesterol, but also Lp(a) serum concentration. In a single-blind placebo-controlled study, the influence of D-thyroxine therapy on Lp(a) serum concentration was evaluated in 30 hemodialysis patients with elevated Lp(a) serum levels. Lp(a) was quantified in parallel by two methods, i.e., rocket immunoelectrophoresis and nephelometry, and apo(a) isoforms were determined by a sensitive immunoblotting technique. Regardless of the apo(a) isoforms, 6 mg/d D-thyroxine reduced elevated Lp(a) levels significantly by 27 +/- 13% in 20 dialysis patients (P < 0.001) compared with 10 control subjects (-9.9 +/- 8.4%). In parallel, D-thyroxine therapy significantly lowered total cholesterol (P < 0.001), LDL cholesterol (P < 0.001), and LDL cholesterol/HDL cholesterol ratio (P < 0.01); raised T4 and T3 serum levels; and suppressed thyroid-stimulating hormone secretion without causing clinical symptoms of hyperthyroidism in any of the patients. D-Thyroxine reduces elevated serum Lp(a) concentration in dialysis patients. The effect in nondialysis patients can be expected but remains to be proven.

scholarly journals Lipoprotein(a) in Chronic Renal Failure

2009 ◽  
Vol 28 (2) ◽  
pp. 82-88
Author(s):  
Velibor Čabarkapa ◽  
Mirjana Đerić ◽  
Zoran Stošić ◽  
Vladimir Sakač ◽  
Sunčica Kojić-Damjanov ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Chronic Renal Failure ◽  
Serum Concentration ◽  
Elevated Serum ◽  
Serum Levels ◽  
Chronic Hemodialysis ◽  
Control Group ◽  
Elevated Concentration ◽  
Lipoprotein A

Lipoprotein(a) in Chronic Renal Failure Cardiovascular diseases are the leading cause of mortality in patients with chronic renal failure. Among the parameters contributing to cardiovascular disease development is the elevated serum concentration of lipoprotein(a) diagnosed in these patients, especially in the terminal stage of CRF. However, an elevated concentration of lipoprotein(a) could influence the renal failure progression. The objective of this study is to examine the lipoprotein(a) serum levels in chronic renal failure, and to establish the relation between the stage of renal function preservation and the level of this lipoprotein. In this study 127 subjects were included, divided into three groups. The first group contained 42 subjects (15 females and 27 males) in different CRF stages, the second group contained 32 subjects (7 females and 25 males) on a chronic hemodialysis program, and the control group contained 53 subjects (22 females and 31 males) with regular renal function. The results obtained point to significantly higher frequency of hyper-Lp(a) lipoproteinaemia in dialysed patients compared to the control group, as well as significantly higher Lp(a) values in both groups of patients compared to the control group. It can be concluded that for the risk assessment of premature atherosclerotic changes, but also renal failure progression in patients with CRF, determination of the Lp(a) serum concentration is recommendable.

Calcium and vitamin D metabolism in acromegaly

1981 ◽  
Vol 96 (4) ◽  
pp. 444-450 ◽  
Author(s):  
Bjarne Lund ◽  
Peter Claes Eskildsen ◽  
Birger Lund ◽  
Anthony W. Norman ◽  
Ole Helmer Sørensen
Keyword(s):  
Growth Hormone ◽  
Serum Concentration ◽  
Urinary Excretion ◽  
Direct Action ◽  
Elevated Serum ◽  
Serum Levels ◽  
Calcium Excretion ◽  
Vitamin D Metabolism ◽  
Dihydroxyvitamin D ◽  
Free Cortisol

Abstract. Acromegalic subjects were found to have elevated serum levels of both 1,25-dihydroxyvitamin D (1,25-(OH)2D), (67 ± 22 (sd) pg/ml) and 24,25-dihydroxyvitamin D (24,25-(OH)2D), (6.9 ± 1.5 (sd) ng/ml). The serum concentration of 1,25-(OH)2D correlated positively (P < 0.02, R = 0.56) to the 24 h urinary excretion of growth hormone, but not to the serum levels of parathyroid hormone, prolactin, thyroid hormones or the urinary excretion of free cortisol. Fourteen patients were treated with bromocriptine at doses from 15–45 mg/day for a period of about 6 months. This was accompanied by a significant decrease in the urinary excretion of growth hormone and calcium and in the serum concentrations of 1,25-(OH)2D and 24,25-(OH)2D. A relationship was demonstrated between the decrease in urinary calcium excretion and the decrease in serum 1,25-(OH)2D (P < 0.02, R = 0.64). It is concluded that the serum concentration of 1,25-(OH)2D is elevated in acromegaly, perhaps as a consequence of a direct action of growth hormone on the renal lα-hydroxylase activity.

scholarly journals Uremic Pruritus and associated factors in Chronic Dialysis Patients: An Observational Study in Western Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1224-1230
Author(s):  
Ajay Kumar ◽  
Saujan Subedi ◽  
Abhisek Maskey ◽  
Mohammad Asim ◽  
Brijesh Sathian ◽  
...  
Keyword(s):  
Observational Study ◽  
Sleep Disturbance ◽  
Associated Factors ◽  
Elevated Serum ◽  
Serum Levels ◽  
Skin Lesions ◽  
Diagnostic Value ◽  
Chronic Dialysis ◽  
Dialysis Patients ◽  
Uremic Pruritus

Introduction: Pruritus is one of the well-recognized major skin derangements in patients with advanced renal failure and are usually  without visible skin lesions. Only few studies have addressed this issue in Nepalese population. Objective:.The present study aims to identify the prevalence and associated factors of uremic pruritus in chronic dialysis patients in western Nepal. Methodology:A prospective observational study was conducted to include all chronic dialysis patients with uremic pruritus at the Manipal Teaching Hospital, Pokhara, Nepal over a period of one year (June 2018 and May 2019). Results: During the study period, a total of 59 patients were included in the study with mean age of 55.8±15.8years,of which 37 (63%) patients developed uremic pruritus. Statistically significant relationship betweenpresence of pruritus and  pruritus severity with frequency of itching grade and sleep disturbance score among elderly (p=0.001) were observed The serum urea can predict uremic pruritus among elderly patients with a good diagnostic value.  The multivariate analysis showed male gender, hypertension, elevated serum albumin and random blood sugarwere independent predictors of pruritus in patients undergoing chronic dialysis. Conclusions: Our findings demonstrate that higher proportion ofpatients undergoing chronic dialysis werediagnosed with uremic pruritus (63%) and occurrence of pruritus had association with frequency of itching grade and sleep disturbance score .The serum levels of urea may predict the occurrence of pruritus among elderly patients.Furthermore, a large multicenter study is warranted with longer follow up which may provide robust information on the burden of pruritus and its associated factors to guide appropriate management among elderly.

Homocysteine Level in Schizophrenia Patients

2009 ◽  
Vol 43 (8) ◽  
pp. 760-765 ◽  
Author(s):  
Yin Ying Ma ◽  
Chi Chung Shek ◽  
Max C. K. Wong ◽  
Ka Chee Yip ◽  
Roger M. K. Ng ◽  
...  
Keyword(s):  
Homocysteine Level ◽  
Blood Donation ◽  
Clinical Symptoms ◽  
Age Of Onset ◽  
Demographic Data ◽  
Elevated Serum ◽  
Serum Levels ◽  
Diagnostic Interview ◽  
Healthy Controls ◽  
Serum Homocysteine

Objective: Elevated serum levels of homocysteine have been shown to be associated with schizophrenia in some studies, but the evidence is still limited and mixed. The aim of the present study was therefore to evaluate the serum homocysteine level in Chinese in schizophrenia patients and assess its association with clinical phenotypes of the disease. Method: A total of 250 inpatients and 250 healthy controls were identified at Kowloon Hospital and the Red Cross Blood Donation Centre, respectively. Each subject was evaluated with a structured diagnostic interview. Demographic data were collected and blood was analysed for homocysteine level. The Positive and Negative Syndrome Scale was used to grade clinical symptoms of schizophrenia. Confounding factors affecting homocysteine levels were controlled by strict exclusion criteria or statistical methods. Results: Serum homocysteine level was elevated in Chinese schizophrenia patients. Both male (mean, 12.26 µmol L−1; control, 11.40 µmol L−1, p = 0.026) and female (mean, 9.61 µmol L−1; control, 8.33 µmol L−1, p < 0.001) patients had a higher serum homocysteine level than the healthy controls, and these differences persisted after controlling for age. There was no significant association between serum homocysteine level and duration of illness, clinical symptoms or age of onset of schizophrenia. Conclusion: The serum homocysteine levels were elevated in both male and female Chinese schizophrenia patients. The levels were not apparently related to other clinical parameters.

scholarly journals Lipoprotein(a) Serum Levels in Diabetic Patients with Retinopathy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Giulia Malaguarnera ◽  
Caterina Gagliano ◽  
Claudio Bucolo ◽  
Marco Vacante ◽  
Salvatore Salomone ◽  
...  
Keyword(s):  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Diabetic Patients ◽  
Oxidized Low Density Lipoprotein ◽  
Lipoprotein A ◽  
The Impact ◽  
The Relationship

Background. Atherogenic lipoproteins, such as total cholesterol, LDL cholesterol, oxidized low density lipoprotein, and triglycerides, are associated with progression of retinopathy.Aim. To evaluate the relationship between lipoprotein(a) and retinopathy in patients with type 2 diabetes mellitus.Materials and Methods. We enrolled 145 diabetic consecutive patients (82 females, 63 males; mean age66.8±12years, mean duration of diabetes9.4±6.8years). Presence and severity of retinopathy were evaluated. Serum lipid profile, including Lp(a) level, was assessed.Results. High Lp(a) levels have been observed in 54 (78.3%) subjects and normal levels in 13 (18.85%) subjects as regards diabetic patients with retinopathy. Lp(a) levels were high in 15 subjects (21.75%) and normal in 63 subjects (91.35%) as regards patients without retinopathy.Conclusions. Lp(a) levels are increased in a significant percentage of patients with retinopathy compared to diabetic patients without retinopathy. The impact of Lp(a) levels on diabetic retinopathy needs to be further investigated.

scholarly journals Rickets guidance: part I—diagnostic workup

2021 ◽  
Author(s):  
Dieter Haffner ◽  
Maren Leifheit-Nestler ◽  
Andrea Grund ◽  
Dirk Schnabel
Keyword(s):  
Vitamin D ◽  
Clinical Symptoms ◽  
Fibroblast Growth Factor 23 ◽  
Correct Diagnosis ◽  
Elevated Serum ◽  
Growth Failure ◽  
Serum Levels ◽  
Calcium Deficiency ◽  
X Rays ◽  
Vitamin D Metabolism

AbstractRickets is a disease of the growing child arising from alterations in calcium and phosphate homeostasis resulting in impaired apoptosis of hypertrophic chondrocytes in the growth plate. Its symptoms depend on the patients’ age, duration of disease, and underlying disorder. Common features include thickened wrists and ankles due to widened metaphyses, growth failure, bone pain, muscle weakness, waddling gait, and leg bowing. Affected infants often show delayed closure of the fontanelles, frontal bossing, and craniotabes. The diagnosis of rickets is based on the presence of these typical clinical symptoms and radiological findings on X-rays of the wrist or knee, showing metaphyseal fraying and widening of growth plates, in conjunction with elevated serum levels of alkaline phosphatase. Nutritional rickets due to vitamin D deficiency and/or dietary calcium deficiency is the most common cause of rickets. Currently, more than 20 acquired or hereditary causes of rickets are known. The latter are due to mutations in genes involved in vitamin D metabolism or action, renal phosphate reabsorption, or synthesis, or degradation of the phosphaturic hormone fibroblast growth factor 23 (FGF23). There is a substantial overlap in the clinical features between the various entities, requiring a thorough workup using biochemical analyses and, if necessary, genetic tests. Part I of this review focuses on the etiology, pathophysiology and clinical findings of rickets followed by the presentation of a diagnostic approach for correct diagnosis. Part II focuses on the management of rickets, including new therapeutic approaches based on recent clinical practice guidelines.

scholarly journals Serum Erythropoietin Concentration And Its Correlation With Stage Of Diabetic Retinopathy

2019 ◽  
Author(s):  
Sofija Davidović ◽  
Babić Nikola ◽  
Jovanović Sandra ◽  
Barišić Sava ◽  
Grković Desanka ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Serum Concentration ◽  
Proliferative Diabetic Retinopathy ◽  
Elevated Serum ◽  
Serum Levels ◽  
Average Concentration ◽  
Control Group ◽  
Patients With Diabetes ◽  
Advanced Stages

Abstract Erythropoietin (EPO) is one of the systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. The latest research data reveal a possible correlation of higher erythropoietin concentrations in the blood and in the eye with the development of more advanced stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development of diabetic retinopathy in patients with diabetes mellitus type 2.Methods The research involved 90 patients examined at the University Eye Clinic of the Clinical Center of Vojvodina, Novi Sad, Serbia. The first group comprised 60 patients with diabetes mellitus lasting for ten years or more, with diabetic retinopathy. The second, control group consisted of 30 healthy individuals. In the first group of 60 patients with diabetes, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method.Results The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in the group of people with diabetes with PDR. The lowest average concentration of EPO in the serum (6.90 mIU/ml) was found in the control group. The average concentration of EPO in serum in the group of patients with diabetes with NPDR was 7.00 mIU/ml. The EPO concentration in serum was elevated in the group of PDR, and it was directly proportional to the level of the clinical stadium of PDR, being significantly higher in the moderate and severe subgroup of PDR comparing to the control healthy subjects, NPDR and mild PDR (p=0.007).Conclusions Significantly elevated serum concentration of EPO in the advanced stages of DR, and positive correlation between EPO serum concentration and clinical stages of PDR, suggest that erythropoietin represents an important growth factor from blood, which plays a significant role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease.

scholarly journals Serum erythropoietin concentration and its correlation with stage of diabetic retinopathy

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sofija Davidović ◽  
Nikola Babić ◽  
Sandra Jovanović ◽  
Sava Barišić ◽  
Desanka Grković ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Serum Concentration ◽  
Proliferative Diabetic Retinopathy ◽  
Elevated Serum ◽  
Serum Levels ◽  
Average Concentration ◽  
Control Group ◽  
Patients With Diabetes ◽  
Advanced Stages

Abstract Background Erythropoietin (EPO) is one of the systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. The latest research data reveal a possible correlation of higher erythropoietin concentrations in the blood and in the eye with the development of more advanced stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development of diabetic retinopathy in patients with diabetes mellitus type 2. Methods The research involved 90 patients examined at the University Eye Clinic of the Clinical Center of Vojvodina, Novi Sad, Serbia. The first group comprised 60 patients with diabetes mellitus lasting for 10 years or more, with diabetic retinopathy. The second, control group consisted of 30 healthy individuals. In the first group of 60 patients with diabetes, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method. Results The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in the group of people with diabetes with PDR. The lowest average concentration of EPO in the serum (6.90 mIU/ml) was found in the control group. The average concentration of EPO in serum in the group of patients with diabetes with NPDR was 7.00 mIU/ml. The EPO concentration in serum was elevated in the group of PDR, and it was directly proportional to the level of the clinical stadium of PDR, being significantly higher in the moderate and severe subgroup of PDR comparing to the control healthy subjects, NPDR and mild PDR (p = 0.007). Conclusions Significantly elevated serum concentration of EPO in the advanced stages of DR, and positive correlation between EPO serum concentration and clinical stages of PDR, suggest that erythropoietin represents an important growth factor from blood, which plays a significant role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease.

scholarly journals Lipoprotein(a) Where Do We Stand? From the Physiopathology to Innovative Terapy

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 838
Author(s):  
Gabriella Iannuzzo ◽  
Maria Tripaldella ◽  
Vania Mallardo ◽  
Mena Morgillo ◽  
Nicoletta Vitelli ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Treatment Options ◽  
Strong Association ◽  
Elevated Serum ◽  
Serum Levels ◽  
Epidemiologic Studies ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lipoprotein A ◽  
Premature Cardiovascular Disease

A number of epidemiologic studies have demonstrated a strong association between increasing lipoprotein a [Lp(a)] and cardiovascular disease. This correlation was demonstrated independent of other known cardiovascular (CV) risk factors. Screening for Lp(a) in the general population is not recommended, although Lp(a) levels are predominantly genetically determined so a single assessment is needed to identify patients at risk. In 2019 ESC/EAS guidelines recommend Lp(a) measurement at least once a lifetime, fo subjects at very high and high CV risk and those with a family history of premature cardiovascular disease, to reclassify patients with borderline risk. As concerning medications, statins play a key role in lipid lowering therapy, but present poor efficacy on Lp(a) levels. Actually, treatment options for elevated serum levels of Lp(a) are very limited. Apheresis is the most effective and well tolerated treatment in patients with high levels of Lp(a). However, promising new therapies, in particular antisense oligonucleotides have showed to be able to significantly reduce Lp(a) in phase II RCT. This review provides an overview of the biology and epidemiology of Lp(a), with a view to future therapies.

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