Which Metabolic Index is Appropriate for Predicting Non-alcoholic Steatohepatitis?

BACKGROUND There are controversial ideas about the application of metabolic indices for the prediction of nonalcoholic steatohepatitis (NASH). In this study, we evaluated some novel metabolic indices for the screening of NASH. METHODS This prospective case-control study was performed in a gastroenterology outpatient clinic. Consecutively selected patients with persistently elevated aminotransferase levels and evidence of fatty liver in ultrasonography were enrolled. Those with other etiologies of aminotransferase elevation were excluded. The remaining was presumed to have NASH. The control group consisted of age and sex-matched subjects with normal liver function tests and liver ultrasound examinations. RESULTS Finally, 94 patients with steatohepatitis and 106 controls were included in the project. The mean liver fat content (LFC), aspartate aminotransferase, and alanine aminotransferase levels were significantly lower in the control group than in the NASH group. LFC was independently associated with the presence of NASH in logistic regression analysis. LFC had a good area under the curve for the prediction of NASH in ROC (receiver operating characteristic curve) analysis. CONCLUSION LFC seems to be a reliable metabolic index for the detection of patients with NASH.

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Inflammatory Biomarkers Predictive of Metabolic Syndrome in a Nigerian Population: A Case-Control Study

Annals of Health Research ◽

10.30442/ahr.0604-03-101 ◽

2020 ◽

Vol 6 (4) ◽

pp. 382-390

Author(s):

EN Adejumo ◽

OA Adejumo ◽

OA Ogundahunsi

Keyword(s):

Metabolic Syndrome ◽

Case Control Study ◽

Inflammatory Marker ◽

Characteristic Curve ◽

Area Under The Curve ◽

Case Control ◽

Control Group ◽

Necrosis Factor Alpha ◽

Hs Crp ◽

Control Study

Background: Inflammation is linked to the aetiopathogenesis of Metabolic syndrome (MetS). Objective: To assess the ability of high sensitivity C-Reactive Protein (hs-CRP), Tumour Necrosis Factor-alpha (TNFα) and Interleukin-6 (IL-6) to predict MetS. Methods: A case-control study involving 123 subjects with MetS (cases) and age-matched 123 subjects. without MetS (controls) was conducted. The levels of TNFα, IL-6, and hs-CRP between independent groups were compared. The Receiver Operative Characteristic Curve was used to assess the ability of inflammatory markers to discriminately identify MetS. Results: The mean age of the case and control groups was 49.9±0.9 years and 48.1±1.1 years (p = 0.274) respectively. The median levels of TNFα, IL-6 and hS-CRP were significantly higher among the cases than the control group in both genders (p <0.001). There was a significant increase in the serum values of the markers with increasing components of MetS (p <0.001). The Area Under the Curve of TNFα, IL-6 and hs-CRP was > 0.9 in both males and females. Conclusion: TNFα, IL-6, and hs-CRP identified MetS. There is a need for further studies to determine the inflammatory marker most predictive of MetS.

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Diagnostic efficacy of serum and urinary netrin-1 in the early detection of diabetic nephropathy

Journal of Investigative Medicine ◽

10.1136/jim-2021-001785 ◽

2021 ◽

pp. jim-2021-001785

Author(s):

Rasha A Elkholy ◽

Reham L Younis ◽

Alzahraa A Allam ◽

Rasha Youssef Hagag ◽

Muhammad Tarek Abdel Ghafar

Keyword(s):

Diabetic Nephropathy ◽

Early Detection ◽

Characteristic Curve ◽

Fasting Blood Glucose ◽

Area Under The Curve ◽

Diagnostic Value ◽

Control Group ◽

Diagnostic Efficacy ◽

Significant Difference ◽

Patients With Diabetes

This study aimed to assess the diagnostic value of serum and urinary netrin-1 in patients with type 2 diabetes mellitus (T2DM) at different stages of diabetic nephropathy (DN) and to compare its efficacy of estimation in serum with that in the urine. This study was carried out on 135 patients with T2DM and 45 healthy subjects. The patients with diabetes were divided according to urinary albumin creatinine ratio (UACR) into: T2DM with normoalbuminuria, incipient DN with microalbuminuria, and overt DN with macroalbuminuria groups. Serum and urinary levels of netrin-1 were measured by ELISA. The mean levels of serum and urinary netrin-1 were significantly higher in the microalbuminuric and macroalbuminuric patients with DN than those in the normoalbuminuric patients with T2DM, with the highest values detected in macroalbuminuric patients with DN. Urinary netrin-1 level was significantly higher in the normoalbuminuric T2DM group than control group, whereas no significant difference existed regarding serum netrin-1 level. In T2DM groups, the urinary and serum netrin-1 correlated with each other and were independently related to fasting blood glucose, UACR, and estimated glomerular filtration rate. Receiver operating characteristic curve analysis showed that the area under the curve of urinary netrin-1 was 0.916 which is significantly higher than that of serum netrin-1 (0.812) for the detection of incipient DN and reached 0.938 on coestimation of both urinary and serum netrin-1. In conclusion, netrin-1 is a potential diagnostic marker for early detection of DN with its estimation in urine has higher accuracy than that of serum.

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Predictive Value of The Combined Detection of Platelets, D-Dimer, and Procalcitonin On Severe Heat Stroke

10.21203/rs.3.rs-618567/v1 ◽

2021 ◽

Author(s):

wang lei ◽

jiang dai shan ◽

zhang Yi ◽

jia han yu ◽

shen jun hua

Keyword(s):

Body Temperature ◽

Characteristic Curve ◽

Heat Stroke ◽

Area Under The Curve ◽

General Information ◽

The Body ◽

Control Group ◽

Clinical Test ◽

Roc Curve Analysis ◽

Combined Detection

Abstract BackgroundTo explore the clinical characteristics of patients with severe heat stroke, we explored the early sensitive indicators of heat stroke (HS) patients, with a view to early intervention for HS patients. MethodsFrom July 30, 2015 to October 5, 2020, 70 inpatients with severe heat stroke admitted to the Second Affiliated Hospital of Nantong University, Jiangsu Province were selected as the research objects. The general information and clinical test indicators of the patients were recorded, and all patients were assessed for acute physiology (APACH Ⅱ) upon admission. According to the severity of heatstroke, they were divided into three groups: control group (heat cramps and heat exhaustion), EHS, and CHS to compare the differences in indicators of each group. Further draw the receiver operating characteristic curve (ROC).Results1. According to the severity of heat stroke, 28 cases were divided into the control group, 24 cases in the EHS group, and 18 cases in the CHS group. The body temperature of the EHS group and the CHS group was significantly higher than that of the control group (both P<0.05), but there was no statistical difference in the body temperature of the EHS group and the CHS group; the DD, PCT, and APACH of the EHS group were significantly higher than those of the control group and the CHS group (both P＜0.05); PLT, CRP, Na, GLU of EHS group were lower than those of control group and CHS group (all P＜0.05), and the decrease of PLT was more significant; CHS group HbA1C was significantly higher than that of control group and EHS group (all P <0.05). 2. ROC curve analysis the areas under the curves of DD, PCT, and PLT are 0.670, 0.705, 0.791, respectively, the sensitivity is 40.48%, 100%, 73.81%, and the specificity is 96.43%, 32.14%, 78.57%, respectively. Using the combined analysis of the three series tests, the area under the curve was 0.838, the sensitivity was 71.43%, and the specificity was 85.71%. ConclusionsEHS patients have higher DD, PCT, APACH, but PLT, CRP, Na, and blood sugar are lower. At the same time, the significant decrease of PLT and the increase of PCT and DD may be early sensitive indicators of HS. The combined detection of the three can be used as a reference basis for early diagnosis of HS and critical illness.

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Assessing Diabetic Foot Infections With the ThermoScale: A Comparative Thermometry Device Designed as a Patient Self-Screening Tool

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734620948304 ◽

2020 ◽

pp. 153473462094830

Author(s):

Laure Arts ◽

Johan De Neve ◽

Samira Baharlou ◽

Nathalie Denecker ◽

Laura Kerselaers ◽

...

Keyword(s):

Temperature Measurement ◽

Diabetic Foot ◽

Characteristic Curve ◽

Screening Method ◽

Area Under The Curve ◽

Control Group ◽

Measurement Technology ◽

Diabetic Patients ◽

Home Setting ◽

Diabetic Foot Infections

Diabetic foot infection (DFI) is an important risk factor for amputation, and late diagnosis or referral is often incriminated for poor outcome. To enable an earlier diagnosis of DFI, comparative foot thermometry has been suggested as a self-screening method for patients in a home setting. We validated the efficacy of the ThermoScale, a weighing scale outfitted with temperature sensors that allows accurate temperature measurement in both feet. Temperature differentials in DFI patients (n = 52) were compared with a control group of similar diabetic patients (n = 45) without any foot wounds. Based on these findings, we drafted a receiver operating characteristic curve to determine an area-under-the-curve of 0.8455. This value suggests that the ThermoScale, as a diagnostic test, is reasonably accurate. A cutoff value of 2.15 °C temperature difference corresponded with a sensitivity of 88.9% and a specificity of 61.5%. As wearables, portable health electronics, and telemedicine become increasingly popular, we think that comparative temperature measurement technology is valuable in improving early diagnosis of DFIs.

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Volume, conductivity, and scatter parameters of leukocytes as early markers of sepsis and treatment response

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_102_18 ◽

2019 ◽

Vol 11 (01) ◽

pp. 029-033

Author(s):

Parul Arora ◽

Praveen Kumar Gupta ◽

Raghavendra Lingaiah ◽

Asok Kumar Mukhopadhyay

Keyword(s):

Characteristic Curve ◽

Area Under The Curve ◽

Receiver Operator Characteristic Curve ◽

Sepsis Group ◽

Control Group ◽

Cutoff Value ◽

Volume Conductivity ◽

Gram Positive Bacteria ◽

Automated Hematology Analyzer ◽

Culture Positive

Abstract INTRODUCTION: Morphologic changes in the size and granularity of leukocytes seen in sepsis could be measured using the volume, conductivity, and scatter (VCS parameters) from the automated hematology analyzers. The objective of this study is to find the clinical usefulness of VCS parameters as possible indicators of sepsis and to determine the effect of treatment on these parameters. METHODS: This observational study was conducted in a tertiary level hospital in India. Hemogram and VCS parameters obtained from LH 750 (Beckman coulter, Fullerton, CA) from 134 proven blood culture-positive cases of sepsis were reviewed on the day of culture positivity (day 0), day 3, and day 7 were analyzed and compared with those of samples from otherwise healthy 100 participants. Statistical analysis of data was done, and cutoff value was established using receiver-operator characteristic curve. RESULTS: Out of 134 culture-positive cases, 55.2% (n = 74) Gram-negative and 44.8% (n = 60) Gram-positive bacteria were isolated. The mean neutrophil volume (MNV) and mean monocyte volume (MMV) were higher in the sepsis group compared to that of the control group (165.43 ± 18.21 vs. 140.59 ± 7.6, P = 0.001 for MNV and 179.8 ± 14.16 vs. 164.54 ± 9.6, P = 0.001 for MMV). A significant decrease in MNV and MMV was observed with the initiation of the treatment. Significant changes in scatter and conductivity parameters were also noticed. A cutoff value of 150.2 for MNV gave a sensitivity and specificity of 79.1% and 95%, respectively, with an area under the curve (AUC) of 92.3%. With a cutoff of 168.3, MMV had a sensitivity of 80.6% and specificity of 77.5%, AUC of 83%. CONCLUSION: VCS parameters such as MNV and MMV can be easily obtained by an automated hematology analyzer and could be used for early detection and therapeutic response in sepsis.

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Predicting experimental success: a retrospective case-control study using the rat intraluminal thread model of stroke

Disease Models & Mechanisms ◽

10.1242/dmm.044651 ◽

2020 ◽

Vol 13 (12) ◽

pp. dmm044651

Author(s):

Lisa Liebenstund ◽

Mark Coburn ◽

Christina Fitzner ◽

Antje Willuweit ◽

Karl-Josef Langen ◽

...

Keyword(s):

Operating Characteristic ◽

Characteristic Curve ◽

Disease Model ◽

Area Under The Curve ◽

Artery Occlusion ◽

Retrospective Case ◽

Stroke Research ◽

Left And Right ◽

Cerebral Artery Occlusion ◽

Control Study

ABSTRACTThe poor translational success rate of preclinical stroke research may partly be due to inaccurate modelling of the disease. We provide data on transient middle cerebral artery occlusion (tMCAO) experiments, including detailed intraoperative monitoring to elaborate predictors indicating experimental success (ischemia without occurrence of confounding pathologies). The tMCAO monitoring data (bilateral cerebral blood flow, CBF; heart rate, HR; and mean arterial pressure, MAP) of 16 animals with an ‘ideal’ outcome (MCA-ischemia), and 48 animals with additional or other pathologies (subdural haematoma or subarachnoid haemorrhage), were checked for their prognostic performance (receiver operating characteristic curve and area under the curve, AUC). Animals showing a decrease in the contralateral CBF at the time of MCA occlusion suffered from unintended pathologies. Implementation of baseline MAP, in addition to baseline HR (AUC, 0.83, 95% c.i. 0.68 to 0.97), increased prognostic relevance (AUC, 0.89, 95% c.i. 0.79 to 0.98). Prediction performance improved when two additional predictors referring to differences in left and right CBF were considered (AUC, 1.00, 95% c.i. 1.0 to 1.0). Our data underline the importance of peri-interventional monitoring to verify a successful experimental performance in order to ensure a disease model as homogeneous as possible.

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Novel predictor of the occurrence of DKA in T1DM patients without infection: A combination of neutrophil/lymphocyte ratio and white blood cells

Open Life Sciences ◽

10.1515/biol-2021-0141 ◽

2021 ◽

Vol 16 (1) ◽

pp. 1365-1376

Author(s):

Yiping Cheng ◽

Wenhao Yu ◽

Yuping Zhou ◽

Tao Zhang ◽

Haiyan Chi ◽

...

Keyword(s):

Blood Cells ◽

Low Cost ◽

Characteristic Curve ◽

White Blood Cells ◽

Area Under The Curve ◽

Control Group ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

Abstract The role of inflammation has been identified in the pathogenesis of diabetic ketoacidosis (DKA). The neutrophil/lymphocyte ratio (NLR) and white blood cells (WBC) can be used to predict a systemic inflammatory response. Changes in NLR and WBC levels have never been explored in type 1 diabetes mellitus (T1DM) patients with DKA and an uninfected state. This retrospective study included a total of 644 participants. NLR and WBC were measured in the control group (n = 316) and in T1DM patients with mild-DKA (n = 92), severe-DKA (n = 52), and non-DKA (n = 184) in an uninfected state. Then, we assessed the independent predictors of DKA occurrence in T1DM patients in an uninfected state. The diagnostic performance of variables was determined by receiver operating characteristic curve analysis. Serum NLR of T1DM patients is significantly higher than that of normal controls, and if DKA occurs, NLR increases further and increases with the severity of DKA. In addition to diastolic blood pressure, blood urea nitrogen, glycated hemoglobin (HbA1c), and WBC, NLR was also independently associated with DKA in T1DM patients with an uninfected state (OR = 1.386, 95% CI: 1.127–1.705, p = 0.002). Furthermore, the diagnosis analysis showed that except for NLR and WBC, the area under the curve (AUC) of indicators with a statistical difference in patients with and without DKA were 0.747 for DKA diagnosis, and after the addition of NLR and WBC, the AUC was 0.806. The increased NLR level represents a low-cost and highly accessible predictor for DKA in T1DM patients with an uninfected state. The addition of inflammation indicators can play a statistically significant role in the prediction model of the DKA occurrence.

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Fibrinogen-to-Albumin Ratio in Familial Mediterranean Fever: Association with Subclinical Inflammation

Klinische Pädiatrie ◽

10.1055/a-1610-9745 ◽

2021 ◽

Author(s):

Esra Nagehan Akyol Onder ◽

Pelin Ertan

Keyword(s):

Familial Mediterranean Fever ◽

Periodic Fever ◽

Characteristic Curve ◽

Area Under The Curve ◽

Colchicine Treatment ◽

Control Group ◽

Subclinical Inflammation ◽

Albumin Ratio ◽

Mediterranean Fever

Abstract Background Familial Mediterranean fever (FMF) is the most seen monogenic periodic fever syndrome characterised by bouts of fever and serositis. It is known that subclinical inflammation (SI) can persist in the symptom-free period and lead to amyloidosis even under colchicine treatment. This study aimed to evaluate the role of the fibrinogen-to-albumin ratio (FAR) in FMF and its correlation with SI. Material and Methods A total of 112 patients with FMF and 78 controls were enrolled in this retrospective study. Demographic, laboratory and genetic data were obtained from the hospital records. Results The FAR values of the FMF cases were significantly higher than the control group (p<0.001). In the FMF group, the patients with SI had higher FAR values than those without SI (p<0.001). FAR was positively correlated with SI (r=0.413, p<0.001). The receiver operating characteristic curve analysis showed that FAR had a higher area under the curve value than albumin and fibrinogen. Conclusion Detecting SI in patients with FMF is crucial in preventing amyloidosis, the most devastating complication of FMF. FAR is a simple, inexpensive, easily obtained indicator which can be used for reflecting SI in FMF.

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Serology and ultrasound for diagnosis of choledocholithiasis

Annals of The Royal College of Surgeons of England ◽

10.1308/003588414x13814021678033 ◽

2014 ◽

Vol 96 (3) ◽

pp. 224-228 ◽

Cited By ~ 13

Author(s):

J Isherwood ◽

G Garcea ◽

R Williams ◽

M Metcalfe ◽

AR Dennison

Keyword(s):

Liver Function ◽

Characteristic Curve ◽

Area Under The Curve ◽

Magnetic Resonance Cholangiopancreatography ◽

Liver Function Tests ◽

Abdominal Ultrasonography ◽

Cbd Stones ◽

Test Parameters ◽

Function Test ◽

Chi Squared

Introduction Magnetic resonance cholangiopancreatography (MRCP) is not a routine investigation to exclude choledocholithiasis unless there is clinical or biochemical suspicion of common bile duct (CBD) stones. This study attempted to determine which radiological or serological parameters best predicted CBD stones. Methods All patients undergoing MRCP from 2005 to 2011 were selected. Patients with pancreatitis were excluded. Liver function tests (LFTs) at admission and prior to MRCP were recorded, as was abdominal ultrasonography and MRCP results. Parameters measured routinely on LFTs included alkaline phosphatase (ALP), alanine transaminase (ALT) and bilirubin. Receiver operating characteristic curve area analysis (area under the curve [AUC]) and chi-squared analysis were undertaken. Results Overall, 195 patients were identified, 71 of whom had CBD stones on MRCP. Raised ALP levels on admission demonstrated a correlation with CBD stones (AUC: 0.619, odds ratio [OR]: 3.16, p=0.06). At ultrasonography, a dilated CBD (OR: 3.76, p<0.001) and intrahepatic duct dilation (OR: 5.56, p<0.001) were highly significant predictors. However, only 37% of patients had a dilated CBD on ultrasonography. Ongoing elevation of LFT parameters, particularly ALP (AUC: 0.707, OR: 4.64, p<0.001) and ALT (AUC: 0.646, OR: 5.40, p<0.001), displayed a significant correlation with CBD stones. Conclusions Ongoing (even if minor) elevations of liver function test parameters should prompt the need to exclude CBD stones even in the presence of a normal CBD diameter on ultrasonography.

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Evaluation of a Quantitative Serological Assay for Diagnosing Chronic Pulmonary Aspergillosis

Journal of Clinical Microbiology ◽

10.1128/jcm.01475-15 ◽

2016 ◽

Vol 54 (6) ◽

pp. 1496-1499 ◽

Cited By ~ 14

Author(s):

Satoru Fujiuchi ◽

Yuka Fujita ◽

Hokuto Suzuki ◽

Kazushi Doushita ◽

Hikaru Kuroda ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Characteristic Curve ◽

Area Under The Curve ◽

Serum Levels ◽

Control Group ◽

Pulmonary Aspergillosis ◽

Content Type ◽

Chronic Pulmonary Aspergillosis ◽

Precipitin Test ◽

Systemic Symptoms

The purpose of this study was to evaluate the clinical utility of a quantitativeAspergillusIgG assay for diagnosing chronic pulmonary aspergillosis. We examinedAspergillus-specific IgG levels in patients who met the following criteria: (i) chronic (duration of >3 months) pulmonary or systemic symptoms, (ii) radiological evidence of a progressive (over months or years) pulmonary lesion with surrounding inflammation, and (iii) no major discernible immunocompromising factors. Anti-AspergillusIgG serum levels were retrospectively analyzed according to defined classifications. MeanAspergillusIgG levels were significantly higher in the proven group than those in the possible and control groups (P< 0.01). Receiver operating characteristic curve analysis revealed that theAspergillusIgG cutoff value for diagnosing proven cases was 50 mg of antigen-specific antibodies/liter (area under the curve, 0.94; sensitivity, 0.98; specificity, 0.84). The sensitivity and specificity for diagnosing proven cases using this cutoff were 0.77 and 0.78, respectively. The positive rates ofAspergillusIgG in the proven and possible groups were 97.9% and 39.2%, respectively, whereas that of the control group was 6.6%. The quantitativeAspergillusIgG assay offers reliable sensitivity and specificity for diagnosing chronic pulmonary aspergillosis and may be an alternative to the conventional precipitin test.

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