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Cathepsin S (CTSS) is a cysteine protease involved in atherogenesis. We compared the plasma CTSS as well as other biomarkers of atherosclerosis in patients with abdominal aortic aneurysms (AAA) and aortoiliac occlusive disease (AOD), aiming to identify the underlying pathogenic mechanisms of the disease development. Also, we hypothesised that the level of plasma CTSS simultaneously increases with a decrease of plasma high-density lipoprotein cholesterol (HDL-C) values.33 patients with AAA and 34 patients with AOD were included in this study.There was no difference in the level of plasma CTSS between the two analysed groups (p=0.833). In the patients with AAA, the plasma CTSS was correlated with HDL-C (r = -0.377, p = 0.034) and total bilirubin (r =0.500, p = 0.003) while, unexpectedly, it was not correlated with cystatin C (Cys C) (r =0.083, p = 0.652). In the patients with AOD, the plasma CTSS correlated with triglycerides (r = 0.597, p0.001), only. When the patients were divided according to HDL-C (with HDL-C ≤0.90 and HDL-C0.90 mmol/L), the plasma CTSS values differed among these groups (31.27These results provide the first evidence that CTSS negatively correlated with HDL-C and bilirubin in patients with AAA. It is possible that differences in the association of the CTSS and other markers of atherosclerosis can determine whether atherosclerotic aorta will develop dilatation or stenosis.Katepsin S (CTSS) je cisteinska proteaza uključena u aterogenezu. Uporedili smo plazmatski CTSS kao i druge biomarkere ateroskleroze kod pacijenata sa aneurizmom abdominalne aorte (AAA) i aorto ilijačnom okluzivnom bolešću (AOD) sa ciljem da se identifikuju osnovni patogeni mehanizmi razvoja bolesti. Takođe, pretpostavili smo da se nivo plazmatskog CTSS istovremeno povećava sa smanjenjem vrednosti holesterola plazmatskih lipoproteina visoke gustine (HDL-C).Ova studija je obuhvatila 33 pacijenta sa AAA i 34 pacijenta sa AOD.Nije bilo razlike u nivou plazmatskog CTSS izme|u dve analizirane grupe (p = 0,833). Kod pacijenata sa AAA, plazmatski CTSS je bio u korelaciji sa HDL-C (r = -0,377, p = 0,034) i ukupnim bilirubinom (r = - 0,500, p = 0,003), dok, neočekivano, nije bio u korelaciji sa cistatinom C (Cys C) (r = 0,083, p = 0,652). Kod pacijenata sa AOD, plazmatski CTSS je bio u korelaciji sa trigliceridima (r = 0,597,p0.001). Kada su pacijenti podeljeni prema HDL-C (sa HDL-C ≤ 0,90 i HDL-C0,90 mmol/L), vrednosti plazmatskog CTSS su se razlikovale među grupama (31,27 naspram 25,61 μg/L, respektivno, p0,001).Ovi rezultati pružaju prvi dokaz da je CTSS negativno povezan sa HDL-C i bilirubinom kod pacijenata sa AAA. Pretpostavka je da se na osnovu razlike u asocijaciji CTSS-a i drugih markera ateroskleroze može utvrditi da li će ateroskleroza aorte dovesti do dilatacije ili stenoze.

Background/Aim. Glycosylated haemoglobin (HbA1c) is currently the gold standard for glucose monitoring in the patients with diabetes. The aim of the present study was to examine the level of success in implementing international guideline targets with regard to glycaemic control in the patients with type 2 diabetes in the Republic of Srpska. This study also aimed to determine the association of albuminuria with the glycaemic control and lipid levels in this patient population. Methods. The participating diabetic patients were those registered in the project titled ??Estimation of the quality of glycoregulation and presence of vascular complications in the persons with diabetes in the Republic of Srpska.? The study was conducted as a cross-sectional study including 1037 patients. HbA1c was determined by a turbidimetric inhibition immunoassay used Roche Diagnostics. Total cholesterol, triglycerides, LDL-C, and HDL-C were determined by reagents from Roche Diagnostics (Roche Diagnostics, Mannheim, Germany) as well as albumin and creatinine in the urine. Results. Mean value for HbA1c was 7.35 ? 1.61% (57 ? 18 mmol/moL). The 49.46% of all participants achieved target values of HbA1c (< 7% or 53 mmol/moL) and 40.30% had albumin to creatinine ratio (ACR) < 30 mg/g. When the patients were divided according to HbA1c (with HbA1c < 7%, 519 patients, and HbA1c ? 7.0%, 510 patients) the ACR values were different between these groups (39.00 vs. 79.50, p < 0.001). We found no significant difference with respect to lipid status between the groups. Conclusion. The patients with type 2 diabetes in the Republic of Srpska, in a large percentage, did not meet targets for glycaemic control. Improvements are necessary in the treatment and maintenance of this disease process to ensure achievement of goals in management of diabetes, which in turn would decrease longstanding complications of type 2 diabetes.

The aim of this study was to determine the reference values for thyrotropin (TSH), thyroid hormones (total and free thyroxine, T4 and fT4; total and free triiodothyronine, T3 and fT3), thyroglobulin (Tg) and thyroid antibodies (thyroid peroxidase, TPOAb and thyroglobulin antibody, TgAb) in the population of the Republic of Srpska.A total of 250 euthyroid subjects were enrolled in this study. A direct method for choosing reference subjects was used to establish reference intervals. The hormones and thyroid antibodies were measured by an electrochemiluminescence immunoassay method (ECLIA, Roche Diagnostics, Mannheim, Germany). We calculated the reference intervals by MedCalc, version 12.1.4.0 (MedCalc software, Belgium) as recommended by the IFCC (CLSI C28-A3).Using guidelines recommended by the National Academy of Clinical Biochemistry (NACB) and based on standard statistical approaches, the reference intervals derived for TSH, fT4, T4, fT3, T3 were 0.75-5.32 mIU/L, 12.29-20.03 pmol/L, 73.49-126,30 nmol/L, 4.11-6.32 pmol/L, 1.15-2.32 nmol/L and for Tg, TPOAb, TgAb were 3.63-26.00 μg/L,18.02 mIU/L,98.00 mIU/L, respectively. We found a significant difference (p0.05) in TSH and fT3 values between different age groups as well as in T4, fT4 and fT3 values between ge nder groups.The established reference values for the population of the Republic of Srpska were significantly different from the values recommended by the manufacturer of reagents (Roche Diagnostics). Our results showed that a laboratory needs to establish its own reference values in order to set up a proper diagnosis, as well as to treat patients successfully.Cilj ovog rada bio je da se utvrde referentne vrednosti tireotropnog hormona (TSH), tireoidnih hormona (ukupni tiroksin, T4 i slobodni tiroksin, fT4; ukupni trijodtironin, T3 i slobodni trijodtironin, fT3), tireoglobulina (Tg) i anti tela štitne žlezde (antitela na tireoperoksidazu, TPO-At i tireoglobulinska antitela, Tg-At) kod stanovništva Republike Srpske.Ukupno 250 eutireoidnih ispitanika bilo je uključeno u ovo istraživanje. Korišćen je direktan način izbora referentnih osoba za utvrđivanje referentnog intervala. Hormoni i antitela štitne žlezde određivani su u serumu elektrohemiluminiscentnom metodom (ECLIA, Roche Diagnostics, Mannheim, Germany). Referentne granice su određene korištenjem programa MedCalc, verzija 12.1.4.0 (MedCalc software, Belgium) po preporuci IFCC (CLSI C28-A3).Koristeći smernice Nacionalne akademije za kliničku biohemiju (NACB) i na temelju standardnih statistiČkih pristupa utvrđeni referentni intervali za TSH, fT4, T4, fT3, T3 bili su 0,75–5,32 mIU/L, 12,29–20,03 pmol/L, 73,49– 126,30 nmol/L, 4.11–6.32 pmol/L, 1,15–2,32 nmol/L kao i za Tg, TPOAt, TgAt 3, 63–26,00 μg/L,18,02 mIU/L,98,00 mIU/L. Takođe, postojala je i značajna razlika između različitih starosnih grupa za TSH i fT3 vrednosti, kao i razlika za T4, fT4 i fT3 vrednosti između žena i muškaraca.Dobijene referentne vrednosti za populaciju Republike Srpske znatno su se razlikovale od vrednosti preporučenih od strane proizvođača reagensa (Roche Diagnostics). Rezultati su ukazali da laboratorije moraju da izrade sopstvene referentne vrednosti sa ciljem postavljanja prave dijagnoze, kao i uspešnog lečenja pacijenata.

SummaryBackground: High-density lipoproteins (HDL) have atheroprotective biological properties: antioxidative, anti-apoptotic, anti-inflammatory, and they have the efflux capacity of cellular cholesterol. Plasma mRNA analysis can be used to investigate statin pleiotropy in vivo as a new analytical tool for non-invasive assessment of gene expression in vascular beds. The aim of this study was to assess the pleiotropic effects of atorvastatin in stable angina patients with highrisk values (group A) as compared with patients who had borderline and desirable HDL-cholesterol (HDL-C) values (group B).Methods: The atorvastatin therapy (20 mg/day) was given to forty-three patients with stable angina for 10 weeks. We investigated three statin pleiotropy-targeted genes: intercellular adhesion molecule-1, chemokine (C-C motif) ligand 2 and cathepsin S and assessed by gel electrophoresis gradient the effects of atorvastatin on HDL size and subclasses.Results: In group A, after therapy, HDL-C concentration was significantly increased but not in group B. Atorvastatin lowered plasma chemokine (C-C motif) ligand 2 and intercellular adhesion molecule-1 mRNA levels in both groups, but did not change the plasma cathepsin S mRNA levels. In group A only, baseline total bilirubin showed negative cor relations with the genes of cathepsin S (r=-0.506; p=0.023) and significantly increased after therapy.Conclusion: HDL-C and bilirubin can be promising therapeutic targets in the treatment of cardiovascular diseases. Analysis of cell-free mRNA in plasma might become a useful tool for estimating statin pleiotropy