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Objectives: The objective of the study is to evaluate plasma homocysteine level and its relation with serum estrogen in pre and postmenopausal women as a risk factor in coronary artery disease (CAD). Materials and Methods: A cross-sectional study was conducted among premenopausal (n = 50) and postmenopausal women (n = 50) with an estimation of plasma homocysteine (Hcy) and serum estradiol (E2). Postmenopausal women based on their angiographic status were sub-grouped into A (with normal coronaries) and B (with CAD). Results: The levels of Hcy, 21.98 (20.89-24.05) μmol/L, increased significantly (P < 0.0001) and that of E2, 3.05 (2.32-3.6) pg/mL, decreased significantly (P = 0.0001) in the postmenopausal group when compared to Hcy, 6.11 (4.94-8.27) μmol/L and E2, 26.37 (25.3-29) pg/mL in premenopausal group. The levels of Hcy were elevated (24.7 ± 3.92 μmol/L) in postmenopausal Group B in comparison with postmenopausal Group A (21.37 ± 3.31 μmol/L), P = 0.002. Logistic regression analysis showed Hcy and body mass index to be independent predictors of CAD. Plasma Hcy showed an area under curve (AUC) of 1.00 with sensitivity and specificity of 100% at cutoff >12.6 μmol/L between pre and postmenopausal groups and AUC of 0.722 with 60% sensitivity and 84% specificity at cutoff >23.7 μmol/L between postmenopausal Groups A and B. Conclusion: We observed low E2 and high Hcy levels in postmenopausal women in comparison with premenopausal women. Among postmenopausal women, those with CAD had higher Hcy levels. Assessing Hcy levels routinely in postmenopausal women will help in better risk prediction of CAD and may also help in conjunction with other risk factors to decide the initiation of hormone replacement therapy. [ABSTRACT FROM AUTHOR]

Introduction: Iron acts as a cofactor in Thyroid Peroxidase (TPO) activity, and low iron levels can impact thyroid hormone metabolism. The function of ferritin and iron has been extensively documented in various studies in patients with Overt Hypothyroidism (OH), but their role in Subclinical Hypothyroidism (SH) remains largely unexplored. Aim: To evaluate the serum ferritin and iron levels in patients who have SH. Materials and Methods: A retrospective observational study was conducted between March 2018 and October 2018 at the Biochemistry Department of Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India. For the study, a total of 100 cases of SH were enrolled, and these patients were matched in terms of age and sex with 50 healthy controls. A fasting sample was obtained and analysed for serum ferritin, Total Iron Binding Capacity (TIBC), TT3, TT4, and Thyroid Stimulating Hormone (TSH). MedCalc software was used to perform statistical analysis. Results: In the SH group, there were 32 males (32%) and 68 females (68%); in the control group, there were 21 males (42%) and 29 females (58%). The median values of TT3 (nmol/L), TT4 (µg/dL), and TSH (µIU/mL) were 1.55 (1.4-1.95), 7.8 (5.9-9.75), and 3 (1.9-3.75) for controls, and 1.4 (1.1-1.75), 6.85 (5.5-8.15), and 6.2 (4.8-8.05), respectively, for cases. In comparison to controls, the TSH level was significantly higher (p<0.0001) in cases. The median iron (µg/dL), ferritin (ng/mL), TIBC (µg/dL), and % saturation in cases were 56.5 (41.5-82), 110 (31.5-194.5), 329 (258-390), and 19 (11.25-26.75), respectively, while in controls they were 84 (68.5-96.5), 195 (121.5-338.5), 233 (188.5-294), and 25 (18-37.5). There was a significant decrease in iron level (p<0.00001), % saturation (<0.00001), and ferritin level (p<0.00001), and a significant increase in TIBC (p<0.0001) in cases when compared to controls. Conclusion: In conclusion, the present study showed a significant negative correlation between SH and iron deficiency. Patients with this condition should be evaluated for ferritin and iron levels and treated appropriately to prevent hypothyroidism. [ABSTRACT FROM AUTHOR]

The coronavirus disease COVID-19 caused by SARS-CoV-2 was a worldwide public health emergency which affected millions of people including frontline healthcare workers too. We evaluated the clinical features and biochemical investigations in COVID-19 affected healthcare workers (HCW) admitted to NIMS Intensive care unit (ICU) including survivors and non-survivors to identify risk factors for mortality. We did a retrospective study of 78 HCW with RTPCR confirmed COVID-19 infection admitted in ICU between July and November, 2020. Subjects were grouped into survivors and non-survivors. Clinical features and biochemical investigations were compared. Survival analysis was performed to analyze the risk factors of mortality. Out of the 78 patients admitted to ICU, the majority were males (64%). Non-survivor patients were older with a median age of 64 years. There were significantly higher proportion of females (59%) in non-survivors. COVID-19 non-survivors had significantly more incidence of cardiovascular disease and also higher blood levels of AST, CPK, CRP, D-dimer, IL-6, LDH, urea, NTproBNP and procalcitonin. Hazard's ratios showed that the mortality risk was significantly higher and survival was significantly lower in patients more than 60 years in age, females and those having IL-6 >40.06 pg/mL, LDH >461U/L, NTproBNP >1188 pg/mL, procalcitonin >0.5 pg/mL, urea >67 mg/dL, creatinine >1.3 mg/dL, D-dimer >573 ng/mL, ferritin >1488 ng/mL, andCPK >191U/L. Our study identified that the mortality risk was significantly higher and survival was significantly lower in patients older age group, females and those having higher IL-6, LDH, NTproBNP, procalcitonin, urea, creatinine, D-dimer, ferritin and CPK. Determination of specific clinical and biochemical features as above would help in better understanding of the pathophysiology, prognosis and appropriate intervention for potential outcomes. [ABSTRACT FROM AUTHOR]

Microalbuminuria is an early biomarker of general vascular dysfunction and a predictor of risk for cardiovascular and renal diseases. It is also considered as a marker of insulin resistance in both diabetic and non-diabetic patients. The rationale of this study was to elucidate threshold values of fasting blood glucose (FBS) and glycosylated hemoglobin (HbA1c) that are associated with microalbuminuria. In the parallel association of microalbuminuria with hyperhomocysteinemia was investigated. Machine learning algorithm and multiple linear regression were applied to study the association of poor glycemic control on microalbuminuria and hyperhomocysteinemia. In non-diabetic subjects with FBS <102 mg/dL and HbA1c <6.3%; and in diabetic subjects with good glycemic control (FBS: 102-118 mg/dL; HbA1c: 6.3-7.0%), urinary microalbumin levels were <40|g/mg creatinine. Poor glycemic control (FBS >172 mg/dL and HbA1c >9.0%) was associated with microalbumin >40|g/mg creatinine. Age, gender, HbA1c and FBS were shown to explain variability in urinary microalbumin to the extent of 54.4% as shown by multiple linear regression model. Analysis of variance (ANOVA) revealed higher levels of FBS (F: 39.77, P <0.0001), HbA1c (F: 64.31, P <0.0001) and total plasma homocysteine (F: 3.69, P =0.04) in microalbuminuria and clinical microalbuminuria groups when compared to subjects with normal microalbumin levels. Diabetic patients with poor glycemic index had a more B12 deficiency. Poor glycemic index and hyperhomocysteinemia were associated with clinical microalbuminuria. [ABSTRACT FROM AUTHOR]

Background: Diabetic nephropathy is a major complication with high morbidity and mortality, and leads to end stage renal disease (ESRD). Type IV collagen is the main component of the glomerular basement membrane (GBM) and the extracellular matrix. The thickening of the GBM is due to accumulation of type IV collagen and alterations in its structure and composition., Aim: The aim of this study was to evaluate the association of plasma and urine type IV collagen with albuminuria status and to determine the clinical implications of type IV collagen as a marker in the early stage of diabetic nephropathy., Materials and Methods: A total of 150 type 2 diabetes mellitus patients with more than 5 year diabetic duration in the age group of 35 to 60 years were selected for this study and 50 age and sex matched healthy individuals were selected as control group. Type IV collagen (Plasma and urine), Insulin were analyzed by ELISA method and micro albumin was analyzed by turbilatex method. Routine investigations fasting plasma glucose, post prandial glucose, lipid profile parameters, serum urea and creatinine were analyzed by using Auto analyzer., Results: The plasma and urinary type IV collagen levels were significantly higher in the normoalbuminuric group with diabetes than in the control group, and increased with increasing severity of albuminuria among diabetics. Both plasma and urine type IV collagen levels showed positive correlation with albumin creatinine ratio (ACR) and regression analysis showed significant influence with ACR and also positive significant correlation of ACR with FPG, PPG, HbA1C, HOMA-IR, negative correlation with HDL cholesterol was observed., Conclusion: Plasma and urinary type IV collagen can be helpful in the prediction of the subsequent development of albuminuria in type 2 diabetic patients.

The present study was performed, to analyse the inter-relationship among trace elements: Iron, copper and zinc in pregnancy. Eighty-four pregnant women were compared with 30 age matched nonpregnant healthy controls. Fasting blood samples were analysed for heamoglobin, iron, copper and zinc. On the basis of Hb concentration (<10g/dl) and iron levels(<50microg/dl), the pregnant women were sub-grouped as anaemic, non-anaemic, Iron deficient anaemic and non-iron deficient anaemic. The level of copper was found to be significantly higher in iron deficiency anaemia, when compared to non-iron deficiency anaemia (p<0.05), and in non-anaemic pregnant women, compared to non-anaemic non-pregnant women (controls).The level of zinc is also significantly lower in Iron deficiency anaemic pregnancy, when compared to the other groups. There is evidence of influence of pregnancy, on the level of trace elements in blood. This could be a result of competitive inhibition in the absorption of trace elements in the intestine, or an effect of hormonal changes (insulin, oestrogen), during pregnancy. A judicious supplementation of micronutrients, during pregnancy, especially in iron deficiency anaemia, is essential.