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Methylglyoxal (MG) is responsible for advanced glycation end‐product formation, the mechanisms leading to diabetes pathogenesis and complications like acute coronary syndrome (ACS). Sugar metabolites, amino acids and fatty acids are possible substrates for MG. The study aimed to measure plasma MG substrate levels using a validated gas chromatography–mass spectrometry (GC–MS) method and explore their association with ACS risk in type 2 diabetes mellitus (T2DM). The study included 150 T2DM patients with ACS as cases and 150 T2DM without ACS as controls for the analysis of glucose, fructose, ribulose, sorbitol, glycerol, pyruvate, lactate, glycine, serine, threonine, C16:0, C16:1, C18:0, C18:1, C18:2, C18:3, C20:0 and C22:6 by GC–MS. Validated GC–MS methods were accurate, precise and sensitive. Cases significantly differed in plasma MG and metabolite levels except for lactate, C16:0, C18:0, C18:2, and C18:3 levels compared with controls. On multivariable logistic regression, plasma C20:0, C18:1, glycine and glycerol levels had increased odds of ACS risk. On multivariate receiver operating characteristic analysis, a model containing plasma C20:0, C16:1, C18:1, C18:2, serine, glycerol, lactate and threonine levels had the highest area under the curve value (0.932) for ACS diagnosis. In conclusion, plasma C20:0, C16:1, C18:1, glycine, glycerol and sorbitol levels were associated with ACS risk in T2DM. Highlights: MG is a determinant of carbonyl stress in T2DM patients.The substrates of MG were analysed by GC–MS in T2DM with and without ACS.The validated GC–MS methods were sensitive, accurate, precise and reliable.Plasma C20:0, C16:1, C18:1, glycine, glycerol and sorbitol are associated with ACS risk in T2DM. [ABSTRACT FROM AUTHOR]

Background: High prevalence of type 2 diabetes mellitus (T2DM) is associated with a higher prevalence of acute coronary syndrome (ACS). Inflammation is one of the important contributors to the pathogenesis and complications of coronary atherosclerotic plaque. Growth Differentiation Factor-15 (GDF-15) and Tenascin-C (TNC) play an important role in the initiation of atherosclerotic plaque as well as its rupture. The aim of the study was to evaluate the association between serum GDF-15, TNC, and the risk of ACS among T2DM patients. Methods: Anthropometric parameters, routine biochemical investigations like liver and renal function tests, lipid profile, and Creatine Kinase-Total (CK-T), Creatine Kinase-MB (CK-MB) were measured in 42 T2DM patients with ACS and 42 T2DM patients. Serum GDF-15 and TNC were measured by Human Sandwich-ELISA kits. Results: Serum GDF-15 and TNC levels were significantly higher in T2DM patients with ACS as compared to T2DM patients. Serum GDF-15 was significantly correlated with waist circumference, diastolic blood pressure, pulse, serum CK-T, and CK-MB. Serum TNC was significantly correlated with the pulse, serum CK-T, CK-MB, high-density lipoprotein-cholesterol, and blood urea nitro GEN. Multivariate linear regression analysis showed that waist circumference was independently positively associated with serum GDF-15. Conclusions: T2DM patients with higher serum GDF-15 and TNC levels were at higher risk of acute coronary syndrome independent of other cardiovascular risk factors.

Background and objectives: The association between body iron stores and risk of deep vein thrombosis/ pulmonary embolism (DVT/ PE) has not been studied among Indian subjects. This study aimed to evaluate the same and also study the association between iron stores and recanalization of affected veins at week-12. Methods: This Case-Control with follow-up study enrolled 85 consecutive adult (≥ 18 years) cases presenting with first episode of spontaneous, proximal lower extremity DVT/ PE and 170 age (± 3 years) and sex matched adult controls without DVT/ PE. Those with haemoglobin(Hb) < 9 g/dl, malignancies, serum creatinine ≥ 2 mg/dL, heart failure and concurrent infections/ inflammatory disorders were excluded. All participants underwent iron profile, serum ferritin light-chain (FtL) and hepcidin testing. Results: Anaemia [OR = 2.3 (95% CI = 1.3–4.0), p = 0.001] and elevated RDW (RDW-CV > 15%) [OR = 2.3 (95% CI = 1.2–4.3), p = 0.012] were significantly associated with increased risk of DVT/ PE. Iron deficiency (ID, defined as serum ferritin < 30 µg/L, along with TSAT < 20%) was not associated with DVT/ PE risk [OR = 0.8 (95% CI = 0.4–1.7), p > 0.05]. Serum FtL in the highest quartile (> 75th centile) was associated with higher risk of DVT/ PE (OR = 5, 95% CI = 2.6–9.6) and levels < 25th centile with protection against DVT/ PE (OR = 0.1, 95% CI = 0.01–0.32), compared to levels between 25th and 75th centiles (referent range). Highest DVT/ PE risk was associated with FtL > 90th centile [OR≈12 (95% CI = 3.9–37.2)]. No associations were noted between serum hepcidin and DVT/ PE risk and ID and DVT recanalization at week-12. Conclusion: Higher iron stores, rather than ID, were associated with increased risk of DVT/ PE among those with Hb ≥ 9 g/dL. Anaemia and elevated RDW were also associated with risk of DVT/ PE. ID was not associated with poorer DVT recanalization at week-12. [ABSTRACT FROM AUTHOR]

Background: Because of the widespread use of organophosphate (OP) pesticides in agriculture, they are major environmental contaminants in developing countries. OP pesticides decrease sperm concentration and affect its quality, viability, and motility. Studies have demonstrated the association between abnormal semen analysis and OP pesticides exposure among the high-risk population. As there is limited data on the percentage of OP pesticides exposure, the study aimed to determine the OP pesticides exposure in Southern Indian men with idiopathic abnormal semen analysis and find the possible source of their OP pesticides exposure. Materials and Methods: In this cross-sectional pilot study, fifty men with idiopathic abnormal semen analysis as cases and fifty men with normal semen analysis as controls were recruited. Detailed history was taken and general and systemic examinations were carried out. OP pesticides exposure was determined by assessment of pseudocholinesterase and acetylcholinesterase levels and urinary OP pesticides metabolites dialkyl phosphate (DAP) consisting of dimethyl phosphate (DMP), diethyl thiophosphate (DETP), and diethyl dithiophosphate (DEDTP). Results: Cases had statistically significantly lower levels of pseudocholinesterase (5792.07 ± 1969.89 vs. 10267.01 ± 3258.58 IU/L) (P=0.006) and acetylcholinesterase [102.90 (45.88-262.74) vs. 570.31 (200.24-975.30) IU/L] (P=0.001) as compared to controls. Cases had a statistically significantly higher percentage of urinary DAP positivity as compared to controls (80 vs. 38%, P<0.0001). Hence, cases had a significantly higher percentage of OP pesticides exposure as compared to controls (20 vs. 4%, P=0.015). OP-exposed cases had significantly higher urinary DETP and DEDTP levels as compared to OP non-exposed cases. Also, urinary DETP and DEDTP levels were significantly negatively associated with sperm concentration, motility, and normal morphology among OP-exposed cases. Conclusion: Southern Indian men with idiopathic abnormal semen analysis had a significantly higher percentage of OP pesticides exposure as compared to men with a normal semen analysis. [ABSTRACT FROM AUTHOR]

Background: High prevalence of type 2 diabetes mellitus (T2DM) is associated with a higher prevalence of acute coronary syndrome (ACS). Inflammation is one of the important contributors to the pathogenesis and complications of coronary atherosclerotic plaque. Growth Differentiation Factor-15 (GDF-15) and Tenascin-C (TNC) play an important role in the initiation of atherosclerotic plaque as well as its rupture. The aim of the study was to evaluate the association between serum GDF-15, TNC, and the risk of ACS among T2DM patients. Methods: Anthropometric parameters, routine biochemical investigations like liver and renal function tests, lipid profile, and Creatine Kinase-Total (CK-T), Creatine Kinase-MB (CK-MB) were measured in 42 T2DM patients with ACS and 42 T2DM patients. Serum GDF-15 and TNC were measured by Human Sandwich-ELISA kits. Results: Serum GDF-15 and TNC levels were significantly higher in T2DM patients with ACS as compared to T2DM patients. Serum GDF-15 was significantly correlated with waist circumference, diastolic blood pressure, pulse, serum CK-T, and CK-MB, Serum TNC was significantly correlated with the pulse, serum CK-T, CK-MB, high-density lipoprotein-cholesterol, and blood urea nitrogen. Multivariate linear regression analysis showed that waist circumference was independently positively associated with serum GDF-15. Conclusions: T2DM patients with higher serum GDF-15 and TNC levels were at higher risk of acute coronary syndrome independent of other cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Background: Human serum paraoxonase 1 (PON1) hydrolyzes organophosphate (OP) compounds and so significantly alters an individual's susceptibility to the toxicity of these chemicals. The study was designed to assess the serum PON1 activity in a series of patients with OP poisoning. Methods: Suspected OP poisoning patients presented within 6 hours of consumption at emergency department were recruited. Demographic information of patients, clinical findings, treatments given, complications, length of hospital stay and clinical outcome were collected into datasheets. Patients were graded into moderate and severe poisoning. Serum PON1 was measured by ELISA method and serum cholinesterase by butyrylthiocholine method. Results: Mean serum PON1 level in patients with severe poisoning was significantly lower than those with moderate poisoning (426 ± 179 U/L vs. 868 ± 79 U/L, P < 0.001). Serum PON1 significantly correlated with serum cholinesterase levels (r = 0.400, P < 0.001) and negatively associated with total length of hospital stay (r = -0.338, P < 0.001), total atropine dose (r = -0.826, P < 0.001), serum amylase (r = -0.331, P < 0.001), lipase (r = 0.260, P = 0.011) and total creatinine kinase (r = -0.456, P < 0.001). Serum PON1 and cholinesterase levels were significantly lower in expired patients and those who required ventilation assistance as compared to recovered patients who did not require ventilation assistance. Conclusion: Lower PON1 activity was significantly associated with lower serum cholinesterase and poorer outcomes. PON1 activity may be considered as an indicator of prognosis in OP poisoning. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 Diabetes Mellitus (DM) is on the verge of becoming a pandemic in India. Type 2 DM is known to have two to four times increased risk of carotid artery disease. Adipokines have been regarded recently as direct link between diabetes and atherosclerosis. Visceral Adipose Tissue Derived Serine Protease Inhibitor (VASPIN); one of the most recently discovered adipokine, inhibits the proteases responsible for insulin resistance, carotid plaque development and rupture. In literature, few studies have addressed the role of vaspin in pathogenesis of Acute Coronary Syndrome (ACS) in patients with type 2 DM. Aim: To identify association between serum vaspin with lipid profile, creatine kinase-total, creatine kinase-MB, troponin-I, age, height, weight, blood pressure, smoking, family history of ACS and to prove the hypothesis of low serum vaspin level as predictor of ACS in patients with type 2 DM. Materials and Methods: Forty-one type 2 DM patients (controls) and 41 type 2 DM patients with ACS (cases) were enrolled in the study. Anthropometric measurements were performed and fasting serum biochemical parameters and vaspin were measured. The data was recorded and analysed on SPSS system. The results of cases and controls were compared by student t-test or Mann-Whitney test. All the parameters were correlated with serum vaspin by Pearson's or Spearman's correlation. Results: Fasting serum vaspin concentration was significantly (p< 0.0001) lower in the cases (0.43 ± 0.22 pg/ml) than in the controls (0.83 ± 0.29 pg/ml). Correlation analysis undertaken on all type 2 DM showed that serum vaspin concentration was negatively correlated with age, waist circumference, hip circumference, systolic and diastolic blood pressure, duration of diabetes, serum Creative Kinase-Total, CK-MB and urea (p< 0.05). Utilizing Receiver Operating Characteristic (ROC) curve, the serum vaspin level of less than 0.594pg/ml showed greatest risk of ACS among type 2 DM patients (p< 0.0001). Conclusion: Type 2 DM patients with low serum vaspin concentration were at risk of ACS independent of other cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Background: The extracellular matrix (ECM) glycoprotein changes are associated with the pathogenesis and complications of atherosclerosis, leading to acute coronary syndrome (ACS). Tenascin-C (TNC), an ECM protein, has been implemented in the pathogenesis, diagnosis, and prognosis of patients with cardiovascular disease. Aim: The study aimed to compare the genetic variants of the TNC gene (rs13321, rs2104772, and rs12347433) between South Indians with ACS and healthy participants. Materials and Methods: This case-control study recruited 150 ACS patients as cases and 150 healthy participants as controls. TNC genotyping was performed using TaqMan 5'-exonuclease allele discrimination assay. Serum TNC levels were measured by enzyme-linked immunosorbent assay. Results: Serum TNC levels were significantly higher in cases compared with controls. No significant difference was observed in allele and genotype frequencies of rs13321, rs2104772, and rs12347433 between cases and controls, which was confirmed by dominant, recessive, codominant, and homozygotic genetic models. The patients with heterozygous genotypes of rs13321, rs2104772, and rs12347433 had significantly lower serum TNC levels than patients with respective homozygous genotypes. Haplotype analyses revealed that the C-T-A haplotype in the block of rs13321-rs12347433-rs2104772 was associated with lower ACS risk (OR = 0.33, 95% CI: 0.15 - 0.75; p  = 0.005). Also, the C-T-T and G-T-A haplotypes of the TNC gene were associated with higher and lower serum TNC levels, respectively. Conclusion: Our study demonstrated no genetic association between single nucleotide polymorphisms of the TNC gene and ACS risk; however, the C-T-A haplotype of the TNC gene might be associated with reduced ACS risk in South Indians.