Patra PK, Khodiar PK, Sahu D, Sahu GK. Alterations in Urinary Microalbumin and Serum Antioxidants in Sickle Cell Disease. Indian J Med Biochem 2016;20(1):1-5.

To compare metabolic status of lean vs overweight/ obese type 2 diabetes mellitus (T2DM) patients and correlate biochemical parameters with anthropometric measures.

A total of 100 T2DM patients were categorized as lean and overweight/obese according to body mass index (BMI); 50 age- and sex-matched healthy controls were selected. Anthropometric measures of BMI, waist circumference (WC), and waist:hip (W:H) were recorded. Fasting blood samples were assayed for fasting plasma glucose (FPG), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and nonesterified free fatty acids (NEFA). Low-density lipoprotein (LDL) was calculated by Friedewald's formula and TG: HDL was measured as measure of insulin resistance (IR).

Anthropometric measures of overall (BMI 31.65 ± 5.49, 20.34 ± 2.45 vs 22.29 ± 3.21) and visceral adiposity (WC 91.98 ± 6.8, 75.45 ± 4.34 vs 74.19 ± 3.98 and W:H 0.99 ± 0.12, 0.78 ± 0.21 vs 0.76 ± 0.32) were significantly higher in overweight/ obese (p < 0.05) compared with lean T2DM and controls. Total cholesterol, TG, LDL, and NEFA were significantly raised and HDL decreased in T2DM compared with those of controls. But much higher values were observed in overweight/obese than in lean group. Triglycerides: HDL was significantly higher in obese than in lean patients (4.66 ± 1.89 vs 7.91 ± 3.01), confirming significantly decreased insulin sensitivity among obese than non-obese diabetics. Positive correlation was observed between BMI, WC, W:H and TC, TG, LDL, NEFA, and TG:HDL, while negative correlation was observed with HDL in obese group. Lean individuals with normal BMI, WC had deranged lipids with IR.

Lean and obese T2DM have dyslipidemia and IR. Poor metabolic profile is associated with overall and visceral adiposity in obese and not in lean T2DM individuals.

Asegaonkar SB, Kareem I, Aghade S, Pagdhune A, Thorat A, Borkar MS. Metabolic Status of Lean, Overweight, and Obese Type 2 Diabetes Mellitus Patients. Indian J Med Biochem 2016;20(1):6-10.

Dysfunctional uterine bleeding (DUB) is a major form of abnormal uterine bleeding, seen in at least 10% of all new outpatient department patients. The thyroid gland is known to play an important role in maintaining a healthy menstrual cycle.

To assess the thyroid hormone status in apparently euthyroid patients with DUB and to correlate it with incidence of DUB.

Fifty DUB patients were selected on the basis of clinical history, examination, and relevant investigations. Equal numbers of age-matched women with normal menstrual cycle were taken as controls. Thyroid hormones, viz., thyroid-stimulating hormone, total triiodothyronine and tetraiodothyronine, were estimated by radioimmunoassay. Statistical analysis of the data was performed by using Microsoft Excel software.

The most common menstrual abnormality was menorrhagia (48%) followed by metrorrhagia and polymenorrhea (14% each). Hypothyroidism was more prevalent among cases (85.7%) as compared with controls (14.3%). In patients with menorrhagia, 33.3% of patients had hypothyroidism.

Hypothyroidism occurs in DUB patients commonly. There is a need for mandatory thyroid screening in all patients with menstrual irregularities to help in early detection of the cause and treatment of DUB patients to avoid surgery.

Phukan JK, Saharia GK, Goswami R. Thyroid Status in Patients with Dysfunctional Uterine Bleeding in a Tertiary Care Hospital of Assam. Indian J Med Biochem 2016;20(1):11-15.

In the DMWN group, vitamin B12 levels were significantly higher than in the DMWON group and controls [1013 (564-1501) pmol/l, 387 (245-731) pmol/l, and 305 (234-472) pmol/l respectively]. Similarly, serum holoTC was also found to be significantly higher in the DMWN [203.8 (129-300) pmol/l] group compared with the DMWON [94.4 (42.2-230.6) pmol/l] group and controls [74 (40-170) pmol/l]. Whereas mean levels of homocysteine and folate did not show any significant difference between groups, significant increase in fasting blood sugar and HbA1c was seen in the DMWN group compared with DMWON group and controls. Duration of diabetes is also significantly more in DMWN group compared with DMWON group.

We found that vitamin B12 and holoTC levels were high in patients with DMWN and DMWON groups compared with controls. Our study demonstrated that peripheral neuropathy was not associated with vitamin B12 deficiency in diabetics. These findings merit further research on a larger population to investigate into the cause of diabetic neuropathy, the factors involved, and benefit of vitamin B12 supplementation in these patients.

Vitamin B12 status has no association with diabetic peripheral neuropathy.

Noorjahan M, Madhavi K, Priscilla C, Jabeen SA. Vitamin B12 and Holotranscobalamin Levels in Diabetic Peripheral Neuropathy Patients. Indian J Med Biochem 2016;20(1):16-20.

Glomerular endotheliosis is an essential component in the pathophysiology of gestational hypertension (GH) and preeclampsia (PE) which results in renal dysfunction. This is not always detected by routine renal function tests, such as serum creatinine, urea, and uric acid. Cystatin C, an endogenous cysteine protease inhibitor, is completely absorbed by renal tubules and has been shown to be an ideal marker of glomerular filtration rate (GFR), which needs to be evaluated in assessing renal dysfunction occurring in GH and PE.

The present study is designed to evaluate serum cystatin C levels in normal pregnancy, GH, and PE and compare its efficacy with traditional renal function tests.

In this prospective cross-sectional study, 75 subjects enrolled, comprised of 25 subjects each of normal pregnancy, GH, and PE. Serum cystatin C, blood urea, serum creatinine, serum uric acid, and urinary protein/creatinine ratio were estimated in all subjects prior to delivery.

All renal parameters including cystatin C were significantly raised in GH and PE compared with control group. However, only serum cystatin C level (and no other renal parameters) was significantly higher in PE group compared with GH group. Area under the curve for cystatin C was maximum (0.917) compared with other parameters. Cystatin C had a higher sensitivity and specificity than other conventional markers.

Serum cystatin C is a better marker of renal dysfunction in hypertensive pregnancies.

Singh A, Gupta M, Ranjan R, Saini V, Gupta SK. Cystatin C is a Better Marker of Renal Dysfunction in Hypertensive Pregnancies. Indian J Med Biochem 2016; 20(1):21-27.

The poor sensitivity of conventional smear microscopy and the delay in obtaining Mycobacterium culture results prevent the early diagnosis of Myobacterium tuberculosis (MTB). By using nucleic acid amplification techniques like polymerase chain reaction (PCR), one may be able to diagnose the disease on the day of arrival of specimen in the laboratory. The present study aimed to evaluate the applicability of the nested-PCR (nPCR) technique as a rapid and direct molecular method for the diagnosis of M. tuberculosis in sputum specimens of patients whose sputum smear was acid-fast bacilli (AFB) negative using heat shock protein (hsp65) as the gene target.

Early morning sputum samples were collected in sterile containers respectively from about 40 suspected patients of pulmonary tuberculosis, attending the outpatient units of JSS Medical College and PKTB Hospital, Mysore and from 20 age and sex-matched healthy controls. Sputum samples were decontaminated by modified Petroff's method and DNA was isolated using QIAGEN DNA extraction kit. The nPCR was carried out for the detection of MTB using the target gene hsp65.

Nested-PCR showed specific amplification (165bp) of M. tuberculosis in 18 out of 20 sputum AFB positive samples and 9 out of 20 AFB negative samples. None of the healthy controls showed any amplification with nPCR. The nPCR when compared to that of Ziehl-Neelsen staining had a sensitivity of 90%, specificity of 77.5%, positive predictive value (PPV) of 66.6%, and negative predictive value (NPV) of 93.9%. The percentage of false positive was 33.3% and percentage of false negative was 6.1%.

The detection of M. tuberculosis with nPCR in smear negative patients provides the bacteriological data 4 to 8 weeks earlier. A molecular approach, based on the amplification of hsp65 gene by nPCR, showed that there is high probability of the disease being absent when the test is negative because of the high negative predictive value (NPV).

Varadaiah YGC, Prashant A, Chinnappa RK, Nagaraj RM, Thejashwini, Samuel RK, Devegowda D, Vishwanath P. Evaluation of Nested Polymerase Chain Reaction targeting hsp65 of Mycobacterium tuberculosis for the Detection of Organism in the Sputum Samples. Indian J Med Biochem 2016;1(1):28-33.

Ekka DC, Jain A, Puri M. Role of Hormones in Unexplained Infertility. Indian J Med Biochem 2016;20(1):34-37.

Agarwal N, Kaur J, Kaur J, Gupta S, Jaswal S, Kaur H, Swami HM. Assessing Status of Iodine Nutrition in Union Territory of Chandigarh, India. Indian J Med Biochem 2016;20(1):38-41.