Lipocalin-2 as a biomarker for diabetic nephropathy

Diabetes is a major global public health issue.The prevalence of type 1 diabetes is comparatively static,as hereditary and genetic causes are involved,while type 2 diabetes(T2D)prevalence is increasing day by day.T2D is associated with chronic complications,including diabetic neuropathy(DN),nephropathy,retinopathy,and other complications like diabetic foot.DN is the main complication of both types of diabetes.DN can be diagnosed by routine laboratory tests,microalbuminuria>300 mg/24 h,and a gradual decrease in glomerular filtration rate.As the appearance of microalbuminuria is a late manifestation,an early marker for renal damage is needed.Lipocalin-2,also known as neutrophil gelatinaseassociated lipocalin(NGAL),is a small protein purified from neutrophil granules and a good marker for kidney disease.NGAL is a transporter protein responsible for many physiological processes,such as inflammation,generation of the immune response,and metabolic homeostasis.NGAL has been reported to depict the early changes in renal damage when urine microalbumin is still undetecable.Therefore,elucidating the role of NGAL in detecting DN and understanding its mechanism can help establish it as a potential early marker for DN.

Is nitric oxide level affected in postmenopausal women with hypothyroidism?

AIM To analyze serum levels of nitric oxide(NO), an indicator of cardiovascular health, in post-menopausal females with and without hypothyroidism.METHODS NO was analyzed colorimetrically in 30 newly diagnosed hypothyroid postmenopausal females and 30 postmenopausal females with normal thyroid profile. Results were compared and subjected to appropriate statisticalanalysis. RESULTS The levels of serum NO were found to be significantly decreased in postmenopausal females with hypothyroidism as compared to the levels in those with normal thyroid profile(P value < 0.05). A negative correlation of NO was observed with thyroid stimulating hormone whereas a positive correlation of NO was observed with free T3(FT3), free T4(FT4), T3 and T4 though it was statistically significant only for FT4 among postmenopausal females with hypothyroidism.CONCLUSION Postmenopausal hypothyroid females may be at a risk of compromised cardiovascular health as indicated by low NO levels. Regular monitoring and risk assessment is essential for timely intervention.

Assessment of quality control system by sigma metrics and quality goal index ratio: A roadmap towards preparation for NABL

AIM To study sigma metrics and quality goal index ratio(QGI). METHODS The retrospective study was conducted at the Clinical Biochemistry Laboratory, PGIMS, Rohtak, which recently became a National Accreditation Board for Testing and Calibration of Laboratories accredited lab as per the International Organization for Standardization 15189:2012 and provides service to a > 1700-bed tertiary care hospital. Data of 16 analytes was extracted over a period of one year from January 2017 to December 2017 for calculation of precision, accuracy, sigma metrics, total error, and QGI. RESULTS The average coefficient of variation ranged from 2.12%(albumin) to 5.42%(creatinine) for level 2 internal quality control and 2%(albumin) to 3.62%(high density lipoprotein-cholesterol) for level 3 internal quality control. Average coefficient of variation of all the parameters was below 5%, reflecting very good precision. The sigma metrics for level 2 indicated that 11(68.5%) of the 16 parameters fall short of meeting Six Sigma quality performance. Of these, five failed to meet minimum sigma quality performance with metrics less than 3, and another six just met minimal acceptable performance with sigma metrics between 3 and 6. For level 3, the data collected indicated eight(50%) of the parameters did not achieve Six Sigma quality performance, out of which three had metrics less than 3, and five had metrics between 3 and 6. QGI ratio indicated that the main problem was inaccuracy in the case of total cholesterol, aspartate transaminase, and alanine transaminase(QGI > 1.2), imprecision in the case of urea(QGI < 0.8), and both imprecision and inaccuracy for glucose.CONCLUSION On the basis of sigma metrics and QGI, it may be concluded that the Clinical Biochemistry Laboratory, PGIMS, Rohtak was able to achieve satisfactory results with world class performance for many analytes one year preceding the accreditation by the National Accreditation Board for Testing and Calibration of Laboratories. Aspartate transaminase and alanine transaminase required strict external quality assurance scheme monitoring and modification in quality control procedure as their QGI ratio showed inaccuracy.

Levels of neutrophil gelatinase-assosciated lipocalin in patients with head and neck squamous cell carcinoma in Indian population from Haryana state

AIM To study the levels of neutrophil gelatinase associated lipocalin(NGAL) in head and neck squamous cell carcinoma(HNSCC).METHODS This was a non randomized case control study conducted at Department of Biochemistry,in collaboration with Regional Cancer Center over a period of one year.The study population included 50 adult newly diagnosed HNSCC patients reporting in outpatient department at Regional Cancer Center and compared with 50 healthy controls.NGAL was estimated by ELISA technique.Student t test and χ~2 test were applied for comparison of means of study groups.Correlations between groups were analyzed using Pearson correlation coefficient(r) formula.RESULTS Patients with HNSCC exhibited significantly increased levels of NGAL(P < 0.05) as compared to healthy controls(978.88 ± 261.39 ng/mL vs 34.83 ± 7.59 ng/mL).Out of 50,26 patients(52%) were in stage Ⅳ,21(42%) in stage Ⅲ,1(2%) patient in stage Ⅱ and 2(4%) patients were in stage Ⅰ.Metastasis was absent in 98% patients and mean NGAL levels were highest in these patients but P value was not significant.Mean NGAL levels were highest in stage Ⅳ [1041.54 ± 222.15 ng/mL(stage Ⅳ) vs 1040 ± 0.00 ng/mL(stage Ⅰ);900 ± 0.00 ng/mL(stage Ⅱ) and 1031.90 ± 202.55 ng/mL(stage Ⅲ)] and χ~2 test was highly significant(P < 0.001).Thirty-six patients(72%) were having moderately differentiated HNSCC and mean NGAL levels were maximum in patients with well differentiated HNSCC(1164 ± 315.64 ng/mL vs 1013.33 ± 161.19 ng/mL in moderately differentiated and 890 ± 11.55 ng/mL in poorly differentiated) and the results were also highly significant(P < 0.001,χ~2 test).CONCLUSION The present work demonstrates a potential role of NGAL as cancer biomarker and its use in monitoring the HNSCC progression.

Updated overview of current biomarkers in head and neck carcinoma

Squamous cell cancer is the most common type of malignancy arising from the epithelial cells of the head and neck region. Head and neck squamous cell carcinoma(HNSCC) is one of the predominant causes of cancer related casualties worldwide. Overall prognosis in this disease has improved to some extent with the advancements in therapeutic modalities but detection of primary tumor at its initial stage and prevention of relapse are the major targets to be achieved for further improvement in terms of survival rate of patients. Latest achievements in basic research regarding molecular characterization of the disease has helped in better perception of the molecular mechanisms involved in HNSCC progression and also in recognizing and tar-geting various molecular biomarkers associated with HNSCC. In the present article, we review the infor-mation regarding latest and potential biomarkers for the early detection of HNSCC. A detailed molecular characterization, ultimately, is likely to improve the development of new therapeutic strategies, potentially relevant to diagnosis and prognosis of head and neck cancers. The need for more accurate and timely disease prediction has generated enormous research interests in this field.