Background:There is interest about the role of platelet (PLT) number and function in nonalcoholic fatty liver disease (NAFLD). NAFLD patients have abnormalities of PLT number and function, especially mean platelet volume (MPV) which is known as a novel biomarker for atherosclerosis. We decided to compare PLT number and function between NAFLD and healthy participants.Materials and Methods:In this case–control study, two groups of patients (65 cases with NAFLD and 65 cases without NAFLD) were included consecutively. The diagnosis of NAFLD was made using ultrasound examination of the liver. Venous blood samples were taken, and the required laboratory markers including PLT number and function (MPV, platelet distribution width [PDW]), prothrombin time (PT), partial thromboplastin time (PTT), lipid profile, hepatic transaminases, ferritin, and fasting blood sugar were assayed.Results:Mean (± standard deviation [SD]) MPV in NAFLD group (10.29 ± 0.95 fL) was significantly higher than in control group (9.56 ± 1.18 fL); P < 0.001. No significant difference was observed regarding mean (± SD) PLT count between NAFLD (271.20 ± 52.11 × 103/mm3) and healthy participants (262.86 ± 75.81 × 103/mm3) (P = 0.46). Mean (± SD) PDW values were not significantly different between NAFLD and control groups. Logistic regression showed that NAFLD was positively associated with higher MPV (odds ratio [OR] =1.9, 95% confidence interval [CI] =1.20–3.02) and body mass index (OR = 1.5, 95% CI = 1.05–2.15) values. However, PT (OR = 0.14, 95% CI = 0.02–0.82) and PTT (OR = 0.72, 95% CI = 0.58–0.88) had negative association with NAFLD.Conclusion:Higher MPV was found to be significantly associated with NAFLD. However, such significant association was not detected regarding PLT count or PDW. As MPV is a reported risk factor for atherosclerosis, this marker may be useful in follow-up of patients with NAFLD. These findings provide basis for further studies to address this marker in long-term follow-up of NAFLD patients.
Heat shock proteins (HSPs) are intracellular proteins with pro-and antiinflammatory actions, playing an important role in the pathogenesis of Behcet's disease (BD). Diagnosis of BD uveitis in early stages is still problematic, thus this study was undertaken to determine diagnostic values of serum HSP-and anti-HSP-70 in BD uveitis. Serum levels of HSP-and anti-HSP-70 were measured in 53 patients with BD (26 with and 27 without uveitis). In control group, 25 age-and sex-matched idiopathic uveitis patients were enrolled consecutively. Both groups had no medical problems save uveitis at the time of sampling. Confounders like medications were analysed subsequently. HSP-and anti-HSP-70 values were measured by commercial ELISA kits. Data were analysed by SPSS 11.5 and MEDCALC 11.5.1 software. The Mean HSP-70 serum levels were different among aforementioned subgroups (P = 0.001, ANOVA). They were elevated in BD uveitis compared with BD without uveitis (4.84 AE 4.21 versus 2.24 AE 2.08 ng/ml; P = 0.045). HSP-70 in sera of BD uveitis was also higher than that parameter in patients with idiopathic uveitis (4.84 AE 4.21 versus 2.37 AE 3.30 ng/ml; P = 0.001; cut-off point value 1.0 9 ng/ml, 95% CI 0.61-0.86, P = 0.0002, ß = 0.06). However, there was not any statistical difference among those groups in the serum anti-HSP-70 levels (P = 0.63, ANOVA). Multiple regression analysis demonstrated that among different confounders, only prednisolone increases and BD uveitis decreases HSP-70 levels independently. This prospective cross-sectional study suggested that HSP-70 serum level is impressed over the course of BD uveitis, and it could be utilized to diagnose or predict developing it.
There is evidence that infection by H. pylori can have a critical proportion in the development of hepatocyte injury and both noncancerous and malignant liver conditions including non-alcoholic fatty liver disease (NAFLD). This is attributed to several mechanisms, the most important one being the toxic products of the bacterium H. pylori and oxidative injury for hepatocytes which promotes hepatic injury. The present research was aimed at determining the association between H. pylori infection and the prevalence of NAFLD in Birjand, Iran. Two groups were included in this cross-sectional study at the outpatient university clinic. One group had NAFLD (65 patients) and the other group was healthy controls without NAFLD (65 subjects). The diagnosis of NAFLD was performed using abdominal ultrasound examination and the absence of taking steatogenic medications or alcohol. Serum anti-H. pylori IgG and fecal H. pylori antigen were tested for diagnosing of H. pylori infection using ELISA method. H. pylori infection diagnosis was made if both tests were positive. None of the subjects in either group had symptoms related to the digestive system including dyspepsia, GERD (gastroesophageal reflux disease), or epigastric pain suspicious of peptic ulcer disease. There were 37 patients (28.5%) in both NAFLD (22 cases, 33.8%) and control (15 cases, 23.1%) groups whose H. pylori tests (both IgG and fecal antigen) were positive. Statistically, no significant difference was observed between the two studied groups regarding H. pylori infection frequency (p = 0.37). Asymptomatic H. pylori infection rate was not significantly different between NAFLD patients and control subjects in Birjand, Iran.
Hyperuricemia is reported to have a high prevalence in patients with psoriasis. This metabolic derangement can be associated with the development of gout in such patients. Presented herein is the case of a 53-year-old male who referred to the hospital because of worsening of skin lesions and multiple swollen and painful joints. Physical examination showed symmetric involvement of the patient's knee, first metatarsophalangeal, and subtalar joints. Knee fluid aspiration revealed numerous monosodium urate monohydrate (MSUM) crystals. The patient's serum uric acid level was 10 mg/dL. Kidney function was normal. Although he had experienced a similar episode two years earlier with involvement of the first metatarsophalangeal joint, he did not seek medical attention then and was not receiving prophylaxis for gout. Treatment with prednisone, allopurinol, colchicine, and sulfasalazine resulted in improvement of the symptoms. The patient was followed for six months and no relapse in his skin conditions or gouty attacks were observed. It is prudent to measure uric acid levels in psoriatic patients. Psoriatic patients with hyperuricemia, even without a known cause for hyperuricemia, are at increased risk of developing gouty arthritis. This presentation suggests that psoriasis can be an independent risk factor for gouty attacks, though this requires further larger studies.
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