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    European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates of beta-isomerized C-terminal telopeptide of type I collagen (beta-CTX), N-terminal propeptide of type I collagen (PINP), osteocalcin, intact fibroblast growth factor 23 and uncarboxylated-unphosphorylated matrix-Gla protein-a cooperation between the EFLM Working Group on Biological Variation and the International Osteoporosis Foundation-International Federation of Clinical Chemistry Committee on Bone Metabolism
    (SPRINGER LONDON LTD, 2020-01-01) Cavalier, E.; Lukas, P.; Bottani, M.; Aarsand, A. K.; Ceriotti, F.; Coskun, A.; Diaz-Garzon, J.; Fernandez-Calle, P.; Guerra, E.; Locatelli, M.; Sandberg, S.; Carobene, A.; Metab, I. O. F.-I.F.C.C. Committee Bone; Che, European Federation Clinical
    We have calculated the biological variation (BV) of different bone metabolism biomarkers on a large, well-described cohort of subjects. BV is important to calculate reference change value (or least significant change) which allows evaluating if the difference observed between two consecutive measurements in a patient is biologically significant or not. Introduction Within-subject (CVI) and between-subject (CVG) biological variation (BV) estimates are essential in determining both analytical performance specifications (APS) and reference change values (RCV). Previously published estimates of BV for bone metabolism biomarkers are generally not compliant with the most up-to-date quality criteria for BV studies. We calculated the BV and RCV for different bone metabolism markers, namely beta-isomerized C-terminal telopeptide of type I collagen (beta-CTX), N-terminal propeptide of type I collagen (PINP), osteocalcin (OC), intact fibroblast growth factor 23 (iFGF-23), and uncarboxylated-unphosphorylated Matrix-Gla Protein (uCuP-MGP) using samples from the European Biological Variation Study (EuBIVAS). Methods In the EuBIVAS, 91 subjects were recruited from six European laboratories. Fasting blood samples were obtained weekly for ten consecutive weeks. The samples were run in duplicate on IDS iSYS or DiaSorin Liaison instruments. The results were subjected to outlier and variance homogeneity analysis before CV-ANOVA was used to obtain the BV estimates. Results We found no effect of gender upon the CV(I)estimates. The following CV(I)estimates with 95\% confidence intervals (95\% CI) were obtained: beta-CTX 15.1\% (14.4-16.0\%), PINP 8.8\% (8.4-9.3\%), OC 8.9\% (8.5-9.4\%), iFGF23 13.9\% (13.2-14.7\%), and uCuP-MGP 6.9\% (6.1-7.3\%). Conclusions The EuBIVAS has provided updated BV estimates for bone markers, including iFGF23, which have not been previously published, facilitating the improved follow-up of patients being treated for metabolic bone disease.
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    Prognostic value of aVR lead and the well-known risk factors in acute ST-segment elevated myocardial infarction
    (MEDCOM LTD, 2011-01-01) Eren, S. H.; Aktas, C.; Korkmaz, I.; Karcioglu, O.; Coskun, A.; Guven, F. M. Kukul
    Objective: The present study was designed to analyse the effect of ST segment changes in aVR lead and the well-known risk factors in ST-segment elevated myocardial infarction (STEMI) patients. Materials and Methods: A total of 250 patients who were admitted between 2009 and 2010 with STEMI and mm ST-segment elevation in aVR lead were enrolled in the study. The patients were followed for life-threatening events like acute pulmonary oedema, atrial fibrillation, AV block, ventricular tachycardia, length of stay in hospital and death. Results: Among the enrolled patients, 222 were discharged and 28 died. Pulmonary oedema and mortality rates were significantly higher in patients with ST-segment elevation in aVR lead (both p=0.001). Conclusions: There is a correlation of ST-segment elevation in aVR lead with poor outcome in STEMI. Therefore aVR lead must be analysed as well as the other leads and well-known risk factors while it estimates the prognosis. (Hong Kong j.emerg.med. 2011
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    Cigarette Smoking Increases Pregnancy-associated Plasma Protein-A in Men
    (UNIV WEST INDIES FACULTY MEDICAL SCIENCES, 2017-01-01) Coskun, A.; Bulut, I.; Serteser, M.; Eren, A.; Ozseker, Z. F.; Cuhadaroglu, C.; Aksungar, F. B.; Ozpinar, A.; Can, O.; Yakar I, H.; Unsal, I.
    Objective: Elevation of pregnancy-associated plasma protein-A (PAPP-A), a pro-atherosclerotic molecule, has been shown to be an independent risk factor for acute coronary syndrome. Smoking is also an important risk factor for acute coronary syndrome (ACS). However, the molecular mechanism of this relationship is not clear. In the present study, we aimed to determine the association between smoking and serum PAPP-A levels in men and non-pregnant women. Method: The study population consisted of 112 smokers and 58 age-matched non-smoking healthy subjects as a control group. Blood samples were drawn from the antecubital vein of all subjects and serum PAPP-A levels were measured using an ELISA kit (ultrasensitive ELISA). Results: The serum PAPP-A level was significantly high in male smokers (smokers: 9.11 ng/mL (3.10 ng/mL, 18.55 ng/mL))