XIX kongres medicinskei laboratorijske medicine

sa me|unarodnim u~e{}em

XIX Congress of MedicalBiochemistry and Laboratory

Medicinewith international participation

Poster SessionsAbstracts

68

P001FACTOR ANALYSIS OF

ASSOCIATION OF LIPID, INFLAMMATORY, CARDIAC AND

RENAL BIOMARKERS WITH LONG-TERM 30-YEAR

CARDIOVASCULAR RISK CLASSIFICATION

Sne`ana Jovi~i}1, Svetlana Ignjatovi}1, R. Kangrga2, Marijana Dajak2,

Nada Majki}-Singh1

1Center for Medical Biochemistry, Clinical Center ofSerbia and Department of Medical Biochemistry,

Faculty of Pharmacy, University of Belgrade,Belgrade, Serbia

2Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

Several risk score algorithms for short-term (10-year) cardiovascular risk assessment based on multi-variable regression equations derived from differentcohorts are being used in clinical practice. However,since the age is variable with the strongest influenceon short-term risk, many individuals with moderateincrease of other traditional risk factors would have a10-year risk below cutoff for intensive treatment, buta significant long-term (30-year) risk. Also, other bio-markers might identify persons with higher actualcardiovascular risk compared with calculated usingshort-term risk scores. The aim of this study was toanalyze the nature of influence of examined biomark-ers on cardiovascular risk and their clustering, as wellas relations of identified factors with long-term 30-year risk categorization, using factor analysis.Interactive calculator »30-year risk of cardiovasculardisease« was used for long-term 30-year risk calcula-tion, for both »full CVD« (all manifestations of cardio-vascular disease) and »hard CVD« (serious manifesta-tions of CVD). Principal component analysis was usedto investigate clustering of markers of inflammation[high sensitivity C-reactive protein (hsCRP), serumamyloid A (SAA), fibrinogen, a1-acid glycoprotein(A1AGP), haptoglobin, C3 and C4 complementcomponents], lipid metabolism [non-HDL and LDLcholesterol, triglycerides, apolipoprotein A-I (apo A-I), apolipoprotein B (apo B), lipoprotein (a) (Lp(a))],

P001FAKTORSKA ANALIZA

POVEZANOSTI INFLAMATORNIH,LIPIDNIH, SRČANIH I BUBREŽNIH

BIOMARKERA SA KLASIFIKACIJOM

DUGOROČNOG 30-GODI[NJEG KARDIOVASKULARNOG RIZIKA

Sne`ana Jovi~i}1, Svetlana Ignjatovi}1, R. Kangrga2, Marijana Dajak2,

Nada Majki}-Singh1

1Centar za medicinsku biohemiju, Kini~ki centarSrbije i Katedra za medicinsku biohemiju,

Farmaceutski fakultet Univerziteta u Beogradu,Beograd, Srbija

2Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd, Srbija

U klini~koj praksi koristi se nekoliko skorova zaprocenu kratkoro~nog (10-godi{njeg) rizika odpojave razli~itih oblika kardiovaskularnih bolesti(KVB) koji se zasnivaju na multivarijabilnim regre-sionim jedna~inama izvedenim iz rezultata pra}enjarazli~itih kohortnih grupa. Me|utim, po{to je starostpromenljiva kojoj se dodeljuje najve}i broj poena umodelima 10-godi{njeg rizika, mnoge osobe sa zna -~ajnim optere}enjem faktorima rizika imaju kratko-ro~ni rizik daleko ispod granice koja uslovljava inten-zivan tretman, iako njihov dugoro~ni (30-godi{nji)rizik mo`e biti zna~ajan. Tako|e, drugi biomarkerimogu da identifikuju osobe sa ve}im kardiovasku-larnim rizikom od onog izra~unatog primenom skoro-va kratkoro~nog rizika. Cilj rada bio je da se analizirapriroda uticaja ispitivanih biomarkera na kardiovas -kularni rizik i njihovo grupisanje, kao i povezanostdobijenih faktora sa kategorizacijom 30-godi{njegrizika faktorskom analizom. Pomo}u interaktivnogkalkulatora »30-year risk of cardiovascular disease«izra~unavan je dugoro~ni 30-godi{nji rizik za pojavu»kompletne« KVB (sve manifestacije KVB) i »te{ke«KVB (potencijalno fatalne komplikacije KVB). Analizaglavnih komponenti je kori{}ena za ispitivanjegrupisanja markera inflamacije [visoko-osetljivi C-reaktivni protein (hsCRP), serumski amiloid A (SAA),fibrinogen, a1-kiseli glikoprotein (A1AGP), haptoglo-bin, C3 i C4 komponente komplementa], metabo -

UDK 577.1 : 61 ISSN 1452-8258

J Med Biochem 34: 68 –96, 2015 Poster sessionsPosterske sekcije

J Med Biochem 2015; 34 (1) 69

lizma lipida [non-HDL i LDL holesterol, trigliceridi,apolipoprotein A-I (apo A-I), apolipoprotein B (apoB), lipoprotein (a) (Lp(a))], bubre`ne [kreatinin,mokra}na kiselina, cistatin C (Cys-C)] i sr~ane funk -cije [N-terminalni pro-natriureti~ki peptid tip B (NT-proBNP), visoko-osetljivi sr~ani troponin T (hs-cTnT)],dobijenih ana lizom uzoraka seruma 242 zdrave oso -be. Faktorskom analizom identifikovano je 5 klastera,kojima je obja {njeno je 67,4% ukupne varijacije, ras-pore|ene na slede}i na~in 1) 29,7% »sistemska infla-macija« (hsCRP, fibrinogen, SAA, A1AGP, haptoglo-bin, C3 i C4 komponenta komplementa); 2) 12,5%»aterogena dislipidemija« (LDL i non-HDL holesterol,apo B i trigliceridi); 3) 11,0% »kardiorenalni faktor«(kreatinin, mokra}na kiselina, Cys-C i hs-cTnT); 4)7,6% »hemodinamski faktor« (NT-proBNP) i 5) 6,7%»lipoproteinski faktor« [apo A-I, Lp(a)]. Prediktivnevrednosti u proceni 30-godi{njeg rizika za »komplet-nu KVB« i »te{ku KVB« su bile zna~ajne za ~etiri fak-tora (OR 1,892–5,590; P<0,0001 i OR 2,183–5,931; P<0,0001, redom), a »hemodinamski fak-tor« nije imao statisti~ki zna~ajan prediktivni potenci-jal za vrednosti iznad optimalnih/normalnih za odgo-varaju}i pol i starost (P>0,05). Povr{ine ispod ROCkrivih (AUC) modela sa pet faktora u predikcijipove}anog 30-godi{njeg rizika za »kompletnu KVB« i»te{ku KVB« iznosile su 0,881 i 0,888, redom, i nisubile statisti~ki zna~ajno razli~ite od multivarijabilnoglogisti~kog modela od 18 polaznih parametara(0,892 i 0,901; P>0,05; redom). Sistemska inflama -cija, aterogena dislipidemija, kardiorenalna funk cija ilipoproteinski status nezavisno doprinose dugo -ro~nom, 30-godi{njem riziku iznad normalnog/opti-malnog kako za ozbiljne komplikacije KVB, tako i zasve vrste kardiovaskularnih komplikacija.

renal [creatinine, uric acid, cystatin C (Cys-C)] andcardiac function [N-terminal pro-natriuretic peptidetype B (NT-proBNP), high sensitivity cardiac troponinT (hs-cTnT)], obtained from 242 apparently healthyindividuals. Factor analysis identified five clusters,which explained 67.4% of the total variance distrib-uted as follows: 1) 29.7% »systemic inflammation«(hsCRP, fibrinogen, SAA, A1AGP, haptoglobin, C3,C4); 2) 12.5% »atherogenic dyslipidemia«, (LDL andnon-HDL cholesterol, apo B, triglycerides); 3) 11.0%»cardiorenal factor« (creatinine, uric acid, Cys-C, hs-cTnT); 4) 7.6% »hemodynamic factor« (NT-proBNP);and 5) 6.7% »lipoprotein factor« [apo A-I, Lp(a)].When estimating 30-year risk from both »full CVD«and »hard CVD«, predictive values were significantfor four factors (OR 1.892–5.590, P<0.0001 andOR 2.183–5.931, P<0.0001, respectively), and»hemodynamic factor« had no statistical significancein predicting potential for values above optimal/nor-mal for corresponding gender and age (P>0.05).The areas under the receiver operating characteristiccurves (AUCs) of the five factor model in predictingincreased 30-year risk for »full CVD« and »hard CVD«were 0.881 and 0.888, respectively, which were notstatistically significantly different from AUCs of themultivariable logistic model of 18 original parameters(0.892 and 0.901, P>0.05, respectively). Long-term, 30-year risk above normal/optimal for hardCVD complications and for all kinds of cardiovascularcomplications was independently contributed by sys-temic inflammation, atherogenic dyslipidemia, car-diorenal function and lipoprotein status.

P002LONGITUDINALNE PROMENE

PARAMETARA LIPIDNOG PROFILATOKOM NEKOMPLIKOVANE

TRUDNOĆE I NAKON PORO\AJA

Daniela Ardali}1, Aleksandra Stefanovi}2, Jelena Kotur-Stevuljevi}2, Slavica Spasi}2,

Vesna Spasojevi}-Kalimanovska2, Zorana Jeli}-Ivanovi}2,

Vesna Mandi}-Markovi}1, @eljko Mikovi}2,Nikola Cerovi}1

1Ginekolo{ko-aku{erska klinika »Narodni Front«, Beograd, Srbija

2Institut za Medicinsku Biohemiju, Univerzitet uBeogradu, Beograd, Farmaceutski Fakultet, Srbija

Specifi~ne metaboli~ke promene u trudno}i suneophodne kako bi se obezbedile potrebe u hra -

P002LONGITUDINAL CHANGES IN LIPID

PROFILE PARAMETERS DURINGUNCOMPLICATED PREGNANCY

AND AFTER DELIVERY

Daniela Ardali}1, Aleksandra Stefanovi}2, Jelena Kotur-Stevuljevi}2, Slavica Spasi}2,

Vesna Spasojevi}-Kalimanovska2, Zorana Jeli}-Ivanovi}2,

Vesna Mandi}-Markovi}1, @eljko Mikovi}2,Nikola Cerovi}1

1Clinic of Gynecology and Obstetrics Narodni Front, Belgrade, Serbia

2Department of Medical Biochemistry, University ofBelgrade, Belgrade, Faculty of Pharmacy, Serbia

Specific metabolic changes in pregnancy arenecessary to provide the needed in nutrients for fetal

70

njivim materijama za rast i razvoj fetusa, te pripremitrudnica za poro|aj i laktaciju. Metabolizam lipida jeesencijalan za razvoj nekomplikovane, zdrave trud-no}e tokom koje se de{avaju odgovaraju}e meta bo -li~ke promene koje dovode do izmenjenog lipidnogprofila, tako da ve}ina trudnica do kraja trudno}erazvije specifi~an lipidni profil koji se kod zdravihnegravidnih `ena mo`e smatrati proaterogenim.Ispitali smo kretanje triglicerida, ukupnog holestero-la, HDL i LDL holesterola, ApoAI, ApoB i odrediliaterogeni indeks plazme – AIP kod 43 zdrave trud-nice u cilju procene potencijalne proaterogenostiizmenjenog lipidnog profila. Uzorci krvi su sakupljaniprema utvr|enom kalendaru poseta u I, II i IIItrimestru, neposredno pred poro|aj u 38. nedeljitrudno}e i 2 meseca nakon poro|aja. Rezultati ana -lize pokazuju kontinuirani porast ukupnog holestero-la i triglicerida tokom trudno}e, sa zna~ajno vi{imvrednostima u odnosu na prvi trimestar (p<0,05).Vrednosti HDL-holesterola zna~ajno rastu u drugomtrimestru (p<0,05), nakon ~ega lagano opadaju dotermina poro|aja, a LDL-holesterol zna~ajno raste udrugom trimestru i dalje tokom tre}eg trimestra doporo|aja. Promene vrednosti ApoAI i ApoB tokomispitivanog perioda uglavnom prate kretanje vrednos-ti HDL i LDL-holesterola. AIP zna~ajno raste tokomtrudno}e u odnosu na prvi trimestar (p<0,05).Nakon poro|aja vrednosti ispitivanih parametara suni`e u pore|enu sa prvim trimestrom. Fiziolo{ka trud-no}a pokazuje proaterogeni potencijal, tako da bive}i broj trudno}a mogao imati uticaj na kardio-vaskularni status `ene u kasnijem `ivotnom dobu.

growth and development, and prepare pregnantwomen for delivery and lactation. Lipid metabolism isessential during pregnancy, with the respective meta-bolic changes that lead to altered lipid profile. Mostpregnant women develop the specific lipid profilewhich in healthy non pregnant women can beregarded as proatherogenic. We evaluated changesin triglycerides, total cholesterol, HDL and LDL cho-lesterol, ApoAI, ApoB and atherogenic index of plas-ma – AIP in 43 healthy pregnant women in order toassess the potential proaterogenic altered lipid pro-file. Blood samples were collected according to thecalendar visit in the I, II and III trimester, before deliv-ery in the 38. week of pregnancy and 2 months afterdelivery. The results show a continuous increase intotal cholesterol and triglyceride levels during preg-nancy, with significantly higher values in the firsttrimester (p<0.05). HDL-cholesterol increased sig-nificantly in the second trimester (p<0.05), followedby slowly decreasing until the birth date and the LDL-cholesterol increased significantly in the secondtrimester, and continued during the third trimesteruntil delivery. Changes in ApoAI and ApoB during theexamined period generally follow the values of HDLand LDL cholesterol. AIP increases significantly dur-ing pregnancy compared with the first trimester(p<0.05). After delivery the studied parameters werelower in comparison with first trimester. Physiologicalpregnancy shows proatherogenic potential, so that agreater number of pregnancies may affect the car-dio-vascular status of women in later life.

P003VITAMIN D AND PARATHYROID

HORMONE IN RELATION TO VERTEBRAL FRACTURES IN POSTMENOPAUSAL WOMEN

Marina Vu~elji}1, Olivera Ili}-Stojanovi}2

1General hospital Belmedic, Department for Biochemical Laboratory,

2Institute for Rehabilitation, Medical University of Belgrade, Belgrade, Serbia

Active vitamin D suppresses the secretion ofparathyroid hormone (PTH) from the parathyroidgland in a negative manner. Increased PTH due tovitamin D insufficiency may increase bone turnover,bone loss and fracture risk. Therefore, the aim of thisstudy was to establish the relationship between verte-bral fractures (VF), serum levels of 25-hydroxyvitaminD (25OHD) and PTH in postmenopausal women. Atotal of 94 postmenopausal women, average age65.09 years (±9.1), were examined. Vertebral frac-tures were diagnosed by X-rays of the thoracic and

P003POVEZANOST VITAMINA D I

PARATIROIDNOG HORMONA SAVERTEBRALNIM FRAKTURAMA KOD

POSTMENOPAUZALNIH ŽENA

Marina Vu~elji}1, Olivera Ili}-Stojanovi}2

1Op{ta bolnica Belmedic, Biohemijska laboratorija,

2Institut za rehabilitaciju, Medicinski fakultetBeograd, Beograd, Srbija

Aktivan oblik vitamina D suprimira osloba|anjeparatiroidnog hormona (PTH) iz paratiroidnih `lezda.Povi{en nivo PTH, usled insuficijencije vitamina Dmo`e da ubrza metabolizam kosti, gubitak ko{tanemase i pove}a rizik od fraktura. S toga, cilj ovog ispi-tivanja je bio da se ustanovi povezanost izma|u ver-tebralnih fraktura (VF), serumkog nivoa 25-hidro ksi -vitamina D (25OHD) i PTH kod postmenopauzalnih`ena. Ispitane su 94 postmenopauzalne `ene pro -se~ne starosti 65,09 godina (±9,1). Vertebralnefrakture su dijagnostikovane pomo}u X-zraka na

J Med Biochem 2015; 34 (1) 71

torakalnom i lumbalnom delu ki~me. 25OHD i PTHsu odre|ivani pomo}u imuno testova metodom elek-trohemiluminiscencije (Roche Diagnostics, Elecsys2010). Srednja vrednost za 25OHD je bila 51,15±21,5 nmol/L, a za PTH 58,14±28,76 pg/mL.Na|ena je zna~ajna negativa korelacija izme|u25OHD i PTH (r= –0,502, p<0,001). Sni`en nivo25OHD (<75 nmol/L) na|en je kod 88.3% post-menopauzalnih `ena (45,78±14,4). Povi{en nivoPTH (>65 pg/mL) na|en je kod 31.08% slu~ajeva(91,2±28,9 pg/mL). U grupi sa povi{enim PTH,srednja vrednost 25OHD je bila 37,77±11,81nmol/L. Kod 30 pacijenata (31,9%) su dijagnosti -kovane VF. U ovoj grupi srednja vrednost 25OHDbila je 48,24±17,73 nmol/L i PTH 49,75±16,86pg/mL. VF su dijagnostikovane kod 34,9% post-menopauzalnih `ena sa insuficijencijom 25OHD, ikod 26,1% sa povi{enim PTH. Rezultati pokazujuvisoku prevalencu insuficijencije 25OHD kod post-menopauzalnih `ena (88,3%) ispitanih u ovom istra -`ivanju. Kod pacijenata sa 25OHD insuficijencijom,povi{enje PTH varira individualno, ali je naj~e{}epovi{en kada je 25OHD oko 37 nmol/L. Visok PTHi sni`en 25OH D mogu biti povezani sa nekim ali nesvim vertebralnim frakturama.

lumbar spine. 25OHD and PTH were measuredusing electrochemiluminiscence immunoassays(Roche Diagnostics, Elecsys 2010). The average of25OHD was 51.15±21.5 nmol/L, while PTH was58.14±28.76 pg/mL. Negative significant correla-tion between 25OHD and PTH (r= -0.502,p<0.001) was found. A decreased value of 25OHD(<75nmol/L) was found in 88.3% postmenopausalwomen (45.78±14.4). An elevated level of PTH(>65 pg/mL) was found in 31.08% of cases(91.2±28.9 pg/mL). In the group with increasedPTH, the mean of 25OHD was 37.77±11.81nmol/L. Thirty patients (31.9%) were diagnosed ashaving VF. In this group the average of 25OHD was48.24±17.73 and PTH 49.75±16.86. VF was diag-nosed in 34.9% of postmenopausal women with25OHD insufficiency, and in 26.1% with elevatedPTH. Results showed a high prevalence of 25OHDinsufficiency among postmenopausal women(88.3%) investigated in this study. In patients with25OHD insufficiencies, elevated PTH varied individ-ually, but was most often increased if 25OHD wasabout 37nmol/L. High PTH and low 25OH D maybe related to some, but not all vertebral fractures.

P004FAKTORI RIZIKA ZA

KARDIOVASKULARNE BOLESTI U PACIJENATA SA SENILNOM

DEGENERACIJOM MAKULE

Emina ^olak1, Aleksandra Radosavljevi}2,Natalija Kosanovi}-Jakovi}2,

Svetlana Ignjatovi}1,3

1Centar za medicinsku biohemiju, KCS, Beogard

2O~na klinika KCS Beograd i Medicinski fakultet Univerziteta u Beogradu

3Farmaceutski fakultet Univerziteta u Beogradu

Senilna degeneracija makule predstavlja vode}iuzrok slepila kod osoba starijih od 55 godina `ivota.Veliki broj faktora rizika je do sada opisano, dok subrojni patofiziolo{ki mehanizmi odgovorni za nastanaki razvoj ove bolesti. Cilj ovog rada je bio da se utvrdipovezanost markera inflamacije i kardiovaskularnogrizika u pacijenata sa senilnom degeneracijom ma ku -le, kao i njihov uticaj na razvoj ove bolesti. U ovo istra -`ivanje uklju~eno je 110 pacijenata sa senilnom de -gen eracijom makule, starosti 71,5±7,1 go dina, kao i87 zdravih ispitanika iste starosti. Svim ispitanicima jeodre|ivan lipidni profil: ukupni holesterol, HDL-, LDL-,

P004RISK FACTORS FOR

CARDIOVASCULAR DISEASE IN PATIENTS WITH AGE-RELATED

MACULAR DEGENERATION

Emina ^olak1, Aleksandra Radosavljevi}2,Natalija Kosanovi}-Jakovi}2,

Svetlana Ignjatovi}1,3

1Institute of Medical Biochemistry, Clinical Center of Serbia, Belgrade

2Institute of Ophthalmology, Clinical Center of Serbia and School of Medicine,

University of Belgrade, Serbia3School of Pharmacy, University of Belgrade, Serbia

Age-related macular degeneration (AMD) is theleading cause of blindness among persons older than55 years of age. Many risk factors and pathologicalmechanisms involved in the pathogenesis of this dis-ease have been described. The aim of this study wasto evaluate the association of inflammatory markersand markers of cardiovascular risk in patients withAMD, and their impact to the development of thisdisease as well. A total of 110 AMD patients aged of71.5±7.1 years of age, and 87 aged-matchedhealthy control subjects were included in this study.The following parameters were determined: lipid pro-

72

non-HDL-holesterol i trigliceridi, kao i markeri infla-macije CRP, fibrinogen i IL-6. Do bijeni rezultati su sta-tisti~ki obra|eni kori{}enjem Man-Whitney-U testa,Pearsonove korelacije i lo gi sti~ke regresione analize.Rezultati istra`ivanja su pokazali da pacijenti sa senil-nom degeneracijom makule imaju znatno ve}e vred-nosti ukupnog holesterola (p=0,001), LDL-holeste ro la(p=0,007) i non-HDL-holesterola (p=0,002), kao ive}e vrednosti parametara inflamacije: CRP (p=0,05) ifibrinogena (p=0,007) u odnosu na zdra ve ispita nikekontrolne grupe. Dobijena je pozitivna korelacija iz -me |u koncentracije CRP-a i ukupnog holesterola uAMD grupi (p=0,001), LDL-holesterola (p=0,02),non-HDL-holesterola (p=0,001) i trigli ce rida (p=0,001),dok sa fibrinogenom pozitivno su korelisali samo non-HDL-holesterol (p=0,003) i trigliceridi (p=0,045).Logisti~ka regresiona analiza je pokazala da je ukupniholesterol (OR:1,89; 95% IP 1,32–2,72; p<0,0001),LDL-holesterol (OR: 1,59; 95% IP 1,13–2,24;p=0,006) non-HDL-holesterol (OR: 1,76; 95% IP1,26–2,46; p=0,000) i trigliceridi (OR:1,68; 95% IP1,06–2,80; p=0,039) zna~ajno povezani sa nas-tankom senilne degeneracije makule, kao i parametriinflamacije: CRP (OR: 1,16; 95% IP 1,04–1,30;p=0,008) i fibrinogen (OR:1,69; 95% IP 1,07–2,65;p=0,021). Na osnovu dobijenih rezultata mo`e se za - klju~iti da su ispitivani parametri zna~ajno me|u sob nopovezani i da su procesi inflamacije i dislipide mije uznatnoj meri uklju~eni u patogenezu ove bolesti.

file (total cholesterol, HDL-, LDL-, non-HDL-choles-terol and triglycerides level, and inflammatory mark-ers CRP, fibrinogen and IL-6. For statistical evaluationof the results, Mann-Whitney U-test, Pearson correla-tion test and logistic regression test were used. Theobtained results showed a significant differencebetween AMD patients and control group in baselinevalues of total cholesterol (p=0.001), LDL-choles-terol (p=0.007), non-HDL-cholesterol (p=0.002),CRP (p=0.05) and fibrinogen values (p=0.007).Positive correlation was found between CRP and totalcholesterol values (p=0.001), LDL-cholesterol(p=0.02), non-HDL-cholesterol (p=0.001) andtriglycerides (p=0.001) in AMD patients. Fibrinogencorrelated positively only with non-HDL-cholesterol(p=0.003) and triglycerides (p=0.045). Logisticregression analysis showed a significant associationof total cholesterol (OR:1.89; 95% CI 1.32–2.72;p<0.0001), LDL-cholesterol (OR: 1.59; 95% CI1.13–2.24; p=0.006), non-HDL-cholesterol (OR:1.76; 95% CI 1.26–2.46; p=0.000), triglycerides(OR:1.68; 95% CI 1.06–2.80; p=0.039), CRP (OR:1.16; 95% CI 1.04–1.30; p=0.008) and fibrinogen(OR:1.69; 95% CI 1.07–2.65; p=0.021) with AMDdevelopment. Based on the obtained results it maybe concluded that the tested parameters are signifi-cantly associated, and inflammation and dyslipidemiaare significantly involved in the pathogenesis of thisdisease.

P005PROCJENA TESTA ZA

ODRE\IVANJE TROPONINA T HS NA ANALIZATORU COBAS E 601

Elma Ku~ukali}, J. ]ori}, B. Hasanefendi}, M. Panjeta

O.J. Klini~ka hemija i biohemija, Klini~ki Centar Sarajevo, Sarajevo,

Bosna i Hercegovina

Sr~ani troponin T(cTnT) je kardiospecifi~ni,visoko osjetljivi marker o{te}enja miokarda. Analizatroponina T hs mo`e se koristiti kao pomo} pri difer-encijalnoj dijagnozi akutnog koronarnog sindroma teindetifikaciju akutnog infarkta miokarda. TnT je kom-ponenta kontraktilnog aparata popre~no-prugastemuskulature porijeklom isklju~ivo iz miokarda (sr~aniTnT, molekularne mase 39,7 kDa). Odre|ivanje tro-ponina T hs smo izvr{ili pomo}u elektrohemilumini-centne metode (ECLIA) na analizatoru Roche-Cobase 601. Analiti~ka procjena odre|ivanja troponina Ths obuhvatila je nepreciznost iz dana u dan i u se riji.Koeficijent varijacije (KV) za humane uzorke je iz -nosio 4,9% za nepreciznost u seriji (N=20). Kod

P005EVALUATION OF TROPONIN T HS ASSAY ON THE COBAS

E 601 ANALYSER

Elma Ku~ukali}, J. ]ori}, B. Hasanefendi}, M. Panjeta

Department for Clinical Chemistry and Biochemistry,Clinical Centre of Sarajevo, Sarajevo, Bosnia and

Herzegovina

Cardic troponin T(cTnT) is a cardiospecific,highly sensitive marker for myocardial damage.Troponin T assay can be used as an aid in the differ-ential diagnosis of acute coronary syndrome to iden-tify acute myocardial infarction. TnT is a componentof the contractile apparatus of the striated muscula-ture and originating exclusively from the myocardium(cardiac TnT, molecular weight 39.7 kDa). Measu -rements of Troponin T hs were performed by electro-chemiluminiscence immunoassay (ECLIA) on Roche-Cobas e 601 analyser. Analytical assessment ofTroponin T hs determination comprised within-runand between-run imprecision. Analytes coefficient ofvariation (CV) on human samples were 4.9% for with-

J Med Biochem 2015; 34 (1) 73

odre|ivanje nepreciznosti iz dana u dan (N=30)koeficijent varijacije je iznosio 5,3% za kontrolniserum Elescys PreciControl Troponin T 1 i 6,7%zaElescys PreciControl Troponin T 2. Paralerno jeodre|ivana vrijednost koncentracije hsTnT (Roche) iAbbott STAT cTnI kod 41 uzorka pacijenata. Li near -nom regresijskom analizom pore|enja odre|ivanjatoponina T hs i STAT cTnI dobivena je sljede}ajedna~ina: y= 1.39x + 6.24 i koeficijent korelacijer=0,88. ECLIA metoda za odre|ivanja troponina Ths na Roche Cobas 601 analizatoru je osjetljiv i pre-cizan test. Rezultati pokazuju da postoji zna~ajno nes-laganje izme|u imunoesejskog odre |i vanja TnT hs iAbbott STAT cTnI.

in-run imprecision (N=20). The between–run impre-cision (N=30) coefficient of variation were 5.3 % forcommercially controls Elescys PreciControl Troponin T1 and 6.7% for Elescys PreciControl Tro ponin T 2.Total of 41 patient samples from routine laboratoryworkload was simultaneously analyzed for hs TnT(Roche) and Abbott STAT cTnI levels. Linear regres-sion analysis comparing the hs TnT and STAT cTnImethod yielded the following equation: y= 1.39 x +6.24 and correlation coefficient r=0.88. ECLIAmethod for Troponin hs T determination on the RocheCobas 601 system is sensitive and accurate test. Theresults attest that substantial discrepancies existamong TnT hs and Abbott STAT cTnI immunoassay.

P006GESTACIJSKI DIJABETES KOD

TRUDNICA STARIJIH OD 35 GODINA

Milosava \elkapi}, Bo`idar Ne{evi}

Zdravstveni centar U`ice, Srbija

Gestacijski dijabetes (GD) se defini{e kao bilokoji stepen poreme}aja tolerancije glukoze koji je prviput otkriven u trudno}i. Trudnice starije od 35 godi-na pripadaju rizi~noj grupi za pojavu GD. Kontrolaglikemije, naro~ito u vreme organogeneze, smanjujeu~estalost makrozomije, ote`anog i prevremenogporo|aja, abortusa, uro|enih anomalija, perinatalnesmrtnosti, dijabeti~ne nefropatije majke, preeklamsi-je i eklampsije. Cilj rada je da se utvrdi u~estalost GDkod trudnica starijih od 35 godina. Istra`ivanje jeobuhvatilo 40 trudnica starijih od 35 godina i 61trudnicu mla|u od 25 godina (kontrolna grupa), u28 nedelji gestacije. Odre|ivana je jutarnja glikemijau venskom uzorku krvi, reagensima firme Siemens,na biohemijskom analizatoru Dimension RxLMax.Statisti~kom obradom podataka, upotrebom Studen -tovog T-testa utvrdili smo da je prose~na vrednostjutarnje glikemije vi{a kod starijih od 35 godina(4,85±1,02 mmol/L) nego kod mla|ih od 25 godi-na (4,54±0,49), {to je statisti~ki zna~ajno (t=1,795;p<0,05). Na osnovu kriterijuma za skrining GD(glikemija ≥ 5,1 mmol/L), utvrdili smo da 12 (30%)trudnica starijih od 35 godina i 7 (11,5%) mla|ih od25 godina ima GD. Zaklju~ili smo da je u~estalostGD ve}a kod trudnica starijih od 35 godina, negokod mla|ih od 25 godina {to je statisti~ki zna~ajnarazlika (t=2,164; p<0,05). Odre|ivanje jutarnjeglikemije u 28 nedelji gestacije neophodno je radiblagovremenog postavljanja dijagnoze GD, posebnokod trudnica starijih od 35 godina, radi blagovre-menog preveniranja mogu}ih posledica kod majke iploda.

P006GESTATIONAL DIABETES AT PREGNANT WOMEN OLDER

THAN 35 YEARS

Milosava \elkapi}, Bo`idar Ne{evi}

Health Center U`ice, Serbia

Gestational diabetes (GD) is defined as anydegree of disorder of tolerance of glucose which isfirst discovered in pregnancy. Pregnant women olderthan 35 years belong to risk group for appearance ofGD. Glicemic control, especially during the organo-genesis decrease frequency of macrosomia, difficultpremature deliveries, abortions, congenital malfor -mations, perinatal lethality, diabetic nephropathy ofmother, preeclampsia and eclampsia. The aim of thework is to determine the frequency of GD at pregnantwomen older than 35 years. The research has gath-ered 40 pregnant women older than 35 years and 61pregnant women younger than 25 years (controlgroup), in 28 week of gestation. Fasting blood glu-cose was measured in venous blood sample, byreagents of the company Siemens, on biochemicalanalyzer Dimension RxL Max. Statistical analysis usingStudent s t-test, we found that the average value offasting plasma glucose is higher at older than 35years (4.85±1.02 mmol/L) than those younger than25 years (4.54±0.49), which was statistically signifi-cant (t=1.795; p<0.05). According to criteria forscreening GD (glicemia ≥ 5.1 mmol/L), we found that12 (30%) pregnant women older than 35 years and 7(11.5%) younger than 25 has GD. We concluded thatthe frequency of GD is higher at pregnant womenolder than 35 years than at younger than 25 which isstatistically significant difference (t=2.164; p<0.05).Determination of fasting plasma glucose in 28 weekof gestation is necessary for early discovery of diagno-sis of GD, especially at pregnant women over the ageof 35 years, for the timely prevention of the possibleconsequences to the mother and fetus.

74

P007UČESTALOST ANEMIJE

KOD STUDENTKINJA

Milosava \elkapi}, Bo`idar Ne{evi}

Zdravstveni centar U`ice, Srbija

Smanjenje koncentracije hemoglobina pred-stavlja osnovni funkcionalni poreme}aj u sindromuanemije i predstavlja najzna~ajniji parametar dijag-nostike anemija. Cilj rada je odre|ivanje parametarakrvne slike i procena u~estalosti anemije, na osnovukoncentacije hemoglobina, kod studentkinja. U na{eistra`ivanje je uklju~eno ukupno 200 ispitanica kojesu podeljene u 2 grupe. I grupu je ~inilo 95 studen-tkinja, starosti 20 godina, a II 105 u~enica starosti 13godina. Kao uzorak je kori{}ena venska krv saK3EDTA antikoagulansom, a kompletna krvna slikaje odre|ivana na hematolo{kom analizatoru HmX(Beckman Coulter). Na osnovu dobijenih podatakasmo utvrdili da su studentkinje imale ni`e prose~nevrednosti eritrocita (4,44±0,27×1012/L), hemoglo-bina (131,6±9,8 g/L), hematokrita (0,37±0,027L/L) od 13-o godi{njakinja (4,57±0,3×1012/L,134,07±7,62 g/L, 0,399±0,026 L/L). StudentovimT-testom smo utvrdili da je razlika statisti~ki zna~ajna(SZR) za hemoglobin i hematokrit (p<0,05), a visokostatisti~ki zna~ajna za eritrocite (p<0,01). Koderitrocitnih parametara (MCV, MCH, MCHC, RDW) itrombocita nismo dobili SZR. Na osnovu koncen-tracije hemoglobina od 120 g/L kao praga zapostavljanje dijagnoze anemije za obe starosnegrupe, utvrdili smo da kod 10 (10,5%) studentkinja i3 (2,85%) u~enice postoji anemija {to je SZR(t=2,16; p<0,05). Na osnovu svega iznetog smoutvrdili da se anemija 3,7 puta ~e{~e javlja kod stu-dentkinja i da je izvo|enje preventivnih pregleda saodre|ivanjem krvne slike neophodno u toj populaciji.

P007FREQUENCY OF ANEMIA

AT STUDENTS GIRLS

Milosava \elkapi}, Bo`idar Ne{evi}

Health Center U`ice, Serbia

Decrease of concentration of hemoglobin is theprimary functional disorder in syndrome of anemiaand is the most important parameters of diagnosticsof anemia. The aim of the work is determination ofparameters of Complete Blood count (CBC) and thedetermination of frequency of anemia, according toconcentration of hemoglobin at student girls. Ourresearch includes 200 subjects divided into 2 groups.I group consists of 95 students, aged 20, and II groupof 105 pupil girl aged 13. As sample is used venousblood with K3EDTA anticoagulant, and the CBC wasdetermined on Hematology analyzer HmX (BeckmanCoulter). According to found data we concluded thatstudents had lower average values of erythrocytes(4.44±0.27×1012/L), of hemoglobin (131.6±9.8g/L), of hematocrit (0.37±0.027 L/L), than girls aged13 (4.57±0.3×1012/L, 134.07±7.62 g/L, 0.399±0.026 L/L). By Student t-test we concluded that thedifference is statistically signi ficant (SSD) for hemo-globin and hematocrit (p<0.05), and height statisti-cally significant for erythro cytes (p<0.01). For ery-throcyte parameters (MCV, MCH, MCHC, RDW) andplatelets we didn’t found SSD. According to concen-tration of hemoglobin of 120 g /L as borderline forgetting the diagnosis of anemia for both groups, weconcluded that at 10 (10.5%) students and 3 (2.85%)pupil there is anemia which is SSD (t=2.16; p<0.05).According to all this we concluded that anemia is 3.7times more often found at students, and doing pre-ventive examinations with determination of CBC nec-essary in that population.

P008PREVENCIJA DANAS ZA ZDRAVIJE SUTRA

Danijela Ristovski-Korni}, Ana Mitri}

Slu`ba laboratorijske dijagnostike, Preventivni centar, Dom Zdravlja Pan~evo

U razvijenim zemljama tokom `ivota od rakadebelog creva (CRC) oboli 1,2 miliona ljudi, {to ~ini9,8 % svih obolelih od malignih tumora. U Srbiji ovajkarcinom je drugi naj~e{}i maligni tumor. Po{to serizik od CRC se pove}ava sa godinama starosti, skoro90% svih pacijenata imaju vi{e od 50 godina. Na{a

P008PREVENTION NOW FOR HEALTHIER TOMORROW

Danijela Ristovski-Korni}, Ana Mitri}

Department of laboratory diagnostics and Prevention Center, Health Center Pan~evo

In developed countries during the life 1.2 millionpeople are diagnosed colorectal cancer (CRC),accounting for 9.8% of all patients with malignanttumors. In Serbia, this cancer is the second most com-mon malignant tumor. Since the risk of CRC increas-es with age, nearly 90% of all patients have more than

J Med Biochem 2015; 34 (1) 75

ustanova u~estvuje u nacionalnom programu skri -ninga ranog otkrivanja kolorektalnog karcinoma.Ciljna populacija su mu{karci i `ene izme|u 50 i 74godina starosti. Pacijente upu}uju izabrani lekari ulaboratoriju za rad testa na okultno krvarenje (FOBT).U periodu od 2010. do 2013. godine koordinisanomsaradnjom laboratorije i klini~ara op{te medicine brojosoba koji su upu}ene na FOBT test pove}an je 3puta. Broj pacijenata po izabranom lekaru, koji suprihvatili preporuke lekara i uradili FOBT test pove -}an je za oko 14%. Preporuka lekara je najuticajnijifaktor koji odre|uje da li }e osoba prihvatiti skriningna CRC. Strategije medicine zasnovane na dokazimamogu pomo}i lekaru kako bi svaki pacijent dobioodgovaraju}u preporuku. Neki lekari vi{e vole dadaju preporuke za skrining na redovnom godi{njempregledu, ali ovaj pristup ne}e sti}i do svih pacijena-ta. Alternativni na~in je preporuka na svim vidovimaposeta lekaru. Adekvatna komunikacija klini~ara ilaboratorije, poseban protokol i izdvajanje osoba kojepredaju uzorke u laboratoriji bez zakazivanja i ~eka -nja pove}ava poverenje pacijenata. Pravim pristupomsvakom pacijentu pove}avamo znanje i smanjujemostrah od preventivnih pregleda. Za sada su preven-tivni pregledi najefektivniji na~in u poku{aju smanje -nja smrtnosti od CRC.

50 years. Our institution is participating in the nation-al program of screening for early detection of colorec-tal cancer. The target populations are men andwomen between 50 and 74 years of age. Patientswere referred to the laboratory for test for occultblood (FOBT). In the period from 2010 to 2013 withgood cooperation laboratories and clinicians generalmedicine patients who were referred for FOBTincreased by 3 times. Number of patients by generalpractitioners, who have accepted the recommenda-tions of doctors and did FOBT increased by about14%. A recommendation from a physician is the mostinfluential factor in determining whether a patient isscreened for colorectal cancer. Evidence-based strate-gies can help the physician ensure that every appro-priate patient leaves the office with the needed rec-ommendation. While some physicians prefer to giverecommendations for screening at an annual checkup, this approach will not reach all patients. An alter-nate style of practice is to recommend screening at alltypes of visits. Adequate communication of cliniciansand laboratories, a special protocol and separation ofthe people submitting the samples to the laboratorywithout an appointment and waiting increases theconfidence of patients. The right approach to eachpatient is increasing the knowledge and reducing thefear of checkups. Primary care-based screeningremains the single most effective tool in a nationaleffort to reduce death from CRC.

P009PRISUSTVO AUTOIMUNIH TIROIDNIH

BOLESTI KOD PACIJENATA SAACHR-AB I MUSK-AB POZITIVNOM

MIJASTENIJOM GRAVIS

Ljiljana Hajdukovi}1, Dragana Lavrni}2

1Instutut za primenu nuklearne energije, INEP, Beograd, Srbija

2Institut za neurologiju, Klini~ki centar Srbije,Beograd, Srbija

Ste~ena autoimuna myasthenia gravis (MG) jeorgan-specifi~na autoimuna bolest uzrokovana po re -me}ajem neuro-mi{i}ne transmisije na post sinap ti~ -kom nivou, sa simptomima abnormalne mi{i}nezamorljivosti i slabosti. Kod 80–90% pacijenata sageneralizovanom i kod 50–70% pacijenata sa o~nomformom MG prisutna su autoantitela na receptor zaacetil holin (ACHR-AB). U grupi pacijenata sa MGbez prisustva ACHR-AB, kod oko 30–70% nalaze seautoantitela na mi{i}-specifi~nu tirozin kinazu(MUSK-AB) i ovaj tip MG karakteri{e razli~ito klini~koispoljavanje, razli~it tok bolesti i odgovor na terapiju.Stoga je od izuzetnog klini~kog zna~aja da se kod

P009PRESENCE OF AUTOIMMUNE

THYROID DISEASES IN PATIENTSWITH ACHR-AB AND MUSK-AB

POSITIVE MYASTHENIA GRAVIS

Ljiljana Hajdukovi}1, Dragana Lavrni}2

1Institute for the Application of Nuclear Energy, INEP, Belgrade, Serbia

2Institute for Neurology, Clinical Centre of Serbia,Belgrade, Serbia

Acquired autoimmune myasthenia gravis (MG)is organ-specific autoimmune disease caused by dis-order of neuromuscular transmission at the postsy-naptic level, with the symptoms of abnormal weak-ness and fatigability of the skeletal muscle.Acetylcholine receptor autoantibodies (ACHR-AB)are present in 80–90% patients with generalized andin 50–70% patients with the ocular form of MG. Inthe group of MG patients without ACHR-AB about30–70% patients have autoantibodies to muscle-spe-cific tyrosine kinase (MUSK-AB) and this type of MGis characterized by different clinical expression andtherapeutic response. Therefore, it is of exceptional-

76

svih pacijenata sa MG {to br`e odredi prisustvoACHR-AB i MUSK-AB u cilju usmeravanja dijagnos-ti~kog postupka i zapo~injanja adekvatnog le~enjakoje je u zna~ajnoj meri razli~ito kod ova dva tipaMG. Odre|ivanje ovih antitela vr{i se radioimunommetodom (RIA) u INEP-u. S obzirom da je poznatoda se MG javlja u~estalo sa drugim autoimunimbolestima, me|u kojima su i oboljenja {titne `lezde,u ovom radu je kod pacijenata sa MG ispitivano pris-ustvo autoantitela na tiroidnu peroksidazu (TPO-AB),koja su karakteristi~na za pojavu autoimunog tireoidi-tisa (kao {to je Hashimoto tireoiditis), kao i antitelana TSH receptor (TR-AB), koja su indikatori Graves-ove bolesti. Ispitivanjem je obuhva}ena grupa od 76pacijenata sa ACHR-AB pozitivnom MG i 24 pacijen-ta sa MUSK-AB pozitivnom mijastenijom. PrisustvoTPO-AB biloje ustanovljeno kod 7 od 76 (9,2%) pa -cijenata sa ACHR-AB pozitivnom MG i kod samojednog od 24 pacijenta sa MUSK-AB pozitivnommijastenijom (4,2%). Antitela na TSH receptor (TR-AB) nismo utvrdili ni kod jednog od ispitivanih paci-jenta sa MG. Na{i rezultati su u skladu sa nekimpodacima iz literature, koji se odnose na MG saACHR antitelima, gde se prisustvo TPO-AB kodobo lelih od MG uglavnom kre}e od 5–10%, a pojavaTR-AB kod mijastenije je znatno re|a ili nije na|ena.Za MUSK-AB pozitivnu mijasteniju do sada nisuobjav ljeni sli~ni rezultati. Ovakav nalaz bi se mogaoobjasniti poznatom ~injenicom da kod ACHR-ABpo zitivne MG postoji sli~na imunogenetska predispo -zi cija kao i za oboljenja {titne `lezde, a pre svega uvidu prisustva HLA B8 antigena, {to se zna~ajno raz-likuje od imunogenetske predispozicije za nastanakMUSK-AB MG. Na{i rezultati, koji pokazuju dajemanji procenat autoimunih tiroidnih oboljenja kodMUSK-AB pozitivne mijastenije, idu u prilog ovimnalazima, i ukazuju na zna~aj ispitivanja karakteristi-ka ova dva oblika mijastenije gravis.

ly importance to determinate, as quickly as possible,level of both antibodies, in order to apply adequatediagnostic procedure and introduce suitable therapywhich is different for those two types of MG.Determination of these antibodies was achievedusing radioimmunoassay (RIA) in INEP. Concerningthe fact that MG can be associated with otherautoimmune disorders, including the thyroid dis-eases, the aim of this study was to determine thyroidperoxidase autoantibodies (TPO-AB), which are char-acteristically present in various autoimmune thyroidi-tis (such as Hashimoto’s thyroiditis), as well as TSHreceptor autoantibodies (TR-AB), which are valuableindicators in Grave’s disease, in MG patients. In thisstudy group of 76 patients with ACHR-AB positiveMG and 24 patients with MUSK-AB positive MG wereincluded. The presence of TPO-AB was establishedin 7 out of 76 (9.2%) patients with ACHR-AB positiveMG, and in only one out of 24 patients with MUSK-AB positive myasthenia (4.2%). TSH receptor anti-bodies (TR-AB) were not found in the examinedpatients with MG. Our results were in accordancewith some literature data in the group of ACHR-ABpositive MG, where other authors found that TPO-ABwas present in about 5–10% of MG patients, whilepresence of TR-AB was in considerably less percent,or was not present at all. For MUSK-AB positive MGthere were not announced similar results until now.Our results can be explained with the fact that inACHR-AB positive MG there is similar genetic predis-position as in thyroid diseases, above all in presenceof HLA B8 antigen, which is different from immuno-genetic predisposition for MUSK-AB MG. Our results,which indicated less percent of autoimmune thyroiddiseases in MUSK-AB positive MG, are in accordancewith that, and indicate the significance of examina-tion of features of these two specific forms of myas-thenia gravis.

P010ODRE\IVANJE TUMORSKOG

MARKERA CA 15-3 U GRUPI @ENA

Sne`ana Ra{ovi}, Sla|ana \or|evi} Cvetkovi},Vesna Markovi}

Op{ta bolnica Kru{evac, SrbijaDom zdravlja Kru{evac, Srbija

Prema podacima Instituta za javno zdravljeSrbije »Dr Milan Jovanovi} Batut«, karcinom dojke jenaj~e{}i maligni tumor i jedan od vode}ih uzrokasmrti `ena u Srbiji. Svake godine se u Srbiji registrujevi{e od 4 000 novih slu~ajeva, preko ~etvrtine svihmaligniteta `ena. 1 600 `ena umire godi{nje od kar-cinoma dojke {to ~ini 18% smrti od karcinoma. U

P010DETERMINATION OF CA 15-3 IN THE GROUP OF WOMEN

Sne`ana Ra{ovi}, Sla|ana \or|evi} Cvetkovi},Vesna Markovi}

General Hospital Kru{evac, SerbiaPrimary Health center Kru{evac, Serbia

According to the National Institute of PublicHealth »Dr. Milan Jovanovi} Batut« breast canser isthe most common malignat tumor and one of theleading cause of death among women in Serbia.Every year in Serbia is registered more than 4000new cases, more than a quarter of all malignancies inwomen. 1600 women die annually from breast can-

J Med Biochem 2015; 34 (1) 77

`ena doba 45–65 godina karcinom dojke je 3. uzroksmrti, posle cerebrovaskularnih bolesti i ishemijskebolesti srca. Na`alost, vi{e od polovine `ena otkrivenoje u poodmakloj fazi bolesti. U periodu od 01. 01.–10. 06. 2014. u na{oj laboratoriji odre|ivali smovrednosti tumorskog markera CA 15-3 u serumu u ugrupi 428 `ena uzrasta 29–85 godina; na analiza-toru IMMULITE 1000, koriste}i BR – MA hemilu-miniscentni imunometrijski test (CA 15-3). Nivoi CA15-3 mogu se koristiti za detekciju recidiva i od -govora na terapiju kod metastaza karcinoma dojke.84 `ene je imalo vrednosti iznad gornjih referentnih,{to je 19,62%. Obuhva}ene su vrednosti od31–3142 U/mL; ve}ina `ena je u starosnoj grupipreporu~enoj za skrining za karcinom dojke ( 45–69godina), dve su mla|e od 45 godina i preko 69 go -dina bilo je 19 `ena. Dr`ava bi trebalo da na|e na~inda uklju~i {to vi{e zdravih `ena preporu~enog dobaod 45–69 godina u skrining program za rak dojke, azdravstveni radnici da promovi{u zdrav na{in `ivota.

cer accounting for 18% of deaths from cancer. Inwomen aged 45–64 years, breast cancer is the thirdhighest cause of death, after cerebrovascular diseaseand ischemic heart disease. Unfortunately, over halfwomen is revealed in an advanced stage. During the01. 01–10. 06 2014. in our laboratory, we deter-mined the levels of the tumor marker CA 15-3 inserum, in a group of 428 women, age 29–85 years;on the analyzer IMMULITE 1000, by BR – MA che -miluminescent immunometric assay (CA 15-3).Serum CA 15-3 values should be used for detectingearly recurrence and for monitoring response totreatment in patients with metastatic breast cancer.84 women had values above the upper referencevalue,which is 19,62%. Obtained values range from31–3142 U/mL; majority of women, 63, is in the agegroup advantageous for screening for breast cancer(45–69 years), two are younger than 45 years andover 69 years were 19 women. The state should finda way to include as many healthy women of recom-mended age, 45–69 years, in the screening programfor breast cancer and health workers to promotehealthy lifestyle.

P011DA LI JE POVI[ENA SERUMSKA

VRIJEDNOST MOKRAĆNE KISELINEJEDNOSTAVAN POKAZATELJ INTENZITETA OKSIDATIVNOG

STRESA U AKUTNOMKORONARNOM SINDROMU?

Sabaheta Hasi}1, Emina Spahi}2, Emina Kiseljakovi}1, Radivoj Jadri}1,

Lejla Ali}1, Damira Kadi}3

1Katedra za medicinsku biohemiju, Medicinski fakultet, Univerzitet u Sarajevu

2Medicinski fakultet, Univerzitet u Sarajevu3Slu`ba za laboratorijsku dijagnostiku, Kantonalna

bolnica Zenica, Bosna i Hercegovina

Oksidativni stres i inflamacija imaju zna~ajnupatofiziolo{ku ulogu u akutnom koronarnom sindro-mu (AKS). Cilj sudije je bio ispitati odnos mokra}nekiseline (MK) i C-reaktivnog proteina (CRP) u ispi-tanika sa AKS. Retrospektivna studija je uklju~ila 80ispitanika sa AKS (40 sa akutnim infarktom miokarda(AIM) i 40 sa nestabilnom anginom pektoris (NAP),dobi od 50 do 83 godine, hospitaliziranih na Kliniciza bolesti srca i reumatizam, Univerzitetsko-Klini~kogCentra u Sarajevu. Ispitanici sa AKS su distribuirani ugrupu hiperurikemi~nih (n=34) i normourikemi~nih(n=46) prema serumskim vrijednostima MK 48 satiposlije hospitalizacije. Parametri su analizirani rutin-

P011IS ELEVATED

SERUM URIC ACID LEVEL A SIMPLE

INDICATOR OF OXIDATIVE STRESS INTENSITYIN ACUTE

CORONARY SYNDROME?

Sabaheta Hasi}1, Emina Spahi}2, Emina Kiseljakovi}1, Radivoj Jadri}1,

Lejla Ali}1, Damira Kadi}3

1Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo

2Faculty of Medicine, University of Sarajevo3Department of Laboratory Diagnostics, Cantonal

Hospital Zenica, Bosnia and Herzegovina

Oxidative stress and inflammation play animportant pathophysiological role in acute coronarysyndrome (ACS).The study aim was to investigate theassociation of uric acid (UA) andC-reactive protein(CRP) in ACS subjects.This retrospective studyincluded 80 ACS subjects (40 acute myocardialinfarction (AMI), and 40 unstable angina pectoris(UAP) subjects), aged 50 to 83 years, hospitalized atthe Clinic for Heart Diseases and Rheumatism at theUniversity Clinical Centre of Sarajevo. ACS subjectswere distributed into hyperuricemic (n=34) and nor-mouricemic (n=46) groups according to serum UAlevel 48 hours after hospitalization. Biochemical

78

skim metodama. Slabo pozitivna, signifikatnakorelacija je utvr|ena izme|u serumskih vrijednostiMK i CRP u AKS (rho=0,246; p=0,028). Utvr|enaje nesignifikatna negativna korelacija izme|u MK iCRP u normourikemi~nih (rho=–0,235, p=0,116),a signifikantna pozitivna korelacija u hipeurikemi~nihispitanika sa AKS (rho=0,406; p=0,017). U hipe-rurikemi~nom stanju, izme|u AIM i NAP ispitanika,signifikantne razlike su utvr|ene za serumske vrijed-nosti sr~anog troponina I (cTnI) i CRP, a u normo -urikemi~nom stanju jedino su vrijednosti cTnI bilestatisti~ki zna~ajno razli~ite (p<0,0005). Serumskevrijednosti MK su zna~ajno pozitivno korelirale uhiperurikemi~nih (rho=0,358; p=0,038) i negativnou normourikemi~nih AKS ispitanika (r=–0,309;p=0,037), dok je CRP pozitivno korelirao sacTnIuobje grupe (rho=0,647, p<0,0005; r=0,407;p=0,005). Odnos MK i CRP u AKS se mijenja ovis-no o nivou MK i neovisno o tipu AKS {to ukazuje namogu}i manje intenzivan oksidativni stres kod nor-mourikemi~nih ispitanika sa AKS.

parameters were determined by routine laboratorymethods. A weak, positive, significant correlation wasobserved between serum levels of UA and CRP inACS (rho=0.246; p=0.028). An insignificant nega-tive correlation between UA and CRP in nor-mouricemic(rho=-0.235, p=0.116), but significantpositive correlation in hyperuricemic ACS subjects(rho=0.406; p=0.017) was observed. In hyper-uricemic state, between AMI and UAP subjects, sig-nificant differences were observed in sera cardiac tro-ponin I (cTnI) and CRP values, but in normouricemicstate only cTnI values were statistically different(p<0.0005). Serum UA values correlated signifi -cantly, positively in hyperuricemic (rho=0.358;p=0.038) and negatively in normouricemic ACS sub-jects (r=–0.309; p=0.037) although CRP correlatedpositively in both groups with cTnI (rho=0.647,p<0.0005; r=0.407; p=0.005, respectively).TheUA and CRP association in ACS was changeddependently on UA serum level, and independentlyof ACS type, which indicates on possible, less inten-sive oxidative stress in normouricemic subjects, inde-pendently of ACS type.

P012ZNA^AJ ALANIN

AMINOTRANSFERAZEU PROCJENI

KARDIOVASKULARNOG RIZIKA

Lejla Ali}, Sabaheta Hasi}, Emina Kiseljakovi}, Radivoj Jadri}

Katedra za medicinsku biohemiju, Medicinski fakultet Univerziteta u Sarajevu,

Sarajevo, Bosna i Hercegovina

Visoke vrijednosti aktivnosti alanin aminotrans-feraze (ALT) unutar referentnog raspona su povezanesa nealkoholnom masnom bolesti jetre i posljedi~noinzulinskom rezistencijom, metaboli~kim sindromomi diabetes mellitusom tip II. Cilj je bio istra`iti mogu}upovezanost ALT aktivnosti unutar referentnograspona sa pokazateljima kardiovaskularnog rizika.Kod 100 nasumi~noodabranih, asimptomati~nih ispi-tanika oba spola su ura|ene biohemijske analize krvi:ALT, ukupni holesterol, trigliceridi i ukupni bilirubin.Odnos ukupni holesterol/(ukupni bilirubin × 100) jeizra~unat kao pokazatelj kardiovaskularnog rizika.Ispitanici su podijeljeni u 4 grupe prema kvartilamaALT aktivnosti (grupa 1: 0–14,9 IU/L, grupa 2:15–19,9 IU/L, grupa 3: 20–26,4 IU/L, grupa 4:≥26,5 IU/L). Biohemijske analize su ra|ene naOdjelu za klini~ku hemiju i biohemiju UniverzitetskogKlini~kog Centra Sarajevo. Statisti~ki zna~ajna razlikaje prona|ena izme|u ~etiri grupe ispitanika u nivou

P012SIGNIFICANCE OF

ALANINE AMINOTRANSFERASE IN CARDIOVASCULAR RISK

ASSESSMENT

Lejla Ali}, Sabaheta Hasi}, Emina Kiseljakovi}, Radivoj Jadri}

Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo,

Sarajevo, Bosnia and Herzegovina

High alanine aminotransferase (ALT) activitylevel within the reference range is associated withNon Alcoholic Fatty Liver Disease, and consequentlyinsulin resistance, metabolic syndrome and diabetesmellitus type II. The aim was to investigate possibleassociation of ALT reference range activity with indi-cators of cardiovascular risk. In 100 randomly select-ed, asymptomatic subjects of both sexes analysis ofbiochemical parameters ALT, total cholesterol, triglyc-erides, total bilirubin were performed. Total choles-terol/(total bilirubin × 100) ratio was calculated asindicator of cardiovascular risk. Subjects were dividedinto 4 groups by ALT activity quartiles (group 1:0–14.9 IU/L, group 2: 15–19.9 IU/L, group 3:20–26.4 IU/L, group 4: ≥26.5 IU/L). Biochemicalanalyzes were performed at Clinical Chemistry andBiochemistry Laboratory, University Clinical CenterSarajevo. A statistically significant difference wasfound between the four groups of subjects for total

J Med Biochem 2015; 34 (1) 79

holesterola i triglicerida (p=0,026 i p=0,009,respektivno), pri ~emu su nivoi mjerenih parametarabili vi{i u vi{im kvartilama aktivnosti ALT. Post-hocanaliza je pokazala signifikantno vi{e vrijednostiodnosa ukupnog holesterola i ukupnog bilirubina ugrupi 4 u odnosu na grupu 2 (p=0,044). Visokaaktivnost ALT unutar referentnog raspona je potenci-jalni pokazatelj kardiovaskularnog rizika kod asimpto-mati~nih odraslih osoba. Porede}i sa vrijednostimatradicionalnih i netradicionalnih pokazatelja kardio-vaskularnog rizika, mjerenje aktivnosti ALT mo`e bitiva`no u ranoj prevenciji kardiovaskularnih bolesti.

cholesterol and triglycerides (p=0.026 and p=0.009,respectively). The levels of the measured parametersare higher in the higher quartiles of ALT activity. Post-hoc analysis showed significantly higher total choles-terol/total bilirubin ratio in group 4 compared togroup 2 (p=0.044). High ALT activity within the ref-erence range is a potential indicator of cardiovascu-lar risk in asymptomatic adults. Compared to the val-ues of traditional and non-traditional indicators ofcardiovascular risk, measurement of ALT activity maybe important in the early prevention of cardiovascu-lar disease.

P013POVEZANOST HIPERURIKEMIJE

I DISLIPIDEMIJE KOD PACIJENATASA DIABETES MELLITUSOM TIP 2

Emina Kiseljakovi}1, Sabaheta Hasi}1, Alisa Bu{atli}1, Radivoj Jadri}1, Lejla Ali}1,

Emina Naka{-I}indi}2

1Katedra za medicinsku biohemiju, Medicinski fakultet Univerziteta u Sarajevu,

Sarajevo, Bosna i Hercegovina2Katedra za fiziologiju ~ovjeka, Medicinski fakultet

Univerziteta u Sarajevu, Sarajevo, Bosna i Hercegovina

Hiperurikemija se smatra markerom rizika zakardiovaskularne komplikacije i mo`e biti povezanasa dislipidemijom, pogor{avaju}i rizik za pojavu kom-plikacija. Cilj studije je bio da se istra`i veza izme|umokra}ne kiseline i nivoa lipida kod pacijenata sapotvr|enim diabetes mellitusom tip 2 (DMT2). Upresje~noj, observacionoj studiji je bilo uklju~eno100 pacijenata (62 `ena i 38 mu{karaca), starostiizme|u 35 i 90 godina, hospitaliziranih na Klinici zaendokrinologiju, Univerzitetskog Klini~kog CentraSarajevo. Pacijenti su podijeljeni u grupu hiperurike-mi~nih (HU) i normourikemi~nih (NU) (n=50 usvakoj grupi), prema nivou mokra}ne kiseline u seru-mu (MK) (>416 mmol/L za mu{karce; >356 mmol/Lza `ene). Biohemijski parametri su mjereni rutinskimlaboratorijskim metodama. Vrijednosti triglicerida(TG) i aterogeni indeks plazme (AIP) su bili zna~ajnovi{i u HU grupi DMT2 pacijenata (p=0,040 ip=0,023). Utvr|ena je slaba, negativna, zna~ajnakorelacija MK i ukupnog holesterola (TC), MK ilipoproteina visoke gusto}e (HDL-C) (rho=–0,316;p=0,025 irho=–0,399; p=0,004;) i pozitivna,zna~ajna korelacija MK i lipoproteina niske gusto}e(LDL-C) (rho=0,343; p=0,030), u HU grupi DMT2pacijenata. Izostanak veze MK sa lipidnim parametri-ma u NU grupi ukazuje na povezanost hiperurikemi-je i dislipidemije u diabetes melitusu tip 2.

P013ASSOCIATION OF HYPERURICEMIAAND DYSLIPIDEMIA IN DIABETES

MELLITUS TYPE 2 SUBJECTS

Emina Kiseljakovi}1, Sabaheta Hasi}1, Alisa Bu{atli}1, Radivoj Jadri}1, Lejla Ali}1,

Emina Naka{-I}indi}2

1Department of Medical Biochemistry, Faculty of Medicine University of Sarajevo,

Bosnia and Herzegovina2Department of Physiology, Faculty of MedicineUniversity of Sarajevo, Bosnia and Herzegovina

Hyperuricemia is considered as risk marker ofcardiovascular complication and it may be associatedwith dyslipidemia, aggravating the risk for events.The objective of this study was to evaluate the rela-tionships between uric acid and lipid levels in subjectwith established. Diabetes mellitus type 2 (DMT2).Cross-sectional, observational study includes 100patients (62 women and 38 men), aged 35 to 90years, hospitalized at the Clinic of Endocrinology,Clinical Center of University of Sarajevo. Subjectswere divided into Hyperuricemia (HU) and normaluricemia groups (NU) (n=50; each) according to theuric acid serum level (UA) (>416 mmol/L for male;>356 mmol/L for female). Biochemical parameterswere measured by routine laboratory methods.Values of triglycerides (TG) and atherogenic index ofplasma (AIP) were significantly higher in HU DMT2group (p=0.040 and p=0.023 respectively). Aweak, negative, significant correlation of UA withtotal cholesterol (TC) and high density lipoproteincholesterol (HDL-C) (rho=–0.316; p=0.025 andrho=–0.399; p=0.004; respectively) and positivesignificant correlation with low density lipoproteincholesterol (LDL-C) (rho=0.343; p=0.030) wasobserved in HU group of DMT2 subject. No associa-tion of UA and lipid parameters in NU subject impli-cates association of hyperuricemia and dyslipidemiain Diabetes Mellitus type 2.

80

P014POVEZANOST MOKRA]NE KISELINE

I BILIRUBINA SERUMA SA MARKERIMA RIZIKA RAZVOJA

KARDIOVASKULARNIH BOLESTI U ZDRAVIH ISPITANIKA

Radivoj Jadri}1, Amra Mehmedba{i}3, Sabaheta Hasi}1, Aida [ap~anin2, Jozo ]ori}4,

Emina Kiseljakovi}1, Lejla Ali}1

1Katedra za medicinsku biohemiju, Medicinski fakultet Univerziteta u Sarajevo

2Katedra za prirodno-matemati~ke predmete u farmaciji

3Farmaceutski fakultet Univerziteta u Sarajevu4OJ Klini~ka hemija i biohemija, Univerzitetskiklini~ki centar, Sarajevo, Bosna i Hercegovina

Promjene koncentracije mokra}ne kiseline (MK)i ukupnog bilirubina (UBIL) u serumu sve vi{e se pos-matraju u kontekstu kardiovaskularnih bolesti. Ciljistra`ivanja je bio ispitati povezanost koncentracijeMK i UBIL seruma i markera rizika razvoja kardio-vaskularnih bolesti, predstavljenih kroz odnose lipidai lipoproteina. Studija je obuhvatila 60 naizgled zdra -vih ispitanika, oba pola. Biohemijske analize MK,UBIL, ukupnog holesterola (UHOL), triglicerida (TGL)i lipoproteina visoke gusto}e (HDL-C) su provedene ulaboratoriji »Poliklinika Sunce – Agram«, a izra~unatesu vrijednosti lipoproteina niske gusto}e (LDL-C)pomo}u Friedewald-ove jedna~ine, te vrijednosti od -nosa lipida i lipoproteina, sa i bez vrijednosti UBILdodate u imenitelj odnosa. Ispitanici su podijeljeni ugrupe, na osnovu vrijednosti MK i UBIL (donja, sred-nja i gornja tre}ina referentnog raspona). Zna~ajnoni`i nivoi odnosa UHOL/HDL-C, LDL-C/HDL-C iTGL/HDL-C bili su prisutni u grupi sa vrijednostimaMK ≤ 240 mmol/L (p<0,05), u odnosu na drugegrupe. Zna~ajno ni`i nivoi odnosa lipida i lipopro-teina su bili prisutni u grupi sa koncentracijom UBIL>14,5 mmol/L, ali samo odnosa sa dodatim vrijed-nostima UBIL (UHOL/HDL-C+UBIL), (LDL-C/HDL-C+UBIL), ili UBIL u imeniocu odnosa (UHOL/UBIL)(p<0,05). Zna~ajno ni`e vrijednosti markera rizikarazvoja kardiovaskularnih bolesti u grupi sa MK ≤240 μmol/L je vjerovatno rezultat sinergije antiok-sidativne aktivnosti MK i UBIL (∼10 mmol/L). U grupisa koncentracijom UBIL>14,5 mmol/ L prisutni suzna~ajno ni`i nivoi markera rizika razvoja kardio-vaskularnih bolesti sa dodatim vrijednostima UBIL,zbog sma njenog antioksidativnog efekta MK ~ije sukoncen tracije u gornjoj tre}ini referentnog raspona.

P014ASSOCIATION OF SERUM

URIC ACID AND BILIRUBIN WITH RISK MARKERS FOR

CARDIOVASCULAR DISEASE IN HEALTHY SUBJECTS

Radivoj Jadri}1, Amra Mehmedba{i}3, Sabaheta Hasi}1, Aida [ap~anin2, Jozo ]ori}4,

Emina Kiseljakovi}1, Lejla Ali}1

1Department of Medical Biochemistry, Faculty of Medicine University of Sarajevo

2Department for Natural Sciences3Faculty of Pharmacy University of Sarajevo

4Department of Clinical Chemistry and Biochemistry,University Clinical Center, Sarajevo,

Bosnia and Herzegovina

Altered serum uric acid (UA) and total bilirubin(TBIL) concentrations are increasingly related to car-diovascular disease. The aim of study was to investi-gate association of serum UA and TBIL concentra-tions with cardiovascular disease risk markers,represented by lipid and lipoprotein ratios. The studyincluded 60 apparently healthy subjects, both gen-der. Biochemical analyzes of UA, TBIL, total choles-terol (TCHOL), triglyceride (TGL) and high densitylipoprotein cholesterol (HDL-C) were performed inthe laboratory of the »Poliklinika Sunce – Agram«,with low density lipoprotein-cholesterol (LDL-C) cal-culated using Friedewald equation, as well as calcu-lated lipid and lipoprotein ratios, with and withoutTBIL values counted in denominator of ratio.Subjects were divided in groups, based on UA andTBIL values (lower, middle and upper third of re -ference range). Significant lower levels of TCHOL/HDL-C, LDL-C/HDL-C and TGL/HDL-C ratios werepresent in serum uric acid ≤ 240 mmol/L group(p<0.05), compared to other groups. Significantlower levels of lipids and lipoproteins ratios werepresent in bilirubin >14.5 mmol/L, but only with thecounted values of bilirubin (TCHOL/HDL-C+TBIL),(LDL-C/HDL-C+TBIL), or bilirubin in the denomina-tor of the ratio (TCHOL/TBIL) (p<0.05). Significantlylower values of the cardiovascular diseases risk mark-ers in uric acid ≤ 240 mmol/L group is likely the resultof synergistic antioxidant activity of uric acid and totalbilirubin (∼10 mmol/L). In bilirubin >14.5 mmol/Lgroup, significant lower levels were observed for car-diovascular disease risk markers with counted totalbilirubin value, because of possible reduced antioxi-dant effects of uric acid in upper third of referencerange.

J Med Biochem 2015; 34 (1) 81

P015OSTEOPONTIN I UGLJENOHIDRATNI

ANTIGEN CA125 U DIJAGNOSTICIRAKA JAJNIKA

Mirjana Milivojevi}1, Biljana Kastratovi}-Kotlica2

Vladimir Bo{kovi}2

1Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd

2Medicinski fakultet, Univerzitet u Beogradu,Beograd

Kod bolesnica sa pelvi~nim masama, tumormarker CA125 nema dovoljnu osetljivost i spe -cifi~nost u detekciji raka jajnika. Cilj ovog rada je daispitamo zna~aj osteopontina (OPN) i udru`enihmarkera Ca125 i OPN, u diferencijalnoj dijagnosticimalignih i benignih tumora jajnika. Ova studija pre-seka je ura|ena na Klinici za ginekologiju i aku{er stvoi Centru za medicinsku biohemiju, Klini~kog centraSrbije. Uzorci krvi su uzeti preoperativno od 107pacijentkinja koje su imale dijagnozu tumora jajnika,od kojih je 57 bolesnica bilo sa histopatolo{komdijag nozom epitelnog ovarijalnog kancera a 50 sabenignim cistama jajnika. U uzorcima krvi je odre|ennivo OPN i CA125 (ELISA i CMIA metodom) i upo -re|eni su sa patohistolo{kim rezultatima. Dijag no -sti~ki zna~aj OPN i CA125 je odre|en statisti~kommetodom ROC krive i povr{inom ispod ovih krivi(AUC). Mediana koncentracije plazmatskog osteo-pontina u grupi benignih bolesnica iznosila je 356,33ng/mL, a 865,15 ng/mL kod malignih bolesnica(p<001). ROC analiza za osteopontin pokazala jepovr{inu ispod krive 0,838. Za speci i~nost 90%osteopontin je imao senzitivnost 62,5%, a kada suudru`eni OPN i CA125 ona je dostizala 74,9% zaistu specifi~nost.Osteopontin ima zadovo ljavaju}usposobnost u diferencijaciji benignih od malignih cistijajnika, koja je jo{ bolja u kombinaciji sa osteopo n -tinom.

P015OSTEOPONTIN AND

CARBOHYDRATE ANTIGEN 125 INPREDICTING OVARIAN CANCER

Mirjana Milivojevi}1, Biljana Kastratovi}-Kotlica2

Vladimir Bo{kovi}2

1Center of Medical Biochemistry, Clinical Center of Serbia, Belgrade

2School of Medicine, University of Belgrade,Belgrade

In women with pelvic mass, cancer antigen 125(CA125) had not achieved satisfactory sensitivity andspecificity in the detection of ovarian cancer. Theobjective of this study was to determine the potentialof the osteopontin (OPN) and OPN+CA125 combi-nation in differential diagnosis of the ovarian cancersand nonmalignant ovarian disease. A prospectivecross-sectional study was conducted at the Clinic forGynecology and Obstetrics, and at the Center ofMedical Biochemistry, Clinical Center of Serbia.Serum samples were obtained preoperatively from107 women undergoing surgery for pelvic mass; 57of them had ovarian carcinoma, and 50 had benigncyst. The samples were analyzed for the levels ofOPN and CA125 (using ELISA and CMIA methods)and then compared with the final pathologic results.The diagnostic performance of OPN and CA125 wasestimated using receiver operating characteristiccurve and area under the receiver operating charac-teristic curve. The mediana plasma level of OPN inpatients with benign and malignant cysts were 356.33 ng/mL and 865.15 ng/mL, respectively (p<0.001).Receiver operating characteristic (ROC) analysis forplasma OPN revealed the area under the curve of 0.838. At the predefined specificity of 90%, OPNshowed sensitivity of 62.5%, whereas the combina-tion of OPN+CA125 reached 74.9% at the samespecificity. OPN showed satisfactory capability of dis-tinguishing benign from malignant ovarian cyst, par-ticularly in combination with CA125.

82

P016AKREDITACIJA PREMA STANDARDU

ISO 15189 – NA[E ISKUSTVO

Vera Stjepanovi}1, Tatjana Vodnik1

1Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd, Srbija

Kvalitetne medicinske laboratorije su sastavnideo zdravstvene za{tite, medicinskih istra`ivanja iklju~ni partneri za bezbednost pacijenata i javnizdrav stveni sistem. Osnovna komponenta ovih aktiv -nosti je izvr{enje usluga osiguranjem kvaliteta krozakreditaciju prema standardima ISO serije. ISO15189, baziran na ISO 9001 i ISO 17025 zahtevada se medicinske laboratorije pridr`avaju zahteva zamenad`ment kvalitetom i tehni~kih zahteva uklju -~uju}i pre- i post- analiti~ke faze kao i sam analiti~kiproces. Laboratorijska etika i bezbednost su tako|euklju~eni. Novo izdanje standarda ISO 15189:2012Labo ratory medicine – Requirements for referentmeasurement laboratories je objavljeno 5. novembra2012. godine. Utvr|en je prelazni period za novistandard ISO 15189:2012 i to do 1. marta 2016.godine. Na{a laboratorija ce imati nadzor premazahtevima novog izdanja standarda ISO 15189:2012do leta 2015. godine. U Srbiji, akreditacija premazahtevima standarda ISO 15189 je po~ela 2009.godine. Od 2009. godine laboratorije Centra zamedicinsku biohemiju, Klini~kog Centra Srbije poredzahteva ISO 9001 i ISO 17025 svoj rad obavljaju iprema zahtevima standarda ISO 15189. LaboratorijeCentra za medicinsku biohemiju Klini~kog CentraSrbije su vodece u na{oj zemlji i one imaju dugogo-di{nje iskustvo sa sertifikacijom prema zahtevima ISO9001 kao i akredi tacijom prema ISO 17025. Na{alaboratorija je akreditovana za 344 testa i obimakreditacije sadr`i metode za ispitivanje parametaraklini~ke hemije, hematologije, hemostaze i imuno -logije. Sistem menad`menta kvalitetom je dokumen-tovan i obra|uje se elektronskim putem. Od 2008na{a laboratorija ima LIS sistem. Tako|e, u~estvuje-mo u 5 razli~itih PT programa, organizujemo i spro -vodimo nacionalnu spolja{nju kontrolu kvaliteta.Akreditacija, upravljanje dokumentacijom, edukacijaosoblja, programi za spolja{nju kontrolu kvaliteta idokazivanje kompetentnosti ocenjivanjem od tre}estrane pobolj{ava laboratorijske usluge i poslovneprocese, povecava kvalitet rezultata, motivi{e osobljei korisno je za sve zainteresovane strane.

P016ACCREDITATION ACCORDING TO

ISO 15189 – OUR EXPERIENCE

Vera Stjepanovi}1, Tatjana Vodnik1

1Center of Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

Quality medical laboratories are an integral partof health care, medical research and the key partnersin patient safety and public health system. Key com-ponent of these actions is the enforcement of qualityassurance services through accreditation by ISOstandards. ISO 15189, based upon ISO 9001 andISO 17025, requires that medical laboratories com-ply with requirements for quality management andtechnical requirements, including pre- and post-ana-lytical phases, as well as the analytical process itself.Laboratory ethics and safety are also included. Newedition of ISO 15189:2012 Laboratory medicine-Requirements for referent measurement laboratorieswas issued on November 5th, 2012. Transitionalperiod for the new standard is up to March 1st,2016. Our laboratory will have surveillance accord-ing to new standard by summer 2015. In Serbia, anISO 15189 accreditation system was started in 2009.Since 2009 Laboratories of Center for medical bio-chemistry Clinical Center of Serbia in addition to therequirements of ISO 9001 and ISO 17025 follow therequirements of ISO 15189 Laboratories of Centerfor medical biochemistry Clinical Center of Serbia arethe leading in our country and they have previous oflong standing experience with ISO 9001 certificationand 17025 accreditation. Our laboratory was accred-ited for 344 tests and accreditation scope containsmethods for testing parameters of clinical chemistry,hematology, hemostasis and immunology. Qualitymanagement system is documented and processedelectronically. Since 2008 our laboratory has LIS sys-tem. Also, we participate in 5 different PT programsand we organize and perform national external qual-ity control. Accreditation, data management, person-nel education, external quality control programs anddemonstration of competence to a third party asses-sor improve laboratory services and business process-es, increases the quality of the results, motivates per-sonnel and is beneficial for all interested

J Med Biochem 2015; 34 (1) 83

P017EVALUACIJA KOMBINACIJE

SERUMSKIH RENALNIH BIOMARKERA U OTKRIVANJUPACIJENATA SA HRONIČNOM

BOLE[ĆU BUBREGA

Marijana Dajak1, Sne`ana Jovi~i}1,2, Svetlana Ignjatovi}1,2

1Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd, Srbija

2Katedra za medicinsku biohemiju, Farmaceutskifakultet, Univerzitet u Beogradu, Beograd, Srbija

Hroni~na bolest bubrega (HBB) je ireverzibilna,progresivna redukcija renalne funkcije. Rani stadijummedicinske intervencije mo`e odlo`iti ili spre~iti pro-gresiju HBB do terminalnog stadijuma bubre`nebolesti. Procena ja~ine glomerulske filtracije (GFR)ima centralnu ulogu za dijagnozu i pra}enje pacijena-ta sa HBB. Trenutna preporuka je upotreba kreatini-na, zajedno sa na kreatininu zasnovanih jedna~ina,kao biomarkera GFR. U proteklih nekoliko godina,nekoliko plazma protein male molekulske te`ine, kao{to su cistatin C (CISC), beta2-mikroglobulin (B2M) ibeta-trace protein (BTP) su prou~avani u cilju iden -tifikovanja boljeg endogenog GFR markera. Cilj ovograda je bio da se uporedi dijagnosti~ka vrednost po -jedina~nih serumskih renalnih biomarkera (kreatinin,urea, CISC, B2M i BTP) za detekciju renalnogporeme}aja u ranim fazama HBB sa njihovim kombi-novanim odre|ivanjem. U studiju je bilo uklju~eno125 zdravih osoba i 71 pacijent sa procenjenom GFR> 60 mL/min/1,73 m2. ROC analiza je pokazala dapojedina~ni renalni biomarkeri imaju nisku dijagnos-ti~ku ta~nost za detekciju renalnog poreme}aja;povr{ine ispod ROC krivih (AUC) za kreatinin, ureu,CISC, B2M i BTP, su bile od 0,559 do 0,700. Kombi -novano odre|ivanje kreatinina i uree (AUC, 0,639) ilikreatinina i CISC (AUC, 0,585) nije pobolj{alo otkri-vanje renalne bolesti. S obzirom da B2M i BTP imajuzna~ajno vi{e AUC u odnosu na druge renalne bio-markere, kombinovano odre|ivanje ovih biomarkerasa kreatininom bolje detektuje prisustvo renalnebolesti (AUC > 0,682) u odnosu na odre|ivanjesamo kreatinina. Rezultati iz ovog rada su pokazali dakombinovana upotreba serumskih renalnih biomar -kera ima ograni~enu vrednost za detekciju ranihstadijuma HBB.

P017EVALUATION OF

THE COMBINATION OF SERUMRENAL BIOMARKERS IN

IDENTIFYING PATIENTS WITHCHRONIC KIDNEY DISEASE

Marijana Dajak1, Sne`ana Jovi~i}1,2, Svetlana Ignjatovi}1,2

1Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

2Department of Medical Biochemistry, Faculty ofPharmacy, University of Belgrade, Belgrade, Serbia

Chronic kidney disease (CKD) is an irreversible,progressive reduction in renal function. Early stagemedical intervention may delay or prevent progres-sion of CKD to end-stage renal disease. Estimation ofthe glomerular filtration rate (GFR) has central rolefor the diagnosis and follow-up of patients with CKD.Current recommendation is the use of creatininetogether with creatinine-based estimation equationsas biomarker for GFR. In the past few years, severallow molecular weight plasma proteins, such as cys-tatin C (CYSC), beta2-microglobulin (B2M) and beta-trace protein (BTP) have been studied aiming atidentifying a better endogenous GFR marker. Theaim of this study was to compare diagnostic value ofindividual serum biomarkers (creatinine, urea, CYSC,B2M and BTP) to detect renal disorder in early CKDstages with their combined determination. The studyincluded 125 healthy individuals and 71 patients withestimated GFR > 60 mL/min/1.73 m2. ROC analy-ses showed that individual serum biomarkers had lowdiagnostic accuracy for detection of renal disorder;the areas under the ROC curves (AUC) for creatinine,urea, CYSC, B2M and BTP, were from 0.559 to0.700. The combined determination of creatinineand urea (AUC, 0.639) or creatinine and CYSC(AUC, 0.585) did not improve the detection of renaldisease. Considering that B2M and BTP had signifi-cantly higher AUCs then other renal biomarkers,combined use of these biomarkers with creatininebetter detect the presence of renal disease (AUCs >0.682) in relation to only determination of creatinine.The results from this study showed that combineduse of serum renal biomarkers had limited value fordetecting early CKD stages.

84

P018KONCENTRACIJE LIPIDNIH

PARAMETARA KOD DOBROVOLJNIHDAVALACA KRVI I DAVALACA NA

PROGRAMU PLAZMAFEREZE

Marijana Mitrovi}, Marina Sin|i} Mili}evi}

Institut za transfuziju krvi Srbije, Svetog Save 39, Beograd

Dobrovoljni davaoci krvi i davaoci plazme naprogramu plazmafereze podle`u redovnim lekarskimkontrolama. Plazmaferezom je omogu}eno odvaja njeplazme od ostalih elemenata krvi u cilju dobijanjaplazme koja se koristi za proizvodnju stabilnih lekovaiz krvi- albumina i imunoglobulina. Ovim ispitivanjemobuhva}eno je ukupno 228 uzoraka dobrovoljnihdavalaca krvi i davalaca plazme na programu plaz-mafereze oba pola. Odre|ene su koncentracijeukupnog holesterola (UH), triglicerida (TG), HDL iLDL holesterola, indeks ateroskleroze (IA) i utvr|enisu faktori rizika (FR). Odre|ivanja ukupnog holes-terola i triglicerida su vr{ena standardnim enzimskimspektrofotometrijskim metodama, HDL-holesterol jeodre|en spektrofotometrijski dekstran sulfat- mag-nezijumovom metodom, dok su vrednosti LDL-holes-terola dobijene izra~unavanjem preko Friedewaldoveformule. Indeks ateroskleroze je dobijen kao koli~nikkoncentracija LDL i HDL holesterola, a faktor rizikakao odnos koncentracija ukupnog i HDL holesterola.Ispitivanjem smo dobili slede}e srednje vrednosti:ukupni holesterol 5,38±1,17 mmol/L, trigliceridi1,64±0,97 mmol/L, HDL-holesterol 1,27±0,33mmol/L, LDL-holesterol 3,37±1,06 mmol/L, IA2,85±1,25 i FR 4,20±1,93. Dobijene vrednostiuka zuju na prisustvo aterogenog rizika lipidnogporekla kod dobrovoljnih davalaca krvi i davalacaplazme na programu plazmafereze, iako oni pripa -daju najzdravijem delu populacije. To ukazuje naneophodnost primene higijensko-dijetetskog re`imaishrane i odgovaraju}e fizi~ke aktivnosti.

P018LIPID PARAMETERS

CONCENTRATION IN VOLUNTARYBLOOD DONORS AND PLASMA-PHERESIS PROGRAM DONORS

Marijana Mitrovi}, Marina Sin|i} Mili}evi}

Blood Transfusion Institute of Serbia, Svetog Save 39, Belgrade

Voluntary blood donors and donors included inthe plasmepheresis program are submitted to med-ical controls on the regular basis. Plasmapheresisprocedure enables separation of plasma from otherblood cell elements and it is used for the preparationof stable blood products – albumin and immunoglob-ulins. The study included total of 228 blood samplescollected from blood and plasmapheresis donors ofboth genders. Total cholesterol (TCC), triglycerides(TG), HDL and LDL cholesterol concentrations weredetermined, as well as atherosclerosis index (AI) andrisk factors (RF). Total cholesterol and triglyceridesdeterminations were performed by standard enzymespectrophotometric method, HDL cholesterol wasmeasured by spectrophotometric dextran sulphate –magnesium method, while LDL cholesterol valueswere obtained by calculation using Friedewald`s for-mula. Atherosclerosis index was calculated as thequotient of LDL and HDL cholesterol concentration,and the risk factor as the ratio between total and HDLcholesterol. Investigation resulted in the followingmean values: total cholesterol 5.38±1.17 mmol/L,triglycerides 1.64±0.97 mmol/L, HDL-cholesterol1.27±0.33 mmol/L, LDL-cholesterol 3.37±1.06mmol/L, IA 2.85±1.25 and FR 4.20±1.93.Obtained results point to the presence of the lipid ori-gin atherosclerosis risk in voluntary blood donors anddonors included in the plasmapheresis program,despite the fact that they belong to the healthiest partof the population. It shows the necessity to apply ade-quate hygiene and dietary nutrition and appropriatephysical activities.

J Med Biochem 2015; 34 (1) 85

P019NERACIONALNA UPOTREBA

LABORATORIJSKIH TESTOVA ZAEVALUACIJU TIROIDNE FUNKCIJE

Vera Luki}

Biohemijska laboratorija, Zavod za zdravstvenu za{titu radnika »@eleznice Srbije«, Beograd

U laboratorijskoj evaluaciji funkcije {titaste`lezde, vodi~i klini~ke prakse preporu~uju vi{estepenipristup u ~ijem je prvom koraku odre|ivanje tire-ostimuliraju}eg hormona (TSH). Tek ako je vrednostTSH izvan referentnog opsega potrebni su daljitestovi, kao {to je slobodni tiroksin (FT4). Me|utim,bez obzira na jasne preporuke, u svakodnevnoj labo-ratorijskoj praksi sre}emo se sa neracionalnim zahte-vima za ispitivanje tiroidne funkcije. U ovom raduanalizirani su rezultati tiroidnih testova 1113 pacije-nata Biohemijske laboratorije ZZZR »@elezniceSrbije« u Beogradu sa ciljem da se utvrdi procenatnepotrebno tra`enih testova. U analizu su uklju~enisamo pacijenti koji se prvi put upu}uju u na{u labo-ratoriju radi testiranja tiroidne funkcije u okviru sis-tematskog pregleda, a tra`eni su im istovremeno iTSH i FT4. Svim pacijentima su TSH i FT4 odre|ivanihemiluminiscentnim mikro~esti~nim imunodre|iva -njem, reagensima proizvo|a~a Abbott na analizatoruArchitect i 2000. Na|eno je da su i TSH i FT4 bili ureferentnom opsegu kod 92% pacijenata. Oba testasu bila izvan referentnog opsega kod 2% pacijenata.TSH je bio izvan referentnog opsega, a FT4 u okvirunjega kod 6% pacijenata. Ni kod jednog od ovih paci-jenata nije se desilo da je TSH u okviru referentnogintervala, a FT4 izvan njega. Dobijeni rezultati ukazu-ju na vrlo visok procenat nepotrebnog ordiniranjatestova za procenu tiroidne funkcije. Odre|ivanjesamo TSH u op{toj populaciji na svakih 5 godina imasvoje upori{te u va`e}im vodi~ima. Tek ako je onizvan referentnog opsega treba tra`iti i FT4, {topotvr|uju i rezultati ovog rada. Neracionalni zahteviza izvo|enje laboratorijskih testova tro{e vreme imaterijalna sredstva, a bez koristi po pacijenta idono{enje klini~kih odluka.

P019UNNECESSARY TESTS IN

LABORATORY EVALUATION OF THYRIOD FUNCTION

Vera Luki}

Clinical Biochemistry Laboratory, Railway Healthcare Institute, Belgrade

In laboratory evaluation of thyroid function,guidelines recommend step-by-step approach. Firststep is thyroid stimulating hormone (TSH) determi-nation. If its level is outside the reference range,other tests, like free thyroxin (FT4), are necessary. Inspite of these clear recommendations, in routine lab-oratory practice we often have requests for unneces-sary thyroid function tests. In this paper, thyroid func-tion tests results of 1113 patients of our laboratorywere evaluated with aim to determine the rate ofunnecessary test utilization. Only patients who aresent to our laboratory for the first time thyroid func-tion evaluation during their routine health check andhave simultaneously ordered TSH and FT4 wereincluded in analysis. TSH and FT4 were determinedby chemiluminescent microparticle immunoassay onAbbott analyzer Architect i2000. Analyzed datashowed that both TSH and FT4 were within refer-ence range in 92% of the patients. Both tests wereoutside of reference range in 2% of the patients. TSHwas outside and FT4 within reference range in 6% ofthe patients. No patients in this study had TSH with-in and FT4 outside the reference range. Theseresults reveal high percentage of unnecessary order-ing of thyroid function tests. It can be concluded thatthese results support recommendations that at thefirst evaluation of thyroid function only TSH determi-nation is sufficient and a kind of screening using TSHcan be made every five years in healthy population.Only if TSH is outside the reference range additionaltests like FT4 should be ordered. Unnecessary test-ing makes time loss and financial costs to the labora-tory and provides no benefit for the patients or clini-cal decision making.

86

P020UTICAJ SMANJENE

KONCENTRACIJE ALBUMINA NA RAZVOJ

SENILNE DEGENERACIJE MAKULE

Emina ^olak1, Svetlana Ignjatovi}1, AleksandraRadosavljevi}2, Natalija Kosanovi}-Jakovi}2

1Centar za medicinsku biohemiju, KCS i Farmaceutski fakultet Univerziteta

u Beogradu,2Klinika za oftalmologiju KCS,

Odeljenje »Medical Retina« i Medicinski fakultetUniverziteta u Beogradu

Na{a prethodna istra`ivanja su pokazala da jesenilna degeneracija makule propra}ena zna~ajnimsmanjenjem koncentracija pojedinih antioksidantnihjedinjenja u serumu. Serumski albumin je dobro po -znat »scavenger« slobodnih radikala. Cilj ovog rada jebio da se odrede koncentracije serumskog albuminakod pacijenata sa senilnom degeneracijom makule(AMD) i da se ispita postojanje mogu}e asocijacijeizme|u ovog parametra i ravoja AMD-a. Ispitano jeukupno 110 pacijenata sa senilnom degeneracijommakule, starosti 71.5±7,1 god. i 87 zdarvih ispita -nika iste starosti, koji su ~inili kontrolnu grupu.Statisti~ka evaluacija rezultata je vr{ena kori{}enjemStudentovog t-testa, ANOVE i Pearsonove korelacije.ROC analiza je kori{}ena za odre|ivanje cut-off vred-nosti, a logisti~ka regresiona analiza za odre|ivanjemogu}e asocijacije izme|u koncentracije albumina irazvoja AMD-a. Reyultati ispitivanja ukazuju da AMDpacijenti imaju zna~ajno ni`e koncentracije albumina(43,4±2,57 g/L) u odnosu na kontrolnu grupu(44,8±2,78 g/L) (p<0,000). Cut-off tj. grani~nevrednosti albumina za razvoj AMD-a su bile 43 g/L(AUC=0,68; SE=0,041, 95%CI 0,603–0,745,Oset ljivost testa 55%, a Specifi~nost od 77%).Zna~ajna asocijacija je dobijena izme|u koncen-tracije albumina i razvoja AMD-a (OR: 1,25; 95%CI1,11–1,41; c2=15,45, P=0,000), a naro~itoizme|u sni`ene vrednosti albumina (<43 g/L) irazvoja AMD-a (OR: 3,95; 95%CI 2,12–7,39;c2=20,13; P<0.000). Na osnovu sprovedenihistra`ivanja mo`e se zaklju~iti da je smanjena koncen-tracija albumina u serumu (ispod 43 g/L), zna~ajnoasocirana sa nastankom senilne degeneracijemakule.

P020THE IMPACT OF DECREASED

ALBUMIN LEVELS TO THE DEVELOPMENT OF AGE-RELATED

MACULAR DEGENERATION IN HUMANS

Emina ^olak1, Svetlana Ignjatovi}1, AleksandraRadosavljevi}2, Natalija Kosanovi}-Jakovi}2

1Institute of Medical Biochemistry, Clinical Centre of Serbia and School of Pharmacy,

University of Belgrade, Serbia2Institute of Ophthalmology, Medical Retina

Department, Clinical Centre of Serbia and MedicalSchool, University of Belgrade, Serbia

Our previous studies showed significantlydecreased levels of some antioxidant substances inpatients with age-related macular degeneration(AMD). Albumin is well known as significant »scav-enger« of free radicals in humans. The aim of thisstudy was to analyze the concentration of serumalbumin in patients with AMD, and to investigate thepossible association of this parameter with the devel-opment of AMD. A total of 110 AMD patients agedof 71.5±7.1 yrs. and 87 healthy age-matched con-trol subjects were enrolled in the study. For statisticalevaluation of the results, Student’s t-test, ANOVAand Pearson correlation test were used. ROC analysiswas used to determine the cut-of values relevant forAMD development and logistic regression analysiswas used for modelling the association of albuminwith AMD development. Results indicated that AMDpatients had significantly lower serum albumin con-centration (43.4±2.57 g/L) compared to the con-trols (44.8±2.78 g/L) (p<0.000). The cut-of albu-min values for development of AMD were 43 g/L(AUC=0.68; SE=0.041, 95%CI 0.603–0.745,Sensitivity 55%, Specificity 77%). A significant associ-ation was obtained between albumin values anddevelopment of AMD (OR: 1.25, 95%CI 1.11–1.41,c2=15.45, P=0.000), especially between decreasedalbumin values (<43 g/L) and AMD (OR: 3.95,95%CI 2.12–7.39; c2=20.13; P<0.000). Based onthe obtained results it may be concluded thatdecreased albumin values, beyond the cut-of valuesare highly associated with development of age-relat-ed macular degeneration in humans.

J Med Biochem 2015; 34 (1) 87

P021KVALITET ODRE\IVANJA

BIOHEMIJSKIH PRAMETARASCREENING-A U DRUGOMTRIMESTRU TRUDNOĆE

Anica \or|evi}1, Neda Milinkovi}1, Ivana Draga{evi}1, Marijana Dajak1,

Svetlana Ignjatovi}1,2

1Slu`ba za poliklini~ku laboratorijsku dijagnostiku,Centar za medicinsku biohemiju,

Klini~ki centar Srbije, Beograd2Univerzitet u Beogradu, Farmaceutski fakultet,

Katedra za medicinsku biohemiju

U prenatalnoj dijagnostici se koristi relativno veli-ki broj testova, pomo}u kojih mo`e da se proceni rizikod patolo{kih trudno}a. Obaveza svake laborato rijekoja se bavi odre|ivanjem biohemijskih parame taraprenatalnog screening-a je da sprovodi unu tra{nju ispolja{nju kontrolu kvaliteta po preporu kama Orga -nizacije koja se bavi prenatalnom dijagnostikom (FetalMedicine Foundation, FMF) i drugih profesionalnihorganizacija. Cilj ove studije je bio da se ispitaju para-metri koji uti~u na kontrolu kvaliteta biohemijskihtestova u drugom trimestru trudno}e, kao i da seustanovi da li se po{tuju neke od preporuka iz FMF.Odre|ivane su koncentracije biohemijskih parametarakod 60 trudnica u drugom trimestru trudno}e (quadtest): a-fetoprotein (AFP) i humani horionski gona -dotropin (hCG) ECLIA metodom, nekonjugovani estri-ol (uE3) i dimerni inhibin A (DIA) CLIA metodom.Analizom odgovaraju}ih komercijalnih kontrola zasvaki biohemijski parametar prenatalnog screening-autvr|eno je da su metode odre|ivanja ta~ne i pre-cizne. Dobijene su zadovoljavaju}e vrednosti z-scoraza AFP, hCG i uE3 aktivnim u~e{}em u spolja{njojkontroli kvaliteta UKNEQUAS, ~ime je obezbe|enokontinuirano kontrolisanje odre|ivanja. Pra}enjemMoM vrednosti u quad testu u odnosu na te`inu trud-nice, gestacijsku nedelju i kretanje vrednosti na me -se~nom nivou zadovoljene su preporuke FMF-a.Utvr|eno je da su medijane MoM vrednosti bile u pre-poru~enim granicama (1 MoM ± 10%). Tako|e suanalizirane vrednosti log MoM, pomo}u ANOVAstatis ti~ke metode i dobijeno je statisti~ki zna~ajno sla-ganje u vrednostima log MoM AFP, hCG, uE3 i DIA(0,656; 0,477; 0,636 i 0,365, p<0,001). Neop ho -dno je da se omogu}i laboratorijama da kontroli{uvrednosti medijana kao i da se postigne ve}a usa gla -{enost u izra~unavanju specifi~nog rizika za Down-ovsindrom.

P021 QUALITY OF DETERMINATION OFBIOCHEMICAL PARAMETERS OF

SCREENING IN THE SECONDTRIMESTER OF PREGNANCY

Anica \or|evi}1, Neda Milinkovi}1, Ivana Draga{evi}1, Marijana Dajak1,

Svetlana Ignjatovi}1,2

1Department of polyclinic laboratory diagnostics,Center for Medical Biochemistry,

Clinical Center of Serbia, Belgrade2University of Belgrade, Faculty of Pharmacy,

Department of Medical Biochemistry

Prenatal diagnosis implies relatively large num-ber of tests, by which it can be possible to estimatethe risk of a pathological pregnancy. The obligationof each laboratory for biochemical parameters of pre-natal screening is to conduct internal and externalquality control, according to the recommendations ofthe Fetal Medicine Foundation (FMF) and other pro-fessional organizations. The aim of this study was toinvestigate the parameters that influence the qualitycontrol of biochemical tests in prenatal screening,and to establish whether they comply with someof the recommendations of FMF. The followingbiochem ical parameters were determined in 60 preg-nant women in the second trimester (quad test):a-fetoprotein (AFP) and human chorionic gonado -tropin (hCG) (ECLIA), unconjugated estriol (uE3) anddimeric inhibin A (DIA) (CLIA). The analysis of thecommercial controls for each biochemical parameterof prenatal screening revealed that the determiningmethods were accurate and precise. We obtainedcorresponding values of z-score for AFP, hCG anduE3 with active participation in external quality con-trol UKNEQUAS, which provided continuous moni-toring of AFP, hCG and uE3. Monitoring of the MoMvalues in quad test in relation to maternal weight,gestational week and the fluctuation of monthly val-ues fulfilled the recommendations FMF. It was foundthat the median MoM values were within recom-mended limits (MoM 1 ± 10%). We also analyzedthe values of log MoM, using ANOVA statisticalmethods and there were statistically significantagreement in the values of log MoM AFP, hCG,uE3 and DIA (0.656, 0.477, 0.636 and 0.365,p<0.001). It is necessary to enable the laboratory tocontrol the median value and to obtain a higher com-pliance of the calculation of the specific risk ofDown’s syndrome.

88

P022EVALUACIJA ODRE\IVANJA HBA1CNA BIOHEMIJSKOM ANALIZATORU

ADVIA 2400

Ivana Draga{evi}1, Neda Milinkovi}1, Anica \or|evi}1, Marijana Dajak1,

Svetlana Ignjatovi}1,2

1Slu`ba za poliklini~ku laboratorijsku dijagnostiku,Centar za medicinsku biohemiju,

Klini~ki centar Srbije, Beograd, Srbija2Katedra za medicinsku biohemiju,

Farmaceutski fakultet, Univerzitet u Beogradu, Srbija

Odre|ivanje HbA1c predstavlja osnov pra}enjadugoro~ne kontrole {e}erne bolesti. Zbog toganjego vo odre|ivanje zahteva visoku analiti~ku pre-ciznost. Cilj rada je bio da se procene analiti~ke per-formanse imunoturbidimetrijske metode za odre|i -vanje HbA1c na biohemijskom analizatoru ADVIA2400 i da se uporede rezultati merenja sa biohemi-jskim analizatorom Architect ci 8200. Nepreciznost izdana u dan i u seriji odre|ivana je sa dva nivoa ko -mercijalne kontrole (Diabetes 1 i 2, Biorad). HbA1cje odre|ivan u 50 uzoraka pune krvi uzetih od paci-jenata sa {e}ernom bolesti, metodom imunotur-bidimetrije sa predtretmanom (Architect ci 8200) ibez predtretmana (Advia 2400). Analizirane su trigrupe vrednosti HbA1c: grupa I (4,0−6,5%), grupaII (6,5−9,0 %) i grupa III (>9,0%). Dobijena je sta-tisti~ki zna~ajna korelacija (p < 0,05) izme|u dvaanalizatora u grupi I (r=0,98), grupi II (r=0,97) igrupi III (r=0,95). Za nepreciznost iz dana u dandobijeni koeficijenti varijacije bili su CV=3,3% iCV=3,0%, za kontrole 1 i 2, a za nepreciznost u ser-iji koeficijenti varijacije su bili CV=3,1% i CV=2,9%.Srednje vrednosti apsolutnih razlika sa Bland-Altmanovog dijagrama su bili: – 0,0125% (grupa I),– 0,141 (grupa II), i – 0,825 (grupa III). Dobijenirezultati ukazuju da postoji dobro slaganje vrednostiHbA1c na dva razli~ita analizatora, kao i da metodabez predretmana daje odgovaraju}e rezultate.

P022EVALUATION OF HBA1C

MEASURMENT ON BIOCHEMICALANALYZER ADVIA 2400

Ivana Draga{evi}1, Neda Milinkovi}1, Anica \or|evi}1, Marijana Dajak1,

Svetlana Ignjatovi}1,2

1Department of Polyclinic Laboratory Diagnostics,Center for Medical Biochemistry,

Clinical Center of Serbia, Belgrade2University of Belgrade, Faculty of Pharmacy,

Department of Medical Biochemistry

Measurement of HbA1c is the basis for moni-toring long-term control of diabetes. Therefore, highanalytical precision is required. The aim of this studywas to evaluate the analytical performance ofimmunoturbidimetric assay for the measurement ofHbA1c by biochemical analyzer ADVIA 2400 and tocompare them with the results obtained on biochem-ical analyzer Architect ci 8200. Within and betweenday imprecision was determined with two levels ofcommercial control (Diabetes 1 and 2, Bio-rad).HbA1c was measured in 50 whole blood samplestaken from the patients with diabetes mellitus, byimmunoturbidimetric method with pretreatment(Architect ci 8200) and without pretreatment (Advia2400). Three groups of HbA1c values were ana-lyzed: group I (4.0–6.5%), group II (6.5–9.0%) andgroup III (>9.0%). Statistically significant correlationwas found (p<0.05) between the two analyzers ingroup I (r=0.98), group II (r=0.97) and group III(r=0.96). For day to day imprecision coefficients ofvariation were CV=3.3% and CV=3.0%, and forwithin run imprecision were CV=3.1% andCV=2.9%, for control 1 and 2, respectively. Themean values of the absolute differences with Bland-Altman diagrams were: – 0.0125% (group I), –0141% (group II), and – 0825% (group III). Theresults indicate that there is good agreementbetween the values of HbA1c by two different analyz-ers, and the method without pretreatment gives ade-quate results.

J Med Biochem 2015; 34 (1) 89

P023 ANALIZA UTICAJA

FAKTORA RIZIKA NA LIPIDNI STATUS STUDENATA

NOVOSADSKOG UNIVERZITETA

Dragana Pap1, Emina ^olak2, VojislavRistovski3, Veselin Dickov1, Nada Majki}-Singh2

1Zavod za zdravstvenu za{titu studenata Novi Sad,Odeljenje laboratorijske dijagnostike2Institut za Medicinsku biohemiju,

Klini~ki centar Srbije i Farmaceutski fakultet,Univerzitet u Beogradu

3Institut za KVB Vojvodina, Sremska Kamenica

Cilj na{ih istra`ivanja je bio da se, jednom sve -obuhvatnom analizom studenata, kroz anketu, odre -|en a merenja i laboratorijske analize, stekne uvid unjihovo zdravstveno stanje, kao i navike u ishrani ina~inu `ivota. Ispitivanja su obuhvatila 510 studenatanovosadskog Univerziteta, koji su popunili Anketu saop{tim i li~nim podacima, podacima li~ne i porodi~neanamneze, i dali odgovore na mnoga pitanja koja seodnose na `ivotne navike. Na osnovu analize odgovo-ra u Anketi i prema indexu telesne mase (BMI) ni`imili vi{im od 25 kg/m2 i obimu struka (OS) ni`im ilivi{im od 94 cm za mu{karce (80 cm za `ene) formi-rane su dve grupe studenata, kontrolna (74 studenta)i rizi~na (164 studenta) sa kojima su sprovedena daljalaboratorijska istra`ivanja lipidnog statusa. VrednostiUH , non HDL-hol., LDL-hol., VLDL-hol. i TG su bilestatisti~ki zna~ajno vi{e u rizi~noj u pore |enju sa kon-trolnom grupom. IA, non HDL-hol./ HDL-hol. i FR-UH/HDL-hol. su bili zna~ajno vi{i, dok je HDL-hol.zna~ajno ni`i u rizi~noj u pore|enju sa kontrolnomgrupom (Fisher test, p<0,01). Na ispitivane parame-tre nije uticao pol ispitanika. Ni`e vrednosti lipopro-teina E (Apo E) i lipoproteina A (Lp a) ne ukazuju namogu}u genetsku osnovu dislipidemija u rizi~noj gru -pi studenata. Indikatori gojaznosti BMI i OS i pozitiv-na porodi~na anamneza pokazali su zna ~ajnu pozi-tivnu korelaciju sa biomarkerima lipidnog statusa urizi~noj grupi (p<0,01). Zna~ajna pozitivna korelacijautvr|ena je i za pu{enje i konzumiranje alkohola savrednostima koji defini{u dislipidemije (p<0.01), dokje zna~ajna negativna korelacija utvr|ena izme|ufizi~ke aktivnosti i UH (p<0,05). Parametri lipidnogstatusa i pojedini aspekti nutritivnog statusa pokazalisu zna~ajnu pozitivnu ko re laciju samo za konzumira -nje crnog vina sa vredno stima HDL-hol. (p<0,05), izna~ajnu negativnu kore laciju sa UH, LDL-hol., IA,FR, non HDL, nonHDL/HDL- hol. (p<0,01). Dobijenirezultati ukazuju i da su pove}ani antropometrijskiparametri pra}eni pove}anim lipoproteinskim statu-som u rizi~noj grupi studentske populacije i da jeskrining lipidnog statusa neophodan pogotovo kodonih studenata koji imaju pove}ani rizik za kardio-vaskularne bolesti. Podaci mogu da pru`e dobruosnovu za preduzimanje primordijalnih i primarnihmera prevencije.

P023 ANALYSIS OF THE IMPACT

OF RISK FACTORS ON LIPID STATUSAMONG STUDENTS OF THE UNIVERSITY OF NOVI SAD

Dragana Pap1, Emina ^olak2, VojislavRistovski3, Veselin Dickov1, Nada Majki}-Singh2

1Students Health Protection Institute, Department of laboratory diagnostics, Novi Sad, Serbia

2Institute of Medical Biochemistry, Clinical Center of Serbia and School of Pharmacy,

University of Belgrade 3Institute of Cardiovascular Diseases of Vojvodina,

Sremska Kamenica

The aim of this study was to gain the insight intostudent’s health, nutrition habits and general lifestylewith a comprehensive analysis of the student healthconducting the survey, specific measurements, andlaboratory analyses of lipid status in aim to establishednovel targets for the cardiovascular prevention. Thestudy included 510 students of the University of NoviSad. Based on the analysis of the conducted survey,according to the body-mass index (BMI) lower andhigher than 25 kg/m2 and waist circumference (WC)lower and higher than 94 cm (80 cm for females) theselected group of 238 students was divided into 2subgroups: the control group of 74 students and therisk group of 164 students and the laboratory exami-nations of lipid status were performed. The values ofTCH, LDL-c, non-HDL-c, VLDL-c and TG were signif-icantly higher in the risk group participants than in thecontrol group. The IA, non HDL-c/HDL-c and RF-TCH/HDL-c ratio were also significantly higher, whileHDL-c was significantly lower in the risk group than inthe control group (Fisher test, p<0.01).Lower valuesof lipoprotein E (Apo E) an lipoprotein A (Lp a) don’tindicate possible genetic base of dyslipidemia in therisk group of students. Indicators of obesity BMI andWC and positive family anamnesis showed significant-ly positive correlation with biomarkers of lipid status inrisk group (p<0.01). Significantly positive correlationwas established for smoking and alcohol consumptionwith values which defined dyslipidemias (p<0.01),while significantly negative correlation was establishedbetween physical activity and TCH (p<0.05).Parameters of lipid status and some aspects of nutri-tive status showed significantly positive correlationonly for drinking red wine with HDL-c (p<0.05), andsignificantly negative correlation with TCH, LDL-c, IA,RF, non HDL, nonHDL/HDL-c. (p<0.01). Theobtained results indicate that in creased anthropomet-ric parameters were followed by the increased lipopro-tein status in the risk group and that the screening ofthe lipid status is necessary, especially for those stu-dents who have an increased risk for cardiovasculardisease (CVD). These data can provide a good basisfor taking the primordial and primary prevention.

90

P024 POVEZANOST

HIPERHOMOCISTEINEMIJE I DEFICIJENCIJE ALFA-1-

ANTITRIPSINA KOD BOLESNIKA SA HRONI^NOM OPSTRUKTIVNOM

BOLE[]U PLU]A

An|elo Beleti}1, Du{ko Mirkovi}1,2, Aleksandra Dudvarski-Ili}3,4,

Ljudmila Nagorni-Obradovi}3,4, Branislava Milenkovi}3,4, Mila Ljuji}5,

Valentina \or|evi}5, Dragica Radojkovi}5, Nada Majki}-Singh6

1Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd, Srbija

2Farmaceutski fakultet, Univerzitet u Beogradu, Srbija

3Medicinski fakultet, Univerzitet u Beogradu, Srbija4Klinika za pulmologiju, Klini~ki centar Srbije,

Beograd, Srbija5Institut za molekularnu genetiku i geneti~koin`enjerstvo, Univerzitet u Beogradu, Srbija6Dru{tvo medicinskih biohemi~ara Srbije,

Beograd, Srbija

Hipehomocistenemija (HHcy) u~estvuje u nas-tanku komorbiditeta hroni~ne obstruktivne bolestiplu}a (HOBP): kardiovaskularnih oboljenja, mi{i}nedisfunkcije, osteoporoze, depresije itd. Procenjen jezna~aj povezanosti HHcy i deficijencije alfa-1-anti -tripsina (AATD), genetskog faktora rizika za HOBP.Istra`ivanje je uklju~ilo 50 bolesnika (28 mu{karaca i22 `ene, starosti 49,0±14,5 godina) kojima jeHOBP dijagnostikovana pre 45. godine `ivota.Homo cistein (Hcy) je odre|ivan u serumu, CMIAmetodom, i HHcy definisana kao koncentracija iznad12 mmol/L. Za detekciju AATD je kori{}en algoritamkoji uklju~uje imunonefelometriju, PCR i reverznuhibridizaciju sa alel-specifi~nim oligonukleotidima,izoelektri~no fokusiranje i sekvenciranje DNK. U sta-tisti~koj analizi kori{}eni su Spearman-ova korelacija,Kruskal-Wallis, c2 i Fisher exact testovi, kao ilogisti~ka regresija. Koncentracija Hcy (medijana(interkvartilni raspon)) je iznosila 13,22 (11,48–16,08) mmol/L, a HHcy je uo~ena kod 36 ispitanika.AATD je bila prisutna kod 7 (pet sa ZZ i dva saZRetki alel genotipom), dok su 10 ispitanika bili het-erozigotni nosioci (osam sa MZ i dva sa MS geno -tipom). Korelacija izme|u koncentracije alfa-1-anti -tripsina i Hcy (rs=–0,046) nije bila statisti~kizna~ajna (P=0,750). Koncentracija Hcy se nije zna -~ajno razlikovala izme|u ispitanika sa razli~itim geno -tipovima (P=0,115). Pore|enjem bolesnika saAATD, heterozigotnih nosilaca i onih bez AATD nisuuo~ene zna~ajne razlike u koncentraciji Hcy

P024 RELATIONSHIP BETWEEN

HYPERHOMOCYSTEINEMIA ANDALPHA-1-ANTITRIPSIN DEFICIENCY

IN PATIENTS WITH CHRONICOBSTRUCTIVE PULMONARY

DISEASE

An|elo Beleti}1, Du{ko Mirkovi}1,2, Aleksandra Dudvarski-Ili}3,4,

Ljudmila Nagorni-Obradovi}3,4, Branislava Milenkovi}3,4, Mila Ljuji}5,

Valentina \or|evi}5, Dragica Radojkovi}5, Nada Majki}-Singh6

1Center for Medical Biochemistry, Clinical Centre of Serbia, Belgrade, Serbia

2Faculty of Pharmacy, University of Belgrade, Serbia3School of Medicine, University of Belgrade,

Belgrade, Serbia4Clinic for Lung Diseases, Clinical Centre of Serbia,

Belgrade, Serbia5Institute of Molecular Genetics and GeneticEngineering, University of Belgrade, Serbia6Society of Medical Biochemists of Serbia,

Belgrade, Serbia

Hyperhomocysteinemia (HHcy) participates indevelopment of chronic obstructive pulmonary dis-ease (COPD) comorbidities: cardiovascular diseases,muscle dysfunction, osteoporosis, depression etc.Significance of the relationship between HHcy andalpha-1-antitrypsin deficiency (AATD), genetic riskfactor for COPD, was evaluated. Study enrolled 50patients (28 males and 22 females, age 49.0±14.5years) diagnosed with COPD before the the age of45. Homocysteine (Hcy) was measured in serum,using CMIA method and HHcy was defined as con-centration above 12 mmol/L considered. AATD wasdetected with an algorithm including immunoneph-elometry, PCR and reverse hybridization with allelespecific oligonucleotides, isoelectric focussing andDNA sequencing. Sstatistical analysis includedSpearman’s correlation, Kruskal-Wallis, 2 and Fisherexact tests, and logistic regression. Median Hcy con-centration (interquartile range) was 13.22 (11.48–16.08) mmol/L and HHcy was observed in 36 partic-ipants. AATD was present in seven patients (five withZZ and two with ZRare allele genotype), while tenwere heterozygous carriers (eight wit MZ and twowith MS genotype). Correlation between alpha-1-antitrypsin and Hcy concnetrations (rs=–0.046) wasnot statistically significant (P=0.750). Hcy concen-tration did not significantly differ between patientswith the abovementioned genotypes (P=0.115).Comparison of patients with AATD, heterozygouscarriers and those without AATD did not revealed sig-

J Med Biochem 2015; 34 (1) 91

(P=0,785) i u~estalosti HHCy (0,249). Odds ratio(95% interval pouzdanosti) od 0,258 (0,050–1,337)nije ukazao da je AATD zna~ajan faktor rizika zapojavu HHcy (P=0,107). U ispitivanoj grupi bolesni-ka sa HOBP nije pokazana zna~ajna povezanostHHcy i AATD.

nificant differences in Hcy concentration (P=0.785)and HHcy incidence (0.249). Odds ratio (95% confi-dence interval) of 0.258 (0.050-1.337) did not indi-cate that AATD was significant risk factor for HHcyoccurence (P=0.107). In the investigated group ofpatients with COPD the significant relationshipbetween HHcy and AATD was not shown.

P025 KORELACIJE

ANTROPOMETRIJSKIH I ANTIOKSIDANTNIH PARAMETARA

U STUDENTSKOJ POPULACIJI SA POVEĆANIM

KARDIOVASKULARNIM RIZIKOM

Dragana Pap1, Emina ^olak2, Nada Majki}-Singh2

1Odeljenje laboratorijske dijagnostike, Zavod za za{tiru zdravlja studenata, Novi Sad

2Centar za medicinsku biohemiju, KCS,Farmaceutski fakultet

Univerziteta u Beogradu

Poznato je da je gojaznost povezana sa meta -boli~kim sindromom, insulinskom rezistencijom i kar-diovaskularnim rizikom. Cilj ovog rada bio je da seodrede i analiziraju vrednosti antioksidantnih enzima:superoksid dizmutaza (SOD), glutation peroksidaza(GPx) i glutation redukataza (GR) kao i totalnog anti -oksidantnog kapaciteta (TAC) u jednoj grupi gojaznihstudenata i da se utvrdi njihova korelacija sa antro -pometrijskim parametrima: indeksom telesne mase(ITM), obimom struka (OS), obimom kuka (OK) kaoi odnosom struk–kuk (OSK). Dve stotine tridesetosam studenata Novosadskog univerziteta je uklju -~eno u ovu studiju; od toga 126 mu{karaca i 112`ena, prose~ne starosti 22,32 ± 1,85 godina. Naosnovu vrednosti ITM manjeg ili ve}eg od 25 kg/m2

i OS manjeg ili ve}eg od 94 cm (za mu{karce) tj. 80cm (za `ene), cela grupa studenata podeljena je udve podgrupe: Grupu 1 (gojazni) – sa pove}animrizikom za nastanak kardiovaskularnih bolesti i Grupu2 – sa smanjenim rizikom za nastanak istih. Vrednostantioksidantnih enzima je odre|ivana u uzorcima krviuzetih nata{te. Dobijeni rezultati su statisti~kiobra|eni kori{}enjem Studentovog t-testa, Mann-Whitney U-testa i Spearmanovom korelacijom.Statisti~kom obradom podataka dobijeno je da suvrednosti antioksidatnih enzima GPx i GR zna~ajnoni`e u Grupi 1 u odnosu na Grupu 2 (p=0,05 ip=0,0001) kao i vrednosti TAC-a (p<0,0001).Spear manovom korelacijom je dobijeno da ITMzna~ajno korelira sa GPx (r=–0,192; p=0,042), kao

P025 THE CORRELATIONS OF ANTHROPOMETRIC AND

ANTIOXIDANT PARAMETERS IN A STUDENT POPULATION

WITH INCREASED CARDIOVASCULAR RISK

Dragana Pap1, Emina ^olak2, Nada Majki}-Singh2

1Department of Laboratory Diagnostics, StudentsHealth Protection Institute, Novi Sad

2Institute of Medical Biochemistry, Clinical Center of Serbia and School of Pharmacy,

University of Belgrade

It has been reported that obesity is associatedwith metabolic syndrome, insulin resistance, andincreased risk for cardiovascular diseases. The aim ofthis study was to analyze the values of antioxidantenzymes: superoxide dismutase (SOD), glutathioneperoxidase (GPx), glutathione reductase (GR), as wellas the total antioxidant capacity (TAC) in a group ofobese students in order to establish their correlationto anthropometric parameters such as: BMI (bodymass index), WC (waist circumference), HC (hip cir-cumference), and WHR (waist-to-hip ratio) com-pared to non-obese students who comprised the con-trol group (CG). In this study, 238 students from theUniversity of Novi Sad of both sexes (126 men and112 women) with a mean age of 22.32 ± 1.85 yearswere included. According to the body mass index(BMI) lower and higher than 25 kg/m2 and waist cir-cumference (WC) lower and higher than 94 cm (80cm for females) the whole group of 238 students wasdivided into 2 subgroups: the obese group atincreased risk for CVD (Group 1) and the group atlower risk for CVD (Group 2). The activities of antiox-idant enyzmes were determined in fasting blood sam-ples. Statistical evaluation was made using theStudent`s t-test, Mann Whitney U-test and Spearmancorrelation coeficient. Statistical processing datarevealed significantly lower activities of antioxidantenzymes: GPx (p<0.05) and GR (p=0.0001) as wellas TAC (p<0.000) in Group 1 compared to Group 2.Spearmann correlation coeficient showed that BMI

92

i GR (r=–0,252; p=0,008) dok SOD zna~ajno kore-lira sa OS (r=0,314; p=0,001) u Grupi 1. Naosnovu dobijenih rezultata mo`e se zaklju~iti dagojazni studenti sa ve}im vrednostima ITM, OS, OK iOSK imaju ni`u antioksidantnu za{titu, {to rezultujepove}anim oksidativnim stresom koji mo`e predstavi-ti zna~ajan mehanizam razvoja metaboli~kog sindro-ma kod istih.

Klju~ne re~i: antropometrijski parametri, anti -oksidantni enzimi, oksidativni stres, gojaznost

correlated significntly with GPx (r=–0.192;p=0.042), and GR (r=–0.252; p=0.008), whileSOD significantly correlated with WC (r=0,314;p=0,001) in the group of obese students. Based onthe obtained results, it can be concluded that obesestudents with higher values of BMI, WC, HC andWHR had lower antioxidant defense system, resultingin increased oxidative stress which can be an impor-tant pathogenic mechanism of obesity-associatedmetabolic syndrome.

Key words: anthropometric parameters, antioxi-dant enzymes, oxidative stress, obesity

P026 TELEFONSKA KOMUNIKACIJA U SLUŽBI LABORATORIJSKE

DIJAGNOSTIKE

Bojana Lugi}1, Zorica [umarac1, Anica \or|evi}1, Ivana Draga{evi}1,

Svetlana Ignjatovi}1,2

1Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd

2Farmaceutski fakultet Univerziteta u Beogradu

Telefonska komunikacija kao efikasan na~inprenosa informacija je od velikog zna~aja u oblastilaboratorijske dijagnostike, kao i u ostalim domenimazdravstvene nege. Evidencija telefonske komunikaci-je je posebno va`na prilikom usmenog izdavanja hit-nih i kriti~nih vrednosti laboratorijskih rezultata. UCentru za medicnsku biohemiju Klinickog centraSrbije (CMB KCS) vodi se evidencija o telefonskojkomunikaciji sa svim korisnicima laboratorijskih uslu-ga, u skladu sa zahtevom standarda ISO 15189 tj.dokumentima sistema menad`menta kvalitetomCMB KCS. Dokumentovanje telefonskog izve{tavanjaobavlja se kroz obrazac »Telefonsko izve{tavanje CMBKCS OBR-065«. U periodu od 01. 01. 2013. godinedo 01. 07. 2014. godine u Slu`bi za poliklini~ku la -boratorijsku dijagnostiku CMB KCS evidentirano je1819 telefonskih izve{tavanja. Pra}en je procentual-ni odnos izve{tavanja o kriti~nim vrednostima, neis-pravnoj identifikaciji pacijenata, neispravanim uzorci-ma i zahtevima za dodatna ispitivanja, u odnosu naukupan broj telefonskih izve{tavanja. Istovremeno sutelefonskom komunikacijom odeljenja obave{tavanao uzorcima, koji prema zahtevima lekara nisu doneti,kao i o poslatoj nedovoljnoj koli~ini biolo{kog mate -rijala. Pored ovih podataka, u obrazac telefonskogizve{tavanja, potpisom je evidentirana odgovornaosoba koja je informaciju prosledila, uz istovremenouno{enje podataka o odgovornoj osobi sa odeljenja,koja je informaciju primila. Analizom podataka do -

P026 TELEPHONE COMMUNICATION IN SERVICE OF LABORATORY

DIAGNOSTICS

Bojana Lugi}1, Zorica [umarac1, Anica \or|evi}1, Ivana Draga{evi}1,

Svetlana Ignjatovi}1,2

1Center of Medical Biochemistry, Clinical Center of Serbia, Belgrade

2Faculty of Pharmacy, University of Belgrade

Telephone communication as an efficient formof information transfer is of significant importance inthe area of laboratory diagnostics. As in other do -mains of health service documentation of telephonecommunication is especially important when stat andcritical values of laboratory results are being reportedby telephone. The Center of Medical Biochemistry ofClinical Center of Serbia (CMB KCS) has been docu-menting telephone communication on all users oflaboratory services in accordance to standard ISO15189 as well as quality system management proce-dures of CMB KCS. Documenting telephone reportsis conduced through the form »Telephone reportingCMB KCS OBR-065«. During the period fromJanuary 1st 2013. To July 1st 2014. in the Service forpolyclinic laboratory diagnostics of CMB KCS, 1819telephone reports have been documented. The per-centage in relation to summary of telephone reportsfor critical values, misidentified patients, wrong sam-ples and requests for additional investigation hasbeen observed. Following that, departments werebeing informed by telephone communication aboutsamples which hadn’t been received by laboratory aswell as insufficient sample volume of biological mate-rial that had been sent. Beside this data it is requiredthat in the telephone report form the person respon-sible for sending the information is noted by its sig-nature and also the notation of identity of a personresponsible for receiving that information. The analy-

J Med Biochem 2015; 34 (1) 93

bijeno je da se najve}i procenat telefonskog izve{ta -vanja odnosio na neispravnost donetih uzoraka(71,03%). Od toga je 91,64% bilo koagulisanih iuzoraka sa neispravnim odnosom krv-antikoagulans,a 8.36% uzoraka neodgovaraju}eg biolo{kog materi-jala prema zahtevu lekara. Izve{tavanje o kriti~nimvrednostima je iznosilo 4,62%, a izve{tavanje o ne -isprav noj identifikaciji pacijenata 12,48%. Pravo vre -me no telefonsko izve{tavanje i evidentiranje komu ni -kacije koje se obavlja po definisanom postupkupro cedure sistema menad`menta kvalitetom pred-stavlja osnov za postizanje bezbednosti pacijenata ipru`anje kvalitetne zdravstvene usluge. Po{tovanjeve{tina dobre komunikacije koje uklju~uju: ljubaz -nost, posve}enost, koncentraciju i jasno preno{enjeinformacija su od velikog zna~aja za preveniranjegre{aka i sticanje poverenja korisnika laboratorijskihusluga.

sis of data has shown that the greatest percentage oftelephone reporting was about wrong samples(71.03%) of which 91.64% was clotted samples andsamples with inappropriate blood-anticoagulant vol-ume ratio and the other 8.36% of samples were ofinappropriate sample type of biological material inregard to doctor request. The amount of reports oncritical values was 4.62% and the amount of patientmisidentification was 12.48%. Realization of appro-priate timing of telephone reporting and communica-tion documentation which is conducted according todefined procedure of quality system managementrepresents basis for achieving safety of patients andgiving quality health service. Using skills of goodcommunication which are kindness, commitment,concentration and sending the precise information isof great significance for prevention of errors andgaining confidence of users of laboratory services.

P027 U^ESTALOST MUTACIJA FAKTOR V

LEIDEN I PROTROMBIN G20210AKOD BOLESNIKA SA

HRONI^NOM OPSTRUKTIVNOMBOLE[]U PLU]A

– PILOT ISTRA@IVANJE

An|elo Beleti}1, Valentina \or|evi}2,Aleksandra Dudvarski-Ili}3,4, Branislava

Milenkovi}3,4, Ljudmila Nagorni-Obradovi}3,4,Dusko Mirkovi}1,5, Nada Majki}-Singh6

1Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd, Srbija

2Institut za molekularnu genetiku i geneti~koin`enjerstvo, Univerzitet u Beogradu, Srbija

3Medicinski fakultet, Univerzitet u Beogradu, Srbija41Klinika za pulmologiju,

Klini~ki centar Srbije, Beograd, Srbija5Farmaceutski fakultet,

Univerzitet u Beogradu, Srbija6Dru{tvo medicinskih biohemi~ara Srbije,

Beograd, Srbija

Pojava venskog tromboembolizma (VTE) mo`epredstavljati komorbiditet hroni~ne obstruktivnebolesti plu}a (HOBP). Za populaciju obolelih odHOBP za sada nema dovoljno podataka o u~estalostidva naj~e{}a genetska faktora rizika za VTE – mutaci-ja FV Leiden i protrombin G20210A. Cilj istra`iva njaje da utvrdi da li se u~estalost navedenih mutacija ugrupi obolelih od HOBP razlikuje u odnosu na zdraveosobe. Istra`ivanje je sprovedeno na grupi od 50 bo -lesnika (28 mu{karaca i 22 `ene, starosti 49,0±14,5

P027 FREQUENCY OF FACTOR V LEIDEN

AND PROTHROMBIN G20210AMUTATIONS IN PATIENTS

WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

– A PILOT STUDY

An|elo Beleti}1, Valentina \or|evi}2,Aleksandra Dudvarski-Ili}3,4, Branislava

Milenkovi}3,4, Ljudmila Nagorni-Obradovi}3,4,Dusko Mirkovi}1,5, Nada Majki}-Singh6

1Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

2nstitute of Molecular Genetics and GeneticEngineering, University of Belgrade, Serbia

3School of Medicine, University of Belgrade,Belgrade, Serbia

4Clinic for Lung Diseases, Clinical Center of Serbia,Belgrade, Serbia

5Faculty of Pharmacy, University of Belgrade, Serbia6Society of Medical Biochemists of Serbia,

Belgrade, Serbia

Venous thromboembolism (VTE) may occur asa comorbidity of chronic obstructive pulmonary dis-ease (COPD). In the population of patients withCOPD there are no enough data on the frequency ofthe two most common genetic risk factors for VTE –factor V Leiden and prothrombin G20210A. Aim ofthe study was to test whether the frequency of thesemutations in a group of COPD patients differs fromhealthy people. The study was conducted on a groupof 50 patients (28 males and 22 females, age

94

godina) kod kojih je HOBP dijagnostikovana pre 45godine `ivota. Uzorci DNK izolovane iz krvi uzorkova -ne sa natrijum citratom su kori{}eni za analizu prime -nom PCR i reverzne hibridizacije sa alel-spe ci fi~nimoligonukleotidima. U~estalost mutacija je upo re|enasa literaturnim podacima o njihovoj frekvenciji ugrupi od 120 zdravih osoba sa teritorije RepublikeSrbije, primenom Fisher exact testa. Kod bolesnikauklju~enih u istra`ivanje nije detektovano homozigot-no prisustvo mutacije faktor V Leiden, dok je jedanbolesnik bio heterozigotni nosilac. Mutacija protrom-bin G20210A nije bila prisutna u ispitivanoj grupibolesnika ni u homo- ni u heterozigotnom obliku. Upomenutoj grupi zdravih osoba identifikovano jesedam heterozigotnih nosilaca mutacije faktor VLeiden i pet heterozigotnih nosilaca mutacije pro-trombin G20210A. Rezultati statisti~ke analize nisupokazali na postojanje statisti~ki zna~ajne razlike uu~estalosti ispitivanih mutacija (P=0,439 za faktor VLeiden odnosno P=0,171 za protrombin G20210A).U~estalost mutacija faktor V Leiden i protrombinG20210A u ispitivanoj grupi bolesnika sa HOBP sene razlikuje zna~ajno od frekvencija sa kojom senavedene mutacije javljaju u populaciji zdravih osobasa teritorije Republike Srbije.

49.0±14.5 years) diagnosed with COPD before theage of 45. DNA samples isolated from the blood col-lected with sodium citrate were used for the muta-tions’ analyses performed by PCR amplification andreverse hybridization with allele specific oligonucleo -tides. Mutations’ frequencies were compared withpreviously published data obtained in a group of 120healthy persons originating from the Republic ofSerbia. Fisher exact test was used for comparison.Homozygous presence of mutation factor V Leidenwas not detected among patients included in thestudy, while one of them was heterozygous carrier.Prothrombin G20210A mutation was not presentamong patients either in homo- or heterozygousform. In the group of healthy persons seven heterozy-gous carriers of factor V Leiden and five heterozygouscarriers of prothrombin G20210A mutation weredetected. Results of statistical analysis did not indi-cate significant differences in the frequency of inves-tigated mutations between these two groups(P=0.439 for factor V Leiden and P=0.171 for pro-thrombin G20210A). The frequency of mutationFactor V Leiden and prothrombin G20210A in theinvestigated group of patients with COPD is not sig-nificantly different from the frequency with whichthese mutations occur in a population of healthy indi-viduals from the Republic of Serbia.

P028 PRAĆENJE VREDNOSTI

NESPECIFIČNIH PARAMETARAZAPALJENJA KOD BOLESNIKA SA

DIJAGNOZOM INFEKCIJE VIRUSOMINFLUENCE A H1N1 U SRBIJI U PERIODU OD 2009. GODINE

DO 2010. GODINE

Neboj{a Maksi}1, Ivan Milo{evi}2, Sonja Stojakovi}1, Goran Stevanovi}2,

Milo{ Kora}2

1Centar za medicinsku biohemiju2Klinika za infektivne i tropske bolesti

Klini~ki Centar Srbije, Beograd

Za dijagnostiku infekcija, pra}enje njihovogtoka i odgovora na primenjenu terapiju veoma jeva`no odre|ivanje vrednosti nespecifi~nih para-metara zapaljenja kao {to su brzina sedimentacijeeritrocita (SE), koncentracija fibrinogena, C reak-tivnog proteina (CRP) i prokalcitonina (PCT). U tokupandemije izazvane virusom gripa Influenza A H1N1tokom 2009/10. godine, opisane su razli~ite formebolesti: od blagih inflamacija gornjih respiratornihputeva, preko inflamacije donjih respiratornih puteva(razli~ite forme bronhitisa i pneumonija), pa sve do

P028 THE MONITORING OF

NON-SPECIFIC PARAMETERS OF INFLAMMATION IN PATIENTS

DIAGNOSED WITH A H1N1 INFLUENZA VIRUS IN SERBIA

SINCE 2009 UNTIL 2010

Neboj{a Maksi}1, Ivan Milo{evi}2, Sonja Stojakovi}1, Goran Stevanovi}2,

Milo{ Kora}2

1Center of Medical Biochemistry, Clinical Center of Serbia, Belgrade

2Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade

For the diagnosis of infection, monitoring theircourse and response to therapy is very important todetermine the value of non-specific parameters ofinflammation, such as erythrocyte sedimentation rate(SE) , the concentration of fibrinogen, C-reactive pro-tein (CRP) and procalcitonin (PCT). During the pan-demia caused by influenza virus A H1N1 in 2009 /10th yr. different forms of the disease weredescribed: from mild inflammation of the upper res-piratory tract, through inflammation of the lower res-piratory tract (different forms of bronchitis and pneu-

J Med Biochem 2015; 34 (1) 95

te{kih klini~kih slika pra}enih pojavom adultnog res-piratornog distres sindroma (ARDS). Istra`ivanje jeimalo za cilj da analizira zna~aj nespecifi~nih para-metara zapaljenja kod bolesnika prilikom prijema iotpusta iz bolnice, kako kod onih sa, tako i bolesnikabez pneumonije, a potom i da se te vrednosti upo -rede kod slu~ajeva sa intersticijumskom (najverovat-nije gripoznom) i segmentnom/lobarnom (bakte rij -skom) pneumonijom. U Klinici za infektivne i tropskebolesti tokom perioda jun 2009. – februar 2010.le~eno je ukupno 340 bolesnika sa klini~kom slikomgripa, od kojih je kod 63 bolesnika dokazana infekci-ja virusom Influenze H1N1. Za virusolo{ku dijagnozuove infekcije kori{}en je test lan~ane reakcijepolimerizacije (Polymerase Chain Reaction, PCR) zadetekciju virusne RNK, iz brisa nazofarinksa. Prilikomprijema u bolnicu i pred otpust bolesnicima odre -|ivane su vrednosti SE, fibrinogena, CRP i PCT. Odukupno 63 bolesnika, 46 (73%) je imalo pneumoni-ju i to: 41 bolesnik (89,13%) imao je intersticijumskupneumoniju, a 5 (10,87%) bolesnika imalo je lobar-nu tj. segmentnu pneumoniju. Analiza vrednosti ne -specifi~nih parametara zapaljenja prilikom prijema ubolnicu ispitanika sa i bez pneumonije je pokazala dabrzina SE i vrednosti fibrinogena nisu bile zna ~ajnorazli~ite (p=0,209, p=0,622 pojedina~no), ali sukod bolesnika sa pneumonijom bile zna~ajno ve}ekoncentracije CRP i PCT (p=0,001, p=0,001 poje-dina~no). Pra}enje nespecifi~nih parametara zapa -ljenja kod bolesnika sa H1N1 infekcijom omogu}ava»prepoznavanje« bolesnika sa komplikacijama, nji-hovu pravovremenu hospitalizaciju i ranije zapo ~i -njanje antivirusne i antibiotske terapije.

monia), to severe clinical features accompanied bythe emergence of adult respiratory distress syndrome(ARDS). The study was aimed to analyze the signifi-cance of non-specific inflammatory parameters inpatients on admission and discharge from the hospi-tal, as those with, and those without pneumonia, andthen to compare these values with the cases withinterstitial and segmental / lobar (bacterial) infec-tions. A total of 340 patients with clinical signs ofinfluenza, out of whom 63 patients with proven infec-tion by influenza virus H1N1 were treated at theClinic for Infectious and Tropical Diseases during theperiod of June 2009. – April 2010. The polymerasechain reaction, (PCR) test was used for the detectionof viral RNA in nasopharyngeal swabs, in order todiagnose the viral infection. On hospital admissionand before discharge of patients the followingparameters were determined: erythrocyte sedimenta-tion rate (SE), fibrinogen, CRP and PCT concentra-tion. Out of 63 patients, 46 (73%) had pneumonia,41 patients (89.13%) had interstitial pneumonia, and5 (10.87%) patients had lobar ie. segmental pneu-monia.The analysis of the non-specific inflammatoryparameter values on patients admission with andwithout pneumonia, showed that the SE and fibrino-gen were not significantly different (p=0.209,p=0.622 respectively), but the patients with pneu-monia had significantly higher concentrations of CRPand PCT (p=0.001, p=0.001 respectively). Mon i -toring of non-specific inflammatory parameters inpatients with H1N1 infection allows »identification«of patients with complications, their timely hospital-ization and early initiation of antiviral and antibiotictherapy.

P029 BIOMARKERI KOD PACIJENATA

SA KRVARENJEM PRI PRIMARNOJPERKUTANOJ KORONARNOJ

INTERVENCIJI

Daniela Bartolovi}1, Dragan Mati}2, Sanja Stankovi}1

1Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd, Srbija

2Klinika za kardiologiju, Klini~ki centar Srbije,Beograd, Srbija

Kao najzna~ajniji faktor mortaliteta kod pacije-nata sa akutnim koronarnim sindromom (ACS) suhemoragijske komplikacije. Cilj rada je bio odre|iva -nje biomarkera kod pacijenata koji su bili podvrgnutiprimarnoj perkutanoj koronarnoj intervenciji (PCI).Analizirani su STEMI pacijenti (643) kod kojih jera|ena primarna PCI izme|u 11/2006 i 7/2009.

P029 BIOMARKERS IN BLEEDING

PATIENTS UNDERGOING PRIMARYPERICUTANEUS CORONARY

INTERVENTION

Daniela Bartolovi}1, Dragan Mati}2, Sanja Stankovi}1

1Center of Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

2Cardiology Clinic, Clinical Center of Serbia,Belgrade, Serbia

Hemorrhagic complications have emerged asan independent risk factor for subsequent mortality inpatients with acute coronary syndromes (ACS). Theaim of this study was to determinate biomarkers inSTEMI patients undergoing contemporary primaryPCI. All consecutive STEMI patients (643) whounderwent primary PCI between 11/2006 and

96

Masivna krvarenja definisana su prema GUSTO kri-terijumu (Global Use of Strategies to Open OccludedCoronary Arteries). Biomarkeri su odre|ivani stan-darnim laoratorijskim metodama. Masivno krvarenjeuo~eno je kod 30 od 643 STEMI pacijenata sa pri-marnom PCI (4,7%). Pacijenti sa masivnim krvare -njem su bili stariji i uglavnom `ene. Upotrebom mul-tivalentne regresione analize dobili smo statisti~kizna~ajne prediktore masovnog krvarenja, i to: godinestarosti (≥65 godina) (OR=3,01; 95% CI za OR1,19–7,62; p=0,020), hemoglobin (Hb) na prijemu(<120 g/L za `ene i <130 g/L za mu{karce)(OR=2,68; 95% CI za OR 1,07–6,73; p=0,035) ileukociti (WBC) na prijemu (>15×109/L) (OR=2,52; 95% CI za OR 1,03–6,12; p=0,042). Godinestarosti, niska koncentracija hemoglobina i visok brojleukocita na prijemu zna~ajni su faktori rizika za nas-tanak masivnog krvarenja pri izvo|enju primarne PCI.

7/2009 were studied. Major bleeding was definedaccording to the Global Use of Strategies to OpenOccluded Coronary Arteries (GUSTO) study criteria.Biomarkers were determined by standard laboratorymethods. Major bleeding occurred in 30 of 643STEMI patients with primary PCI (4.7%). Patientswith major bleeding were older, more frequentlyfemale. Multivariate logistic regression analysisshowed that significant predictors of major bleedingwere: advanced age (³65 years) (OR=3.01; 95% CIfor OR 1.19–7.62; p=0.020), hemoglobin (Hb) atadmission (<120 g/L for female and <130 g/L formale) (OR=2.68; 95% CI for OR 1.07–6.73;p=0.035) and white blood cell (WBC) at admission(>15×109/L) (OR=2.52; 95% CI for OR 1.03–6.12; p=0.042). Advanced age, low hemoglobinand high WBC at admission are main factors of majorperi-procedural bleeding.

P030 ISPITIVANJE UTICAJA LIPEMIJE

NA TA^NOST ODRE\IVANJA HEMOGLOBINA

Dragana Vukosavljevi}, Marijana Dajak, Olivera Gabri}, An|a ^ukanovi},

Jelena Ra{i}, Zorica [umarac

Centar za medicinsku biohemiju, Klini~ki centar Srbije, Beograd, Srbija

^ak 58% gre{aka u laboratorijskoj hematologijipredstavljaju gre{ke u preanaliti~koj fazi. Modernihematolo{ki analizatori omogu}avaju odre|ivanjekako osnovnih, tako i novih hematolo{kih parame -tara, koji, pre svega, zavise od preanaiti~kih varijabli.Da bi se na pravilan na~in interpretirao laboratorijskirezultat, moraju se uzeti u obzir razli~ite fiziolo{ke var-ijable, postupak venepunkcije i kapilarne punkcije,kao i transport uzoraka. Na odre|ivanje hematolo{kihparametara uti~u brojne interferencije, kao sto suhemoliza, poviseni trigliceridi (TG), krioglobulini,povi{ena koncentracija glukoze, prisustvo hladnihaglutinina. Ispitivanje uticaja povi{enih triglicerida nahematolo{ke parametre obavljeno je na uzorcimavenske krvi kod 140 pacijenata, podeljenih u trigrupe: A (TG: 3–7 mmol/L), B (TG: 7–12 mmol/L) iC (TG>12 mmol/L). Hemoglobin je odre |ivan pre iposle tretmana EDTA uzorka krvi, koji obuhvata cen-trifugiranje uzorka, zamenu plazme identi~nomzapreminom izotona, me{anje uzorka i analizu.Hemo globin je odre|ivan spektrofotome trijskommetodom na HMX-Al analizatoru (Beckman Coulter,Germany). Uzimaju}i u obzir celu ispitivanu popu-laciju, zna~ajna razlika u korelaciji nivoa hemoglobi-na, pre i posle tretmana uzorka, nije prona|ena.Srednje vrednosti hemoglobina u grupama A, B i C,

P030 INVESTIGATION OF EFFECTS OFLIPEMIA ON THE ACCURACY OF

THE HEMOGLOBIN DETERMINATION

Dragana Vukosavljevi}, Marijana Dajak, Olivera Gabri}, An|a ^ukanovi},

Jelena Ra{i}, Zorica [umarac

Center of Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia

Even 58% of errors in hematological determi-nation correspond to errors in pre-analytical phase.Modern hematological analyzers enable determina-tion of standard, as well as new hematologicalparameters, which depend mostly of pre-analyticalvariables. In order to interpret the result in a rightway, it is necessary to take into account differentphysiological variables, venipuncture and capillaryprocedure, as well as the transport of the sample. Itis well known that different interferences, as hemoly-sis, increased triglycerides (TG), cryoglobulins,increased glucose, presence of cold agglutinins, andinfluence on determination of hematological param-eters. Examination of the impact of increased TG onhematology parameters was done using the samplesof vein blood, on 140 patients, separated in threegroups- A (TG: 3–7 mmol/L), B (TG: 7–12 mmol/L),C (TG>12 mmol/L). Hemoglobin was determinedbefore and after the treatment of EDTA-sample. Thetreatment of the EDTA-sample implied »salinereplacement« which included whole blood centrifu-gation, replacement of the plasma with the same vol-ume of saline, mixing the sample and its analyzing.Hemoglobin was determined using spectrophoto-metric method on the HMX-Al analyzer (BeckmanCoulter, Germany). Considering the whole examined

J Med Biochem 2015; 34 (1) 97

pre tretmana uzorka iznose 117.8, 121.2 i 150 g/L,dok nakon tretmana iznose 116.9, 118.6 I 142.2g/L. Za razliku od grupa A i B (p>0.05), u grupi C jeprona|ena zna~ajna razlika u koreleaciji nivoa hemo-globina pre i posle tretmana uzorka (p=0.0019).Lipemija, kao jedna od najuticajnijih interferencija,uti~e na ta~nost odre|ivanja hematolo{kih para-metara, pre svega hemoglobina. Rezultati ove studijesu pokazali da povi{ene vrednosti TG (>12 mmol/L)uti~u na spektrofotometrijsko odre|ivanje hemoglo-bina, zbog povi{enog turbiditeta uzorka. U takvimslu~ajevima neophodno je celokupno sagledavanjarezultata.

population, significant difference in correlation of thelevel of hemoglobin before and after the treatment ofthe sample has not been found. Mean values ofhemoglobin in groups A, B and C, before the treat-ment, are 117.8, 121.2 and 150 g/L and after thetreatment, are 116.9, 118.6 and 142.2 g/L, respec-tively. In the groups A and B significant difference incorrelation of the level of hemoglobin before andafter the treatment has not been found (p>0.05),while in group C has been found (p= 0.0019).Lipemia, as one of the most significant interference,influence the precise determination of laboratoryparameters, especially of hemoglobin. Results of thisstudy have shown that the levels of triglycerides high-er than 12 mmol/L do impact on determining thelevel of hemoglobin using spectrophotometricmethod because of the significant turbidity of thesample. In this situation it is necessary to have abroad overview of the result in order to make theright conclusion.

P031 NIVOI ADIPONEKTINA

I EKSPRESIJA ADIPONEKTINSKIHRECEPTORA KOD PACIJENATA

NA HEMODIJALIZI

Miron Sopi}1, Jelena Joksi}1, Nata{a Bogavac-Stanojevi}1,

Vesna Kalimanovska-Spasojevi}1, Zorana Jeli}-Ivanovi}1, Milica Kravljaca2, Sanja Simi}-Ogrizovi}2,3, Milan Sto{ovi}2

1Katedra za Medicinsku biohemiju, Farmaceutskifakultet, Univerzitet u Beogradu

2Nefrolo{ka klinika, Klini~ki centar Srbije3Medicinski fakultet, Univerzitet u Beogradu

Adiponektin je protein koji sekretuje }elije adi -poznog tkiva. Njegova anit-inflamatorna, anti-atero-gena i anti-apoptotska dejstva ostvaruju se preko re -ceptora ozna~enih kao AdipoR1 i AdipoR2. Prisustvonekoliko tradicionalnih i netradicionalnih faktorarizika kod pacijenta sa bole{}u bubrega u zavr{nomstadijumu ukazuje na veliki rizik od smrti usledkardio vaskularnih komplikacija. Iako je adipo nektinpoznat kao protektitvan molekul, prethodne studijenedvosmislen opokazuju da su njegov inivoi u plazmipacijenata sahroni~nom bole{}u bubrega kao i kodpacijenata na hemodijalizi izuzetno pove}ani. S dru -ge strane, malo se zna o ekspresiji adiponektinskihreceptora kod pacijenata sa oboljenjem bubrega. Ciljna{e studije je bio da se utvrdi da li su nivo cirku li{u -}eg adiponektina i ekspresija adiponektinskih recep-tora u mononuklearnim }elijama periferne krvi

P031 LEVELS OF ADIPONECTIN ANDEXPRESSION OF ADIPONECTIN

RECEPTORS IN PATIENTS ON HEMODIALYSIS

Miron Sopi}1, Jelena Joksi}1, Nata{a Bogavac-Stanojevi}1,

Vesna Kalimanovska-Spasojevi}1, Zorana Jeli}-Ivanovi}1, Milica Kravljaca2, Sanja Simi}-Ogrizovi}2,3, Milan Sto{ovi}2

1Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade2Nephrology Clinic, Clinical Center of Serbia3School of Medicine, University of Belgrade

Adiponectin is a protein secreted by adipose tis-sue, which exerts its anti-inflammatory, anti-athero-genic and anti-apoptotic effects via two receptors,AdipoR1 and AdipoR2. Patients with end-stage kid-ney disease (ESKD) are greatly exposed to high riskof cardiovascular (CV) mortality due to presence ofseveral traditional and nontraditional risk factors. Incontrast to adiponectin protective functions, it hasbeen consistently reported that its levels areincreased in patients with chronic kidney disease(CKD), but not much is known about expression of itsreceptors in patients on hemodialysis. We sought toinvestigate if circulating adiponectin levels and theexpression of AdipoR1 and AdipoR2 in PBMCs arechanged in patients with ESKD compared to healthysubjects. This study included 33 patients (19 malesand 14 females) with ESKD and 33 healthy subjects

98

(PBMC) promenjeni kod pacijenata na hemodijalizi uodnosu na zdrave ispitanike. U ovoj studiji su u~e -stvo vala 33 pacijenta na hemodijalizi (19 mu{karacai 14 `ena) i 33 zdrava ispitanika (15 mu{karaca i 18`ena). Koncentracija adiponektina je merena u plaz-mi ELISA metodom, dok su nivoi AdipoR1 i AdipoR2mRNA u PBMCodre|eni real-time PCR metodom.Nivoi adiponektina su bili zna~ajno vi{i u plazmi paci-jenta u pore|enju sa kontrolonom grupom(p=0,036). Nakon korekcije za godine, BMI i kon-cen-traciju serumskog kreatinina ova razlika je posta-la jo{ zna~ajnija (p=0,027). Ekspresija AdipoR1mRNA je bila zna~ajno ni`a kod pacijenata(p=0,034), dok je ekspresija AdipoR2 mRNA bilagotovo identi~na u obe grupe ispitanika. U grupi pa -cijenata prona|ena je zna~ajna korelacija adipone -ktina sa holesterolom lipoproteina velike gustine(HDL-C) (r=0.584, p=0.001), trigiliceridima (TG)(r=–0.488, p=0.001) i serumskim kreatininom (SC)(r=–0.375, p=0.038). Vi{estrukom regresio nomanalizom (forward metod) utvr|eno je da je u mo delukoga su ~inili: HDL-C, TG i SC, jedini neza visniprediktor koncentracije adiponektina u plazmi pacije-nata HDL-C (R2=0.363, adjR2=0.341, p<0.001).Nedostatak efekata adiponektina usled sma njeneekspresije AdipoR1 kod pacijenata na hemo dijalizimo`e dovesti do kompenzatornog pove}anjaadiponektina. Veza izme|u HDL-C i adiponektina su -geri{e da je ovaj kompenzatorni mehanizam dovoljnosna`an da protektivne funkcije adiponektina kod pa -cijenata na hemodijalizi ne budu kompromitovane.

(15 males and 18 females). Circulating adiponectinlevels were measured by ELISA method, whereasPBMCs’ AdipoR1 and AdipoR2 mRNA levels weredetermined by real-time PCR method. Adiponectinlevels were significantly higher in plasma of patientscompared to control group (p=0.036). After adjust-ment for age, BMI and serum creatinine levels thisdifference have become more significant (p=0.027).Significantly lower expression of AdipoR1 mRNA wasfound in patients PBMCs (p=0.034), whereasAdipoR2 mRNA levels were similarly expressed inPBMCs of both groups. Adiponectin significantly cor-related with high-density lipoprotein cholesterol(HDL-C) (r=0.584, p=0.001), triglycerides (TG)(r=-0.488, p=0.001) and serum creatinine (SC)(r=-0.375, p=0.038), in patients with ESKD.Multiple linear regression analysis using forwardmethod was performed to identify the determinantsof plasma adiponectin concentration in patients.Model included HDL-C, SC and TG. HDL-C wasrevealed as only independent predictor of adipo -nectin in patients with ESKD (R2=0.363,adjR2=0.341, p<0.001). The lack of adiponectineffect due to downregulation of AdipoR1 in patientswith ESKD could induce its counter-regulatoryincrease. Positive association of HDL-C andadiponectin implies that this compensatory mecha-nism is strong enough to keep adiponectin athero-protective functions active in patients with ESKD.

P032DA LI SU AKTIVNOSTI LCAT-E

I CETP-A POVEZANE SA RAZVOJEM HIPERTENZIJE

KOD GOJAZNE DECE?

Jelena Joksi}1, Tamara Gojkovi}1, Osama Bekhet1, Jelena Jana}1,

Aleksandra Zeljkovi}1, Vesna Spasojevi}-Kalimanovska1, Jelena Veki}1, Du{an Paripovi}2,

Amira Peco-Anti}2,3, Zorana Jeli}-Ivanovi}1

1Institut za medicinsku biohemiju, Farmaceutski fakultet, Univerzitet u Beogradu

2Institut za nefrologiju, De~ija univerzitetska bolnica ‘Tir{ova’

3Medicinski fakultet, Univerzitet u Beogradu

Smatra se da je hipertenzija jedna od glavnihkomplikacija de~ije gojaznosti. AteroprotektivnaLCAT (lecitin holesterol aciltransferaza) i proatero-geni CETP (holesterol estar transferni protein) imajubitnu ulogu u metabolizmu HDL-a i mogu uticati na

P032 ARE CETP AND LCAT

ACTIVITIES RELATED TO HYPERTENSION IN

OVERWEIGHT CHILDREN?

Jelena Joksi}1, Tamara Gojkovi}1, Osama Bekhet1, Jelena Jana}1,

Aleksandra Zeljkovi}1, Vesna Spasojevi}-Kalimanovska1, Jelena Veki}1, Du{an Paripovi}2,

Amira Peco-Anti}2,3, Zorana Jeli}-Ivanovi}1

1Department of Medical Biochemistry, Faculty of Pharmacy, Belgrade University

2Institute for Nephrology, Children university hospital ‘Tir{ova’

3School of Medicine, Belgrade University

Hypertension is considered to be one of themajor repercussions of childhood obesity. Athero -protective LCAT (lecithin cholesterol acyltransferase)and proatherogenic CETP (cholesterol ester transferprotein), as important constituents of HDL metabo-

J Med Biochem 2015; 34 (1) 99

razvoj dislipidemije i posledi~ne hipertenzije kod go -jazne dece. Cilj ovog rada bio je da se utvrdi da li suaktivnosti LCAT-e i CETP-a povezane sa razvojemhipertenzije kod gojazne dece. U ovoj studiji u~estvo-valo je 65 gojazne dece (godine=14,2±2,1;BMI=30,0±3,4 kg/m2): 38 sa hipertenzijom (Hgrupa) i 27 sa normalnim krvnim pritiskom (NKPgrupa). Aktivnosti LCAT-a i CETP-a su merene premaFildingovoj metodi: aktivnost LCAT-e je definisanakao smanjenje slobodnog holesterola (SH) u plazminakon dva sata inkubacije na 37 °C; aktivnost CETP-a je definisana kao razlika izme|u smanjenja SH uplazmi, i pove}anja esterifikovanog holesterola uHDL-frakciji plazme, nakon dva sata inkubacije na37 °C. Dobijeni rezultati su pokazali da je H grupaimala ve}u aktivnost CETP-a u odnosu na NKP grupu(76,9(54,6–114,3) mmol/L/h vs. 58,4(41,3–84,6)mmol/L/h; p=0,011). Aktivnost LCAT-enije bilazna~ajno razli~ita izme|u ove dve grupe (111,3(94,5–135,2) mmol/L/h vs. 98,9 (70,8–128,9). Kod svihispitanika, CETP aktivnost je pozitivno korelirala saLCAT aktivnosti (r=0,638; p<0,001). Mo`emozaklju~iti da aktivnost LCAT-a nije zna~ajno prome -njena kod gojazne dece sa hipertenzijom, dok jepove}ana aktivnost CETP-a povezana sa prisustvomhipertenzije kod gojazne dece: CETP mo`e uticati napromenu sastava lipoproteinskih ~estica ka proatero -genom fenotipu, i na taj na~in indukovati dislipide -miju i posledi~no hipertenziju.

lism, could impact on development of dyslipidemia inobesity and subsequent hypertension. The aim of thisstudy was to determine whether CETP and LCATactivity are related to hypertension in obese children.65 obese children (age=14.2±2.1; BMI=30.0±3.4kg/m2) were included in this study: 38 with hyperten-sion (H group) and 27 with normal blood pressure(NBP group). LCAT and CETP activities were meas-ured as described by Fielding: LCAT activity wasdefined as a decrease in whole plasma free choles-terol (FC) after 2 hour incubation at 37 °C; CETPactivity represented the difference between the rateof decrease of whole plasma FC, and the rate ofincrease of CE in HDL fraction, after 2 hour incu -bation at 37 °C. Our results have shown that H grouphad increased CETP activity compared to the NBPgroup (76.9 (54.6–114.3) mmol/L/h vs. 58.4(41.3–84.6) mmol/L/h; p=0.011). LCAT activitydidn’t differ between the two groups (111.3(94.5–135.2) mmol/L/h vs. 98.9 (70.8–128.9). Inall subjects, CETP activity showed positive correlationwith LCAT activity (r=0.638; p<0.001). We canconclude that LCAT activity is not significantly alteredin H group compared to NBP group, while increasedCETP activity is related to hypertension in obese chil-dren: CETP could influence shifting of the composi-tion of lipoprotein particles to proatherogenic pheno-type, thus inducing dyslipidemia, and consequentlyhypertension.

P033RASPODELA SUBFRAKCIJA

LIPOPROTEINA I OKSIDATIVNO-STRESNI STATUS

U PLU]NOJ I VANPLU]NOJSARKOIDOZI

Jasmina Ivani{evi}1, Jelena Veki}1, Aleksandra Zeljkovi}1, Aleksandra Stefanovi}1,

Jelena Kotur-Stevuljevi}1, Zorana Jeli}-Ivanovi}1, Vesna Spasojevi}-Kalimanovska1,

Slavica Spasi}1, Jelica Videnovi}-Ivanov2, Violeta Vu~ini}-Mihailovi}2

1Katedra za medicinsku biohemiju, Farmaceutski fakultet, Univerzitet u Beogradu,

2Institut za plu}ne bolesti i tuberkulozu, Klini~ki Centar Srbije, Beograd, Srbija

Sarkoidoza je inflamatornabolest plu}ne ili van-plu}ne lokalizacije koja se karakteri{e dislipidemijomi povi{enim oksidativnim stresom. U takvim uslovima,lipoproteini niske gustine (engl. LDL) i visoke gustine(engl. HDL) bivaju izlo`eni funkcionalnim promena-ma, {to mo`e da ubrza razvoj ateroskleroze. Ispitivalismo raspodelu LDL i HDLsubfrakcija, markere infla-

P033 LIPOPROTEIN SUBCLASSES

DISTRIBUTION AND OXIDATIVESTRESS STATUS IN PULMONARY

AND EXTRAPULMONARY SARCOIDOSIS

Jasmina Ivani{evi}1, Jelena Veki}1, Aleksandra Zeljkovi}1, Aleksandra Stefanovi}1,

Jelena Kotur-Stevuljevi}1, Zorana Jeli}-Ivanovi}1, Vesna Spasojevi}-Kalimanovska1,

Slavica Spasi}1, Jelica Videnovi}-Ivanov2, Violeta Vu~ini}-Mihailovi}2

1Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade

2Institute for Pulmonary Diseases and Tuberculosis,Clinical Centre of Serbia, Belgrade, Serbia

Sarcoidosis is an inflammatory disease charac-terized by dyslipidemia and elevated oxidative stressshowing pulmonary orextrapulmonary manifesta-tions. In such conditions, low density (LDL) and highdensity (HDL) lipoproteinscan suffer functionalchanges which could accelerate atherosclerosisdevelopment. We decided to explore LDL and HDL

100

macije i oksidativnog stresa u plu}noj (PS) i van -plu}noj (VPS) sarkoidozi. Lipidni, inflamatorni i para-metri oksidativnog stresa su odre|eni u serumu 77pacijenata (53 PS i 24 VPS) i 139 kontrolnih ispitani-ka. Ispitanici u PS i VPS grupama su imali zna~ajnovi{e koncentracije triglicerida (P<0,05), serumskogamiloida A, udeleLDL IVA (P<0,01) i LDLIII i to tal -nog oksidantnog statusa (TOS) (P<0,001) u odnosuna kontrolnu grupu i zna~ajno ni`e udeoLDL I, veli -~inu HDL ~estica, koncentraciju sulfhidrilnih (SH)grupa (P<0,001) i aktivnosti paraoksonaze 1(PON1) (P<0,05). U samoj PS, koncentracija HDL-a(P<0,01), udeliHDL 3a (P<0,05) i LDL IVB(P<0,001) su bili zna~ajno ni`i dok je pro-oksidant-no-antioksidativni balans (PAB) bio zna~ajno vi{i(P<0,05) u pore|enju sa kontrolnom grupom. Zna -~aj ne pozitivne korelacije izme|u HDL 3c i malihHDL ~estica (ssHDL) sa malondialdehidom(P<0,001) i zna~ajne negativne korelacije sa HDL-om, SH grupama i PON1 (P<0,05) su dobijene kodpacijenata sa PS. SH grupe, TOS i PON1 su nezavis-no povezani sa ssHDL ~esticama u plu}noj sarko -idozi. Obe grupe pacijenata se odlikuju inflamacijom,poreme}ajima u lipidnom profilu i pove}anim oksida-tivnim stresom, ali je stepen ovih patolo{kih promenabio izra`eniji u plu}noj bolesti.

subclasses profile, inflammatory and oxidative stressmarkers in pulmonary (PD) and extrapulmonary(EPD) disease. Lipid, inflammatory and oxidativestress status parameters were determined in serum of77 patients (53 PD and 24 EPD) and 139 controls.Both PD and EPD patients had significantly higherconcentrations of triglycerides (P<0.05),serum amy-loid A, proportions ofLDL IVA (P<0.01) and LDLIIIandtotal oxidant status (TOS) (P<0.001) than con-trols and significantly lower proportion of LDL I, HDLparticle size, sulfhydryl (SH) groups (P<0.001) andparaoxonase 1 (PON1) activity (P<0.05). In PD,HDL-c (P<0.01), proportions ofHDL 3a (P<0.05)and LDL IVB (P<0.001) were significantly lowerwhereas pro-oxidant antioxidant balance (PAB) wassignificantly higher (P<0.05) comparing to controlgroup. PD was also characterized by significant posi-tive correlations between relative proportions of HDL3c and small sized HDL (ssHDL) with malondialde-hyde (P<0.001) and by significant negative correla-tions with HDL-c, SH groups and PON1 (P<0.05). InPD, SH groups, TOS and PON1 were also independ-ently associated with ssHDL particles. Both patientsgroups were characterized by inflammation, adverselipoprotein profile and elevated oxidative stress, whilethe extent of these pathological conditions was moreevident in pulmonary group.

P034VREDNOSTI GLUKOZE IZ

KAPILARNE KRVI KOD PACIJENATAKOJI PRIMAJU GLUKOZU

ILI INSULIN

Veroljub Kne`evi}

Slu`ba za laboratorijsku dijagnostiku, Dom zdravlja Kragujevac, Kragujevac, Srbija

Kod kriti~no bolesnih pacijenata koji dobijajuintravenozno glukozu ili insulin, glukoza se prati~esto, i zdravstveni radnici koriste za pra}enje izme|uostalog, glukometre za merenje glukoze iz kapilarnekrvi, koji su pristupa~ni pacijentu. Mi smo ispitivali dali kori{}enje glukometra mo`e da bude pogodno kaoanaliziraju}a metoda za ovu vrstu pacijenata kada jekrv uzeta iz kapilara. Analize iz kapilarne krvi su izve-dene po Accu-Chek Perform od Novartisa. Arterijskai venozna krv uzeta je istovremeno za analizu labora-torijski referentnim metodama (Novartis), kao i apa -ratom za biohemijske analize «Architeckt-c8000».Dodatno, merena je zapremina eritrocita (MCV).Ukupno je uradjeno 26 uzoraka krvi. Glukoza mere-na sa Accu-Chek Perform od Novartisa pokazujevrednosti 7,9 (4,8–15,8) i 8,1 (4,6–16,7) mmol/L.Referentna metoda i biohemijski analizator je izmerio

P034 GLUCOSE VALUES FROM CAPILLARY BLOOD FOR

PATIENTS RECEIVING GLUCOSE OR INSULIN

Veroljub Kne`evi}

Department for Laboratory Diagnostic, »Dom zdravlja Kragujevac«, Kragujevac, Serbia

Critically ill patients who receive glucose/insulintreatment need close glucose control. Point-of-caretesting (POCT) devices are commonly used to moni-tor blood glucose levels. The purpose of our studywas to see if capillary glucose measured with a POCTdevice was acceptable for this group of patients.Glucose values obtained with POCT devices Accu-Chek Performa and Novartis from fingerstick. Thevalues were compared with arterial/venous glucosevalues obtained by laboratory analysis (Modular) anda biochemistry instrument (Architeck-c8000). Inaddition hematocrit (hct) was measured. A total of26 samplings were included. Mean glucose obtainedby Accu-Chek Performa and Novartis 7.9 (4.8–15.8)and 8.1 (4.6–16.7) mmol/L. Mean glucose was 8.6(4.3–17.4) and 8.6 (4.6–17.1) mmol/L from thelaboratory (Modular) and from the biochemistry

J Med Biochem 2015; 34 (1) 101

prose~nu vrednost glukoze 8,6 (4,3–17,4) i 8,6(4,6–17,1) mmol/L. Izmerene glukoze su pokazalesignifikantnu razliku izme|u laboratorijskih refe -rentnih metoda i glukometra (p 0,05). Glukometrine zadovoljavaju zahtev koji se postavlja u ISO15197. Niske vrednosti MCV (<0,40) potcenjujuvrednosti glukoze za 10%. Pomo}u standardizovanihmetoda dokazane su signifikantne razlike izme|uglukometra i laboratorijskih referentnih metoda.Uslov glukometra za ta~nost merenja nije odr`iva,istovremeno izmerene vrednosti glukoze se potcenju-ju kada pacijent ima niske vrednsti MCV-a. Zbog toganije sigurno da je merenje glukometrom dovoljnota~no za kori{}enje kod kriti~no obolelih pacijenata.

instrument (ABL 725). Significant differences werefound between glucose values obtained by the POCTdevices and by the reference laboratory methods(p<0.05). POCT devices do not satisfy the require-ments from ISO 15197. Low hematocrit values (HCT< 0.40) underestimated the glucose values by 10%.Under standardized conditions there was a significantdifference between the glucose results obtained byuse of POCT devices and those obtained by refer-ence laboratory methods. POCT devices do not sat-isfy accuracy requirements and the glucose valuesare underestimated for patients with low hematocrit.Therefore it is uncertain as to whether POCT devicesare precise enough to be used on critically ill patients.

P035SERUMSKI IGG ODGOVOR NA

UOBIČAJENE ANTIGENE HRANEKOD DECE KAO MOGU]I ETIOLO[KI

FAKTOR U POREME]AJIMAAUTISTI^NOG SPEKTRA

Sne`ana Stevanovi}, Mirjana Sarki}, Miodrag ^konjovi}, Aleksandra Zdravkovi}

BioMedica, Institiut za laboratorijsku dijagnostiku,Beograd, Srbija

Poslednjih godina brojni podaci su pokazali daimuni odgovor posredovan IgG, koji sledi nakon izla-ganja odre|enom antigenu iz hrane, ima veliki zna~aju nastanku netolerancije prema namirnici iz kojeantigen poti~e. Ispitivanje dece sa poreme}ajimaautisti~nog spektra (ASD-autism spectrum disorder)je ukazalo da su mogu}i etiolo{ki faktori ovih bolestireakcije preosetljivosti i netolerancije prema hrani.Ova studija je obuhvatila ispitivanje i pore|enje nivoaIgG antitela prema specifi~nim antigenima hrane iidentifikovanje namirnica koje izazivaju najve}i speci-fi~ni IgG odgovor u uzorcima seruma dece stare od2 do 18 godina. Specifi~na serumska IgG antitela suanalizirana metodom ELISA (Allerquant Food AllergyScreening ELISA Kit, Biomerica) na 90 uobi~ajenihnamirnica. Rezultati su pokazali da je 1 od 65 deceimalo negativne vrednosti za svih 90 namirnica, {toje 1,53% od ukupnog broja. Povi{en nivo specifi~nihIgG razli~itog stepena utvr|en je kod 64 dece, {to je98,46% od ukupnog broja. Najve}i nivo specifi~nihIgG utvr|en je kod 28 pacijenata, {to je 43,07% odukupnog broja. 11 namirnica je izazvalo najve}i IgGodgovor, me|u njima posebno mleko, mle~ni pro -izvo di i jaja. Primenom ELISA metode u odre|ivanjuspecifi~nih IgG antitela na antigene koiji poti~u iznamirnica pokazali smo da odre|ene vrste hrane, kao{to su mleko, mle~ni proizvodi i jaja izazivaju najve}iimunogeni odgovor. Odre|ivanje nivoa antitela na

P035 SERUM IGG RESPONSES TO COMMON FOOD ANTIGEN IN CHILDREN AS A POSSIBLE

ETOLOGICAL FACTOR IN AUTISMSPECTRUM DISORDER

Sne`ana Stevanovi}, Mirjana Sarki}, Miodrag ^konjovi}, Aleksandra Zdravkovi}

BioMedica, Institute for Laboratory Diagnostics,Belgrade, Serbia

Accumulated data in recent years have shownthat IgG mediated immune response following expo-sure to a certain food antigen is of great importancein food intolerance reaction. Investigations of chil-dren with autism spectrum disorder (ASD) implicatedfood sensitivity and food intolerance reactions as pos-sible etiological factors. This study involved investiga-tion and comparison of food antigen-specific IgGantibody levels and identification of food items thatelected the greatest IgG response in serum obtainedfrom children age 2 to 18. Serum food antigen-spe-cific IgG antibodies were analyzed with enzyme lin -ked immunosobent assay (AllerquantFoodAllergyScreening ELISA Kit) to 90 common food items.Results showed that food antigen-specific IgG anti-body levels were negative in each food item in 1 outof 65 patients, which is 1.53 % of total number.Elevated levels of various foods in different degreeswere determined in 64 patients, which is 98.46 % oftotal number. Highest positive food-specific IgG lev-els were determined in 28 patients, which is 43.07%of total number. 11 foods elected highest food-spe-cific IgG response, particularly milk, dairy productsand eggs. Applying ELISA method in serum food-specific IgG determination we demonstrated that cer-tain foods, like milk, dairy products and eggs electthe greatest food antigen-specific IgG response.Deter mination of antibody titers to food antigens

102

specifi~ne antigene hrane mo`e da bude svrsishodnoza identifikaciju dece sa ASD, kod kojih primenarestrikcione dijete mo`e da predstavlja medicinskunutritivnu terapiju. Neophodna su dodatna ispitivanjaradi identifikacije fenotipova odre|enih na osnovuodgovora na dijetetske modifikacije.

could be useful to identify the ASD subjects in whomthe implementation of a restriction diet might be con-sidered as medical nutrition therapy. Additional inves-tigations are required in order to identify phenotypesbased on best and no responders to dietary modifica-tions.

P036POVEZANOST

CITOMETRIJSKIH KARAKTERISTIKA LEUKOCITA I PARAMETARA

ANEMIJE

Dragana Toto{kovi}1, Jelena Martinovi}2,Violeta Dopsaj3

1Op{ta bolnica Medigroup, Beograd, Srbija

2Dom zdravlja Rakovica, Beograd, Srbija

3Klini~ki centar Srbije, Farmaceutski fakultet,Beograd, Srbija

Savremeni hematolo{ki analizatori, pored kon-vencionalnih parametara krvne slike, imaju mogu} -nost odre|ivanja i citometrijskih parametara sub -populacija leukocita. Citometrijske karakteristike(CPD) leukocita na Beckman Coulter hematolo{kombroja~u LH750 podrazumevaju srednji volumen neu-trofila i monocita istovremeno daju}i i informaciju onjihovoj heterogenosti. Cilj ove studije je da se ispitapovezanost morfometrijskih karakteristika leukocitaizra`enih kroz CPD i parametara anemije s obziromda u anemiji dolazi i do morfolo{kih promena poje-dinih populacija leukocita. U studiju je uklju~eno 120poliklin~kih pacijenata Klini~kog centra Srbije (71`ena, 49 mu{karaca) sa MCV 80–100 fL i C-reaktiv -nim proteinom manjim od 5 mg/L. Rezulati krvneslike i CPD dobijeni su na Beckman Coulter LH750hematolo{kom broja~u. Podaci za CPD predstavljenisu kroz srednju vrednost i standardnu devijaciju volu-mena, provodljivosti i rasipanja svetlosti neutrofila,limfocita i monocita. Parametri statusa gvo`|a kao ivitamina B12 i folne kiseline: serumsko gvo`|e, fe -ritin, transferin, vitamin B12, serumski folat, folat ueritrocitima, solubilni transferinski receptori i CRPodre|eni su na Olympus AU480® i Access®2(Beckman Coulter Miami, Fl, USA). Pacijenti suprema WHO kriterijumima(Hb 120 g/L kod `ena iHb 130 g/L kod mu{karaca) podeljeni na anemi~ne(66)i one bez anemije (54). Statisti~ka analiza jeura|ena u programu IBM® SPSS® 20. Pore|enjemove dve grupe dobijena je statisti~ki zna~ajna razlikauHb (118.2 g/L vs 141.6 g/L, p=0.000), MCV(90.6 fL vs 92.6 fL, p=0.012), %SAT (19.9% vs

P036 THE RELATIONSHIP OF

MORPHOMETRIC LEUCOCYTEPARAMETERS WITH MARKERS

OF ANEMIA

Dragana Toto{kovi}1, Jelena Martinovi}2,Violeta Dopsaj3

1General Hospital Medigroup, LaboratoryDepartment, Belgrade, Serbia

2Health Center Rakovica, Laboratory Department,Belgrade, Serbia

3Clinical Centre of Serbia, Faculty of Pharmacy,Belgrade, Serbia

Recently, modern hematology analysers havethe ability to determine the morphometric character-istics of leukocyte subpopulations in blood in additionto the conventional CBC. Cell Population Data (CPD)measured on Beckman Coulter LH750 haematologyanalyzer include mean neutrophil and monocyte vol-umes and give more information’s about heterogene-ity of different cell populations. The aim of this studywas to determine relationship of morphometric char-acteristics of leucocytes with markers of anemia, withrespect that certain morphological characteristics ofleucocyte subpopulations follow changes of erythro-cyte morphology. 120 patients, attending thePoliclinic laboratory in Clinical Centre of Serbia (71female, 49 male) with MCV 80–100 fL and hs CRP< 5mg/L, were selected. Blood samples were ana-lyzed for CBC and CPD on the Beckman Coulter LH750 haematology analyzer. Numerical data for CPDwere reported for the mean and standard deviation ofthe volume, conductivity and scatter for the neu-trophils, lymphocytes and monocytes. Biochemicalmarkers of iron deficiency, as well as B12 and folatedeficiency, were determined: serum iron, ferritin,transferrin, vitamin B12, serum and RBC folate, sol-uble transferrin receptor (sTfR) and CRP. These mark-ers were measured using assay kits on OlympusAU480® and Access®2 (Beckman Coulter Miami, Fl,USA). Patients were divided according to WHO ane-mia criteria (Hb<120 g/L in women and Hb<130g/L in men) in anemic (66) and non-anemic (54).Statistical analysis was performed by IBM® SPSS®

20. Sta tistical differences between anemic with non-

J Med Biochem 2015; 34 (1) 103

26.1%, p=0.007), sTfR (1.64 mg/L vs 1.44 mg/L,p=0.005), index sTfR (1.07 vs 0.81, p=0.012),NeMC (146.5 vs 144.6p=0.019), NeMS (151.4 vs149.3 p=0.000), MoMS (127.3 vs 125.3 p=0.000), MoVSD (18.0 vs 17.1 p=0.003), MoSSD(4.6 vs 4.4 p=0.002). Primena ANOVA analizepokazala je zna~ajnu razliku u NeMS izme|u grupasa 145–180 pg/mL i vi{e od 180 pg/mL vitaminaB12 (F=3.384, p=0.034). Rezultati ove studije po -kazuju da srednja vrednost i standardna devijacijavolumena, provodljivosti i rasipanja svetlosti neutrofi-la i monocita kao citometrijske karakteristike leukoci-ta jesu povezane sa parametrima anemije.

anemic group were found in following parameters:Hb (118.2 g/L vs. 141.6 g/L, p=0.000), MCV (90.6fL vs. 92.6 fL, p=0.012), %SAT (19.9% vs. 26.1%,p=0.007), sTfR (1.64 mg/L vs. 1.44 mg/L,p=0.005), index sTfR (1.07 vs. 0.81, p=0.012),NeMC (146.5 vs. 144.6 p=0.019), NeMS (151.4vs. 149.3 p=0.000), MoMS (127.3 vs. 125.3p=0.000), MoVSD (18.0 vs. 17.1 p=0.003),MoSSD (4.6 vs. 4.4 p=0.002). ANOVA showed stat-ically significant differences in NeMS between groupswith B12 145–180 pg/mL and >180 pg/mL(F=3.384, p=0.034). Our results suggest that meanand standard deviation of the volume, conductivityand scatter for neutrophiles and monocytes as mor-phometric characteristics are related to the markersof anemia.

P037PRODUKTI ODMAKLE OKSIDACIJE

PROTEINA I ANTIOKSIDATIVNAZA[TITA U NORMALNOJ TRUDNOĆI

Vidosava Petrovi}1, Jelena O{ap1, VesnaSpasojevi}-Kalimanovska2, Slavica Spasi}2,

Jelena Kotur-Stevuljevi}2, AleksandraStefanovi}2, Daniela Ardali}3, Tatjana ]ebovi}4

1Dom Zdravlja »Novi Sad«, Novi Sad2Farmaceutski fakultet, Univerzitet u Beogradu, Beograd

3Klinika za ginekologiju i aku{erstvo »Narodni Front«, Beograd

4Medicinski fakultet, Univerzitet u Novom Sadu,Novi Sad

Trudno}a je povezana sa promenama u oksi -dativno-antioksidativnom sistemu, sa tendencijompove}anja produkcije slobodnih radikala koje prati ipove}anje antioksidativne za{tite. Produkti odmakleoksidacije proteina (AOPP), su jedan od markeraoksidativnog stresa, koji predstavljaju proteinskeagregate nastale stvaranjem disulfidnih mostovaunakrsnim povezivanjem ditirozina. Tokom ove stu -dije smo pratili promene AOPP i markera antioksida-tivne za{tite, kao i korelaciju izme|u njih, tokom nor-malne trudno}e. Odre|ivane su vrednosti AOPP kaomarkera oksidativnog stresa, slobodnih sulfhidrilnihgrupa (SH) i aktivnost superoksid dismutaze (SOD)kao markera antioksidativne za{tite i prooksidativno-antioksidativni balans (PAB), u serumu 43 trudne`ene u 1-om, 2-om i 3-em trimestru, pre (38-a ne -delja trudno}e) i posle (7 nedelja) poro|aja i u seru-mu 45 `ena koje nisu bile trudne. AOPP je odre|ivanmetodom koju su postavili Witko-Sarsat, SOD jeodre|ivan metodom koju su postavili Mirsa i Fridovic,za odre|ivanje SH grupa kori{}ena je ditiobis-nitro -benzoeva kiselina a PAB je odre|ivan modifikovanov

P037ADVANCED OXIDATION PROTEINPRODUCTS AND ANTIOXIDATIVE

DEFENCE IN NORMAL PREGNANCY

Vidosava Petrovi}1, Jelena O{ap1, VesnaSpasojevi}-Kalimanovska2, Slavica Spasi}2,

Jelena Kotur-Stevuljevi}2, AleksandraStefanovi}2, Daniela Ardali}3, Tatjana ]ebovi}4

1Public Health Service »Novi Sad«, Novi Sad2Faculty of Pharmacy, University of Belgrade,

Belgrade3Clinic of Gynecology and Obstetrics »Narodni

Front«, Belgrade4Faculty of Medicine, University of Novi Sad, Novi Sad

Pregnancy is associated with changes in theoxidative-antioxidative systems with the tendencytowards the increase of free radical production withan accompanying increase in the antioxidativedefense. The values of advanced oxidation proteinproducts (AOPP) are one group of markers of oxida-tive stress which represent protein agregates createdby the formation of disulphide bridges made bycross-bonding of dityrosine. During this study weobserved the changes in AOPP and the markers ofantioxidative defense, as well as the corelationamong them, during a normal pregnancy. We deter-mined the values of AOPP as markers of oxidativestress, free sulfhydryl groups (SH) and activities of theenzym superoxide dismutase (SOD), as markers ofantioxidative defense and pro-oxidative/oxidative bal-ance (PAB) in sera of 43 pregnant women in 1st, 2nd

and 3rd trimester, before (38th week of gestation) andafter (7th week) delivery, as well as in 45 samples ofsera of non-pregnant women. AOPP was determinedby the method established by Witko-Sarsat, SOD bythe method established by Mirsa and Fridovic, SH

104

metodom pomo}u 3, 3’,5, 5’-tetramethylbenzidina.Za pore|enje parametara koristili smo Analizu vari-janse a odnose izme|u njih smo testirali nepara-metarskom Spearmanovom korelacijom. Rezultatipokazuju da vrednosti AOPP progresivno rastu tokomtrudno}e a neposredno pred poro|aj su zna~ajnovi{e u odnosu na vrednosti kod `ena koje nisu biletrudne (p<0,001). Vrednosti ukupnih SH grupatokom prvog i drugog trimestra, kao i neposrednopred poro|aj su zna~ajno ni`e u odnosu na vrednos-ti u ostalim trimestrima trudno}e i u kontrolnoj grupi(p<0,037, p<0,001, p<0,037). Aktivnost SOD sepostepeno pove~ava tokom tre}eg trimestra,neposredno pred poro|aj i posle poro|aja u odnosuna aktivnost kod `ena koje nisu bile trudne (sva trip<0,001). Vrednosti PAB se zna~ajno pove}avaju oddrugog, tokom tre}eg trimestra i neposredno predporo|aj (sva tri p<0,001) u odnosu na vrednosti kod`ena koje nisu bile trudne. Dobijeni rezultati ukazujuda tokom svih perioda trudno}e, vrednosti AOPPpozitivno koreliraju sa vrednostima ukupnih SHgrupa. Neposredno pred sam poro|aj vrednostiAOPP pokazuju zna~ajnu pozitivnu korelaciju savrednostima PAB (r=0,422, p<0,05). Tokom nor-malne trudno}e dolazi do pove}anja oksidativnogstresa ali se tako|e pove}avaju i mehanizmi anti -oksidativne za{tite.

groups were determined by dithiobis-nitrobenzoicacid, while PAB was determined by the modifiedmethod using 3, 3’, 5, 5’- tetramethylbenzidine. Theresults were compared by using the analysis of vari-ance method, while their mutual influences weretested by nonparametric Spearman’s correlation. Theresults show that the values of AOPP increase pro-gressively during pregnancy, immediately beforedelivery they are significantly higher in comparison tothe values obtained from the women who were notpregnant (p<0.001). The values of total free SHgroups during the first and second trimester, as wellas immediately before the delivery, were significantlylower in comparison to the values in other trimestersof pregnancy and in the control group (p<0.037,p<0.001, p<0.037 respectively). The activity ofSOD increases gradually during the third trimester,immediately before the delivery and after the deliveryin comparison to the activity of women who were notpregnant (all three values p<0.001). PAB increasessignificantly starting from the second trimester, dur-ing the third trimester and immediately before thedelivery (all three values p<0.001), in comparison tothe values obtained from the women who were notpregnant. The obtained results indicate that duringall periods of pregnancy the values of AOPP correlatepositively with the values of the free SH groups.Immediately before the delivery the values of AOPPshow a significant positive correlation with the valuesof PAB (r=0.422, p<0.05). During a normal preg-nancy oxidative stress increases, but the mecha-nisims of antioxidative defense increase as well.