1.Lipoprotein (A) biomarkers for clinical practice
Sodgerel B ; Anudari I ; Buyandelger J
Mongolian Medical Sciences 2022;202(4):38-47
A lot of factors can cause coronary heart disease and ischemic stroke including external risk factors such as tobacco, alcohol consumption, decreased physical activity, obesity while arterial maintenance, high blood sugar, increased LDL are internal risk factors. We can reduce our external risk factors by changing our lifestyle. Recent studies have shown increased blood Lp(a) levels are independent risk factor for cardiovascular disease. After 1987, the number of publications has increased since the cDNA homology sequence of Lp(a) and plasminogen 2 was identified. Lp(a) is protein complex consisting from apolipoprotein, phospholipid, free cholesterol, cholesterol esters and tryglyceride. Apoliprotein is a lipid that binds with lipoprotein. Lipoproteins have water-soluble and fat-soluble parts, and those parts bind to lipids and are transported in the bloodstream.How is elevated Lp(a) a risk factor for cardiovascular disease? How much does lowering Lp(a) reduce CVD risk factors? If high Lp(a) concentrations are present, mitigation measures are outlined below.
2.Clinical Significance of BNP and NT-proBNP in Chronic Kidney Disease
Anudari I ; Buyandelger J ; Munkhzul D ; Sodgerel B
Mongolian Medical Sciences 2024;210(4):53-60
Chronic kidney disease (CKD) is a global health issue characterized by a gradual loss of kidney
function over time. As the disease progresses, it leads to an increased risk of cardiovascular
complications, which are the leading cause of morbidity and mortality in CKD patients.
B-type natriuretic peptide (BNP) and its inactive fragment, N-terminal pro b-type natriuretic
peptide (NT-proBNP), are biomarkers widely used in the diagnosis and management of heart
failure. Their role in CKD, however, is complex due to the overlapping pathophysiological
mechanisms between cardiac and renal dysfunctions. This literature review aims to explore
the diagnostic and prognostic value of BNP and NT-proBNP in patients with CKD, highlighting
their clinical relevance, the impact of renal function on their levels, and potential therapeutic
implications. The review focuses on studies published in the last decade, examining the
clinical applications, outcomes, and challenges associated with using BNP and NT-proBNP
as biomarkers in CKD patients.
3.A study of the BALAD model to evaluate the prognosis of liver cancer
Odongoo J ; Solongo E ; Nurlan Kh ; Buyandelger B ; Otgonbyamba D ; Batnasan B ; Bayarmagnai L
Diagnosis 2023;106(3):118-127
Background and Aims:
The BALAD scores are developed to provide an objective determination of prognosis for hepatocellular carcinoma (HCC) by incorporating five serum markers, namely albumin, bilirubin, alpha-fetoprotein (AFP), agglutinin-reactive alpha fetoprotein (AFP-L3), and des-γ-carboxy prothrombin. We aim to study the applicability of BALAD score and prognostication of the three tumor markers, albumin and bilirubin.
Methods:
Patients who were served by clinical laboratory were prospectively enrolled. All the baseline characteristics and serum albumin and bilirubin level were documented at base line. The levels of the three tumor markers (AFP, AFP-L3, and des-γ-carboxy prothrombin) were determined in serum samples. assays of AFP, AFP-L3, and DCP were conducted in the same serum sample by using a microchip capillary electrophoresis and liquid phase binding assay on a μTAS Wako i30 analyzer (Wako Pure Chemical Industries, Ltd, Osaka, Japan). To detect albumin and bilirubin amount were using the cobas 6000 analyzer series that is a fully automated, software-controlled system for immunoassay and photometric analysis intended for qualitative and quantitative in vitro determinations.
Results:
A total of 103 patients who were served by clinical laboratory were recruited. AFP, albumin, bilirubin, DCP and AFP-L3 levels were independent prognostic factors. When the study participants evaluated BALAD scores, 45.63% scored 0 points, 28.16% scored 1 point, 10.68% scored 2 points, 8.74% scored 3 points, 3.88% scored 4 points, 1.94% 5 points, and 0.97% 7 points.
Conclusion
BALAD score is applicable in the population of hepatitis B and C virus related HCC. When AFP L3% increases by one unit, BALAD scores are 0.04 times higher (P=0.0001) that is presenting statistically significance.
4.The prevalence of dyslipidemia and the risk factor for cardiovascular disease
Pilmaa Yo ; Anudari B ; Buyandelger J ; Bayaraa T ; Sodgerel B ; Batbold B
Mongolian Medical Sciences 2023;205(4):84-90
Cardiovascular diseases related death rates have been declining over, but during the two decades,
mortality and morbidity attributable by cardiovascular diseases are continuously taking the first place
among the leading causes of morbidity and deaths among the population. Statistics show that >4
million people die each year from cardiovascular disease (CVD) causes in Europe. The World Health
Organization reports that in less developed and developing countries, obesity and mortality are
expected to continue to increase, depending on the age of the population and the characteristics of
lifestyle.
Dyslipidaemia is characterized by elevated low-density lipoprotein cholesterol (LDL-C) and decreased
high-density lipoprotein cholesterol (HDL-C) and is a known risk factor for development and progression of atherosclerosis in CAD.
Dyslipidemia and hypertension are major risk factors for cardiovascular disease (CVD) and account
for more than 80% of deaths and disability in low- and middle-income countries. Increased serum
levels of total cholesterol (TC), triglycerides (TG), high-density lipid (HDL)-cholesterol and decreased
low-density lipid (LDL)-cholesterol are known to be associated with major risk factors for CVD. The
Framingham study and others that followed could show that HDL-C is an independent cardiovascular
risk factor and that the increase of HDL-C of only 10 mg·L(-1) leads to a risk reduction of 2-3%. A
recent meta-analysis, including 302.430 subjects from 68 long-term prospective studies, supported the
importance of HDL-C measurement in the risk assessment for CAD.
However, data about the relationship between cardiovascular disease and lipid profile among
Mongolian adult are rare in the literature. In recent years, rapid urbanization, unhealthy diet, increased
life expectancy and lifestyle changes have led to an increased rate of CVD around the world.
5.Chronic kidney disease and serum NT-proBNP level
Sodgerel B ; Anudari I ; Buyandelger J ; Pilmaa Yo ; Gantogtokh D ; Yesukhei E ; Bilguun E ; Nyam-Erdene N ; Yundendash D ; Munkhbayar S ; Bolormaa Do ; Sarangerel Ga ; Munkhzul D ; Batbold B ; Sodnomtsogt L
Mongolian Medical Sciences 2024;210(4):9-17
Background:
Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular
dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD),
emphasizing the need for its early detection and prognosis.
Objective:
This study aimed to determine the serum NT-proBNP levels in participants with CKD and
establish a cut-off value for predicting heart failure.
Methods:
A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study
received approval from the Ethics Committee of the Institute of Medical Sciences (Approval
No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology
Department of the third state hospital were enrolled based on predefined inclusion and
exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound
test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence
quantitative analyzer. Data were analyzed with SPSS 26.0.
Results:
The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The
mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences
were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension
between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly
between heart failure and non-heart failure groups (p<0.05). Significant differences were
also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05).
NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted
between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value
for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%,
specificity: 55%).
Conclusion
Serum NT-proBNP levels are elevated in CKD patients regardless of heart
failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure
was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).