1.Kidney Injury Molecule 1 (KIM1) as a Diagnostic Biomarker for Chronic Kidney Disease
Duurenbileg J ; ; Oyunpurev E ; Altansukh S ; Chinzorig B ; Munkhtsetseg J ; Buyankhuu T
Mongolian Journal of Health Sciences 2026;92(2):28-32
Background:
Globally, 697.5 million people—9.1% of the world’s population—suffer from chronic kidney disease (CKD). In Mongolia, diseases of the kidney and urinary tract rank third in overall morbidity and are a leading cause of hospital admissions. Due to the asymptomatic and progressive nature of these diseases, early diagnosis of CKD has become a critical issue in recent years. One such early diagnostic marker is KIM-1 (Kidney Injury Molecule-1). KIM-1 is synthesized in the epithelial cells of the proximal tubule during renal injury and serves as a receptor for the phagocytosis of apoptotic cell debris. It is considered a promising biomarker for the early detection of kidney damage.
Aim:
To evaluate the relationship between KIM-1 (Kidney Injury Molecule-1) and clinical biochemical parameters in patients with chronic kidney disease.
Materials and Methods:
An analytical case-control study was conducted. A total of 54 participants were involved: a case group of 26 and a control group of 28. The case group included 26 patients with chronic kidney disease who were being treated at the Emergency and Internal Medicine departments of the First Central Hospital of Mongolia (FCHM). Serum KIM-1 protein levels were determined using an Enzyme-Linked Immunosorbent Assay (Human Kim-1 ELISA Kit, Cat: ELK2287). Statistical analysis was performed using SPSS-23.0, while text processing and data visualization were conducted using Microsoft Office.
Result:
KIM1 levels are positively correlated with creatinine, urea, uric acid, glucose, and potassium, and inversely correlated with calcium, total protein, and albumin, indicating a correlation with clinical biochemical parameters. The mean level of KIM-1 protein was 1379±208.3 pg/mL in the chronic kidney disease group and 91.19±22.09 pg/mL in the control group, showing a statistically significant difference between the two groups (p<0.0001). ROC analysis for KIM-1 (pg/mL) showed an Area Under the Curve (AUC) of 0.979 (95% CI: 0.951–1.000, p<0.001). The optimal diagnostic cut-off value was determined at KIM-1 236.17 pg/mL, where sensitivity reached 96.2% and specificity 92.9%, with the highest Youden index (0.89).
Conclusion
KIM1 levels were positively correlated with creatinine, urea, uric acid, glucose, and potassium, and inversely correlated with calcium, total protein, and albumin. KIM1 protein levels were significantly higher in patients with chronic kidney disease, suggesting that KIM1 is a highly sensitive and specific biomarker for the diagnosis of CKD.
2.Sex-specific differences in serum neurotrophic and neuromuscular biomarkers in older adults with Sarcopenia
Odgerel Ch ; Erdenesuvd B ; Altankhishig B ; Nomin-Erdene E ; Enguun E ; Saranzayaa S ; Bat-Erdene D ; Tulgaa S ; Munkh-Erdene U ; Nandin-Erdene M ; Oyun-Erdene R ; Tserenvandan Kh ; Ganbaatar B ; Munkhtsetseg J ; Buyankhuu T
Mongolian Journal of Health Sciences 2026;95(5):12-17
Background:
Sarcopenia is a multifactorial geriatric syndrome characterized by age-related loss of muscle mass, muscle strength, and physical performance. In recent years, neurotrophic and neuromuscular biomarkers have been investigated as potential diagnostic indicators of sarcopenia; however, evidence regarding their sex-specific differences remains limited.
Aim:
To evaluate the sex-specific associations of serum BDNF, GDNF, and CAF22 levels with sarcopenia and muscle-related parameters among older adults.
Materials and Methods:
This analytical cross-sectional study included adults aged 60 years and older. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS 2019) criteria. Serum BDNF, GDNF, and CAF22 levels were measured using ELISA. Group differences were analyzed using independent t-tests, correlations were assessed using Pearson correlation analysis, and diagnostic performance for sarcopenia was evaluated using receiver operating characteristic (ROC) analysis. Multivariable logistic regression analysis was also performed.
Results:
No statistically significant differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic participants in either the male or female groups (all p>0.05). ROC analysis demonstrated AUC values ranging from 0.540 to 0.542 in males and from 0.508 to 0.530 in females for BDNF, GDNF, and CAF22. Multivariable logistic regression analysis revealed that age (OR=1.12, 95% CI: 1.04–1.21, p=0.003) and lower fat-free mass index (OR=0.78, 95% CI: 0.66–0.91, p=0.001) were significantly associated with sarcopenia, whereas BDNF, GDNF, and CAF22 showed no independent association with sarcopenia.
Conclusions
1. No statistically significant sex-specific differences were observed in serum BDNF, GDNF, and CAF22 levels between sarcopenic and non-sarcopenic older adults (all p>0.05). 2. CAF22 levels were weakly negatively correlated with muscle mass and fat-free mass index in males (p<0.05), whereas BDNF levels showed weak positive correlations with handgrip strength and fat-free mass index in females (p<0.05). CAF22 levels also demonstrated a weak positive correlation with age (p<0.05). 3. ROC and multivariable logistic regression analyses indicated limited diagnostic utility of BDNF, GDNF, and CAF22 for sarcopenia (AUC=0.508–0.542), and none of these biomarkers showed an independent association with sarcopenia (all p>0.05). In contrast, older age (OR=1.12, p=0.003) and lower fat-free mass index (OR=0.78, p=0.001) were significantly associated with sarcopenia.
3.Identification of selected risk factors associated with ovarian tumor development
Gankhuyag B ; ; Munkhtsetseg D ; ; Bolorchimeg B ; ; Amarsanaa E
Mongolian Journal of Health Sciences 2026;95(5):136-140
Background:
Ovarian cancer (OC) ranks first in mortality among gynecological malignancies, and according to the 2024 WHO report, 90–95% of ovarian tumors are diagnosed as high-grade malignant forms. Early identification of ovarian cancer risk factors is of great importance in improving diagnostic and treatment management.
Aim:
To investigate risk factors influencing malignant and benign ovarian tumors in women.
Materials and Methods:
The study was conducted using a prospective observational design between 2025 and 2026, based at the Departments of Gynecological Surgery of the National Cancer Center (NCC) and the Mongolian Japanese Teaching Hospital (MJTH). A total of 93 women aged 26–78 years diagnosed with ovarian masses (72% benign, 28% malignant) were enrolled, and data were collected using a 116-item questionnaire. Statistical analysis was performed using binary logistic regression in SPSS 25.0.
Results:
The mean age of the malignant group (53.45±12.97) was statistically significantly higher than that of the benign group (38.95±12.81) (p<0.0001). Lower educational level (p=0.046) and higher smoking rates (p=0.034) were observed in the malignant group. Regarding symptoms, abdominal distension (p=0.005), urinary difficulty (p=0.016), and weight loss (p=0.002) were predominantly present in the malignant group. Multivariate logistic regression analysis showed that weight loss increased the risk of malignant ovarian tumor by 7.0-fold (OR=7.0; 95% CI: 1.74–28.14; p=0.006), urinary difficulty by 4.05-fold (OR=4.05; 95% CI: 1.23–13.37; p=0.022), and abdominal distension by 3.52-fold (OR=3.52; 95% CI: 1.43–8.67; p=0.006). Additionally, menstrual irregularity, postmenopausal status, and family history of ovarian cancer were statistically significantly associated with malignancy.
Conclusion
Malignant ovarian tumors predominantly occur in postmenopausal women, with risk increasing with age. Weight loss, urinary difficulty, and abdominal distension are the key clinical symptoms for differentiating malignant tumors, and menstrual irregularity, menopausal status, and family history showed statistically significant associations with malignancy. The use of the HE4 biomarker and the ROMA algorithm is recommended for early detection of ovarian cancer in future practice.
4.A case of Fitz-Hugh-Curtis syndrome
Mandukhai T ; Odonchimeg B ; Bat-Olzii E ; Munkhtsetseg S ; Badamkhand N ; Dashdelger L ; Shinebileg D ; Nyamtsengel V
Mongolian Journal of Health Sciences 2026;94(4):150-153
Background:
Fitz-Hugh-Curtis syndrome is a rare condition most commonly caused by Chlamydia trachomatis infection. It is associated with pelvic inflammatory disease and inflammation of the liver capsule (perihepatitis). Due to its clinical presentation, early detection and careful differential diagnosis are essential.
Case Presentation:
We present the case of a 17-year-old female with a prior history of latent syphilis that had been treated. She developed progressively worsening lower abdominal pain and was admitted through the emergency department. Based on computed tomography (CT) findings, she was diagnosed with Fitz-Hugh-Curtis syndrome and received appropriate treatment.
Conclusion
Fitz-Hugh-Curtis syndrome should be suspected in sexually active women presenting with severe right upper quadrant abdominal pain requiring emergency care, especially when ultrasound findings show no abnormalities of the gallbladder but reveal signs of peritoneal inflammation in the abdominal and pelvic cavities. In such cases, abdominal CT plays a crucial role in diagnosis. Performing dynamic CT imaging, including the arterial phase, may improve diagnostic accuracy.
5.Association between lower back pain and some inflammatory biomarkers among heavy machinery operators in open-pit mining
Nansalmaa M ; Enkhdulguun A ; Miyegombo J ; Erdenechamba N ; Erdenechimeg E ; Munkhtsetseg J
Mongolian Journal of Health Sciences 2025;88(4):165-170
Background:
Musculoskeletal disorders account for 23.1-47.1% of occupational diseases in several countries. Studies
have shown that operators of heavy machinery, including tractors and dump trucks, are twice as likely to experience lower back pain compared to workers not exposed to whole-body vibration. Furthermore, research has indicated that acute
exposure to vibration can cause vasoconstriction and vascular inflammation. However, limited research has explored the
relationship between lower back pain and specific biomarkers, highlighting the need for this study.
Aim:
This study aimed to compare lower back pain prevalence and muscle inflammation biomarkers among heavy machinery operators.
Materials and Methods:
A purposive sampling method was used to recruit 15 male participants aged 25-35 years who
had worked as heavy machinery drivers for no more than three years. Inclusion criteria were: no alcohol consumption
within 24 hours prior to sampling, body mass index (BMI) between 18.5-28.9 kg/m², no prior diagnosis of musculoskeletal disorders, and absence of infectious or non-infectious diseases during the study period. Blood samples were analyzed
for Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α) levels using enzyme-linked immunosorbent assay
(ELISA).
Results:
The mean BMI of participants was 25.89±3.23 kg/m². Over half (53.3%, n=8) exceeded the exposure limit
for whole-body vibration. Low back pain was reported by 13 participants (86.7%) over the past six months and by 12
participants (80%) over the past seven days. TNF-α levels did not differ significantly between groups based on low back
pain status or vibration exposure. However, IL-6 levels showed a significant increase 24 hours after whole-body vibration
exposure (p=0.027).
Conclusion
Lower back pain was highly prevalent among participants exposed to whole-body vibration. Furthermore,
IL-6 levels were elevated among participants reporting lower back pain, regardless of vibration exposure levels.
6.Assessment of Prebiotic Activity of Xylooligosaccharides Extracted from Food Industry By-Products via Microwave assisted enzymatic hydrolysis
Odgerel Ch ; Purevdulam E ; Anuujin G ; Buyankhuu T ; Munkhjargal B ; Battogtokh Ch ; Munkhtsetseg J
Mongolian Journal of Health Sciences 2025;86(2):183-190
Background:
This study explores the potential of food industry by-products, such as plant peels, stems, and slags, as
valuable sources of lignocellulosic material (LCM), which contains 25-40% xylan. These underutilized resources, often
discarded as waste, hold the promise of sustainable applications in biotechnology. By safely extracting xylooligosaccharides
(XOS) from LCM biomass, the value of these materials can be significantly enhanced, contributing to green production
and supporting sustainable development. XOS, recognized for its prebiotic activity, has been shown to promote the
growth of beneficial gut bacteria, making it a vital research area in the fields of food science, medicine, and technology.
Aim:
To extract and characterize oligosaccharides derived from by-products of the food industry, evaluate their physicochemical
properties, and investigate selected biological activities.
Materials and Methods:
This study utilized microwave pretreatment and enzymatic hydrolysis to isolate and purify
XOS from wheat bran and brewers’ spent grains (BSG), provided by Altan Taria LLC and APU CoL, respectively. Microwave
irradiation at 200°C for 5 minutes was employed as a pretreatment step, followed by hydrolysis using commercial
xylanase (Thermomyces lanuginosus, recombinant Aspergillus oryzae, 2500 BXU/g) at 55°C for 24 hours. The resulting
hydrolysate underwent filtration with activated carbon and ethanol precipitation to yield purified XOS. Analytical methods,
including FTIR spectroscopy, TLC and HPLC, were used for structural and compositional analysis of the purified
oligosaccharides. In vitro tests evaluated the ability of XOS to support the growth of beneficial gut bacteria, including
Bifidobacterium spp., Lactobacillus fermentum (ATCC 9338), and Lactobacillus casei (ATCC 344), using XOS-enriched
media. Additionally, in vivo studies were conducted on rats to determine the biological effects of XOS on gut microbiota.
Results:
The results demonstrated that prolonged enzymatic hydrolysis for more than 10 hours, using 0.25 g of xylanase
per 100 g of substrate, resulted in optimal yields. XOS purity was measured at 87.6% with an 8.1 g yield from wheat bran
and 89% purity with a 7.2 g yield from brewers’ spent grains. Structural analysis confirmed the presence of xylobiose,
xylotriose, and xylotetraose, with xylotetraose being the most abundant component in WBP-XOS (47.5%), and xylobiose
dominating BGS’s derived XOS (47.8%). Biological effects revealed that wheat bran-derived XOS significantly supported
the growth of Bifidobacterium spp. and L. fermentum (ATCC 9338) in a concentration-dependent manner, whereas
no significant effect was observed on L. casei (ATCC 344). In vivo studies confirmed that XOS consumption increased
populations of Bifidobacterium spp. and Akkermansia muciniphila spp. in gut microbiota (p<0.05). Furthermore, XOS
consumption reduced plasma cholesterol, triglycerides, and LDL-C levels while increasing HDL-C levels, demonstrating
metabolic benefits.
Conclusion
This research establishes that XOS with prebiotic activity can be efficiently extracted and purified from food
industry by-products using microwave-assisted enzymatic hydrolysis. This approach highlights the potential of utilizing
agricultural and industrial waste for producing functional prebiotics, contributing to sustainable practices and offering
valuable applications in health and nutrition.
7.The Correlation Between Prognostic Indicators of Chronic Liver Diseases and Certain Blood Test Parameters
Munkhtsetseg M ; Allabyergyen M ; Temuulen Ts ; Narangere .B ; Temuulen E ; Sumiyabazar A ; Bolormaa B ; Munkhuu A ; Dorjzodov D ; Munkhbat R ; Odgerel Ts
Mongolian Journal of Health Sciences 2025;86(2):191-195
Background:
Hepatocellular carcinoma (HCC) is a primary liver cancer originating from liver cells, classified as a chronic
liver disease. This cancer ranks third in the world in terms of mortality rate. The MELD (Model for End-Stage Liver
Disease) and Child-Pugh scoring systems are utilized to assess the prognosis of chronic liver diseases. Based on studies
suggesting that certain blood test indicators, particularly red cell distribution width (RDW), could be used to predict the
prognosis of liver cancer and other cancers, as well as serve as diagnostic markers, this topic was chosen to evaluate the
clinical significance of RDW in hepatocellular carcinoma.
Aim:
The aim is to study some blood test indicators and compare them with the MELD score and Child-Pugh score systems
in order to determine the prognosis of chronic liver diseases.
Materials and Methods:
A retrospective, single-center, cross-sectional study was conducted at Mongolia-Japan Hospital.
Among 322 patients diagnosed with HCC, 24 patients were selected for the case group, and 37 patients with liver cirrhosis
were included in the control group.
Results:
According to the research criteria, 61 patients were selected and divided into 3 groups, and statistical analysis
was performed. In the detailed blood test, platelet count and WBC count showed statistically significant differences
among the 3 groups (p< 0.024). In the biochemical tests, C-reactive protein (CRP) was p< 0.018, total bilirubin p< 0.001,
and the mean albumin level p< 0.015, all showing statistically significant differences among the 3 groups. A statistically
significant inverse correlation was observed between RDW-CV and the clinical MELD score (r=-0.356).
Conclusion
Platelet count, RDW, CRP, total bilirubin, and average albumin levels are significantly different across the
studied groups. RDW-CV shows a moderate inverse correlation with MELD scores, suggesting its potential as a prognostic
marker in chronic liver diseases. Further research with larger sample sizes is recommended to confirm these findings.
8.Uterine wall perforation anol subsequent bladder damage by T-shaped Intrauterine device
Nomin E ; Ganzorig B ; Munkhtsetseg E ; Mungunsukh U ; Dashjantsan G
Mongolian Medical Sciences 2025;214(4):68-71
Intrauterine devices (IUDs) are often considered a form of contraception by women of
reproductive age because of their reversible, effective, safe, and convenient nature. However,
its complications include bleeding, infection, displacement, and uterine perforation. Effective
contraception can minimize the risk of unintended pregnancy, particularly for women who
have additional health risks associated with unintended pregnancy. Intrauterine device (IUD)
is considered to be a highly effective and reversible method of contraception (long-acting
reversible contraceptives) that is suitable for most women, highly effective, affordable, and
requires minimum patient compliance [1]. Despite being infrequent, perforation constitutes
a significant complication associated with IUD insertion, with an estimated incidence of
0.8–2.2 per 1,000 insertions [2, 3]. Ultrasound is the preferred diagnostic modality in cases
where partial embedding of the IUD is suspected. However, when the IUD extends near or
beyond the uterine serosa, radiologists can more confidently diagnose embedding [4]. The
patient is a 44-year-old woman with four children. She gave birth for the first time in 1997.
A contraceptive device was inserted in 1999, and another was placed four months after her
2009 delivery. She does not recall the date when she had the latter device removed and
has no record of having seen it. This case represents a rare instance of secondary bladder
stone formation resulting from migration of an intrauterine device (T-shaped IUD) into the
bladder. Rapid diagnostic methods, including ultrasonography, CT, and cystoscopy, along
with endoscopic surgical intervention, proved to be the most effective approach for both
diagnosis and treatment.
9.A new diagnostic biomarker in early detection of Hepatocellular Carcinoma
Batchimeg B ; Baljinnyam T ; Khulan U ; Khaliun M ; Bilguun E ; Munkhtsetseg B ; Terguunbileg B ; Chinzorig M ; Gan-Erdene B ; Bilegtsaikhan Ts ; Erkhembulgan P ; Batbold B ; Munkhbat B ; Munkhtuvshin N ; Munkhbayar S
Mongolian Medical Sciences 2021;197(3):10-16
Background and Aims:
Hepatocellular carcinoma (HCC) is a common cause of cancer related death
in Mongolia. Early diagnosis is the very important management to increase successful treatment
and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC)
tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a
diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic
value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic
biomarker of HCC.
Methods:
We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver
cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP)
levels were measured using commercially available enzyme-linked immunosorbent assay kits. The
diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and
estimated sensitivity and specificity of each biomarker.
Results:
sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and
healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity
was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999
(0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6
ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 %
with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%).
Conclusion
Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC.
Combination of two markers showed greatest diagnostic accuracy.
10.The effects of Particulate matter (PМ2.5) pollutants on cancer cells in in vitro model
Baljinnyam T ; Bilguun E ; Batchimeg B ; Zolzaya D ; Lkhaasuren N ; Oyungerel G ; Munkhtsetseg B ; Khaliun M ; Khulan U ; Batkhishig M ; Uranbileg U ; Sonomdagva Ch ; Bilegtsaikhan Ts ; Munkhbayar S ; Munkhtuvshin N ; Erkhembulgan P
Mongolian Medical Sciences 2021;197(3):17-25
Introduction:
Air pollution has become one of the major problems in socio-economic and health
issues in Mongolia. Among the various hazards of particulate matter (PM) pollutants, microorganisms
in PM2.5 and PM10 are thought to be responsible for various allergies and for the spread of respiratory
diseases. Recent studies have shown that PM2.5 particles can cause chronic heart failure, heart
arrhythmias, and strokes, as well as lung damage, cirrhosis, inflammation, cancer, cardiovascular
disease, and metabolic disorders. Furthermore, some studies have concluded that PM2.5 particles
in the environment are a risk factor for gastrointestinal, liver, colon, and lung cancer as well as it
affects the growth and metastasis of various cancer cells caused by other factors. In our country, the
health effects of air pollution and the relationship between the pathogenesis of cancer research are
scarce. Therefore, the study of the effects of PM2.5 particles on cancer cell proliferation, migration
(metastasis) can provide a significant role for cancer treatment, diagnosis, and prevention.
Purpose:
Determining the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis)
in in-vitro
Material and Methods:
A human liver cancer cell line (HepG2), human gastric cancer cell line (AGS)
were obtained from the central scientific research laboratory in the Institute of medical sciences.
HepG2, AGS cells were seeded at a concentration of 1*105 cells/mL in a culture flask and cultured
in RPMI-1640 medium supplemented with 10% FBS, 1% antibiotic mix (penicillin, streptomycin) in a
humidified atmosphere of 5% CO2 at 37 °C. The cytotoxic effect of PM 2.5 in AGS, HepG2 cells were
evaluated by MTT, CCK8 assays. AGS, HepG2 cells were incubated in 96 well plates for 24h then
treated with different concentrations (0, 5, 10, 25, 50 and 100 μg ) of Bayankhoshuu, Buhiin urguu,
and Zaisan samples for 24h, respectively.
Results:
Concentrations of 10, 25, and 50 μg/ml of samples collected from the Bukhiin urguu and
Zaisan in March increased HepG2 cell growth, while doses of 25, 50 μg/ml of samples collected from
Bayankhoshuu in March and December increased HepG2 cell growth. Therefore, concentrations of
25 and 50 μg/ml of samples collected from Bayankhoshuu in March increased AGS cell growth, while concentrations of 25, 100 and μg/ml of samples collected in December increased AGS cell growth.
However, no cytotoxic effect was observed in the sample collected from Zaisan in March, whereas
the PM2.5 sample enhanced AGS cell growth in dose dependent manner in December.(p <0.05)
Conclusion
High levels of heavy metals were detected in samples collected in December from
Bayankhoshuu, Bukhiin urguu and Zaisan of Ulaanbaatar. Concentration of 25 μg/ml of samples
collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth. Concentrations
of 25 μg/ml of PM2.5 collected from three regions around Ulaanbaatar increased HepG2 and AGS
cell migration.
Result Analysis
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