Bone fractures are a significant public health issue among elderly subjects. This study examines the impact of diet and vitamin D status on the risk of long bone fractures due to falls in elderly subjects in Vojvodina, Serbia. Conducted at the University Clinical Center of Vojvodina in autumn/winter 2022–2023, the study included 210 subjects >65 years: 105 (F: 80/M: 15) with long bone fractures due to falls and 105 (F: 80/M: 15) controls. Groups were similar regarding age and BMI. Dietary intakes (by two 24-h recalls) and serum vitamin D levels were analyzed. The fracture group had a significantly lower median daily vitamin D intake (1.4 μg/day vs. 5.8 μg/day), intake of calcium, energy, proteins, fats, fibers, dairy products, eggs, fish, edible fats/oils, and a higher intake of sweets (p < 0.001 for all). Serum vitamin D levels were significantly lower in the fracture group (40.0 nmol/L vs. 76.0 nmol/L, p < 0.001). Logistic regression identified serum vitamin D as the most important protective factor against fractures, and ROC curve analysis indicated that serum vitamin D levels > 50.5 nmol/L decreased fracture risk. Nutritional improvements (increased intake of vitamin D and protein sources such as fish, eggs, and dairy), increased sun exposure, and routine vitamin D supplementation during winter are advised.

Background: Multiple sclerosis (MS) is one of the most common demyelinating diseases of the central nervous system. We aimed to investigate serum and cerebrospinal fluid levels of different laboratory inflammatory biomarkers in patients with MS. Methods: A total of 120 subjects participated in the study, 60 of whom were diagnosed with MS, 30 with the final diagnosis of non-inflammatory diseases of the central nervous system (CNS), and 30 healthy subjects representing the control group. Regarding the progression of radiological findings after 2 years from the initial diagnosis, the MS group was divided into stationary radiological findings (n=30) and radiologically proven disease progression (n=30). In all patients, we analyzed levels of laboratory inflammatory biomarkers: C reactive protein (CRP), Neutrophil-to-lymphocyte ratio (NLR), Growth differentiation factor 15 (GDF15) in serum samples, and neurofilaments (NFs) in cerebrospinal fluid (CSF). NFs and GDF15 were analyzed initially, while CRP and NLR values were analyzed initially and after two years. Results: We found statistically lower GDF15 values and initial CRP values in the MS group regarding the group with non-inflammatory diseases of the CNS (p<0.0001). On the other side, we determined a significant elevation of laboratory markers CRP and NLR, initially and after a two-year period, in the MS subgroup with the progression of magnetic resonance imaging (MRI) findings (p<0.0001 and p=0.050, respectively). Also, we found a positive correlation between CRP and NFs (r=0.243, p=0.04), as well as a positive correlation between CRP and GDF15 in patients with MS (r=0.769, p<0.0001). Conclusions: We found a significant elevation of laboratory markers of systemic inflammation, CRP, and NLR in MS patients who developed disease progression based on MRI findings. There is a need for further studies to validate current parameters to be considered as useful markers of MS activity and disability.

Background/Objectives: Most cases of colorectal cancer (CRC) arise from adenomatous polyps. Identifying risk factors for colorectal adenoma (CRA) is critical for CRC prevention. Emerging evidence suggests a link between metabolic syndrome (MetS) and an elevated risk of CRA and CRC, potentially mediated by visceral obesity and adiponectin (APN). We aimed to evaluate the association between different markers of visceral obesity, serum APN, MetS, and the presence of CRA. Methods: A cross-sectional study was conducted at the University Clinical Center of Vojvodina, involving 120 patients, aged 40–75 years, who underwent colonoscopy between January 2022 and January 2023. Sixty patients with CRA were compared to 60 controls with normal colonoscopy findings. Visceral fat thickness (VFT) was measured using ultrasound (US), and bioelectrical impedance analysis (BIA) was used to assess visceral fat area (VFA). Serum APN levels, anthropometric measures, and MetS components were also evaluated. Results: Patients with CRA had significantly higher VFT measured by US (p < 0.05), but no significant differences were found in VFA measured by BIA, waist circumference (WC), or waist-to-hip ratio (WHR). MetS was significantly more prevalent in the CRA group (55% vs. 31.6%, p < 0.05), and logistic regression confirmed MetS as a significant predictor of CRA presence (OR = 2.6). Serum APN levels were inversely correlated with visceral fat measurements and MetS (p < 0.01), but no significant difference in APN levels was observed between patients with and without CRA. Conclusions: This study highlights the importance of VFT measured by US and the presence of MetS as significant factors associated with CRA.

Various biomarkers like certain complete blood cell count parameters and the derived ratios including neutrophil–lymphocyte ratio are commonly used to evaluate disease severity. Our study aimed to establish if baseline levels of complete blood cell count-derived biomarkers and CRP, measured before any treatment which can interfere with their values, could serve as a predictor of development of pneumonia and the need for hospitalization requiring oxygen therapy. We retrospectively analyzed the laboratory data of 200 consecutive patients without comorbidities, who denied usage of medications prior to blood analysis and visited a COVID-19 ambulance between October and December 2021. Multivariate regression analysis extracted older age, elevated CRP and lower eosinophil count as significant independent predictors of pneumonia (p = 0.003, p = 0.000, p = 0.046, respectively). Independent predictors of hospitalization were higher CRP (p = 0.000) and lower platelet count (p = 0.005). There was no significant difference in the neutrophil–lymphocyte and platelet–lymphocyte ratios between examined groups. Individual biomarkers such as platelet and eosinophil count might be better in predicting the severity of COVID-19 than the neutrophil–lymphocyte and platelet–lymphocyte ratios.

Introduction. Macroprolactinemia is one of the common causes of hyperprolactinemia, especially in cases where standard routine commercial immunometric assays are used for prolactin level measurement. Two forms of prolactin, inactive dimeric prolactin (50 - 60 kDa) and a low-activity tetramer (molecular weight above 150 kDa), contribute to this condition. The relatively low incidence of symptoms in macroprolactinemia patients has necessitated a relatively simple method to detect large, biologically inactive prolactin molecules, such as polyethylene glycol precipitation method. The aim of this study was to compare the precipitation method using polyethylene glycol dissolved in phosphate buffered saline in relation to polyethylene glycol dissolved in water. Material and Methods. This study included 82 patients who visited the Center of Laboratory Medicine, Clinical center of Vojvodina, to determine serum prolactin levels. The obtained serum samples were divided into two aliquots. The first aliquot was frozen and stored at - 20?C and the other was immediately analyzed. Aqueous solution was added to one aliquot and polyethylene glycol Merck 6000 to the other. All serum and supernatant samples were analyzed using the automated Abbott Architect i2000sr immunoassay. Recovery values were calculated as the ratio of double values of free prolactin and total prolactin concentration, expressed as a percentage. Results. The prolactin concentrations and calculated recovery values were lowest in fresh supernatant prolactin treated with phosphate buffered saline. Statistical analysis showed no significant difference in the calculated recovery values obtained by precipitation of fresh and frozen sera using polyethylene glycol dissolved in phosphate buffered saline (p = 0.893). Conclusion. Precipitation using polyethylene glycol dissolved in phosphate buffered saline is a more reliable method for laboratory detection of macroprolactinemia compared to polyethylene glycol dissolved in water.

Background: The platelet-to-lymphocyte ratio (PLR) is a simple laboratory index that can be applied in the diagnosis and follow-up of various diseases, particularly those with a primary or accompanying systemic inflammatory component. However, its clinical utility is limited by the absence of established reference intervals in the general population. This study aimed to determine the reference interval for PLR. Methods: This retrospective observational study included 4,672 adults who underwent regular systematic check-ups consisting of clinical examinations and basic laboratory analyses, including a complete blood count (CBC). The PLR reference interval was calculated using Clinical and Laboratory Standards Institute (CLSI) guidelines, which estimate percentiles and their 95% confidence intervals (CI). Verification of the reference interval was performed in a group of 95 healthy adults, matched by age and sex to the study cohort. Results: The mean age of participants was 43± 10 years, with a predominance of males (83.7% ). The median PLR was 109 (25th percentile: 90; 75th percentile: 131). The lower limit of the reference interval was 62 (95% CI: 61-63), and the upper limit was 194 (95% CI: 188-198). Female participants had significantly higher PLR values compared with males (P < 0.0001), while elderly participants had significantly lower PLR values compared with the middle-aged and younger groups (P= 0.019). The determined reference interval was 70-231 for females and 61-183 for males. PLR values did not differ significantly between the primary study group and the validation group [108.0 (87-136) vs. 109.0 (90-131); P> 0.05]. Conclusions: In this representative sample, consisting primarily of young and middle-aged adults, the PLR reference interval was 70-231 for women and 61-183 for men. In individuals older than 65 years, PLR values may be lower.