Caloric restriction (CR) is proven to be effective in increasing life span and it is well known that, nutritional habits, sleeping pattern and meal frequency have profound effects on human health. In Ramadan some Muslims fast during the day-light hours for a month, providing us a unique model of intermittent fasting (IF) in humans. In the present study, we have investigated the effects of IF versus CR on the same non-diabetic obese subjects who were followed for two years according to the growth hormone (GH)/Insulin like growth factor (IGF)-1 axis and insulin resistance. Single-arm Interventional Human Study. 23 female subjects (Body Mass Index (BMI) 29–39, aged between 28–42years). Follow-up is designed as 12 months of CR, after which there was a month of IF and 11 months of CR again, to be totally 24 months. Subjects’ daily diets were aligned as low calorie diet during CR and during the IF period, the same subjects fasted for 15 hours in a day for a month and there was no daily calorie restriction. Nutritional pattern was changed as 1 meal in the evening and a late supper before sleeping and no eating and drinking during the day light hours in the IF model. Subjects made brisk walking twice a day during the whole follow-up including both CR and IF periods. BMI, Blood glucose, insulin, TSH, GH, HbA1c, IGF-1, Homa-IR and urinary acetoacetate levels were monitored once in three months and twice in the fasting month. While subjects lost 1250 ± 372g monthly during the CR, in the IF period, weight loss was decreased to 473 ±146 g. BMI of all subjects decreased gradually and as the BMI decreased, glucose, HbA1c, insulin, Homa-IR and TSH levels were decreased. GH levels were at baseline at the beginning, increased in the first six months and stayed steady during the CR and IF period than began decreasing after the IF period, while IGF-I increased gradually during the CR period and beginning with the 7th day of IF period, it decreased and kept on decreasing till the end of the follow-up. Urinary acetoacetate levels were higher during the IF period suggesting a constant lipid catabolism. Our results suggest that, CR affects metabolic parameters positively which will help especially pre-diabetic and insulin resistant patients without any pharmacological approach. In addition IF without calorie restriction can enhance health and cellular resistance to disease without losing weight and those effects may be attributed to different signalling pathways and circulating ketones during IF. Changes observed during IF are probably due to the changes in eating and sleeping pattern and thus changes in metabolic rhythm.

Background: Calorie restriction (CR) during daily nutrition has been shown to affect the prognosis of many chronic diseases such as metabolic syndrome, diabetes, and aging. As an alternative nutrition model, prolonged intermittent fasting (PF) in humans is defined by the absence of food for more than 12 h. In our previous human studies, CR and PF models were compared and it was concluded that the two models might have differences in signal transduction mechanisms. We have investigated the effects of these models on neurons at the molecular level in this study. Methods: Neurons (SH-SY5Y) were incubated with normal medium (N), calorie-restricted medium (CR), fasting medium (PF), and glucose-free medium (G0) for 16 h. Simultaneously, ketone (beta-hydroxybutyrate; bOHB) was added to other experiment flasks containing the same media. Concentrations of lactate, lactate dehydrogenase (LDH), bOHB, and glucose were measured to demonstrate the changes in the energy metabolism together with the mitochondrial functions of cells. Citrate synthase activity and flow cytometric mitochondrial functions were investigated. Results: At the end of incubations, lactate and LDH levels were decreased and mitochondrial activity was increased in all ketone-added groups (P < .01) regardless of the glucose concentration in the environment. In the fasting model, these differences were more prominent. Conclusion: Our results demonstrated that neurons use ketones regardless of the amount of glucose, and bOHB-treated cells had positive changes in mitochondrial function. We conclude that the presence of bOHB might reverse neuron damage and that exogenous ketone treatment may be beneficial in the treatment of neurological diseases in the future.

Background: Alzheimer's disease is a progressive neurodegenerative disorder characterized by memory loss and cognitive impairment. The diagnosis of Alzheimer's disease according to symptomatic events is still a puzzling task. Developing a biomarker-based, low-cost, and high-throughput test, readily applicable in clinical laboratories, dramatically impacts the rapid and reliable detection of the disease. Objective: This study aimed to develop an accurate, sensitive, and reliable screening tool for diagnosing Alzheimer's disease, which can significantly reduce the cost and time of existing methods. Methods: We have employed a MALDI-TOF-MS-based methodology combined with a microaffinity chromatography enrichment approach using affinity capture resins to determine serum kappa (κ) and lambda (λ) light chain levels in control and patients with AD. Results: We observed a statistically significant difference in the kappa light chain over lambda light chain (κLC/λLC) ratios between patients with AD and controls (% 95 CI: -0.547 to -0.269, p<0.001). Our method demonstrated higher sensitivity (100.00%) and specificity (71.43%) for discrimination between AD and controls. Conclusion: We have developed a high-throughput screening test with a novel sample enrichment method for determining κLC/λLC ratios associated with AD diagnosis. Following further validation, we believe our test has a potential for clinical laboratories.

Objectives: This study aimed to evaluate the effect size of each parameter used in the first trimester Down syndrome (DS) risk analyses by using multiple regression analysis techniques. Methods: This data mining study included data of 44,260 pregnant women screened at the Acibadem Labmed laboratories from 2010 to 2019. In this study, risk was calculated using the PRISCA software on the basis of nuchal translucency (NT), crown-rump length measurement, in vitro fertilization application, diabetes mellitus, Down syndrome story, smoking, maternal age, and the level of maternal serum biochemistry markers including pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (hCGβ). Results: Forty-four thousand two hundred sixty risk analysis patients result data were re-investigate, and 851 (1.93%) risk analysis results were found as positive. PAPP-A 747 (CI%, 476–1,170) times, NT value 512 (CI%, 343–764) times, DS story 21 times (CI%, 6.7–63.2) and hCGβ value 7.01 (CI%, 6.31–7.79) times affect the combined first-trimester risk analysis results. Conclusions: We have suggested that those accurate PAPP-A levels and NT levels evaluation are the most critical point of combined risk analysis and that the risk of free hCGβ levels after PAPP-A is essential as a biochemical test.

Celiac Disease (CD) is a gluten-sensitive enteropathy, and an autoimmune disorder involving an innate and adaptive immune response that occurs in genetically predisposed patients who are exposed to gluten-containing foods and other environmental factors. Early diagnosis and treatment are essential in preventing complications of the disease. Symptoms may appear both in childhood or adulthood by the ingestion of gluten and are usually characterized by gastrointestinal symptoms; however, the diagnosis may be delayed because of various extraintestinal manifestations, such as iron deficiency anemia, osteoporosis, or non-specific skin lesions in adult patients. Although CD has been shown to have an increased risk of all malignancies, plasma dyscrasias, especially multiple myeloma (MM) associations, are rare and reported to be seen in elderly patients. The current report presents a 42-year-old female patient with a recent dysphagia after a hot food ingestion with no other complaints. Laboratory investigations revealed a mild anemia and high serum protein levels. CD was diagnosed after a small bowel biopsy and MM was diagnosed after a serum protein electrophoresis with immunotyping studies (IgA lambda as the monoclonal protein) and bone marrow biopsy. In the laboratory, Immunotyping studies of monoclonal protein included two alternative methods; Immunofixation electrophoresis and immunosubtraction method with capillary electrophoresis. Our patient, is young to have MM, since the median age at diagnosis of MM is 66 years and only 2% of patients are younger than 50 years. We believe that celiac disease played a significant role in the development of MM in this particular patient with IgA monoclonality and conclude that CD patients, even if they are young, must be monitored for plasma dyscrasias in addition to other malignancies.

This study aimed to determine the exposure levels of young individuals living in Istanbul, a region in Turkey with a high population density and significant environmental pollution, by measuring the levels of heavy metals and trace elements in blood, serum, and urine. A total of 95 young people aged 18–24 participated in the study. Toxic heavy metals (Pb, As, Hg, Cd, and Cr) and physiological trace elements (Cu, Zn, Se, Mo, Mn, and Co) were measured in participants’ whole blood, serum, and urine samples using the ICP-MS technique. Participants were stratified by gender, as differences in body surface area may affect the absorption and metabolism of trace elements, and by smoking status, since smoking is a recognized source of heavy metal exposure. Gender differences revealed that blood lead levels were higher in males (p < 0.05), while manganese levels were higher in females (p < 0.05). When serum samples were analyzed, males had significantly higher zinc (p < 0.05) and selenium (p < 0.05) levels compared to females, whereas females had significantly higher levels of copper (p < 0.05) and cobalt (p < 0.05). Similar differences for copper (p < 0.05) and cobalt (p < 0.05) were observed in urine samples, with higher levels found in females. Blood cadmium levels were found to be significantly higher in smokers (p < 0.05). This biomonitoring study is one of the rare studies conducted in this region to assess heavy metal exposure among young adults.