We intended to investigate the presence and medical application of serum hypoxia-inducible factor-1 alpha (HIF-1α) along with the already known systemic inflammatory markers and the new one’s inflammatory indices, the proportion of mean corpuscular volume and lymphocytes (MCVL) and the cumulative inflammatory index (IIC), for patients with ulcerative colitis (UC). We sought to establish correlations that may be present between the serum levels of HIF-1α and these inflammatory indices, as well as their relationship with disease activity and the extent of UC, which can provide us with a more precise understanding of the evolution, prognosis, and future well-being of patients. Serum samples were collected from 46 patients diagnosed with UC and 23 controls. For our assessment of the serum levels of HIF-1α, we used the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Thus, for HIF-1α we detected significantly higher values in more severe and more extensive UC. When it came to MCVL and IIC, we observed statistically significant differences between the three groups being compared (Severe, Moderate, and Mild). Our study highlighted that HIF-1α correlated much better with a disease activity score, MCVL, and IIC. With MCVL and IIC, a strong and very strong correlation had formed between them and well-known inflammation indices. By examining the ROC curves of the analyzed parameters, we recognized that TWI (accuracy of 83.70%) provides the best discrimination of patients with early forms of UC, followed by HIF-1α (73.90% accuracy), MCVL (70.90% accuracy), and PLR (70.40%). In our study, we observed that HIF-1α, MCVL, and PLR had the same sensitivity (73.33%) but HIF-1α had a much better specificity (60.87% vs. 58.70%, and 54.35%). Also, in addition to the PLR, HIF-1α and MCVL can be used as independent predictor factors in the discrimination of patients with early forms of UC.

Background/Objectives: Type 2 diabetes mellitus (T2DM), is a rapidly growing global health concern, often accompanied by chronic kidney disease (CKD) and metabolic disturbances. Obesity-related indices, such as the visceral adiposity index (VAI) and body adiposity index (BAI), have been linked to cardiovascular and renal complications in diabetic patients. However, studies integrating both the atherogenic coefficient (AC) and prognostic nutritional index (PNI) for evaluating diabetic nephropathy (DN) remain limited. This study aimed to assess the associations of obesity-related indices with immunological and nutritional factors in patients with T2DM and prediabetes (PreDM). Methods: A retrospective, cross-sectional study was conducted over six months at a university clinical hospital in Dolj County, Romania. The study enrolled 268 newly diagnosed T2DM patients and 150 PreDM patients. Anthropometric parameters, laboratory tests, and demographic data were collected. AC and PNI were calculated using standard formulas, and statistical analyses were performed to determine their associations with metabolic and inflammatory markers. Results: Our study found that T2DM patients had significantly lower PNI values, indicating mild malnutrition, while PreDM patients maintained a normal nutritional status. AC was significantly higher in T2DM patients, correlating with lipid profile alterations and systemic inflammation. Obesity indices, particularly VAI, were significantly elevated in T2DM patients with higher AC values. Statistically significant differences in total cholesterol, low-density lipoprotein cholesterol (LDL-c), and triglycerides were observed between AC subgroups, reinforcing its role in cardiovascular risk assessment. Conclusions: The findings highlight the potential of AC and PNI as biomarkers for assessing nutritional, inflammatory, and lipemic status in diabetic patients. The significant associations between obesity-related indices, lipid profiles, and inflammation markers suggest that early assessment of these parameters may potentially aid in predicting diabetic complications. Further studies are needed to explore the clinical utility of AC and PNI in managing T2DM and CKD progression. Future research should investigate how the lipidic spectrum alters the progression of DN across various patient groups with diabetes and prediabetes

Background: We aimed to analyze the presence and clinical use of serum 8-iso-prostaglandin F2-alpha (8-iso-PGF2α) as an oxidative stress marker and some inflammatory status biomarkers (tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), IL-10, high-sensitivity C-reactive protein (hs-CRP), and pentraxin-3 (PTX3)) for patients with preeclampsia (PE). Methods: Sixty pregnant women, including thirty diagnosed with PE and thirty who were healthy (NP), were included in this study. For the assessment of serum levels of biomarkers, we used the Enzyme-Linked Immunosorbent Assay (ELISA) technique. Results: Our preliminary study showed that the expression level of serum 8-iso-PGF2α in the PE group was higher than in the PE after delivery (PE-AD) group (742.00 vs. 324.00 pg/mL, p < 0.0001). Groups of preeclamptic patients (PE + PE-AD) expressed significantly elevated levels for all of the assessed inflammatory mediators as compared to NP. Significant strong positive correlations with 8-iso-PGF2α levels were found for systolic blood pressure (SBP), and TNF-α (Spearman’s rho = 0.622, p-value = 0.020 and rho = 0.645, p-value = 0.002, respectively). Our study demonstrates that 8-iso-PGF2α and PTX3 have the greatest diagnostic value for pregnant women with PE. Conclusions: 8-iso-PGF2α and PTX3 can be used as independent predictor factors, along with already-known cytokines, that could represent a prophylactic way to help clinicians identify or predict which pregnant women will develop PE.

Systemic inflammation has an important role in the prognosis and progression of many chronic diseases, including diabetes (T2DM). This retrospective study aimed to evaluate inflammatory status by determining the serum inflammatory biomarkers (PTX3, hs-CRP, TNF-α, and IL-6) and new indices, like the mean corpuscular volume (MCV) to lymphocyte ratio (MCVL) and cumulative inflammatory index (IIC), in a cohort of patients with prediabetes (PreDM) and newly diagnosed T2DM. We also wanted to assess the association with clinical parameters and different obesity-related indices, to identify possible correlations and to evaluate the diagnostic accuracy of the biomarkers using ROC curve analysis. In this study, we included 60 patients diagnosed with T2DM and 30 patients with PreDM. The ELISA method was applied. Elevated PTX3, hs-CRP, TNF-α, and IL-6 levels were found in T2DM patients compared to preDM patients. An independent relationship was found between PTX3, hs-CRP, and different obesity-related indices in patients with preDM and T2DM. The MCVL index exhibited an inverse trend proportional to the rising levels of HbA1c in the T2DM group. Spearman’s analysis revealed in the T2DM group that the PTX3 values correlated much better with IIC (rho = 0.445, p-value = 0.014) and MCVL (rho = 0.338, p-value = 0.048). Hs-CRP values expressed moderate-to-weak correlations with IIC and MCVL in both groups. Additionally, ROC analysis showed that the PTX3 (AUC was 0.720; p = 0.003; cut-off value 1888.00 pg/mL, with 67.60% sensitivity and 73.30% specificity) and MCVL index (AUC was 0.677; p = 0.047; cut-off value 39.60, with 63.30% sensitivity and 66.70% specificity) have a good, accurate diagnosis compared with IL-6 (AUC was 0.866; p < 0.0001; cut-off value 40.30 pg/mL, with 100.00% sensitivity and 60.00% specificity). IIC showed 61.70% sensitivity and 60.00% specificity, with an AUC of 0.572, p = 0.027 and a cut-off value of 2.35. PTX3 and MCVL can serve as independent predictor factors in the inflammatory status in preDM and T2DM patients, supporting their potential as biomarkers for T2DM management and future research.

Insulin resistance is central in metabolic syndrome, but indices such as Homeostasis Model Assessment-estimated Insulin Resistance (HOMA-IR) require insulin assays that are costly and not always available. Non-insulin-based indices and refined anthropometric markers may offer simpler risk stratification in prediabetes and diabetes. Our objective was to compare insulin and non-insulin-based indices of insulin resistance, together with advanced anthropometric and lipid markers, between prediabetes (PreDM) and type 2 diabetes (T2DM) and across hypertension grades in metabolic syndrome. We conducted a cross-sectional study in 200 adults with metabolic syndrome, 80 with PreDM and 120 with T2DM. Clinical, anthropometric and biochemical parameters were recorded, and HOMA-IR, Homeostasis Model Assessment of Beta-cell function (HOMA%B), Metabolic Score for Insulin Resistance (METS-IR), triglyceride to glucose index (TyG), triglyceride-to-glucose index to high-density lipoprotein cholesterol ratio (TyG/HDL-c) and other derived indices were calculated. Group comparisons, correlations and multiple linear regression were performed. Compared with PreDM, T2DM showed higher glycemic indices and inflammation, but similar body mass index (BMI) and triglycerides. Across glycemic categories and hypertension grades, METS-IR, TyG and TyG/HDL-c increased and correlated strongly with body roundness index (BRI), abdominal volume index (AVI) and weight-adjusted waist index (WWI), while HOMA-IR contributed little independent information. In regression models, lipid adipose product (LAP) and WWI best explained METS-IR in prediabetes, whereas TyG and BRI were the main determinants of METS-IR in diabetes. In metabolic syndrome with PreDM or T2DM, METS-IR and TyG, particularly combined with BRI, AVI and WWI, outperformed traditional lipid ratios and added value beyond HOMA-IR. These composite indices appear useful for insulin resistance assessment when insulin measurement is unavailable or unreliable.

Clostridium difficile (C. difficile) infection (CDI) is the most common cause of healthcare‑associated diarrhea and among adults, the worldwide incidence rate of the infection is increasing. There is a small amount of data in the literature for pediatric patients, but most indicate an increasing trend. C. difficile is a constituent of the normal microbiota; however, under specific conditions that cause a disruption of the normal bacterial flora, colonization of C. difficile and the released toxins that cause inflammation and mucosal damage occurs. Risk factors for CDI at any age include hospitalization, exposure to antibiotics, administration of proton pump inhibitors, invasive mechanical ventilation, immunosuppression and presence of associated comorbidities. Clinical manifestations range from asymptomatic colonization to fulminant disease characterized by toxic megacolon, intestinal perforation and, rarely, death. The aim of the present review was to outline the features of CDI in pediatric patients.