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BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY

Yıl 2021, Cilt: 22 Sayı: 6, 439 - 444, 18.10.2021
https://doi.org/10.18229/kocatepetip.772149

Öz

ABSTRACT
OBJECTIVE: Investigation of blood lipid profile in primary open-angle glaucoma (POAG).
MATERIAL AND METHODS: In this study, there were 100 participants, of whom 50 were patients with POAG and 50 were non-POAG patients consulted in the ophthalmology clinic. Levels of blood lipids including total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride (TG) were investigated. Data were compared with t-test, Mann Whitney U, Fischer correlation and Chi-square test. p<0.05 was considered statistically significant.
RESULTS: While the mean age of the POAG patients was 65.7±11.09 years, the mean age of the non-POAG patients was 66.2±10.44 years. The normal reference ranges for laboratory tests in this study were 0-200 mg/dl for total cholesterol, 0-130 mg/dl for LDL, 35-70 mg/dl for HDL, and 35-160 mg/dl for TGs. The blood lipid levels in POAG and non-POAG patients were as following: total cholesterol 199±47 mg/dl and 202±46 mg/dl (p>0.05), LDL 114±37 mg/dl and 112±43 37 mg/dl (p>0.05), HDL 51±14 mg/dl and 54±19mg/dl (p>0.05), and TG 170±69 mg/dl and 146±102 mg/dl (p<0.05), respectively.
CONCLUSIONS: In this study, no statistically significant difference was found between POAG and non-POAG patients regarding total cholesterol, LDL, and HDL levels. Yet, changes in the blood lipid profile may be associated with not only the patients' age but also prevalent systemic diseases. The present study demonstrated a remarkable finding that the level of TG was hig

Destekleyen Kurum

The study did not receive any financial support.

Kaynakça

  • 1. Casson RJ, Chidlow G, Wood JP, Crowston JG, Goldberg I. Definition of glaucoma: clinical and experimental concepts. Clin Exp Ophthalmol. 2012;40(4):341-9.
  • 2. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-11.
  • 3. Saccà SC, Centofanti M, Izzotti A. New proteins as vascular biomarkers in primary open angle glaucomatous aqueous humor. Invest Ophthalmol Vis Sci. 2012;53(7):4242-53.
  • 4. Huck A, Harris A, Siesky B et al. Vascular considerations in glaucoma patients of African and European descent. Acta Ophthalmol. 2014;92(5):336-40.
  • 5. Coleman AL, Miglior S. Risk factors for glaucoma onset and progression. Surv Ophthalmol. 2008;53(1):3-10.
  • 6. Venkataraman ST, Flanagan JG, Hudson C. Vascular reactivity of optic nerve head and retinal blood vessels in glaucoma--a review. Microcirculation. 2010;17(7):568-81.
  • 7. Abegão Pinto L, Willekens K, Van Keer K, et al. Ocular blood flow in glaucoma - the Leuven Eye Study. Acta Ophthalmol. 2016;94(6):592-8.
  • 8. American Academy of Ophthalmology. Basic and Clinical Science Course Section 10. San Francisco. 1999-2000:5-6.
  • 9. Winder AF, Paterson G, Miller SJ. Biochemical abnormalities associated with ocular hypertension and low tension glaucoma. Trans Ophthalmol Soc U K. 1974;94(2):518-24.
  • 10. Chapman MJ, Ginsberg HN, Amarenco P; European Atherosclerosis Society Consensus Panel. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J. 2011;32(11):1345-61.
  • 11. Sahinoglu-Keskek N, Keskek SO, Cevher S, et al. Metabolic syndrome as a risk factor for elevated intraocular pressure. Pak J Med. 2014;30(3):477-82.
  • 12. Aptel F, Béglé A, Razavi A, et al. Short- and long-term effects on the ciliary body and the aqueous outflow pathways of high-intensity focused ultrasound cyclocoagulation. Ultrasound Med Biol. 2014;40(9):2096-106.
  • 13. Ye S, Chang Y, Kim CW, et al. Intraocular pressure and coronary artery calcification in asymptomatic men and women. Br J Ophthalmol. 2015;99(7):932-6.
  • 14. Kim YH, Jung SW, Nam GE, et al. High intraocular pressure is associated with cardiometabolic risk factors in South Korean men: Korean National Health and Nutrition Examination Survey, 2008-2010. Eye (Lond). 2014;28(6):672-9.
  • 15. Elisaf M, Kitsos G, Bairaktari E, Kalaitzidis R, Kalogeropoulos C, Psilas K. Metabolic abnormalities in patients with primary open-angle glaucoma. Acta Ophthalmol Scand. 2001;79(2):129-32.
  • 16. Kim MJ, Kim MJ, Kim HS, Jeoung JW, Park KH. Risk factors for open-angle glaucoma with normal baseline intraocular pressure in a young population: the Korea National Health and Nutrition Examination Survey. Clin Exp Ophthalmol. 2014;42(9):825-32.
  • 17. Ko F, Boland MV, Gupta P et al. Diabetes, Triglyceride Levels, and Other Risk Factors for Glaucoma in the National Health and Nutrition Examination Survey 2005-2008. Invest Ophthalmol Vis Sci. 2016;57(4):2152-7.
  • 18. Güngör IU, Güngör L, Ozarslan Y, et al. Is symptomatic atherosclerotic cerebrovascular disease a risk factor for normal-tension glaucoma? Med Princ Pract. 2011;20(3):220-4.
  • 19. Pavljasević S, Asćerić M. Primary open-angle glaucoma and serum lipids. Bosn J Basic Med Sci .2009;9(1):85-8.
  • 20. Gasser P, Flammer J. Blood-cell velocity in the nailfold capillaries of patients with normal-tension and high-tension glaucoma. Am J Ophthalmol. 1991;111(5):585-8.
  • 21. Flammer J. The vascular concept of glaucoma. Surv Ophthalmol 1994;38:3-6.
  • 22. Bonomi L, Marchini G, Marraffa M et al. Vascular risk factors for primary open angle glaucoma: the Egna-Neumarkt Study. Ophthalmology. 2000;107(7):1287-93.
  • 23. Harris A, Evans D, Martin B, et al. Nocturnal blood pressure reduction: effect on retrobulbar hemodynamics in glaucoma. Graefes Arch Clin Exp Ophthalmol . 2002;240(5):372-8.
  • 24. Wong TY, Klein R, Sharrett AR et al. Retinal microvascular abnormalities and cognitive impairment in middle-aged persons: the Atherosclerosis Risk in Communities Study. Stroke. 2002;33(6):1487-92.
  • 25. Resch H, Garhofer G, Fuchsjäger-Mayrl G et al. Endothelial dysfunction in glaucoma. Acta Ophthalmol. 2009;87(1):4-12.
  • 26. Rosenthal R, Fromm M. Endothelin antagonism as an active principle for glaucoma therapy. Br J Pharmacol. 2011;162(4):806-16.
  • 27. Pache M, Dubler B, Flammer J. Peripheral vasospasm and nocturnal blood pressure dipping-two distinct risk factors for glaucomatous damage? Eur J Ophthalmol. 2003;13(3):260-5.
  • 28. Su WW, Cheng ST, Ho WJ, Tsay PK, Wu SC, Chang SH. Glaucoma is associated with peripheral vascular endothelial dysfunction. Ophthalmology. 2008;115(7):1173-1178.
  • 29. Boullart AC, de Graaf J, Stalenhoef AF. Serum triglycerides and risk of cardiovascular disease. Biochim Biophys Acta. 2012;1821(5):867-75.
  • 30.Tziomalos K, Athyros VG, Karagiannis A, Kolovou GD, Mikhailidis DP. Triglycerides and vascular risk: insights from epidemiological data and interventional studies. Curr Drug Targets. 2009;10(4):320-7.
  • 31. Yanagi M, Kawasaki R, Wang JJ, Wong TY, Crowston J, Kiuchi Y. Vascular risk factors in glaucoma: a review. Clin Exp Ophthalmol. 2011;39(3):252-8.
  • 32. Leske MC, Heijl A, Hyman L, Bengtsson B, Dong L, Yang Z; EMGT Group. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007;114(11):1965-72.
  • 33. Stewart WC, Osterman J. Serum lipid physiology and the influence of glaucoma medications. Surv Ophthalmol .1998;43(3):233-44.
  • 34. Mitchell P, Wang JJ, Cumming RG, House P, England JD. Long-term topical timolol and blood lipids: the Blue Mountains Eye Study. J Glaucoma. 2000;9(2):174-8.
  • 35. Walker WM, Walton KW, Magnani HN, Marsters JB, Ward EG. Glaucoma and ischaemic vascular disease risk factors. Trans Ophthalmol Soc U K. 1976;96(2):237-40.
  • 36. Chisholm IA, Stead S. Plasma lipid patterns in patients with suspected glaucoma. Can J Ophthalmol.1988;23(4):164-7.
  • 37. Türker HH, Mensiz E, Sönmez K, Bardak Y, Özertürk Y. Primer açık açılı glokomda timolol ve betaksolol kullanımının serum lipoprotein düzeyleri üzerine etkisi. SDÜ Tıp Fakültesi Derg. 1999;6(1):59-63.
  • 38. Elgin U, Batman A, Zilelioğlu O. Primer açık açılı glokom olgularında sistemik damar hastalığı görülme sıklığının, normal bireylerle karşılaştırılması. Türkiye klinikleri J opthalmology. 2006;15:40-44.
  • 39. Pertl L, Mossböck G, Wedrich A et al. Triglycerides and Open Angle Glaucoma - A Meta-analysis with meta-regression. Sci Rep. 2017;7(1):7829.
  • 40. Coleman AL, Diehl DL, Jampel HD, Bachorik PS, Quigley HA. Topical timolol decreases plasma high-density lipoprotein cholesterol level. Arch Ophthalmol. 1990;108(9):1260- 3.

PRİMER AÇIK AÇILI GLOKOMDA KAN LİPİD PROFİLİ: BİR BİYOKİMYASAL ANALİZ ÇALIŞMASI

Yıl 2021, Cilt: 22 Sayı: 6, 439 - 444, 18.10.2021
https://doi.org/10.18229/kocatepetip.772149

Öz

AMAÇ: Primer açık açılı glokomda (POAG) kan lipit profilinin araştırılması.
GEREÇ VE YÖNTEM: Bu çalışmada, 50'si POAG hastası ve 50'si POAG olmayan hasta olmak üzere oftalmoloji kliniğine başvuran 100 katılımcı vardı. Total kolesterol, düşük yoğunluklu lipoprotein (LDL), yüksek yoğunluklu lipoprotein (HDL) ve trigliserit (TG) dahil olmak üzere kan lipit seviyeleri araştırıldı. Veriler t testi, Mann Whitney U, Fischer korelasyonu ve Ki-kare testi ile karşılaştırıldı. p <0,05 istatistiksel olarak anlamlı kabul edildi.
BULGULAR: POAG hastalarının yaş ortalaması 65.7 ± 11.09 iken POAG olmayan hastaların yaş ortalaması 66.2 ± 10.44 idi. Çalışmada kullanılan laboratuvar testlerinin normal sınırları total kolesterol için 0-200 mg / dl, LDL için 0-130 mg / dl, HDL için 35-70 mg / dl ve TG'ler için 35-160 mg / dl idi. POAG ve POAG dışı hastalarda sırası ile kan lipit düzeyleri; total kolesterol: 199 ± 47 mg / dl ve 202 ± 46 mg / dl (p> 0.05), LDL: 114 ± 37 mg / dl ve 112 ± 43 37 mg / dl (p> 0.05), HDL: 51 ± 14 mg / dl ve 54 ± 19mg / dl (p> 0.05) ve TG: 170 ± 69 mg / dl ve 146 ± 102 mg / dl (p <0.05) idi.
SONUÇ: Bu çalışmada POAG ve POAG olmayan hastalar arasında total kolesterol, LDL ve HDL düzeyleri açısından fark bulunmadı. Bununla birlikte, kan lipit profilindeki değişiklikler sadece hastaların yaşı ile değil, aynı zamanda yaygın sistemik hastalıklarla da ilişkili olabilir. Bu çalışma POAG hastalarında TG düzeyinin genel popülasyona göre daha yüksek olduğunu dikkat çekici bir bulgu olarak göstermiştir.

Kaynakça

  • 1. Casson RJ, Chidlow G, Wood JP, Crowston JG, Goldberg I. Definition of glaucoma: clinical and experimental concepts. Clin Exp Ophthalmol. 2012;40(4):341-9.
  • 2. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA. 2014;311(18):1901-11.
  • 3. Saccà SC, Centofanti M, Izzotti A. New proteins as vascular biomarkers in primary open angle glaucomatous aqueous humor. Invest Ophthalmol Vis Sci. 2012;53(7):4242-53.
  • 4. Huck A, Harris A, Siesky B et al. Vascular considerations in glaucoma patients of African and European descent. Acta Ophthalmol. 2014;92(5):336-40.
  • 5. Coleman AL, Miglior S. Risk factors for glaucoma onset and progression. Surv Ophthalmol. 2008;53(1):3-10.
  • 6. Venkataraman ST, Flanagan JG, Hudson C. Vascular reactivity of optic nerve head and retinal blood vessels in glaucoma--a review. Microcirculation. 2010;17(7):568-81.
  • 7. Abegão Pinto L, Willekens K, Van Keer K, et al. Ocular blood flow in glaucoma - the Leuven Eye Study. Acta Ophthalmol. 2016;94(6):592-8.
  • 8. American Academy of Ophthalmology. Basic and Clinical Science Course Section 10. San Francisco. 1999-2000:5-6.
  • 9. Winder AF, Paterson G, Miller SJ. Biochemical abnormalities associated with ocular hypertension and low tension glaucoma. Trans Ophthalmol Soc U K. 1974;94(2):518-24.
  • 10. Chapman MJ, Ginsberg HN, Amarenco P; European Atherosclerosis Society Consensus Panel. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J. 2011;32(11):1345-61.
  • 11. Sahinoglu-Keskek N, Keskek SO, Cevher S, et al. Metabolic syndrome as a risk factor for elevated intraocular pressure. Pak J Med. 2014;30(3):477-82.
  • 12. Aptel F, Béglé A, Razavi A, et al. Short- and long-term effects on the ciliary body and the aqueous outflow pathways of high-intensity focused ultrasound cyclocoagulation. Ultrasound Med Biol. 2014;40(9):2096-106.
  • 13. Ye S, Chang Y, Kim CW, et al. Intraocular pressure and coronary artery calcification in asymptomatic men and women. Br J Ophthalmol. 2015;99(7):932-6.
  • 14. Kim YH, Jung SW, Nam GE, et al. High intraocular pressure is associated with cardiometabolic risk factors in South Korean men: Korean National Health and Nutrition Examination Survey, 2008-2010. Eye (Lond). 2014;28(6):672-9.
  • 15. Elisaf M, Kitsos G, Bairaktari E, Kalaitzidis R, Kalogeropoulos C, Psilas K. Metabolic abnormalities in patients with primary open-angle glaucoma. Acta Ophthalmol Scand. 2001;79(2):129-32.
  • 16. Kim MJ, Kim MJ, Kim HS, Jeoung JW, Park KH. Risk factors for open-angle glaucoma with normal baseline intraocular pressure in a young population: the Korea National Health and Nutrition Examination Survey. Clin Exp Ophthalmol. 2014;42(9):825-32.
  • 17. Ko F, Boland MV, Gupta P et al. Diabetes, Triglyceride Levels, and Other Risk Factors for Glaucoma in the National Health and Nutrition Examination Survey 2005-2008. Invest Ophthalmol Vis Sci. 2016;57(4):2152-7.
  • 18. Güngör IU, Güngör L, Ozarslan Y, et al. Is symptomatic atherosclerotic cerebrovascular disease a risk factor for normal-tension glaucoma? Med Princ Pract. 2011;20(3):220-4.
  • 19. Pavljasević S, Asćerić M. Primary open-angle glaucoma and serum lipids. Bosn J Basic Med Sci .2009;9(1):85-8.
  • 20. Gasser P, Flammer J. Blood-cell velocity in the nailfold capillaries of patients with normal-tension and high-tension glaucoma. Am J Ophthalmol. 1991;111(5):585-8.
  • 21. Flammer J. The vascular concept of glaucoma. Surv Ophthalmol 1994;38:3-6.
  • 22. Bonomi L, Marchini G, Marraffa M et al. Vascular risk factors for primary open angle glaucoma: the Egna-Neumarkt Study. Ophthalmology. 2000;107(7):1287-93.
  • 23. Harris A, Evans D, Martin B, et al. Nocturnal blood pressure reduction: effect on retrobulbar hemodynamics in glaucoma. Graefes Arch Clin Exp Ophthalmol . 2002;240(5):372-8.
  • 24. Wong TY, Klein R, Sharrett AR et al. Retinal microvascular abnormalities and cognitive impairment in middle-aged persons: the Atherosclerosis Risk in Communities Study. Stroke. 2002;33(6):1487-92.
  • 25. Resch H, Garhofer G, Fuchsjäger-Mayrl G et al. Endothelial dysfunction in glaucoma. Acta Ophthalmol. 2009;87(1):4-12.
  • 26. Rosenthal R, Fromm M. Endothelin antagonism as an active principle for glaucoma therapy. Br J Pharmacol. 2011;162(4):806-16.
  • 27. Pache M, Dubler B, Flammer J. Peripheral vasospasm and nocturnal blood pressure dipping-two distinct risk factors for glaucomatous damage? Eur J Ophthalmol. 2003;13(3):260-5.
  • 28. Su WW, Cheng ST, Ho WJ, Tsay PK, Wu SC, Chang SH. Glaucoma is associated with peripheral vascular endothelial dysfunction. Ophthalmology. 2008;115(7):1173-1178.
  • 29. Boullart AC, de Graaf J, Stalenhoef AF. Serum triglycerides and risk of cardiovascular disease. Biochim Biophys Acta. 2012;1821(5):867-75.
  • 30.Tziomalos K, Athyros VG, Karagiannis A, Kolovou GD, Mikhailidis DP. Triglycerides and vascular risk: insights from epidemiological data and interventional studies. Curr Drug Targets. 2009;10(4):320-7.
  • 31. Yanagi M, Kawasaki R, Wang JJ, Wong TY, Crowston J, Kiuchi Y. Vascular risk factors in glaucoma: a review. Clin Exp Ophthalmol. 2011;39(3):252-8.
  • 32. Leske MC, Heijl A, Hyman L, Bengtsson B, Dong L, Yang Z; EMGT Group. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007;114(11):1965-72.
  • 33. Stewart WC, Osterman J. Serum lipid physiology and the influence of glaucoma medications. Surv Ophthalmol .1998;43(3):233-44.
  • 34. Mitchell P, Wang JJ, Cumming RG, House P, England JD. Long-term topical timolol and blood lipids: the Blue Mountains Eye Study. J Glaucoma. 2000;9(2):174-8.
  • 35. Walker WM, Walton KW, Magnani HN, Marsters JB, Ward EG. Glaucoma and ischaemic vascular disease risk factors. Trans Ophthalmol Soc U K. 1976;96(2):237-40.
  • 36. Chisholm IA, Stead S. Plasma lipid patterns in patients with suspected glaucoma. Can J Ophthalmol.1988;23(4):164-7.
  • 37. Türker HH, Mensiz E, Sönmez K, Bardak Y, Özertürk Y. Primer açık açılı glokomda timolol ve betaksolol kullanımının serum lipoprotein düzeyleri üzerine etkisi. SDÜ Tıp Fakültesi Derg. 1999;6(1):59-63.
  • 38. Elgin U, Batman A, Zilelioğlu O. Primer açık açılı glokom olgularında sistemik damar hastalığı görülme sıklığının, normal bireylerle karşılaştırılması. Türkiye klinikleri J opthalmology. 2006;15:40-44.
  • 39. Pertl L, Mossböck G, Wedrich A et al. Triglycerides and Open Angle Glaucoma - A Meta-analysis with meta-regression. Sci Rep. 2017;7(1):7829.
  • 40. Coleman AL, Diehl DL, Jampel HD, Bachorik PS, Quigley HA. Topical timolol decreases plasma high-density lipoprotein cholesterol level. Arch Ophthalmol. 1990;108(9):1260- 3.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Leyla Eryiğit Eroğul 0000-0003-3622-2089

Murat Kaşıkcı 0000-0002-2748-9702

Özgür Eroğul 0000-0002-0875-1517

Hamidu Gobeka 0000-0002-7656-3155

Yayımlanma Tarihi 18 Ekim 2021
Kabul Tarihi 21 Aralık 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 22 Sayı: 6

Kaynak Göster

APA Eryiğit Eroğul, L., Kaşıkcı, M., Eroğul, Ö., Gobeka, H. (2021). BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY. Kocatepe Tıp Dergisi, 22(6), 439-444. https://doi.org/10.18229/kocatepetip.772149
AMA Eryiğit Eroğul L, Kaşıkcı M, Eroğul Ö, Gobeka H. BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY. KTD. Ekim 2021;22(6):439-444. doi:10.18229/kocatepetip.772149
Chicago Eryiğit Eroğul, Leyla, Murat Kaşıkcı, Özgür Eroğul, ve Hamidu Gobeka. “BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY”. Kocatepe Tıp Dergisi 22, sy. 6 (Ekim 2021): 439-44. https://doi.org/10.18229/kocatepetip.772149.
EndNote Eryiğit Eroğul L, Kaşıkcı M, Eroğul Ö, Gobeka H (01 Ekim 2021) BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY. Kocatepe Tıp Dergisi 22 6 439–444.
IEEE L. Eryiğit Eroğul, M. Kaşıkcı, Ö. Eroğul, ve H. Gobeka, “BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY”, KTD, c. 22, sy. 6, ss. 439–444, 2021, doi: 10.18229/kocatepetip.772149.
ISNAD Eryiğit Eroğul, Leyla vd. “BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY”. Kocatepe Tıp Dergisi 22/6 (Ekim 2021), 439-444. https://doi.org/10.18229/kocatepetip.772149.
JAMA Eryiğit Eroğul L, Kaşıkcı M, Eroğul Ö, Gobeka H. BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY. KTD. 2021;22:439–444.
MLA Eryiğit Eroğul, Leyla vd. “BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY”. Kocatepe Tıp Dergisi, c. 22, sy. 6, 2021, ss. 439-44, doi:10.18229/kocatepetip.772149.
Vancouver Eryiğit Eroğul L, Kaşıkcı M, Eroğul Ö, Gobeka H. BLOOD LIPID PROFILE IN PRIMARY OPEN-ANGLE GLAUCOMA: A BIOCHEMICAL ANALYSIS STUDY. KTD. 2021;22(6):439-44.

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