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Jia M, Reynolds KL, Wong EA. Effects of high incubation temperature on tight junction proteins in the yolk sac and small intestine of embryonic broilers. Poult Sci 2023; 102:102875. [PMID: 37406432 PMCID: PMC10339051 DOI: 10.1016/j.psj.2023.102875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023] Open
Abstract
During the transition from incubation to hatch, the chicks shift from obtaining nutrients from the yolk sac to the intestine. The yolk sac tissue (YST) and small intestine serve as biological barriers between the yolk or gut contents and the blood circulation. These barriers must maintain structural integrity for optimal nutrient uptake as well as protection from pathogens. The objective of this study was to investigate the effect of high incubation temperature on mRNA abundance of the tight junction (TJ) proteins zona occludens 1 (ZO1), occludin (OCLN), claudin 1 (CLDN1), and junctional adhesion molecules A and 2 (JAMA, JAM2) and the heat shock proteins (HSP70 and HSP90) in the YST and small intestine of embryonic broilers. Broiler eggs were incubated at 37.5°C. On embryonic day 12 (E12), half of the eggs were switched to 39.5°C. YST samples were collected from E7 to day of hatch (DOH), while small intestinal samples were collected from E17 to DOH. The temporal expression of TJ protein mRNA from E7 to DOH at 37.5°C and the effect of incubation temperature from E13 to DOH were analyzed by one-way and two-way ANOVA, respectively and Tukey's test. Significance was set at P < 0.05. The temporal expression pattern of ZO1, OCLN, and CLDN1 mRNA showed a pattern of decreased expression from E7 to E13 followed by an increase to DOH. High incubation temperature caused an upregulation of ZO1 and JAM2 mRNA in the YST and small intestine. Using in situ hybridization, OCLN and JAMA mRNA were detected in the epithelial cells of the YST. In addition, JAMA mRNA was detected in epithelial cells of the small intestine, whereas JAM2 mRNA was detected in the vascular system of the villi and lamina propria. In conclusion, the YST expressed mRNA for TJ proteins and high incubation temperature increased ZO1 and JAM2 mRNA. This suggests that the TJ in the vasculature of the YST and intestine is affected by high incubation temperature.
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Affiliation(s)
- M Jia
- School of Animal Sciences, Virginia Tech, Blacksburg, VA 24061, USA
| | - K L Reynolds
- School of Animal Sciences, Virginia Tech, Blacksburg, VA 24061, USA
| | - E A Wong
- School of Animal Sciences, Virginia Tech, Blacksburg, VA 24061, USA.
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Wang YH, Lin J, Wang J, Wu SG, Qiu K, Zhang HJ, Qi GH. The Role of Incubation Conditions on the Regulation of Muscle Development and Meat Quality in Poultry. Front Physiol 2022; 13:883134. [PMID: 35784883 PMCID: PMC9240787 DOI: 10.3389/fphys.2022.883134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Muscle is the most abundant edible tissue in table poultry, which serves as an important source of high protein for humans. Poultry myofiber originates in the early embryogenic stage, and the overall muscle fiber number is almost determined before hatching. Muscle development in the embryonic stage is critical to the posthatch muscle growth and final meat yield and quality. Incubation conditions including temperature, humidity, oxygen density, ventilation and lighting may substantially affect the number, shape and structure of the muscle fiber, which may produce long-lasting effect on the postnatal muscle growth and meat quality. Suboptimal incubation conditions can induce the onset of myopathies. Early exposure to suitable hatching conditions may modify the muscle histomorphology posthatch and the final muscle mass of the birds by regulating embryonic hormone levels and benefit the muscle cell activity. The elucidation of the muscle development at the embryonic stage would facilitate the modulation of poultry muscle quantity and meat quality. This review starts from the physical and biochemical characteristics of poultry myofiber formation, and brings together recent advances of incubation conditions on satellite cell migration, fiber development and transformation, and subsequent muscle myopathies and other meat quality defects. The underlying molecular and cellular mechanisms for the induced muscle growth and meat quality traits are also discussed. The future studies on the effects of external incubation conditions on the regulation of muscle cell proliferation and meat quality are suggested. This review may broaden our knowledge on the regulation of incubation conditions on poultry muscle development, and provide more informative decisions for hatchery in the selection of hatching parameter for pursuit of more large muscle size and superior meat quality.
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YALCIN S, Özkan S, Shah T. Incubation Temperature and Lighting: Effect on Embryonic Development, Post-Hatch Growth, and Adaptive Response. Front Physiol 2022; 13:899977. [PMID: 35634161 PMCID: PMC9136109 DOI: 10.3389/fphys.2022.899977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/18/2022] [Indexed: 11/29/2022] Open
Abstract
During incubation, the content of the egg is converted into a chick. This process is controlled by incubation conditions, which must meet the requirements of the chick embryo to obtain the best chick quality and maximum hatchability. Incubation temperature and light are the two main factors influencing embryo development and post-hatch performance. Because chicken embryos are poikilothermic, embryo metabolic development relies on the incubation temperature, which influences the use of egg nutrients and embryo development. Incubation temperature ranging between 37 and 38°C (typically 37.5–37.8°C) optimizes hatchability. However, the temperature inside the egg called “embryo temperature” is not equal to the incubator air temperature. Moreover, embryo temperature is not constant, depending on the balance between embryonic heat production and heat transfer between the eggshell and its environment. Recently, many studies have been conducted on eggshell and/or incubation temperature to meet the needs of the embryo and to understand the embryonic requirements. Numerous studies have also demonstrated that cyclic increases in incubation temperature during the critical period of incubation could induce adaptive responses and increase the thermotolerance of chickens without affecting hatchability. Although the commercial incubation procedure does not have a constant lighting component, light during incubation can modify embryo development, physiology, and post-hatch behavior indicated by lowering stress responses and fearful behavior and improving spatial abilities and cognitive functions of chicken. Light-induced changes may be attributed to hemispheric lateralization and the entrainment of circadian rhythms in the embryo before the hatching. There is also evidence that light affects embryonic melatonin rhythms associated with body temperature regulation. The authors’ preliminary findings suggest that combining light and cyclic higher eggshell temperatures during incubation increases pineal aralkylamine N-acetyltransferase, which is a rate-limiting enzyme for melatonin hormone production. Therefore, combining light and thermal manipulation during the incubation could be a new approach to improve the resistance of broilers to heat stress. This review aims to provide an overview of studies investigating temperature and light manipulations to improve embryonic development, post-hatch growth, and adaptive stress response in chickens.
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Affiliation(s)
| | - Sezen Özkan
- *Correspondence: Servet YALCIN, ; Sezen Özkan,
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Wijnen HJ, van der Pol CW, van Roovert-Reijrink IAM, De Smet J, Lammers A, Kemp B, van den Brand H, Molenaar R. Low Incubation Temperature During Late Incubation and Early Feeding Affect Broiler Resilience to Necrotic Enteritis in Later Life. Front Vet Sci 2021; 8:784869. [PMID: 34970618 PMCID: PMC8713642 DOI: 10.3389/fvets.2021.784869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/26/2021] [Indexed: 01/12/2023] Open
Abstract
Resilient animals can cope with environmental disturbances in life with minimal loss of function. Resilience can be enhanced by optimizing early-life conditions. In poultry, eggshell temperature (EST) during incubation and early feeding are two early-life conditions that are found to alter neonatal chick quality as well as immune response in later life. However, whether these early-life conditions affect disease resilience of chickens at later ages has never been studied yet. Hence, we studied the effects of EST [(37.8°C (control) or 36.7°C (lower)] during late incubation (≥embryonic days 17-19.5) and feeding strategy after hatch [immediately (early feeding) or 51-54 h delayed (delayed feeding)] on later-life broiler resilience in a 2 × 2 factorial arrangement. At hatch, 960 broilers of both sexes from a 54-week-old Ross breeder flock were equally divided over 32 pens (eight replicate pens per treatment combination) and grown for 6 weeks. Necrotic enteritis was induced by a single inoculation of Eimeria spp. at d 21 and repeated Clostridium perfringens inoculation (3×/d) during d 21-25. Mortality and body weight (BW) gain were measured daily during d 21-35 as indicators of resilience. Additionally, disease morbidity was assessed (gut lesions, dysbacteriosis, shedding of oocysts, footpad dermatitis, and natural antibody levels in blood). Results showed a lack of interaction between EST and feeding strategy for the vast majority of the variables. A lower EST resulted in lower BW gain at d 5 and 8 post Eimeria inoculation (P = 0.02) and more Eimeria maxima oocysts in feces at d 8 post Eimeria inoculation compared to control EST (P < 0.01). Early feeding tended to lower mortality compared to delayed feeding (P = 0.06), but BW gain was not affected by feeding strategy. Morbidity characteristics were hardly affected by EST or feeding strategy. In conclusion, a few indications were found that a lower EST during late incubation as well as delayed feeding after hatch may each impair later-life resilience to necrotic enteritis. However, these findings were not manifested consistently in all parameters that were measured, and conclusions are drawn with some restraint.
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Affiliation(s)
- Hendrikus J. Wijnen
- Adaptation Physiology Group, Department of Animal Sciences, Wageningen University & Research, Wageningen, Netherlands
- Research Department, HatchTech B.V., Veenendaal, Netherlands
| | | | | | - Joren De Smet
- Clinical Research Organization, Poulpharm BVBA, Izegem, Belgium
| | - Aart Lammers
- Adaptation Physiology Group, Department of Animal Sciences, Wageningen University & Research, Wageningen, Netherlands
| | - Bas Kemp
- Adaptation Physiology Group, Department of Animal Sciences, Wageningen University & Research, Wageningen, Netherlands
| | - Henry van den Brand
- Adaptation Physiology Group, Department of Animal Sciences, Wageningen University & Research, Wageningen, Netherlands
| | - Roos Molenaar
- Adaptation Physiology Group, Department of Animal Sciences, Wageningen University & Research, Wageningen, Netherlands
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Damaziak K. Preincubation and preheating – two different methods but with one purpose for use in hatchery. Can their interaction be twice as effective? WORLD POULTRY SCI J 2021. [DOI: 10.1080/00439339.2021.1960237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K. Damaziak
- Department of Animal Breeding, Institute of Animal Sciences, Warsaw University of Life Sciences, Warsaw, Poland
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Research Note: Storage period and prewarming temperature effects on synchronous egg hatching from broiler breeder flocks during the early laying period. Poult Sci 2020; 100:100918. [PMID: 33518347 PMCID: PMC7936211 DOI: 10.1016/j.psj.2020.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 11/21/2022] Open
Abstract
The effects of the storage period and prewarming temperature on embryonic mortality, hatchability, and synchronous hatching of broiler eggs were investigated. Eggs were obtained from commercial flocks of Ross 308 broiler breeders at 27 and 28 wk of age for trials 1 and 2, respectively. In both trials, 2,400 eggs were stored for 4 d (short) or 11 d (long) at 18°C (64.4°F) and 75% RH and were randomly assigned to 2 groups at either a prewarming temperature of 26.1°C (79°F, low) or 29.4°C (85°F, high) for 8 h before setting. The eggs were transferred from setters to hatching baskets at 444 h (18.5 d) of incubation. The hatched chicks were counted at 6-h intervals between 468 h and 516 h of incubation and categorized as early, middle, or late hatching. The eggs stored for 4 d hatched earlier than the eggs stored for 11 d (P < 0.05). An increased prewarming temperature (29.4°C) resulted in a 1.0-h shorter incubation duration, but this difference was not significant (P = 0.064). An interaction between the storage period and prewarming temperature was observed for middle- and late-hatched chicks (P < 0.05). No interactions between the storage period and prewarming temperature were observed for hatchability of fertile eggs or embryonic mortality; however, a significant interaction was found between the storage period and prewarming temperature on the second-quality chick percentage (P < 0.05). The eggs stored for 11 d had a significantly reduced hatchability of fertile eggs owing to increased embryonic mortality than short-stored eggs (P < 0.05). The interaction effect indicated that eggs held for 8 h with prewarming at 29.4°C after 11 d of storage had more middle- and fewer late-hatched chicks and improved chick quality than those that received the 26.1°C prewarming treatment (P < 0.05), but no significant difference was found among the prewarming treatments for eggs stored for 4 d. This study demonstrated that prolonged egg storage resulted in reduced hatchability, increased incubation duration, and an asynchronous hatching time. Moreover, increasing the prewarming temperature could be used to promote uniformity among embryos through synchronous hatching, thus improving broiler flock uniformity and performance of the prolonged stored eggs.
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Damaziak K, Koznaka-Lipka M, Gozdowski D, Gołębiowska A, Kędziorek E. Effects of broiler breeder strain, age, and eggs preheating profile in single-stage systems on the hatchability of eggs and quality of chicks. Animal 2020; 15:100057. [PMID: 33516020 DOI: 10.1016/j.animal.2020.100057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 01/05/2023] Open
Abstract
Preheating can increase the efficiency of commercial broiler breeding. A slow increase in temperature can counteract the negative effects of water condensation on the surface of the shell and reduces the thermal shock to the embryos. It is essential to design different preheating profiles because of the variances between breeds in terms of egg construction and the course of embryogenesis, along with the influence of the parental flocks' age on hatching rates. This study aimed to analyze six preheating profiles with different time and temperature patterns (A-F), which were immediately applied before the egg incubation began. These profiles were used for two broiler breeder strains - Hubbard Flex and Ross 308 - for the entire laying cycle divided into six age ranges: 25-30, 31-36, 37-42, 43-48, 49-54, and 55-60wk of life. A total of 7839250 Hubbard Flex and 57167060 Ross 308 eggs were used in the study. The eggs were stored for 4-7d before the preheating profile was applied. Mortality during incubation, hatchability, and the quality of chicks were analyzed. The most favorable results were obtained with profile B - 02 h (25.0 °C):02 h (29.4 °C):02 h (32.2 °C):02 h (35.0 °C):02 h (37.8 °C), while the worst results were obtained with profile C - 03 h (23.9 °C):03 h (25.0 °C):04 h (32.2 °C). These findings indicated that compared to a rapid temperature increase during incubation, multistage slow heating of eggs is more advantageous as it enables achieving better hatchability from apparent fertile eggs and obtaining more first-grade chicks. An analysis of the interaction of different preheating profiles with flock age and breed of parental flock revealed that profile C is not suitable for eggs from older flocks, in particular Ross 308. Deterioration of hatchability of chicks from apparent fertile eggs was also confirmed for flocks over 49wk of life after the application of profile E - 03 h (77 °C):02 h (29.4 °C):02 h (32.2 °C):01 h (35.0 °C):02 h (37.8 °C). Increased early and late mortality of embryos was observed in the case of Hubbard Flex after the use of profile D - 03 h (25.0 °C):02 h (29.4 °C):01 h (32.2 °C):02 h (35.05 °C):02 h (37.8 °C). Based on the obtained results, it can be recommended that profile B can be applied for the entire duration of Ross 308 and Hubbard Flex flock utilization to achieve high egg hatchability and obtain high-quality chicks.
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Affiliation(s)
- K Damaziak
- Department of Animal Breeding, Faculty of Animal Breeding, Bioengineering and Conservation, Institute of Animal Science, Ciszewskiego 8, 02-786 Warsaw, Poland.
| | | | - D Gozdowski
- Department of Biometry, Faculty of Agriculture and Biology, Institute of Agriculture, Warsaw University of Life Sciences, Nowoursynowska 164, 02-787 Warsaw, Poland
| | - A Gołębiowska
- SuperDrob S.A., Hatchery, Stoczek 44, 07-104, Poland
| | - E Kędziorek
- SuperDrob S.A., Hatchery, Stoczek 44, 07-104, Poland
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Wong EA, Uni Z. Centennial Review: The chicken yolk sac is a multifunctional organ. Poult Sci 2020; 100:100821. [PMID: 33518342 PMCID: PMC7936120 DOI: 10.1016/j.psj.2020.11.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/04/2020] [Accepted: 11/08/2020] [Indexed: 11/26/2022] Open
Abstract
The yolk sac (YS) consists of the yolk, which supplies nutrients, and the YS tissue, which surrounds the yolk and provides essential metabolic functions for the developing embryo. The YS tissue is derived from the midgut of the embryo and consists of a layer of endodermal epithelial cells (EEC) in contact with the yolk contents, a mesodermal layer that contains the vascular system and an outer ectodermal layer. The YS tissue is a multifunctional organ that provides essential functions such as host immunity, nutrient uptake, carbohydrate and lipid metabolism, and erythropoiesis. The YS tissue plays a role in immunity by the transport of maternal antibodies in the yolk to the embryonic circulation that feeds the developing embryo. In addition, the YS tissue expresses high mRNA levels of the host defense peptide, avian β-defensin 10 during mid embryogenesis. Owing to its origin, the YS EEC share some functional properties with intestinal epithelial cells such as expression of transporters for amino acids, peptides, monosaccharides, fatty acids, and minerals. The YS tissue stores glycogen and expresses enzymes for glycogen synthesis and breakdown and glucogenesis. This carbohydrate metabolism may play an important role in the hatching process. The mesodermal layer of the YS tissue is the site for erythropoiesis and provides erythrocytes before the maturation of the bone marrow. Other functions of the YS tissue involve synthesis of plasma proteins, lipid transport and cholesterol metabolism, and synthesis of thyroxine. Thus, the YS is an essential organ for the growth, development, and health of the developing embryo. This review will provide an overview of the studies that have investigated the functionalities of the YS tissue at the cellular and molecular levels with a focus on chickens.
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Affiliation(s)
- E A Wong
- Department of Animal and Poultry Sciences, Virginia Tech, Blacksburg, VA 24061.
| | - Z Uni
- Department of Animal Sciences, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
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Dayan J, Reicher N, Melkman-Zehavi T, Uni Z. Incubation temperature affects yolk utilization through changes in expression of yolk sac tissue functional genes. Poult Sci 2020; 99:6128-6138. [PMID: 33142531 PMCID: PMC7647798 DOI: 10.1016/j.psj.2020.07.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/12/2020] [Accepted: 07/14/2020] [Indexed: 01/15/2023] Open
Abstract
The yolk sac tissue (YST) is a multifunctional metabolic organ supporting chicken embryonic development. This study examined whether incubation temperatures (ITs) affect YST functions. For this purpose, 300 eggs were assigned to 3 groups and incubated at control IT of 37.8°C, at 1.5°C below, 36.3°C (cold IT), and at 1.5°C above, 39.3°C (hot IT). For each group, 6 embryos' whole body mass and residual yolk (RSY) weights were recorded during incubation, and YST was sampled for both histology and gene expression analysis. YST functionality during incubation was examined by regression analysis, comparing changes in expression patterns of genes involved in lipid uptake and metabolism (LRP2, ApoA1), oligopeptides uptake (PepT1), gluconeogenesis (FBP1), glycogenesis (GYS2), and thyroid hormones regulation (TTR, DIO1, DIO2). Results show that hot and cold ITs affected YST gene expression and yolk utilization. PepT1 expression decreased towards hatch, in both hot and cold ITs, while in the Control IT, it reached a plateau. ApoA1 and DIO2 expression showed a moderate linear fit compared to polynomial fit in the control. GYS2 expression had no change along incubation, while in the control IT, it showed a polynomial fit. Expression of LRP2, FBP1, and DIO1 genes was affected by either cold or hot IT's. TTR expression patterns were similar in all IT groups. The variations in gene expression patterns observed in the 3 ITs can explain the changes in yolk utilization, an important parameter for hatchling quality. While the control IT showed optimal utilization, with an RSY value of 11.12% at the day of hatch, the cold and hot IT groups exhibited lower utilization with an RSY value of 18.18 and 29.99%, respectively. These findings are the first to show that ITs change the expression of key YST genes, leading to variations in yolk utilization by the embryo.
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Affiliation(s)
- Jonathan Dayan
- Department of Animal Science, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel
| | - Naama Reicher
- Department of Animal Science, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel
| | - Tal Melkman-Zehavi
- Department of Animal Science, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel
| | - Zehava Uni
- Department of Animal Science, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel.
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Amini MA, Talebi SS, Karimi J. Reactive Oxygen Species Modulator 1 (ROMO1), a New Potential Target for Cancer Diagnosis and Treatment. Chonnam Med J 2019; 55:136-143. [PMID: 31598470 PMCID: PMC6769249 DOI: 10.4068/cmj.2019.55.3.136] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/14/2019] [Accepted: 06/19/2019] [Indexed: 02/01/2023] Open
Abstract
Today, the incidence of cancer in the world is rising, and it is expected that in the next several decades, the number of people suffering from cancer or (the cancer rate) will double. Cancer is defined as the excessive and uncontrolled growth of cells; of course (in simple terms), cancer is considered to be a set of other diseases that ultimately causes normal cells to be transformed into neoplastic cells. One of the most important causes of the onset and exacerbation of cancer is excessive oxidative stress. One of the most important proteins in the inner membrane of mitochondria is Reactive Oxygen Species (ROS) Modulator 1 (ROMO1) that interferes with the production of ROS, and with increasing the rate of this protein, oxidative stress will increase, which ultimately leads to some diseases, especially cancer. In this overview, we use some global databases to provide information about ROMO1 cellular signaling pathways, their related proteins and molecules, and some of the diseases associated with the mitochondrial protein, especially cancer.
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Affiliation(s)
- Mohammad Amin Amini
- Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Saman Talebi
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jamshid Karimi
- Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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