journal article·2024-11-28Open access

Differentiating Primary and Secondary Hypothermia in a Rat Model: The Role of Biochemical Markers in Postmortem Analysis

Emina Dervišević, Džan Ahmed Jesenković, Aida Bešić, Nedim Šuta, Aida Selmanagić, Zurifa Ajanović, Edina Lazović, Muhamed Katica, Adis Salihbegović

Applied Sciences· Volume 14· Issue 23

Abstract

Postmortem biochemistry is a valuable tool in forensic investigations, providing insights into the tissue damage and organ dysfunction associated with death. This study aimed to identify biochemical markers that distinguish primary and secondary hypothermia. Twenty-one Wistar rats were allocated into three groups: the Control group (n = 7), which was exposed only to hypothermic conditions, the Alcohol + Hypothermia group (n = 7), and the Benzodiazepines + Hypothermia group (n = 7). The temperature metrics assessed included the normal core temperature, the post-ketamine (0.3 ml injection) core temperature, the immersion temperature, temperature at the onset of hypothermia, and temperature at death. Blood samples were collected from the thoracic aorta in EDTA vacuum tubes for biochemical analysis. The key biochemical parameters measured included the Total Protein (g/L), Albumin (g/L), Globulin (g/L), Albumin to Globulin Ratio, Alanine Aminotransferase (U/L), Alkaline Phosphatase (U/L), Cholesterol (mmol/L), Amylase (U/L), and Lipase (U/L), using an automated IDEXX (Netherlands) cell counter. Significant between-group differences were found for the total protein and globulin levels (p < 0.001 and p = 0.002, respectively), with post-hoc tests confirming differences between the alcohol and control, and benzodiazepine and control groups. The cholesterol levels were found to be significantly different through an omnibus test (p = 0.03), but post hoc tests did not confirm these differences on a statistically significant level. The amylase levels varied significantly across all groups (p < 0.001), with post hoc tests confirming significant differences among all pairs: alcohol vs. benzodiazepine (p = 0.002), alcohol vs. control (p = 0.003), and benzodiazepine vs. control (p < 0.001). The lipase levels showed significant differences in the omnibus test (p = 0.030), but there was no significance in the post hoc tests. Amylase emerged as the most significant parameter in our study, with reduced levels strongly associated with secondary hypothermia. These findings highlight the potential use of total protein, globulin, and amylase levels as biomarkers to differentiate between primary and secondary hypothermia in forensic contexts.
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Research context

OpenAlex topics: Thermal Regulation in Medicine · Neuroscience of respiration and sleep · Diet and metabolism studies

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Forensic Medicine, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina

Department of Epidemiology and Biostatistics, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina

Department of Clinical Sciences Veterinary Medicine, Veterinary Faculty, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina

Department of Biology, Faculty of Science, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina

Department of Tooth Morphology with Dental Anthropology and Forensics, School of Dentistry, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina

Department of Human Anatomy, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina

Department of Pathology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina

Funding

Cantonal Ministry of Science, Higher Education and Youth of Bosnia and Herzegovina

References (39)

Show source-provided references
1. Li, J., Silverberg, M.A., Decker, W., Edelstein, J.A., Talavera, F., Walker, J.S., Alcock, J., and Danzl, D. (2023, August 15). Hypothermia: Background, Pathophysiology, Etiology. Available online: https://emedicine.medscape.com/article/770542-overview?form=fpf.
2. The evaluation and management of accidental hypothermia
3. Cold-induced thermogenesis in humans10.1038/ejcn.2016.223 ↗
4. The history of therapeutic hypothermia and its use in neurosurgery10.3171/2017.10.JNS171282 ↗
5. The global burden of liver disease: The major impact of China10.1002/hep.27406 ↗
6. The pathophysiological mechanisms of the onset of death through accidental hypothermia and the presentation of ”The little match girl” case10.15386/cjm.2014.8872.871.iij1 ↗
7. Thermal Conductivity of Water at Extreme Conditions10.1021/acs.jpcb.3c02972 ↗
8. Yang, C., Sugimoto, K., Murata, Y., Hirata, Y., Kamakura, Y., Koyama, Y., Miyashita, Y., Nakama, K., Higashisaka, K., and Harada, K. (2020). Molecular mechanisms of Wischnewski spot development on gastric mucosa in fatal hypothermia: An experimental study in rats. Sci. Rep., 10.10.1038/s41598-020-58894-8 ↗
9. National Athletic Trainers’ Association Position Statement: Environmental Cold Injuries10.4085/1062-6050-43.6.640 ↗
10. Postmortem diagnosis of hypothermia10.1007/s00414-014-0977-1 ↗
11. Režić-Mužinić, N., Mastelić, A., Benzon, B., Markotić, A., Mudnić, I., Grković, I., Grga, M., Milat, A.M., Ključević, N., and Boban, M. (2018). Expression of adhesion molecules on granulocytes and monocytes following myocardial infarction in rats drinking white wine. PLoS ONE, 13.10.1371/journal.pone.0196842 ↗
12. Forensic significance of cTnI serum for the detection of terminal myocardial damage in rats (Rattus norvegicus) caused by hyperthermia
13. The forensic significance of core temperature in identifying primary and secondary hypothermia as a cause of death: A pilot study on Wistar rats
14. Teległów, A., Romanovski, V., Skowron, B., Mucha, D., Tota, Ł., Rosińczuk, J., and Mucha, D. (2021). The Effect of Extreme Cold on Complete Blood Count and Biochemical Indicators: A Case Study. Int. J. Environ. Res. Public Health, 19.10.3390/ijerph19010424 ↗
15. Accidental hypothermia—An update10.1186/s13049-016-0303-7 ↗
16. International Commission for Mountain Emergency Medicine. The medical on-site treatment of hypothermia: ICAR-MEDCOM recommendation10.1089/152702903321489031 ↗
17. In brief: Hypothermia10.1067/j.cpsurg.2014.07.005 ↗
18. Paal, P., Pasquier, M., Darocha, T., Lechner, R., Kosinski, S., Wallner, B., Zafren, K., and Brugger, H. (2022). Accidental Hypothermia: 2021 Update. Int. J. Environ. Res. Public Health, 19.10.3390/ijerph19010501 ↗
19. Interpretation of postmortem forensic toxicology results for injury prevention research10.1136/injuryprev-2012-040488 ↗
20. Pancreatitis or not?—Elevated lipase and amylase in ICU patients10.1016/j.jcrc.2015.08.020 ↗
21. Acute pancreatitis10.1016/S0140-6736(08)60107-5 ↗
22. Suppression of amylase activity by hypertriglyceridemia10.1001/jama.1973.03220390031007 ↗
23. Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis
24. Classification of acute pancreatitis—2012: Revision of the Atlanta classification and definitions by international consensus10.1136/gutjnl-2012-302779 ↗
25. A critical evaluation of laboratory tests in acute pancreatitis10.1111/j.1572-0241.2002.05766.x ↗
26. Synthesis and lipid-lowering properties of novel N-(4-benzoylphenyl) pyrrole-2-carboxamide derivatives in Triton WR-1339-induced hyperlipidemic rats. Indonesia
27. Comparative analysis of the effect of white and red table wines on the brain of wister rats
28. Effect of Diazepam on Salivary Gland (Parotid Gland) in Rats
29. Prognostic Value of Serum Albumin at Admission for Neurologic Outcome with Targeted Temperature Management after Cardiac Arrest10.1155/2019/6132542 ↗
30. Elmsjö, A., Ward, L.J., Horioka, K., Watanabe, S., Kugelberg, F.C., Druid, H., and Green, H. (2024). Biomarker patterns and mechanistic insights into hypothermia from a postmortem metabolomics investigation. Sci. Rep., 14.10.1038/s41598-024-68973-9 ↗
31. Post-mortem metabolomics: A novel approach in clinical biomarker discovery and a potential tool in death investigations10.1021/acs.chemrestox.0c00448 ↗
32. Acid-base and electrolyte abnormalities in heart failure: Pathophysiology and implications10.1007/s10741-015-9482-y ↗
33. Lin, H., Deng, K., Zhang, J., Wang, L., Zhang, Z., Luo, Y., Sun, Q., Li, Z., Chen, Y., and Wang, Z. (2019). Biochemical detection of fatal hypothermia and hyperthermia in affected rat hypothalamus tissues by Fourier transform infrared spectroscopy. Biosci. Rep., 39.10.1042/BSR20181633 ↗
34. Elevated serum globulin fraction as a biomarker of multiyear disease severity in inflammatory bowel disease
35. Hypothermia in the trauma patient10.1016/S0020-1383(03)00309-7 ↗
36. Pathophysiology of accidental hypothermia10.1093/qjmed/95.12.775 ↗
37. Lam, R., and Muniraj, T. (2024, November 04). Hyperamylasemia, StatPearls [Internet], Available online: https://www.ncbi.nlm.nih.gov/books/NBK559273/.
38. Acute Pancreatitis Associated with Hypothermia: An Uncommon Presentation
39. Drugs and alcohol in hypothermia and hyperthermia related deaths: A retrospective study10.1520/JFS11228J ↗