Abdullah Erman Yagiz

Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus

Objective Leukocytosis is thought to be directly associated with the pathogenesis of atherosclerosis and metabolic syndrome. Increased white blood cell (WBC) count is related to cardiovascular disease in patients with type 2 diabetes mellitus; raised neutrophil lymphocyte ratio (NLR) is associated with metabolic syndrome. There is little information, however, concerning a correlation between glycosylated haemoglobin (HbA1c) and NLR. The aim of the present study was to investigate the relationship between NLR and blood glucose regulation. Methods This retrospective study was conducted in patients with type 2 diabetes mellitus, divided into two groups according to HbA1c levels: group 1, HbA1c levels ≤ 7%; group 2, HbA1c levels > 7%. Venous WBC, neutrophil and lymphocyte counts were determined. Results Of 71 patients included, fasting serum glucose, neutrophil and WBC counts were significantly higher in group 2 compared with group 1. NLR had a positive correlation with HbA1c. Conclusion There may be a significant relationship between NLR and blood glucose regulation. The authors propose that increased NLR may be associated with elevated HbA1c in patients with type 2 diabetes mellitus.

Thymoquinone Attenuates Trauma Induced Spinal Cord Damage in an Animal Model

BACKGROUND Spinal cord injury (SCI) is one of the most devastating conditions leading to neurological impairment and disabilities. The aim of the study was to investigate the potential neuroprotective effect of thymoquinone (TQ) histopathologically in an experimental model of traumatic spinal cord injury (SCI). METHODS Twenty-four male Wistar albino rats were randomly divided into 4 groups: control group; SCI group; SCI-induced and 10 mg/kg/day TQ administered group; SCI-induced and 30 mg/kg/day TQ administered group. TQ was given as intraperitoneal for three days prior to injury and four days following injury. Spinal cord segment between T8 and T10 were taken for histopathologic examination. Hemorrhage, spongiosis and liquefactive necrosis were analyzed semiquantatively for histopathological changes. RESULTS Administration of TQ at a dose of 10 mg/kg did not cause any significant change on the histological features of neuronal degeneration as compared to the SCI group (p=0.269); however, 30 mg/kg TQ significantly decreased the histological features of spinal cord damage below that of the SCI group (p=0.011). CONCLUSION Data from this study suggest that TQ supplementation attenuates trauma induced spinal cord damage. Thus, TQ needs to be taken into consideration, for it may have a neuroprotective effect in trauma induced spinal cord damage.

Association of Vitamin D with Disease Activity in Rheumatoid Arthritis and Ankylosing Spondylitis

1 Abdullah Erman Yagiz1, Nilgun Ustun1, Hacer Paksoy1, Ihsan Ustun2, Ayhan Mansuroglu3, Hayal Guler1, Ayse Dicle Turhanoglu1 1Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Mustafa Kemal University, 2Department of Internal Medicine, Faculty of Medicine, Mustafa Kemal University, 3Clinic of Physical Medicine and Rehabilitation, Antakya State Hospital, Hatay, Turkey Vitamin D ve Hastalık Aktivitesi / Vitamin D and Disease Activity Association of Vitamin D with Disease Activity in Rheumatoid Arthritis and Ankylosing Spondylitis

Spectral domain-optical coherence tomographic findings in patients with ankylosing spondylitis under anti-tumor necrosis factor-alpha therapy.

Abstract Objective: To evaluate the effect of tumor necrosis factor-alpha (TNF-α) blockade on the thickness of the peripapillary retinal nerve fiber layer (RNFL), the ganglion cell-inner plexiform layers (GCIPL), and the macula in ankylosing spondylitis (AS) patients under anti-TNF-α therapy. Materials and methods: Twenty-one patients with AS received etanercept, or adalimumab, or infliximab for at least 6 months. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores were measured before and 6 months after the beginning of the treatment. Peripapillary RNFL, four regional fields (superior, inferior, nasal, and temporal), GCIPL, and macular thicknesses of the patients were analyzed by optical coherence tomography before the treatment, at 3 months and 6 months after the beginning of the treatment. Results: The mean BASDAI, ESR, and CRP values were 5.2 ± 1.5, 31.6 ± 21.7, and 15.7 ± 13.9, respectively, at the beginning of the treatment and 2.3 ± 1.7, 21.3 ± 15.1, and 10.1 ± 10.3, respectively, 6 months after the beginning of treatment. There were significant differences among the mean BASDAI, ESR, and CRP values at the beginning of treatment and 6 months later (p < 0.001, p = 0.007, and p = 0.009, respectively). There were no significant differences among peripapillary RNFL (p = 0.24), four regional fields (p = 0.98, p = 0.23, p = 0.09, p = 0.47), GCIPL (p = 0.25), or macular (p = 0.33) thicknesses of the patients during anti-TNF-α treatment. In addition, the mean intraocular pressure levels throughout the follow-up did not show significant variation on repeated-measures ANOVA (p = 0.77). Conclusions: TNF-α blockade does not seem to influence RNFL, GCIPL, or macular thickness of patients with AS in the short term.

AB0952 Subclinical Left Ventricular Dysfunction in Patients with Ankylosing Spondylitis without Clinically Evident Cardiovascular Disease: A Two-Dimensional Speckle Tracking Echocardiographic Study

Background Cardiac involvement is common in ankylosing spondylitis (AS), which has not been previously evaluated by using speckle tracking echocardiography (STE). Objectives The objectives of this study were to evaluate the left ventricle (LV) systolic strain by STE in order to provide the subclinical myocardial dysfunction in patients with AS and to examine the relationship between LV systolic strain and disease activity indices. Methods A total of 26 patients with AS without clinically evident cardiovascular disease and 26 age-,sex-,and BMI-matched healthy controls were included in the study. Bath AS disease activity index, Bath AS fuctional index, Bath AS metrology index and Bath AS radiologic index were used as clinical indices. Conventional echocardiography, tissue Doppler imaging, color tissue Doppler derived strain/strain rate echocardiographic imaging were performed by a single cardiologist using a 2.5–3.5 MHz transducer and Vingmed System 7 (Vivid 7 Pro; Horton, Norway). All data were transferred to a workstation for further offline analysis (EchoPAC 6.1; GE Vingmed Ultrasound AS). For left ventricle color tissue Doppler dynamic images were obtained from from LV apical 4-, 3- and 2-C (chamber) views. Results There were no significant differences in baseline demographic characteristics and cardiovascular risk factors between the patients and the controls. There were no significant differences between patients and controls in terms of left ventricle diameters, ejection fraction, posterior wall thickness, interventriculer septum wall thickness, mitral deceleration time and systolic myocardial flow velocity (p>0.05). AS patients were observed to have statistically significantly lower left ventricule peak longitudinal and global strain/strain rate values in the 4C, 3C, and 2C views compared with the controls (p>0.05). In addition, we detected no correlation in left ventricule global strain values and AS clinical indices values (p>0.05). Conclusions Myocardial systolic function assessed by STE, which is a sensitive marker of ventricular dysfunction is impaired in AS. References Teske AJ, De Boeck BW, Melman PG, Sieswerda GT, Doevendans PA, Cramer MJ. Echocardiographic quantification of myocardial function using tissue deformation imaging, a guide to image acquisition and analysis using tissue Doppler and speckle tracking. Cardiovasc Ultrasound 2007;5:27. Schiller NB, Shah PM, Crawford M, et al: American Society of Echocardiography committee on standards, subcommittee on quantitation of two-dimensional echocardiograms: Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. J Am Soc Echocardiography 1989;2:358–367. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.1961

AB0681 Bisphenol A Levels in Patients with Ankylosing Spondylitis and Its Correlation with Disease Activity

Background Ankylosing spondilitis (AS) is a systemic chronic inflammatory disorder of unidentified etiology. Bisphenol A (BPA) which act as a protective lining on the inside of metal-based food and beverage cans, is a chemical produced in large quantities for use primarily in the production of polycarbonate plastics such as hard plastic bottles and epoxy resins. BPA is an estrogenic endocrine disruptor that exerts an extensive variety of metabolic effects. Objectives The objective of present study was to measure serum BPA levels in patients with AS and to explore a possible link between serum BPA levels and disease activity scores. Methods A total of 50 AS patients (40 male, 10 female, mean age 41.14±11.65 years, mean body mass index 26.78±3.94 kg/m2) and 30 age-sex- and body mass index-matched healthy controls (23 male, 7 female, mean age 41.44±6.98, mean body mass index 27±3.06 kg/m2) were taken to the study. Disease activity of the AS patients was measured by Bath ankylosing spondylitis disease activity index (BASDAI). Results The median disease duration of the AS patients was 10.68±10.43 years. Forty-three patients were taking NSAID and/or DMARD. Seven patients were taking an anti-TNF agent. Serum BPA levels of the patients with AS was significantly higher than that of healthy controls (3.98±2.35 vs. 0.49±0.29; p=0.001). There was significant positive correlation between the serum BPA levels and BASDAI scores (r=0.321, p=0.025). Conclusions These data clearly show that serum BPA levels are significantly higher in patients with AS in comparison to age-sex-BMI-matched healthy controls. Furthermore, levels of BPA in AS patients were positively correlated with disease activity scores. References Ozgocmen S, Akgul O, Altay Z, et al. Expert opinion and key recommendations for the physical therapy and rehabilitation of patients with ankylosing spondylitis. International journal of rheumatic diseases 2012;15(3):229-38. Vandenberg LN, Maffini MV, Sonnenschein C, Rubin BS, Soto AM. Bisphenol-A and the great divide: a review of controversies in the field of endocrine disruption. Endocrine reviews 2009;30(1):75-95. Rogers JA, Metz L, Yong VW. Review: Endocrine disrupting chemicals and immune responses: a focus on bisphenol-A and its potential mechanisms. Molecular immunology 2013;53(4):421-30. Wells EM, Jackson LW, Koontz MB. Association between bisphenol A and waist-to-height ratio among children: National Health and Nutrition Examination Survey, 2003-2010. Annals of epidemiology 2013. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.1383