Fatma Hümeyra Yerlikaya

The Relationship Between Neutrophil-to-Lymphocyte Ratio and Inflammation in End-Stage Renal Disease Patients

Abstract Background: Patients with end-stage renal disease (ESRD) have elevated serum levels of inflammatory mediators including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-6. Systemic inflammation was found to be correlated with coronary artery disease (CAD) in this population. Neutrophil-to-lymphocyte ratio (NLR) was introduced as a potential marker to determine inflammation in cardiac and non-cardiac disorders. Data regarding NLR and its association with inflammation are lacking. We aimed to determine the relationship between NLR and inflammation in ESRD patients. Material and methods: This was a cross-sectional study involving 61 ESRD patients (25 females and 36 males; mean age: 48.3 ± 14.5 years) receiving peritoneal dialysis (PD) or hemodialysis (HD) for ≥6 months in the Dialysis Unit of Selcuk University. NLR, CRP, TNF-α, and IL-6 levels were measured. Results: NLR, serum CRP, IL-6, and TNF-α levels were significantly higher in PD patients when compared with HD patients. ESRD patients with NLR ≥ 3.5 had significantly higher TNF-α levels when compared with patients with NLR < 3.5. In the bivariate correlation analysis, NLR was positively correlated with TNF-α in this population. Conclusions: Simple calculation of NLR can predict inflammation in ESRD patients.

Plasma fatty acid composition in continuous ambulatory peritoneal dialysis patients: an increased omega-6/omega-3 ratio and deficiency of essential fatty acids.

Abstract Patients with end-stage renal disease, including those treated with peritoneal dialysis, have a high risk for death, particularly from cardiovascular causes. Plasma fatty acid (FA) composition is used as an indicator of disease risk, because its alteration has been related to metabolic disease and cardiovascular disease. For this purpose, we have measured plasma FA composition in continuous ambulatory peritoneal dialysis (CAPD) patients and compared them with those of healthy subjects. This study was performed on 51 (21 M, 30 F) CAPD patients at least 6 months under dialysis, aged 20–75 years (mean 47.81 ± 11.8 years) and 45 (25 M, 20 F) healthy control subjects aged 20–60 years (mean 38.62 ± 12.9 years). Plasma 10-cis-pentadecanoic acid, 10-cis-heptadecanoic acid, heneicosanoic acid, tricosanoic acid, nervonic acid, saturated fatty acid, and monounsaturated FA levels and delta 9 desaturase activity were significantly higher whereas linoleic acid, linolenic acid, 11,14-eicosedienoic acid, arachidonic acid, docosahexaenoic acid, and omega-3 FA levels were significantly lower in the CAPD group than those in the healthy group. Our results show that there are FA abnormalities and especially a depletion in essential FA levels and a high level of omega-6/omega-3 ratio in CAPD patients, the underlying mechanism of which is not known and needs to be investigated. Therefore, we believe that essential FA supplementation should be encouraged for CAPD patients.

Obesity is an independent determinant of ischemia-modified albumin.

Objective: We have measured ischemia-modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS) and high-sensitivity C-reactive protein (hsCRP) levels in obese and normal-weight subjects to investigate if IMA can be used as a biomarker of oxidative stress and inflammation and if IMA was an independent determinant of obesity or not. Methods: The study was performed on 92 obese subjects (20 male, 72 female) aged 38 ± 11 years and 78 normal-weight controls (19 male, 59 female) aged 37 ± 11 years. Serum lipids, IMA, TAS, TOS, and hsCRP levels of the subjects were measured. Results: IMA (p < 0.05), TOS (p < 0.001), and hsCRP (p < 0.001) levels of the obese subjects were significantly higher, whereas TAS levels were significantly lower (p < 0.05) than those of the controls after adjustment for age and gender. In the linear regression analysis, waist circumference (r2 = 0.139, p < 0.01), BMI (r2 = 0.136, p < 0.01) and insulin (r2 = 0.120, p < 0.05) were shown to be significant independent determinants of IMA levels. Conclusions: We have found that oxidative stress and inflammation were increased and antioxidative defense was decreased, which resulted in increased levels of IMA, a biomarker of ischemia, in obese subjects. Also, obesity and insulin were found to be independent determinants of IMA. Thus, obese subjects are under high risk of ischemia, and IMA may be used as a biomarker of oxidative stress and ischemia. Further larger investigations are needed to confirm this opinion.

Effects of acrylamide treatment on oxidant and antioxidant levels in rats.

The aim of this study was to investigate serum total antioxidant status (TAS), total oxidant status (TOS) and ischemia-modified albumin (IMA) levels in long term acrylamide (ACR) given rats, compared to control rats. In total, 25 male and 25 female Wistar rats were involved in this experiment. Animals in each sex were segregated into three groups. Two of them were treatment groups and one of them was control group. Each treatment group consisted of ten animals and each control group consisted of five animals. ACR was administered to the treatment groups at 2 and 5 mg/kg/day via drinking water for 90 days. In the end of the experiment, serum samples were analyzed for IMA, TAS, TOS and albumin levels with the spectrophotometric method. Serum IMA and adjusted IMA levels were significantly higher at concentrations of 2 mg/kg and 5 mg/kg in the male rats when compared with those of the control male rats. Serum TAS levels significantly decreased at concentrations of 5 mg/kg in the male rats when compared with those of the control rats. We also observed a significant increase in the levels of serum TOS at concentrations of 5 mg/kg in the male rats. There were no significant differences between serum IMA, TAS, TOS and albumin levels at concentrations of 2 mg/kg and 5 mg/kg in the female rats. Our findings show that long term treatment with 2 mg/kg and 5 mg/kg doses of ACR led to a significant depletion of serum TAS levels and overproduction of serum TOS and IMA levels, consequently, to an increase in oxidative stress.