Haluk Savli

Serum Levels of Omentin in End-Stage Renal Disease Patients

Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in hemodialysis patients. Therefore, evaluation and prevention of cardiovascular diseases in end-stage renal disease (ESRD) patients are very important. The plasma level of omentin was found to be associated with different conditions such as insulin resistance. It is one of the novel adipokines synthesized mainly in the visceral adipose tissue. In this study, we aimed to investigate the level of omentin in patients with ESRD receiving hemodialysis. Methods: The study population consisted of 59 adult chronic hemodialysis patients (30 women and 29 men) and age-matched control subjects were selected from apparently healthy subjects (28 participants; 14 women and 14 men). Blood samples were obtained before the dialysis session. Omentin concentrations were determined by using enzyme-linked immunosorbent assay. Results: Plasma levels of omentin were found to be markedly higher in ESRD patients (606.6 ± 313.0 ng/ml) than in the control group (357.5 ± 147.4 ng/ml; p < 0.0001). Also, serum omentin levels were found to be correlated with creatinine (r = 0.333, p = 0.002). Conclusions: Omentin levels were found to be elevated in patients with ESRD receiving hemodialysis. To the best of our knowledge, this is the first clinical study that demonstrated the association between omentin and ESRD.

Could red cell distribution width be a marker in Hashimoto's thyroiditis?

AIMS Hashimotos Thyroiditis (HT) is the most common autoimmune thyroiditis worldwide and characterized with lymphomonocytic inflammation of the thyroid gland. Red cell distribution width (RDW) reflects erythrocyte anisocytosis and besides it increases in iron deficiency anemia, recent studies reported that RDW was also associated with conditions characterized with overt or subclinical inflammation. We aimed to answer whether RDW increased in Hashimotos thyroiditis. METHODS Patients with HT admitted to outpatient clinic of our hospital were included to the study. Patients with anemia (especially iron deficiency), diabetes mellitus, chronic inflammatory disease and on medication that may affect hemogram results (e. g., aspirin) excluded from the study. Patient characteristics, thyroid stimulating hormone (TSH), Free T3 (FT3), Free T4 (FT4), Anti-thyroid peroxidase (Anti-TPO), Anti-Thyroglobulin (Anti-TG), leukocyte count (WBC), Hemoglobin (Hb), Hematocrit (Htc), mean corpuscular volume (MCV), RDW and platelet count (PLT) values of the study cohort were obtained from computerized database of our institution. RESULTS There was no significant difference between study and control groups in terms of WBC, Hb, Htc, MCV, PLT, PDW and FT3 levels. However, FT4 level was significantly lower and TSH was significantly higher in study group compared to controls. RDW was significantly increased in study group compared to control group. CONCLUSION We suggest that elevated RDW values in patients without iron deficiency anemia may require further evaluation for HT, especially in female population.

Red cell distribution width and mean platelet volume in patients with irritable bowel syndrome

Introduction Possible pathophysiological mechanisms of irritable bowel syndrome (IBS) are interactions between microbial flora of the gut and the mucosal/systemic immune system, post-infectious status and inflammation. Mean platelet volume (MPV) and red cell distribution width (RDW) have been reported as inflammatory markers in patients with inflammatory bowel disease, but they have not been studied in functional gastrointestinal disorders. Aim To investigate whether there was an association between haemogram parameters (RDW and MPV) and IBS. Material and methods Forty patients with IBS and 44 healthy controls were included to this retrospective study. Patients diagnosed with IBS according to Rome III criteria were included as the IBS group. They were all screened for psychiatric or organic bowel diseases for the sake of precise diagnosis. Results Both RDW (p < 0.001) and MPV (p = 0.046) were increased in patients with IBS compared to controls. This increase in RDW and MPV was independent of the type of IBS. Conclusions The RDW and MPV should be laboratory indicators of IBS. More prospective studies with larger cohorts are needed to confirm our results.

Association between omentin levels and insulin resistance in pregnancy.

AIMS Omentin is a new adipokine secreted mainly from visceral adipose tissue. Serum omentin is found to be reduced in patients with impaired glucose tolerance, type 2 diabetes mellitus, obesity and insulin resistant states. Despite the fact that pregnancy is also characterized with hyperinsulinemia, literature is lacking about data of omentin levels and its association with insulin resistance in pregnant women. We aimed to evaluate the association of omentin levels and insulin resistance in pregnant women and to compare these levels with those of non-pregnant, non-diabetic women. METHODS Uncomplicated pregnant women who admit to our outpatient clinics for routine follow-up were included in the study group. Non-pregnant women without diabetes mellitus were served as control group. Fasting glucose, insulin, omentin levels and HOMA IR were recorded. SPSS 15.0 for Windows was used for statistical analysis. RESULTS There were 36 pregnant women in the study group and 37 healthy, non-pregnant women in the control group. Serum omentin and fasting glucose levels were significantly decreased and fasting insulin was significantly increased in the study group compared to control group. CONCLUSION Omentin might be an indicator of insulin resistance in pregnant women. Larger prospective studies are needed to claim whether omentin can have a clinical use for diagnosis of gestational diabetes mellitus.

Analysis Of The Factors Related To The Blood Pressure Control In Hypertension

OBJECTIVE To determine the factors associated with blood pressure control and comparing anthropometric and clinical parameters of subjects with well-controlled hypertension to those with poorly controlled blood pressure. STUDY DESIGN Observational cross-sectional study. PLACE AND DURATION OF STUDY Abant Izzet Baysal University Hospital, Bolu, Turkey, from January to June 2016. METHODOLOGY Medical data obtained and recorded from computerised database and case files of our clinic. Subjects with mean blood pressure above target levels were defined as poorly controlled and others were as well-controlled hypertension group according to JNC VIII. RESULTS Out of 342 subjects, only 116 (33.9%) were aware of normal blood pressure range. The number of patients who had a blood pressure on goal in the group and knew the normal range of blood pressure was significantly higher than the patients in group who did not know the normal range of blood pressure. Body mass index and waist circumference were both significantly higher in poorly controlled compared to well-controlled hypertensive subjects. Treatment compliance was significantly associated with better control of hypertension. CONCLUSION Striking results of present study indicate that lower body mass index and lesser waist circumference along with treatment compliance and awareness of normal blood pressure ranges are important factors that affect reaching treatment targets in hypertensive subjects.

Elevated neutrophil-to-lymphocyte ratio in the diagnosis of Hashimoto's thyroiditis

OBJECTIVE Hashimotos thyroiditis (HT) is an autoimmune inflammatory disorder. The purpose of this study was to determine the neutrophil-to-lymphocyte ratio (NLR), a novel marker of inflammation, in patients with HT and to compare these values with those from healthy subjects. METHOD A total of 154 participants were included in the study, 90 HT patients and 64 healthy volunteers. Retrospectively, demographic and laboratory data of the subjects were obtained from our institutions database. Patients with active infection, diabetes mellitus, malignancy, other chronic inflammatory diseases, hematologic disorders and patients on aspirin or steroid treatment were excluded from the study. Values for complete blood count (CBC) and serum laboratory parameters of HT patients were the baseline values obtained at the time of HT diagnosis. Control subjects consisted of healthy volunteers who visited our institution for a routine check-up. RESULTS Age, gender and CBC parameters were not different between the HT group and the control group; however, the NLR of HT group (2.1 [1.3-5.8]) was significantly higher than the control group (1.9 [0.6-3.3]), p=0.04. CONCLUSION Increased NLR may be useful as an indicator of the presence of HT, especially in complicated cases. NLR is inexpensive and easy to determine. Larger, prospective studies are required to determine its usefulness in assessing diagnostic potential and treatment outcomes in HT patients.

Could Mean Platelet Volume and Red Cell Distribution Width Predict Vitamin B12 Deficiency

Aims: Vitamin B12 deficiency causes an increase in homocysteine levels which is associated with inflammatory conditions. Mean platelet volume (MPV) and red cell distribution width (RDW) are also associated with inflammation. Therefore, we aimed to compare hematological parameters in patients with and without vitamin B12 deficiency to find out whether they could predict vitamin B12 deficiency. Methods: Patients who underwent vitamin B12 assessment grouped based on the serum level of vitamin B12. We grouped 116 patients, whose B12 level was lower than 250, in first group and 62 patients, whose B12 ≥ 250 pg/ml, in second group. Results: Red cell distribution width was significantly higher in group 1 (patients with a vitamin B12 level lower than 250 pg/ml) compared to those in group 2 (patients with a vitamin B12 level higher than 250 pg/ml). Mean platelet volume was significantly lower in group 1 compared to group 2. Conclusion: We suggest that MPV and RDW should be an indicator of vitamin B12