Handan Inonu Koseoglu

Endocan: A Novel Predıctor of Endothelıal Dysfunctıon ın Obstructıve Sleep Apnea Syndrome

Obstructive sleep apnea syndrome (OSA) is an independent risk factor for endothelial dysfunction and cardiometabolic diseases. Plasma endocan levels are elevated in a large number of diseases, and is a novel surrogate endothelial cell dysfunction marker. We aimed to assess the role of serum endocan level as a potential mechanism of endothelial dysfunction in OSA patients.

Cysteinyl leukotrienes in exhaled breath condensate of smoking asthmatics

Abstract Background: Cysteinyl leukotrienes (CysLTs) are among important inflammatory mediators in asthma pathogenesis. In this study, we aimed to determine leukotriene D4 (LTD4) and leukotriene E4 (LTE4) levels in exhaled breath condensate (EBC) in asthmatics and to evaluate the effect of smoking upon CysLTs levels and to speculate the importance of adding leukotriene receptor antagonists in smoking asthmatics. Methods: A total of 88 participants were included in the study. Of them, 59 were asthmatics; 30 of the 59 asthmatics were smokers (Group I) and the others were non-smokers (Group II). As a control group (Group III), 29 healthy non-smokers were enrolled. EBC samples were collected (EcoScreen, Jaeger, Hoechberg, Germany) and pulmonary function tests (PFTs) were performed in each case, and an asthma control questionnaire (ACQ) was completed by the asthmatics. LTD4 and LTE4 levels in EBC samples were analyzed by using ELISA. Results: LTD4 levels were found to be higher in Group I than other groups and similar in Group II and Group III. LTE4 levels were lower in Group III than other groups and similar in Group I and Group II. PFTs were different between Group I and Group III and there was a significant negative correlation between LTE4 levels and forced expiratory volume in one second and forced vital capacity ratio in Group I. Conclusions: LTD4, but not LTE4, concentrations in EBC were higher in asthmatic smokers than asthmatic non-smokers. LTE4 concentrations in EBC were higher in asthmatics than healthy non-smokers. In smoking asthmatics usage of agents that block the effects of LTD4 can be beneficial; however, new clinical studies are required.

Monocyte Count/HDL Cholesterol Ratio and Cardiovascular Disease in Patients With Obstructive Sleep Apnea Syndrome A Multicenter Study

Background: Obstructive sleep apnea syndrome (OSAS) is an independent risk factor for cardiovascular disease (CVD). Although monocyte to high-density lipoprotein cholesterol ratio (MHR) is increasingly being implicated in cardiovascular morbidity and mortality, no study has attempted to determine the role of MHR in cardiovascular morbidity of patients with OSAS. We aimed to investigate the association between MHR and CVD in patients with OSAS and the relationship between severity of OSAS, polysomnographic parameters, and MHR. Methods: In this cohort study, patients who had undergone a full-night polysomnography for the diagnosis of OSAS were recruited. Included patients were grouped according to the apnea–hypopnea index (AHI) as mild (5-15), moderate (15-30), and severe (>30) OSAS. Patients with AHI < 5 served as the control group. The presence of heart failure, coronary artery disease, or arrhythmia was defined as CVD. Results: A total of 1050 patients were included (131 controls, 222 mild, 228 moderate, and 469 severe OSAS). The severe group had higher MHR compared with the control and other OSAS groups (9.99, 12.11, 13.65, and 20.67 in control, mild, moderate, and severe OSAS groups, respectively, P < .001). The MHRs were significantly correlated with AHI, oxygen desaturation index, and minimum O2 saturation values (P < .001). Values of MHR were significantly higher in patients with CVD compared with those without (P < .001). Multiple regression analysis demonstrated that MHR is an independent predictor of CVD. Conclusion: The MHR is strongly associated with CVD and the severity of OSAS and might be used as a biomarker to predict CVD in patients with OSAS.

Evaluation of oxidative stress using exhaled breath 8-isoprostane levels on chronic kidney disease.

BACKGROUND There have been limited numbers of studies on patients with chronic kidney disease (CKD) to determine oxidative stress in exhaled breath condensate (EBC). Those two studies have been carried out on hemodialysis patients, and hydrogen peroxide and nitric oxide have been studied in order to show oxidative stress on EBC. AIMS We investigated oxidative stress in EBC evaluating 8-isoprostane levels on different stages of CKD. MATERIALS AND METHODS A total of 81 patients with 2-4 CKD stages have been evaluated prospectively. The patients have been categorized into three groups according to their CKD stages. For biochemical analysis, blood and breathing air samples were taken. 8-isoprostane has been measured using immunoassay method as the indicator of oxidative stress in EBC. RESULTS 8-isoprostane values were 8.19 ± 4.56, 13.89 ± 8.70, and 14.20 ± 10.68 pg/min group 1, 2, and 3, respectively; and the EBC 8-isoprostane levels increased significantly as CKD stages advanced (P0 = 0.018). There was a statistically significant reverse correlation between 8-isoprostane and glomerular filtration rate (GFR; r = -0.275; P = 0.014), but not between 8-isoprostane and C-reactive protein (r = -0.183; P = 0.177). CONCLUSIONS We determined the level of 8-isoprostane in EBC of patients with different stages of CKD and showed that the level of 8-isoprostane significantly increased through the progress of CKD. We consider that our study is important because there have been limited number of studies that evaluate oxidative stress in CKD using EBC which is a noninvasive method.

Serum levels of gamma-glutamyl transferase are associated with cardiovascular disease in obstructive sleep apnea syndrome.

BACKGROUND AND OBJECTIVES Obstructive sleep apnea syndrome (OSAS) significantly increases the risk of cardiovascular disease (CVD). γ-glutamyl transferase (GGT) is a new marker for predicting CVD. The aim of this study was to evaluate the relationship of serum GGT levels with cardiovascular event, severity of OSAS, and polysomnographic parameters in patients with OSAS. DESIGN AND SETTINGS This was a retrospective, cross-sectional study conducted between January 2011 and March 2013 (Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey). METHODS We performed a retrospective study. Patients were divided according to their apnea-hypopnea index (AHI) scores into OSAS negative (AHI< 5, Group 1), mild OSAS (AHI: 5–15, Group 2), moderate OSAS (AHI=15–30, Group 3), and severe OSAS (AHI > 30, Group 4) groups. The presence of heart failure, coronary artery disease, or arrhythmia was defined as CVD. RESULTS A total of 320 patients, with a mean age of 50.2 (10.8) years, were included in this study. There were 47, 68, 58, and 147 patients in Groups 1, 2, 3, and 4, respectively. Serum GGT levels were significantly different between groups (Group 1: 25.24 [14.95]; Group 2: 28.03 [11.92]; Group 3: 32.82 [18.18], and Group 4: 40.41 [31.90] mg/dL, P<.001). Besides, serum GGT levels were significantly correlated with AHI, oxygen desaturation index, and average and minimum O2 saturation values (P<.05). Serum GGT levels were significantly higher in patients with CVD compared with those without (P<.05). Multiple regression analysis demonstrated that independent predictors of CVD were serum GGT and low-density lipoprotein-cholesterol levels, age, and body mass index in patients with OSAS. CONCLUSION GGT level is an important predictor for CVD in patients with OSAS. The effectiveness of continuous positive airway pressure therapy on CVD and GGT levels should be investigated.

Association of Acromegaly and Central Sleep Apnea Syndrome

Acromegaly is usually characterized by the excessive secretion of growth hormone (GH) after the closure of epiphyseal plaques, resulting from functional pituitary adenomas. The most common manifestations of acromegaly are acral and soft tissue overgrowth, diabetes mellitus, hypertension, and heart and respiratory failure. In patients, obstruction of the upper airway may develop due to enlargement of the tongue and thickening of the tissues of the larynx; consequently, obstructive sleep apnea syndrome (OSAS) occurs commonly in acromegaly. Previous studies have shown an association between acromegaly and central sleep apnea syndrome (CSAS). Some of these described patients described showed that an elevation in the GH level may cause a defect in the respiratory drive. Most systemic diseases seen in acromegaly require effective treatment. We believe that it is necessary to perform effective treatments by examining respiratory disorders in sleep.

Antiinflammatory effect of telmisartan on chronic obstructive pulmonary disease: 8-isoprostane concentration in exhaled breath condensate

Amac. Kronik obstruktif akciger hastaligi (KOAH) kronik, ilerleyici, inflamatuar bir hastaliktir. Oksidatif stres ve havayolu inflamasyonu hastaligin ana patofizyolojik etkenleridir. Bu calismada bir anjiyotensin reseptor blokeri (ARB) olan telmisartan’in KOAH’daki antiinflamatuar etkisini arastirmayi amacladik. Yontem. Calismaya 25’i telmisartan kullanan 50 KOAH hastasi alindi. Hastalarin yogunlastirilmis soluk havasi (EBC) ornekleri EBC toplama cihazi kullanilarak toplandi (Ecoscreen, Jaeger, Germany). EBC ornekleri analiz edildi ve enzim immunoassay metodu (Cayman Chemical Co. Michigan, USA) kullanilarak 8-izoprostan duzeyleri olculdu. Bulgular. Her iki grup arasinda ortalama yas, cinsiyet ve sigara kullanimi acisindan fark yoktu. Telmisartan kullanan ve kullanmayan grupta 8-izoprostan duzeyleri sirasiyla 33,98 ve 35,91 pg/mL olarak olculdu, iki grup arasindaki fark istatistiksel olarak anlamli bulundu (p < 0,001). Sonuc. ARB’lerin oksidatif stres ve inflamasyonu azaltarak hastaligin patofizyolojisi ve ilerleyisine olumlu etkileri olabilir.