Naime Canoruç

Is serum C-reactive protein concentration correlated with HbA1c and insulin resistance in Type 2 diabetic men with or without coronary heart disease?

Background and aims: C-reactive protein (CRP) is an inflammatory marker that predicts coronary heart disease (CHD) risk. Diabetes mellitus (DM) counts as a CHD risk equivalent. We aimed to compare serum high sensitivity CRP (hs-CRP) levels in Type 2 diabetic (T2DM) men without CHD, non-diabetic CHD patients and T2DM patients with CHD. Subjects and methods: Four groups were formed; Group 1 [DM(+) CHD(−), no.=25], Group 2 [DM(−), CHD(+) no.=25], Group 3 [DM(+), CHD(+), no.=25], and Group 4 (controls, no.=30). Serum hs-CRP, insulin, glucose, total, HDL-, LDL- and VLDL-cholesterol, triglyceride levels and homeostasis model assessment for insulin resistance (HOMA-IR) index were determined. Results: Mean hs-CRP level of Group 1 (0.6±0.29) was not different statistically from Group 2 (1.44±0.97). Mean hs-CRP levels were higher in men with CHD, whether they were diabetic (Group 3; 3.83±2.01 mg/dl) or non-diabetic (Group 4), than in control subjects (0.16±0.15; p=0.0001 and p<0.004, respectively). Mean hs-CRP level of Group 3 was also higher than Group 2 (p=0.0001). There was a positive correlation between serum hs-CRP and glycated hemoglobin (HbA1c; r=0.277, p<0.01), fasting insulin (r=0.336, p<0.02) and HOMA-IR (r=0.348, p<0.02) in T2DM men with or without CHD. Conclusions: T2DM men without CHD had similar CRP levels with non-diabetic CHD patients, whereas CRP levels of T2DM men with CHD were higher than non-diabetic men with CHD. Because of a positive correlation between serum hs-CRP and HbA1c, fasting insulin and HOMA-IR, inflammation, insulin resistance and hyperglycemia jointly contribute to the cardiovascular risk in T2DM men.

Serum c-reactive protein (CRP) levels and insulin resistance in non-obese women with polycystic ovarian syndrome, and effect of bicalutamide on hirsutism, CRP levels and insulin resistance

Background/Aims: Insulin resistance is associated with serum C-reactive protein (CRP) levels. We aimed to evaluate the effect of bicalutamide on insulin resistance and serum CRP levels in non-obese polycystic ovarian syndrome (PCOS) patients. Methods: 40 non-obese patients (BMI ≤25 kg/m2) with PCOS and, 40 age- and BMI-matched healthy women were studied. Patients received bicalutamide orally at the dose of 25 mg/day. Serum CRP levels were measured with immunometric assay. Homeostasis model assessment (HOMA-IR) index was used for insulin resistance. Results: Mean Ferriman-Gallwey score (FGS) (p = 0.001), insulin (p = 0.001), serum glucose (p = 0.001), prolactin (p < 0.003), total (p < 0.04) and free testosterone (p = 0.001) and free androgen index (FAI) levels (p = 0.001) of PCOS subjects were higher than in the control group. Mean HOMA-IR of PCOS patients was higher than in control subjects (2.43 ± 1.2 and 0.94 ± 0.37, p = 0.001). CRP levels in subjects with PCOS was also higher than in control subjects (4.27 ± 1.33 and 0.98 ± 0.19, p = 0.001). After bicalutamide treatment, FGS, free and total testosterone and FAI decreased (p = 0.001). HOMA-IR, prolactin and CRP levels did not show any statistical difference with bicalutamide treatment. Conclusions: PCOS patients had insulin resistance and a high CRP level. Bicalutamide treatment did not influence insulin resistance and CRP level in PCOS, and this ineffectiveness of bicalutamide on CRP levels may be the result of insulin resistance and/or high prolactin levels at this time.

Elevated amniotic fluid amino acid levels in fetuses with gastroschisis

Our objective was to measure maternal plasma and amniotic fluid amino acid concentrations in pregnant women diagnosed as having fetuses with gastroschisis in the second trimester of pregnancy. Twenty-one pregnant women who had fetuses with gastroschisis detected by ultrasonography (gastroschisis group) in the second trimester and 32 women who had abnormal triple screenings indicating an increased risk for Down syndrome but had healthy fetuses (control group) were enrolled in the study. Amniotic fluid was obtained by amniocentesis, and maternal plasma samples were taken simultaneously. The chromosomal analysis of the study and control groups was normal. Levels of free amino acids and non-essential amino acids were measured in plasma and amniotic fluid samples using EZ:fast kits (EZ:fast GC/FID free (physiological) amino acid kit) by gas chromatography (Focus GC AI 3000 Thermo Finnigan analyzer). The mean levels of essential amino acids (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine) and non-essential amino acids (alanine, glycine, proline, and tyrosine) in amniotic fluid were found to be significantly higher in fetuses with gastroschisis than in the control group (P < 0.05). A significant positive correlation between maternal plasma and amniotic fluid concentrations of essential and nonessential amino acids was found only in the gastroschisis group (P < 0.05). The detection of significantly higher amino acid concentrations in the amniotic fluid of fetuses with a gastroschisis defect than in healthy fetuses suggests the occurrence of amino acid malabsorption or of amino acid leakage from the fetus into amniotic fluid.

Karaciğer hastalıklarında (siroz veya hepatit) homosistein ve selenyum düzeyleri

Background/aim: The liver has a crucial role in homocysteine synthesis and metabolism. Important changes in homocysteine metabolism occur when hepatic deficiency exists. Selenium levels have also been reported as being decreased in liver damage. Furthermore, many changes take place in the liver when selenium deficiency occurs, and the role in pathogenesis is being investigated. We aimed to search the changes in homocysteine and selenium levels in liver damage and determine the probable influencing factors. Materials and methods: Twenty-two chronic hepatitis (m:11, f:11, average age: 43.90±15.02), 28 cirrhotic patients (m:25, f:3, average age: 42.50±16.00) and 20 healthy subjects (m:12, f:8, average age: 36.65±8.29) were included in the study. Etiology was hepatitis B in 36, hepatitis C in 7, hepatitis B + D in 3 and Wilson disease in 1 patient. Three patients had cryptogenic cirrhosis. Homocysteine level was measured by fluorescent detector using high performance liquid chromatography (HPLC); selenium level in graphite mode by atomic absorption; AST, ALT, GGT and albumin by Abotte Aeroset autoanalyzer with photometric method; and vitamin B12 and folate levels by ELECYSIS E170 using chemiluminescence method; methylene tetrahydrofolate reductase (MTHFR) gene analysis in DNA of whole blood samples was done. Results: There was no significant difference between the three groups with respect to age. Both chronic hepatitis and cirrhotic groups had higher homocysteine levels than those of the control group (p=0.001). There was no difference in homocysteine levels between chronic hepatitis and cirrhotic groups. On the other hand, there was no difference between chronic hepatitis and control groups with respect to vitamin B12 levels. Vitamin B12 level was higher in the cirrhotic group than in controls and the difference was statistically significant. There was no difference between any of the groups in respect to folate levels. MTHFR gene mutation was similar in both patient and control groups. Selenium level was found to be lower in both patient groups than in the control group (p=0.001). Conclusion: Our results showed that hyperhomocysteinemia in chronic hepatitis and cirrhosis is not related to deficiency in folate and vitamin B12 and MTHFR gene mutation. It is seen that other enzymes involved in homocysteine metabolism might play a part in this process. It is noteworthy that selenium deficiency exists in both chronic hepatitis and liver cirrhosis.

Assidik sıvı hücre sayımında otomatik yöntem yeterince güvenilir bir seçenek midir

Background and aims: Ascitic fluid cell count is used routinely in analysis of ascitic fluid. In this study, two methods used in ascitic fluid cell count were compared (automatic method in which a hemogram device is used and standard manual hemocytometer count method in which a Thoma lam is used). Materials and methods: Twenty-six patients (20 men, six women, age range: 19-63 years) admitted to our clinic with ascites were included in the study and ascites fluid obtained from each patient, following which cell counts were performed by both methods. Results: A total of 44 ascitic fluid samples were examined. The upper limit of normal total White Blood Cell (WBC) count (>500 cell/mm3) was exceeded in 23 samples analyzed by the automatic method and 14 samples by the Thoma lam method. Nine out of 23 patients in whom cut-off levels were exceeded by automatic method had normal results with the Thoma lam method. There was no culture-positive result in any of these nine patients. Conclusions: Overdiagnosis may be obtained by use of the automatic method in evaluating ascitis fluid cell counts and the results of this study indicate that further investigation of this subject should be undertaken.