Ömer Yazgan

Mean platelet volume in patients with non-alcoholic fatty liver disease

Mean platelet volume (MPV) is an indictor of platelet activation. Platelet activation and aggregation are central processes in the pathophysiology of coronary heart disease. Non-alcoholic fatty liver disease (NAFLD) is present up to one–third of the general population and the majority of patients with cardio-metabolic risk factors such as abdominal obesity, type 2 diabetes and other components of the metabolic syndrome (MS). The aim of the current study was to investigate the MPV in patients who had NAFLD. MPV values of the patients with NAFLD and of the patients without fatty liver disease were compared. NAFLD patients had significantly higher body mass index compared to the control cases. Among biochemical variables, fasting plasma glucose and triglyceride were significantly higher in the NAFLD group. NAFLD cases also had lower platelet count and higher MPV (10.43 ± 1.14 vs. 9.09 ± 1.25; p < 0.001, respectively). MPV was positively correlated with AST (r: 0.186, p < 0.042), ALT level (r: 0.279; p 0.002) and the presence of NAFLD (0.492; p < 0.001) but negatively correlated with platelet number (r: −0.26; p 0.004) and creatinine (r: −0.255; p 0.005). In logistic regression analysis (age, gender, NAFLD, body mass index, high-density lipid (HDL) cholesterol, systolic and diastolic blood pressure, triglyceride and fasting plasma glucose were used as covariates) only NAFLD was found to be the independent predictor of MPV (Odds Ratio (OR) 21.98) [95% confidence interval (CI): 2.404–201.048; p: 0.006]. We have shown for the first time in the literature that, patients with NAFLD have higher MPV. It may have prognostic value in NAFLD patients indicating a possible cardiovascular disease (CVD) risk increase.

Doppler waveforms of the hepatic veins in children with diffuse fatty infiltration of the liver.

OBJECTIVE The aim of this study was to investigate the effect of fatty infiltration of the liver (FIL) on the Doppler waveform pattern in the hepatic veins of obese children. METHODS In this prospective study, 59 patients with diffuse FIL and 45 normal healthy children who served as control group underwent hepatic vein B-mod and duplex Doppler sonography. The Doppler sonography spectrum of the right hepatic vein was classified into three groups: triphasic waveform, biphasic waveform, and monophasic or flat waveform. RESULTS There was a statistically significant difference in the phasicity of hepatic venous flow between patients and control subjects (p<0.001). The Doppler flow pattern in the right hepatic vein was triphasic in 28 (47.5%), biphasic in 28 (47.5%), and monophasic in 3 (5%) children with fatty liver, while it was triphasic in 43 (95.6%) and biphasic in 2 (4.4%) control subjects. There was an inverse correlation between the sonographic grade of fatty infiltration of the liver and the phasicity of hepatic venous flow (r=-0.479, p<0.001). CONCLUSIONS Abnormal right hepatic vein Doppler waveform, biphasic as well as monophasic, can be seen in healthy obese children with diffuse FIL.

Normal values correlates' of carotid intima- media thickness and affecting parameters in healthy adults

OBJECTIVE Early changes in atherosclerosis can be diagnosed by the carotid artery intima-media thickness (CIMT) measurement. Normal range of CIMT in healthy subjects has not been studied yet in our country. Therefore, the aim of this study was to measure the CIMT in healthy individuals and investigate affecting parameters of CIMT. METHODS Overall, 2298 subjects, aged 18 to 92 years were undergone CIMT measurement in this observational cohort study. 151 healthy adult subjects, aged 20 to 79 year without atherosclerotic risk factors, normal body mass index and normal metabolic parameters were selected to establish normative CIMT values. Correlations between CIMT and atherosclerotic risk factors were evaluated in the Turkish population. The independent variables associated with CIMT were evaluated with multiple linear regression analysis. RESULTS CIMT value was 0.458 ± 0.116 mm in males and 0.47 ± 0.104 mm in females. Mean values of CIMT (in mm) for healthy reference sample aged 20-29, 30-39, 40-49, 50-59, 60-69 and 70-79 years were 0.402; 0.466; 0.492; 0.586; 0.692 and 0.733, respectively. CIMT increased significantly (p<0.001) by 0.066 mm, in every decade. Correlates of CIMT were age, visceral fat level, fasting serum glucose, total and low-density lipoprotein cholesterol. Multiple linear regression analysis revealed that age was the single independent predictor of CIMT thickness in healthy individuals (β=0.007, 95% CI: 0.006-0.008, p<0.001). CONCLUSION CIMT was 0.458 ± 0.116 mm in men and 0.47 ± 0.104 mm in Turkish healthy adults. Age was the only predictor of CIMT. CIMT measurement can be used in the assessment of early atherosclerosis burden in adults.

Ötiroid multinodüler guatrlı olguların sitoloji ve histopatoloji sonuçları: Ultrasonografi özellikleri ile karşılaştırılması

Objectives: Fine-needle aspiration biopsy (FNAB) is the gold standard in the management of thyroid nodules and specimen should be obtained from dominant nodule. In our study, we aimed to compare the FNAB and histopathology results of dominant and non-dominant nodules and to evaluate the association between nodule size and histopathology results in patients with MNG. Materials and methods: Between 2009 and 2010, 197 cases who had diagnosed MNG were analyzed. These cases were performed FNAB from both dominant nodule and non-dominant nodule. 26 patients with inadequate cytological results were excluded and 171 cases were included in the analysis. Malignant ultrasonographic (US) features were defined as showing marked hypoecho genicity, microcalcifications, solid structure and not hav ing peripheral halo. Results: No statistically significant difference was ob served between malign cytology and suspected cytology ratios of dominant nodules and non-dominant nodules (p=0.083). Malignancy rates were higher at dominant nodules not having peripheral halo and non-dominant nodules including microcalcification at US. Also statisti cally significant difference was not observed (p=0.485) between malign histopathology rates of dominant and non-dominant nodules after surgery. Conclusions: According to cytological and histopathological results of patients with MNG, there was no signifi cant difference between the malignancy ratio of dominant and non-dominant nodules. There is no obvious correlation between malignancy and nodule size in patients with MNG. We think that FNAB obtained not from only dominant nodules but also nodules with suspicious features of malignancy is necessary for most accurate diagnosis.

Breast arterial calcifications and carotid intima-media thickness and haemodynamics: Is there any association?

OBJECTIVE In this study, we aimed to research the relation between breast arterial calcifications (BACs) detected on mammography and two well-known markers of cardiovascular diseases-carotid artery intima-media thickness (C-IMT) and haemodynamics parameters like carotid peak-systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI). METHODS The study group consisted of 50 consecutive BAC (+) women and the control group consisted of 55 BAC (-) women. In all participants, BAC was diagnosed using mammography and C-IMT was measured using B-mode and Doppler ultrasonography. BAC was defined as two linear calcification depositions in a conical periphery or as calcific rings at the mammographic evaluation. Doppler spectrum samples were obtained from 2 cm proximal to the main carotid artery bifurcation. RESULTS Postmenopausal female patients ranging in age from 40 to 86 included in this study. When the groups were adjusted for age, a statistically significant difference was found between mean C-IMT of BAC (+) and BAC (-) groups (0.81 ± 0.2 vs. 0.69 ± 0.2 mm; p<0.001). No significant differences were observed between BAC (+) and BAC (-) groups in terms of PSV, EDV, RI. CONCLUSION The findings of the present study suggest that BAC, diagnosed by mammography, is independently associated with C-IMT. C-IMT measurement is suggested as a useful tool to detect early atherosclerotic changes. However, haemodynamic variables (PSV, EDV, RI) were not statistically different between the BAC (+) and BAC (-) groups. Prospective larger cohort studies are needed to further elucidate whether BAC is an independent risk factor for cardiovascular disease.