Ozlem Tarcin

Epicardial Fat Tissue Thickness Correlates with Endothelial Dysfunction and Other Cardiovascular Risk Factors in Patients with Metabolic Syndrome

BACKGROUND Epicardial adipose tissue has shown to be related to cardiovascular risk. The aim of this study is to investigate the relationship between epicardial adiposity and endothelial function in metabolic syndrome. METHODS Fifty patients with metabolic syndrome were recruited. Anthropometric measurements, fasting blood glucose, insulin, lipid profile, high-sensitivity C-reactive protein (hsCRP), fibrinogen, apolipoprotein A (Apo A), Apo B1, and lipoprotein (a) [Lp(a)] were determined. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Epicardial fat thickness was measured via two-dimensional M-mode echocardiography. Endothelial function was assessed as flow-mediated dilatation at the brachial artery. RESULTS Epicardial fat tissue thickness was shown to be correlated negatively with FMD and positively with age, diastolic blood pressure, hsCRP, fibrinogen, HOMA-IR, and lipid parameters. Multiple regression analysis showed epicardial fat tissue thickness to be an independent factor influencing the endothelial function. CONCLUSIONS Epicardial fat tissue may be a useful parameter in the assessment of patients with metabolic syndrome.

Melatonin ameliorates methionine- and choline-deficient diet-induced nonalcoholic steatohepatitis in rats.

Abstract:  Nonalcoholic steatohepatitis (NASH) may progress to advanced fibrosis and cirrhosis. Mainly, oxidative stress and excessive hepatocyte apoptosis are implicated in the pathogenesis of progressive NASH. Melatonin is not only a powerful antioxidant but also an anti‐inflammatory and anti‐apoptotic agent. We aimed to evaluate the effects of melatonin on methionine‐ and choline‐deficient diet (MCDD)‐induced NASH in rats. Thirty‐two male Wistar rats were divided into four groups. Two groups were fed with MCDD while the other two groups were fed a control diet, pair‐fed. One of the MCDD groups and one of the control diet groups were administered melatonin 50 mg/kg/day intraperitoneally, and the controls were given a vehicle. After 1 month the liver tissue oxidative stress markers, proinflammatory cytokines and hepatocyte apoptosis were studied by commercially available kits. For grading and staging histological lesions, Brunt et al.’s system was used. Melatonin decreased oxidative stress, proinflammatory cytokines and hepatocyte apoptosis. The drug ameliorated the grade of NASH. The present study suggests that melatonin functions as a potent antioxidant, anti‐inflammatory and antiapoptotic agent in NASH and may be a therapeutic option.

Association of Metabolic Syndrome Parameters with TT3 and FT3/FT4 Ratio in Obese Turkish Population

BACKGROUND Obesity and metabolic syndrome are major health problems worldwide, including Turkey. Recent studies have shown an association between thyroid function tests and metabolic syndrome parameters. In this study, we aimed to determine the frequency of metabolic syndrome in an obese Turkish population and the relationship between metabolic syndrome and thyroid functions. MATERIALS AND METHOD We recruited 211 patients (187 females/24 males; mean age, 39.7±11.7 years) with body mass index (BMI) >30 kg/m(2) and no other hormonal pathology that could cause obesity. Anthropometric evaluation was followed by measurement of fasting blood glucose (FBG), insulin, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free T3 (FT3), and free T4 (FT4). Metabolic syndrome was defined according to the 2005 revision of the National Cholesterol Education Program Adult Panel III (NCEP ATP III) criteria. Insulin resistance was calculated from homeostasis model assessment of insulin resistance (HOMA-IR) formula. The TSH cutoff value was set at 2.5 mU/L. RESULTS Metabolic syndrome was diagnosed in 122 patients (58%). Metabolic syndrome positive patients had significantly higher FBG, triglycerides, FT4, systolic (SBP) and diastolic blood pressure (DBP), and statistically lower HDL-C and FT3/FT4 ratio than metabolic syndrome negative patients. TSH decreased with age and was not related with any metabolic syndrome parameters. The FT3/FT4 ratio negatively correlated with FBG, triglycerides, SBP, and DBP (P=0.003, r=-38; P=0.02, r=-0.28; P=0.005, r=-0.35; and P=0.007, r=-0.34, respectively); TT3 positively correlated with HOMA-IR (P=0.006, r=0.40), FBG (P=0.009, r=0.38), and waist circumference (P=0.02, r=0.34). CONCLUSION Metabolic syndrome frequency was increased in our study population compared to the general population. Metabolic syndrome parameters (except HDL) correlated with TT3, FT4, and the FT3/FT4 ratio. FT4 levels were associated with obesity and metabolic syndrome independently of insulin resistance, whereas TT3 levels were associated with both insulin resistance and metabolic syndrome. This relationship can be explained by compensatory effects of TT3, and probably FT4, on energy expenditure and thermogenesis in obese people.

In vivo inefficiency of pentoxifylline and interferon-alpha on hepatic fibrosis in biliary-obstructed rats: Assessment by tissue collagen content and prolidase activity

Background and Aim: To evaluate the possible antifibrotic effects of two drugs, pentoxifylline (PTX) and interferon (IFN)‐α as well as their combination, on a bile‐duct‐ligated rat hepatic fibrosis model.

Insulin Resistance, Adipocyte Biology, and Thiazolidinediones: A Review

Obesity is a well-recognized risk factor for the development of insulin resistance and the metabolic syndrome. Adipokines secreted from adipocytes play an important role in the pathogenesis of insulin resistance, hypertension, disorders of coagulation, dyslipidemia, and glucose abnormalities associated with insulin resistance or the metabolic syndrome. The selective ligands of the nuclear transcription factor PPARgamma, Thiazolidinediones (TZDs), induce differentiation of preadipocytes to mature and more insulin sensitive adipocytes. This review summarizes adipocyte biology, the role of the adipokines in the pathogenesis of insulin resistance, and the effects of TZDs on insulin resistance and the metabolic disorders associated with it.

Hastanede yatan hastalarda hiperglisemi sikliği

Amac: Hiperglisemi hastane mortalite ve morbiditesini etkileyen faktorlerden birisidir. Yatan hastalarin yaklasik yarisinda hiperglisemi varliginin ilk kez tespit edildigi rapor edilmistir. Bu calismanin amaci, Marmara Universitesi Hastanesi’nde yatan hastalarda yattiklari ve taburcu olduklari donemlerde hiperglisemi sikliginin ve hipergliseminin yatis suresi ile iliskisinin belirlenmesidir. Hastalar ve Yontem: Calismaya, Şubat-Temmuz 2007 tarihleri arasinda Marmara Universitesi Hastanesi kliniklerinde 24 saatten uzun sureli yatan 1971 eriskin hasta dahil edilmistir. Hastalarin yattiklari ve taburcu olduklari gunlerde kan sekerleri, kapiller kandan glukometre ile olculmustur. Glukometre ile olculen aclik kan sekeri 126 mg/dL veya tokluk kan sekeri 200 mg /dLuzerinde bulunan hastalarin damarlarindan alinan kan orneklerinde kan sekeri olcumleri laboratuvarda yapilmistir. Hastalarin diyabet oykuleri ve yatis sureleri kaydedilmistir. Bulgular: Hastalarin %23.8’inde bilinen diyabet (Grup 1), % 12.3’ unde yeni tanili diyabet (Grup 2) saptanmistir. Grup 1 en sik Koroner Yogun Bakim Unitesi’nde (%80) ve en seyrek Beyin Cerrahisi Servisi’nde (% 5.8) gorulurken, Grup 2’nin sikligi en yuksek Goz Servisi hastalarinda (%25), en dusuk ise Fizik Tedavi Servisi hastalarindadir (%2.7). Grup 1’de yatis ve cikis sirasinda kan sekeri degerleri sirasi ile cerrahi bolumlerde diyabet olan ve olmayanlarda (157.6 ± 49.0 vs 151.0 ± 60.0, p>0.05) (114.4 ± 37.7 vs 111.8 ± 26.6, p>0.05), dahili bolumlerde diyabet olan (173.9 ± 89.5 vs 155.6 ± 43.4, p>0.05) ve olmayanlarda (110.7 ± 38.3 vs 111.9 ± 28.0, p>0.05) olarak bulunmustur. Diyabetik hastalarin yatis suresi (14.1±19 gun) diyabetik olmayanlara (7.5±13 gun) gore daha uzundur (p<0.001). Sonuc: Hastanede yatan hastalarda hiperglisemi sikligi %36.1 olup, bunlarin yaklasik 1/3’u yeni tanili diyabettir. Diyabetik hastalarin yatis suresi daha uzundur.