Umit Aydogan

Relationship of cystatin C with coronary artery disease and its severity.

ObjectiveCystatin C, which is an endogenous marker for renal function, is reported to be a novel marker for coronary atherosclerosis. In this study, we aimed to evaluate its role in determining the presence and also the severity of coronary atherosclerosis in patients with coronary artery disease (CAD). Materials and methodsEighty-eight patients who underwent elective coronary angiography were enrolled in the study. Patients with heart failure, renal failure, diabetes, and thyroid disease were excluded from the study. The study population was divided into three groups: individuals with normal coronary arteries, patients with critical CAD, and patients with noncritical CAD. We also analyzed the relationship of cystatin C levels with the presence and the severity of CAD and the number of vessels involved. ResultsThe mean age of the study group was 51.73±9.21 years, and the majority were men (n=71, 80.7%). Cystatin C levels were significantly lower in patients with CAD (1334.86±93.45 vs. 836.49±411.29, P<0.001). It was significantly lower in patients with critical CAD compared with those with noncritical CAD and normal individuals (656.60±346.35, 1016.38±396.54, and 1334.86±393.45, P<0.001, respectively). Serum levels of cystatin C according to the numbers of coronary vessels such as none, single-vessel, two-vessel, three-vessel, and four-vessel disease were as follows: 1334.86±393.45, 801.67±418.70, 993.90±457.34, 744.09±354.53, and 682.30±294.43, respectively. ConclusionLower cystatin C levels may be associated with increased severity of CAD in clinically stable patients, whereas higher levels may indicate the presence of any vulnerable plaque. It may also guide the diagnostic and therapeutic options for the clinical scene on the presentation.

High plasma level of long Pentraxin 3 is associated with insulin resistance in women with polycystic ovary syndrome

Objectives: Polycystic ovary syndrome (PCOS) is characterized by insulin resistance. Chronic low-grade inflammation has been anticipated to play role in the pathogenesis of both insulin resistance and atherosclerosis. Pentraxin 3 (PTX3) is an inflammatory mediator synthesized in a variety of cells and tissues including heart, vascular endothelial cells, macrophages and adipocytes. In the present study, serum PTX3 level and its relationship with insulin resistance were investigated in patients with PCOS. Materials and Methods: Forty patients with PCOS and 40 age- and body mass index (BMI)-matched healthy controls were enrolled in the study. PTX3 and high-sensitivity C-reactive protein (hs-CRP) levels were determined by enzyme immunoassay (EIA). Insulin resistance was calculated by the homeostasis model assessment of insulin resistance (HOMA-IR) formula. Results: Plasma levels of PTX3, hs-CRP and HOMA-IR scores were all significantly higher (p = 0.021, p = 0.002 and p = 0.0001, respectively) in women with PCOS compared with healthy controls. Blood PTX3 level correlated positively with hs-CRP, BMI, waist-to-hip ratio (WHR), HOMA-IR and negatively with high-density lipoprotein cholesterol level (p < 0.05, for all). After adjustment for age and BMI, PTX3, total testosterone levels and BMI remained as independent predictors of HOMA-IR scores (p < 0.05, for all). Conclusion: PTX3 level is increased in patients with PCOS in concordance with insulin resistance.

Elevated pentraxin-3 levels are related to blood pressure levels in hypertensive patients: an observational study.

OBJECTIVE In this study, relationship between systolic and diastolic blood pressure and pentraxin-3 (PTX3) levels in hypertensive patients was investigated. METHODS Overall, 80 patients with stage 1 hypertension between 40-61 years of age without any disease and 80 healthy volunteers were included to the study. Blood samples obtained to measure PTX3 levels and biochemical analysis. Relationship between PTX3 levels and clinical and biochemical parameters were analyzed using multivariate regression analysis. RESULTS Although systolic and diastolic blood pressures were significant different, there were no differences regarding age and gender between hypertensives and normotensives. In each group, significant statistical differences were found between PTX3 and CRP levels (PTX3 (ng/mL) 35.25±5.45 and 0.27±0.24, p<0.001; CRP (mg/dL) 10.03±5.81 and 4.30±3.38, p<0.001; in hypertensive and normotensive groups respectively). It was observed that increase in PTX3 levels accompanies the increase in systolic and diastolic blood pressures (r2=0.78). It was observed that PTX3 levels are not effected from CRP, lipid levels and body mass index (p>0.05). On multivariate regression analysis PTX3 was found to strongly affect blood pressure (beta=0.82, 95% CI 0.644-0.799, p<0.001, and beta=0.84, 95% CI 0.422-0.799, p<0.001, respectively for systolic and diastolic blood pressures), CRP and total cholesterol are found to affect moderately (beta=0.115-0.265, 95% CI 0.101-0.572, p<0.05 and beta=0.107-0.141, 95% CI 0.041-0.110, p<0.05, respectively). CONCLUSION This study showed that PTX3 levels are higher in newly diagnosed hypertensive patients than in healthy individuals. In addition, it was noticed that increased PTX3 levels causes increase in systolic and diastolic blood pressures.

Predictors of knowledge level and awareness towards breast cancer among Turkish females.

BACKGROUND Breast cancer (BC) is the most-common malignancy of women worldwide. Though there are differences among developed and developing countries, BC remains the most common cancer type of women in Turkey. OBJECTIVE This study aimed to identify the level of knowledge, awareness, and their potential predictors towards BC in Ankara, Turkey. MATERIALS AND METHODS The present descriptive study was conducted on 376 females attending a breast health outpatient clinic. A self-administered questionnaire was designed to evaluate knowledge level about BC and predictors effecting its level. Data analysis was performed using the chi-square test. A value of p<0.05 was considered statistically significant. RESULTS Mean age of the participants was 46.2±9.93 (22-75). The majority (92.6 %) were married; 41.5% were educated less than nine years. Most of the women were housewives (82.7%) and, were living in an urban region (86.4%). Predictors of effecting responses to seven knowledge and awareness questions about BC varied from demographic features including older age groups, higher educational levels, being married, living in an urban area, being employee, smoking, having greater BMI to additional attributes associated breast health such as the increased number of births, applying for the purpose of control, positive family history of breast diseases, any diagnoses of breast diseases and performing BSE practice. CONCLUSIONS It was determined that females in Turkey have better knowledge of BC than other developing countries even though it is not at the desired level. These findings revealed that females should be more informed about BC risk factors, prognosis and treatments by primary health-care providers to counteract the ascending burden of this disease.

The effect of valsartan and nebivolol treatment on ADMA and pentraxin-3 levels in hypertensive patients

Long pentraxin 3 (PTX3) is a recently discovered multimeric inflammatory mediator that is structurally linked to short pentraxins, such as C-reactive protein (CRP) and serum amyloid P component. PTX3 is produced by a variety of tissues and cells, including vascular endothelial cells and macrophages. Because of its extrahepatic synthesis (in contrast to CRP), the PTX3 level is believed to be a true independent indicator of disease activity because PTX3 is produced at sites of inflammation and is intimately linked to endothelial dysfunction. PTX3 also has key functions in innate immunity and has been identified in atherosclerotic lesions. Previously, PTX3 was associated with myocyte damage in myocardial infarction (MI), mortality after MI, and unstable angina. Because PTX3 release is likely a specific response to vascular damage, PTX3 levels may provide more explicit information on development and progression of atherosclerosis than nonspecific markers like CRP and interleukin-6. Asymmetric dimethylarginine (ADMA) is a naturally occurring component of human blood plasma. More than one decade ago ADMA was first reported to exert biological effects by inhibiting nitric oxide synthesis. Many researchers today agree that ADMA may play a prominent role in the pathogenesis and in the progression of cardiovascular diseases. In this study PTX3 and ADMA levels investigated of valsartan and nebivolols effect on newly diagnosed hypertensive patients.

The prevalence and sociodemographic risk factors of enuresis nocturna among elementary school-age children

Introduction and Aim: Many etiological reasons are blamed for enuresis nocturna (EN). The aim of this study was to research prevalence and severity of EN among elementary school-age children and sociodemographic risk factors related to it. Materials and Methods: The study was performed in three elementary schools in Ankara, Turkey between January and May 2011. It was planned to have 2500 students of 6–14 ages in the study. The questionnaire, which consisted of questions, aiming to evaluate the EN condition of participants and their characteristics, were distributed to the parents. It was observed that 2314 participants’ questionnaires (92.56%) were in accordance with evaluation criteria. Statistical Analysis: The relation between EN and the sociodemographic factors was evaluated through Chi-square test and logistic regression analysis. Results: The mean age of 2314 participants was 9.21 ± 2.08. 48.5% (n = 1123) of the students were male and 51.5% (n = 1191) were female. While the general EN prevalence was 9.9% (n = 230); 10.7% (n = 120) for males, as 9.2% (n = 110) for females. Statistical significant difference was determined between the two groups, with EN and without EN, regarding age groups (P < 0.001), education level of parents (P < 0.001, P < 0.001), and the number of sibling (P = 0.002), income level (P < 0.001), and positive family history (P < 0.001). However, logistic regression analysis revealed that there was a significant difference only between EN and age groups (odds ratio [OR] =4.42, P < 0.001), education level of mother (OR = 2.13, P = 0.017) and family history (OR = 0.12, P < 0.001). Conclusions: As a consequence, such factors as age groups, education level of parents, positive family history could be accepted as a risk of concerning EN. It is important to perform a detailed evaluation on population, carrying risk of having EN.

Predictors Affecting Breast Self-Examination Practice among Turkish Women

BACKGROUND Breast cancer (BC) is the most common cancer among females in Turkey. Predictors affecting the breast self-examination (BSE) performance vary in developing countries. OBJECTIVE To determine the frequency of BSE performance and predictors of self-reported BSEs among women in the capital city of Turkey. MATERIALS AND METHODS This cross-sectional study was conducted on 376 Turkish women using a self- administered questionnaire covering socio-demographic variables and BSE-related features. RESULTS Of the participants, 78.7% (N=296) reported practicing BSE, whereas 9.5% (N=28) were implementing BSE regularly on a monthly basis, and only 5.7% (N=17) were performing BSE regularly within a week after each menstrual cycle. Multivariate logistic regression modeling revealed that BSE performance was more likely in younger age groups [20-39 years] (p=0.018, OR=3.215) and [40-49 years] (p=0.009, OR=3.162), women having a family history of breast disease (p=0.038, OR=2.028), and housewives (p=0.013, OR=0.353). CONCLUSIONS Although it appears that the rates of BSE performers are high, the number of women conducting appropriate BSE on a regular time interval basis is lower than expected. Younger age groups, family history of breast diseases and not being employed were identified as significant predictors of practicing BSE appropriately. Older age and employment were risk factors for not performing BSE in this sample.

Effects of Smoking during Pregnancy on DNA Damage and ROS Level Consequences in Maternal and Newborns’ Blood

Some of the genotoxic/carcinogenic substances or metabolites in cigarette smoke are capable of passing through the placenta and harming a newborn’s health. Smoking is also known as a factor in the formation of oxidative damage and the main mechanism involved in the carcinogenic process. Predetermining this genotoxic risk can be successfully achieved by measuring certain parameters of oxidative stress. The comet assay is considered an important biomarker for the evaluation of genotoxic substances and is effective for detecting DNA damage caused by smoking. This study examined third trimester bloods and the cord blood of 28 actively smoking and 22 non-smoking mothers in terms of DNA damage and oxidative stress parameters. Cu/Zn superoxide dismutase (CuZn-SOD), malondialdehyde (MDA), catalase (CAT), plasma nitrite/nitrates (NO2 -/NO3 -), selenium-dependent glutathione peroxidase (Se-GPx), Cu, and Zn levels were measured as indicators of oxidative damage. There were no significant increases in DNA damage of the actively smoking pregnant group in comparison with the non-smoking pregnant group, either in the third trimester or cord blood. Oxidative stress parameters of smoker and non-smoker groups were statistically different for MDA (p<0.05), CuZn-SOD (p<0.01), Se-GPx (p<0.05) values while the difference was not significant for NO2 -/NO3 -, CAT, Zn, and Cu values. The same values were also investigated in cord blood, and only NO2/NO3 -(p<0.01), Se-GPx (p<0.01 and CAT (p<0.001) values were found statistically different. Smoking mothers may have been exposed to more oxidative stress than non-smoking mothers.

Serum Pentraxin-3 Level in Patients Who Underwent Coronary Angiography and Relationship with Coronary Atherosclerosis

Objectives: To evaluate the role of pentraxin-3 (PTX-3) in determining the presence and severity of coronary atherosclerosis in patients with coronary artery disease (CAD). Subjects and Methods: Ninety-five patients (77 males and 18 females) who underwent elective coronary angiography were enrolled in this study. Patients with heart failure, renal failure, diabetes and thyroid disease were excluded. The study population was divided into 3 groups: individuals with normal coronary arteries, patients with critical CAD (n = 35) and patients with noncritical CAD (n = 36). The association of PTX-3 levels with the presence and severity of CAD and the number of involved vessels were analyzed. Results: The mean age was 53.40 ± 10.25 years. The PTX-3 levels were significantly higher in patients with CAD than without CAD (146.48 ± 48.52 vs. 109.83 ± 49.06 pg/ml, p < 0.001). A statistically significant difference was found among the 3 groups regarding the severity of CAD (165.66 ± 49.10, 127.83 ± 40.51 and 109.83 ± 49.06 pg/ml, p < 0.001, respectively). The serum PTX-3 levels in normal arteries were 110.4 ± 48.11 pg/ml, in single-vessel disease 132.35 ± 32.96 pg/ml, in 2-vessel disease 142.57 ± 55.88 pg/ml, in 3-vessel disease 156.07 ± 50.53 pg/ml, and in 3-vessel disease 160.50 ± 30.41 pg/ml. After adjusting for baseline confounders, older age (OR = 1.107, 95% CI = 1.027-1.193, p = 0.008) and higher PTX-3 levels (OR = 1.017, 95% CI = 1.003-1.032, p = 0.021) were detected as significant predictors for the presence of CAD. Conclusions: Higher PTX-3 levels were associated with the presence of CAD and its increased severity in clinically stable patients. Higher PTX-3 levels may be regarded as a novel diagnostic predictor and may offer therapeutic options in the clinic.

Comparison of cystatin-C and pentraxin-3 in coronary atherosclerosis.

ObjectiveInflammation is one of the numerous factors that promote atherosclerosis. Cystatin-C (Cys-C) and pentraxin-3 (PTX-3) predominantly play roles in inflammation. Thus, we evaluated whether these markers were related to the presence and severity of coronary artery disease (CAD). MethodsEighty-two stable patients who had undergone coronary angiography were enrolled in the study. Patients were diagnosed with significant (>50% stenosis) and nonsignificant (<50% stenosis) CAD. Patients with diabetes, chronic heart failure, chronic kidney disease, and so on were excluded from the study. ResultsPatients without CAD had higher Cys-C levels compared with those with CAD (1338.96±396.71 vs. 853.69±406.72 ng/ml, P<0.001). However, the PTX-3 level was inversely lower in patients without CAD (110.40±48.10 vs. 149.46±49.44 pg/ml, P=0.001). The Cys-C level was found to be 677.11±335.56, 1024.18±401.21, and 1338.96±396.71 ng/ml in patients with significant CAD and nonsignificant CAD, and healthy individuals, respectively (P<0.001). The PTX-3 level was inversely reduced in these groups: 168.43±49.09, 131.14±43.10, and 110.40±48.10 pg/ml, respectively (P<0.001). ConclusionWe observed that the levels of Cys-C and PTX-3 were inversely varied in the same study groups. These parameters may aid detection of the presence or identification of the severity of CAD when used in combination. Determinative values could exactly be described in the large study groups.