Kategori: Dahiliye – İç Hastalıkları

Clin Biochem. 2012 Jan;45(1-2):92-5. doi: 10.1016/j.clinbiochem.2011.10.022. Epub 2011 Nov 7.

Soluble CD40 ligand, soluble P-selectin and von Willebrand factor levels in subjects with prediabetes: the impact of metabolic syndrome.

Genc H1, Dogru T, Tapan S, Tasci I, Bozoglu E, Gok M, Aslan F, Celebi G, Erdem G, Avcu F, Ural AU, Sonmez A.

Author information

Abstract

OBJECTIVES:

The data regarding circulating levels of markers of platelet activation and endothelial function in people with prediabetes are scant. The aim of the present study was to search blood levels of soluble CD40 ligand (sCD40L), soluble P-selectin (sP-sel) and von Willebrand Factor (vWF) in subjects with prediabetes, along with the effects of the metabolic syndrome (MetS) on these markers.

DESIGN AND METHODS:

A total of 77 prediabetic individuals and 81 age, sex and body mass index matched healthy subjects with normal glucose tolerance (NGT) were prospectively analyzed. Anthropometric parameters, fasting plasma glucose, blood d lipid profiles and insulin resistance indexes were determined. Plasma sCD40L, sP-sel and vWF levels were measured by ELISA.

RESULTS:

sCD40L, sP-sel and vWF levels in the prediabetic group were similar to those in the controls. However, prediabetic subjects with the MetS had significantly higher level of sCD40L compared to those without MetS. Moreover, sCD40L level correlated significantly with waist circumference, systolic blood pressure and HDL-cholesterol level in the patient group.

CONCLUSION:

These data imply that MetS may contribute, at least in part, to the mechanism of platelet activation and endothelial dysfunction in people with prediabetes.

Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

PMID:

22100896

DOI:

10.1016/j.clinbiochem.2011.10.022

Send to

Metab Syndr Relat Disord. 2015 Sep;13(7):319-25. doi: 10.1089/met.2015.0018. Epub 2015 May 26.

Insulin Resistance but Not Visceral Adiposity Index Is Associated with Liver Fibrosis in Nondiabetic Subjects with Nonalcoholic Fatty Liver Disease.

Ercin CN1, Dogru T1, Genc H2, Celebi G1, Aslan F3, Gurel H1, Kara M4, Sertoglu E5, Tapan S6, Bagci S1, Rizzo M7, Sonmez A8.

Author information

Abstract

BACKGROUND:

Nonalcoholic fatty liver disease (NAFLD) is associated with obesity, type 2 diabetes mellitus, and dyslipidemia. It is well known that the presence of visceral fat increases the risk for metabolic complications of obesity, especially NAFLD. The visceral adiposity index (VAI), a novel marker of visceral fat dysfunction, shows a strong association with insulin resistance and also cardiovascular and cerebrovascular events. However, there is conflicting data regarding the association between VAI and NAFLD. Our aim was to assess the relationship between VAI, insulin resistance, adipocytokines, and liver histology, in nondiabetic subjects with NAFLD.

METHODS:

A total of 215 male patients with biopsy-proven NAFLD were included. Among this group, serum levels of adiponectin, tumor necrosis factor-α (TNF-α, interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hsCRP) were measured in 101 patients whose blood samples were available.

RESULTS:

High gamma-glutamyl transferase (GGT), high total cholesterol (TC), high triglycerides (TGs), low high-density lipoprotein cholesterol (HDL-C), and presence of metabolic syndrome were significantly associated with higher VAI, although only higher GGT and TC were independent factors on multiple linear regression analysis. On the other hand, no significant association was found between VAI and adiponectin, TNF-α, IL-6, and hsCRP levels. The multivariate analysis of variables in patients with (n=124) and without (n=91) fibrosis showed that only higher homeostasis model assessment of insulin resistance value was independently associated with liver fibrosis.

CONCLUSIONS:

Our findings suggest that VAI is not related to the severity of hepatic inflammation or fibrosis in nondiabetic patients with NAFLD. The lack of association between the adipocytokines and VAI also implies that the VAI may not be a significant indictor of the adipocyte functions.

PMID:

26011302

DOI:

10.1089/met.2015.0018

Send to

Eur J Gastroenterol Hepatol. 2015 Oct;27(10):1144-8. doi: 10.1097/MEG.0000000000000405.

Neutrophil-to-lymphocyte ratio is not a predictor of liver histology in patients with nonalcoholic fatty liver disease.

Kara M1, Dogru T, Genc H, Sertoglu E, Celebi G, Gurel H, Kayadibi H, Cicek AF, Ercin CN, Sonmez A.

Author information

Abstract

OBJECTIVES:

It has been reported that the neutrophil-to-lymphocyte ratio (NLR) can be measured relatively easily and can serve as a valuable index for much clinical pathology. The aim of this study was to investigate the association between NLR and hepatic histological findings in patients with nonalcoholic fatty liver disease (NAFLD).

DESIGN AND METHODS:

A total of 226 consecutive patients with biopsy-proven NAFLD [nonalcoholic steatohepatitis (NASH, n=105), borderline-NASH (n=74), and simple steatosis (n=47)] were enrolled. NASH and fibrosis were diagnosed histologically using the NAFLD Clinical Research Network criteria.

RESULTS:

Significant differences were found in aspartate aminotransferase (P<0.001), alanine aminotransferase (P<0.001) levels, and white blood cell (P=0.007) and neutrophil counts (P=0.042) between the three groups of patients. In addition, significantly higher BMI (P=0.024), waist circumference (P=0.011), aspartate aminotransferase (P=0.003), alanine aminotransferase (P=0.005), insulin (P=0.008), and homeostasis model assessment-insulin resistance (P=0.009) levels were found in patients with fibrosis (n=133) in comparison with those without fibrosis (n=93). There was no correlation between NLR and glucose, homeostasis model assessment-insulin resistance, lipid parameters, and the NAFLD activity score. Analysis of the NLR in relation to histological findings also showed no association between these parameters.

CONCLUSION:

To the best of our knowledge, this is the largest study that has investigated these relationships in this clinically relevant condition. The findings of the present study show that NLR is not associated with the severity of hepatic inflammation or fibrosis and thus cannot be recommended as a surrogate marker of liver injury in patients with NAFLD.

Comment in

Neutrophil-to-lymphocyte ratio for predicting fibrosis in nonalcoholic fatty liver disease. [Eur J Gastroenterol Hepatol. 2015]

PMID:

26062078

DOI:

10.1097/MEG.0000000000000405

[Indexed for MEDLINE]

Send to

Ophthalmologica. 2016;235(2):72-7. doi: 10.1159/000442216. Epub 2015 Dec 5.

Choroidal Thickness Changes in the Acute Attack Period in Patients with Familial Mediterranean Fever.

Gundogan FC1, Akay F, Uzun S, Ozge G, Toyran S, Genç H.

Author information

Abstract

PURPOSE:

The aim of this study was to evaluate choroidal thickness changes during acute attacks of familial Mediterranean fever (FMF).

METHODS:

Fifty patients with FMF and 50 healthy controls were included. Choroidal thickness of each participant was measured at the foveola and horizontal nasal and temporal quadrants at 500-µm intervals to 1,500 µm from the foveola using spectral-domain optical coherence tomography. White blood cell count, erythrocyte sedimentation rate (ESR) and serum levels of fibrinogen and C-reactive protein (CRP) were evaluated. The clinical findings (peritonitis, arthritis and pleuritis) were noted.

RESULTS:

Choroidal thickness was significantly thicker at all measurement points in FMF patients compared to healthy controls during an acute attack (p < 0.05). There were positive correlations between the choroidal thickness and ESR, fibrinogen and, particularly, CRP levels. Clinical findings did not change the choroidal thickness significantly (p > 0.05).

CONCLUSIONS:

Increased choroidal thickness in the acute phase of FMF is possibly related to the inflammatory edematous changes in the choroid.

© 2015 S. Karger AG, Basel.

Comment in

Temperature Control Function of the Choroid May Be the Reason for the Increase in Choroidal Thickness during the Acute Phase of Familial Mediterranean Fever. [Ophthalmologica. 2016]

Reply to the Letter by Kaya et al. Entitled “Temperature Control Function of the Choroid May Be the Reason for the Increase in Choroidal Thickness During the Acute Phase of Familial Mediterranean Fever”. [Ophthalmologica. 2016]

Response to the Letter by Kosker et al. Entitled ‘Choroidal Changes in Patients with Familial Mediterranean Fever’. [Ophthalmologica. 2016]

Choroidal Changes in Patients with Familial Mediterranean Fever. [Ophthalmologica. 2016]

PMID:

26637112

DOI:

10.1159/000442216

[Indexed for MEDLINE]

Turk J Med Sci. 2016 Jun 23;46(4):985-91. doi: 10.3906/sag-1502-144.

The relationship between blood urea nitrogen levels and metabolic, biochemical, and histopathologic findings of nondiabetic, nonhypertensive patients with nonalcoholic fatty liver disease.

Erçin CN1, Doğru T1, Çelebi G1, Gürel H1, Genç H2, Sertoğlu E3, Bağci S1.

Author information

Abstract

BACKGROUND/AIM:

Nonalcoholic fatty liver disease (NAFLD) is known as the most common cause of chronic liver disease. It is accepted that the leading cause of death in patients with NAFLD is from coronary events. Blood urea nitrogen (BUN) was used as a prognostic indicator for cardiovascular disease. We aimed to investigate the relationship between BUN levels and metabolic, biochemical, and histopathologic findings of nondiabetic patients with NAFLD.

MATERIALS AND METHODS:

A total of 195 male patients with biopsy proven NAFLD and 82 healthy controls with normal liver and renal function tests and normal abdominal ultrasonography were enrolled in the study. BUN levels were reviewed retrospectively.

RESULTS:

The mean BUN levels of patients and controls were 13.07 (11.3-15.41) and 13.31 (10.97-15.87) mg/dL respectively. Patients were grouped as simple steatosis (n = 33, 16.9%), borderline nonalcoholic steatohepatitis (n = 64, 32.8%), and nonalcoholic steatohepatitis (n = 98, 50.3%), and the BUN levels of the histologic subgroups were 13.14 ± 2.89, 14.34 ± 3.04, and 13.71 ± 3.21 mg/dL, respectively. We could not find any differences between the patient group and control group with respect to BUN levels.

CONCLUSION:

Our findings showed that there was no relationship between BUN levels and metabolic, biochemical, and histopathologic findings of patients with NAFLD. Further investigations, including in patients with late stages of NAFLD, are required.

KEYWORDS:

Nonalcoholic fatty liver disease; blood urea nitrogen; insulin resistance

PMID:

27513394

DOI:

10.3906/sag-1502-144

Efficacy of a modified sequential therapy including bismuth subcitrate as first-line therapy to eradicate Helicobacter pylori in a Turkish population.

Uygun A, et al. Helicobacter. 2012.

Authors

Uygun A1, Ozel AM, Sivri B, Polat Z, Genç H, Sakin YS, Çelebi G, Uygur-Bayramiçli O, Erçin CN, Kadayifçi A, Emer O, Gunal A, Bagci S.

Author information

1

Department of Gastroenterology, Gulhane Military Medical Academy, School of Medicine, GATA Tıp Fakultesi, General Doktor Tevfik Sağlam Caddesi Etlik, Ankara, Turkey.

Citation

Helicobacter. 2012 Dec;17(6):486-90. doi: 10.1111/j.1523-5378.2012.00989.x. Epub 2012 Aug 26.

Abstract

BACKGROUND: Eradication rates of Helicobacter pylori with standard triple therapy are not satisfactory. Sequential therapy is an alternative method to overcome this problem.

OBJECTIVES: The aim of this study was to assess efficacy of a modified sequential therapy with the addition of a bismuth preparation, as first-line treatment in the eradication of H. pylori infection.

MATERIALS AND METHODS: One hundred and forty-two H. pylori-positive patients were included in the study. Patients were given a 14-day sequential therapy program consisting of pantoprazole, 40 mg (b.i.d. for 14 days); colloidal bismuth subcitrate, 300 mg 4 (two tablets before breakfast and dinner, for 14 days); amoxicillin, 1 g (b.i.d.for the first 7 days); tetracycline, 500 mg (q.i.d. for the second 7 days); and metronidazole, 500 mg (t.i.d. for the second 7 days). Eradication was tested by urea breath test (UBT) 6 weeks after completion of treatment.

RESULTS: Of the 142 patients included, 131 completed the study. “Per-protocol” and “intention-to-treat” analyses revealed high eradication rates in this group (92.0-95% CI, 87.2-96.8%, and 81.0-95% CI, 74.5-87.4%, respectively). There was no relation to sex and age with this modified sequential therapy. Compliance was satisfactory (11 patients – four women and seven men were unavailable for follow-up), and side effects were minimal (six patients had to stop treatment – metronidazole-related facial swelling and numbness on the face and hands in two patients; tetracycline-related fever and epigastric pain and nausea and vomiting in two patients; and amoxicillin-related diarrhea and vaginal discharge in two patients). These side effects were reversible and resolved after the cessation of the related medication.

CONCLUSIONS: This 14-day modified sequential treatment, including bismuth, achieves a significantly high eradication rates in patients with H. pylori infection, with five satisfactory patient compliance and minor side effects.

© 2012 Blackwell Publishing Ltd.

PMID

23067136 [Indexed for MEDLINE]

Circulating vaspin and its relationship with insulin sensitivity, adiponectin, and liver histology in subjects with non-alcoholic steatohepatitis.

Genc H, et al. Scand J Gastroenterol. 2011.

Show full citation

Abstract

OBJECTIVE: Non-alcoholic steatohepatitis (NASH) is closely associated with components of metabolic syndrome. Vaspin is a novel adipocytokine that may link obesity, insulin resistance (IR), and type 2 diabetes mellitus. We aimed to investigate circulating vaspin levels in subjects with NASH and also to search for the association of vaspin with IR, adiponectin, and histological findings.

MATERIAL AND METHODS: A total of 50 male patients with NASH and 30 healthy male controls were enrolled. Vaspin and adiponectin were measured with ELISA method. Insulin sensitivity determined by homeostasis model assessment (HOMA-IR) index.

RESULTS: Plasma vaspin levels were higher and adiponectin levels were lower in NASH group compared with controls (p < 0.01 and p < 0.001, respectively). However, in multivariate analysis adjusted for glucose and lipid parameters, and HOMA-IR indexes, the difference in vaspin concentrations was disappeared. Nonetheless, the difference regarding the adiponectin levels remained significant between groups (p = 0.03). Vaspin was negatively correlated with low-density lipoprotein cholesterol (r = -0.32, p = 0.03) in subjects with NASH.

CONCLUSIONS: This study indicates that circulating vaspin levels are not altered in male subjects with NASH. These results suggest that in the absence of metabolic risk factors, vaspin per se may not be involved in the pathogenesis of NASH.

PMID

21770819 [Indexed for MEDLINE]

Association of plasma visfatin with hepatic and systemic inflammation in nonalcoholic fatty liver disease.

Genc H, et al. Ann Hepatol. 2013 Jul-Aug.

Show full citation

Abstract

BACKGROUND: Visfatin is a proinflammatory and insulin-mimetic adipokine contributing to whole body glucose and lipid metabolism. Studies to date are conflicting regarding the relationship between visfatin and non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to evaluate the relationship of circulating visfatin with NAFLD.

MATERIAL AND METHODS: The study included 114 NAFLD patients and 60 healthy non-diabetic controls. Plasma visfatin, adiponectin, tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) levels were measured by ELISA. High sensitive C-reactive protein (hsCRP) levels were measured by immunoturbidimetric fixed rate method. Insulin sensitivity determined by homeostasis model assessment (HOMA-IR) index.

RESULTS: TNF-α, IL-6 and hsCRP levels were higher and, Adiponectin levels were lower in NAFLD group when compared to healthy controls (p < 0.001, for all). However, no difference was found regarding to visfatin levels between two groups. Different histologic subgroups of NAFLD had a significantly higher TNF-α, IL-6 and hsCRP, and lower adiponectin levels than those with controls (p < 0.001, for all). On the other hand, no statistically significant difference was found regarding to visfatin levels among different histologic groups. Visfatin was found to be negatively correlated with TNF-α (r = -0.236, p = 0.011) in NAFLD group. However, no association was found between visfatin and histological findings.

CONCLUSION: Our findings show that plasma visfatin levels are not altered in the early stages of NAFLD. However, it is inversely associated with TNF-α. These findings suggest a role for visfatin in protection against liver injury in this widespread disease.

PMID

23813132 [Indexed for MEDLINE]