Relationship Between Serum Endocan Levels and Other Predictors of Endothelial Dysfunction in Obese Women

Endocan, or endothelial cell-specific molecule-1 (ESM-1), is a potential inflammatory marker implicated in endothelial dysfunction. The purpose of this study was to determine the correlation between serum endocan levels and the presence and severity of endothelial dysfunction, and the relationships with serum intracellular adhesion molecule-1 (ICAM-1), adiponectin (a marker of inflammation), high sensitivity C-reactive protein (hsCRP) levels, and carotid intima-media thickness (cIMT) in obese subjects. Serum endocan, ICAM-1, adiponectin, hsCRP levels, and cIMT were evaluated in 76 obese women (BMI > 30 kg/m2) and 53 controls (BMI < 25 kg/m2). ICAM-1 (P = .01), hs-CRP (p < 0.001), and cIMT (p < .001) were significantly higher, while adiponectin (P = .006) was significantly lower, in obese women compared with the controls. Serum endocan levels were similar between the obese (470.5 ± 171.3 pg/mL) and controls (471.9 ± 146.3 pg/mL) (P = .732). There was no correlation between serum endocan values and the endothelial dysfunction markers, hsCRP (r = -.021), ICAM-1 (r = -.054), adiponectin (r = .113), or cIMT (r = -.060) in obesity. Endocan is not a suitable marker of endothelial dysfunction in the context of obesity. More research is required to evaluate the role of endocan in the regulation of inflammatory processes in obesity.

Helicobacter pylori can be related to carotid intima-media thickness, epicardial adipose tissue thickness and serum neutrophil gelatinase-associated lipocalin (NGAL) levels

BACKGROUND

Helicobacter pylori (HP) affects the cardiovascular system. Our aim in this study was to evaluate, whether an infection with HP causes subclinical atherosclerosis.

METHODS

We included 90 patients with dyspeptic symptoms in this study. The patients underwent an upper gastrointestinal endoscopy and biopsies were taken. The patients were grouped according to histopathologic examination, as HP infection negative (n = 21), HP infection positive (+) (n = 23), HP infection (++) (n = 22), HP infection (+++), (n = 24).

RESULTS

The neutrophilic gelatinase-associated lipocalin (NGAL) and high-sensitive C-reactive protein (hs-CRP) levels and the carotid intima-media thickness (cIMT) and epicardial adipose tissue (EAT) thickness in the HP negative group were significantly lower than the NGAL (p < 0.001) and hs-CRP (p < 0.001) levels and the cIMT (p < 0.008) and EAT (p < 0.008) thickness in the HP (+++) group. There was a strong correlation between the serum NGAL and hs-CRP levels, cIMT and EAT thickness.

CONCLUSION

HP-infection can lead to subclinical atherosclerosis via chronic inflammation. The higher the activity of HP infection, the higher the acceleration of atherosclerosis (Tab. 3, Fig. 2, Ref. 46). Text in PDF www.elis.sk.

Helicobacter pylori can be related to carotid intima-media thickness, epicardial adipose tissue thickness and serum neutrophil gelatinase-associated lipocalin (NGAL) levels

BACKGROUND

Helicobacter pylori (HP) affects the cardiovascular system. Our aim in this study was to evaluate, whether an infection with HP causes subclinical atherosclerosis.

METHODS

We included 90 patients with dyspeptic symptoms in this study. The patients underwent an upper gastrointestinal endoscopy and biopsies were taken. The patients were grouped according to histopathologic examination, as HP infection negative (n = 21), HP infection positive (+) (n = 23), HP infection (++) (n = 22), HP infection (+++), (n = 24).

RESULTS

The neutrophilic gelatinase-associated lipocalin (NGAL) and high-sensitive C-reactive protein (hs-CRP) levels and the carotid intima-media thickness (cIMT) and epicardial adipose tissue (EAT) thickness in the HP negative group were significantly lower than the NGAL (p < 0.001) and hs-CRP (p < 0.001) levels and the cIMT (p < 0.008) and EAT (p < 0.008) thickness in the HP (+++) group. There was a strong correlation between the serum NGAL and hs-CRP levels, cIMT and EAT thickness.

CONCLUSION

HP-infection can lead to subclinical atherosclerosis via chronic inflammation. The higher the activity of HP infection, the higher the acceleration of atherosclerosis (Tab. 3, Fig. 2, Ref. 46). Text in PDF www.elis.sk.

The impact of hypertension on retinal nerve fiber layer thickness and its association with carotid intima media thickness

OBJECTIVE

Our aim was to investigate retinal nerve fiber layer (RNFL) thickness in hypertensive patients using spectral-domain optical coherence tomography (SD-OCT) and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT).

METHODS

This study included 59 patients with hypertension (HT) (53.6 ± 10.7 years) and 54 age-matched healthy controls (51.0 ± 8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with hypertension and controls.

RESULTS

The average RNFL thickness was 86.60 ± 10.86 μm in hypertensive patients and 93.63 ± 7.30 μm in healthy controls (p < 0.001). Selective thinning of the RNFL was found in the superior and inferior quadrants. Mean CIMT values were higher in patients with HT (0.80 ± 0.15 mm) than the healthy subjects (0.71 ± 0.1 mm) (p < 0.001). The average, inferior and nasal RNFL thickness were negatively associated with diastolic blood pressure respectively (r = - 0.112, r = - 0.210, r = - 0.225). There was an inverse correlation between RNFL thickness in the average and superior retinal quadrant and CIMT (r = - 0.201, r = - 0.185). There were no correlations between RNFL thickness and age, body mass index, fasting plasma glucose, lipid parameters, high-sensitive C-reactive protein and microalbuminuria.

CONCLUSION

RNFL thickness is reduced in hypertensive patients and may be associated with atherosclerosis.

The relationship between retinal nerve fiber layer thickness and carotid intima media thickness in patients with type 2 diabetes mellitus

AIMS

The aim of the present study was to investigate retinal nerve fiber layer (RNFL) thickness in patients with type 2 diabetes mellitus (T2D) using spectral-domain optical coherence tomography and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT).

METHODS

This study included 171 patients with T2D (53.2 ± 8.8 years) and age matched 61 healthy controls (51.9 ± 8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with T2D and controls. The Mann-Whitney U test was used to compare the continuous variables and the Chi-square test was used to compare categorical variables. Spearman's rank correlation test was used for calculation of associations between variables.

RESULTS

The average RNFL thickness was 84.82 ± 11.22 μm in patients with T2D and 92.35 ± 8.45 μm in healthy controls (p<0.001). Mean CIMT values were higher in patients with T2D (0.80 ± 0.1mm) than the healthy subjects (0.72 ± 0.1mm) (p<0.001). A significant negative correlation was found between age and all quadrants of RNFL. There was a negative correlation between average RNFL thickness and HbA1c (r=-0.176), uric acid (r=-0.145), CIMT (r=-0.190) and presence of carotid plaque (r=-0.193). The superior RNFL thickness was negatively associated with HbA1c (r=-0.175), CIMT (r=-0.207) and carotid plaque (r=-0.176). There was also an inverse correlation between the inferior RNFL thickness and HbA1c (r=-0.187) and carotid plaque (r=-0.157).

CONCLUSION

Thinning of RNFL might be associated with atherosclerosis in patients with T2D.

Relationship of the angiographic extent of peripheral arterial disease with coronary artery involvement

OBJECTIVE

To determine the co-incidence of coronary artery disease (CAD) in patients investigated for peripheral arterial disease (PAD), and to establish the relationship between the risk factors in the two groups of patients.

METHODS

The prospective study, done from January 2005 and April 2009, at the Cardiology Clinic of Rize Education and Research Hospital, Rize and John F. Kennedy Hospital, Istanbul, Turkey, had a cohort of 307 patients who had been diagnosed with peripheral artery disease either clinically or by ultrasonography for the arteries of the lower extremities and had undergone coronary angiography and peripheral angiography in the same or different sessions. The patients were evaluated in terms of age, gender and atherosclerotic risk factors. Relationship of the extent of peripheral arterial disease with coronary artery involvement was investigated.

RESULTS

Of the 307 patients, 251 (81.8%) were male, and the mean age was 62.1 +/- 9.5 years. In the study population, 178 (58.0%) patients were diagnosed as hypertensive, 84 (27.4%) patients were diabetic, 18 (5.9%) patients had a family history of coronary artery disease, 111 (36.2%) were smokers, 149 (48.5%) were hypercholesterolemic, and 20 (6.5%) had cerebrovascular/carotid disease. In 92.3% of patients with peripheral arterial disease, various levels of coronary stenosis (P = 0.007) was noticed. Hypertension was a risk factor for both coronary and peripheral artery diseases (p = 0.012 and 0.027, respectively). Univariate logistic regression analysis demonstrated that the presence of peripheral artery disease was related to the coronary variety (Odds ratio [OR]: 6, 95% CI: 1.4-25.5, P = 0.016) and severe cases (diffused atherosclerotic stenosis and complete occlusion in all segments) significantly indicated the presence of some coronary pathology (OR: 8, 95% CI: 1.7-37.4, P = 0.008). This relationship maintained its significance after adjustment for age, gender, hypercholesterolaemia, smoking, hypertension, diabetes, family history, and the presence of cerebrovascular/carotid disease (p = 0.010).

CONCLUSIONS

Peripheral coronary artery diseases had similar risk factors. The extent of peripheral arterial disease observed during peripheral lower extremity angiography was significantly associated with the presence and severity of coronary artery disease. Particular attention should be focused on the possibility of coronary artery disease in patients with established and extensive peripheral arterial disease. Non-invasive, as well as invasive tests, should be performed to decrease morbidity and mortality risk of such patients.

Does nebivolol prevent contrast-induced nephropathy in humans?

BACKGROUND

An experimental study showed that nebivolol is an effective agent in contrast-induced nephropathy (CIN) prophylaxis.

HYPOTHESIS

We hypothesized that prophylactic nebivolol use had protective effects on renal function in human beings subjected to iodinated contrast agent since it has vasodilatory effect and antioxidant properties.

METHODS

The present study enrolled 120 patients scheduled for coronary angiography and ventriculography. All patients were hydrated with intravenous isotonic saline. The patients in group I received 600 mg N-acetylcysteine every 12 hours for 4 days. The patients in group II received 5 mg nebivolol every 24 hours for 4 days. The patients in group III were only hydrated. The primary endpoint was the occurrence of CIN. The secondary endpoint was the change in serum creatinine (Cr) levels at 2 days and 5 days after the contrast exposure.

RESULTS

Nine (22.5%) patients in group I developed CIN, as did 8 patients (20.0%) in group II and 11 patients (27.5%) in group III (P = 0.72). Changes in mean Cr level from baseline to day 2 were not statistically significant in all groups. However, we detected a statistically significant increase in mean Cr levels at day 5 compared with baseline levels in group I and group III (from 1.42 ± 0.13 to 1.52 ± 0.26, p2 = 0.02; and from 1.43 ± 0.14 to 1.55 ± 0.30, p2 = 0.01, respectively). Although an increase was detected in mean Cr level from baseline to the 5-day Cr level in group II, this did not reach statistical significance (from 1.40 ± 0.12 to 1.48 ± 0.23, P = 0.06).

CONCLUSIONS

Pretreatment with nebivolol is protective against nephrotoxic effects of contrast media.

Effect of long-term and high-dose allopurinol therapy on endothelial function in normotensive diabetic patients

OBJECTIVES

Endothelial dysfunction is a well known risk factor for atherosclerosis. Uric acid levels are associated with endothelial dysfunction and atherosclerosis even if in physiological range. Xanthine oxidase inhibition with allopurinol decreases uric acid levels and oxidative stress and improves endothelial function. We have investigated the effect of high-dose and long-term allopurinol therapy on endothelial function in diabetic normotensive patients.

METHODS

This study is a randomized, single-blind, placebo-controlled trial. Both treatment and placebo groups consisted of 50 patients. In the treatment group, daily oral 900 mg allopurinol was started after randomization and maintained for 12 weeks. Brachial artery flow-mediated dilatation (FMD) and nitrate-induced dilatation (NID) were measured at baseline and after the allopurinol therapy to evaluate endothelial function.

RESULTS

HbA1c and uric acid levels decreased after allopurinol therapy (6.1 ± 2.1 vs 5.5 ± 1.0%, 5.0 ± 0.8 vs 3.3 ± 0.5 mg/dl, respectively, p = 0.01) but no change was observed in the placebo group (7.7 ± 1.9% vs 7.6 ± 2.0%, 5.3±2.1 vs 5.6 ± 0.8 mg/dl, respectively, p > 0.05). FMD and NID increased significantly in the treatment group (5.6 ± 2.1% vs 8.5 ± 1.2%, 10 ± 7.4% vs 14 ± 4.0%, 10 ± 7.4% vs 14 ± 4.0%, respectively, p = 0.01), whereas no change was observed in the placebo group (5.8 ± 1.8% vs 6.1 ± 0.8%, 12 ± 9.5 vs 10 ± 3.8%, respectively, p > 0.05).

CONCLUSION

Long-term and high-dose allopurinol therapy significantly improved endothelial function in diabetic normotensive patients. In addition, allopurinol therapy contributes to the lower HbA1c levels.

Clinical events in mad honey poisoning: a single centre experience

The aim was to evaluate the clinical findings of patients who admitted to the hospital with the diagnosis of grayanotoxin/mad honey poisoning. Thirty-three patients were included in this study. Three patients were female (9%) and the others male (91%). Median age of patients was 52 (42-68). The most frequently observed findings were sinus bradycardia (91%), nausea-vomiting (81.8%), and dizziness (78.8%). Average heart rate was 55.35 +/- 6.72 beats/min. Mean systolic and diastolic blood pressures were 77.86 +/- 16.64 mmHg and 46.42 +/- 12.30 mmHg, respectively. Mad honey poisoning is an important problem that is life-threatening in the Black Sea region of Turkey.