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Öğe Effects of ivabradine therapy on heart failure biomarkers(Via Medica, 2015) Ordu, Serkan; Yıldız, Bekir Serhat; Alihanoğlu, Yusuf İzzettin; Özsoy, Aybars; Tosun, Mehmet; Evrengül, Harun; Özhan, HakanBackground: Heart rate (HR) reduction is associated with improved outcomes in patients with heart failure (HF) and biomarkers can be a valuable diagnostic tool in HF management. The primary aim of our study was to evaluate the short-term (6 months) effect of ivabradine on N-terminal pro B-type natriuretic peptide (NT-proBNP), CA-125, and cystatin-C values in systolic HF outpatients, and secondary aim was to determine the relationship between baseline HR and the NT-proBNP, CA-125, cystatin-C, and clinical status variation with ivabradine therapy. Methods: Ninety-eight patients (mean age: 65.81 +/- 10.20 years; 33 men), left ventricular ejection fraction < 35% with Simpson method, New York Heart Association (NYHA) class II-III, sinus rhythm and resting HR > 70/min, optimally treated before the study were included. Among them, two matched groups were formed: the ivabradine group and the control group. Patients received ivabradine with an average (range of 10-15) mg/day during 6 months of follow-up. Blood samples for NT-proBNP, CA-125, and cystatin-C were taken at baseline and at the end of a 6-month follow-up in both groups. Results: There was a significant decrease in NYHA class in the ivabradine group (2.67 +/- +/- 0.47 vs. 1.85 +/- 0.61, p < 0.001). When ivabradine and control groups were compared, a significant difference was also found in NHYA class 6 months later (p = 0.013). A significant decrease was found in HR in the ivabradine and control groups (84.10 +/- 8.76 vs. 68.36 +/- +/- 8.32 bpm, p = 0.001; 84.51 +/- 10 vs. 80.40 +/- 8.3 bpm, p = 0.001). When both groups were compared, a significant difference was also found in HR after 6 months (p = 0.001). A significant decrease was found in cystatin-C (2.10 +/- 0.73 vs. 1.50 +/- 0.44 mg/L, p < 0.001), CA-125 (30.09 +/- 21.08 vs. 13.22 +/- 8.51 U/mL, p < 0.001), and NT-proBNP (1,353.02 +/- 1,453.77 vs. 717.81 +/- 834.76 pg/mL, p < 0.001) in the ivabradine group. When ivabradine and control groups were compared after 6 months, a significant decrease was found in all HF parameters (respectively; cystatin-C: p = 0.001, CA-125: p = 0.001, NT-proBNP: p = 0.001). Creatinine level was significantly decreased and glomerular filtration rate (GFR) was significantly increased in the ivabradine group (1.02 +/- 0.26 vs. 0.86 +/- 0.17, creatinine: p = 0.001; 79.26 +/- +/- 18.58 vs. 92.48 +/- 19.88, GFR: p = 0.001). There was no significant correlation between NYHA classes (before and after ivabradine therapy) and biochemical markers, or HR. Conclusions: In the outpatients with systolic HF, persistent resting HF > 70/min with optimal medical therapy, the NT-proBNP, CA-125, and cystatin-C reductions were obtained with ivabradine treatment. Measurement of NT-proBNP, CA-125, and cystatin-C may prove to be useful in biomarker panels evaluating ivabradine therapy response in HF patients.Öğe Serum and aqueous xanthine oxidase levels, and mRNA expression in anterior lens epithelial cells in pseudoexfoliation(Springer, 2015) Simavlı, Hüseyin; Tosun, Mehmet; Bucak, Yasin Y.; Erdurmuş, Mesut; Ocak, Zeynep; Önder, Halil İbrahim; Acar, MuradiyeThe aim of this study was to determine serum and aqueous xanthine oxidase (XO) levels, and mRNA expression in anterior lens epithelial cells in pseudoexfoliation (PEX). In this prospective study, serum, aqueous and anterior lens capsules were taken from 21 patients with PEX and 23 normal subjects who had undergone routine cataract surgery. Serum and aqueous XO levels were analyzed using the colorimetric method. mRNA expression of XO in anterior lens epithelial cells was evaluated using reverse transcription polymerase chain reaction analysis. Serum XO levels (means +/- standard deviations) were 207.0 +/- 86.1 IU/mL and 240.6 +/- 114.1 IU/mL in the normal and PEX groups, respectively (p = 0.310). Aqueous XO levels (means +/- standard deviations) were 65.5 +/- 54.3 IU/mL in the normal group and 130.5 +/- 117.4 IU/mL in the PEX group (p = 0.028). There was a 2.9 fold decrease in mRNA expression in anterior lens epithelial cells of PEX, which is significantly lower than the normal group (p = 0.01). Higher aqueous XO levels lacking associated different serum XO suggests higher oxidative stress in the aqueous. Higher aqueous XO levels in PEX with decreased mRNA expression in anterior lens epithelial cells indicate possible overexpression of XO in other structures related to the aqueous.Öğe Serum Levels of Omentin in Pseudoexfoliation Syndrome(Lippincott Williams & Wilkins, 2016) Bucak, Yasin Y.; Tosun, Mehmet; Simavlı, Hüseyin; Önder, Halil İbrahim; Erdurmuş, MesutPurpose: Omentin, a member of the adipocytokines family, is derived from adipose tissue and a lower level of serum omentin is considered as a metabolic risk factor. The aim of the present study is to evaluate the serum levels of omentin in patients with pseudoexfoliation syndrome (PES). Materials and Methods: Patients without any systemic or ocular disease other than PES were included in the study. Age-matched and sex-matched healthy volunteers without PES were accepted as a control group. After detailed ophthalmologic examination, blood samples were obtained from a forearm vein. Serum levels of omentin were determined by the method of enzyme-linked immunosorbent assay. Results: The mean age of the PES group (12 females, 12 males, n = 24) was 75.2 +/- 8.4 years, and the control group (10 females, 10 males, n = 20) was 75 +/- 6.7 years. There was no difference between the groups in terms of age (P = 0.93) and sex (P = 0.9). The mean serum levels of omentin in the PES group were 801.5 +/- 317.1 ng/mL and in the control group were 1150.1 +/- 584.1 ng/mL. The mean serum omentin levels were significantly lower in patients with PES (P = 0.016). Conclusion: Lower levels of serum omentin in patients with PES compared with healthy subjects may support the theory of systemic nature of the disease.Öğe Serum levels of visfatin, resistin and adiponectin in patients with psoriatic arthritis and associations with disease severity(Wiley-Blackwell, 2016) Dikbaş, Oğuz; Tosun, Mehmet; Bes, Cemal; Tönük, Şükrü Burak; Akşehirli, Özge Yılmaz; Soy, MehmetAim: Psoriatic arthritis (PsA) is an inflammatory form of arthritis typically associated with psoriasis and/or psoriatic nail disease. Adipocytokines were once thought to influence development of (only) insulin resistance and diabetes mellitus. However, it is now clear that adipocytokines play important roles in development of the inflammation associated with either autoimmune or auto-inflammatory disorders. In the present study, we measured changes in the serum levels of adiponectin, resistin and visfatin, and the associations of such changes with the extent of disease activity and insulin resistance in PsA patients. Material and methods: A total of 67 subjects (28 with PsA and 39 healthy controls) without hypertension or diabetes mellitus were enrolled. Adiponectin, resistin and visfatin levels, and the extent of insulin resistance (assayed using the homeostasis model [HOMA-IR]), were measured in all subjects. Assessment of PsA disease activity was done with the Disease Activity Index for Psoriatic Arthritis (DAPSA). Results: Psoriatic arthritis patients had considerably higher serum levels of adiponectin, resistin and visfatin than did healthy controls (all P < 0.05). In the logistic regression analysis, the following variables may contribute to complex pathogenesis of PsA: adiponectin (P = 0.001, OR = 3.1, 95% CI = 1.6-6.0), resistin (P = 006, OR = 1.8, 95% CI = 1.2-2.9) and visfatin (P = 0.031, OR = 3.9, 95% CI = 1.1-13.9). In contrast, we have not detected any correlation between DAPSA and adipocytokine serum levels (P > 0.05). Conclusion: There is no correlation between adipocytokines and disease activity. Although serum adiponectin, resistin and visfatin levels are higher in patients with PsA, pathophysiological significance of the result has to be evaluated with more extensive studies.Öğe Vitamin D status in children with attention-deficit-hyperactivity disorder(Wiley, 2014) Göksügür, Sevil Bilir; Tufan, Ali Evren; Semiz, Murat; Güneş, Cemalettin; Bekdaş, Mervan; Tosun, Mehmet; Demircioğlu, FatihBackgroundAttention-deficit-hyperactivity disorder (ADHD), one of the most common psychiatric disorders of childhood, has an early onset, affecting 2-18% of children worldwide. The etiopathogenesis of ADHD is obscure. In recent studies, a low level of vitamin D has been found in association with many disorders as well as in neuropsychiatric diseases. The aim of this study was therefore to investigate serum vitamin D level in pediatric ADHD patients. MethodsA total of 60 ADHD patients and 30 healthy controls were included in the study. The age of both groups was in the 7-18-year-old range. Serum 25-OH-vitamin D, calcium, phosphorus and alkaline phosphatase were investigated. ResultsSerum 25-OH-vitamin D was found to be significantly lower in children and adolescents with ADHD compared to healthy controls, and no significant differences were found between the groups in terms of other variables. 25-OH-vitamin D level in the ADHD group and control group was, respectively, 20.9 19.4ng/mL and 34.9 +/- 15.4ng/mL (P = 0.001). ConclusionThere is an association between lower 25-OH-vitamin D concentration and ADHD in childhood and adolescence. To the authors' knowledge this is the first study to investigate the relationship between vitamin D and ADHD in children.
