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    Do cardiac risk factors affect the homocysteine and asymmetric dimethylarginine relationship in patients with coronary artery diseases?
    (Pergamon-Elsevier Science Ltd, 2012) Isiklar, Ozben O.; Barutcuoglu, Burcu; Kabaroglu, Ceyda; Mutaf, Isil; Ozmen, Dilek; Bayindir, Oya; Zoghi, Mehdi; Uluer, Hatice
    Objectives: Elevated homocysteine (Hcy) concentrations have been shown to be a risk factor for atherosclerotic vascular disease and thrombosis. Increased asymmetric dimethylarginine (ADMA) levels have been implicated in the pathogenesis of numerous conditions affecting the cardiovascular system. In this study, the influence of cardiovascular risk factors and other variables on Hcy and ADMA relationship in patients with coronary artery disease (CAD) was investigated. Design and methods: Seventy-five patients with CAD were divided into three tertiles according to their Hcy levels. The effect of age, gender, blood pressure, lipid profile, renal function, and the presence of diabetes, insulin resistance, heart failure, inflammation, overweight, smoking and severity of coronary atherosclerosis on Hcy and ADMA relationship was evaluated. Results: ADMA concentrations of patients in the middle and highest Hcy tertiles were significantly higher than the patients in the lowest tertile. When ADMA concentrations were adjusted for demographic, clinical and laboratory variables, the significant differences in ADMA concentrations between the tertiles were preserved. ADMA levels positively correlated with Hcy. Homocysteine levels positively correlated with serum creatinine and NT-proBNP concentrations and negatively correlated with glomerular filtration rates. Stepwise multiple regression analysis revealed Hcy as the unique predictor of ADMA levels. Conclusion: Homocysteine concentration has an effect on ADMA levels. There is a strong correlation between Hcy and ADMA. Cardiovascular risk factors do not have an influence on this relationship. (C) 2012 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
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    Effect of telmisartan on vascular endothelium in hypertensive and type 2 diabetic hypertensive patients
    (Tubitak Scientific & Technical Research Council Turkey, 2010) Barutcuoglu, Burcu; Parildar, Zuhal; Mutaf, M. Isil; Ozmen, Dilek; Alioglu, Emin; Habif, Sara; Bayindir, Oya
    Aim: Hypertension and type 2 diabetes mellitus (DM) cause endothelial dysfunction and may result in cardiovascular disease. The aim of this study was to assess endothelial dysfunction in essential hypertensives, and normotensive and hypertensive type 2 diabetics and to evaluate the effect of telmisartan on endothelium in hypertensives. Materials and methods: Eighteen essential hypertensives (group 1), 16 type 2 diabetic hypertensives (group 2), 10 type 2 diabetic normotensives (group 3), and 10 control subjects (group 4) were included in this study Groups 1 and 2 received 40 mg/day telmisartan for 12 weeks and were evaluated at the beginning and end. Groups 3 and 4 were evaluated once by serum nitrate (NO), vascular cell adhesion molecule-1 (VCAM-1), platelet endothelial cell adhesion molecule-1 (PECAM-1), thrombomodulin (TM), plasminogen activator inhibitor-1 (PAI-1), paraoxonase (PON1), urine microalbumin (MAU), and endothelium dependent flow mediated dilation (FMD). Results: In groups I, 2, and 3, PAI-1 (P < 0.001, for all) and MAU (P = 0.012, P = 0.006, P = 0.004, respectively) were significantly higher than they were in group 4. In group 2, PON1 was significantly lower than it was in groups 4 and 1 (P = 0.028, P < 0.001 respectively), and NO was significantly lower than it was in groups I, 3, and 4 (P < 0.001, for all). Brachial artery FMD was significantly lower in groups 1 and 2 than it was in group 4 and EMD in group 2 was lower than it was in group 3. After telmisartan treatment there were significant increases in PON1 in groups 1 and 2, and in TM in group 2. Conclusion: Type 2 DM and essential hypertension result in endothelial dysfunction. Telmisartan decreases blood pressure to normal ranges in hypertensives, but it has a minimal role in improvement of endothelial dysfunction.
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    Fibroblast Growth Factor-19 Levels in Type 2 Diabetic Patients with Metabolic Syndrome
    (Assoc Clinical Scientists, 2011) Barutcuoglu, Burcu; Basol, Gunes; Cakir, Yasemin; Cetinkalp, Sevki; Parildar, Zuhal; Kabaroglu, Ceyda; Ozmen, Dilek; Mutaf, Isil; Bayindir, Oya
    This study aimed to examine fibroblast growth factor-19 (FGF-19) in type 2 diabetic (T2DM) patients with metabolic syndrome (MetS) and to evaluate the relationship between FGF-19 and other cardiovascular risk factors, such as atherogenic index of plasma (AIP) and hsCRP. 26 T2DM patients with MetS and 12 healthy controls were enrolled in the study. Serum FGF-19 levels were measured by sandwich ELISA, and compared with other cardiovascular risk factors; lipid profile, AIP, glucose, HbA1c, and hsCRP. AIP was calculated as log (TG/HDL-c). The median (1-3.quartile) FGF-19 levels in T2DM patients with MetS and healthy controls were 122.90 (108.63-237.60) pg/ml and 293.45 (153.64-370.31) pg/ml, respectively (P=0.003). Patients were also grouped by body mass index (BMI) <30 kg/m(2) (n=13) and >= 30 kg/m(2) (n=13) with median (1-3.quartile) FGF-19 values 168.70 (113.54-275.77) pg/mL and 115.89 (97.94-200.40) pg/mL, respectively (P=0.007). Significant negative correlations were found between FGF-19 and BMI, triglyceride, log (TG/HDL-c), hsCRP, and HbA1c (r=-0.526, P=0.001; r=-0.327, P=0.05; r=-0.312, P=0.05; r=-0.435, P=0.006; r=-0.357, P=0.028, respectively). We showed that FGF-19 levels are low in T2DM patients with MerS. The negative relationship between FGF-19 and several known cardiovascular risk factors such as TG, log (TG/HDL-c), hsCRP and HbA1c in diabetic patients with MetS suggests that FGF-19 can be used as a contributing marker.
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    Increased serum neopterin levels in women with polycystic ovary syndrome
    (Assn Clinical Scientists, 2006) Barutcuoglu, Burcu; Bozdemir, A. Erkin; Dereli, Didem; Parildar, Zuhal; Mutaf, M. Isil; Ozmen, Dilek; Bayindir, Oya
    Polycystic ovary syndrome (PCOS) occurs in 5-10% of premenopausal women. Studies suggest that PCOS is associated with increased risk of coronary heart disease (CHD). To investigate this relationship, 15 PCOS women (group 1) and 10 healthy women (group 2) were studied. Blood leukocyte counts (white blood cells, WBC) and serum levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, sensitive C-reactive protein (sCRP), and neopterin were measured in the 2 groups. There were no significant differences in serum total cholesterol, HDL-cholesterol, or LDL-cholesterol concentrations between groups 1 and 2. Blood WBC counts and serum levels of neopterin and sCRP were significantly higher in group I than group 2. The median (min-max) levels were: WBC, group 1: 8.05 (5.10-9.70) cells x 10(9)/L, group 2: 6.25 (4.70-9.70) cells x 109/L (p < 0.01); neopterin, group 1: 10.6 (7.5-49.5) nmol/L, group 2: 9.6 (6.5-12.9) nmol/L (p < 0.05); and sCRP, group 1: 7.0 (1.2-12.0) mg/L, group 2: 2.0 (0.1-12.0) mg/L (p < 0.01). This study shows that blood WBC counts and serum sCRP and neopterin levels are significantly elevated in women with PCOS. These findings support an increased risk for early-onset cardiovascular disease in women with PCOS. This is the first report that women with PCOS have higher serum neopterin levels than healthy women with regular menstrual cycles.
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    Prognostic Utility of Serum Neopterin in Obstructive Jaundice Secondary to Malignant Lesions Treated by Percutaneous Transhepatic Biliary Drainage
    (Elsevier Science Inc, 2013) Yilmaz, Betul; Parildar, Zuhal; Bozkaya, Halil; Barutcuoglu, Burcu; Cinar, Celal; Basol, Gunes; Parildar, Mustafa; Ozmen, Dilek
    Purpose: To perform biochemical profiles before and after percutaneous transhepatic biliary drainage (PTBD) and investigate the potential utility of measuring C-reactive protein (CRP); circulating cytokines, and neopterin, a marker Of cell-mediated immunity, to predict outcomes of patients with obstructive jaundice. Materials and Methods: In a prospective study, 47 patients with obstructive jaundice secondary to malignant lesions were evaluated before, at the fifth hour after, and on the fifth day after PTBD for neopterin, nitrate, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-10, CRP levels, and liver function. Results: Neopterin levels on day 5 after PTBD were significantly higher than the levels before treatment bent and at the fifth hour. However, nitrate, cytokine, white blood cell, albumin, and creatinine levels were not significantly different. On the fifth day after PTBD, CRP levels were significantly higher and total bilirubin, direct bilirubin, alkaline phosphatase, aspartate transaminase, and alanine transaminase values were lower than the before-treatment values. Seven patients (15%) died within 30 days after drainage. On the fifth day after PTBD, neopterin, IL-6, IL-10, and creatinine levels were significantly higher and albumin levels were lower in the early mortality group. The performance characteristics of neopterin and creatinine were statistically significant in predicting mortality. Conclusions: Neopterin levels increased after PTBD, indicating cellular immune activation. The nonsignificant change in cytokine levels may be related to low enduring release in malignancy. The extremely elevated level a of neopterin and creatinine after PTBD might serve as harbingers of early death in patients with cholestasis secondary to malignant lesions.