[show abstract][hide abstract] ABSTRACT: Objective: Disability is one of the significant problems that the public faces as regards social aspects, economics, public health and politics. Our aim was to review the prevalence of diseases causing disabilities in young adult men who are declared "unfit for military service" in Turkey after medical examination. Methods: We reviewed the prevalence of diseases among 113,175 young adult men who were referred for medical examination between 2009 and 2011. Results: Prevalence of unfitness for military service was 5.56% in 2009, 6.74% in 2010 and 6.77% in 2011. Leading causes for young adult men to be rejected from military service was intellectual disability 6.88, hearing loss 3.71, epilepsy 1.59, schizophrenia 1.54 and diabetes mellitus 1.47 per thousand people. Conclusion: Screening for the prevalence of disability conditions is an important data source for policies to be developed. Supporting such survey with community based studies in different populations in future shall be beneficial for improvement of policies in social and health fields.
Pakistan Journal of Medical Sciences Online 09/2013; 29(5):1240-4. · 0.10 Impact Factor
[show abstract][hide abstract] ABSTRACT: High level of circulating red cell distribution width (RDW) and neutrophil/lymphocyte ratio (N/L) may reflect ongoing vascular inflammation and plays an important role in pathophysiology of hypertension. We evaluate the effects of nebivolol and metoprolol on the RDW and N/L in new essential hypertensives. After baseline assessment, 72 patients were randomly allocated to 5 mg/day of nebivolol (n=37, 20 males) or 100 mg/day of metoprolol (n=35, 18 males) and treated for 6 months. Blood pressure (BP), heart rate (HR), RDW and N/L were measured before and after treatment. BP significantly decreased with both drugs (P<0.001). Analogue reduction was observed for resting HRs (P<0.001), but metoprolol caused greater HR fall as compared to nebivolol (P<0.001). After 6 months treatment, nebivolol significantly lowered not only RDW but also total WBC and N/L (P<0.001, P=0.023, P=0.017, respectively). No changes were observed in metoprolol group. Percent decrease in RDW was found to be significantly higher in nebivolol than in metoprolol group (P=0.001) and remained also after correction for confounders (P=0.012). Nebivolol improved RDW and N/L to a greater extent that metoprolol in hypertensives. These favourable effects may participate, together with the BP reduction, at the favourable properties of the drug in hypertension.
Journal of cardiovascular pharmacology 08/2013; · 2.83 Impact Factor
[show abstract][hide abstract] ABSTRACT: Psoriasis vulgaris is an inflammatory disease characterized by epidermal hyperproliferation, leucocyte adhesion molecule expression and leucocyte infiltration. Psoriasis is associated with an increased risk of cardiovascular disease. Endothelial dysfunction is widely regarded as being the initial lesion in the development of atherosclerosis Human endothelial-cell specific molecule-1(endocan) is a novel human endothelial cell specific molecule. Previous studies suggested that endocan may be a novel endothelial dysfunction marker.
To investigate the relationship between serum levels of endocan and cardiovascular risk as well as disease activity in patients with psoriasis vulgaris.
A total of 29 patients with psoriasis vulgaris and 35 control subjects were included in the study. Endocan, high-sensitivity C-reactive protein (hsCRP) and carotid artery intima-media thickness (cIMT) were measured in all subjects.
Serum endocan levels were significantly different between the two groups (p< 0.001). In patients with psoriasis, serum endocan levels correlated with psoriasis activity and severity index (PASI), hsCRP and cIMT (r=0.477, p=0.009; r=0.408, p=0.02; r=484, p=0.008, respectively).
Circulating endocan may represent a new marker that correlates with cardiovascular risk as well as the severity of disease in patients with psoriasis vulgaris. Endocan may be a surrogate endothelial dysfunction marker and may have a functional role in endothelium-dependent pathological disorders. Whether endocan levels could become a treatment target merits further investigation. This article is protected by copyright. All rights reserved.
British Journal of Dermatology 07/2013; · 3.76 Impact Factor
[show abstract][hide abstract] ABSTRACT: Background/Aims: The role of chronic kidney disease-mineral bone disorder (CKD-MBD) reversibility in the amelioration of vascular function and in the reduction of the risk for cardiovascular events after renal transplantation is still unknown. Methods: We investigated the longitudinal relationship between the main biomarkers of CKD-MBD and the evolution of vascular function [flow-mediated dilatation (FMD)] after transplantation in a series of 161 patients with kidney failure maintained on chronic dialysis (5D-CKD). Results: Before transplantation, FMD in patients was markedly lower (-40%, p < 0.001) than in well-matched healthy subjects and increased by 27% after transplantation (p = 0.001). Fibroblast growth factor 23 (FGF23), 25-hydroxy-vitamin D (25OHVD) and serum phosphate (p < 0.01) were independently associated with simultaneous changes in FMD. Changes in classical risk factors and in risk factors related to CKD like the glomerular filtration rate, serum albumin, C-reactive protein and insulin resistance failed to independently explain the variability in FMD changes after transplantation. Conclusion: Endothelium-dependent vasodilatation improves after kidney transplantation, which is parallel to the dramatic fall in FGF23, the reduction in serum phosphorus and the increase in 25OHVD levels. If these associations are causal, a part of decline in cardiovascular risk after transplantation is related to partial resolution of CKD-MBD.
American Journal of Nephrology 01/2013; 37(2):126-134. · 2.62 Impact Factor
[show abstract][hide abstract] ABSTRACT: No detailed data exist in the literature on the accurate diagnosis of chronic brucellar meningitis or meningoencephalitis. A multicentre retrospective chart review was performed at 19 health centres to determine sensitivities of the diagnostic tests. This study included 177 patients. The mean values of CSF biochemical test results were as follows: CSF protein, 330.64 ± 493.28 mg/dL; CSF/ blood-glucose ratio, 0.35 ± 0.16; CSF sodium, 140.61 ± 8.14 mMt; CSF leucocyte count, 215.99 ± 306.87. The sensitivities of the tests were as follows: serum standard tube agglutination (STA), 94%; cerebrospinal fluid (CSF) STA, 78%; serum Rose Bengal test (RBT), 96%; CSF RBT, 71%; automated blood culture, 37%; automated CSF culture, 25%; conventional CSF culture, 9%. The clinician should use every possible means to diagnose chronic neurobrucellosis. The high seropositivitiy in brucellar blood tests must facilitate the use of blood serology. Although STA should be preferred over RBT in CSF in probable neurobrucellosis other than the acute form of the disease, RBT is not as weak as expected. Moreover, automated culture systems should be applied when CSF culture is needed.
Clinical Microbiology and Infection 11/2012; · 4.58 Impact Factor
[show abstract][hide abstract] ABSTRACT: BACKGROUND: Tularemia is a bacterial zoonosis with diverse clinical manifestations depending on bacterial subspecies and the route of the infection. METHODS: We collected data prospectively of cases diagnosed and treated for tularemia in our institution during the epidemics from December 2009 to August 2011. Specific antibodies were screened by a microagglutination test. Throat swab and lymph node aspirate cultures were obtained and polymerase chain reaction (PCR) was performed on these specimens. Lymph nodes were characterized on the basis of ultrasound reports. RESULTS: A total of 139 patients were confirmed with tularemia. The age range of the patients was 6-83 years (mean: 43) and 84 (60.4 %) of them were females. Patients had clinical presentations compatible with oropharyngeal (74 %), glandular (15.8 %), and oculoglandular (5.0 %) tularemia. Ultrasonography (US) was performed in 108 patients. Antibiotics (aminoglycosides, quinolones, and doxycycline) were used in 138 patients. Fine-needle aspiration (FNA) or surgical drainage of fluctuant lymph nodes were performed in 51 (39 %) patients. Therapeutic failure was observed in 43 (30.9 %) patients. Elevation of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were observed to be significantly higher in patients with therapeutic failures (p = 0.003 and 0.004, respectively). The success rate was significantly higher in patients with early treatment (p = 0.004). No difference was found between the effectiveness of aminoglycoside or quinolone treatments. The increase in the short and long axes, and the characteristics of lymph nodes detected on US were significantly associated with treatment failures (p < 0.001). Intranodal necrosis was found in 45 patients. The treatment success rate was 40 % in patients with intranodal necrosis. CONCLUSION: To the best of our knowledge, this is the first study defining the US findings of patients with tularemia and its association with treatment success. Ciprofloxacin is an effective and convenient choice in epidemics of tularemia and early treatment is still the cornerstone of successful therapies.
[show abstract][hide abstract] ABSTRACT: Prehypertension is characterized by an increased cardiovascular risk and by an increased prevalence of target organ damage compared with the pure normotensive state. The present study was designed to assess in prehypertensive subjects the possible relationships between early left ventricular dysfunction, vascular inflammation and aortic stiffness. The study population consisted of 31 untreated prehypertensive subjects (age: 34 ± 6 years, mean ± SD) and 31 age-matched pure normotensive controls. Left ventricular function was assessed by echocardiography, aortic distensibility parameters were derived from aortic diameters measured by ultrasonography, and high-sensitivity C-reactive protein was assessed by latex-enhanced reagent. Prehypertensive subjects displayed a significantly lower E/A ratio and a significantly greater deceleration time and isovolumetric relaxation time compared with normotensive controls. They also displayed aortic systolic diameter, diastolic diameter and mean aortic stiffness index beta significantly increased while systo-diastolic diameter change, mean aortic distensibility and aortic strain were significantly reduced compared with controls. Values of inflammatory markers were increased. At multiple regression analysis, E/A ratio was significantly related to high-sensitivity C-reactive protein and aortic stiffness index beta, after correction for age, left ventricular mass index and mean blood pressure (β coefficient = -0.49, overall r(2) = 0.24, p = 0.01 and β coefficient =-0.46, overall r(2) = 0.21, p = 0.02, respectively). Thus, in prehypertension, left ventricular dysfunction is significantly related to vascular inflammation and aortic stiffness, suggesting that early cardiac and vascular alterations may have an increased inflammatory process as a common pathophysiological link.
[show abstract][hide abstract] ABSTRACT: Chitotriosidase (CHT) enzyme has been known to be secreted from the activated macrophages. We infer with these data that CHT activity is an indicator for the defence.
In this study, we evaluated CHT levels in both neutropenic and non neutropenic patients. CHT enzyme activity was measured and compared to each other groups.
Chitotriosidase levels were found to be significantly higher in neutropenic patients with candidemia.
In the comparison between neutropenic and non neutropenic patients, there was a significant difference for CHT levels. The use of this enzyme as a surrogate marker for candidemias were evaluated in neutropenic and non neutropenic patients.
[show abstract][hide abstract] ABSTRACT: No data on whether brucellar meningitis or meningoencephalitis can be treated with oral antibiotics or whether an intravenous extended-spectrum cephalosporin, namely, ceftriaxone, which does not accumulate in phagocytes, should be added to the regimen exist in the literature. The aim of a study conducted in Istanbul, Turkey, was to compare the efficacy and tolerability of ceftriaxone-based antibiotic treatment regimens with those of an oral treatment protocol in patients with these conditions. This retrospective study enrolled 215 adult patients in 28 health care institutions from four different countries. The first protocol (P1) comprised ceftriaxone, rifampin, and doxycycline. The second protocol (P2) consisted of trimethoprim-sulfamethoxazole, rifampin, and doxycycline. In the third protocol (P3), the patients started with P1 and transferred to P2 when ceftriaxone was stopped. The treatment period was shorter with the regimens which included ceftriaxone (4.40 ± 2.47 months in P1, 6.52 ± 4.15 months in P2, and 5.18 ± 2.27 months in P3) (P = 0.002). In seven patients, therapy was modified due to antibiotic side effects. When these cases were excluded, therapeutic failure did not differ significantly between ceftriaxone-based regimens (n = 5/166, 3.0%) and the oral therapy (n = 4/42, 9.5%) (P = 0.084). The efficacy of the ceftriaxone-based regimens was found to be better (n = 6/166 [3.6%] versus n = 6/42 [14.3%]; P = 0.017) when a composite negative outcome (CNO; relapse plus therapeutic failure) was considered. Accordingly, CNO was greatest in P2 (14.3%, n = 6/42) compared to P1 (2.6%, n = 3/117) and P3 (6.1%, n = 3/49) (P = 0.020). Seemingly, ceftriaxone-based regimens are more successful and require shorter therapy than the oral treatment protocol.
Antimicrobial Agents and Chemotherapy 12/2011; 56(3):1523-8. · 4.57 Impact Factor
[show abstract][hide abstract] ABSTRACT: Fibroblast growth factor 23 (FGF-23) is a marker of endothelial dysfunction and atherosclerotic complications in patients with chronic kidney disease (CKD). Because previous studies suggested that sevelamer may exert effects on FGF-23 level and endothelial function independently of its phosphate-lowering action, we tested the effect of sevelamer versus calcium acetate on vascular function and FGF-23 levels.
Randomized prospective open-label trial.
Patients with stage 4 CKD with hyperphosphatemia (n = 100).
An 8-week intervention with sevelamer (n = 47) and calcium acetate (n = 53).
The primary study outcome was change in flow-mediated vasodilatation in the forearm. The secondary outcome was change in FGF-23 levels.
Serum phosphate levels decreased in both treatment arms (P < 0.001), but more markedly in the sevelamer group (P < 0.001). Flow-mediated vasodilatation increased from 6.1% to 7.1% (P < 0.001) in sevelamer-treated patients, whereas it was unchanged in the calcium-acetate group (6.0% vs 6.0%). In a combined analysis, treatment-induced changes in flow-mediated vasodilatation were (P < 0.001) associated with simultaneous changes in FGF-23 levels (-27.1% [-33.2% to -8.8%] for the sevelamer group; 3.5% [-8.4% to 12.1%] for the calcium acetate group), as well as with C-reactive protein and fetuin A levels. These relationships were confirmed in multiple regression analysis adjusting for changes in serum phosphate levels and other factors.
Unblinded randomized controlled study that cannot establish mechanisms of effect.
In hyperphosphatemic patients with stage 4 CKD, treatment with phosphate lowering induces measurable improvements in flow-mediated vasodilatation. Furthermore, independently of serum phosphate level, FGF-23 level changes induced by phosphate binders are associated with simultaneous changes in flow-mediated vasodilatation. These observations are compatible with the hypothesis that FGF-23 may contribute to vascular dysfunction in this population.
American Journal of Kidney Diseases 11/2011; 59(2):177-85. · 5.29 Impact Factor
[show abstract][hide abstract] ABSTRACT: The present study was conducted to develop a clinical pathway for breast cancer patients undergoing breast surgery. We also aimed to determine the effects of this model on the (1) reduction of patient anxiety, (2) satisfaction of the patient, and (3) quality of life.
The present study was conducted using a quasi-experimental nonequivalent study design. The study was applied to 69 patients diagnosed with breast cancer, who underwent surgical operations. We collected data using a questionnaire form, the State-Trait Anxiety Inventory, Questionnaire for the Evaluation of Patient Satisfaction, and SF-36 Quality of Life Scale. The data were analysed using percentages, the Student's t-tests, Mann-Whitney U-Test, and chi-square tests.
This study showed that a comprehensive breast surgery clinical pathway significantly improved the quality of life and patient treatment satisfaction and reduced anxiety, even though it did not affect the hospitalization time. According to the level of state anxiety, there was not a meaningful statistical difference between groups but the anxiety level of the study group was lower than the control group and there was not a statistically meaningful difference between them in the period of pre-discharge. For quality of life, the physical, general health, vitality, social functioning, and emotional subscale averages were higher for the study group.
The results of the study indicate that the implementation of a clinical pathway on patients with breast surgery has a positive effect on increasing patient satisfaction, decreasing patient anxiety levels, and improving their quality of life.
European journal of oncology nursing: the official journal of European Oncology Nursing Society 07/2011; 16(4):368-74. · 1.13 Impact Factor
[show abstract][hide abstract] ABSTRACT: The knowledge about vitamin B(12) and folic acid levels in preserving bone mass in older men is limited. In this retrospective study, we aimed to find out whether levels of vitamin B(12) and folic acid are related to BMD in older men. Two hundred and sixty-nine older men were included in the study. Forty-two (15.6%) of them had osteoporotic, 150 (55.8%) had osteopenic, and 77 (28.6%) had normal BMD. Vitamin B(12) and folic acid levels were categorized as indicating normal, borderline, or low vitamin statuses. Femur neck densities showed statistically significant differences in subjects having low, borderline, and normal vitamin B(12), respectively. There were no significant differences between the three tertiles of vitamin B(12) in femur total, trochanteric, and intertrochanteric densities. After adjustment for age, body mass index (BMI), alcohol, smoking, and exercise with analysis of covariance, the difference was still statistically significant between two groups for femur neck density (p=0.011). No significant difference was observed between the groups of folic acid in any femur sites. We found that the normal level of vitamin B(12) in older men may be related to a decrease of femur neck bone loss.
Archives of gerontology and geriatrics 06/2011; 54(3):469-72. · 1.36 Impact Factor
[show abstract][hide abstract] ABSTRACT: Transthoracic cardioversion (TTC) is widely used in emergency departments and daily clinical practice. TTC may cause skin lesions on the application of apical and sternal paddle areas. The lesions are characterised by redness, erythema and blister(s), and can be defined as first degree burns locally causing pain and increased sensitivity.
To evaluate the effectiveness of local cold application on reducing the incidence, severity and pain/sensitivity of skin burns in patients who underwent TTC.
The study was conducted in the intensive care unit of the cardiovascular surgery department. The patients were assigned to study (n=24) and control groups (n=24). Local cold application was performed for a 1 hour period on patients in the study group, whereas only clinical procedures were applied in the control group following TTC. Incidence and severity of burn was evaluated 2 h after TTC, and pain/sensitivity scores were evaluated at 2, 4 and 24 h after TTC. Results The incidence of burn was significantly lower in the study group (3/24) compared to the control group (21/24) (12.5% vs 83.3%, p<0.001). Pain/sensitivity scores were significantly lower in the study group compared to the control group (p<0.05).
Local cold application following TTC is an effective means of reducing the incidence and severity of burns and pain/sensitivity. It is cost-effective and can easily be applied by nurses in medical/surgical units and emergency departments.
Emergency Medicine Journal 06/2011; 29(7):544-9. · 1.65 Impact Factor
[show abstract][hide abstract] ABSTRACT: This study was designed to evaluate the possible relationship between vascular inflammatory status [namely, high-sensitivity C-reactive protein (hs-CRP) and white blood cell (WBC)] and aortic elasticity parameters in patients with prehypertension.
The study population consisted of 25 newly diagnosed prehypertensive individuals (18 men, mean age=34±6 years) and 25 healthy controls (16 men, mean age=33±6 years) eligible for this study. Aortic elasticity parameters were calculated from aortic diameters measured by echocardiography and blood pressures, simultaneously measured by sphygmomanometry. hs-CRP measurements were taken with latex-enhanced reagent using a Behring BN ProSpec analyzer.
Baseline characteristics of patients with prehypertension and controls were homogeneous. Inflammatory markers were significantly higher in patients with prehypertension compared with those of controls [for WBC (×10(9)/l): 11.46±0.77 (11.50) vs. 8.94±0.91 (9.20), P<0.001; for hs-CRP (μg/dl): 137.84±50.71 (130.00) vs. 78.30±35.20 (65.27), P<0.001]. There was a strong positive correlation between the mean aortic stiffness index and markers of inflammation (for WBC, r=0.857, P<0.001; for hs-CRP, r=0.858, P<0.001), whereas strong negative correlations were observed between aortic elasticity parameters and markers of inflammation (for aortic distensibility of WBC and hs-CRP, r=-0.862, P<0.001; r=-0.869, P<0.001, respectively, and for aortic strain of WBC and hs-CRP, r=-0.890, P<0.001; r=-0.906, P<0.001, respectively).
Young prehypertensives have increased markers of inflammation, namely, hs-CRP and WBC, compared with controls. More importantly, impaired arterial stiffness is significantly associated with the markers of inflammation in patients with prehypertension.
[show abstract][hide abstract] ABSTRACT: Systemic inflammation, endothelial dysfunction and arterial thickening contribute to the elevated cardiovascular risk of dialysis patients. However, the course of these derangements and their relative contribution to the cardiovascular risk of nondialysed chronic kidney disease (CKD) are scarcely investigated.
Flow-mediated dilatation (FMD) and intima-media thickness (IMT) were assessed in 304 nondialysed CKD patients Stages 1-5 (mean age 46 ± 12 years, 158 men), together with routine biochemical measurements, C-reactive protein (CRP) and insulin resistance. Patients were then followed for time-to-event analysis of cardiovascular outcomes (fatal and nonfatal).
CRP and IMT increased, while FMD decreased in parallel with estimated glomerular filtration rate (eGFR) decline (P < 0.001 for all). CRP and intact parathormone, as well as eGFR, appeared as strong determinants of FMD and IMT in multivariate analyses. After a median follow-up of 41 (range 6-46) months, 30 fatal and 59 nonfatal cardiovascular events occurred. In univariate analysis, FMD, IMT and CRP were significant predictors of outcome. In a multivariate Cox model excluding IMT, both FMD [hazard ratios 0.52 (95% confidence intervals 0.37-0.73) per %] and CRP [1.07 (1.03-1.11) per mg/L] predicted cardiovascular outcomes independently of confounders. In a model excluding FMD, only CRP (and not IMT) was a significant predictor.
Endothelial dysfunction, arterial thickening and inflammation occur in parallel with the decline in eGFR, contributing to the increased cardiovascular risk of nondialysed CKD. Our results support the use of FMD over IMT measurements to monitor nondialysed CKD patients at risk.
[show abstract][hide abstract] ABSTRACT: Chronic kidney disease (CKD) conveys high mortality rates. Soluble TNF-like weak inducer of apoptosis (sTWEAK) and long pentraxin 3 (PTX3) are predictors of mortality in dialysis patients and determinants of endothelial dysfunction. Now, we hypothesize that both sTWEAK and PTX3 act as biomarkers of cardiovascular outcomes in nondialysis CKD patients.
Cross-sectional analysis in which flow-mediated dilation (FMD) and intima-media thickness (IMT) were assessed in 257 nondialysis stage 1 to 5 CKD patients (mean age, 52 ± 12 years; 130 men), together with biochemical measurements and sTWEAK and PTX3 assessments. Patients were followed for cardiovascular outcomes.
PTX3 and IMT increased, whereas FMD and sTWEAK decreased across CKD stages (P<0.001 for all). Both PTX3 and sTWEAK appeared as strong determinants of FMD in multivariate analysis. The univariate associations of sTWEAK and PTX3 with IMT were dependent on estimated GFR. After a median of 39 months (range, 2 to 43 months), 22 fatal and 57 nonfatal cardiovascular events occurred. In a Cox model excluding PTX3, decreasing sTWEAK concentration was associated with increased risk of cardiovascular events independently of basic confounders (age, gender, estimated GFR, C reactive protein, diabetes, and cardiovascular comorbidity) and FMD. In a model excluding sTWEAK, circulating levels of PTX3 were directly associated with cardiovascular outcomes independently of basic confounders, but this association was lost after adjustment for FMD.
Both PTX3 and sTWEAK levels associated with the endothelial dysfunction observed with progressive kidney failure. Additionally, both biomarkers impacted the predictability of cardiovascular outcomes.
Clinical Journal of the American Society of Nephrology 02/2011; 6(4):785-92. · 5.07 Impact Factor
[show abstract][hide abstract] ABSTRACT: Subclinical or frank hypothyroidism is causally implicated in endothelial dysfunction. Since the plasma concentration of the active form of thyroid hormone, triiodothyronine (T₃), is reduced in chronic kidney disease (CKD), where endothelial function is frequently altered, low T₃ may be a factor implicated in this disturbance in CKD patients.
We investigated the relationship between flow-mediated vasodilatation (FMD) and thyroid hormones in a series of 217 nondiabetic patients with stage 3-4 CKD.
The plasma concentration of free T₃ (fT₃) was closely associated with FMD (r = 0.38; p < 0.001). fT₃ was also inversely associated with hemoglobin (r = -0.41; p < 0.001), systolic pressure (r = -0.28; p < 0.001) and the plasma concentration of the endogenous inhibitor of NO synthase, asymmetric dimethylarginine (ADMA; r = -0.18; p = 0.007). However, adjustment for ADMA markedly attenuated the fT₃-FMD link, a phenomenon suggesting that raised plasma ADMA, possibly driven by low fT₃, at least in part mediates the adverse effects of low T₃ on endothelial function in CKD.
Low T₃ in patients with moderate-to-severe CKD is a marker of endothelial dysfunction. This study sets a solid rationale for designing specific intervention studies aimed at clarifying the nature (causal or not causal) of the endothelial function-T₃ link in CKD.
American Journal of Nephrology 01/2011; 33(1):25-32. · 2.62 Impact Factor
[show abstract][hide abstract] ABSTRACT: Non-alcoholic fatty liver disease (NAFLD) is linked to an increased risk of cardiovascular disease. Mean platelet volume (MPV), a determinant of platelet activation, is an emerging risk factor for atherothrombosis.
The aim of this study was to investigate the levels of MPV in subjects with NAFLD having no confounding factors for atherosclerosis such as obesity, diabetes mellitus, and hypertension. In addition, the possible relationship between MPV and carotid artery intima media thickness (CIMT), a well known marker of subclinical atherosclerosis, was also studied.
MPV and CIMT levels were measured in 60 biopsy-proven NAFLD subjects and 54 healthy controls. Age and sex were similar between two groups.
Body mass index and waist circumference levels were higher in the NAFLD group when compared to the controls. There were no differences between the two groups regarding LDL cholesterol levels, whereas HDL cholesterol levels were lower in the NAFLD group. MPV and CIMT levels were not different between the two groups. According to the correlation analyses, CIMT levels were positively correlated to age in patients with NAFLD. However, no significant correlation was found between MPV and CIMT levels.
The results of this study do not show any difference in MPV levels between subjects with NAFLD and controls. These finding suggests that in the absence of other metabolic risk factors, MPV might not be involved in the mechanism(s) of increased cardiovascular risk in NAFLD.
Upsala journal of medical sciences 11/2010; 115(4):253-9. · 0.73 Impact Factor
[show abstract][hide abstract] ABSTRACT: To examine the association between body mass index (BMI) and cognitive decline (CD) due to Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD), and Vascular Dementia (VaD).
The subjects aged ≥ 65 years were recruited prospectively from the Geriatrics Clinic of Gulhane Medical School, between 2004 and 2008 years.
1302 patients were included in the study.
Cognitive status, clinical diagnosis of CD (MCI, AD, and VaD) and clinical and environmental risk factors were evaluated by comprehensive geriatric assesment. Finally, the subjects were categorized into two groups according to having CD or not.
905 (69.5%) subjects were not having CD whereas 397 (30.5%) patients with CD. Of the patients with CD, 140 (10.4%) had MCI, 227 (16.9%) AD, and 30 (2.2%) VaD. After adjustment for confounding with a model for multiple regression analysis, age (OR=1.054; CI:1.027-1.083; p < 0.001) and family history of dementia (OR=1.662; CI:1.038-2.660; p=0.034) were found to be independent risk factors for CD. Also, overweight (OR=0.594; CI:0.370-0.952; p=0.03) and obese (OR=0.396; CI:0.242-0.649; p < 0.001), and high education level (OR=0.640; CI:0.451-0.908; p=0.012) were found to be independent protective factors for CD.
We found the risk of CD decreases in overweight and obese elderly. The results indicate that the primary prevention should not only consider risk factors, but must also take anthropometric data into consideration in order to identify persons at high risk for CD.
The Journal of Nutrition Health and Aging 10/2010; 14(10):834-8. · 2.39 Impact Factor