[Show abstract][Hide abstract] ABSTRACT: The objectives of this study were to examine the prevalence and risk of pressure ulcers (PrUs) among hospitalized patients 65 years or older in a university hospital setting and to assess the potential for prevention and healing in that population.
The retrospective study conducted at the general medicine departments of Ege University Hospital in Izmir, Turkey, included 209 patients (115 females, 94 males) 65 years or older, who had been admitted to the hospital for a variety of reasons between April 1, 2011, and October 1, 2011. The following tools were used to collect data: a data collection form to identify the sociodemographic and medical characteristics of the patients, the Braden Risk Assessment Scale to assess the risk of PrUs, and a form to monitor PrUs, which included the site of the PrU, the category, and the PUSH (Pressure Ulcer Scale for Healing) score, a tool for tracking changes in PrUs status applied at weekly intervals.
The mean patient age was 73 (6.4) years. The prevalence of PrUs was 5.8% during the hospital stay. Pressure ulcers appeared most frequently in the ischeal tuberosity area (40%), and 45.2% of all PrUs observed were category II. The comorbidities of the patients who had PrUs were as follows: rheumatoid arthritis, 40% (n = 5); acute renal failure, 24% (n = 3); multiple myeloma, 8% (n = 1); chronic renal failure, 8% (n = 1); pneumonia, 8% (n = 1); and acute lymphoblastic leukemia, 8% (n = 1).
Pressure ulcers are a common healthcare complication in the older adult population, with potentially severe consequences. The most important intervention that healthcare professionals can make to reduce PrUs is to determine and address risk factors.
Advances in skin & wound care 03/2014; 27(3):122-6.
[Show abstract][Hide abstract] ABSTRACT: Background/objectives:Sarcopenia and sarcopenic obesity (SO) are geriatric syndromes leading to physical disability, poor quality of life and death. The aim of this study was to investigate the prevalence of sarcopenia and SO in nursing homes in Turkey and to define local disparities for diagnosing sarcopenia and SO.Subjects/methods:This cross-sectional multicenter study was performed in 711 patients in 14 nursing homes. Comprehensive geriatric assessment tests, handgrip strength and calf circumference (CC) measurements were carried out. Sarcopenia was both defined by handgrip strength and CC criteria.Results:According to handgrip strength measurement, 483 (68%) of patients were sarcopenic (male: 72%, female: 63.8%), 228 were non-sarcopenic. The prevalence of SO was 22% (13.7% in men, 30.2% in women). Patients (82.5%) who were diagnosed as sarcopenic by the handgrip strength test were not sarcopenic according to CC sarcopenia criteria. Therefore, we tried to determine the optimal CC value for diagnosing sarcopenia in our population.Conclusions:Both sarcopenia and SO were prevalent among Turkish nursing home elderly residents. Most of the patients with sarcopenia were obese or overweight. We showed that diagnosing sarcopenia with CC measurement underestimated the sarcopenia prevalence assessed by handgrip strength. So we concluded that, although different assessment methods are recommended for the diagnosis of sarcopenia local disparities should be considered.European Journal of Clinical Nutrition advance online publication, 26 February 2014; doi:10.1038/ejcn.2014.15.
European journal of clinical nutrition 02/2014; · 3.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: The aim of this study was to determine the diagnostic accuracy of the CC-SF, which was developed to use calf circumference (CC) instead of BMI in the MNA-SF, for elderly people living in the community and in nursing homes. It also aimed separately to determine the correlation of CC-SF and BMI-SF with the full MNA. Study Design and Methods: The study included 640 elderly people living in their community and 243 elderly people living in nursing homes. Accuracy was assessed by determining the sensitivity and selectivity of the nutritional assessments. The correlations between the MNA-SFs and the full MNA were analyzed. Results: The correlation between MNA-SFs and full MNAs was strong, significant and almost identical both in the community and in nursing homes (r=0.86-0.88; p<0.001). The observed agreement between the BMI-SF and the full MNA was 82.2% in the community and 77.8% in the nursing homes. There was a substantial agreement by kappa values in the comparison of community and nursing homes (the Kappa value of the BMI-SF was 0.63 in the community and 0.62 in the nursing homes, and the kappa value of the CC-SF was 0.62 in the community and 0.63 in the nursing homes). When compared to the full MNA the MNA-SFs tended to underestimate nutritional status. Both MNA-SFs had similarly high sensitivity and selectivity, both in the community and nursing homes. (when dichotomized as "malnourished-at risk of malnutrition" versus " well nourished" and "malnourished" versus "at risk of malnutrition-well nourished") (over 80%). Conclusion: In cases where BMI cannot be determined, the CC-SF is a good substitute for the BMI-SF.
The Journal of Nutrition Health and Aging 01/2014; 18(8):725-729. · 2.39 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background and aim
Malnutrition is related with serious morbidity and mortality in institutionalized older adults. The aim of this study is to determine the frequency of malnutrition in nursing homes and care homes and to identify the factors associated with malnutrition in these settings.
This multicenter study was conducted in 14 centers of nursing homes/care homes in three different cities. Total number of 1797 residents aged ≥ 65 years was enrolled. Malnutrition screening was made by Mini Nutritional Assessment Short Form (MNA-SF) and full MNA. Statistical analyses were conducted by SPSS 15.0.
The median age (min–max) of the study population was 78.0 (65.0–108.0) and 917 (51%) were female. MNA-SF score of the residents was 11 (0-14). According to the MNA-SF 850 (49.3%) residents had normal nutritional status, 654 (38.3%) residents were at malnutrition risk, and 204 (11.9%) had malnutrition. Number of medications, gender, duration of stay in the institution, frequency of family visits, social security status, type of nursing home (government or not), daily life activities (ADL), Geriatric Depression Scale (GDS) and MMSE scores, get up & go test, hypertension, dementia, depression, and Parkinson disease were associated with malnutrition. Regression analyses revealed that get up&go test, GDS, hypertension, and ADL were independently related to malnutrition diagnosed by MNA-SF.
This study provides important information on the prevalence and associated factors of malnutrition in a large multicentered setting of nursing homes and care homes. It will direct the screening plans and interventions taken in order to detect, prevent, and manage malnutrition in these settings.
European geriatric medicine 11/2013; 4(5):329–334. · 0.63 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Purpose: It is well established that diabetic peritoneal dialysis (PD) patients have a higher mortality rate than the other PD population. This study was designed to determine the overall predictors of survival and compared mortality and morbidity between diabetic and non-diabetic Turkish PD patients. Methods: We conducted a multicenter retrospective study with 915 PD patients [217 had diabetes mellitus (DM)]. Serum albumin, PTH, HbA1c, co-morbid diseases, dialysis adequacy (Kt/V), and peritoneal transport characteristics as well as peritonitis episodes and ultrafiltration failure during the follow-up period were recorded. Results: DM patients were older and had more co-morbidities than non-DM patients. Peritonitis rates were higher in DM patients (one episode per 35.9 patient months) compared to non-DM patients (one episode per 41.5 patient months) (p < 0.001). On Kaplan-Meier analysis, patient survival was significantly lower in DM patients with the 2-, 3- and 5-year patient survival rates of 90.8%, 87.8% and 78.2% in non-diabetics and 80.9%, 70.4% and 61.2% in diabetics, respectively. On Cox regression analysis, DM (HR 1.5, p = 0.022), age (HR 1.03, p < 0.001), baseline serum albumin (HR 0.39, p < 0.001), heart failure (HR 0.038, p = 0.038), peripheral artery disease (HR 1.83, p = 0.025) and amputation (HR 4.1, p = 0.009) at baseline were significant predictors of overall mortality. Conclusions: Patient survival is lower in diabetic compared to non-diabetic patients on PD. Peritonitis rates were also higher in diabetic PD patients. DM, older age, albumin level and cardiovascular co-morbidities are predictors of mortality.
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: Measurement of carotid artery intima-media thickness (CA-IMT) is directly associated with cardiovascular (CV) outcomes. We retrospectively investigated the impact of CA-IMT progression on new CV events in patients on peritoneal dialysis (PD). MATERIAL and METHODS: All PD patients who have been followed in our unit (n=163) were screened. The patients who had no CA-IMT were excluded. Ninety-six patients who had baseline CA-IMT measurement were included. Fifty-two patients had second CA-IMT measurement. Fatal and nonfatal CV events were screened from patients' charts. RESULTS: At baseline, mean CA-IMT was 0.62±0.16 mm (median 0.60 mm). In patients treated with PD more than 2 years, CV event rate was higher in patients with high CA-IMT (>0.60 mm) compared to the patients with low CA-IMT at baseline (22.2% versus 4.2%, p=0.041).
Turkish Nephrology, Dialysis and Transplantation Journal. 07/2013; 22(3):238-244.
[Show abstract][Hide abstract] ABSTRACT: Background
The aim of this study was to evaluate the general characteristics of geriatric patients hospitalized at the internal medicine intensive care unit (IMICU).Methods
All patients aged above 65 years and admitted to the intensive care unit of the internal medicine department at Ege University Hospital October 2010 to February 2011 were included in the study. Files of the patients were accessed retrospectively and the following information was recorded: age, gender, main cause of intensive care admission, number of chronic diseases, laboratory results, drug use and other therapeutic procedures, length of stay, outcomes in terms of survival and mortality. Secondary outcomes were defined to compare patients admitted to the intensive care unit from the emergency ward with those transferred from the internal medicine wards.ResultsThe total number of patients admitted to the internal medicine intensive care unit during the study period was 357, of whom 171 (47.99%) were aged above 65 years, a mean age of 74 ± 6.6 years without any statistically significant difference between gender (P = 0.859). Days of hospitalization at the intensive care were 15.7 ± 4.8, in patient mortality was found to be 17.7%, The mean number of chronic diseases per patient was 2.2 ± 1.3. and the most frequent chronic diseases were arterial hypertension 57%. The most frequent pathology of the patients was found to be renal dysfunction 38.6% (n = 66), followed by anaemia 38.0% (n = 65) and liver dysfunction 11.7% (n = 20). The ratio of haemodialysis (HD) was found as 11.7%. When the patients were assessed in terms of invasive interventions by grouping them into those admitted from the emergency unit and those transferring from the internal medicine departments, it was seen that foley, intravenous catheterization, nasogastric tube insertion and HD were significantly higher for the patients admitted from the emergency unit. Mortality rate was found to be significantly higher for same group (44% versus 17, P < 0.001).Conclusion
The proportion of elderly in the intensive care unit is increasing. In the present study renal dysfunction is the most common organ failure. Infection seems to be one of the common problems in IMICU. Organ failure and invasive intervention needs are high in elderly patient admitted from the emergency ward to intensive care.
European geriatric medicine 02/2013; 4(1):20-24. · 0.63 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction. Acute kidney injury (AKI) pathogenesis is complex. Findings of gentamicin nephrotoxicity are seen in 30% of the AKI patients. Vitamin D has proven to be effective on renin expression, inflammatory response, oxidative stress, apoptosis, and atherosclerosis. We aimed to investigate the effect of vitamin D in an experimental rat model of gentamicin-induced AKI. Methods. Thirty nonuremic Wistar albino rats were divided into 3 groups: Control group, 1 mL saline intramuscular (im) daily; Genta group, gentamicin 100 mg/kg/day (im); Genta + vitamin D, gentamicin 100 mg/kg/day (im) in addition to 1 α , 25 (OH)2D3 0.4 mcg/kg/day subcutaneously for 8 days. Blood pressures and 24-hour urine were measured. Blood urea and creatinine levels and urine tubular injury markers were measured. Renal histology was semiquantitatively assessed. Results. Urea, creatinine and urine neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1 were all increased in Genta group indicating AKI model. Systolic blood pressure decreased, but urine volume and glutathione increased in Genta + Vit D group compared to Control group. Histological scores indicating tubular injury increased in Genta and Genta + Vit D groups. Conclusions. Vitamin D does not seem to be effective on histological findings although it has some beneficial effects via RAS system and a promising effect on antioxidant system.
International Journal of Endocrinology 01/2013; 2013:313528. · 2.52 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Trimethylaminuria (fish malodour syndrome) is a rare genetic metabolic disorder presented with a body odour which smells like a decaying fish. This odour is highly objectionable, that can be destructive for the social, and work life of the patient. Trimethylamine is derived from the intestinal bacterial degradation of foods that are rich of choline and carnitine. Trimethylamine is normally oxidised by the liver to odourless trimethylamine N-oxide which is excreted in the urine, so, uremia may worsen the condition. Uremia itself may cause more or less unpleasant odour. Poor uremic control may worsen the odour. We reported this case because Trimethylaminuria is not usually considered in the differential diagnosis of malodour in chronic renal failure and it is the first case that shown the association with Trimethylaminuria and chronic renal failure in the literature.
[Show abstract][Hide abstract] ABSTRACT: Encapsulated peritoneal sclerosis (EPS) is a devastating complication of peritoneal dialysis. We aimed to investigate the effects of mycophenolate mofetil (MMF) treatment in experimental EPS in rats.
40 nonuremic Wistar albino rats were divided equally into 4 groups: control rats received 2 ml isotonic saline intraperitoneally daily for 3 weeks without any other treatment. The chlorhexidine gluconate group received intraperitoneally 2 ml/200 g injection of chlorhexidine gluconate and ethanol dissolved in saline for 3 weeks. The resting group received chlorhexidine gluconate (0 - 3rd week) + peritoneal resting (4th - 6th week). The MMF group received chlorhexidine gluconate (0 - 3rd week) + 125 mg/l MMF in drinking water (4th - 6th week). Dialysate cytokine levels, leukocyte count, peritoneal thickness, inflammation and fibroblast activities were evaluated.
Although the MMF and resting groups showed beneficial effects on ultrafiltration and D1/D0 glucose compared to the chlorhexidine gluconate group, only MMF treatment improved dialysate TGFβ1, VEGF and MCP-1 levels compared to the resting group. Inflammatory activity and vascularity observed in a tissue biopsy, including capillaries number per mm2 of submesothelial area, decreased in the treatment group.
MMF treatment has beneficial effects on EPS via inhibiting inflammation and neovascularisation by reducing dialysate VEGF overexpression.
[Show abstract][Hide abstract] ABSTRACT: The population of above 65 years of age is increasing fast in societies, as the life expectancy is increasing and it leads to high demands for health care service. Health care service for the elderly should be provided by trained team in this field. Success of health care service to be rendered is related to knowledge, skill and attitudes of team members in different profession group (doctor, nurse, social worker, psychologist, etc.) about health of elderly. The aim of this study is to establish the Turkish validity and reliability of 14-question UCLA-GA scale, validity and reliability of which was proven and used the most frequently among the scales that assess attitudes of health care providers toward elderly. A total 256 people, 150 of them were post-graduates, 106 of them were pre-graduates were involved in the study at Ege University, medical faculty between the dates of December 2010 and February 2011. Majority of the participants (63.67%) were women and in the age group of 18-29 (58.3%). The ratio of the ones undergoing geriatric education is 38.2%. It was found out that the Kaiser-Meyer-Olkin (KMO) sampling adequacy test presented high correlation among the items in both single adult households of 14 items of the scale was 0.72. Cronbach alpha value of the scale was found as 0.67 and satisfying. As a result of examination with Tukey's test of additivity, it was seen that items of the scale have additive quality (F=85.25, p<0.0001). When we calculated the correlation of each item with total score, it was found that correlation coefficient varied between 0.32 and 0.68. Test-retest reliability was defined by use of Pearson correlation analysis. It was determined that test-retest consistency of correlation scale between two measurements was r=0.51. As a result of test-retest application, the correlation between the first and second application scores of each item was analyzed to determine the internal consistency of each item of the scale. Based on this analysis it was found as p<0.01 between r=0.22 and 0.65. As a conclusion, Turkish validity and reliability of UCLA-GA scale was demonstrated in this study. Since Turkish version of UCLA-GA scale is short and clear, it is recommended to use it for determining attitudes of health care providers toward elderly in geriatrics.
Archives of gerontology and geriatrics 09/2011; 55(1):205-9. · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to evaluate the effects of hemodialysis (HD) and peritoneal dialysis (PD) treatments on oxidative and nitrosative stress markers comparatively.
Twenty HD and 20 PD patients as well as 20 healthy individuals were included in this study. Plasma advanced oxidation protein products, myeloperoxidase, thiol group and 3-nitrotyrosine (3-NT) levels were measured in all subjects.
Plasma advanced oxidation protein products and myeloperoxidase levels were elevated by HD and PD treatments when compared to the control group. Conversely, plasma thiol group levels were decreased in HD and PD patients. 3-NT levels were increased by HD treatment only.
The elevated plasma 3-NT levels in pre-HD and post-HD patients suggest that those patients have a considerably increased risk for nitrosative tissue injury. However, similar 3-NT levels of the control and PD groups support the advantage of PD therapy in terms of nitrosative tissue injury.
[Show abstract][Hide abstract] ABSTRACT: Encapsulated peritoneal sclerosis is characterized by neoangiogenesis and fibrosis. Octreotide, a somatostatin analogue is a well-known antifibrotic, antiproliferative and anti-angiogenic agent. The aim of the study is to evaluate the effects of octreotide in encapsulated peritoneal sclerosis-induced neoangiogenesis and fibrosis and compare the results with resting.
Non-uraemic Wistar-Albino male rats (n = 35) were divided into four groups. Group I, control rats, received 2 mL isotonic saline i.p. daily for 3 weeks. Group II, received daily i.p. 2 mL/200 g injection of chlorhexidine gluconate (0.1%) and ethanol (%15) dissolved in saline for 3 weeks. Group III, chlorhexidine gluconate for 3 weeks plus an additional 3 weeks without any treatment (rest), to a total of 6 weeks. Group IV, chlorhexidine gluconate for 3 weeks plus an additional 3 weeks octreotide, 50 mcg/kg bodyweight s.c., for a total of 6 weeks.
Octreotide significantly reversed ultrafiltration capacity of peritoneum with decreasing inflammation, neoangiogenesis and fibrosis compared to the resting group. Octreotide also caused inhibition of dialysate transforming growth factor-β1, vascular endothelial growth factor and monocyte chemotactic protein-1 activity and improved mesothelial cell cytokeratin expression. Peritoneal resting has no beneficial effects on peritoneum.
In conclusion, octreotide may have a therapeutic value in peritoneal dialysis patients who suffer from encapsulated peritoneal sclerosis.
[Show abstract][Hide abstract] ABSTRACT: Strict volume control strategy provides better cardiac functions and control of hypertension in dialysis patients. We investigated the effect of this strategy on mortality and technique failure in peritoneal dialysis patients over a 10-year period. 243 patients were enrolled. Strict volume control by dietary salt restriction and ultrafiltration was applied. Mean systolic and diastolic blood pressures decreased from 138.4 ± 29.9 and 86.3 ± 16.8 to 114.9 ± 32.3 and 74.7 ± 18.3 mm Hg, respectively. Overall and cardiovascular mortality rates were 48.4 and 29.6 per 1,000 patient-years, respectively. In multivariate analysis, age, diabetes and baseline serum albumin level were independent predictors of overall mortality, and age, diabetes and baseline serum calcium of cardiovascular mortality. Residual diuresis and peritoneal equilibration test values were not related to mortality. Strict volume control leads to lower mortality than comparable series in the literature. Technique survival is better during the first 3 years, but not after 5 years.
[Show abstract][Hide abstract] ABSTRACT: Encapsulated peritoneal sclerosis (EPS) is characterized by neoangiogenesis and fibrosis. Increased inflammation is the leading cause of EPS. In turn, neoangiogenesis is both a consequence of and contributor to inflammation. The effects of sunitinib, a multitargeted receptor tyrosine kinase inhibitor, have been postulated in various antiangiogenesis, antiinflammatory and antifibrotic processes both in vitro and in vivo. This novel angiogenesis inhibitor, Sutent (sunitinib malate), was investigated in our rat EPS model.
Forty nonuremic Wistar albino rats were divided into 4 groups as follows: 2-mL isotonic saline intraperitoneally (i.p.) daily, for 3 weeks (control group); daily 2 ml/200 g injection i.p. of chlorhexidine gluconate (0.1%) and ethanol (15%) dissolved in saline, 3 weeks (CG group); CG + additional 3 weeks without any treatment, total 6 weeks (resting group); and CG + additional 3 weeks 1 mg/kg daily Sutent (SUT) in drinking water, total 6 weeks (SUT group). At the end of the study, 1-hour PET was performed. Functional parameters and morphological changes of peritoneum with dialysate cytokine levels were examined.
SUT renewed ultrafiltration failure, D1/D0 glucose levels and dialysate protein loss. Peritoneal thickness, white blood cell count and inflammation of peritoneum were also decreased with SUT treatment. SUT significantly improved overexpression of dialysate transforming growth factor-ß1, monocyte chemoattractant protein-1 and vascular endothelial growth factor (VEGF) levels as compared with resting group.
In conclusion, SUT might preserve membrane viability even at lower dosages. Although this is an experimental study, we believe that SUT after controlled trials may be a therapeutic agent for long-term peritoneal dialysis patients.
Journal of nephrology 01/2011; 24(3):359-65. · 2.02 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Chronic fluid overload (FO) is frequently present in peritoneal dialysis (PD) patients and is associated with hypertension and left ventricular hypertrophy and dysfunction, which are important predictors of death in dialysis patients. In the present study, we investigated the relationship between nutrition, inflammation, atherosclerosis and body fluid volumes measured by multi-frequency bioimpedance analysis (m-BIA) in PD patients. In addition, we analysed the relationship of extracellular volume values by m-BIA to echocardiographic parameters in order to define its usefulness as a measure of FO.
Ninety-five prevalent PD patients (mean age 50 ± 13 years, 10 of them diabetic) were enrolled. Extracellular water (ECW), total body water (TBW), dry lean mass (DLM) and phase angle (PA) were measured by m-BIA. Volume status was determined by measuring left atrium diameter (LAD) and left ventricular end-diastolic diameter (LVEDD). Measurement of carotid artery intima-media thickness (CA-IMT) was used to assess the presence of subclinical atherosclerosis. Serum albumin was used as a nutritional marker, and serum C-reactive protein (CRP) was used as an inflammatory marker.
Mean ECW/height was 10.0 ± 1.0 L/m for whole group and 9.3 ± 0.6 L/m in patients with normal clinical hydration parameters. In correlation analysis, markers of nutrition, inflammation and atherosclerosis correlated well with m-BIA parameters. When we used echographically measured LAD (> 40 mm) or LVEDD (> 55 mm) as a confirmatory parameter, a cut-off value of 10.48 L/m ECW/height (78% specificity, with a sensitivity of 77% for LAD and 72% specificity, with a sensitivity of 70% for LVEDD) was found in ROC analysis for the diagnosis of FO. Patients with FO were older and had higher systolic blood pressure, cardiothoracic index, serum CRP level and mean CA-IMT than patients without FO. Patients with inflammation had higher CA-IMT values. In multivariate analysis, only two factors-low urine output and ECW/height-were independently associated with the presence of inflammation.
FO defined by m-BIA is significantly correlated with markers of malnutrition, inflammation and atherosclerosis in PD patients. The indices obtained from m-BIA, especially ECW/height, correlated well with volume overload as assessed by echocardiography and might be a measure worth testing in a properly designed clinical study.
[Show abstract][Hide abstract] ABSTRACT: The aims of this study were to compare the tumor necrosis factor (TNF)-α and osteopontin levels, to identify the relationship between insulin resistance (IR) and osteopontin levels in obese patients with and without obstructive sleep apnea syndrome (OSAS).
The study population included 62 obese patients (35 males, 27 females) with OSAS and was compared with 26 obese patients (16 males, 10 females) without OSAS as a control group. Polysomnographic evaluation, spirometric tests and arterial blood gas sampling were performed on the obese patients with OSAS. Plasma levels of TNF-α and osteopontin were measured by enzyme-linked immunosorbent assays during the process. IR was estimated using the homeostasis model assessment (HOMA).
Mean plasma levels of fasting glucose, insulin, HOMA, liver function test, hematocrit, leukocyte, TSH, free T4, fibrinogen, TNF-α, and osteopontin were similar in the 2 groups. In patients with OSAS, mean osteopontin levels were positively correlated with mean fasting insulin levels (r=0.306, p=0.01), HOMA (r=0.299, p=0.01), apnea-hypopnea index (r=0.377, p=0.03) and Epworth Sleepiness Scale (r=0.299, p=0.01). However, mean TNF-α levels were negatively correlated with Epworth Sleepiness Scale (r=-0.298, p=0.01) in the patients with OSAS.
It was observed that TNF-α and osteopontin levels showed no difference between obese patients with and without OSAS. However, osteopontin levels increased with fasting insulin, IR, OSAS severity, and daytime sleepiness.
Journal of endocrinological investigation 10/2010; 34(7):528-33. · 1.65 Impact Factor