Browsing by Author "Arikan, Serap"

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High sensitivity C-reactive protein and cerebral white matter hyperintensities on magnetic resonance imaging in migraine patients
(2015) Avci, Aynur Yilmaz; Lakadamyali, Hatice; Arikan, Serap; Benli, Ulku Sibel; Kilinc, Munire; 25595197
Migraine is a common headache disorder that may be associated with vascular disease and cerebral white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) scan. High sensitivity C-reactive protein (hs-CRP) is a marker of inflammation that may predict subclinical atherosclerosis. However, the relation between migraine, vascular risks, and WMHs is unknown. We evaluated hs-CRP levels and the relation between hs-CRP level and WMHs in adult migraine patients. This case-control study included 432 subjects (216 migraine patients [without aura, 143 patients; with aura, 73 patients]; 216 healthy control subjects without migraine; age range 18-50 y). Migraine diagnosis was determined according to the International Classification of Headache Disorders II diagnostic criteria. The migraine patients and control subjects had no known vascular risk factors, inflammatory disease, or comorbid disease. The presence and number of WMHs on MRI scans were determined, and serum hs-CRP levels were measured by latex-enhanced immunoturbidimetry. Mean hs-CRP level was significantly greater in migraine patients (1.94 +/- 2.03 mg/L) than control subjects (0.82 +/- 0.58 mg/L; P a parts per thousand currency signaEuro parts per thousand.0001). The mean number of WMHs per subject and the presence of WMHs was significantly greater in migraine patients (69 patients [31.9%]; 1.68 +/- 3.12 mg/dL) than control subjects (21 subjects [9.7%]; 0.3 +/- 1.3; P a parts per thousand currency signaEuro parts per thousand.001). However, there was no correlation between hs-CRP level and WMHs in migraine patients (r = 0.024; not significant). The presence of WMHs was increased 4.35-fold in migraine patients (odds ratio 4.35, P a parts per thousand currency signaEuro parts per thousand.001). High hs-CRP level may be a marker of the proinflammatory state in migraine patients. However, the absence of correlation between hs-CRP level and WMHs suggests that hs-CRP is not causally involved in the pathogenesis of WMHs in migraine patients. The WMHs were located mostly in the frontal lobe and subcortical area.
Migraine and Subclinical Atherosclerosis: Endothelial Dysfunction Biomarkers and Carotid Intima-Media Thickness: A Case-Control Study
(2019) Avci, Aynur Yilmaz; Akkucuk, Mehmet Husamettin; Torun, Ebru; Arikan, Serap; Can, Ufuk; Tekindal, Mustafa Agah; https://orcid.org/0000-0001-9004-9382; https://orcid.org/0000-0003-4569-1143; https://orcid.org/0000-0001-5752-3812; https://orcid.org/0000-0001-8689-417X; https://orcid.org/0000-0002-4060-7048; 30645751; F-6770-2019; AAJ-2828-2021; AAJ-1289-2021; AAJ-2999-2021; U-9270-2018
Background Migraine is a common neurovascular disease associated with vascular risks, especially in young adult females, but the mechanism underlying these associations remains unknown. This study evaluated the relationships between plasma endothelial dysfunction biomarkers and carotid intima-media thickness (IMT) in young adult females with migraine. Methods This case-control study included 148 female patients (age range: 18-50years). Migraine was diagnosed according to the International Headache Society-IIIb criteria. Endothelial dysfunction biomarkers, such as von Willebrand factor (vWF), C-reactive protein (CRP), homocysteine, total nitrate/nitrite concentration, and thiobarbituric acid-reactive substances (TBARS), were evaluated in plasma. Carotid IMT was measured by a radiologist with sonography. Results The CRP, TBARS, vWF, and IMT levels were increased in the migraine compared with the control group (p<0.001, p=0.02, p<0.001, and p<0.001, respectively). After adjusting for confounders, multiple linear regression analysis revealed that systolic arterial blood pressure, CRP, vWF, TBARS, and right and left internal carotid artery (ICA) IMT were independently positively correlated with migraine (p<0.01, p=0.004, p=0.023, p=0.024, p=0.032, and p=0.048, respectively). Multiple logistic regression analysis revealed that right ICA IMT was independently associated with ergotamine and triptan and left ICA IMT was independently associated with ergotamine (p=0.013, p=0.026, and p=0.017, respectively). In addition, significant correlations were found between LDL lipoprotein and carotid IMT in the migraine group (p<0.05). Conclusions Carotid IMT enhancement and elevated TBARS, vWF, and CRP levels in migraine subjects during a migraine attack could be regarded as consequences of migraine attack pathophysiology. The independent associations between triptan and ergotamine consumption and enhanced carotid IMT suggest that repeated use of these vasoconstrictive antimigraine agents may have additional effects on carotid IMT.
Periaortic Fat Tissue: A Predictor of Cardiac Valvular Calcification, Malnutrition, Inflammation, and Atherosclerosis Components in Hemodialysis Patients
(2015) Genctoy, Gultekin; Eldem, Olcay; Ergun, Tarkan; Arikan, Serap; 0000-0002-5145-2280; 0000-0001-5752-3812; 25940595; AAJ-5551-2021; AAM-4084-2021; AAJ-1289-2021
Cardiac valvular calcification (CVC) in end-stage renal disease is shown to be a component of malnutrition, inflammation, atherosclerosis, calcification (MIAC) syndrome. Thoracic periaortic fat tissue (T-PAFT) is shown to be increased in patients with end-stage renal disease (ESRD), and has positive correlation with MIAC. Negative correlation between CVC and vitamin D is shown in hemodialysis (HD) patients. In this study, we investigated a relationship between body composition, T-PAFT, metabolic and inflammatory parameters, and CVC in HD patients. Seventy-six HD patients (49M) were included. CVC is defined as bright echoes of >1mm on one or more cusps on echocardiography. Results were expressed as the number of calcified valves (0,1,2). Calcium, phosphorus, parathyroid hormone (PTH), C-reactive protein (CRP), albumin and 25-hydroxy vitamin D levels were studied from predialysis blood samples. T-PAFT was calculated using a method with manual definition of borders on images from multislice computed tomography. Basal metabolic rate, muscle mass, total and truncal fat mass were measured by bioimpedance analysis. There were 65.8% of patients who had CVC. Patients with CVC were older (63.5 +/- 14.6 +/- 17, P=0.02). T-PAFT (1599 +/- 596, 739.7 +/- 179mm(2), P=0.001) and CRP (15.8 +/- 11; 11.1 +/- 13.2mg/dL; P=0.04) were higher in the group with CVC. T-PAFT had positive correlations with CRP, MIAC, body mass index (BMI) and number of calcified valves, negative correlation with left ventricular ejection fraction, and no correlation with albumin, calcium, phosphorus, and PTH. The logistic regression analysis revealed that T-PAFT was a significant predictor of CVC. In this study, T-PAFT showed a positive correlation with inflammation, CVC, and MIAC score in HD patients. T-PAFT was a significant predictor of CVC.
Pulmonary hypertension associates with malnutrition and body composition hemodialysis patients
(2015) Genctoy, Gultekin; Arikan, Serap; Eldem, Olcay; 25410114
Background/Aim: The prevalence of pulmonary hypertension (PH) is reported between 17 and 56% in hemodialysis (HD) patients. Pathogenesis of PH in HD patients is still unclear. Malnutrition associating impaired pulmonary function tests in HD patients previously reported. Present study aimed to investigate an association between PH and nutrition and inflammation HD patients. Patients/Methods: Total 179 HD patients (109 M, 70 F) were included. Pulmonary artery pressure (PAP) and ejection fraction (EF) percentage was determined by echocardiography after a midweek HD session. Bioimpedance analyses were performed after dialysis. Percent body fat mass truncal fat (%), total body water (%), body-mass index was determined. Serum 25-OH vitamin D, albumin, lipid parameters, C-reactive protein (CRP), calcium, phosphorus, parathyroid hormone, ferritin levels, and hemogram were studied. Results: Pulmonary hypertension (PAP >35 mmHg) was found in 48 (26.8%) of 179 patients studied. Body-mass index (BMI) was negatively correlated with PAP (r = -0.34; p = 0.02). HD vintage, prevalence of diabetes, sex, type of vascular access were not different between patients with PH and without PH. Patients with PH were older (68.1 +/- 14.4; 61.3 +/- 14.7; p = 0.005). Percent body fat (19.8 +/- 8.1% vs. 28.1 +/- 10%; p = 0.001), albumin (3.4 +/- 0.5 g/dl vs. 3.9 +/- 3.3 g/dl; p = 0.0001), truncal fat (16.8 +/- 10.7 vs. 26.4 +/- 10.5; p = 0.001), triglyceride (147.9 +/- 88.5 vs. 182.1 +/- 97.7 mg/dl; p = 0.03), and total cholesterol (146.9 +/- 34.5 vs. 169.5 +/- 43 mg/dl; p = 0.004) levels were significantly lower in patients with PH than with no PH. Logistic regression analysis revealed that increased percent body fat, albumin, and total cholesterol associate with a decreased risk of PH. Conclusion: Present study demonstrated a significant association between malnutrition and PH in HD patients. Those results should be confirmed by further prospective studies including cytokine levels and spirometric measurements.
Secondary Hyperparathyroidism Is Associated with Pulmonary Hypertension in Older Patients with Chronic Kidney Disease and Proteinuria
(2015) Genctoy, Gultekin; Arikan, Serap; Gedik, Olcay; 0000-0002-5145-2280; 0000-0001-5752-3812; 25537827; AAJ-5551-2021; AAM-4084-2021; AAJ-1289-2021
Hyperparathyroidism is associated with pulmonary vascular calcification and pulmonary hypertension (PH) in a chronic kidney failure dog model, and increased prevalence of PH and a PH-hyperparathyroidism relationship in pre-dialysis chronic kidney disease (CKD) and hemodialysis patients are reported. This study investigated the prevalence of PH and relationships between PH and metabolic abnormalities in patients with stage 1-4 proteinuria CKD. One-hundred and ninety patients (mean age 61 +/- A 17.4, 116 males) with proteinuria CKD and no coronary diseases, congestive heart failure, smoking history, and pulmonary diseases were enrolled. Estimated glomerular filtration rate was 39.7 +/- A 23 ml/min. CKD etiology was diabetes mellitus in 52 (27.3 %), chronic glomerulonephritis or tubulointerstitial nephritis in 56 (29.4 %), hypertension in 36 (19 %), and other etiologies (nephrolithiasis, obstructive nephropathy, and amyloidosis) in 46 (25.3 %) patients. Echocardiography was performed, and systolic pulmonary artery pressure (PAP) and left ventricular ejection fraction were determined. Laboratory tests examined lipid parameters, serum albumin, urea, creatinine, calcium, phosphorus, C-reactive protein, parathyroid hormone, ferritin, and hemoglobin levels. PH (PAP > 35 mmHg) was detected in 68 patients (35.9 %). Patients with PH were older (68 +/- A 12.3 vs. 52.1 +/- A 16.7, p = 0.03), had lower ejection fractions (51.3 +/- A 13.4 vs. 60.8 +/- A 9.1 %, p = 0.003), lower hemoglobin (11.3 +/- A 1.5 vs. 12.1 +/- A 1.9, p = 0.05), and higher parathyroid hormone (218 +/- A 159.3 vs. 127.7 +/- A 67.4 pg/ml, p = 0.05) levels. The remaining parameters were similar between groups. Older age, lower ejection fraction, and secondary hyperparathyroidism may contribute to PH in stage 1-4 proteinuria CKD.
Urinary N-Acetyl-Beta-D Glucosaminidase Activity is Associated with Inflammation and Proteinuria in Diabetic and Non-Diabetic Patients with Different Stages of Chronic Kidney Disease
(2015) Genctoy, Gultekin; Arikan, Serap; 0000-0002-5145-2280; 0000-0001-5752-3812; AAJ-5551-2021; AAM-4084-2021
OBJECTIVE: Clinical studies have demonstrated that tubulointerstitial rather than glomerular pathology correlates with the degree and progression of renal impairment. Urinary n-acetyl-betaD- glucosaminidase (NAG) is a biomarker of tubular damage, shown to be elevated in patients with glomerulonephritis and acute kidney injury. However, it has not been assessed longitudinally in chronic kidney disease (CKD). The aim of the present study was to determine urinary NAG activity and its possible associations with metabolic and inflammatory parameters in CKD. MATERIAL and METHODS: A total of 72 patients (mean age: 64.5 +/- 15.7) with stage 1-5 CKD were included. Of the 72 patients 23 (32%) had diabetic nephropathy and 49 (68%) had different types of primary glomerular diseases. Fasting blood samples were collected to analyse complete blood count, urea, creatinine, albumin, lipid parameters, C-reactive protein, uric acid and parathyroid hormone. 24-hour urine was collected to determine protein excretion. Urinary NAG and creatinine levels were analysed from the first morning urine samples. The NAG index (urinary NAG/ creatinine) was used to exclude dilutional errors. RESULTS: Mean eGFR was 38.3 +/- 21.7 ml/min. The urinary NAG index was significantly higher in stage 3 compared to stage 2 (32.1 +/- 23.5 vs. 7.5 +/- 3.3 U/gr-creatinine; p=0.002) and lower in stage 5 compared to stage 3 CKD (8.2 +/- 7.6 vs. 32.1 +/- 23.5; p=0.017). The urinary NAG index was positively correlated with 24-hour urine protein excretion (r=0.43; p=0.0001) and serum CRP (r=0.549; p=0.04) and negatively correlated with hemoglobin levels (r-0.394; p=0.004). CONCLUSION: The present study demonstrated that urinary NAG correlates with systemic inflammation and proteinuria and may be associated with progression of CKD.