Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Avci, Aynur YilmazSubject: search.filters.subject.Inflammation

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    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.
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    Hypoxia and Inflammation Indicate Significant Differences in the Severity of Obstructive Sleep Apnea within Similar Apnea-Hypopnea Index Groups
    (2017) Avci, Aynur Yilmaz; Avci, Suat; Lakadamyali, Huseyin; Can, Tfuk; 0000-0001-9004-9382; 0000-0003-2155-8014; 0000-0003-2155-8014; 28271327; F-6770-2019; O-3636-2018; O-3636-2018
    Purpose We determined whether hypoxia parameters are associated with C-reactive protein (CRP), mean platelet volume (MPV), white matter hyperintensity (WMH), and the severity of obstructive sleep apnea (OSA), and also evaluated whether hypoxia parameters, CRP, MPV, and WMH differ in patients with similar apnea-hypopnea index (AHI) scores. Methods A total of 297 patients, who were evaluated using Polysomnography, were assessed retrospectively. The measured hypoxia parameters included total sleep time with oxygen saturation <90% (ST90), percentage of cumulative time with oxygen saturation <90% (CT90), and lowest oxygen saturation (min SaO(2)). The patients were divided into subgroups according to their CT90 values, and patients with different AHI severities were divided into subgroups according to their ST90 and min SaO(2) levels. Results Hypoxia parameters are associated with CRP, MPV, WMH, and the severity of OSA (P < 0.05). The hypoxia parameters differed in all subgroup analyses of similar AHI groups (P < 0.001), and CRP differed only in severe OSA (P < 0.008, P < 0.001). In subgroup analyses of similar AHI groups, MPV and. WMH were not significantly different (P > 0.05). Above the hypoxia threshold (CT90 >= 10%) of CRP, MPV increased significantly and the presence of WMH increased twofold. Conclusions These data suggest that increased hypoxia severity may mediate increased inflammation and activation of platelets and contribute to the pathogenesis of WMH in patients with OSA. In addition, patients with severe OSA may show significant variability in inflammation and vascular risk. Further prospective data are needed.
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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.