Wos İndeksli Yayınlar Koleksiyonu
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Item Combined past preeclampsia and gestational diabetes is associated with a very high frequency of coronary microvascular dysfunction(2021) Kul, Seref; Guvenc, Tolga Sinan; Baycan, Omer Faruk; Celik, Fatma Betul; Caliskan, Zuhal; Guvenc, Rengin Cetin; Ciftci, Faika Ceylan; Caliskan, Mustafa; 33189732Background: A history of preeclampsia (pPE) and gestational diabetes (pGDM) are female-specific risk markers for atherosclerosis and future cardiovascular risk. In addition to increasing the risk of established risk factors for atherosclerosis, such as hypertension or diabetes, evidence suggests that pregnancy-related complications can also directly accelerate atherosclerosis by inducing endothelial dysfunction. A combination of both conditions is seen in a subset of patients with pregnancy, though it is not known whether this combination increases the overall risk for cardiovascular events. Aims: Present study aimed to find the impact of combined pPE/pGDM on the prevalence of coronary micro vascular dysfunction (CMD). Methods: A total of 24 patients with combined pPE/pGDM, 19 patients with isolated pPE and 63 patients with pGDM were included to the present study and a further 36 healthy women with no previous pregnancy-related complications served as controls. Coronary flow reserve was measured using echocardiography and CMD was defined as a coronary flow reserve <= 2.5. Results: Patients with combined pPE/pGDM had a high prevalence of CMD (91%), which was significantly higher than controls (5.6%, p < 0.001) and patients with pGDM (55%, p = 0.01). A history of pPE on top of pGDM was associated with an increased risk of CMD (HR:6.28, 95%CI:1.69-23.37, p = 0.006) after multivariate adjustment, but pGDM did not increase the odds for CMD in those with pPE. Conclusions: Combined pPE/pDM is associated with a very high prevalence of CMD, which may indicate an increased risk for future cardiovascular events.Item Parathyroidectomy improves cardiovascular risk factors in normocalcemic and hypercalcemic primary hyperparathyroidism(2019) Beysel, Selvihan; Caliskan, Mustafa; Kizilgul, Muhammed; Apaydin, Mahmud; Kan, Seyfullah; Ozbek, Mustafa; Cakal, Erman; 31068134BackgroundParathyroidectomy has ameliorated cardiovascular risk factors in patients with hypercalcemic primary hyperparathyroidism (PHPT), but the effect of parathyroidectomy on normocalcemic PHPT is not exactly known. This case-controlled study aimed to investigate the effect of parathyroidectomy on cardiovascular risk factors in patients with normocalcemic and hypercalcemic PHPT.MethodsSubjects with normocalcemic PHPT (n=35), age- and sex-matched hypercalcemic PHPT (n=60) and age- and sex-matched control (n=60) were included. Cardiometabolic disorders were investigated with traditional cardiometabolic risk factors and the Framingham cardiovascular risk score (CRS) before and 6months after parathyroidectomy.ResultsDiabetes, dyslipidemia, hypertension, obesity, insulin resistance, osteoporosis, having fractures were similarly increased in the hypercalcemic and normocalcemic PHPT groups (p>0.05) compared with the controls (p<0.05). Blood pressures, glucose metabolism (glucose, insulin, HOMA-IR) and lipid profiles were similarly increased in the PHPT groups (p>0.05) compared with the controls (p<0.05). After parathyroidectomy, blood pressures, serum total cholesterol, and HOMA-IR were decreased in both PHPT groups (p<0.05). CRS was lower in the controls (5.743.24, p<0.05). After parathyroidectomy, CRS was decreased in the normocalcemic (11.98 +/- 10.11 vs. 7.37 +/- 4.48) and hypercalcemic (14.62 +/- 11.06 vs. 8.05 +/- 7.72) PHPT groups. Increased blood pressures were independent predictors of serum iPTH.Conclusion p id=Par4 The normocalcemic and hypercalcemic PHPT groups had similarly increased cardiovascular risk factors, even independently of serum calcium. Parathyroidectomy ameliorated the increased cardiovascular risk factors in both normocalcemic and hypercalcemic PHPT.Item Maternal genetic contribution to pre-pregnancy obesity, gestational weight gain, and gestational diabetes mellitus(2019) Beysel, Selvihan; Eyerci, Nilnur; Ulubay, Mustafa; Caliskan, Mustafa; Kizilgul, Muhammed; Hafizoglu, Merve; Cakal, Erman; 31114636IntroductionPre-pregnancy obesity, gestational diabetes mellitus (GDM), and gestational weight gain (GWG) are associated with each other. This is the first study to investigate whether genetic variants were associated with having GDM, and whether genetic variants-related GDM were associated with adiposity including pre-pregnancy obesity and excessive GWG in Turkish women.Patients and methodsWomen with GDM (n=160) and without GDM (n=145) were included in case-controlled study. Genotyping of the HNF1A gene (p.I27L rs1169288, p.98V rs1800574, p.S487N rs2464196), the VDR gene (p.BsmI rs1544410, p.ApaI rs7975232, p.TaqI rs731236, p.FokI rs2228570), and FTO gene (rs9939609) SNPs were performed by using RT-PCR.ResultsThe FTO AA genotype was associated with an increased risk of having GDM (AA vs. AT+TT, 24.4% vs. 12.4%, OR=2.27, 95% CI [1.23-4.19], p=0.007). The HNF1A p.I27L GT/TT genotype was associated with increased GDM risk (GT+TT vs. GG-wild, 79.4% vs. 65.5%, OR=2.02, 95% CI 1.21-3.38], p=0.007). However, all VDR gene SNPs and the HNF1A p.A98V, p.S487N were not associated with having GDM (p>0.05). The FTO AA genotype was associated with an increased risk for pre-pregnancy overweight/obesity (OR=1.43, 95% CI [1.25-3.4], p=0.035), but not associated with excessive GWG after adjusting for pre-pregnancy weight (p>0.05). Pre-pregnancy weight, weight at delivery, and GWG did not differ in both VDR and HNF1A gene carriers (p>0.05). HOMA-IR and HbA1c were increased in both p.I27L TT and FTO AA genotype carriers (p<0.05).ConclusionThe adiposity-related gene FTO is associated with GDM by the effect of FTO on pre-pregnancy obesity. The diabetes-related p.I27L gene is associated with GDM by increasing insulin resistance.Item The VDR gene FokI polymorphism is associated with gestational diabetes mellitus in Turkish women(2019) Apaydin, Mahmut; Beysel, Selvihan; Eyerci, Nilnur; Pinarli, Ferda Alparslan; Ulubay, Mustafa; Kizilgul, Muhammed; Ozdemir, Ozhan; Caliskan, Mustafa; Cakal, Erman; 31096931BackgroundThe association between the vitamin D receptor (VDR) gene and gestational diabetes mellitus (GDM) has not been investigated in Turkish pregnant women. We aimed to investigate associations between VDR gene BsmI (rs15444410), ApaI (rs7975232), FokI (rs19735810), and TaqI (rs731236) single nucleotide polymorphisms (SNPs) and GDM.Material-methodsThis case-control study comprised 100 women with GDM and 135 pregnant women without GDM. The VDR polymorphism was evaluated using Sanger-based DNA sequencing.ResultVDR gene ApaI, BsmI, and TaqI SNPs did not differ between women with and without GDM (each, p>0.05). ApaI, BsmI, and TaqI were not associated with GDM risk. The VDR gene FokI CT/TT genotype was associated with an increased GDM risk (CT vs. CC, OR=1.84, 95% CI: [1.05-3.23], p=0.031; TT vs. CC, OR=3.95, 95% CI: [1.56-9.96], p=0.002; CT/TT vs. CC, OR=2.29, 95% CI: [1.35-3.89], p=0.002; and CT/CC vs. TT, OR=3.02, 95% CI: [1.23-7.38], p=0.012). The FokI-TT genotype was more associated with younger age and higher glucose, HbA1c, and HOMA-IR than the CC and CT genotype. FokI-T was positively correlated with log-HOMA-IR (r=0.326, p=0.004). FokI SNPs were independently associated with GDM after adjusting for BMI and age (=1.63, 95% CI: [1. 2-4.2], p=0.012). There were no associations between the FokI, ApaI, BsmI and TaqI haplotypes and GDM.ConclusionVDR gene FokI SNPs were independently associated with having GDM in Turkish women. VDR gene FokI SNPs might contribute to insulin resistance of developing GDM.Item HNF1A gene p.I27L is associated with early-onset, maturity-onset diabetes of the young-like diabetes in Turkey(2019) Beysel, Selvihan; Eyerci, Nilnur; Pinarli, Ferda Alparslan; Kizilgul, Muhammed; Ozcelik, Ozgur; Caliskan, Mustafa; Cakal, Erman; 31109344BackgroundThe molecular basis of the Turkish population with suspected maturity-onset diabetes of the young (MODY) has not been identified. This is the first study to investigate the association between HNF1A-gene single-nucleotide polymorphisms (SNPs) and having early-onset, MODY-like diabetes mellitus in the Turkish population.MethodsAll diabetic patients (N=565) who presented to our clinic between 2012 and 2015 with a clinical suspicion of MODY were included in the study. Analysis of HNF1A, HNFB, HNF4A, GCK gene mutations was performed using real-time polymerase chain reaction sequencing. After genetic analysis, diabetics (n=46) with HNF1A, HNF1B, HNF4A, GCK gene mutations (diagnosed as MODY) and diabetics (n=30) with HNF1B, HNF4A, GCK gene SNPs were excluded. Patients with early-onset, MODY-like diabetes (n=486) and non-diabetic controls (n=263) were included. Genetic analyses for the HNF1A gene p.S487N (rs2464196), p.A98V (rs1800574) and p.I27L (rs1169288) SNPs were performed using Sanger-based DNA sequencing among the control group.Resultsp.S487N and p.A98V was similar between the diabetics and controls in dominant and recessive models with no association (each, p>0.05). p.I27L GT/TT carriers (GT/TT vs. GG, OR=1.68, 95% CI: [1. 21-2.13]; p=0.035) and p.I27L TT carriers had increased risk of having MODY-like diabetes (GT/GG vs. TT, OR=1.56, 95% CI: [1. 14-2.57]; p=0.048). Family inheritance of diabetes was significantly more common in patients with the p.I27L TT genotype. The p.I27L SNP was modestly associated with having diabetes after adjusting for body mass index and age (=1.45, 95% CI: [1. 2-4.2]; p=0.036).ConclusionsThe HNF1A gene p.I27L SNP was modestly associated with having early-onset, MODY-like diabetes in the Turkish population. HNF1A gene p.I27L SNP might contribute to age at diabetes diagnosis and family inheritance.Item HNF1A gene p.I27L is associated with co-existing preeclampsia in gestational diabetes mellitus(2019) Beysel, Selvihan; Pinarli, Ferda Alparslan; Eyerci, Nilnur; Kizilgul, Muhammed; Hepsem, Sema; Alhan, Ali; Kan, Seyfullah; Caliskan, Mustafa; Bozkurt, Erhan; Cakal, Erman; 31825269The association of the FTO gene and HNF1 alpha gene on gestational diabetes mellitus (GDM) and preeclampsia remains unclear. This is the first study to examine whether HNF1 alpha gene and FTO gene were associated with having GDM and preeclampsia in Turkish women. Healthy pregnant women (n = 101) and women with GDM (n = 169) were included. GDM was divided into two groups as GDM-only (n = 90) and GDM-preeclampsia (n = 79). Genotyping of HNF1 alpha gene p.I27L, p.A98V, and p.S487N, and FTO gene rs9939609 SNPs were performed using RT-PCR. The frequency of p.S487N, p.A98V, and FTO genotype were similar between the groups (p > .05). p.I27L GG-wild, GT, and TT genotype were 56.5%, 36.6%, and 6.9% in controls; 40.0%, 51.1%, and 8.9% in GDM-only; and 26.6%, 51.9%, and 21.5% in GDM-preeclampsia (p = .034). TT and GT genotype was more frequent in GDM-preeclampsia than in controls (p < .05). GT genotype was increased in GDM-only compared with controls (p < .05). TT genotype was more frequent in GDM-preeclampsia than in GDM-only (p < .05). p.I27L TT genotype was independently associated with increased blood pressure (BP) and urinary protein. p.I27L TT genotype was associated with increased preeclampsia risk in patients with GDM by increasing BP and urinary protein.Item Interrelation of RDW and coronary flow reserve in patient with idiopathic dilated cardiomyopathy(2014) Ozulku, Mehmet; Caliskan, Mustafa; Gullu, Hakan; Erdogan, Dogan; Caliskan, Zuhal; Muderrisoglu, HaldunObjective: Idiopathic dilated cardiomyopathy (IDC) impairs and reduces coronary flow reserve (CFR). High level of red cell distribution width (RDW) is an independent risk factor for cardiovascular diseases. Therefore, in this observational case-control study we have aimed to determine whether RDW level is associated with CFR impairment in patients with IDC. Methods: We examined 36 patients with IDC and 35 healthy subjects formed as a control group. In addition to this, patients with IDC were divided into two subgroups according to their CFR levels [normal CFR group (CFR value >= 2) and lower CFR group (CFR value<2)]. Control and patients groups were compared using the student t-test for multiple comparisons. The subgroups were compared using the Mann-Whitney U test for continuous variables and chi-square for categorical variables. The Pearson's and Spearman correlation analysis was used to test the possible associations between CFR and the study variables as appropriate. The receiver-operating characteristic (ROC) curve was determined to evaluate the predictive performance of RDW to detect low CFR. Results: There were no significantly differences between the lower and higher CFR groups' clinical data, baseline hemodynamic, medication and biochemical data except RDW and high-sensitivity C-reactive protein (hsCRP) levels. We found that RDW level was a good predictor of low CFR at the receiver-operating characteristic curve. The area under the curve (AUC) was 73% (95% confidence interval between 0.56-0.90 is 95%, p:0.018) After adjusting potential confounders include age, body-mass index, blood pressure, lipid and glucose, RDW independently associated with CFR level (Beta:-0.374; p=0.015) and hsCRP value (Beta:-0.520; p=0.001) were the independent predictors of lower CFR. Conclusion: Results showed that there was an independent correlation between RDW level and CFR level in patients with IDC.Item Does mild preeclampsia cause arterial stiffness and ventricular remodeling through inflammation?(2014) Citfci, Faika Ceylan; Ciftci, Ozgur; Gullu, Hakan; Caliskan, Mustafa; Uckuyu, Ayla; Ozcimen, Ebru Emel; 25669058Background: A link between preeclampsia (PE) and excessive maternal morbidity and mortality is a commonly recognized fact. Moreover, it has been suggested that chronic inflammatory state connected with PE contributes to accelerated atherosclerosis. There is also an association between PE and maternal cardiac remodeling and biventricular diastolic dysfunction. The aim of the study was to investigate the presence of impaired myocardial performance and increased arterial stiffness in patients who experienced a mild case of PE five years previously. Methods: The study included forty PE patients (40 women; mean age 33.75 +/- 7.95) and 27 healthy volunteers (27 women; mean age 36.44 +/- 10.45) Transthoracic echocardiography, including Doppler echocardiography combined with tissue Doppler imaging (TDI), and aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic elastic modulus (AoEM) values were measured in each study participant. Results: There was a statistically significant increase in hsCRP, aortic stiffness index, and aortic elastic modulus in PE patients as compared to controls (2.43 +/- 1.91 vs. 3.80 +/- 2.06, p=0.007; 3.09 +/- 2.41 vs. 7.32 +/- 6.89, p=0.001; 2.89 +/- 2.11 vs. 7.00 +/- 6.83, p=0.001), while a significant decrease was observed in the aortic strain and distensibility (respectively, 22.35 +/- 15.99 vs. 12.24 +/- 9.22, p=0.005; 11.17 +/- 9.68 vs. 6.13 +/- 4.99, p=0.018). No differences between the two groups were observed with regard to the left ventricular myocardial performance index (MPI) (0.55 +/- 0.16 vs. 0.53 +/- 0.19, p=0.630). Conclusions: To the best of our knowledge, this has been the first study to demonstrate impaired aortic elasticity and unaffected myocardial performance index in patients with mild PE. Moreover, these effects turned out to be significantly correlated with inflammation.