Browsing by Author "Parildar Z."
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Item Serum and urinary nitric oxide in Type 2 diabetes with or without microalbuminuria: Relation to glomerular hyperfiltration(Elsevier Inc., 2003) Apakkan Aksun S.; Özmen B.; Özmen D.; Parildar Z.; Şenol B.; Habif S.; Mutaf I.; Turgan N.; Bayindir O.Background: Glomerular hyperfiltration is considered as one of the pathophysiological mechanisms for the development of diabetic nephropathy. Oxidative stress is enhanced in patients with diabetes mellitus. Reportedly, nitric oxide (NO) might be involved in the pathogenesis of hyperfiltration. We investigated the relationship between hyperfiltration and NO system, and malondialdehyde (MDA) levels in Type 2 diabetics with/without microalbuminuria. Methods: In 39 microalbuminuric, 29 normoalbuminuric Type 2 diabetic patients and 32 healthy controls, serum creatinine, nitrite, nitrate, urinary microalbumin, nitrite, nitrate, plasma MDA and estimated glomerular filtration rate (EGFR) values, calculated according to the Cockcroft and Gault formula, were recorded. Results: Serum and urine NO levels were higher in both microalbuminurics and normoalbuminurics than controls. There were no significant differences in EGFR between groups. However, hyperfiltration was determined in 31% of normoalbuminurics and 20% of microalbuminurics. Serum and urine NO levels were higher in patients with hyperfiltration. Plasma MDA levels were significantly elevated in both microalbuminurics and normoalbuminurics when compared with controls. Serum glucose and microalbuminuria were positively correlated in microalbuminuric diabetics. Serum NO levels were also positively correlated with EGFR in both normoalbuminurics and microalbuminurics. HbA1c levels were positively correlated with both urinary albumin excretion and plasma MDA levels in normoalbuminuric diabetics. Conclusion: Hyperglycemia is associated with an increased NO biosynthesis and lipid peroxidation. Increased oxidative stress may contribute to the high NO levels in Type 2 diabetes. Furthermore, the high NO levels may lead to hyperfiltration and hyperperfusion, which in turn leads to an increase in urinary albumin excretion and thus causes progression of nephropathy in early Type 2 diabetes. © 2003 Elsevier Inc. All rights reserved.Item β2-microglobulin and cystatin C in type 2 diabetes: Assessment of diabetic nephropathy(2004) Apakkan Aksun S.; Özmen D.; Özmen B.; Parildar Z.; Mutaf I.; Turgan N.; Habif S.; Kumanlioǧluc K.; Bayindir O.Background: Changes in glomerular filtration rate (GFR) provide a valuable indicator of the progression of diabetic nephropathy (DN). This study was designed to demonstrate the clinical values of serum cystatin C (Cys C) and β2-microglobulin in the assessment of renal function in type 2 diabetics by comparing them with the GFR, estimated from the uptake phase of 99 m technetium dimetiltriamino pentaacetic acid renogram (GFR-DTPA) and creatinine clearances. Materials and Methods: 68 type 2 diabetic patients with (urinary albumin excretions (UAE) 30-300 mg/24 h) (n = 39) and without (UAE < 30 mg/ 24 h) (n = 29) microalbuminuria and 32 controls were enrolled in the study. Serum Cys C, β2-microglobulin, creatinine, urinary microalbumin levels, creatinine clearances and GFR-DTPA values were determined in all groups. Non-parametric ROC curves, using a cut-off GFR-DTPA of 60 mL/min/1.73 m 2, were obtained for these markers. Results: Serum Cys C, β2-microglobulin, glucose and HbA1c concentrations were significantly higher in the group with diabetes compared to controls. In the patients with microalbuminuria, serum Cys C and glucose concentrations increased significantly in comparison to patients with normoalbuminuria, while no differences were observed for β2-microglobulin levels. Serum creatinine concentrations, GFR-DTPA values and creatinine clearances were not different between both diabetic groups and controls. Cys C was positively correlated with β2-microglobulin and creatinine and negatively with GFR values; β2-microglobulin was also positively correlated with serum creatinine in microalbuminurics. A significant inverse correlation was found between β2-microglobulin and GFR values in both microalbuminurics and normoalbuminurics. Conclusions: Increased Cys C and β2-microglobulin in diabetics may be early indicators of incipient DN. The diagnostic accuracies of Cys C and β2-microglobulin are superior to that of serum creatinine in distinguishing between mild and moderately reduced GFR.Item Treatment and prophylaxis with sucralfate ameliorates hypoxia/ reoxygenation-induced intestinal injury in pup rats(2005) Sencan A.B.; Sencan A.; Aktas S.; Habif S.; Kabaroglu C.; Parildar Z.; Karaca I.Background: Sucralfate is widely used as a cytoprotective agent in patients with peptic ulcer and other intestinal mucosal injury. The aim of this study is to investigate whether sucralfate has any effect on the prevention and treatment of hypoxia/reoxygenation-induced intestinal injury. Material/Methods: Four groups of 10 1-day-old rat pups were studied. Hypoxia/reoxygenation (H/O)-induced intestinal injury was created. Group 1 was subjected to H/O just after birth and sacrificed at the end of the third day (Treatment Control). Group 2 was subjected to H/O just after birth and treated with sucralfate for 3 days. They were sacrificed at the end of the third day (Treatment). Group 3 was subjected to H/O on the third day after birth and then sacrificed (Prophylaxis Control). Group 4 was treated with sucralfate for the first 3 days, then H/O was created. Just after H/O, the pups were sacrificed (Prophylaxis). The intestinal tissues were harvested for histopathological investigation. Malondialdehyde (MDA) levels in the intestinal tissues were determined. Results: The mucosal injury grades of the treatment and prophylaxis groups were significantly lower than those of control groups (p<0.05). The mean MDA level in the treatment and prophylaxis groups were 0.42±0.17 and 0.21±0.23 nmol/mg respectively. The MDA levels of both groups were significantly lower than in the control groups (p<0.05). Conclusions: The present study shows that sucralfate has beneficial effects in an experimental model of hypoxia/reoxygenation-induced intestinal injury. © Med Sci Monit, 2005.Item Serum N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) levels in hyperthyroidism and hypothyroidism(2006) Özmen B.; Özmen D.; Parildar Z.; Mutaf I.; Bayindir O.Natriuretic peptides represent a novel diagnostic tool in the assessment of heart failure. N-terminal-pro-B-type natriuretic peptide (NT-proBNP), a member of the natriuretic peptid family, is produced and released from cardiac ventricles. Changes in cardiac functions are observed in thyroid dysfunctions. The aim of this study was to assess the changes in serum NT-proBNP levels and to evaluate impact of thyroid hormones on serum NT-proBNP in patients with hyperthyroidism and hypothyroidism. Serum NT-proBNP levels were measured in 21 patients with hyperthyroidism and in 24 patients with hypothyroidism and compared with 20 healthy control subjects. Patients without cardiac disease were included into the study as well. Serum NT-proBNP levels were measured by electrochemiluminescence immunoassay. Serum NT-proBNP levels were higher in hyperthyroid patients than in hypothyroid patients and in control subjects, with mean values of 239.03 ± 47.33, 45.97 ± 13.48, 55.57 ± 13.01 pg/ml, respectively (p < 0.0001). Serum NT-proBNP and thyroid hormones were correlated in all patients. Moreover, there was a significant positive correlation between serum NT-proBNP and serum free T4 (FT4) levels (r = 0,549, p = 0.012) in hyperthyroidic patients. Multiple regression analyses demonstrated that increasing FT4 was independently associated with a high serum NT-proBNP levels, whereas heart rate was not in hyperthyroid patients. Serum NT-proBNP levels are higher in the hyperthyroid state as compared with the hypothyroid and euthyroid state. Thyroid dysfunction affects serum NT-proBNP levels, possibly influencing the secretion of the peptide. Therefore, thyroid function has to be considered when evaluating high serum NT-proBNP levels in patients without cardiac dysfunction. Copyright © Informa Healthcare USA, Inc.Item Impact of renal function or folate status on altered plasma homocysteine levels in hypothyroidism(2006) Özmen B.; Özmen D.; Parildar Z.; Mutaf I.; Turgan N.; Bayindir O.Hyperhomocysteinemia is an independent risk factor for coronary, peripheral and cerebrovascular diseases. Moderately elevated total homocysteine (tHcy) levels have been reported in patients with overt hypothyroidism. Plasma tHcy concentration is affected by several physiological factors and is elevated under conditions of impaired folate and cobalamin status and in renal failure. The aim of this study was to assess plasma tHcy concentrations and to evaluate the role of potential determinants of plasma tHcy levels in hypothyroid patients. Fasting plasma tHcy, serum homocysteine-related vitamins folate and vitamin B12, serum cystatin C (CysC) and creatinine, were determined in 22 hypothyroid patients and compared with 25 healthy control subjects. Creatinine clearance (CCr) was calculated using the Cockroft-Gault formula. Plasma tHcy levels were determined by HPLC with fluorescence detection and serum CysC by automated particle enhanced immunoturbidimetry. Plasma tHcy, creatinine levels were significantly higher, and serum CysC levels, and creatinine clearance values were lower in hypothyroid patients than in control subjects. Folate levels were lower in hypothyroidic group compared to the control group. There were no differences in vitamin B12 levels between hypothyroid and control groups. Positive correlation was noted between tHcy and creatinine levels in hypothyroid patients (r = 0.596); however, an inverse correlation was found between tHcy and folate levels (r = -0.705) in hypothyroid patients. In conclusion, tHcy was increased in hypothyroidism, and this increase was more strongly associated with changes in serum folate than in serum creatinine and CysC, suggesting an altered folate status.Item Serum N-terminal-pro-brain natriuretic peptide (NT-pro-BNP) and homocysteine levels in type 2 diabetic patients with asymptomatic left ventricular diastolic dysfunction(2010) Görmüş U.; Özmen D.; Özmen B.; Parildar Z.; Özdoǧan O.; Mutaf I.; Bayindir O.Aims: : The aim of this study was to determine serum NT-proBNP and plasma Hcy levels and to explore the relationship between serum NT-proBNP and plasma Hcy levels in type 2 diabetic patients with and without asymptomatic LVDD. Methods: : NT-proBNP and Hcy levels were measured 31 patients with type 2 diabetes mellitus. According to echocardiographic data, diabetic patients were divided into two groups: normal LV function or LV diastolic dysfunction. Results: : Serum NT-proBNP levels in diabetic patients with LVDD were significantly higher than in diabetic patients with normal LV function and controls. The area under the receiver-operating characteristic (ROC) curve for NT-proBNP to separate normal vs. diastolic dysfunction was 0.96 in type 2 diabetic patients. Plasma Hcy levels were significantly higher in both diabetic groups than in controls. Positive correlation was noted between NT-proBNP and Hcy levels in diabetic patients with LVDD (r = 0.881, p = 0.0001). Conclusions: : The correlation between elevated NT-proBNP and Hcy levels in diabetic patients with LVDD suggest an association between homocysteinemia and increased NT-proBNP secretion. Our data indicate that NT-proBNP may be a simple screening tool to select diabetic patients with LVDD requiring further examination with echocardiography. © 2009 Elsevier Ireland Ltd. All rights reserved.Item Diagnosing metabolic syndrome in type 2 diabetic Turkish patients: Comparison of AHA/NHLBI and IDF definitions(2011) Basol G.; Barutcuoglu B.; Cakir Y; Ozmen B.; Parildar Z.; Kose T; Ozmen D; Bayindir O.Objectives: The objective of this study was to determine the percentage of metabolic syndrome (MetS) in a Turkish population with type 2 diabetes mellitus (T2DM) according to the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and International Diabetes Federation (IDF) definitions and to assess the agreement among these definitions. Background: It is essential to identify the prevalence of MetS in diabetic patients, as MetS is a stronger risk factor for cardiovascular disease in patients with T2DM than in non-diabetic subjects. Methods: 235 consecutive patients with T2DM were included in the study. The MetS was defined according to AHA/NHLBI and IDF definitions. Cohen's kappa was used as a measure of agreement between the two definitions. Logistic regression analysis was performed to calculate the odds ratios. Results: The percentage of MetS was 85.1 % by AHA/NHLBI and 87.2 % by IDF criteria. The agreement between AHA/NHLBI and IDF was fairly good (kappa=0.55). Females were more affected than males. When the frequencies of each individual feature of the MetS according the definitions were assessed, hypertension was the most common feature in males, whilst abdominal obesity was in females. Serum triglyceride and waist circumference had the highest predictive ability for MetS according to AHA/NHLBI and IDF definitions, respectively. Conclusion: The MetS is a common condition among diabetic patients. Since diabetic patients carry a cluster of cardiovascular risk factors, correct identification of the MetS among this population is of great importance, for an integrated approach to reduce the high costs and the associated disabilities.