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Early Acsess In this study, it was aimed to assess effects of subclinical hyperthyroidism (SH) on bone metabolism using osteoprotegerin (OPG), sclerostin, Dickkopf-1 (DKK1) and biochemical parameters. This cross-sectional prospective study included 40 patients with SH and 40 euthyroid controls. Serum OPG, sclerostin, DKK-1, type-1 procollagen, C-terminal polypeptide (CTx) and 24-hours urine N-terminal telopeptide (NTx) were measures using ELISA kit. Bone mineral density measurements were performed using dual energy X-ray absorptiometry (DEXA). Risk for 10-years hip and major fracture was estimated by Turkish version of FRAX. No significant difference was detected in age, gender, body mass index, smoking and menopause rates between SH and control groups. The risk for 10-years hip fracture and major osteoporotic fracture were estimated as 4.45% and 0.55% in SH group, respectively. The OPG levels were significantly lower in patients with SH than controls (P = 0.017). No significant difference was detected in other bone formation and degradation parameters. No significant correlation was detected between OPG level and risk for major osteoporotic fracture (P > 0.05); however, a negative correlation was detected between OPG level and risk for hip fracture (rho = 0.233; P = 0.038). Serum OPG is markedly affected in patients with SH. In addition, OPG seemed to be associated with osteoporotic fracture risk. Available data show that SH is significantly associated with risk for fracture; thus, it is important to assess risk for fracture in patients with SH.

Makale, WOS:000941436500004, Objective: This study was aimed to compare serum galectin-3 (Gal-3) levels in gestational diabetes mellitus (GDM) and healthy pregnant women and to evaluate the relationship between insulin resistance parameters and serum Gal-3 levels. Materials and Methods: Fifty-nine pregnant women who were screened for GDM with oral glucose tolerance tests (OGTT) at the 24th-28th gestational weeks were included in the study. According to the results of OGTT, 34 pregnant women were included in the GDM group and 25 pregnant women were included in the control group. Results: Serum Gal-3 value was found to be similar in the GDM and control group (P < 0.471). However, there was a significant positive association between Gal-3 and fasting insulin (r = 0.509, P < 0.001) and homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.479, P < 0.001) in the whole pregnancies, and between Gal-3 levels and fasting insulin (r = 0.608, P < 0.001), HOMA-IR (r = 0.609, P < 0.001), and OGTT 60 min glucose (r = 0.444, P = 0.016) in the GDM patients. Conclusions: There was no difference in the last trimester serum Gal-3 levels between GDM and healthy pregnant women. However, a significant positive correlation was determined between Gal-3 and fasting insulin, HOMA-IR, and OGTT 60 min glucose values in the GDM group, and fasting insulin and HOMA-IR values in whole pregnancies. The results of our study support previous data reporting the relationship between Gal-3 and GDM through insulin resistance., Scientific Research Projects (BAP) Coordination Unit of Selcuk University

WOS: 000486972405094, …

WOS: 000437674103232, …

Occupationaldiseases and exposure are at issue recently in our country. Early diagnosis andcorrective actions of occupational diseases provides oppurtunity for preventingfrom chronic diseases. Clinical laboratories are of great importance especiallyin diagnosis and monitoring of the treatment. Occupational diseases become morespecific due to usage of different sample types in analysis, application ofuncommon techniques that is not frequently used in routine laboratories, issuesabout the preanalytical variables and conditions. Having a deep biochemicalknowledge about analysis and parameters will contribute to clinicians.

Purpose: The aim of this study was set as to compare procalcitonin levels of gestational diabetes mellitus patients and healthy pregnant individuals and evaluate link between serum procalcitonin concentration and metabolic parameters of gestational diabetes mellitus. Materials and Methods: 142 pregnant individual who consulted to Endocrinology Division were taken to the study. According to the oral glucose tolerance test results, 57 were diagnosed gestational diabetes mellitus, and 85 healthy pregnant were included in the control group. For the serum analysis, samples were obtained after overnight fasting and between 7:00 AM and 8:00 AM.Results: In the gestational diabetes mellitus group serum procalcitonin levels was found significantly higher than control group. A positive correlation was found between serum procalcitonin levels and fasting glucose and oral glucose tolerance test 60. minute glucose levels. Conclusion: Our results shown that levels of serum procalcitonin in gestational diabetic mellitus were significantly higher than healthy pregnancies for the first time. This result supports the knowledge that chronic low-grade inflammation plays an important role in the pathogenesis of gestational diabetes mellitus. Procalcitonin level may be considered as a new biomarker for chronic low-grade inflammation in patients with gestational diabetes mellitus, Amaç: Bu çalışmanın amacı gestasyonel diabetes mellitus hastalarında ve sağlıklı gebelerde serum prokalsitonin düzeylerini karşılaştırmak ve prokalsitonin düzeyinin diğer metabolik parametreler ile ilişkisini değerlendirilmesidir. Gereç ve Yöntem: Endokrinoloji Bilim Dalı polikliniğine başvuran 142 gebe çalışmaya dahil edildi. Oral glukoz tolerans testi sonuçlarına göre 57 gebeye gestasyonel diabet mellitus tanısı konuldu. 85 sağlıklı gebe ise kontrol grubuna dahil edildi. Serum analizi için tüm kan örnekleri bir gecelik açlık sonrası oral glukoz tolerans testi başlangıcında sabah 7:00 ve 8:00 saatleri arasında alındı.Bulgular: Gestasyonel diabet mellitus grubunda serum prokalsitonin düzeyleri kontrol grubuna göre anlamlı olarak yüksek bulundu. Serum prokalsitonin düzeyi ile açlık glukozu ve oral glukoz tolerans testi 60. dakika glukoz düzeyleri arasında anlamlı pozitif korelasyon bulundu.Sonuç: Bu çalışmada gestasyonel diabet mellitus’lu gebelerde serum prokalsitonin düzeylerinin sağlıklı gebelere göre anlamlı olarak yüksek olduğu ilk kez gösterilmiştir. Bu sonuç kronik düşük-dereceli inflamasyonun gestasyonel diabet mellitus patogenezinde önemli role sahip olduğu bilgisini desteklemektedir. Prokalsitonin düzeyi gestasyonel diabet mellitus hastalarında kronik düşük-dereceli inflamasyonun yeni bir biyobelirteci olarak düşünülebilir.

Annual European Congress of Rheumatology -- JUN 14-17, 2017 -- Madrid, SPAIN, WOS: 000413181402708, …

Amaç: Artmış asimetrik dimetil arjinin (ADMA) düzeyleri başta kardiyovasküler sistem olmak üzere birçok sistemde nitrik oksit (NO) düzeylerini azaltarak olumsuz etkilere neden olur. Helicobacter pylori (H. pylori) enfeksiyonun ADMA düzeylerinde artışa neden olduğu bilinmektedir. Bu çalışmanın amacı H. pylori ile enfekte bireylerde eradikasyon tedavisinin ADMA ve diğer metilarjinin metabolizma ürünlerinin serum düzeylerine etkisini değerlendirmek olarak belirlendi.Yöntemler: 14C üre nefes testi ve gaita antijen testlerinin her ikisinde pozitiflik tespit edilen hastalar H. pylori ile enfekte kabul edildi. Hastalara 14 günlük eradikasyon tedavisi (günde 2 kez 40 mg pantoprazol, günde iki kez 1000 mg amoksisilin ve günde iki kez 500 mg klaritromisin) verildi. Eradikasyon tedavisi öncesinde ve eradikasyon sağlanan hastalarda tedaviden 3 ay sonra ADMA, simetrik dimetil arjinin (SDMA) ve N-monometil-L-arjinin (L-NMMA) serum düzeylerinin ölçümü için kan örnekleri alındı. Bulgular: Çalışmaya dahil edilen 45 hastadan 23'ü kadın ve 22'si erkek idi. Hastaların ortalama yaşı 32,4±8 idi. Hastaların serum ADMA, SDMA ve L-NMMA düzeylerinde eradikasyon tedavisi sonrasında, tedavi öncesine göre anlamlı düzeylerde azalma olduğu görüldü.Sonuç: Bu çalışmada H. pylori eradikasyonu ile plazma ADMA, SDMA ve L-NMMA düzeylerinde anlamlı azalma olduğu gösterildi. H. pylori eradikasyonuna bağlı azalan serum ADMA, SDMA ve L-NMMA düzeylerinin, başta kardiyovasküler sistem olmak üzere bütün sistemlerde oluşturabileceği yararlı etkilerin değerlendirilmesi için geniş çaplı, uzun süreli çalışmalara ihtiyaç vardır, Objective: Increased asymmetric dimethylarginine (ADMA) levels are associated with reduced nitric oxide (NO) levels in many systems, particularly the cardiovascular system, and cause adverse effects. The objective of this study is to evaluate the effect of eradication therapy in patients infected with Helicobacter pylori (H. pylori) on the serum level of ADMA and other metabolic products of methylarginine.Methods: Patients who were found positive both in urea breath tests and stool antigen tests were considered to have H. pylori infection. These patients received eradication therapy for 14 days (twice daily pantoprazole 40 mg, twice daily amoxicillin 1000 mg, and twice daily clarithromycin 500 mg). Blood samples were taken to measure serum ADMA, symmetric dimethylarginine (SDMA), and N-monomethyl-Larginine (L-NMMA) levels before eradication therapy and 3 months after the therapy for patients for whom eradication was achieved. Results: A total of 23 of the 45 patients included in the study were female, whereas 22 were male. The mean age of the patients was 32.4±8 years. Significant reductions in the serum ADMA, SDMA, and L-NMMA levels of the patients were observed post-eradication therapy versus pre-eradication therapy. Conclusion: This study demonstrated significant reductions in serum ADMA, SDMA, and L-NMMA levels with H. pylori eradication. Further extensive long-term studies are needed to evaluate the positive effects that reduced serum ADMA, SDMA, and L-NMMA levels after H. pylori eradication can have on all systems, particularly the cardiovascular system

Benzene is the basic member of organic compounds classified as aromatic hydrocarbons. In many studies, it is determined that the risk of acute myeloid leukaemia (AML) or other leukaemias increase in conditions of recurrent exposure of benzene and products containing benzene. Benzene exposure can be determined by the analysis of phenol in urine. The aim of this study is to assess retrospectively the biochemical and hematological markers of workers who exposed to benzene.189 patients were included in this study who referred to Ankara Occupational Diseases Hospital for periodical examination that had exposed to benzene. 151 persons were included as control group. Phenol analysis was made by Agilent Gas Chromatography device, biochemical parameters by Konelab Prime 60i device, whole blood analysis by Beckman Coulter LH780 device and sedimentation measurement by Alifax device.While there were not a significant difference between benzene exposed workers and control group in aspartate aminotranspherase (AST), alanine aminotranspherase (ALT), creatinine, C-reactive protein, sedimentation and lymphocyte levels (p values; 0.935, 0.576, 0.673, 0.110, 0.171, 0.157 respectively), there were a significant difference in erithrocyte, leukocyte, hemoglobine, neutrophil and blood urea nitrogen levels (p values; 0.021, 0.045, 0.001, 0.018, 0.017 respectively). The mean erythrocyte and hemoglobine values were lower in benzene exposed workers according to control group, but the mean leukocyte, neutrophil and blood urea nitrogen values were higher in benzene exposed workers according to control group.As a result, although hematological effects of benzene and the relation between benzene and AML or other leukaemias were retained, we think that it should be investigated in more detail the effects on other systems in case of chronic exposure.

Amaç: Çocuklarda akut civa maruziyetine bağlı hızlı glomerüler fitrasyon hızı azalmalarında sistatin C düzeyinin böbrek fonksiyonlarını değerlendirme açısından kreatinine üstün olup olmadığını belirlemeyi amaçladık. Ayrıca kreatinin ve/veya sistatin C kullanılan 8 ayrı glomerular filtrasyon hızı hesaplama formülünü birbiriyle karşılaştırdık.Metod: Civa maruziyeti yaşayan 39 çocuğun serum üre, kreatinin ve sistatin C düzeyleri ölçüldü. Glomerular filtrasyon hızı 8 farklı formülle hesaplandı. Hasta grubu civa seviyelerine göre üç subgruba bölündü.Bulgular: Hastaların sistatin C ve civa düzeyleri kontrol grubundan anlamlı olarak farklı bulundu (p

Amaç: Koroner kalp hastal ı ğ ı olan bireylerde genetik olarak polimorfizm olmas ı kardiyovasküler olaylara yatk ı nl ı ğ ı arttı rabilir. Dimetilarjinin Dimetilamino Hidrolaz (DDAH) enziminde bu genetik de ğ iş imin saptanmas ı ile bu hastal ı k grubunda daha ileri tedavi protokolleri geliştirilmesine katk ı sa ğ lamak için koroner kalp hastalar ı nda Asimetrik Dimetil Arjinin (ADMA) seviyeleri ve DDAH 1 (E.C. 3.5.3.18) enziminin T87M mutasyonu incelendi. Materyal ve Metot: Konya bölgesinde ya şayan 50 koroner kalp hastası ve 50 kontrol bireyi çal ı şmaya dahil edilmiştir. Serum örneklerinden ADMA yüksek performansl ı s ı vı kromatografisi, tam kan örneklerinden izole edilen DNA örneklerinden DDAH 1 T87M mutasyonu PCR yöntemi ile çal ı şı ld ı . Bulgular: ADMA düzeyleri hasta grubunda kontrol grubuna k ı yasla anlaml ı olarak yüksek bulunmu ş olup Arjinin/ADMA oranlar ı nda istatistiksel olarak bir farkl ı l ı k gözlenmemiş tir (Sı ras ı yla p0,001 ve p0.08). Hasta grubunda trigliserid düzeyleri kontrol grubuna k ı yasla anlaml ı olarak yüksek (p0,033), Yüksek yo ğ unluklu lipoprotein (HDL)-kolesterol seviyeleri ise dü ş ük tespit edilmiştir (p0,001). Hasta grubundan bir kiş ide DDAH 1 T87M gen polimorfizmi heterozigot bulunurken homozigot varyant hiçbir kat ı l ı mcı da gözlenmemiştir. Diğ er katı l ı mcı larda genin ilgili bölgesi wild tip olarak belirlenmiştir. Sonuçlar: Daha geniş bir toplum kesimi ile yapı lacak polimorfizm çal ı ş malar ı ve bu polimorfik bireylerde risk etmenlerinin detayl ı olarak incelenmesi yüksek ADMA düzeylerinin kardiyovasküler olaylardaki rolünü netle ş tirilmesi ad ı na katk ı sa ğ layacaktı r., Background: Genetic polymorphism may enhance the predisposition to cardiovascular events in patients with coronary heart disease (CHD). The aim of this study is to contribute further treatment protocol development via investigation serum ADMA levels and dimethylarginine dimethylaminohydrolase DDAH 1 (E.C. 3.5.3.18) T87M mutation of CHD patients. Material and Methods: 50 CHD patients and 50 healthy volunteers from Konya region were included to this study. Serum ADMA levels were analyzed by high performance liquid chromatograpy. DDAH (E.C. 3.5.3.18) T87M mutation were determined by PCR from extracted whole blood DNA samples. Results: ADMA levels were significantly higher in patient group compared to control group and there was no statistically diffference between groups for Arginine / ADMA ratio (p

Ateroskleroz tanısı almış olan 50 birey ve koroner aterosklerozu bulunmayan 50 kontrol bireyi çalışmaya dahil edilmiştir. Bu hastaların kardiyak belirteç düzeyleri ve risk faktörleri çalışma kapsamında incelenmiştir. ADMA ve Arjinin için hastalar oturur pozisyonda iken iki ayrı düz tüpe venöz kan örnekleri alındı. ADMA ve Arjinin örnekleri hemen soğuk zincire riayet edilerek soğutmalı santrifüj ile +4 0C de 2000 x g de 5 dakika santrifüj edildikten sonra serumları ayrıldı. Ayrılan serumlar sülfosalisilik asit ile uygulanan deproteinizasyon işleminden sonra ADMA ve Arjinin çalışmaları için ependorf tüplere aktarılıp ? 80 0 C de çalışma gününe kadar muhafaza edildi. DDAH gen polimorfizmi çalışmaları için aynı hasta ve kontrol grubundan K2-EDTA içeren tam kan tüplerine kan örnekleri alındı. Total kolesterol ve LDL kolesterol konsantrasyonlarında anlamlı bir farklılık gözlenmemiştir (Sırasıyla p=0,955 ve p=0,960). Mann Whitney U analizi sonucunda hasta grubunda trigliserid düzeyleri kontrol grubuna kıyasla anlamlı olarak yüksek (p=0,033), HDL-kolesterol seviyeleri ise düşük tespit edilmiştir (p, Fifty patients diagnosed with coronary heart disease and fifty healthy subjects were included to this study. Risk factors and levels of cardiac markers were eveluated. For arginine and ADMA measurements, venous blood samples were collected from patients at sitting position to two different anticoagulant free tubes. Serum was seperated by centrifugation of tubes at +4 0C at 2000 g for five minutes according to the procedures. After deproteinization with sulfosalicylic acid, serum was stored in eppendorff tubes at -80 0C until arginine and ADMA analysis. For DDAH gene polymorphism analysis, blood samples were taken from all subjects to K2-EDTA containing tubes. There was no significant difference for total cholesterol and LDL-cholesterol levels between groups (p=0,955 and p=0,960 respectively). By Mann-Whitney U analysis, triglyceride levels were higher in patients and HDL-cholesterol levels were lower compared to the control group (p=0,033 and p

ÖZET SEPTİK RAT MODELİNDE LİDOKAİNİN KARACİĞER DOKUSUNDA LİPİD PEROKSİTLERİ ÜZERİNE OLAN ETKİSİ Sepsis, multiple organ disfonksiyonuna yol açan, artmış serbest oksijen metabolitleri ile karekterizedir. Bu çalışmada lidokainin steril ve sepsise bağlı karaciğer hasarında oksidan ve antioksidan sistem üzerine olan etkisi araştırılmıştır. Çalışmaya 44 adet swiss-albino erkek rat (200-250 g) dahil edilerek dört gruba ayrılmıştır: Grup I: Sham kontrol (n=12); sadece sham laparatomi ve SF uygulanan grup. Grup II: Sepsis kontrol (n=12); çekal ligasyon perforasyon (ÇLP) oluşturulan ve serum fizyolojik (SF) uygulanan grup. Grup III: Sham+lidokain (n=12); sham laparatomi yanında 2mg/kg bolus ve 2mg/kg/saat lidokain infüzyonu uygulanan grup. Grup IV: Sepsis+lidokain (n=8); ÇLP oluşturulan ve 2mg/kg bolus ve 2mg/kg/saat lidokain infüzyonu uygulanan grup. Subkutan SF veya lidokain tedavisi cerrahi girişimden 10 dakika sonra başlanmış ve 24 saat sürdürülmüştür. Bu sürenin sonunda sakrifiye edilen deneklerden karaciğer doku örnekleri alınmış, MDA, NO düzeyleri ve MPO aktivitesi ölçümleri spektrofotometrik olarak yapılmıştır. Sepsis kontrol grubunda (II), MDA, NO düzeyi ve MPO aktivitesi sham kontrol grubuna (I) göre anlamlı yüksek bulundu (sırasıyla p=0.000, p=0.001, p=0,002). Lidokain uygulanan sham grubunda (III) MDA, NO düzeyi ve MPO aktivitesi, sham kontrol grubuna (I) göre anlamlı düşük bulundu (sırasıyla p=0.000, p=0,008, p=0.018,). Lidokain uygulanan sepsis grubunda (IV) MDA, NO düzeyi ve MPO aktivitesi, sepsis kontrol grubuna (II) göre anlamlı düşük bulundu (sırasıyla p=0.000, p=0,001, p=0.02). Sonuç olarak: Lidokain, steril ve sepsise bağlı karaciğer dokusunda artmış olan lipid peroksidasyonunu azaltarak antioksidan sistem lehine pozitif etkiye sahiptir. SUMMARY Sepsis is characterized with increased free oxygen metabolites which leads to multiple organ disfunction, in our study, the effect of lidocaine onto oxidative and antioxidative system is researched in sterile and sepsis-induced liver injury. There were used 44 Swiss-Albino male rat (200-250 g) in our study and animals were randomly divided into four groups: Group I: Sham kontrol (n=12); only sham laparatomi, saline was applied. Grup II: Sepsis control (n=12); cecal ligation perforation (CLP) was occured, saline was applied. Grup III: Sham+lidocaine (n=12); with sham laparatomi, 2 mg/kg bolus and 2 mg/kg/hour lidocaine was infused. Grup IV: Sepsis+lidocaine (n=8); CLP was occured, 2mg/kg bolus and 2mg/kg/hour lidocaine was infused. Subcutaneous saline or lidocaine treatment was made after 10 minutes after surgical operation and was continued for 24 hours. At the end of this period, the liver tissue samples were taken from the rats, MDA, NO levels and MPO activity were calculated by means of spectrophotometry. In the sepsis control group (II), MDA, NO levels and M PO activity were found significantly increased as compared to sham control group (I) (respectively p=0.000, p=0.001, p=0,002). In the lidocaine infused sham group (III) MDA, NO levels and MPO activity were found significantly decreased as compared to sham control group (I) (respectively p=0.000, p=0,008, p=0.018). In the lidocaine infused sepsis group (IV) MDA, NO levels and MPO activity were found significantly decreased as compared to sepsis control group (II) (respectively p=0.000, p=0.001, p=0.02). In the light of these findings: Lidocaine has a positive effect to antioxidative system by decreasing the lipid peroxidation at the sterile and sepsis-induced liver tissue. 50

WOS: 000468363100004, PubMed: 31156337, Background: Tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) are well-known biomarkers of systemic inflammation that have been associated with many diseases in the past. In this study, we aimed to determine the relationship between impaired lung functions and the levels of these biomarkers in DMAc exposed people. Methods: 101 non-exposed control subjects (Group 1) and 109 DMAc-exposed workers from the polyvinyl chloride (PVC) industry were included in the study. In the next step, the exposed group was divided into two groups according to the level of exposure (Group 2 and 3). DMAc, TNF-alpha, IL-6, creatinine, ALT, AST, GFR and standard spirometry measurements were carried out in all subjects. Results: When compared to the control group, TNF-alpha and IL-6 levels were significantly high compatible with the increase of DMAc levels, in the exposed groups. Urinary DMAc Levels were 0.06 mg/L in the control group. This level is significantly low when compared to exposed and severely exposed group (2.43 mg/L and 3.17 mg/L). TNF-alpha levels were 56.86 pg/mL, 145.52 pg/mL and 230.52 pg/mL in control, exposed and severely exposed groups. IL-6 levels were found to be 38.08 pg/mL, 89.19 pg/mL and 116 pg/mL for control, exposed and severely exposed groups, respectively. Similarly, the FEV1/FVC ratio decreased especially in the severely exposed group (p 0.001). Conclusions: In our study, results have revealed that TNF-and IL-6 levels are promising biomarkers in the early diagnosis of lung function impairment in inhalational DMAc exposure.

WOS: 000456448100003, Background: Oxidative damage is of great importance for patients with breast cancer. Thus, studies were performed to identify the relationship between breast cancer and oxidative stress biomarkers. Objectives: In this study, our aim was to find out the oxidative and antioxidant status, serum thiol-disulphide levels in subjects with breast cancer. Methods: This study was conducted between March and June 2018 with 82 control subjects (aged between 3267 years) and 127 breast cancer patients (aged between 27-66 years) (p= 0.058) in Selcuk University Faculty of Medicine, Konya, Turkey. Serum myeloperoxidase (MPO), catalase, prolidase were analyzed with kinetic spectrophotometric and thiol-disulphide, ischemia-modified albumin (IMA), ceruloplasmin were detected by colorimetric methods. Results: Serum levels of catalase [199.3 (16.4-489.9) vs 81.6 (18.2-322.9) (kU/L)], MPO [124 +/- 28 vs 101 +/- 31 U/L], disulphide [25 (11-61) vs 18 (2-41) mu mol/L], IMA [0.66 (0.31-3.30) vs 0.62 (0.19-1.31) absorbance unit (ABSU)] and prolidase levels [2217 +/- 538 vs 1456 +/- 401 U/L] were higher in patients than control subjects (For all p< 0.001 except for IMA p=0.031). Native thiol [342 +/- 60 vs 391 +/- 52 mu mol/L] and total thiol levels [396 +/- 56 vs 430 +/- 52 mu mol/L] were lower in patients compared with the control group (For all p< 0.001). Conclusions: Levels of serum thiol/disulphide and prolidase might be reliable indicators for determining oxidative status in certain patient populations.

WOS: 000505789700005, PubMed: 30795691, Asymmetric dimethylarginine, symmetric dimethylarginine, and L-monomethylarginine are originated from the subsequent proteolytic catalysis of methylated arginine residues on different proteins and inhibit the endogenous nitric oxide generation. The changes in total methylarginine load (Asymmetric dimethylarginine plus symmetric dimethylarginine plus L-monomethylarginine) may contribute to hypertension. The aim of this study was to determine serum methylarginine concentrations in patients with masked hypertension and determine the association between these biomarkers and blood pressure measurements. Control group, masked hypertension and hypertension groups consisted of 40 subjects (11 males, 28 females, mean age 48.6 +/- 13.1), 28 subjects (14 males, 14 females, mean age 50.9 +/- 11.0) and 36 subjects (15 males, 21 females, mean age 54.4 +/- 12.3 years), respectively (P= 0.149). Serum total methylarginine load was significantly higher in hypertension group (0.63 +/- 0.23) compared to masked hypertension (0.49 +/- 0.16) and control groups (0.38 +/- 0.13) (P= 0.008 and P< 0.001). While there was no statistically significant difference between healthy control groups [0.147 (0.03-0.29)] and masked hypertension patients [0.144 (0.05-0.42)] for serum symmetric dimethylarginine levels (P= 0.970), it was markedly elevated in hypertension group [0.25 (0.07-0.54)] compared to masked hypertension group [0.14 (0.05-0.42)] (P= 0.001). Serum total methylarginine load was positively correlated with night-time SBP (r = 0.214, P= 0.029). Serum methylarginine levels might be a useful marker for determining the courses of clinical hypertension.

Homozigot β-Talasemili hastalarda tedavisi gerçekleştirilmemiş ise, prognoz kötüdür. Transfüzyon ve şelasyon programlarında son 15 yıl içinde yaşanan gelişmeler hastalığın mortalitesini ve morbiditesini anlamlı bir şekilde farklılaştırmıştır. Demir yükü, kronik transfüzyon tedavisinin en ciddi komplikasyonudur. Aritmiler, miyokard ve perikardit yetersizliği fazla miktarda demirin neden olduğu kardiyak komplikasyonlardır. Hemoglobin S Hemoglobin C hastalığı görülen çocuklarda anestezi sonrasında myokardiyal nekroz geliştiği belirtilmiştir. Ortaya çıkan problemlerin hipotansiyon, hipoksi ve asidoza sekonder olduğu tahmin edilmektedir. Otosomal resesif geçişli hematolojik hastalıklar arasında Hemoglobinopatiler dünyada en sık görülen olup, taşıyıcı sıklığı Dünya Sağlık Örgütü verilerine göre dünyada yaklaşık % 7 oranındadır ve her yıl 300.000-500.000 civarında hemoglobinopatili çocuk dünyaya gelmektedir. Ülkemizde anormal Hb'lerden en sık görüleni olan HbS orak hücreli anemi taşıyıcılığı ise % 0.6, ortalama β talasemi taşıyıcılığı ise % 2, civarındadır. Ülkemizde ve dünyada Anormal Hb'lerden en yayın bir şekilde rastlananı ise orak hücreli anemiye yol açan Hb S'dir.Serum metilarjinin düzeyleri kardiyak patolojiler ortaya çıkmadan erken dönemde risk belirtici olarak değerlendirilmektedir. Dolayısıyla bu hasta gruplarında kardiyovasküler olası patolojilerin erken dönemde saptanabilmesi veya analiz edilecek moleküllerin düzeylerinin yüksek bulunması uzun dönem komplikasyonlara karşı tedbir alınmasını sağlayabilir.Bu çalışmanın amacı özellikle talasemi veya hemoglobinopatisi bulunan hastalarda kardiyovasküler risk faktörlerinden olan serum metilarjinin düzeylerinin saptanmasıdır.Anahtar Sözcükler: Hemoglobin; Metilarjininler; Talasemi Prognosis is poor in untreated homozygous β-Thalassemia patients. Over the past 15 years, advances in transfusion and chelation programs have significantly altered the morbidity and mortality of the disease. The most important complication of chronic transfusion therapy is iron overload. Cardiac complications caused by iron overload are pericarditis, arrhythmia and myocardial insufficiency. Myocardial necrosis has been reported in children with Hemoglobin S and Hemoglobin C, after anesthesia. The problems that occur are thought to be secondary to hypoxia, hypotension and acidosis.Hemoglobinopathies are among the most common autosomal recessive hematological diseases in the world, and the carrier frequency is around 7 % in the world according to World Health Organization data, and 300.000-500.000 hemoglobinopathic children are born every year.In our country, average β thalassemia carrier ratio is 2 %, and the most common abnormal Hb deficency is, HbS sickle cell anemia, which has a 0.6 % ratio. The most common cases of abnormal Hb in the world and in our country are sickle cell anemia.Serum methylarginine levels are considered to be early risk factor indicator before cardiac pathologies occur. Therefore, early detection of possible cardiovascular pathologies or high levels of molecules to be analyzed in these patient groups may provide protection against long-term complications.The aim of this study is to determine serum Methylarginine levels; especially in patients with thalassemia or hemoglobinopathy.Keywords: Hemoglobin; Methylarginine; Thalassemia 59

WOS: 000469774300017, PubMed: 30170483, Background. Nitric oxide synthase (NOS) is present in the brain and cerebral arteries and it enables the synthesis of nitric oxide (NO), which plays a critical role in brain perfusion. Asymmetrical dimethylarginine (ADMA) is an endogenous NOS inhibitor.

Amaç: Bu çalışmanın amacı gestasyonel diabetes mellitus hastalarında ve sağlıklı gebelerde serum prokalsitonin düzeylerini karşılaştırmak ve prokalsitonin düzeyinin diğer metabolik parametreler ile ilişkisini değerlendirilmesidir.Gereç ve Yöntem: Endokrinoloji Bilim Dalı polikliniğine başvuran 142 gebe çalışmaya dahil edildi. Oral glukoz tolerans testi sonuçlarına göre 57 gebeye gestasyonel diabet mellitus tanısı konuldu. 85 sağlıklı gebe ise kontrol grubuna dahil edildi. Serum analizi için tüm kan örnekleri bir gecelik açlık sonrası oral glukoz tolerans testi başlangıcında sabah 7:00 ve 8:00 saatleri arasında alındı.Bulgular: Gestasyonel diabet mellitus grubunda serum prokalsitonin düzeyleri kontrol grubuna göre anlamlı olarak yüksek bulundu. Serum prokalsitonin düzeyi ile açlık glukozu ve oral glukoz tolerans testi 60. dakika glukoz düzeyleri arasında anlamlı pozitif korelasyon bulundu.Sonuç: Bu çalışmada gestasyonel diabet mellitus’lu gebelerde serum prokalsitonin düzeylerinin sağlıklı gebelere göre anlamlı olarak yüksek olduğu ilk kez gösterilmiştir. Bu sonuç kronik düşük-dereceli inflamasyonun gestasyonel diabet mellitus patogenezinde önemli role sahip olduğu bilgisini desteklemektedir. Prokalsitonin düzeyi gestasyonel diabet mellitus hastalarında kronik düşük-dereceli inflamasyonun yeni bir biyobelirteci olarak düşünülebilir., Purpose: The aim of this study was set as to compare procalcitonin levels of gestational diabetes mellitus patients and healthy pregnant individuals and evaluate link between serum procalcitonin concentration and metabolic parameters of gestational diabetes mellitus.Materials and Methods: 142 pregnant individual who consulted to Endocrinology Division were taken to the study. According to the oral glucose tolerance test results, 57 were diagnosed gestational diabetes mellitus, and 85 healthy pregnant were included in the control group. For the serum analysis, samples were obtained after overnight fasting and between 7:00 AM and 8:00 AM.Results: In the gestational diabetes mellitus group serum procalcitonin levels was found significantly higher than control group. A positive correlation was found between serum procalcitonin levels and fasting glucose and oral glucose tolerance test 60. minute glucose levels.Conclusion: Our results shown that levels of serum procalcitonin in gestational diabetic mellitus were significantly higher than healthy pregnancies for the first time. This result supports the knowledge that chronic low-grade inflammation plays an important role in the pathogenesis of gestational diabetes mellitus. Procalcitonin level may be considered as a new biomarker for chronic low-grade inflammation in patients with gestational diabetes mellitus

WOS: 000510932200004, PubMed: 31544220, Background Depression is common in chronic kidney disease ( CKD) patients and associated with significant increase in morbidity and mortality. In recent years, a relationship between vitamin D deficiency and depression has been shown. The aim of this study is to investigate the relationship between 25-hydroxy (OH) vitamin D and depression in hemodialysis patients. Methods A total of 140 patients were included in the study. Hamilton depression scale (HAM-D) was completed by all patients. 25(OH) vitamin D levels were compared between patients with and without depressive symptoms. Results Patients who had depressive symptoms had significantly lower 25(OH) vitamin D levels (13.70 [24.3-8.25] vs. 18.20 [29.2-11.7] ng/mL, p = 0.016). HAM-D score showed significant association with gender (p = 0.011) and 25(OH) vitamin D level (p = 0.011). Univariate logistic regression analysis showed that males had lower risk of depression by a ratio of 61.1% (OR 0.389, p = 0.012) and vitamin D-deficient patients had 2.88 times greater risk of depression compared to non-deficient patients (OR 2.885, p = 0.013). Multivariate logistic regression analysis showed that males had 53.7% less risk of depression (OR 0.463, p = 0.046) and vitamin D-deficient patients had 2.39 times greater risk of depression (OR 2.397, p = 0.047). When evaluated by gender, univariate logistic regression analysis showed that 25(OH) vitamin D and other variables were not associated with depression in females (p > 0.05), while only vitamin D level had a significant effect on depression in males (OR 8.207, p = 0.008). Conclusions We found a significant association between vitamin D level and depressive symptoms in hemodialysis patients. When analyzed according to gender, this association was found to stand independent of other variables only in males.

Homosistein, metiyoninin demetilasyonu ile türetilen bir ara amino asit içeren bir sülfürdür. Birincil metiyonin kaynağı hayvansal proteindir. Serum homosistein normal aralığı 5-15 µmol / L'dir. Normal aralığın dışındaki (> 15 µmol / L) yükselmiş serum homosisteinine geleneksel olarak hiperhomosisteinemi denir. Düşük alım ve folat ve vitamin plazma konsantrasyonları (vitamin B6 ve vitamin B12) artan plazma homosistein düzeyleriyle ilişkilendirilmiştir. Ek olarak, hiperhomosisteinemi, tip 2 diyabetik hastalarda diyabetik nefropatiye bağlanmıştır.Prolidaz, diyabet, diyabetik nöropati gibi birçok hastalık için oksidatif stres belirteci olarak rapor edilmiştir. C-terminal amino ucunda prolin veya hidroksiprolin ile dipeptidleri keser ve hücre büyümesinde, kollajen metabolizmasında ve matrisin yeniden şekillenmesinde rol oynar. Prolidaz, plazma, lökositler, eritrositler, böbrek ve uterus, dermal fibroblastlar ve timus gibi çeşitli organlarda rapor edilmiştir. Birçok kronik hastalıkta oksidatif stres ve serum prolidaz birlikteliği bildirilmiştir. Glomerüler bazal membranın ana bileşenlerinden biri tip 4 kollajendir. Prolidaz, prolin içeren ve esas olarak hidroksiprolin ile zenginleştirilmiş tip 4 kollajenin cirosunda önemli bir rol oynar.Azalmış antioksidan savunma mekanizması ve diyabette ilişkili iskemi ile birleşmiş serbest radikal üretimi, arteriyel oklüzyonun dakikalarında insan serum albüminin tersiyer yapısında bir değişikliğe yol açar, bu nedenle iskemi modifiye albümin olarak adlandırılır. Reaktif oksijen türlerinin (ROT) artmış üretimi sonucunda, albümin molekülünün yapısal modifikasyonları meydana gelebilir. Piwowar ve ark., İlk kez, IMA'nın diyabetteki ilişkisini bildirmiş ve manuel spektroskopik yöntemle tahmin ettikten sonra kontrol ile karşılaştırıldığında, diyabette IMA'nın değerinin% 75 oranında arttığını bildirmişlerdir. Bar-Or ve ark.nın miyokard iskemisinin yeni bir serum biyobelirteç maddesi olarak tanıtılan IMA, araştırmacıların dikkatini çekmiş ve çeşitli iskemik ve iskemik olmayan koşullarda değerlendirilmiş ve daha sonra iskemia işaretçisi olmak yerine oksidatif stres belirteci olarak önerilmişlerdir. Oksidatif stresin diabetes mellitus (DM) ve diyabetik komplikasyonların patogenezinde rol oynadığı öne sürülmüştür. Daha önce, çeşitli diyabet tiplerinde (Tip 1 DM, Tip 2 DM), gebelik diyabetinde İMA seviyelerinin arttığı ve bozulmuş glukoz toleransı, hiperlipidemi ve diğer bazı metabolik parametrelerle ilişkili olduğu öne sürülmüştür.Çalışmaya toplam 99 denek alınmıştır (45 kadın, 54 erkek ). Bu bireyler iki gruba ayrıldı, kontrol grubu normoalbuminürili bireylerden (n = 49), hasta grubu aşikâr proteinüri ve mikroalbümüriüri diyabetik nefropatili (n = 50) hastalarından oluştu.Serum homosistein düzeyleri diyabetik nefropatili hastalarda (18.7 ± 7.2 µmol / l) kontrol grubundan (16.1 ± 4.8 µmol / l) anlamlı derecede yüksekti. Serum iskemi modifiye albümin düzeyleri diyabetik nefropatili hastalarda (0.60 ± 0.068 µmol / l) kontrollerden (0.58 ± 0.077 µmol / l) yüksekti fakat aradaki bu fark istatiksel olarak anlamlı değildi. Diyabetik nefropati hastalarında (860.6 ± 148.6 IU / L) serum prolidaz düzeyleri kontrollerden (888.4 ± 256.4 IU / L) düşüktü. Serum iskemi modifiye albümin seviyeleri ve Serum prolidaz seviyeleri, erken evre diyabetik hastalarda diyabetik nefropatinin ilerlemesi için iyi bir belirteç olmayabilir. Literatürde diyabetik nefropatili hastalarda prolidaz ve iskemi modifiye albüminin serum seviyeleri ile ilgili bir boşluk var gibi görünüyor. Homocysteine is a sulfur containing an intermediate amino acid derived by demethylation of methionine. The primary source of methionine is animal protein. The normal range of serum homocysteine is 5-15 µmol / L. Elevated serum homocysteine outside the normal range (> 15 µmol / L) is traditionally called hyperhomocysteinemia. Low intake and folate and vitamin plasma concentrations (vitamin B6 and vitamin B12) have been associated with increased plasma homocysteine levels. In addition, hyperhomocysteinemia has been linked to diabetic nephropathy in type 2 diabetic patients.Prolidase has been reported as a marker of oxidative stress for many diseases such as diabetes, diabetic neuropathy. It cleaves dipeptides with proline or hydroxyproline at the C-terminal amino terminus and plays a role in cell growth, collagen metabolism and matrix remodeling. Prolidase has been reported in various organs such as plasma, leukocytes, erythrocytes, kidney and uterus, dermal fibroblasts and thymus. Oxidative stress and serum prolidase coexistence have been reported in many chronic diseases. One of the main components of the glomerular basement membrane is type 4 collagen. Prolidase plays an important role in the turnover of proline-containing type 4 collagen enriched with hydroxyproline.Decreased antioxidant defense mechanism and ischemia-associated free radical production in diabetes leads to a change in the tertiary structure of human serum albumin in the minutes of arterial occlusion, so called ischemia-modified albumin. As a result of the increased production of reactive oxygen species (ROS), structural modifications of the albumin molecule may occur. For the first time, Piwowar et al. reported the relationship of IMA in diabetes and reported that the value of IMA in diabetes increased by 75% compared with control after predicting by manual spectroscopic method. Bar-Or et al., IMA, a new serum biomarker of myocardial ischemia, has attracted researchers' attention and has been evaluated in a variety of ischemic and non-ischemic conditions, and has subsequently been proposed as a marker of oxidative stress rather than a marker of ischemia. Oxidative stress has been suggested to play a role in the pathogenesis of diabetes mellitus (DM) and diabetic complications. Previously, it has been suggested that IMA levels are elevated in various types of diabetes (Type 1 DM, Type 2 DM) and associated with impaired glucose tolerance, hyperlipidemia, and some other metabolic parameters.In the study a total number of 99 subjects (45 women 54 men) were enrolled. These individuals were divided into two groups as the control group consisted of individuals with normoalbuminuria (n=49) and patient group consisted of apparent proteinuria and microalbuminuria patients with diabetic nephropathy (n=50).Serum homocysteine levels were significantly higher in patients with diabetic nephropathy (18.7±7.2 µmol/l) than control group (16.1± 4.8 µmol/l). Serum ischemia modified albumin levels were higher in patients with diabetic nephropathy (0.60 ± 0.068 µmol / l) than controls (0.58 ± 0.077 µmol / l), but this difference was not statistically significant. Serum prolidase levels were lower in diabetic nephropathy patients (860.6 ± 148.6 IU / L) than controls (888.4 ± 256.4 IU / L).We think that plasma homocysteine is a useful marker for the progression of diabetic nephropathy in early stage diabetic patients. Serum ischemia-modified albumin levels and Serum prolidase levels may not be a good marker for for the progression of diabetic nephropathy in early stage diabetic patients. It seems that there is a gap in the literature regarding the serum levels of prolidase and ischemia-modified albumin in patients with diabetic nephropathy. 106

WOS: 000473280800006, Objectives: Micro- and macrovascular endothelial deterioration has been mentioned in diabetic pregnants with critical clinical outcome for the fetus. Our aim was to measure serum and cord blood concentrations of methylated arginines in patients with gestational diabetes and find a relationship with endothelial dysfunction. Materials and methods: Methylated arginines were detected with high performance liquid chromatography mass spectrometry via electrospray ionization positive technique with a chromatographic C18 column. Results: Although gestational diabetes mellitus (GDM) groups' asymmetric dimethylarginine (ADMA) levels were higher compared to control group, this difference was not significant. Control cord blood ADMA and N-monomethy-larginine levels were significantly higher than insulin-regulated GDM cord blood ADMA and N-monomethylarginine levels (p = 0.001; p= 0.003, respectively). Diet-regulated GDM group's cord blood N-monomethylarginine was significantly higher than insulin-regulated GDM group's cord blood N-monomethylarginine (p= 0.045). A negative correlation was found between cord blood symmetric dimethylarginine and oral glucose tolerance testing Oh glucose values (r = -0.453, p = 0.002). Conclusions: According to this study's results, methylated arginine levels may not be associated with endothelial deterioration in GDM otherwise with preeclampsia risk.

PubMed: 31887669, Objective: Clozapine is one of the most effective drugs for resistant schizophrenia, but its severe metabolic and hematological side effects limit the use of clozapine. It has been reported that clozapine blood concentrations should be maintained between 350?600 ng/mL. Our aim was to develop a determination method for clozapine and its main metabolites norclozapine and clozapine-N-oxide, to perform validation studies and to investigate the change of various biochemical parameters in patients using clozapine. Methods: A liquid chromatography-tandem mass spectrometry (LC–MS/MS) method was developed and validated for clozapine measurement. Thus, blood samples were collected from 38 patients with schizophrenia and 32 healthy volunteers. Biochemical and hematological parameters were measured by Beckman-Coulter AU 5800 (Beckman Coulter, Brea, USA) and Beckman Coulter LH 780 analyzer (Beckman Coulter, Miami, FL, USA), respectively. Hormone levels were analyzed using Cobas 6000 analyzer (Roche Diagnostics, Germany). Results: The LC[sbnd]MS/MS method was linear between 1.22?2500 ng/mL (r2 = 0.9971) for clozapine. The retention times of clozapine, norclozapine and clozapine-N-oxide were 0.92, 0.89 and 0.95, respectively. Blood glucose (GLU) (p = 0.025), low density lipoprotein (LDL-cholesterol) (p = 0.015), triglyseride (TG) (p = 0.042) and total cholesterol (TC) (p = 0.024) levels were higher; hemoglobin (HGB) (0.015), mean corpuscular hemoglobin (MCH) (0.036), red blood cell count (RBC) (0.020), neutrophil (NEU) (0.034), and platelet (PLT) (P = 0.005) levels were lower in the clozapine group. Conclusions: This LC–MS/MS method was rapid, simple, cost-effective and suitable for the routine clozapine monitoring. Furthermore, norclozapine and clozapine-N-oxide were also determined. Monitoring of metabolic and hematological parameters with clozapine levels is very important. However, the limitations of the study were that the method was not validated for norclozapine and clozapine-N-oxide, so the validation parameters were not evaluated for these two metabolites. © 2019 Elsevier B.V., Firat University Scientific Research Projects Management Unit: 17202068, This work was supported by Selcuk University Scientific Research Projects Coordinator (grant number 17202068 ).The authors thank the Selcuk University for funding this project.

WOS: 000440978000010, PubMed: 30160136, OBJECTIVE: This study was designed to investigate prorenin and secreted frizzled-related protein 4 (SFRP4) levels in pregnancies with or without gestational diabetes mellitus (GDM). METHODS: A total of 76 pregnant women were included in the study. Thirty-five of the pregnant women were included in GDM group according to the results of oral glucose tolerance tests (OGTT) and 41 of them were included in the control group. RESULTS: In the group with GDM, SFRP4 value was found to be significantly higher than that of the control group (5.59 +/- 3.32 ng/mL vs 4.05 +/- 2.15 ng/mL; p = 0.017). Women with GDM had significantly higher serum prorenin levels compared with control group [737 (427-1339) pg/mL vs. 535 (376-725) pg/mL; p = 0.009]. There was a significant positive association between prorenin and SFRP4 levels in GDM (r = 0.91; p < 0.001) and control groups (r = 0.42; p = 0.002) and whole pregnancies (r = 0.75; p = 0.002). CONCLUSION: We have shown that prorenin and SFRP4 were significantly elevated in GDM patients when compared to healthy control group. Furthermore, we found that there was a positive correlation between prorenin and SFRP4 (Tab. 1, Fig. 2, Ref. 38). Text in PDF www.elis.sk., Selcuk UniversitySelcuk University [BAP 15401082], This study has been partially supported by Selcuk University under grant number BAP 15401082.

WOS: 000433285000013, PubMed: 29236646, A decrease in bone mass is observed in hemophilic patients. The aim of this study was to evaluate bone mineral density (BMD), parathyroid hormone (PTH), 25-hydroxy vitamin D (vitamin D), and a bone formation and resorption marker, procollagen type I N-terminal propeptide (PINP) and urinary N-terminal telopeptide (uNTX) respectively, in hemophilic patients and healthy controls. Laboratory parameters related to the pathogenesis of bone loss such as neutrophil- lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were also evaluated. Thirty-five men over 18 years of age, with severe hemophilia (A and B) and receiving secondary prophylaxis, were included in the study. The same number of age-, sex-, and ethnicity-matched healthy controls were evaluated. Anthropometric, biochemical, and hormonal parameters were determined in both groups. No significant difference in anthropometric parameters was found between the two groups. The BMD was low in 34% of hemophilic patients. Vitamin D, calcium, and free testosterone levels were significantly lower (p < 0.001, p = 0.011, p < 0.001, respectively), while PTH, PINP, and activated partial thromboplastin time (aPTT) levels were significantly higher (p < 0.014, p = 0.043, p < 0.001, respectively), in hemophilic patients compared to controls. There was no significant difference between the two groups in NLR, PLR, phosphorus, thyroid-stimulating hormone, and uNTX level. The reduction of bone mass in hemophilic patients may be evaluated using the markers of bone formation and resorption, enabling early detection and timely treatment., Selcuk UniversitySelcuk University [15401129], This work was supported by Selcuk University Scientific Research Project (Project No: 15401129).

Asimetrik dimetil arjinin (ADMA) klinik tanıda değerlendirilmek maksadıyla üzerinde. araştırmaların devam ettiği, metillenmiş bir arjinin türevidir. ADMA, Nitrik Oksit (NO) sentezini bloke ederek vazospazma ve endotel disfonksiyonuna sebebiyet vermekte ve gebelik döneminde preeklampsi oluşumu ile ilgili risk faktörü olarak kabul edilmektedir Homoarjinin, arjininin homoloğudur ve arjininle yarışarak NOS'ın subsratı olarak görev yapar. Fakat NO üretiminde arjininden daha az etkilidir. Gebelikte erken dönemde ADMA düzeyi yüksek olan kadınlarda ADMA seviyeleri ile endotelyal disfonksiyon arasında ilişki vardır. Gebelik döneminde ADMA seviyesinin ve diğer metilarjinin seviyelerinin nasıl değişkenlik gösterdiği, hastalıkların patogenezini anlamak ve bunları tedavi ile ilişkilendirmek, yeni tedavi protokollerinin geliştirilmesi ve hatta hastalıklar oluşmadan sağlıklı kişilerin risk faktörlerinin elimine edilmesi açısından son derece önemlidir. Bu sebeple çalışmamızda ikili ve dörtlü test istemi yapılan gebe katılımcıların serumlarında metilarjinin seviyelerini belirleyebilmeyi amaçladık. Çalışmaya, toplam 200 gebe kadın dahil edildi. Bu katılımcılar 4'lü test istemi yapılan kontrol grubu (n=50), 4'lü test istemi yapılan riskli grup (n=50), 2'li test istemi yapılan kontrol grubu(n=50) ve 2'li test istemi yapılan riskli grup(n=50) olacak şekilde dört gruba ayrıldı. Her gruba ait serum metilarjinin ve bazı biyokimya testlerinin seviyeleri ölçüldü. Dörtlü ve ikili test istemi yapılan riskli gruplardaki bireylerde serum homoarjinin seviyeleri bu grupların kontrollerine göre anlamlı derecede düşüktü. (sırasıyla p=0.001, p= 0.001) ve en düşük homoarjinin seviyelerinin ikili test istemi yapılan riskli gruba [0.91(0.45- 2.71)] ait olduğu görüldü. Gruplarda HArg seviyeleri yaş parametresi (r= -0.295**, p=0.000) ve serum İnhibin-A seviyeleri ile( r= -0.288**, p=0.005) güçlü negatif bir korelasyon gösterirken ,serum ADMA seviyeleri (r= 0.309**, p=0.000) ile güçlü pozitif bir korelasyon gösterdi. Ayrıca arjinin (r= 0.471**, p=0.000) ve total metilarjininler (r= 0.476**, p=0.000) ile de arasında güçlü pozitif bir korelasyon söz konusuydu. Dörtlü test istemi yapılan kontrol grubunda serum ADMA seviyeleri [0.13(0.02- 0.44)], dörtlü test istemi yapılan riskli gruba [0.06(0.02- 0.17)] ve ikili test istemi yapılan riskli gruba [0.09(0.03-0.24)] göre sırasıyla anlamlı derecede yüksek bulundu (p= 0.000, p= 0.038). İkili test istemi yapılan kontrol grubunda riskli gruptan daha yüksek serum ADMA düzeyleri bulunmasına rağmen aradaki fark istatiksel olarak anlamlı değildi (p= 0.080). Tüm gruplar arasında en yüksek ADMA seviyelerinin dörtlü test istemi yapılan kontrol grubuna ait olduğu görüldü [0.13(0.02- 0.44)]. Serum ADMA seviyeleri serum İnhibin-A seviyeleri (r= -0.352**, p=0.001) ile güçlü negatif bir korelasyon gösterirken, serum HCG seviyeleri (r= -0.261**, p=0.012) zayıf negatif bir korelasyon gösterdi. Normal gebelik sırasında düşük serum maternal ADMA ve L-arjinin konsantrasyonu gibi gebelikle ilgili metabolik değişikliklerin endotel fonksiyonu düzenleyemeyebileceği düşünmekteyiz. Preeklampsi dışında serum ADMA düzeyi iyi bir belirteç olarak kullanılamayabilir. Homoarjinin serum seviyelerinin gebe kadınlardaki düzeyleri açısından literatürde bir boşluk olduğu görülmektedir. Gebelikte yüksek risk altındaki kadınların erken dönemde belirlenmesinde homoarjinin yeni bir risk markırı olarak ortaya çıkabilir. Asymmetric dimethyl arginine (ADMA) is a derivative of a methylated arginine that continues to be studied for use in clinical diagnosis. Nitric oxide synthase synthesizes NO from L-arginine. ADMA inhibits nitric oxide (NO) synthesis and causes vasospasm and endothelial .dysfunction and it is considered as a risk factor for the occurrence of preeclampsia during pregnancy. Homo arginine is the homologous of arginine and serves as a subsrat of NOS, competing with arginine. But it is less effective than arginine in NO production. There is a relationship between ADMA level and endothelial dysfunction in women with high ADMA levels in early stage in pregnancy. How the levels of ADMA and other methlyarginines vary during pregnancy and related diseases, to understand pathogenesis of diseases and to associate them with treatment are extremely important in terms of the development of new treatment protocols and even the elimination of risk factors for healthy persons and as a subject that needs to be investigated. Due to thıs reason we aimed to determine the levels of the methlyarginine levels in the serum of pregnant participants who were subjected to binary- quad test in our study In this study, a total of 200 pregnancy woman were enrolled. These individuals were divided into four groups as the control group with quadruple test (n=50), high risk group with quadruple test (n=50), control group with binary test (n=50) and high risk group with binary test (n=50). In each group, serum methylarginine levels and some of biochemical tests were measured. Serum homoarginine levels were significantly lower (p = 0.001, p = 0.001, respectively) in the subjects high risk groups with in the quadruple and binary test than in the controls of these groups and the lowest homoarginine levels were found to belong to the high risk group [0.91 (0.45-2.71)] with binary test. While serum homorgininne levels showed a strong negative relationship with parameter of age (r= -0.295**, p=0.000) and serum inhibin A levels ( r= -0.288**, p=0.005) there was a strong positive correlation with serum ADMA levels (r= 0.309**, p=0.000). There was also a strong positive correlation between serum homoarginine and arginine levels (r= -0.352**, p=0.001) and total methylarginines levels (r= 0.476** , p= 0.000). In the control group with quadruple test serum ADMA values [0.13(0.02- 0.44)], were significantly higher than ( p= 0.000, p= 0.038, respectively) high risk group with quadruple test [0.06(0.02- 0.17)] and high risk group with binary test [0.09(0.03-0.24)]. Although there was a higher serum ADMA levels in the control group with binary test than high risk group the difference was not statistically significant (p = 0.080). The highest ADMA levels among all groups were found to belong to the control group with quadruple test [0.13 (0.02-0.44)]. While serum ADMA levels showed a strong negative correlation with serum inhibin A (r= -0.352**, p=0.001) there was weak negative correlation with serum HCG levels (r= -0.261**, p=0.012). We think that pregnancy-related metabolic changes such as low serum maternal ADMA and L-arginine concentration during normal pregnancy may not regulate endothelial function. Serum ADMA levels other than preeclampsia may not be a good indicator. It seems that there is a gap in the literatüre regarding the serum levels of homoarginine in pregnant women. Homoarginine may emerge as a new risk marker when women at high risk are identified early stage in pregnancy. 120

Asimetrik dimetil arjinin (ADMA) klinik tanıda değerlendirilmek maksadıyla üzerinde. araştırmaların devam ettiği, metillenmiş bir arjinin türevidir. ADMA, Nitrik Oksit (NO) sentezini bloke ederek vazospazma ve endotel disfonksiyonuna sebebiyet vermekte ve gebelik döneminde preeklampsi oluşumu ile ilgili risk faktörü olarak kabul edilmektedir Homoarjinin, arjininin homoloğudur ve arjininle yarışarak NOS'ın subsratı olarak görev yapar. Fakat NO üretiminde arjininden daha az etkilidir. Gebelikte erken dönemde ADMA düzeyi yüksek olan kadınlarda ADMA seviyeleri ile endotelyal disfonksiyon arasında ilişki vardır. Gebelik döneminde ADMA seviyesinin ve diğer metilarjinin seviyelerinin nasıl değişkenlik gösterdiği, hastalıkların patogenezini anlamak ve bunları tedavi ile ilişkilendirmek, yeni tedavi protokollerinin geliştirilmesi ve hatta hastalıklar oluşmadan sağlıklı kişilerin risk faktörlerinin elimine edilmesi açısından son derece önemlidir. Bu sebeple çalışmamızda ikili ve dörtlü test istemi yapılan gebe katılımcıların serumlarında metilarjinin seviyelerini belirleyebilmeyi amaçladık. Çalışmaya, toplam 200 gebe kadın dahil edildi. Bu katılımcılar 4'lü test istemi yapılan kontrol grubu (n=50), 4'lü test istemi yapılan riskli grup (n=50), 2'li test istemi yapılan kontrol grubu(n=50) ve 2'li test istemi yapılan riskli grup(n=50) olacak şekilde dört gruba ayrıldı. Her gruba ait serum metilarjinin ve bazı biyokimya testlerinin seviyeleri ölçüldü. Dörtlü ve ikili test istemi yapılan riskli gruplardaki bireylerde serum homoarjinin seviyeleri bu grupların kontrollerine göre anlamlı derecede düşüktü. (sırasıyla p=0.001, p= 0.001) ve en düşük homoarjinin seviyelerinin ikili test istemi yapılan riskli gruba [0.91(0.45- 2.71)] ait olduğu görüldü. Gruplarda HArg seviyeleri yaş parametresi (r= -0.295**, p=0.000) ve serum İnhibin-A seviyeleri ile( r= -0.288**, p=0.005) güçlü negatif bir korelasyon gösterirken ,serum ADMA seviyeleri (r= 0.309**, p=0.000) ile güçlü pozitif bir korelasyon gösterdi. Ayrıca arjinin (r= 0.471**, p=0.000) ve total metilarjininler (r= 0.476**, p=0.000) ile de arasında güçlü pozitif bir korelasyon söz konusuydu. Dörtlü test istemi yapılan kontrol grubunda serum ADMA seviyeleri [0.13(0.02- 0.44)], dörtlü test istemi yapılan riskli gruba [0.06(0.02- 0.17)] ve ikili test istemi yapılan riskli gruba [0.09(0.03-0.24)] göre sırasıyla anlamlı derecede yüksek bulundu (p= 0.000, p= 0.038). İkili test istemi yapılan kontrol grubunda riskli gruptan daha yüksek serum ADMA düzeyleri bulunmasına rağmen aradaki fark istatiksel olarak anlamlı değildi (p= 0.080). Tüm gruplar arasında en yüksek ADMA seviyelerinin dörtlü test istemi yapılan kontrol grubuna ait olduğu görüldü [0.13(0.02- 0.44)]. Serum ADMA seviyeleri serum İnhibin-A seviyeleri (r= -0.352**, p=0.001) ile güçlü negatif bir korelasyon gösterirken, serum HCG seviyeleri (r= -0.261**, p=0.012) zayıf negatif bir korelasyon gösterdi. Normal gebelik sırasında düşük serum maternal ADMA ve L-arjinin konsantrasyonu gibi gebelikle ilgili metabolik değişikliklerin endotel fonksiyonu düzenleyemeyebileceği düşünmekteyiz. Preeklampsi dışında serum ADMA düzeyi iyi bir belirteç olarak kullanılamayabilir. Homoarjinin serum seviyelerinin gebe kadınlardaki düzeyleri açısından literatürde bir boşluk olduğu görülmektedir. Gebelikte yüksek risk altındaki kadınların erken dönemde belirlenmesinde homoarjinin yeni bir risk markırı olarak ortaya çıkabilir., Asymmetric dimethyl arginine (ADMA) is a derivative of a methylated arginine that continues to be studied for use in clinical diagnosis. Nitric oxide synthase synthesizes NO from L-arginine. ADMA inhibits nitric oxide (NO) synthesis and causes vasospasm and endothelial .dysfunction and it is considered as a risk factor for the occurrence of preeclampsia during pregnancy. Homo arginine is the homologous of arginine and serves as a subsrat of NOS, competing with arginine. But it is less effective than arginine in NO production. There is a relationship between ADMA level and endothelial dysfunction in women with high ADMA levels in early stage in pregnancy. How the levels of ADMA and other methlyarginines vary during pregnancy and related diseases, to understand pathogenesis of diseases and to associate them with treatment are extremely important in terms of the development of new treatment protocols and even the elimination of risk factors for healthy persons and as a subject that needs to be investigated. Due to thıs reason we aimed to determine the levels of the methlyarginine levels in the serum of pregnant participants who were subjected to binary- quad test in our study In this study, a total of 200 pregnancy woman were enrolled. These individuals were divided into four groups as the control group with quadruple test (n=50), high risk group with quadruple test (n=50), control group with binary test (n=50) and high risk group with binary test (n=50). In each group, serum methylarginine levels and some of biochemical tests were measured. Serum homoarginine levels were significantly lower (p = 0.001, p = 0.001, respectively) in the subjects high risk groups with in the quadruple and binary test than in the controls of these groups and the lowest homoarginine levels were found to belong to the high risk group [0.91 (0.45-2.71)] with binary test. While serum homorgininne levels showed a strong negative relationship with parameter of age (r= -0.295**, p=0.000) and serum inhibin A levels ( r= -0.288**, p=0.005) there was a strong positive correlation with serum ADMA levels (r= 0.309**, p=0.000). There was also a strong positive correlation between serum homoarginine and arginine levels (r= -0.352**, p=0.001) and total methylarginines levels (r= 0.476** , p= 0.000). In the control group with quadruple test serum ADMA values [0.13(0.02- 0.44)], were significantly higher than ( p= 0.000, p= 0.038, respectively) high risk group with quadruple test [0.06(0.02- 0.17)] and high risk group with binary test [0.09(0.03-0.24)]. Although there was a higher serum ADMA levels in the control group with binary test than high risk group the difference was not statistically significant (p = 0.080). The highest ADMA levels among all groups were found to belong to the control group with quadruple test [0.13 (0.02-0.44)]. While serum ADMA levels showed a strong negative correlation with serum inhibin A (r= -0.352**, p=0.001) there was weak negative correlation with serum HCG levels (r= -0.261**, p=0.012). We think that pregnancy-related metabolic changes such as low serum maternal ADMA and L-arginine concentration during normal pregnancy may not regulate endothelial function. Serum ADMA levels other than preeclampsia may not be a good indicator. It seems that there is a gap in the literatüre regarding the serum levels of homoarginine in pregnant women. Homoarginine may emerge as a new risk marker when women at high risk are identified early stage in pregnancy., Bu araştırma Selçuk Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğü tarafından 16202040 proje numarası ile desteklenmiştir.

Vitamin D, uzun yıllardır kalsiyum- fosfor metabolizmasını düzenleyen bir vitamin olarak bilinse de son 10-15 yıl içinde yapılan çalışmalarla antiinflamatuar, antikanserojen, antidiabetik, antianjiogenik ve antifibrotik özellikleri olduğu yönünde veriler elde edilen steroid yapılı bir hormon olarak kabul edilmektedir. Bunun yanında D vitamini reseptörlerinin (VDR)'nin geniş bir doku dağılımı göstermesi nedeniyle insülin direnci ve diyabet gelişiminde, bağışıklık sistemi, kardiyovasküler sistem ve üreme sistemi ile ilgili hastalıklarda önemli rol oynar. D vitamini yetersizliğinin insanda alerjik hastalıklar, kardiyovasküler problemler, otoimmün hastalıklar ve diyabetle ilişkili olabileceği gösterilmiştir. Son yıllarda yapılan birçok çalışma, D vitamini eksikliği ile Hashimoto tiroiditi (HT) ve Graves hastalığı (GD) gibi otoimmün tiroid hastalıkları (AITD) arasında bir bağ olduğunu varsaymaktadır (Kivity ve ark). Biz çalışmamızda Graves, Hashimoto ve nontoksik multinoduler guatr hastalarının D vitamini düzeylerine ek olarak D vitamini bağlayıcı protein (VDBP), Vitamin D reseptörü (VDR), Anti TPO, Anti TG düzeylerini sağlıklı kontrollerle karşılaştırarak D vitaminin bir immunmodulatör olarak otoimmun tiroid hastalıklarındaki rolünü ortaya koymayı amaçladık.Yaptığımız çalışmalarda otoimmun tiroid hastalıkları olan Hashimoto, Graves ve Nontoksik Multinodüler guatr hastası olan bireylerle sağlıklı bireyler D vitamini ve D vitamininin taşınmasında ve hücreler tarafından kullanılmasında fonksiyonu olan VDBP ve VDR düzeyleri açısından karşılaştırdık. D vitamini düzeyleri sağlıklı bireylere göre tüm hasta bireylerde düşük bulundu. VDBP ve VDR düzeyleri hasta gruplarına göre sağlıklı bireylerde daha düşük bulundu ve D vitamini düzeyleriyle korele olarak bulundu.Anahtar Kelimeler: Vitamin D, Hashimoto, Graves, İmmun Sistem Vitamin D is known as a vitamin that regulates the calcium-phosphorus metabolism for many years, but it has been accepted as a steroid-structured hormone in the course of the last 10-15 years and has been shown to have antiinflammatory, anticarcinogenic, antidiabetic, antiangiogenic and antifibrotic properties. However, because of the wide tissue distribution of vitamin D receptors (VDR), it plays an important role in the development of insulin resistance and diabetes, diseases related to the immune system, cardiovascular system and reproductive system. D vitamine insufficiency has been shown to be associated with human allergic diseases, cardiovascular problems, autoimmune diseases and diabetes. Many recent studies have assumed that vitamin D deficiency is a link between autoimmune thyroid diseases (AITD) such as Hashimoto thyroiditis (HT) and Graves' disease (GD) (Kivity et al.). In this study, we aimed to compare vitamin D receptor (VDR), vitamin D binding protein (VDBP), anti TPO and anti TG levels to healthy controls in addition to vitamin D levels in patients with Graves, Hashimoto and nontoxic multinodular goitre patients and found that vitamin D as an immunomodulator plays a role in autoimmune thyroid diseases.In our studies, Hashimoto, Graves and Nontoxic multinodular goiters who has autoimmune thyroid diseases, compared healthy individuals in terms of levels of VDBP and VDR functioning in the transport of vitamin D and in the use of cells by healthy subjects. D vitamin levels were lower in all patients than in healthy subjects. VDBP and VDR levels were found to be lower in healthy subjects and correlated with vitamin D levels according to patient groups.Keywords: Vitamin D, Hashimoto, Graves, Immune System 69

Tip 2 diabetes mellitus, çoğunlukla insülinin etkisine karşı dokularda direnç gelişmesi ya da insülin duyarlığının azalması ve/veya insülin sentezi ve salgılanmasının görece azalması ile karakterize bir hastalıktır. Eğer tip 2 diyabetik hastalar erken ve doğru zamanda tedavi edilmezse, kötü diyabeti ve kötü glukoz kontrolü olan hastalarda kalıcı glukoz farklı yollarla AGE'lere dönüşür. Böylece diyabetik hastalarda makro ve mikro komplikasyonlar gelişmektedir. Bu çalışmamızda amaç, AGE'ler için çöpçü reseptörü olan, inflamasyon ve fibrozis süreçleriyle ilişkilendirilmiş galektin-3'ün, enfeksiyon ve inflamasyonlara karşı yüksek duyarlığa sahip olan high sensitive CRP (hs-CRP)'nin, endotelyal disfonksiyon ve kardiyovasküler hastalıklarda minör bir risk belirteci olduğu bildirilen ADMA'nın ve viral, bakteriyel enfeksiyonlarda artığı bildirilen neopterinin sağlıklı bireylerde, regüle ve regüle olmayan diyabetik hastalarda ve prediyabetik olgulardaki düzeyleri ve aralarındaki ilişkiyi değerlendirmeyi amaçladık.Çalışmada, toplam 159 kişi (98 kadın, 61 erkek) değerlendirmeye alındı. Bu kişiler; kontrol grubu (n=41), prediyabet (n=34), regüle diyabet (n=40) ve regüle olmayan diyabet (n=44) olacak şekilde dört gruba ayrıldı. Her gruba ait serum galektin-3, ADMA, hs-CRP, neopterin ve bazı biyokimya testlerinin seviyeleri ölçüldü.Sağlıklı gruba göre serum galektin-3 seviyeleri (13.3±3.4), diyabetik hasatlara (regüle diyabet (15.7±4.2) ve regüle olmayan (15.6±3.3)) göre daha düşük bulundu (sırasıyla p=0.007 ve p=0.002). Serum galektin-3 seviyeleri, hs-CRP (r=0.208** p=0.008) ile güçlü pozitif ilişki gösterirken, L-NMMA (r=0,188* p=0,018) ve neopterin (r=0.177* p=0.026) seviyeleriyle de zayıf pozitif ilişki gösterdi. Sağlıklı, prediyabetik ve regüle diyabetik gruplarda serum ADMA (sırasıyla p=0.01, p=0.03 ve p=0.01) ve hs-CRP (sırasıyla p

In this study, it is aimed to estimate not just the uncertainty measurement for the parameters of glucose and insulin having role when calculating HOMA-IR, but also true positiveness and negativeness in terms of cut-off values. The evaluation of the acceptability of the uncertainty value was also among the goals of the study. The uncertainty measurement for glucose and insulin is calculated as uncertainty measurement of HOMA-IR based on Eurochem/CITAC Guide CG 4. The uncertainty measurement for glucose and insulin was estimated as 3.83% and 4.16%, respectively. The measurement uncertainty for the calculated test HOMA-IR was calculated with cut-off values as 27% (0.27). Based on the cut-off value for HOMA-IR of 2.5%, IR(+) and IR(-) patients were 155 and 265, respectively. If the uncertainty measurement for HOMA-IR was added to its calculation, the cut-off value was detected as 2.23-2.77%. We reported the measurement uncertainty of the calculated test HOMA-IR at 95 % CI as 0.27 between 2.23 - 2.77. Especially for the tests used for screening; determination of cut-off values as a range including measurement uncertainty instead of a single value will be more suitable. No data is found in the literature for the calculated test HOMA-IR up to date. [Med-Science 2019; 8(1.000): 32-6]

Glukoz yüklemesi yapılan ve bilinen herhangi bir sağlık problemi olmayan bireylerde, glukoz yüklemesine bağlı olarak meydana gelen kan glukozunun akut yüksekliğinin ADMA düzeylerini etkileyerek endotel disfonksiyonuna olası etkilerini araştırmayı amaçladığımız çalışmamız, 30 erkek 32 bayan toplam 62 hasta üzerinde gerçekleştirilmiştir. Çalışmamızda 62 bireyin herbirinden açken ve 75 gr glukoz yüklenmesinden sonraki 60. ve 120. dakikalarda ayrı ayrı kan örneği alınmış ve bu numunelerden Arjinin, ADMA, SDMA, LNMMA, Sitrüllin, Arjinin/ADMA değerleri belirlenmiştir. Çalışmamızda elde edilen bulgulara göre glukoz yüklenmesinden sonra Arjinin, Sitrüllin ve Arjinin/ADMA değerlerinin anlamlı olarak düştüğü, ADMA, SDMA, LNMMA değerlerinde ise anlamlı bir değişikliğin olmadığı gözlemlenmiştir., The study was designed with 62 healthy individuals (30 men, 32 women) who do not take any medications and have no known diseases to find out the possible effects of acute blood glucose elevations on serum ADMA levels contributing to endotelial disfunction. Fasting and 60. and 120. hour blood samples were collected from 62 subjects and Arginin, ADMA, SDMA, L-NMMA, Citrulline levels were analyzed. Arginin/ADMA ratio was calculated. According to study's results, Arginin, Citrullin and Arginin/ADMA levels were decreased and ADMA, SDMA, L-NMMA levels were found to be constant after glucose loading., Bu araştırma Selçuk Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğü tarafından 14202018 proje numarası ile desteklenmiştir.