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OBJECTIVES To examine the effects of aging and/or diabetes mellitus on oxidative stress and the protective effect of vitamin E in the bladder. It was proposed that the balance between oxidant and antioxidant species is important regarding the aging process and prevention of diabetic complications.

PURPOSE: An experimental study was carried out to investigate the efficacy of an anti-inflammatory and antiproliferative agent all-trans retinoic acid (ATRA) and an antioxidant agent zinc sulphate (ZnSO(4)) in the prevention of stricture after caustic esophageal burn in rats. METHODS: Esophageal burn was induced using 50% NaOH. Rats were divided into four groups as follows: group A (sham; n = 8), group B (control; n = 8), group C (treated with ATRA; n = 8) and group D (treated with ZnSO(4); n = 8). All rats were killed on the 28th day and esophageal tissues were evaluated for histopathologic damage score, hydroxyproline (HP) content and TGF-beta1 expression. RESULTS: Significant difference was detected in terms of histopathologic damage score between groups B and C (p = 0.002). Although mean HP levels of groups C and D were lower than group B, statistical comparison was not significant. TGF-beta1 expression in group C was significantly lower than group B. CONCLUSION: Zinc has not been found effective in the prevention of stricture formation. The results indicate that ATRA has a preventive effect in the development of fibrosis in an experimental model of caustic esophageal burns in rats.

OBJECTIVES: Decreased serum adiponectin levels have been shown in patients with coronary artery disease (CAD). We evaluated the association between serum adiponectin levels and CAD severity on the angiogram. STUDY DESIGN: The study included 86 patients (70 males, 16 females; mean age 60 years) with angiographically documented CAD (=/>50% stenosis). The patients were divided into three groups according to the number of vessels affected; thus, 18 had single-vessel, 16 had two-vessel, and 52 had multiple-vessel disease. The severity of coronary lesions was assessed using the modified Gensini score. Serum adiponectin levels were measured in the CAD group and in a control group of 33 subjects (16 males, 17 females; mean age 54.8 years) who were found to have normal coronary arteries on angiography. RESULTS: The mean age, the number of male patients, and the number of smokers were significantly higher in the CAD group (p=0.01). Patients with CAD exhibited significantly lower serum levels of adiponectin compared to the control group (2.0+/-2.0 micromg/dl vs. 3.2+/-2.7 micromg/dl; p=0.01). There were no significant differences in adiponectin levels between patients with single-, two, and multiple-vessel disease. Compared to the controls, patients with two- and multiple-vessel disease had significantly lower adiponectin levels (1.5+/-0.9 microg/dl and 2.0+/-2.0 microg/dl, respectively), whereas those with single-vessel disease (2.6+/-2.5 microg/dl) did not differ from the controls in this respect. The mean Gensini score was 3.8+/-1.7 in the CAD group. There was a weak inverse correlation between serum adiponectin levels and the Gensini score (r=-0.209; p=0.02). CONCLUSION: Serum adiponectin levels are decreased in CAD patients compared to controls. This decrease is more prominent with increasing levels of CAD severity, which may be a helpful clue of multivessel disease.

Objectives: Decreased serum adiponectin levels have been shown in patients with coronary artery disease (CAD). We evaluated the association between serum adiponectin levels and CAD severity on the angiogram. Study design: The study included 86 patients (70 males, 16 females; mean age 60 years) with angiographically documented CAD (≥50% stenosis). The patients were divided into three groups according to the number of vessels affected; thus, 18 had single-vessel, 16 had two-vessel, and 52 had multiple-vessel disease. The severity of coronary lesions was assessed using the modified Gensini score. Serum adiponectin levels were measured in the CAD group and in a control group of 33 subjects (16 males, 17 females; mean age 54.8 years) who were found to have normal coronary arteries on angiography. Results: The mean age, the number of male patients, and the number of smokers were significantly higher in the CAD group (p=0.01). Patients with CAD exhibited significantly lower serum levels of adiponectin compared to the control group (2.0±2.0 μmg/dl vs. 3.2±2.7 μmg/dl; p=0.01). There were no significant differences in adiponectin levels between patients with single-, two, and multiple-vessel disease. Compared to the controls, patients with two- and multiple-vessel disease had significantly lower adiponectin levels (1.5±0.9 μg/dl and 2.0±2.0 μg/dl, respectively), whereas those with single-vessel disease (2.6±2.5 μg/dl) did not differ from the controls in this respect. The mean Gensini score was 3.8±1.7 in the CAD group. There was a weak inverse correlation between serum adiponectin levels and the Gensini score (r=-0.209; p=0.02). Conclusion: Serum adiponectin levels are decreased in CAD patients compared to controls. This decrease is more prominent with increasing levels of CAD severity, which may be a helpful clue of multivessel disease.

OBJECTIVES: We aimed to evaluate serum adiponectin levels in relation to the NYHA functional capacity class in patients with heart failure (HF). STUDY DESIGN: The study included 49 patients (40 males, 9 females; mean age 63 years) with HF, whose functional capacity was NYHA class II to IV. Echocardiographic examination was performed and serum adiponectin levels were measured. The results were compared in relation to the NYHA classes and with those of 41 control subjects (24 males, 17 females; mean age 54.2 years) without HF. RESULTS: Functional capacity was NYHA class II in 13 patients (26.5%), class III in 23 patients (46.9%), and class IV in 13 patients (26.5%). Compared to the control group, the HF group exhibited a significantly higher mean age (p=0.001), lower body mass index (p=0.004), decreased left ventricular ejection fraction (EF) (33.2+/-7.7% vs. 64.9+/-4.3%; p=0.0001), and increased serum adiponectin level (4.0+/-3.2 micromg/dl vs. 2.4+/-2.3 micromg/dl; p=0.009). Both EF (p=0.001) and adiponectin level (p=0.004) showed significant differences between the NYHA groups, with the latter showing a sharp increase from 2.6+/-2.6 micromg/dl in class II to 6.8+/-3.7 micromg/dl in class IV. In all paired comparisons between the three NYHA groups, EF and serum adiponectin level exhibited significant differences except for the serum adiponectin level for NYHA class II and III (for NYHA class II and IV, p=0.003; for class III and IV, p=0.008). In correlation analysis, serum adiponectin level was in a significantly inverse correlation with EF (r=-0.380, p=0.0001), and a positive correlation with the NYHA class (r=0.423, p=0.0001). CONCLUSION: Serum adiponectin levels significantly increase in patients with HF, in parallel with deterioration in functional capacity and with significant decreases in EF.

BACKGROUND: Carnitine plays essential roles in energy production, oxidative stress and glucose metabolism. This study was planned to determine serum total L-carnitine levels in non-obese women with polycystic ovary syndrome (PCOS). METHODS: There were 27 non-obese women with PCOS and 30 healthy, age- and body mass index (BMI) matched controls were evaluated in this controlled clinical study. Serum lipid sub-fractions, fasting glucose, insulin and other hormones (gonadotrophins, androgens) and total L-carnitine levels were measured. Homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance. RESULTS: The women with PCOS had significantly higher serum dehydroepiandrosterone sulfate, total testosterone, free androgen index (FAI), luteinizing hormone (LH), low-density lipoprotein (LDL) cholesterol, non-high density lipoprotein (HDL) cholesterol, fasting insulin levels and HOMA-IR measurement and LH/FSH ratios than healthy women. However, total L-carnitine and sex hormone-binding globulin (SHBG) levels were significantly lower in women with PCOS. L-Carnitine level was negatively correlated with FAI, but positively correlated with SHBG. Multiple regression analysis revealed that SHBG was a strong predictor of serum total L-carnitine level. CONCLUSIONS: Decreased total L-carnitine levels may be associated with hyperandrogenism and/or insulin resistance in non-obese women with PCOS. Long-term studies are needed to evaluate carnitine metabolism in PCOS, especially with regard to the molecular basis.

BACKGROUND: Carnitine plays essential roles in energy production, oxidative stress and glucose metabolism. This study was planned to determine serum total L-carnitine levels in non-obese women with polycystic ovary syndrome (PCOS). METHODS: There were 27 non-obese women with PCOS and 30 healthy, age- and body mass index (BMI) matched controls were evaluated in this controlled clinical study. Serum lipid sub-fractions, fasting glucose, insulin and other hormones (gonadotrophins, androgens) and total L-carnitine levels were measured. Homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance. RESULTS: The women with PCOS had significantly higher serum dehydroepiandrosterone sulfate, total testosterone, free androgen index (FAI), luteinizing hormone (LH), low-density lipoprotein (LDL) cholesterol, non-high density lipoprotein (HDL) cholesterol, fasting insulin levels and HOMA-IR measurement and LH/FSH ratios than healthy women. However, total L-carnitine and sex hormone-binding globulin (SHBG) levels were significantly lower in women with PCOS. L-Carnitine level was negatively correlated with FAI, but positively correlated with SHBG. Multiple regression analysis revealed that SHBG was a strong predictor of serum total L-carnitine level. CONCLUSIONS: Decreased total L-carnitine levels may be associated with hyperandrogenism and/or insulin resistance in non-obese women with PCOS. Long-term studies are needed to evaluate carnitine metabolism in PCOS, especially with regard to the molecular basis.

Background: Several prospective epidemiological studies have demonstrated that high-sensitivity C-reactive protein (hsCRP) and plasma homocysteine (hcy) are predictors of future coronary events among healthy men and women. The aim of the present study was therefore to investigate a possible relationship between hsCRP, hcy levels and body mass index (BMI), relative weight (RW), serum leptin levels, and cardiovascular risk factors in obese children and adolescents. Methods: The study involved 28 obese children and adolescents (13 girls, 15 boys; BMI > 95 parts per thousand for age and sex), 4.5-15 years of age (mean 10.7 +/- 0.6 years), who attended hospital for a basic obesity check-up. The association between hsCRP, hcy levels and BMI, RW, serum leptin levels, and cardiovascular risk factors such as blood pressure (BP), lipid profile, serum fasting insulin levels, and insulin resistance indexes, was investigated. Results: Serum hsCRP level was positively correlated with BMI (r = 0.512, P < 0.01), RW (r = 0.438, P < 0.05), systolic and diastolic BP (r = 0.498, P < 0.01), serum leptin levels (r = 0.457, P < 0.05), but not with serum lipid, glucose, fasting insulin, plasma hcy levels or insulin resistance indexes. For hcy level, in contrast, no correlation was found with BMI, RW, systolic and diastolic BP, serum lipid levels, leptin, hsCRP, glucose, fasting insulin levels, or insulin resistance indexes. Conclusions: hsCRP is correlated with BMI, RW, BP and leptin, which are risk factors for coronary heart disease, which supports the relationship between obesity, inflammation and atherosclerosis. hsCRP in childhood obesity might be a useful index to predict possible atherosclerotic events.

Objective: To examine the effects of age and/or diabetes on oxidative stress and steroidogenesis,and the protective effect of vitamin E in testis tissue: Design: Controlled experimental study. Setting: Pamukkale University School of Medicine animal facility. Animal(s): Male Wistar rats divided into six groups with. six animals in each group: young control; young diabetic; young diabetic with vitamin E treatment; aged control; aged diabetic; and aged diabetic with vitamin E treatment. Intervention(s): Diabetes was induced by a single intraperitoneal injection of 50 mg/kg streptozotocin and was confirmed by testing blood glucose levels 5 to 7 days after injection. Vitamin E was administered orally for 6 weeks. Main Outcome Measure(s): Serum testosterone and tissue malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) levels were measured, and testis tissue was examined histopathologically. Result(s): Elevated malondialdehyde and reduced superoxide dismutase, glutathione, and serum testosterone levels were detected only in the young and aged-diabetic groups. Histopathologic change was not detected in the testis tissue in any of the groups. Conclusion(s): Age does not alter the effects of diabetes-induced free radical damage in testis tissue; improvement in this damage can be achieved by vitamin E treatment.

OBJECTIVE: To examine the effects of age and/or diabetes on oxidative stress and steroidogenesis, and the protective effect of vitamin E in testis tissue. DESIGN: Controlled experimental study. SETTING: Pamukkale University School of Medicine animal facility. ANIMAL(S): Male Wistar rats divided into six groups with six animals in each group: young control; young diabetic; young diabetic with vitamin E treatment; aged control; aged diabetic; and aged diabetic with vitamin E treatment. INTERVENTION(S): Diabetes was induced by a single intraperitoneal injection of 50 mg/kg streptozotocin and was confirmed by testing blood glucose levels 5 to 7 days after injection. Vitamin E was administered orally for 6 weeks. MAIN OUTCOME MEASURE(S): Serum testosterone and tissue malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) levels were measured, and testis tissue was examined histopathologically. RESULT(S): Elevated malondialdehyde and reduced superoxide dismutase, glutathione, and serum testosterone levels were detected only in the young and aged-diabetic groups. Histopathologic change was not detected in the testis tissue in any of the groups. CONCLUSION(S): Age does not alter the effects of diabetes-induced free radical damage in testis tissue; improvement in this damage can be achieved by vitamin E treatment.

Objective: In growth and differentation of keratinizing stratified squamous epithelium, 1.25-dihydroxyvitamin D3 has an important role. Cornifin α as a marker of vaginal epithelial differentiation distribution in vagina epithelium has not been studied. We examined distribution of VDR and cornifin α in vagina epithelium in ovariectomized and treated vitamin D rats. Materials and Methods: Bilateral ovariectomies were performed in 20 mature non-pregnant Wistar female rats. All the animals were divided into 2 groups; control group I untreated and group II i.m. 0.025 μg 1.25-dihydroxyvitamin D3 injected for three days of a week for 2 weeks. In 15 days after the last injection, vaginas were removed and processed for immunohistochemistry. Results: Recorded epithelial differentiation, 1.25-dihydroxyvitamin D 3 receptor and cornifin α expression in vaginal epithelium of control and vitamin D3 treated rats. In treated animals, vaginal epithelium changed into highly-stratified keratinizing layers. Cornifin α and 1.25-dihydroxyvitamin D3 receptor as a marker of squamous differentiation is present in ovariectomized rats treated with 1.25-dihydroxyvitamin D3. In contrast, cornifin α and 1.25-dihydroxyvitamin D3 receptor were absent in all layers of vaginal epithelium in control group. Discussion: The results indicate that 1.25-dihydroxyvitamin D3 induced proliferation of vaginal epithelium which was consistent with the cornifin α expression. We demonstrated for the first time that 1.25-dihydroxyvitamin D3 up-regulated 1.25-dihydroxyvitamin D3 receptor expression in vaginal epithelium.

Objective: Identification of specific origin of lipid accumulation in the liver of patients with non-alcoholic fatty liver disease (NAFLD) is the most important step in preventing this condition. Because liver steatosis, in the obese patients without any systemic disease, can be graded easily by ultrasonography (US), we aimed to demonstrate the degree of liver steatosis and abdominal fat distribution by US, furthermore evaluate biochemical, anthropometrical measurements, and define the possible relationship between these parameters in obese women with different grades of liver steatosis. Methods: In this controlled clinical study, according to US evaluation of liver steatosis, the patients were divided into four groups: control (no steatosis), mild, moderate and severe steatosis groups. Demographic, biochemical and anthropometric measurements were done. Insulin resistance was determined by using homeostasis model assessment (HOMA-IR). Liver steatosis and abdominal fat distributions were evaluated by US. Results: The subcutaneous and preperitoneal fat layer measurements did not show any significant difference between the groups. The visceral fat layer thickness was significantly higher in severe liver steatosis group compared to the control and steatosis groups. The highest serum fasting insulin, uric acid levels and HOMA-IR index were observed in the severe liver steatosis group. Visceral fat thickness was positively correlated with serum UA levels and HOMA-IR Conclusions: This study suggests that visceral adipose tissue, HOMA-IR and serum uric acid levels are the main determinants of NAFLD in obese patients.

The purpose of this study was to investigate the clinical effects of balneotherapy in the treatment of Fibromyalgia Syndrome (FMS) and to determine if balneotherapy influences serum levels of inflammation markers, IL-1, PGE(2) and LTB4. 24 primary fibromyalgia female patients diagnosed according to American College of Rheumatology criteria were included to the study. Their ages ranged between 33 and 55 years. FMS patients were randomly assigned in two groups as, group 1 (n = 12) and group 2 (n = 12). Group 1 received 20-min bathing, once in a day for five days per week. Patients participated in the study for 3 weeks (total of 15 sessions) in Denizli. Group 2 did not receive balneotherapy. FMS patients were evaluated by tenderness measurements (tender point count and algometry), Visual Analogue Scale, Beck's Depression Index, Fibromyalgia Impact Questionnaire. Ten healthy women recruited group three as the controls. Serum PGE(2), LTB4 and IL1-alpha levels were measured in all three groups. The biochemical measurements and clinical assessments were performed before and at the end of general period of therapy. Statistically significant alterations in algometric score, Visual Analogue score, Beck's Depression Index and PGE(2) levels (P < 0.001), numbers of tender points (P < 0.01) and Fibromyalgia Impact Questionnaire score (P < 0.05) were found after the balneotherapy between group 1 and 2. Mean PGE(2) level of FMS patients were higher compared to healthy control group (P < 0.0001) and decreased after the treatment period, only in group 1 (P < 0.05). As in the group 2 and 3, detectable IL-1 and LTB4 measurements were insufficient, statistical analysis was performed, only in group 1. After balneotherapy IL-1 and LTB4 significantly decreased in group 1 (P < 0.05). In conclusion, balneotherapy is an effective choice of treatment in patients with FMS relieving the clinical symptoms, and possibly influencing the inflammatory mediators.

Objective: Obesity is recognized as a major worldwide health problem. In particular, visceral fat accumulation is usually accompanied by insulin resistance or type 2 diabetes mellitus, hypertension, hyper-triglyceridemia, high Uric acid and low high-density lipoprotein cholesterol levels defined as metabolic syndrome. Metabolic syndrome is strongly associated with increased risk of cardiovascular morbidity and mortality. The objective of this study was to assess the effects of sibutramine therapy on body mass index (BMI), body fat distribution, visceral fat mass (VF) accumulation, insulin resistance and plasma lipid profile in central obese patients. Material and Methods: Demographic, biochemical and anthropometric measurements, insulin resistance that was calculated by using homeostasis model assessment of 43 obese patients treated with 15 mg/day sibutramine for 6 months were evaluated. Abdominal fat distributions were determined by ultrasound examination. Results: Sibutramine treatment accompanied with life style changes (diet and exercise) demonstrated significant reductions in BMI (p < 0.0001), total body fat mass (p < 0.01), waist circumference (p < 0.0001), subcutaneous (p < 0.05) and VF (p < 0.0001), and HOMA-IR (p < 0.01). Serum total cholesterol (p < 0.05) and triglyceride (p < 0.05) levels reduced significantly after the sibutramine treatment. BMI was inversely associated with HOMA-IR. Conclusion: Sibutramine is a well-tolerated drug and may improve metabolic abnormalities in insulin resistance syndrome. In addition, it may have beneficial effects by preventing the progression of diabetes and cardiovascular diseases. C1 [Fenkci, Semin; Yaylali, Guezin Fidan; Sermez, Yurdaer] Pamukkale Univ, Sch Med, Dept Internal Med, Div Endocrinol & Metab, Denizili, Turkey. [Rota, Simin] Pamukkale Univ, Sch Med, Dept Biochem, Denizili, Turkey. [Sabir, Nuran] Pamukkale Univ, Sch Med, Dept Radiodiagnost, Denizli, Turkey.

Background: Fallopian tube carcinoma is a rare disease, and few data about prognostic factors are available in the literature. Patients and methods: The medical charts of 47 patients with primary carcinoma of the fallopian tube treated at our institution between 1982 and 1994 were reviewed. Age, stage, histologic grade, residual disease after surgery, peritoneal cytology and lymph-node involvement were evaluated for their prognostic impact in a univariate analysis. Results: The mean age of the patients was 57.5 years and 19 of them (40%) had early-stage disease. Poorly differentiated tumors were diagnosed in 64% of the patients. Eleven of 20 patients (55%) submitted to surgical evaluation of lymphnodes had retroperitoneal involvement. Thirty-three patients received CAP chemotherapy following surgery, and the overall clinical response rate was 80%. Sixteen patients (34%) had recurrences within 8 to 50 months from diagnosis. Twenty patients (42.6%) are alive without disease, one patient is alive with tumor, and 26 patients (55.3%) died of the disease. The median survival for the group as a whole was 44 months, and the actuarial 5-year survival was 29%. In univariate analysis stage (I+II vs. III+IV), grade (G1+G2 vs. G3) residual disease after surgery (less than 2 cm vs. greater than 2 cm), peritoneal cytology (negative vs. positive) and lymph-node metastases were all factors significantly affecting survival. Conclusions: Aggressive cytoreductive surgery followed by platin-based chemotherapy offer the possibility of long-term control of primary tubal carcinoma

This longitudinal, controlled clinical study was conducted to compare the effects of resistance exercise (RE) and aerobic exercise (AE) on body mass index (BMI), weight, fat mass (FM), serum lipid profile, and insulin resistance in obese women who cannot adhere to energy-restricted diets. A total of 60 obese women with severe eating disorders were evaluated. Patients were randomly divided into 3 groups: control group with no exercise (n=20), group 1 with AE (n=20), and group 2 with RE (n=20). Demographic and anthropometric measurements were taken. Serum lipid fractions and fasting (FGlc) and postprandial glucose insulin (PGlc) levels were measured. Insulin resistance was calculated with use of homeostasis model assessment (HOMA-IR). Total body FM was measured by bioelectric impedance analysis. After 12 wk of exercise, significant decreases in BMI, waist and weight measurements, and FGlc, PGlc, triglyceride, and total cholesterol levels were noted in each of the study groups. Reduced low-density lipoprotein cholesterol level and FM and HOMA-IR measurements were observed only in group 1 (with AE). This study indicated that AE and RE training induces improvement in body fat composition and has a favorable metabolic effect in obese women with severe eating disorders.

BACKGROUND: The objective of this study was to measure associations of circulating interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) levels with anthropometric and abdominal fat distribution in overweight or obese postmenopausal women. METHODS: One hundred eight overweight or obese postmenopausal were evaluated. Demographic and anthropometric measurements were done. Serum IL-6, TNF-alpha, glucose, and insulin levels were measured. Insulin resistance was calculated by using homeostasis model assessment-insulin resistance (HOMA-IR). The assessment of abdominal fat distribution was performed by ultrasonography. Statistical analysis was made with Pearson and partial correlation analysis. RESULTS: There was a positive correlation between serum IL-6 and TNF-alpha (r = .19; p = .047). IL-6 was positively correlated with body mass index (BMI) (r = .43; p = .0001), waist circumference (r = .41; p = .0001), and visceral fat layer (r = .33; p = .0001) measurements and HOMA-IR index (r = .31, p = .001). A positive relationship between HOMA-IR and visceral fat layer thickness was observed (r = .320; p = .0001). TNF-alpha was positively associated with BMI but not with any measures of central obesity. When adjustment for BMI was performed, there were no significant relationships between the studied parameters. CONCLUSIONS: There are no significant correlations between abdominal fat distributions measured by ultrasonography and circulating IL-6 and TNF-alpha levels. BMI may have a stronger association with circulating inflammatory cytokine concentrations than with different measures of central obesity in overweight or obese postmenopausal women.

Serum lipoperoxidation products such as malondialdehyde (MDA) reflect oxidative stress. There are contradictory results addressing the levels of lipoperoxidation products in chronic phase of ischemic stroke. In the present study, we aimed to determine the serum MDA levels in stroke patients 6 months after the cerebrovascular accident. We also compared serum MDA levels in two major groups of patients with ischemic stroke resulting from small vessel and large vessel diseases, respectively. Serum MDA levels of thirty-eight patients who had ischemic stroke (19 with atherothrombotic ischemic stroke and 19 with lacunar infarction) and 30 healthy volunteers were measured. While there was no significant difference in serum MDA levels between the chronic ischemic stroke subgroups (p = 0.795), the serum MDA levels of patients with atherothrombotic ischemic stroke (p < 0.001) or with lacunar infarction (p < 0.001) were significantly higher compared to the control group. We also demonstrated that serum MDA levels of the patients with and those without hypertension (p = 0.846), diabetes mellitus (p = 0.891), or dyslipidemia (p = 0.38) were not significantly different. In conclusion, serum MDA levels were elevated in chronic stroke patients with small or large vessel diseases. To the best of our knowledge, this is the first report showing that serum MDA levels of these two groups are not sigificantly different. Furthermore, serum MDA levels do not differ solely by the existence or nonexistence of hypertension, diabetes mellitus or hyperlipidemia.

Most current statistical strategies for determining risk factors for hypertension (HT) among certain populations have proved inconclusive. In this study, the classification tree method, which is more practical and easy to understand than other statistical methods, was used to determine the risk for HT among outpatients in a clinic in Denizli province, western Turkey, between January 2002 and July 2004. The effects of 14 risk factors (body mass index, waist-to-hip ratio, age, serum total cholesterol, serum triglycerides, sex, HT in first-degree relatives, diabetes mellitus, smoking, stress factors, alcohol consumption, dyslipidemia in first-degree relatives, dyslipidemia [previously diagnosed], and saturated fat consumption) on HT were evaluated in this population. in all, 1761 adults at the outpatient clinic were recruited for lipid and HT measurements. The classification tree method revealed 7 main risk factors (body mass index, waist-to-hip ratio, sex, serum triglycerides, serum total cholesterol, HT in first-degree relatives, and saturated fat consumption) for HT. The findings of the present study suggest that the classification tree is a valuable statistical method for evaluating multiple risk factors for HT. C1 Pamukkale Univ, Dept Biostat, TR-20070 Denizli, Turkey. Pamukkale Univ, Dept Endocrinol & Metab, TR-20070 Denizli, Turkey. Pamukkale Univ, Dept Internal Med, TR-20070 Denizli, Turkey. Pamukkale Univ, Dept Biochem, TR-20070 Denizli, Turkey. Private Ctr, Dept Internal Med, Izmir, Turkey. Zonguldak Karaelmas Univ, Dept Biostat, Zonguldak, Turkey.

Serum lipoperoxidation products such as malondialdehyde (MDA) reflect oxidative stress. There are contradictory results addressing the levels of lipoperoxidation products in chronic phase of ischemic stroke. In the present study, we aimed to determine the serum MDA levels in stroke patients 6 months after the cerebrovascular accident. We also compared serum MDA levels in two major groups of patients with ischemic stroke resulting from small vessel and large vessel diseases, respectively. Serum MDA levels of thirty-eight patients who had ischemic stroke (19 with atherothrombotic ischemic stroke and 19 with lacunar infarction) and 30 healthy volunteers were measured. While there was no significant difference in serum MDA levels between the chronic ischemic stroke subgroups (p = 0.795), the serum MDA levels of patients with atherothrombotic ischemic stroke (p < 0.001) or with lacunar infarction (p < 0.001) were significantly higher compared to the control group. We also demonstrated that serum MDA levels of the patients with and those without hypertension (p = 0.846), diabetes mellitus (p = 0.891), or dyslipidemia (p = 0.38) were not significantly different. In conclusion, serum MDA levels were elevated in chronic stroke patients with small or large vessel diseases. To the best of our knowledge, this is the first report showing that serum MDA levels of these two groups are not significantly different. Furthermore, serum MDA levels do not differ solely by the existence or nonexistence of hypertension, diabetes mellitus or hyperlipidemia.

In recent years, the results of some studies have revealed the possible potential role of several infectious agents in the inflammatory mechanism of atherosclerosis. The detection of specific antibodies against microorganisms such as Chlamydia pneumoniae and cytomegalovirus as well as antibodies directed to heat shock proteins in the sera of atherosclerotic patients and the presence of genomic material in atheromatous plaques all provide evidence supporting the presumptive role of infectious agents in atherosclerosis. There are some findings that can be accepted as clues for the possible involvement of Mycobacterium tuberculosis in atherosclerosis. These consist of the presence of high levels of mycobacterial heat shock protein 65 in atherosclerotic patients, and in animal studies, the detection of atherosclerotic changes in the vascular wall of animals vaccinated with recombinant heat shock protein 65, and Mycobacterium tuberculosis containing heat shock protein 65. The probable proatherogenic effect of the specific immune response to BCG-associated heat shock protein was also suggested. The mycobacterium cell wan contains a phospholipid, phosphatidylinositol, which was shown to have a procoagulant effect similar to that of a cytomegalovirus possessing phosphatidylserine, another phospholipid showing a procoagulant effect. These data suggest that Mycobacterium tuberculosis may also be involved in the pathogenesis of atherosclerosis. C1 Pamukkale Univ, Sch Med, Dept Biochem, TR-20070 Denizli, Turkey. Gazi Univ, Sch Med, Dept Microbiol, TR-06500 Ankara, Turkey.

The possible potential role of several infectious agents in atherosclerosis has been shown. Several infectious agents DNA in atheromatous plaques have been displayed by PCR. In patients with atheromas antibody levels against Hsp65 were higher. Vaccination of mice with recombinant Hsp65 and Hsp65-rich M. tuberculosis resulted in formation of atheromatous plaques. We attempted to detect M. tuberculosis DNA in atherosclerotic plaque samples by PCR. In endarterectomy tissue samples obtained from patients during coronary artery bypass graft surgery DNA was prepared by proteinase-K digestion, phenol/chloroform extraction and ethanol precipitation. After amplification with M.tuberculosis complex IS6110 region specific primers, the products were analyzed on electrophoresis. M. tuberculosis DNA was negative in all tissue samples. More data on etiological studies with mycobacteriaceae will be yield information on atherosclerosis pathogenesis. C1 Pamukkale Univ, Sch Med, Dept Biochem, Denizli, Turkey. Metis Biotechnol Ltd, Ankara, Turkey. Gazi Univ, Sch Med, Dept Med Microbiol, Ankara, Turkey. City Hosp, Dept Cardiovasc Surg, Ankara, Turkey.

ROTA, S., YILDIRIM, B., KALELI, B., AYBEK, H., DUMAN, K. and KAPTANOGLU, B. C-Reactive Protein Levels in Non-Obese Pregnant Women with Gestational Diabetes. Tohoku J. Exp. Med., 2005, 206 (4), 341-345 - A low-grade systemic inflammation is concomitant in diabetes. There is a pathophysiological relation between gestational diabetes mellitus and type 2 diabetes mellitus, which was further supported by significantly elevated risk of type 2 diabetes in women with a history of previous gestational diabetes mellitus. We investigated the relation between low-grade systemic inflammation expressed as C-reactive protein and gestational diabetes in non-obese pregnant women. This study included 20 non-obese pregnant women with gestational diabetes mellitus and 30 non-obese pregnant women without gestational diabetes mellitus as a control group. The body mass index of all the subjects were < 25 kg /m(2). During 26-28 gestational weeks 100-g oral glucose tolerance test was performed and simultaneously fasting C-reactive protein levels were measured. Serum median C-reactive protein level was higher in patients with gestational diabetes mellitus (p = 0.0001). C-reactive protein was strongly associated with glycemic parameters and weight gain during pregnancy. A model consisting of glucose intolerance, age, parity, and weight gain during pregnancy accounted for 61 % of the variance in log C-reactive protein. We demonstrated that serum C-reactive protein level was related with gestational diabetes mellitus and weight gain during pregnancy in late second and early third trimesters. - gestational diabetes; CRP; subelinical inflammation; pregnancy; BMI. (c) 2005 Tohoku University Medical Press. C1 Pamukkale Univ, Fac Med, Dept Biochem, Denizli, Turkey. Pamukkale Univ, Fac Med, Dept Obstet & Gynecol, Denizli, Turkey.

A low-grade systemic inflammation is concomitant in diabetes. There is a pathophysiological relation between gestational diabetes mellitus and type 2 diabetes mellitus, which was further supported by significantly elevated risk of type 2 diabetes in women with a history of previous gestational diabetes mellitus. We investigated the relation between low-grade systemic inflammation expressed as C-reactive protein and gestational diabetes in non-obese pregnant women. This study included 20 non-obese pregnant women with gestational diabetes mellitus and 30 non-obese pregnant women without gestational diabetes mellitus as a control group. The body mass index of all the subjects were < 25 kg/m2. During 26-28 gestational weeks 100-g oral glucose tolerance test was performed and simultaneously fasting C-reactive protein levels were measured. Serum median C-reactive protein level was higher in patients with gestational diabetes mellitus (p = 0.0001). C-reactive protein was strongly associated with glycemic parameters and weight gain during pregnancy. A model consisting of glucose intolerance, age, parity, and weight gain during pregnancy accounted for 61% of the variance in log C-reactive protein. We demonstrated that serum C-reactive protein level was related with gestational diabetes mellitus and weight gain during pregnancy in late second and early third trimesters.