Ezetimibe therapy and its influence on oxidative stress and fibrinolytic activity.

OBJECTIVE: The effect of ezetimibe on blood lipids, oxidative stress, and fibrinolytic activity in hyperlipidemic patients was investigated after three months of therapy. METHODS: Thirty hyperlipidemic patients were treated for twelve weeks with ezetimibe 10 mg/day. A healthy control group with matching age and gender was also included. Fasting blood glucose, lipid parameters, paraoxonase (PON1), protein carbonyl (PCO), oxidized LDL (oxLDL), 8-isoprostane (ISOPR), total antioxidant capacity (TAC) levels, tissue-type plasminogen activator (tPA), plasminogen activator inhibitor type-1 (PAI-1), and PAI-1/t-PA levels were evaluated. RESULTS: Ezetimibe therapy for twelve weeks led to changes in lipid profile in accordance with the literature. Fibrinolytic activity parameters, PAI-1/tPA and tPA-1 decreased, whereas PAI-1 levels did not change significantly. Antioxidant parameters, serum PON1 activity, and TAC levels increased significantly compared with the basal values. Oxidant parameters, oxLDL, ISOPR, and PCO (which is an indicator of oxidative protein damage) decreased significantly after therapy. CONCLUSIONS: Ezetimibe therapy has beneficial effects on fibrinolytic activity and homeostasis between oxidant and antioxidant activity in hyperlipidemic patients This may be through lowering lipid levels or other mechanisms such as decreasing insulin resistance and the pleiotropic effects of the drug.

Effects of serum homocysteine and adiponectin levels on platelet aggregation in untreated patients with essential hypertension.

The aim of the present study is to determine and correlate adiponectin, homocysteine, nitric oxide, and ADP-induced platelet aggregation levels in untreated patients with essential hypertension and healthy individuals. A total of 36 individuals, 23 untreated patients with essential hypertension and 13 healthy individuals, were included in the scope of this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine the serum adiponectin and TNF-alpha levels. The levels of serum homocysteine were measured by using competitive chemiluminescent enzyme immunoassay. Serum concentrations of hsCRP were measured by the Nephelometer. Plasma nitrite, nitrate, and total nitric oxide (NOx) levels were determined by colorimetric method. Homocysteine and hsCRP levels in patients with essential hypertension were found to be significantly higher than those in the control group (P = 0.02, P = 0.001, respectively). The average platelet aggregation levels in patient group were higher than control group, but there were no statistically significant differences between them (P > 0.05). In addition, in patients with essential hypertension adiponectin and nitrite levels are significantly lower than control group (P < 0.001, P = 0.045, respectively). We have also found significant correlations between nitrite-platelet aggregation amplitude, nitrite-platelet aggregation slope, nitrite-adiponectin, homocysteine-platelet aggregation amplitude, and sistolic blood pressure-platelet aggregation amplitude levels (r = -0.844; P < 0.001, r = -0.680; P = 0.011, r = 0.454; P = 0.05, r = 0.414; P = 0.05, r = 0.442; P = 0.035, respectively). Increased homocysteine and decreased adiponectin serum levels in patients with essential hypertension correlate well with changes in ADP-induced conventional platelet aggregation. This association may potentially contribute to future thrombus formation and higher risks for cardiovascular events in hypertensive patients.

Association of blood lead levels with demographic, reproductive and employment related factors in Turkish women.

OBJECTIVE: The aim of this study is to compare the blood lead levels in employed and unemployed women and associate the difference with sociodemographic and reproductive factors. PARTICIPANTS: Out of a 100 women attending the routine check-up unit of Family Medicine Department for screening of osteoporosis and blood lead levels, 63 post-menopausal participants; 36 unemployed and 27 employed, were included in the study. METHODS: Patients completed a questionnaire regarding their sociodemographics. Their blood chemistry and blood lead levels were determined and bone mineral densities were measured by Dual Energy X-Ray Absorptiometry. In the statistical analysis, Mann-Whitney U test was used to compare means and χ ^{2} was used to compare ratios. Backward logistic regression was used for multivariate analysis. RESULTS: There was no significant difference between the age (57.17 ± 7.46; unemployed, 54.19 ± 5.36; employed). The mean blood lead levels were 25.92 ± 9.31 µ g/dl in the unemployed group and 33.98 ± 13.50 µg/dl in the employed group (p=0.011) adjusted for age. Smoking rate was significantly higher in employed women (p=0.033) whereas the number of births (p=0.032) and duration of breastfeeding (p=0.008) were significantly lower. Although both groups were osteoporotic and post-menopausal, there was no association between osteoporosis and employment while unemployed women had an earlier menopause (p=0.037). CONCLUSIONS: Lead levels are above the accepted threshhold (20 µg/dl) in both groups. Strict environmental and social improvement efforts in both groups are recommended.