Is mean platelet volume related to disease activity in systemic lupus erythematosus?

INTRODUCTION: Systemic lupus erythematosus (SLE) is a connective tissue disease that is chronic, recurrent and multisystem with unknown aetiology. There is still no single biomarker that is pathognomonic for the disease. We know that platelets are the main part of haemostasis and thrombosis. We aimed to investigate whether there is a connection between MPV with SLE and inflammatory markers. MATERIAL AND METHODS: We have included 39 female patients with SLE and 45 controls in this study. In both groups, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) levels and MPV levels were investigated. Clinical findings and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) were evaluated in patients. RESULTS: There was no significant difference between the two groups in terms of demographic data. The MPV was 8.1 ± 0.5 (mean ± SD) in the patient's group and 7.6 ± 0.3 in the control group. There was a significant difference between the two groups in terms of MPV (P < .001). The ESR level was 30.7 ± 29 in the patient's group and 16.7 ± 10 in the control group. In the patient's group, the CRP levels were higher compared with that of the control group (8.2 ± 13, 4.5 ± 4, respectively). We found a statistically significant positive correlation between MPV with arthritis (r = .310,P = .004), nephritis (r = .446,P < .001), central nervous system involvement (r = .241,P = .027), vasculitis (r = .228,P = .037) and SLEDAI (r = .329,P = .002). In our study, we found increased levels of MPV in patients with SLE. Also, we observed a positive correlation among MPV with sedimentation, CRP, clinical manifestations and SLEDAI. CONCLUSION: We consider that MPV may be a new activation indicator for the SLE.

Utilization of statins and LDL-cholesterol target attainment in Turkish patients with type 2 diabetes - a nationwide cross-sectional study (TEMD dyslipidemia study).

BACKGROUND: Attaining acceptable levels of LDL Cholesterol (LDL-C) significantly improves cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (T2DM). The LDL-C target attainment and the characteristics of patients attaining these targets were investigated in this study. Furthermore, the reasons for not choosing statins and the physicians' attitudes on the treatment of diabetic dyslipidemia were also examined. METHODS: A nationwide, cross-sectional survey was conducted in tertiary centers for diabetes management. Adult patients with T2DM, who were under follow-up for at least a year in outpatient clinics, were consecutively enrolled for the study. LDL-C goals were defined as below 70 mg/dL for patients with macrovascular complications or diabetic nephropathy, and below 100 mg/dL for other patients. Data about lipid-lowering medications were self-reported. RESULTS: A total of 4504 patients (female: 58.6%) were enrolled for the study. The mean HbA1c and diabetes duration was 7.73 ± 1.74% and 10.9 ± 7.5 years, respectively. The need for statin treatment was 94.9% (n = 4262); however, only 42.4% (n = 1807) of these patients were under treatment, and only 24.8% (n = 448) of these patients achieved LDL-C targets. The main reason for statin discontinuation was negative media coverage (87.5%), while only a minority of patients (12.5%) mentioned side effects. Physicians initiated lipid-lowering therapy in only 20.3% of patients with high LDL-C levels. It was observed that the female gender was a significant independent predictor of not attaining LDL-C goals (OR: 0.70, 95% CI: 0.59-0.83). CONCLUSIONS: Less than 50 % of patients with T2DM who need statins were under treatment, and only a quarter of them attained their LDL-C targets. There exists a significant gap between the guideline recommendations and the real-world evidence in the treatment of dyslipidemia in T2DM.

Is otitis media with effusion associated with oxidative stress? Evaluation of thiol/disulfide homeostasis.

BACKGROUND: We evaluated the relationship between otitis media with effusion and thiol/disulfide homeostasis using a novel marker of oxidative stress. METHODS: The study group consisted of 30 patients (mean age 8.33 ±â€¯3.30 years) with bilateral otitis media with effusion admitted to our hospital. The control group consisted of 35 (mean age 7.40 ±â€¯3.97 years) age-, sex-, and body mass index-matched healthy subjects. Thiol/disulfide homeostasis was measured using a newly developed method. RESULTS: Native and total thiol levels were lower in the study than the control group (native thiols 421.37 ±â€¯72 µmol/L vs. 464.46 ±â€¯46.42 µmol/L, p < 0.05; total thiols 468.42 ±â€¯77.89 µmol/L vs. 501.32 ±â€¯50.30 µmol/L, respectively). Disulfide levels and the disulfide/native thiol and disulfide/total thiol ratios were higher in the study group (disulfides 23.56 ±â€¯4.68 µmol/L vs. 18.43 ±â€¯4.94 µmol/L; disulfide/native thiol ratio 5.65 ±â€¯1.05 vs. 3.97 ±â€¯1.03%; disulfide/total thiol ratio 5.06 ±â€¯0.83 vs. 3.66 ±â€¯0.88%, respectively). CONCLUSION: Oxidative stress may be the major cause of the increase in oxidized thiols in patients with bilateral otitis media with effusion, however, this relationship requires further investigation.

Role of γ-glutamyl transferase levels in prediction of high cardiovascular risk among patients with non-alcoholic fatty liver disease.

BACKGROUND & OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is an important cause of elevated liver functions. There is evidence showing an association between NAFLD and subclinical atherosclerosis independent of traditional risk factors. We undertook this retrospective study to determine the association of Framingham cardiovascular risk scoring system with liver function tests and inflammatory markers and to find the role of liver function tests in determination of CVD risk among non-obese and non-diabetic subjects with non-alcoholic fatty liver disease. METHODS: A total of 2058 patients were included in the study. Framingham cardiovascular risk scoring was done of all patients according to the age, gender, systolic blood pressure, serum total cholesterol and HDL cholesterol levels, smoking and antihypertensive medication history. Liver function test, lipid profile, insulin, uric acid, ferritin levels, etc. were determined. RESULTS: According to the ultrasonography findings, patients were grouped as without any fatty infiltration of the liver (control group) (n=982), mild (n= 473), moderate (n=363) and severe fatty liver disease (n= 240) groups. In severe fatty liver disease group, the mean Framingham cardiovascular risk score was significantly higher than that of other groups. t0 here was a positive correlation between GGT, uric acid and ferritin levels with Framingham cardiovascular score. In multivariate analysis, high GGT levels were positively associated with high-risk disease presence (OR: 3.02, 95% CI: 2.62-3.42) compared to low GGT levels independent of the age and sex. INTERPRETATION & CONCLUSIONS: Cardiovascular disease risk increases with the presence and stage of fatty liver disease. Our findings showed a positive correlation between elevated GGT levels and Framingham cardiovascular risk scoring system among non-diabetic, non-obese adults which could be important in clinical practice. Though in normal limits, elevated GGT levels among patients with fatty liver disease should be regarded as a sign of increased cardiovascular disease risk. Larger studies are warranted to elucidate the role of GGT in prediction of cardiovascular risk.

Evaluation of the anatomical and auditory outcomes of minimally invasive cartilage myringoplasty: Our technique and experience.

The purpose of this study was to assess closure rates in tympanic membrane perforations of various dimensions using the tragal cartilage-perichondrium composite graft and its effect on hearing values and also to present our own experiences. MATERIALS AND METHODS: Sixty-one patients presenting to our clinic in 2014-2015 and diagnosed with tympanic membrane perforation were included in the study. Otomicroscopic and otoendoscopic examinations were performed preoperatively and at the 12th month postoperatively. Patients were divided into three groups depending on perforation diameter. Pure tone audiometry was performed at 500, 1000, 2000, and 4000Hz (Hz) preoperatively and at the 12th month postoperatively, air-bone values were recorded, and air-bone gap (ABG) was calculated. Surgery was performed under local anesthesia using the transcanal, push-through (transperforation) technique. Perichondrium supported by thinned cartilage graft obtained from the tragal cartilage was used for tympanic membrane repair. RESULTS: Graft acceptance levels after 12months in small, medium, and large perforations were 100%, 93.5%, and 93.75%, respectively, and 95% on average. Preoperative air-bone gap values were 18.64±9.63 decibel (dB), 22.51±9.66dB, and 28.43±11.36dB, respectively, and 23.18±11.36dB on average, while 12th month postoperative air-bone gap values were 9.14±8.27dB, 11.25±6.73dB, and 17.37±9.22dB, respectively, and 12.37±8.28dB on average. The difference between pre- and postoperative 12th month air-bone gap values was statistically significant (p<0.005). CONCLUSION: The use of thinned cartilage-supported perichondrial grafts in patients with all sizes of tympanic membrane perforation is safe and effective in terms of both anatomical healing and restoration of hearing and can represent a first-choice technique that is easy to perform and involves minimal morbidity.

Plasma nesfatin-1 levels are increased in patients with polycystic ovary syndrome.

BACKGROUND: Nesfatin-1 is a recently discovered neuropeptide derived from its precursor nucleobindin-2 (NUCB2) and has been implicated in the regulation of feeding and energy metabolism. It is located in the brain and also produced at the periphery and present in the plasma. However, its pathophysiological role in humans remains unknown. Polycystic ovary syndrome (PCOS) is commonly presented with obesity, insulin resistance, hyperandrogenemia and hirsutism. AIM: To characterize serum nesfatin-1 levels in PCOS women and determine association of nesfatin-1 with metabolic parameters. MATERIALS AND METHODS: It is a cross-sectional study of 55 PCOS and 28 healthy women matched in age, in a university hospital setting. Anthropometric, hormonal, metabolic parameters and nesfatin-1 blood levels were determined. RESULTS: Nesfatin-1 levels were significantly higher in PCOS group compared with the controls 371.43 ± 2.50 versus 275.55 ± 1.74 pg/mL. Multivariate logistic regression analysis that contains: nesfatin-1, body mass index and homeostasis model assessment index revealed significant correlation of nesfatin-1 with the existence of PCOS (p < 0.05). CONCLUSIONS: Higher nesfatin-1 levels in PCOS women compared to control group may suggest a possibility that nesfatin-1 may play some role in the PCOS.

Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity.

Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and the presence of specific tender points. The prevalence of FM has been estimated at 2-7 % of the general global population. The presence of FM in several rheumatic diseases with a structural pathology has been reported as 11-30 %. The objectives of this study were to determine the prevalence of FM and to evaluate the possible relationship between FM existence and disease activity among rheumatic diseases. The study group included 835 patients--197 rheumatoid arthritis (RA), 67 systemic lupus erythematosus (SLE), 119 ankylosing spondylitis (AS), 238 osteoarthritis (OA), 14 familial Mediterranean fever (FMF), 53 Behçet's disease (BD), 71 gout, 25 Sjögren's syndrome (SS), 20 vasculitis, 29 polymyalgia rheumatica (PMR), and two polymyositis (PM)--with or without FM. Recorded information included age, gender, laboratory parameters, presence of fatigue, and disease activity indexes. The prevalence of FM in patients with rheumatologic diseases was found to be 6.6 % for RA, 13.4 % for SLE, 12.6 % for AS, 10.1 % for OA, 5.7 % for BD, 7.1 % for FMF, 12 % for SS, 25 % for vasculitis, 1.4 % for gout, and 6.9 % for PMR. One out of two patients with PM was diagnosed with FM. Some rheumatologic cases (AS, OA) with FM were observed mostly in female patients (p = 0.000). Also, there were significant correlations between disease activity indexes and Fibromyalgia Impact Questionnaire scores for most rheumatologic patients (RA, AS, OA, and BD) (p < 0.05; respectively, r = 0.6, 0.95, 0.887, and 1). Concomitant FM is a common clinical problem in rheumatologic diseases, and its recognition is important for the optimal management of these diseases. Increased pain, physical limitations, and fatigue may be interpreted as increased activity of these diseases, and a common treatment option is the prescription of higher doses of biologic agents or corticosteroids. Considerations of the FM component in the management of rheumatologic diseases increase the likelihood of the success of the treatment.

Effect of ethinyl estradiol-cyproterone acetate treatment on asymmetric dimethyl-arginine levels in women with polycystic ovary syndrome.

PURPOSE: Our study was undertaken to evaluate the levels of asymmetric dimethyl-arginine (ADMA) in a group of patients affected with polycystic ovary syndrome (PCOS)--under ethinyl estradiol-cyproterone acetate treatment or not--as compared with a group of healthy controls. METHODS: Fifty-eight women with PCOS and 45 patients as control group were included in the study. The 58 women with PCOS were separated into two groups: Group A (n = 29) were treated with an oral contraceptive pill containing 0.035 mg of ethinyl estradiol (EE) and 2 mg of cyproterone acetate (CA) (Diane-35) for 6 months. Group B (n = 29) did not take any drug. Group C (n = 45) was healthy women as control group. Serum levels of ADMA, lipid and glucose metabolism parameters, hormone profile were measured on the sixth month of treatment. RESULTS: ADMA levels were similar in women with PCOS and controls, whereas ADMA levels significantly decreased after a period of 6 months treatment with EE + CA in women with PCOS. ADMA levels and insulin resistance were decreased with treatment. However, patients with PCOS had significantly higher total cholesterol and Low-density lipoprotein cholesterol (LDL-C) compared to controls, treatment with EE + CA did not provide any improvement on lipid parameters. CONCLUSION: Serum ADMA levels and insulin resistance were lower in PCOS group treated with EE + CA than control group.

The platelet activating factor acetyl hydrolase, oxidized low-density lipoprotein, paraoxonase 1 and arylesterase levels in treated and untreated patients with polycystic ovary syndrome.

PURPOSE: To evaluate the platelet activating factor acetyl hydrolyze (PAF-AH), oxidized low-density lipoprotein (ox-LDL), paraoxonase 1 (PON1), arylesterase (ARE) levels and the effects of metformin and Diane-35 (ethinyl oestradiol + cyproterone acetate) therapies on these parameters and to determine the PON1 polymorphisms among PCOS patients. METHODS: Ninety patients with PCOS, age 30, and body mass index-matched healthy controls were included in the study. Patients were divided into three groups: metformin treatment, Diane-35 treatment and no medication groups. The treatment with metformin or Diane-35 was continued for 6 months and all subjects were evaluated with clinical and biochemical parameters 6 months later. One-way Anova test, t test and non-parametric Mann-Whitney U tests were used for statistical analysis. RESULTS: PAF-AH and ox-LDL levels were statistically significantly higher in untreated PCOS patients than controls, and they were statistically significantly lower in patients treated with metformin or Diane-35 than untreated PCOS patients. In contrast, there were lower PON1 (not statistically significant) and ARE (statistically significant) levels in untreated PCOS patients than the control group and they significantly increased after metformin and Diane-35 treatments. In PCOS patients serum PON1 levels for QQ, QR and RR phenotypes were statistically significantly lower than the control group. CONCLUSION: In patients with PCOS, proatherogenic markers increase. The treatment of PCOS with metformin or Diane-35 had positive effects on lipid profile, increased PON1 level, which is a protector from atherosclerosis and decreased the proatherogenic PAF-AH and ox-LDL levels.

Does hormone replacement therapy have beneficial effects on renal functions in menopausal women?

BACKGROUND: The study was carried out to evaluate the possible effects of hormone replacement therapy (HRT) on renal functions in postmenopausal women. METHODS: A total of 85 postmenopausal women without a history of medical illness were enrolled in the study. They were divided into HRT users and control groups. After 30 weeks of HRT use, the changes in serum urea, creatinine, uric acid, urinary protein, urinary creatinine, urinary protein/creatinine ratio and glomerular filtration rate (GFR) (mL/min/1.73 m(2)) were evaluated. RESULTS: HRT was associated with statistically significant increases in glomerular filtration rate (p < 0.01), while serum urea, creatinine, uric acid, urinary protein, urinary creatinine and urinary protein/creatinine ratio did not change significantly in both groups. CONCLUSION: In our study, we suggested that usage of hormone replacement therapy appeared to affect renal functions in postmenopausal women. There were beneficial effects of HRT on GFR in our postmenopausal patients. HRT may have possible protective mechanisms for kidney against adverse effects of aging.

Influence of snoring on microalbuminuria in diabetic patients.

OBJECTIVE: Obstructive sleep apnea (OSA) and snoring are known independent risk factors for insulin resistance. Microalbuminuria is an early marker of diabetic nephropathy and an independent risk factor for cardiovascular disease. The aim of our study was to search the prevalence of self-reported snoring and high-risk pre-test OSA diagnosis in diabetic patients and search the influence of snoring on microalbuminuria. METHODS: A total of 237 diabetic patients (mean age, 58.6 ± 12.4 years; 126 males), were asked to complete the Berlin Questionnaire that includes questions about snoring, witnessed apnea, tiredness, history of high blood pressure and/or BMI < 30 kg/m(2). Also, their past and current medical records were reviewed for their medications, diabetic control, and complications like neuropathy, retinopathy, and microalbuminuria. RESULTS: According to the Berlin Questionnaire, a high pre-test probability for the diagnosis of OSA was found in 47.3% of the patients. Snoring was detected in 60.3% of the patients. The mean Epworth Sleepiness Scale score was 7.8 ± 4.6 and 31.6% of the patients reported excessive daytime sleepiness. We found that the both BMI and waist circumferences were significantly associated with snoring and high-risk pre-test OSA. There were no differences for age, gender, fasting glucose, HbA1c, and lipid panels between snorers and non-snorers, and between high-risk pre-test OSA and low-risk pre-test OSA patients. Microalbuminuria was significantly more common in patients who snore. Although snoring was independently associated with microalbuminuria, there were no differences between groups for other microvascular diabetic complications. CONCLUSION: Prevalence of OSA-related symptoms was very common in diabetic patients and further prospective studies are needed to elucidate the role of OSA's effect on diabetic control and complications.

Cardiac flow parameters with conventional and pulsed tissue Doppler echocardiography imaging in patients with polycystic ovary syndrome.

BACKGROUND: Polycystic ovary syndrome (PCOS) is independently associated with the major cardiovascular risk factors. The aim of this study was to examine the echocardiographic profiles of patients with PCOS using conventional echocardiographic methods and tissue Doppler imaging. METHODS: For this study, we have registered 48 women with PCOS and 21 healthy control subjects who were matched with respect to age and body mass index. Standard two-dimensional and M-mode measurement, transmitral valve flows and tissue Doppler imaging of mitral and tricuspid anulus were recorded. RESULTS: In PCOS and control groups, left ventricular and atrium diameters, ejection fraction, mitral E/A ratio, deceleration time and isovolumic relaxation time were similar. There were no significant differences between patients with PCOS and control subjects with respect to tissue Doppler profiles. CONCLUSION: Patients with PCOS execute echocardiographic measures of cardiac function that are similar to those of healthy women.

Thiol/Disulfide Balance in Patients with Familial Hypercholesterolemia.

OBJECTIVE: Herein, we investigated the balance of thiol/disulfide, with the hypothesis that the balance between disulfides and thiols, which are natural antioxidants, might be disrupted in patients with familial hypercholesterolemia, which eventually leads to endothelial damage. METHODS: In this study, we evaluated 51 patients diagnosed with familial hypercholesterolemia and 81 healthy subjects. Blood samples were taken from the patients after a minimum of 12 hours of fasting; samples were immediately centrifuged, stored in Eppendorf tubes, and preserved at -80°C. RESULTS: This study found that thiol levels are significantly lower in patients with familial hypercholesterolemia, whereas disulfide levels are higher (independent of age, gender, and body mass index). This means that in such patients, the thiol/disulfide balance changes in favour of disulfide. CONCLUSIONS: In this study, we found that the thiol/disulfide balance in patients with familial hypercholesterolemia is disrupted in favour of disulfide.

Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study).

AIMS: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. METHODS: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c < 7%, home arterial blood pressure (ABP) < 135/85 mmHg, or LDL-C < 100 mg/dL. Achieving all parameters indicated triple metabolic control. RESULTS: HbA1c levels of patients (n = 5211) were 8.6 ±â€¯1.9% (71 ±â€¯22 mmol/mol) and 7.7 ±â€¯1.7% (61 ±â€¯19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, non-smoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. CONCLUSIONS: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease.

Fibromyalgia in patients with thyroid autoimmunity: prevalence and relationship with disease activity.

Fibromyalgia (FM) is a syndrome characterised by chronic musculoskeletal pain, tenderness and other somatic symptoms. The prevalence of FM is approximately 2-7% in the general global population and is 30-40% in the population of Hashimoto thyroiditis (HT) with a structural pathology. In 2010, new classification criteria for FM were proposed, as an alternative to the American College of Rheumatology (ACR) 1990 criteria. The objectives of the present study were to identify the prevalence of FM in the HT population and evaluate the associated features by using the new diagnostic criteria. The study group included 79 consecutive patients with HT with or without FM. Recorded data included age, gender, laboratory parameters, sociodemographic features and clinical findings, presence of somatic symptoms, and disease activity indices. The prevalence of FM in patients with HT was 62%. Antithyroid peroxidase antibody (TPOAb) positivity, duration of disease, and waist circumference were significantly associated with concomitant FM (p = 0.000, p = 0.000, and p = 0.015, respectively). A strong positive correlation was noted between fibromyalgia impact questionnaire (FIQ) scores and disease duration, age, values of thyroid-stimulating hormone (TSH) and TPOAb, waist circumference and marital status. TPOAb was found to be independent of body mass index, age and TSH. Concomitant FM is a common clinical problem in HT and its recognition is important for the optimal management of the disease. The new set of diagnostic criteria for FM reinforces this situation. Consideration of the FM component in the management of HT increases the likelihood of treatment success.

Serum nesfatin-1 levels are decreased in pregnant women newly diagnosed with gestational diabetes.

OBJECTIVE: To investigate serum nesfatin-1 levels at 24-28 weeks of pregnancy in women newly diagnosed with gestational diabetes and determine the association of nesfatin-1 with several metabolic parameters. SUBJECTS AND METHODS: Forty women newly diagnosed with gestational diabetes at 24-28 weeks of pregnancy and 30 healthy pregnant women matched in age and gestational week were included in this cross-sectional study. Serum nesfatin-1 levels were analyzed using ELISA, and the relationship between nesfatin-1 and several metabolic parameters were assessed. RESULTS: Serum nesfatin-1 levels were found to be lower in women with gestational diabetes compared to the pregnant women in the control sample (p = 0.020). Multiple linear regression analysis revealed that nesfatin-1 was lower in participants with gestational diabetes independently from gestational age, BMI, HOMA-IR, fasting plasma glucose, and age. In correlation analysis, the only variable that was found to have a statistically significant correlation with nesfatin-1 was gestational age (p = 0.015, r = 0.30). CONCLUSION: Lower nesfatin-1 levels in women with gestational diabetes compared to the control group at 24-28 weeks of gestation draws attention to nesfatin-1 levels in gestational diabetes and motivates further research in this area.

A novel method for determining the relation between nasal polyposis and oxidative stress: the thiol/disulphide homeostasis.

CONCLUSION: It is thought that oxidative stress may be the major cause of the increase in the oxide thiol form in the study group. The relationship between oxidative stress status and dynamic thiol/disulphide in nasal polyposis now needs to be investigated. OBJECTIVES: The purpose of this study was to evaluate the relation between nasal polyposis and thiol/disulphide homeostasis, used as a marker of oxidative stress, by measuring that exchange using a novel technique. MATERIALS AND METHODS: The study group consisted of 40 patients (mean age = 46.75 ± 13.92 years) with bilateral nasal polyposis patients admitted to the hospital. The control group consisted of 31 (mean age = 43.20 ± 5.68 years) age, sex, and body mass index matched healthy subjects. Thiol/disulphide homeostasis concentrations were measured using a newly-developed method (Erel & Neselioglu). RESULTS: Native thiol and total thiol levels were lower in the study group compared to the control group (native thiol = 415.8 ± 69.1 µmol/L vs 448.7 ± 37.5 µmol/L, p < 0.05; total thiol = 449.02 ± 72.0 µmol/L vs 477.28 ± 44.5 µmol/L, p < 0.05, respectively). Disulphide level and the disulphide/native thiol and disulphide/total thiol ratios were higher in the study group compared to the control group (disulphide = 16.58 ± 5.04 µmol/L vs 14.28 ± 5.3 µmol/L, p < 0.05; disulphide/native thiol ratio = 4.07 ± 1.52% vs 3.14 ± 1.04%, p < 0.05, disulphide/total thiol ratio = 3.73 ± 1.23% vs 2.94 ± 0.92%, p < 0.05, respectively).

Mean platelet volume in euthyroid patients with Hashimoto's thyroiditis.

Mean platelet volume (MPV) is the measure of platelet size. MPV possibly is a simple way to estimate platelet activity. In this study, we aimed to investigate MPV levels in euthyroid Hashimoto's thyroiditis patients. Fifty-one euthyroid patients with Hashimoto's thyroiditis attending our outpatient clinic of the endocrinology department, and 51 age and BMI-matched healthy individuals were included in this study. All patients with euthyroid Hashimoto's thyroiditis were at euthyroid state. None of the study patients was subjected to levothyroxine replacement therapy. Anti-thyroid peroxidase (anti-TPO) antibody and anti-tiroglobulin antibody were positive. All the study participants were evaluated by biochemical and platelet parameters. There were no significant differences in age (33.88 ±â€Š12.87 and 30.18 ±â€Š12.43 years, respectively; P > 0.05) and BMI (23.55 ±â€Š3.34 and 22.25 ±â€Š3.65 kg/m, respectively, P > 0.05) between the study and the control groups. Anti-TPO and anti-tiroglobulin levels were significantly higher in the study group (anti-TPO 428.32 ±â€Š668.39 IU/ml in the euthyroid Hashimoto's thyroiditis group; 14.85 ±â€Š9.66 IU/ml in the control group, P = 0.001; anti-tiroglobulin 320.46 ±â€Š796.05 IU/ml in the euthyroid Hashimoto's thyroiditis group, 21.28 ±â€Š26.24 IU/ml in the control group, P = 0.09). There were no significant differences in terms of serum thyroid-stimulating hormone (TSH) (1.76 ±â€Š0.79 and 1.85 ±â€Š1.14 uIU/ml, respectively), FT3 (3.10 ±â€Š0.37 and 3.29 ±â€Š0.76 pg/ml, respectively) and FT4 (1.22 ±â€Š0.42 and 1.46 ±â€Š0.78 pg/ml, respectively) levels between the study and the control groups. Serum triglyceride levels were significantly higher in the study group than in the control group (133.81 ±â€Š91.50 and 90.18 ±â€Š41.15 mg/dl, respectively; P = 0.015). Mean MPV levels were significantly higher in the euthyroid Hashimoto's thyroiditis group than in the control patients (8.8 ±â€Š1.05 and 7.9 ±â€Š0.79 fl, respectively; P = 0.0001). To assess the correlation with MPV, a Pearson's correlation analysis was performed on each variable. There were positive correlations between anti-TPO and MPV levels (r = 0.246, P = 0.042), and between anti-tiroglobulin and MPV levels (r = 0.256, P = 0.033). The multiple regression analysis of MPV and other risk factors was performed. Age, BMI, C-reactive protein and waist circumference were independent predictive factors of MPV. Adjustment for other factors did not alter these relative risks. Our results suggest that even if in euthyroid state, patients with euthyroid Hashimoto's thyroiditis have higher MPV levels than the healthy controls. As higher MPV levels are closely related with cardiovascular diseases, euthyroid Hashimoto's thyroiditis patients have greater risk of atherothrombotic complications than controls.

How medical treatment affects mean platelet volume as a cardiovascular risk marker in polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a prevalent disease with many potential long-term metabolic and cardiovascular risks if not managed appropriately. Mean platelet volume (MPV) is a marker associated with adverse cardiovascular events. In this study, we aimed to investigate MPV levels under ethinyl estradiol/cyproterone acetate or metformin therapy for the previous 6 months in PCOS. A total of 114 individuals [metformin treatment (n = 18), ethinyl estradiol/cyproterone acetate treatment (n = 29), newly diagnosed PCOS patient with no treatment (n = 35), and control group of eumenorrheic healthy individuals (n = 32)] were included in the current study. Hematologic parameters other than MPV were similar in all groups. The MPV value was significantly higher in the newly diagnosed PCOS patients compared with the other three groups independent of age, BMI, and C-reactive protein level in multiple regression analysis (P < 0.01). The MPV value of control group was comparable to the groups under ethinyl estradiol/cyproterone acetate or metformin therapy (P = 1.0). There was no statistically significant difference in the white blood cell count among the groups. The MPV values were positively correlated with the homeostatic model assessment-insulin resistance and Ferriman-Gallwey Score (P = 0.044, r = 0.261; P = 0.037, r = 0.229, respectively). Ethinyl estradiol/cyproterone acetate and metformin similarly appear to decrease MPV, a marker of cardiovascular risk. Therefore, a possible beneficial effect of ethinyl estradiol/cyproterone acetate and metformin on long-term cardiovascular morbidities in PCOS may be suggested.

Mean platelet volume in a patient with male hypogonadotropic hypogonadism: the relationship between low testosterone, metabolic syndrome, impaired fasting glucose and cardiovascular risk.

Isolated male hypogonadotropic hypogonadism (IHH) can be congenital or acquired. Mean platelet volume (MPV), determinant of platelet function, is an independent risk factor for cardiovascular disease (CVD). The aim of this study was to evaluate MPV values in male IHH and the relationships between MPV, low testosterone levels, metabolic syndrome, impaired fasting glucose (IFG) and cardiovascular risk. Thirty-one patients with untreated, normosmic, isolated, male IHH (mean age 22.5 ± 7.58 years) and 30 age and BMI-matched healthy individuals (mean 22.51 ± 4.94 years) were included in the study. All hormonal analyses were done by chemiluminesance assay. All study participants were evaluated by biochemical and platelet parameters. MPV were significantly higher in IHH than controls (8.6 ± 0.65 and 7.6 ± 0.54 fl, respectively; P = 0.000). MPV had a positive correlation between metabolic syndrome (r = 0.444; P = 0000), IFG (r = 0.371; P = 0.04), insulin (r = 0.820; P = 0.02), homeostasis model assessment (HOMA)-IR (r = 0.822; P = 0.0023) and BMI (r = 0.373; P = 0.012). MPV had a negative correlation between total testosterone (r =  -0.586; P = 0.0000), free testosterone (r =  -0.634; P = 0.0000), luteinizing hormone (r =  -0.471; P = 0.0000) and FSH (r =  -0.434; P = 0.0000). Although control patients did not have metabolic syndrome and IFG, IHH patients had metabolic syndrome and IFG significantly more often (P < 0.001, P = 0.003, respectively). Age, metabolic syndrome, IFG, BMI, fasting glucose, insulin, CRP and HOMA-IR were independent predictive factors of MPV in the multiple regression analysis. These results suggest that men with IHH are susceptible to increased platelet activation and increased MPV values that contribute to an increased risk of cardiovascular complications. From this study, it has been observed that IHH with low testosterone may be a feature of the metabolic syndrome, IFG, increased MPV levels and cardiovascular risk in young adult males.