Evaluation of MCV/RDW Ratio and Correlations With Ferritin in Telogen Effluvium Patients.

Introduction: Telogen effluvium is one of the chronic diseases that affect the quality of life (QoL) in women. Genetic factors, vitamin deficiencies, hormonal and environmental conditions take roles in the etiology of hair loss. Objectives: The study aimed to evaluate the RDW(Red cell distribution witdh)/MCV(Mean corpuscular volume) ratio and its correlation with ferritin in Telogen Effluvium patients and to reveal their potential role in the etiopathogenesis of Telogen effluvium. Methods: We retrospectively evaluated the medical data of 250 patients who were admitted to the dermatology outpatient clinic between September 2020 and December 2020 with a diagnosis of telogen effluvium. The control group was created retrospectively from the medical records of 250 healthy individuals. HB(Hemoglobin), HCT(Hematocrit), MPV(mean platelet volume), MCV, RDW, ferritin, and MCV/RDW ratio of both groups were compared and evaluated statistically. Results: All telogen effluvium patients were women in terms of gender. The mean age of the patient group was 33.11 ± 9.66 years and the mean age of the control group was 34.98 ± 12.37 years. The ratio of MCV/RDW, MPV, MCV, and ferritin is lower in the group with telogen effluvium compared to the control group and a statistically significant difference was found (P < 0.05). Conclusions: Iron deficiency anemia is thought of as a factor in female patients with telogen effluvium. Although the data shows the correction of iron deficiency is insufficient telogen effluvium, we proposed that laboratory tests should be routinely used in the diagnosis and treatment phase of patients who apply with the complaint of hair loss.

Investigation of serum adropin levels and its relationship with hypothalamic atrophy in patients with multiple sclerosis.

OBJECTIVE: Adropin is expressed in vascular endothelial cells and regulates nitric oxide (NO) bioavailability by upregulating nitric oxide. In recent years, some studies have revealed its relationship with the pathogenesis of multiple sclerosis (MS). Our aim in this study is to determine serum adropin levels in MS patients and to investigate adropin levels's relationship with hypothalamic atrophy. METHODS: A total of 80 people, 40 of whom had MS and 40 of whom were healthy volunteers, were included in the study. Serum samples were taken from all participants. Hypothalamus and pituitary diameters were calculated from magnetic resonance imaging of MS patients. The relationship between serum adropin levels and demographic characteristics, Expanded Disability Status Scale (EDSS), and hypothalamic atrophy were evaluated. RESULTS: The levels of adropin were 848,282±139,229 ng/L in patients with MS and 2957,108±284,034 ng/L in the healthy controls. MS patients had significantly lower levels of adropin than the healthy controls (p = 0.003). Adropin has the highest diagnostic value (AUC=0.874, (95% CI, 0,800-0,947) as cut-off value (838.00), sensitivity (80.43%) and specificity (70.64%) in the MS group. In the study, serum adropin levels were not significantly correlated with 3 ventricle diameter (3VD) and pituitary diameter (PD) size (p = 0,968) and no significant relationships were determined between adropin and other clinical parameters. CONCLUSION: As a potential diagnostic marker, adropin levels were significantly lower in MS patients than in those without. Comprehensive studies are needed to verify this entity.

Investigation of serum adropin levels and its relationship with hypothalamic atrophy in patients with multiple sclerosis.

Objective Adropin is expressed in vascular endothelial cells and regulates nitric oxide (NO) bioavailability by upregulating nitric oxide. In recent years, some studies have revealed its relationship with the pathogenesis of multiple sclerosis (MS). Our aim in this study is to determine serum adropin levels in MS patients and to investigate adropin levels's relationship with hypothalamic atrophy. Methods A total of 80 people, 40 of whom had MS and 40 of whom were healthy volunteers, were included in the study. Serum samples were taken from all participants. Hypothalamus and pituitary diameters were calculated from magnetic resonance imaging of MS patients. The relationship between serum adropin levels and demographic characteristics, Expanded Disability Status Scale (EDSS), and hypothalamic atrophy were evaluated. Results The levels of adropin were 0.85±0.14 ng/mL in patients with MS and 2.96 ng/mL±0.285 ng/mL in the healthy controls. MS patients had significantly lower levels of adropin than the healthy controls (p = 0.003). Adropin has the highest diagnostic value (AUC=0.874, (95% CI, 0,800-0,947) as cut-off value (838.00), sensitivity (80.43%) and specificity (70.64%) in the MS group. In the study, serum adropin levels were not significantly correlated with 3 ventricle diameter (3VD) and pituitary diameter (PD) size (p = 0,968) and no significant relationships were determined between adropin and other clinical parameters. Conclusion As a potential diagnostic marker, adropin levels were significantly lower in MS patients than in those without. Comprehensive studies are needed to verify this entity.

Possible roles of sestrin2 in multiple sclerosis and its relationships with clinical outcomes / Possíveis papéis da sestrina2 na esclerose múltipla e suas relações com resultados clínicos

ABSTRACT Background: Characterized by demyelination, inflammation and axonal damage, multiple sclerosis (MS) is one of the most common disorders of central nervous system led by the immune system. There is an urgent and obvious need for biomarkers for the diagnosis and follow-up of MS. Objective: To investigate serum levels of sestrin2 (SESN2), a protein that responds to acute stress, in MS patients. Methods: A total of 85 participants, 40 patients diagnosed previously with relapsing-remitting MS and 45 healthy controls, were included. Serum SESN2 parameters were investigated in blood samples drawn from each participant in the patient and control groups. Results: SESN2 levels were significantly lower in MS patients than in controls (z: -3.06; p=0.002). In the ROC analysis of SESN2, the predictive level for MS was 2.36 ng/mL [sensitivity, 72.50%; specificity, 55.56%; p=0.002; area under the curve (AUC)=0.693]. For the cut-off value in both groups, SESN2 was an independent predictor for MS [Exp (B)=3.977, 95% confidence interval (95%CI) 1.507-10.494 and p=0.013]. Conclusions: The decreased expression of SESN2 may play a role in MS pathogenesis, and SESN2 could be used as a biomarker for MS and as immunotherapeutic agent to treat MS.

RESUMO Antecedentes: Caracterizada por desmielinização, inflamação e dano axonal, a esclerose múltipla (EM) é uma das doenças mais comuns do sistema nervoso central liderada pelo sistema imunológico. Há uma necessidade urgente e óbvia de biomarcadores para o diagnóstico e acompanhamento da EM. Objetivo: Investigar os níveis séricos de sestrina2 (SESN2), uma proteína que responde ao estresse agudo, em pacientes com EM. Métodos: Foram incluídos 85 participantes, 40 pacientes com diagnóstico prévio de EM recorrente-remitente e 45 controles saudáveis. Os parâmetros do SESN2 sérico foram investigados em amostras de sangue coletadas de cada participante nos grupos de paciente e controle. Resultados: os níveis de SESN2 foram significativamente mais baixos em pacientes com EM do que em controles (z: -3,06; p=0,002). Na análise ROC do SESN2, o nível preditivo para MS foi 2,36 ng/mL [sensibilidade, 72,50%; especificidade, 55,56%; p=0,002; área sob a curva (AUC)=0,693]. Para o valor de corte em ambos os grupos, SESN2 foi um preditor independente para MS [Exp (B)=3,977, intervalo de confiança de 95% (95%CI) 1,507-10,494; p=0,013]. Conclusões: A expressão diminuída de SESN2 pode desempenhar um papel na patogênese da EM, e SESN2 poderia ser usado como um biomarcador para EM e como agente imunoterapêutico para o tratamento de EM.

Serum levels of irisin and nesfatin-1 in multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is an inflammatory and neurodegenerative autoimmune chronic neurological disease. Currently, there are no effective serum biomarkers to verify MS diagnosis, to assess disease prognosis, and evaluate response to MS treatment. OBJECTIVE: The present study is a preliminary assessment of irisin and nesfatin-1 serum levels in patients with relapsing- remitting MS (RRMS). METHODS: A total of 86 participants, 42 patients with RRMS diagnosis and 44 healthy controls were included in the study. The serum irisin and nesfatin-1 parameters of the patients and control group members were analyzed. RESULTS: Irisin and nesfatin-1 levels of the RRMS patients were significantly lower than the controls (z: -3.82, p<0.001; z: -4.79, p<0.001, respectively) The cut-off level of irisin is 10.390 (ng/mL) (sensitivity: 84.1%, specificity: 71.4%, AUC: 0.800), and the cut-off level of nestatin-1 is 7.155 (ng/mL) (sensitivity: 68.2%, specificity: 64.3%, AUC: 0.739) in the ROC analysis. For these cut-off levels in the case-control groups, the lower irisin and nesfatin-1 levels are the independent variables for MS patients (OR 9.723, 95%CI 2.884-32.785, p<0.001; OR 3.992, 95%CI 1.336-11.928, p<0.001) respectively. CONCLUSION: The present study revealed lower irisin and nesfatin-1 levels in patients with RRMS. These findings suggest that the decreased levels of irisin and nesfatin-1 peptides may contribute to MS pathogenesis such as inflammation, oxidative stress, and apoptosis in MS, leading to demyelination, axonal damage with neuronal loss, and gliosis.

Possible roles of sestrin2 in multiple sclerosis and its relationships with clinical outcomes.

BACKGROUND: Characterized by demyelination, inflammation and axonal damage, multiple sclerosis (MS) is one of the most common disorders of central nervous system led by the immune system. There is an urgent and obvious need for biomarkers for the diagnosis and follow-up of MS. OBJECTIVE: To investigate serum levels of sestrin2 (SESN2), a protein that responds to acute stress, in MS patients. METHODS: A total of 85 participants, 40 patients diagnosed previously with relapsing-remitting MS and 45 healthy controls, were included. Serum SESN2 parameters were investigated in blood samples drawn from each participant in the patient and control groups. RESULTS: SESN2 levels were significantly lower in MS patients than in controls (z: -3.06; p=0.002). In the ROC analysis of SESN2, the predictive level for MS was 2.36 ng/mL [sensitivity, 72.50%; specificity, 55.56%; p=0.002; area under the curve (AUC)=0.693]. For the cut-off value in both groups, SESN2 was an independent predictor for MS [Exp (B)=3.977, 95% confidence interval (95%CI) 1.507-10.494 and p=0.013]. CONCLUSIONS: The decreased expression of SESN2 may play a role in MS pathogenesis, and SESN2 could be used as a biomarker for MS and as immunotherapeutic agent to treat MS.

Evaluation of the association between platelet tests and thyroid-stimulating hormone levels in patients with vitiligo.

OBJECTIVE: Vitiligo is a common dermatological disease of unknown cause and progressing with depigmentation and affects approximately 1% of the world population. In the study, we aimed to compare plateletcrit (PCT), mean platelet volume (MPV), platelet (PLT), and thyroid-stimulating hormone (TSH) values in vitiligo patients. MATERIAL AND METHODS: We retrospectively evaluated the medical data of 100 patients who were admitted to the dermatology outpatient clinic between January 2020 and December 2021 with a diagnosis of vitiligo. The control group was retrospectively constituted from medical records of 90 healthy individuals. PCT, MPV, PLT, and TSH levels of both groups were compared statistically. RESULTS: A total of 190 participants (100 vitiligo patients and 90 healthy volunteers) were included in the study. The mean age of the patient group was 38.62 ± 1.62, while the mean age of the control group was 41.52 ± 1.54. There were no differences between the two groups in terms of age and gender. It was found that the mean MPV value in the patient group was lower than the control group (p = 0.00). PLT and PCT values were significantly higher in the patient group than the control group (p = 0.00, p = 0.01, respectively). There was no statistically significant difference between the two groups in terms of TSH (p > 0.05). A negative correlation between MPV and PLT values in the patient group (r = -0.218, p = 0.029), and a negative correlation between MPV and TSH (r = -0.218, p = 0.029), (-0.230, p = 0.021). CONCLUSION: In the study, a comparison of the PCT, MPV, and PLT levels showed a difference between both groups, but no differences in TSH levels. To clarify these results, comprehensive studies with more samples are needed.

Elevated survivin levels in patients with acne vulgaris.

OBJECTIVE: Acne vulgaris is a multifactorial disease of the pilosebaceous unit. As the most common skin disease, it may affect approximately 85% of the young population. Survivin, a member of the inhibitors of the apoptosis (IAP) gene family, can inhibit apoptosis and regulate cell division and proliferation. In the study, we aimed to investigate the potential role of serum survivin in acne vulgaris. METHODS: Forty individuals who were diagnosed with acne vulgaris and forty healthy subjects as the control group were enrolled in the study. Venous blood samples were collected from each participant, and the serum levels of survivin were measured by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using SPSS software version 25. RESULTS: The serum survivin levels were statistically significant between the groups, and the levels of survivin were measured as acne vulgaris patients group 153.44 and control group 104.17 pg/ml, respectively (p < 0.018). When the serum survivin levels were compared according to gender, females had higher levels of survivin than the males (168.16 versus 50.45 pg/mL, p = 0.001). A significant correlation was found between acne severity (p = 0.017) and Scale for Acne Scar severity (SCAR-S) score (p = 0.001) according to the survivin levels. In terms of age, no significant relationship was found between age and survivin (p = 0.4048). CONCLUSION: Elevated serum levels of survivin were determined in acne vulgaris. Moreover, there was a significant correlation between acne stage and SCAR-S score according to survivin levels.

Elevated levels of neopterin and pentraxin 3 in patients with rheumatoid arthritis.

OBJECTIVES: As a systemic inflammatory disease, rheumatoid arthritis (RA) is the most common inflammatory arthritis in the population and there is no specific diagnostic marker in laboratory tests. The purpose of the study was to determine whether serum neopterin and pentraxin 3 (PTX3) levels may be a marker of increased inflammation in RA patients. MATERIALS AND METHODS: The study were consist of 30 RA patients and 30 healthy controls who were admitted to the department of rheumatology. Blood specimens were taken from both group, and the levels of neopterin were analyzed by chromatography method (HPLC) and the PTX 3 levels were measured by enzyme-linked immunosorbent assay (ELISA). All data and demographic characteristics of participants were also recorded. RESULTS: Serum neopterin and PTX 3 levels of the patient group (25.99 ± 7.24 ng/mL and 4.19 ± 1.01 ng/dL, respectively) was higher than the control group (9.55 ± 0.74 ng/mL and 2.23 ± 0.39 ng/dL, respectively). These results were remarkable significant (p<0.01). No statistically significant correlation was found between age-PTX 3, age-neopterin and PTX 3-neopterin parameters in the patient group. In the control group, a significant negative correlation was found between age and PTX 3 (p<0.05), and a positive correlation between neopterin and PTX 3. CONCLUSIONS: Consequently, the serum neopterin and PTX 3 levels were higher in RA patients as compared to the healthy individuals. Our study suggest that there is a relation between neopterin and PTX 3 levels with RA patients. These findings suggest that neopterin and PTX 3 are important markers in the monitoring of RA disease.

Evaluation of diagnostic performance of haematological parameters in Behçet's disease.

OBJECTIVE: Behçet's Disease (BD) is a polygenic and chronic autoinflammatory multisystemic vasculitis disease characterised by mucocutaneous, musculoskeletal, neurological, gastrointestinal and ophthalmologic lesions. There has been no specific test or serum marker to measure and determine the diagnosis and severity of BD. PURPOSE: The study aimed to investigate the diagnostic performance of haematological parameters as MLR (monocyte to lymphocyte ratio), NLR (neutrophil to lymphocyte ratio), PLR (platelet to lymphocyte ratio), MPV (mean platelet volume), MPVPR (mean platelet volume to platelet ratio), LMR (lymphocyte to monocyte ratio), LPM (lymphocyte and platelet multiplication), WLP (lymphocyte and leukocyte multiplication), RDW (red blood cell distribution width) and PCT (plateletcrit) in BD and compare these with disease activity and clinical findings. METHODS: A total of 266 participants (49 healthy control and 217 BD patients) were recruited from the rheumatology department in a single-centre as a case-control study. The laboratory data were obtained from the electronic registration database. BD Activity scores (BDCAF/Behcet's Disease Current Activity Form) were calculated. Laboratory findings of BD patients and healthy controls were compared and evaluated. RESULTS: RDW, Platelet, PCT, NLR and PLR values were significantly higher in patient group than in the healthy controls. However, haemoglobin, MPVPR and LMR were significantly lower in the patient group which compared with the healthy controls. LPM in BD with genital ulcers, WLP in BD with genital ulcers and arthritis, MPR in BD with uveitis, RDW in BD with thrombosis and neuro-Behçet's disease (NBD), PLR in NBD were observed to be higher. However, LMR in NBD and MPV in BD with thrombosis were lower than those without. There was a positive correlation between BDCAF score and RDW, and NLR. CONCLUSION: Haemoglobin, RDW, Platelet, PCT, NLR, LMR, PLR and MPVPR were statistically significant predictors for BD. RDW, PCT and NLR are the most valuable predictors for BD.

Evaluation of serum interleukin-6 (IL-6), IL-13, and IL-17 levels and computed tomography finding in interstitial lung disease associated with connective tissue disease patients.

OBJECTIVE: Interstitial lung disease (ILD) is one of the most severe complications which is associated with connective tissue disease (CTD) and causes to morbidity and mortality. So, we aimed to determine serum levels of interleukin-6 (IL-6), IL-13, and IL-17, to investigate whether these cytokines are related to CTD-ILD, and to find their possible contribution to determining the prognosis of the disease. METHODS: A total of 150 participants, 80 patients diagnosed with CTD-ILD (mean age, 58.21 ± 12.36) and 70 healthy controls (mean age, 57.07 ± 9.60) were recruited from the rheumatology department between January 2016 and June 2019 in the study. High-resolution computed tomography (HRCT) findings were scored as similarly to previous studies. Serum IL-6, IL 13, and IL-17 levels were measured by ELISA test kits. RESULTS: The levels of IL-6, IL-13, and IL-17 in CTD patients were significantly higher than the healthy individuals (p < 001), but the HRCT score's relation were not determined. IL-6 was associated with disease duration and disease activity scores of DAS28, ESDAII, and dSSc. There was a significant relation between dSSc, HCRT fibrosis, and total score.CRP, hemoglobin, and platelets were associated with the HRCT inflammation pattern. CONCLUSION: At the study, it has been observed that serum IL-13, IL-6 and IL-17 levels are increased in patients with CTD-ILD. Besides, IL-6 was associated with disease activity scores of DAS28, ESDAII, and dSSc. Also, HRCT fibrosis score is associated with dSSc. Further and comprehensive studies are needed to understand better the complex intersection of lung disease with systemic autoimmunity. Key Points • Serum IL-13, IL-6, and IL-17 levels are increased in patients with CTD-ILD. • IL-6 was associated with disease activity scores of DAS28, ESDAII, and diffuse skin involvement. • HRCT fibrosis score is associated with diffuse skin involvement in patients with SSc-ILD. • HRCT inflammation score is associated with PAH.

Is there a relation between serum methylarginine levels and infertility?

OBJECTIVES: Infertility is defined as the absence of pregnancy within the reproductive period despite regular sexual intercourse. Methylarginines are formed as a result of methylation of arginine residues in proteins and formed in three forms as asymmetric dimethyl arginine (ADMA), symmetrical dimethyl arginine (SDMA) and monomethylarginine (L-NMMA). So, here, we aimed to evaluate arginine and their derivatives levels in fertile and infertile individuals. METHODS: Present study were consist of 30 oligozoospermia patients (proven by spermiogram analysis) and 30 healthy individuals with normozoospermia group who were applied to the urology department. With blood samples taken from individuals, serum methylarginine and its derivatives levels were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Clinic data and demographic characteristics of individuals were also recorded at the same time. RESULTS: The serum ADMA level (0.38 ± 0.07) of the oligozoospermia group was found to be significantly higher than the normozoospermia group (0.35 ± 0.05) (p=0.046). A positive correlation were observed between ADMA and SDMA (r=0.686, p=0.000), HArg and SDMA (r=0.611, p=0.001), citrulline and L-NMMA (r=0.595, p=0.001) in patients with oligosospermia. The increase in SDMA, arginine and HArg levels and a decrease in L-NMMA and citrulline levels were not significant as statistically. Also, the ADMA level was found to be high in individuals with low sperm concentration. CONCLUSIONS: Consequently, serum ADMA levels of individuals with oligozoospermia were statistically significantly higher than those with normozoospermia. As proposal, determination of ADMA levels may be a potential biomarker parameter in terms of early diagnosis of fertility and infertility.

Cystatin C as a potential biomarker to evaluate migraine.

BACKGROUND: Migraine is a multifactorial neurovascular syndrome and closely associated to inflammation. Cystatin C (Cys C) is a neuroendocrine polypeptide which also plays a role in inflammation. Objective: To investigate the levels of Cys C in migraine patients without aura. METHODS: A total of 80 participants were included in the study; 40 patients and 40 healthy controls. Serum Cys C levels were investigated by using enzyme-linked immunosorbent assay (ELISA). Statistical analysis were performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (SPSS Inc, IL, USA). RESULTS: Serum Cys C levels were found as 73.88 ng/mL in the patient group and 24.92 ng/mL in the healthy control group, being significantly higher among patients (p=0.000). Serum Cys C levels were significacntly different across age subgroups among patients (p=0.049), but not among controls. However, visual analog scale (VAS) (p=0.707), disease duration time (p=0.725) and body mass index (p=0.136) were not significantly different between the two groups. CONCLUSION: Our findings demonstrate that high serum Cys C levels are independently associated to migraine without aura. To the best of our knowledge, this is the first study to determine the serum levels of Cys C in patients with migraine. Thus, serum Cys C may be a potential biomarker of migraine.

Cystatin C as a potential biomarker to evaluate migraine / Cistatina C como potencial biomarcador para avaliação de enxaqueca

ABSTRACT Background: Migraine is a multifactorial neurovascular syndrome and closely associated to inflammation. Cystatin C (Cys C) is a neuroendocrine polypeptide which also plays a role in inflammation. Objective: To investigate the levels of Cys C in migraine patients without aura. Methods: A total of 80 participants were included in the study; 40 patients and 40 healthy controls. Serum Cys C levels were investigated by using enzyme-linked immunosorbent assay (ELISA). Statistical analysis were performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (SPSS Inc, IL, USA). Results: Serum Cys C levels were found as 73.88 ng/mL in the patient group and 24.92 ng/mL in the healthy control group, being significantly higher among patients (p=0.000). Serum Cys C levels were significacntly different across age subgroups among patients (p=0.049), but not among controls. However, visual analog scale (VAS) (p=0.707), disease duration time (p=0.725) and body mass index (p=0.136) were not significantly different between the two groups. Conclusion: Our findings demonstrate that high serum Cys C levels are independently associated to migraine without aura. To the best of our knowledge, this is the first study to determine the serum levels of Cys C in patients with migraine. Thus, serum Cys C may be a potential biomarker of migraine.

RESUMO Introdução: A enxaqueca é uma síndrome neurovascular multifatorial e está intimamente associada à inflamação. A cistatina C (Cys C) é um polipeptídeo neuroendócrino que também desempenha papel importante na inflamação. Objetivo: Investigar os níveis de Cys C em pacientes com enxaqueca sem aura. Métodos: Foram incluídos no estudo 80 participantes; 40 pacientes e 40 controles saudáveis. Os níveis séricos de Cys C foram investigados usando o ensaio de imunoabsorção ligado à enzima (enzyme-linked immunosorbent assay - ELISA). A análise estatística foi realizada utilizando o Statistical Package for the Social Sciences (SPSS), versão 22.0 (SPSS Inc, IL, EUA). Resultados: Em nosso estudo, os níveis séricos de Cys C foram encontrados em 73,88 ng/mL no grupo de pacientes e 24,92 no grupo de controle saudável, sendo os níveis significativamente maiores nos pacientes (p=0,000). Os níveis séricos de Cys C foram significativamente diferentes entre faixas etárias no grupo de pacientes (p=0,049). No entanto, a escala visual analógica (EVA) (p=0,707), o tempo de duração da doença (p=0,725) e o índice de massa corporal (p=0,136) não foram significativamente diferentes entre os dois grupos. Conclusão: Nossos achados demonstram que altos níveis séricos de Cys C estão independentemente associados à enxaqueca sem aura. Até onde sabemos, este é o primeiro estudo a determinar os níveis séricos de Cys C em pacientes com enxaqueca e os resultados sugerem que o Cys C sérico pode ser um potencial biomarcador nessa condição clínica.