The relationship between dietary salt intake and ambulatory blood pressure variability in non-diabetic hypertensive patients / Relación entre el consumo de sal y la variabilidad de la presión arterial ambulatoria en pacientes hipertensos no diabéticos

High dietary salt intake was reported to increase blood pressure by numerous studies, but no study has investigated the effect of dietary salt intake on blood pressure variability (BPV). This study aimed to determine if daily salt intake is related to ambulatory BPV. The study included 136 primary hypertensive patients (92 male, 44 female) with a mean age of 50.7±11.1 years. All the patients underwent 24-h ambulatory blood pressure monitoring to determine both the 24-h systolic and 24-h diastolic BPV. 24-h urine sodium was measured. The correlation between BPV and 24-h urinary sodium was investigated. Logarithmic transformation of 24-h urinary sodium [log(24-h urinary sodium)] was positively correlated with the mean 24-h systolic ARV, and nighttime systolic ARV (r=0.371 and p=0.001, r=0.329 and p=0.028, respectively). Similarly, log(24-h urinary sodium) was positively correlated with mean 24-h diastolic ARV and nighttime diastolic ARV (r=0.381 and p=0.001, r=0.320 and p=0.020 respectively). Log(24-h urinary sodium) was an independent predictor of BPV based on multivariate regression analysis. Dietary salt intake might play a role in the pathogenesis of ambulatory BPV (AU)

En numerosos estudios se ha señalado que el consumo elevado de sal aumenta la presión arterial; no obstante, no se ha investigado el efecto de la ingesta alimenticia de sal sobre la variabilidad de la presión arterial (VPA). El objetivo de este estudio fue determinar si el consumo diario de sal está relacionado con la VPA ambulatoria. En el estudio se incluyeron 136 pacientes hipertensos esenciales (92 hombres y 44 mujeres) con una edad media de 50,7±11,1años. Todos los pacientes se sometieron a una monitorización ambulatoria de la presión arterial de 24h para determinar la VPA sistólica y diastólica de 24h. Se midió la natriuria de 24h y se estudió la correlación de la misma con la VPA. La transformación logarítmica de la natriuria de 24h (log [natriuria 24h]) se relacionó con certeza con el índice Average Real Variability (ARV) sistólico de 24h y el ARV sistólico nocturno medios (r=0,371 y p=0,001, r=0,329 y p=0,028, respectivamente). De forma parecida, el log [natriuria 24h] se relacionó con seguridad con el ARV diastólico de 24h y el ARV diastólico nocturno medios (r=0,381 y p=0,001, r=0,320 y p=0,020, respectivamente). El log [natriuria 24h] fue una variable independiente de la VPA, según el análisis de regresión multivariante. Es posible que el consumo de sal intervenga en la patogénesis de la VPA ambulatoria (AU)

The relation between serum cathepsin D level and carotid intima-media thickness in nondiabetic hypertensive patients.

BACKGROUND/AIM: We aimed to investigate the relation between carotid intima-media thickness (CIMT) and serum cathepsin D level in hypertensive patients. MATERIALS AND METHODS: This was a cross-sectional study of 74 hypertensive patients (22 males and 52 females, with a mean age of 51.86 ± 11.75 years). Serum levels of cathepsin D were measured with an enzyme-linked immunosorbent assay. CIMT measurements were taken from 3 different points: right and left common carotid arteries, bifurcation, and the first 2 cm of the internal carotid artery. Mean CIMT was calculated by averaging the measurements taken 3 times from each carotid artery. RESULTS: Mean CIMT value was 0.76 ± 0.15 mm, and median cathepsin D level was 190.3 (12.8-2681.3) ng/mL. A marked positive correlation was found between cathepsin D levels and CIMT (r = 0.331, P = 0.04). In multivariate linear regression analysis, cathepsin D, albumin levels, and the duration of hypertension were significant predictors of CIMT (P = 0.017, P = 0.008, and P = 0.043, respectively). CONCLUSIONS: Increased serum cathepsin D level was found to be associated with CIMT in nondiabetic hypertensive patients.

The relationship between dietary salt intake and ambulatory blood pressure variability in non-diabetic hypertensive patients.

High dietary salt intake was reported to increase blood pressure by numerous studies, but no study has investigated the effect of dietary salt intake on blood pressure variability (BPV). This study aimed to determine if daily salt intake is related to ambulatory BPV. The study included 136 primary hypertensive patients (92 male, 44 female) with a mean age of 50.7±11.1 years. All the patients underwent 24-h ambulatory blood pressure monitoring to determine both the 24-h systolic and 24-h diastolic BPV. 24-h urine sodium was measured. The correlation between BPV and 24-h urinary sodium was investigated. Logarithmic transformation of 24-h urinary sodium [log(24-h urinary sodium)] was positively correlated with the mean 24-h systolic ARV, and nighttime systolic ARV (r=0.371 and p=0.001, r=0.329 and p=0.028, respectively). Similarly, log(24-h urinary sodium) was positively correlated with mean 24-h diastolic ARV and nighttime diastolic ARV (r=0.381 and p=0.001, r=0.320 and p=0.020 respectively). Log(24-h urinary sodium) was an independent predictor of BPV based on multivariate regression analysis. Dietary salt intake might play a role in the pathogenesis of ambulatory BPV.

Unknown aspect of the old disease: does dyslipidemia in systemic AA amyloidosis differ from the dyslipidemia in primary glomerulonephritis?

AIM: To investigate the nature of dyslipidemia and its diversity in patients with systemic AA amyloidosis. METHODS: The reports of the kidney biopsies performed due to nephrotic proteinuria (>3.5 g/day/1.73 m(2)) with preserved renal function [glomerular filtration rate (GFR) >60 mL/min/1.73 m(2)] were reviewed. Clinical and laboratory data of the patients with systemic AA amyloidosis and primary glomerulonephritis (PG) were analyzed. RESULTS: A total of 104 (systemic AA amyloidosis: 43, PG: 61) patients were included in the study. Proteinuria and GFR levels were similar in both the groups. Patients with systemic AA amyloidosis group had lower serum albumin (p = 0.002), lower hemoglobin levels (p = 0.001), higher platelet counts (p = 0.002) and higher C-reactive protein levels (p = 0.001) compared to patients in PG group. Although the frequency of dyslipidemia was similar in the groups (86.0 vs. 93.4%), patients with systemic amyloidosis had both lower values of LDL-C (4.56 ± 2.05 vs. 5.49 ± 2.23 mmol/L, p = 0.028) and HDL-C (1.19 ± 0.36 vs. 1.35 ± 0.39 mmol/L, p = 0.035). Serum lipid levels were correlated with serum total protein, albumin and proteinuria levels in PG group. However, in the systemic amyloidosis group, only one clear correlation between serum lipid and hemoglobin levels was estimated. A multivariate analysis demonstrated that LDL-C was independently associated with the etiology of nephrotic proteinuria, serum total protein, serum albumin (inversely) and hemoglobin levels. CONCLUSIONS: Although dyslipidemia is closely associated with serum total protein, albumin and proteinuria in patients with PG, there is no clear such association in patients with systemic amyloidosis. Correlation between serum lipid and hemoglobin levels in this group and other findings point out that probably complex mechanisms take place in dyslipidemia of nephrotic syndrome caused by systemic AA amyloidosis.

Relation between serum cathepsin D levels and endothelial dysfunction in patients with chronic kidney disease

We aimed to investigate the role of cathepsin D, an inflammatory and atherosclerotic mediator, in endothelial dysfunction in chronic kidney disease. The study included 65 patients with stage 2–4 chronic kidney disease (35 females, 30 males; mean age, 55.8±15.6 years). Serum creatinine and cathepsin D levels and glomerular filtration rates (GFRs) were determined, and brachial flow-mediated dilation (FMD) percentage was measured by two-dimensional gray scale and color flow Doppler and vascular imaging. FMD ≤6% was considered to indicate endothelial dysfunction. Mean GFR, median creatinine levels, and median cathepsin D levels were 40.2±11.2mL/min/1.73m2, 1.7mg/dL, and 819.75ng/mL, respectively. Endothelial dysfunction was present in 30 of the 65 patients (46.2%). There was a significant difference between groups with and without endothelial dysfunction in terms of cathepsin D (p=0.001) and creatinine (p=0.03) levels, and negative and significant correlations were found between brachial artery FMD% and cathepsin D (r=−0.359, p=0.003) and creatinine (r=−0.304, p=0.014) levels. Cathepsin D, which is known to be associated with atherosclerosis, may play a role in the process of endothelial dysfunction. Further studies are essential to determine the exact function of cathepsin D in endothelial dysfunction in chronic kidney disease and to determine its value as a tool for early diagnosis and target for treatment of cardiovascular diseases in patients with chronic kidney disease (AU)

Este estudio se llevó a cabo con el objetivo de investigar el papel de la catepsina D, un mediador inflamatorio y aterosclerótico de la disfunción endotelial en la enfermedad renal crónica. En él, se incluyó a 65 pacientes con enfermedad renal crónica en los estadios 2-4 (35 mujeres y 30 hombres con una media de edad de 55,8 ± 15,6 años). Se calcularon los niveles séricos de creatinina y catepsina D así como la tasa de filtrado glomerular (TFG) y se midió el porcentaje de dilatación mediada por flujo (DMF) de la arteria braquial mediante angiografía y ecografía doppler bidimensional en color y en escala de grises. Se consideró que una DMF de ≤6% era indicativa de disfunción endotelial. La TFG media, la mediana de los niveles de creatinina y la mediana de los niveles de catepsina D fueron, respectivamente, 40,2 ± 11,2 mL/min/1,73 m2; 1,7 mg/dL; y 819,75 ng/mL. La disfunción endotelial afectaba a 30 de los 65 pacientes (46,2%). Entre los grupos con y sin disfunción endotelial, se observó una diferencia significativa en los niveles de catepsina D (p = 0,001) y creatinina (p = 0,03) así como correlaciones significativas y negativas entre el porcentaje de DMF de la arteria braquial y los niveles de catepsina D (r = -0,359, p = 0,003) y creatinina (r = -0,304, p = 0,014). La catepsina D, que se asocia a la aterosclerosis, tiene un papel importante en el proceso de disfunción endotelial. Es fundamental que se realicen otros estudios que puedan determinar la función exacta de la catepsina D en la disfunción endotelial y su valor como herramienta de diagnóstico temprano y como diana del tratamiento de enfermedades cardiovasculares en pacientes con enfermedad renal crónica (AU)

Relation between serum cathepsin D levels and endothelial dysfunction in patients with chronic kidney disease.

We aimed to investigate the role of cathepsin D, an inflammatory and atherosclerotic mediator, in endothelial dysfunction in chronic kidney disease. The study included 65 patients with stage 2–4 chronic kidney disease (35 females, 30 males; mean age, 55.8±15.6 years). Serum creatinine and cathepsin D levels and glomerular filtration rates (GFRs) were determined, and brachial flow-mediated dilation (FMD) percentage was measured by two-dimensional gray scale and color flow Doppler and vascular imaging. FMD ≤6% was considered to indicate endothelial dysfunction. Mean GFR, median creatinine levels, and median cathepsin D levels were 40.2±11.2mL/min/1.73m2, 1.7mg/dL, and 819.75ng/mL, respectively. Endothelial dysfunction was present in 30 of the 65 patients (46.2%). There was a significant difference between groups with and without endothelial dysfunction in terms of cathepsin D (p=0.001) and creatinine (p=0.03) levels, and negative and significant correlations were found between brachial artery FMD% and cathepsin D (r=−0.359, p=0.003) and creatinine (r=−0.304, p=0.014) levels. Cathepsin D, which is known to be associated with atherosclerosis, may play a role in the process of endothelial dysfunction. Further studies are essential to determine the exact function of cathepsin D in endothelial dysfunction in chronic kidney disease and to determine its value as a tool for early diagnosis and target for treatment of cardiovascular diseases in patients with chronic kidney disease.

The relationship between asymptomatic organ damage, and serum soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and Interleukin-17A (IL-17A) levels in non-diabetic hypertensive patients.

BACKGROUND: This study aimed to measure the serum soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and interleukin-17A (IL-17A) levels in hypertensive patients with/without asymptomatic organ damage (AOD), as well as to determine the relationship between the serum sTWEAK and IL17-A levels, and carotid intima media thickness (CIMT), proteinuria, retinopathy, and the left ventricle mass index (LVMI). METHODS: The study included 159 patients diagnosed with and followed-up for primary hypertension (HT); 79 of the patients had AOD (61 female and 18 male) and 80 did not (52 female and 28 male). sTWEAK and IL-17A levels were measured in all patients. RESULTS: The sTWEAK level was significantly lower in the patients with AOD than in those without AOD (858.4 pg/mL vs. 1151.58 pg/mL, P = 0.001). The sTWEAK level was negatively correlated with the mean microalbuminuria level and LVMI. The median IL-17A level was significantly higher in the patients with AOD than in those without AOD (2.34 pg/mL vs. 1.80 pg/mL, P = 0.001). There was a positive correlation between mean IL-17A level, and mean microalbuminuria level, CIMT, and LVMI. Multivariate logistic regression analysis showed that patient age, sTWEAK level, and mean 24-h systolic blood pressure were predictors of AOD. CONCLUSIONS: The sTWEAK level was lower and IL-17A level was higher in the patients with AOD. It remains unknown if sTWEAK and IL-17A play a role in the pathophysiology of AOD. Prospective observational studies are needed to determine the precise role of sTWEAK and IL-17A in the development of target organ damage.

Evaluation of the mean platelet volume in secondary amyloidosis due to familial Mediterranean fever.

Familial Mediterranean fever (FMF) is an inflammatory disorder that is leading cause of secondary amyloidosis (AA). This study was designed to investigate the level of mean platelet volume (MPV) in AA. Seventy-four FMF, 29 AA patients and 180 healthy controls, were included. There was no significant difference between the cases in terms of sex and age. MPV levels were measured in all groups. In the FMF group, MPV level was significantly higher when compared to the control group. MPV level was significantly lower in AA group in comparison with the FMF and healthy control groups. In summary, our present study showed low MPV values in AA due to FMF.