Vertebrobasilar insufficiency and gamma-glutamyltransferase: An emerging relationship demonstrating inflammation and atherosclerosis.

OBJECTIVES: Vertebrobasilar insufficiency (VBI) is a pathology arising from the reduction in flow rate of vertebral arteries and mainly caused by inflammation and atherosclerosis. Gamma-glutamyltransferase (GGT) is a marker which has been recently recognized as a marker of inflammation and atherosclerosis. We aimed to investigate the relationship between GGT levels and VBI for the first time. METHODS: In this cross-sectional study, of 3100 subjects who had vertebrobasilar doppler ultrasonography (VBU) were evaluated and 1042 of them who met the inclusion criterias were included. VBU reports, GGT levels, blood chemistry, lipid profile were received from patients' files. Patients were evaluated according to VBU measurements and divided into two groups,VBI and non-VBI. RESULTS: Mean vertebral arterial blood flow volume values were 149.99±32.93 mL/m in VBI group and 286.88 ± 70.98 mL/m in non-VBI group. Mean GGT and CRP values were significantly higher in the VBI group than in the non-VBY group (p < 0.001) ( p < 0.001), respectively. Vertebral artery blood flow volume was negatively correlated with GGT (r: -0.208, p < 0.001) and CRP (r: -0.119, p < 0.001). CONCLUSION: We demonstrated a significant correlation between serum GGT levels and VBI. In addition, higher GGT level was an independent risk factor for the presence of vertebrobasilar system inflammation and atherosclerosis (Tab. 2, Fig. 3, Ref. 27).

Does vitamin D have any role in the improvement of diabetic peripheral neuropathy in type 1 diabetic patients?

AIM: The aim of this study was to evaluate the relationship between diabetic peripheral neuropathy (DPN) and vitamin D, nerve growth factor (NGF) and oxidative stress markers in patients with type 1 diabetes. METHODS: Ninety-six patients with type 1 diabetes were included in the study. All patients were evaluated for DPN with Michigan Neuropathy Screening Instrument. Fasting blood glucose, HbA1c, lipid parameters, 25 (OH) D3, NGF, total oxidant status, total antioxidant status and oxidative stress index were measured. RESULTS: Twenty-six patients (27 %) had DPN (group 1) and 70 patients did not have neuropathy (group 2). When the groups were evaluated with respect to general demographic characteristics, no differences were detected. Mean age, duration of diabetes and retinopathy were found significantly higher in patients who had neuropathy. Glomerular filtration rate levels were significantly lower in the neuropathy group. Between the groups, 25 (OH) vitamin D levels were significantly lower in the neuropathy group, while there were no differences in NGF levels or in oxidative stress markers. Michigan neuropathy examination score was positively correlated with age, and diabetes duration was negatively correlated with 25 (OH) vitamin D levels. In addition, 25 (OH) vitamin D was positively correlated with NGF. In the logistic regression analysis to determine the independent variables that will affect the development of neuropathy, duration of diabetes was detected as the only factor (p = 0.039, OR = 1.071). CONCLUSION: It seems that the most important risk factor for the development of neuropathy in type 1 diabetic patients is disease duration.

Neutrophil-to-lymphocyte ratio in inflammatory bowel disease - as a new predictor of disease severity.

BACKGROUND: The aims of this study were to investigate the utility of neutrophil-to-lymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in inflammatory bowel disease (IBD). METHODS: Sixty-six patients (22 CD, 44 UC) and 41 healthy controls were enrolled in the study. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and complete blood count (CBC) were measured. The neutrophil and lymphocyte counts were recorded and NLR was calculated. The patients with active or inactive UC and CD were classified according to the severity of the disease. RESULT: The serum NLR values of active CD patients were significantly higher than those of inactive ones and controls (p = 0.000, p = 0.000, respectively). NLR values of active UC patients were significantly higher than those of inactive ones and controls (p = 0.000, p = 0.000, respectively. The optimum NLR cut-off point for active CD and UC was 3.2 and 3.1. CONCLUSION: This study demonstrates that NLR in subjects with IBD is strongly associated with active disease and correlated with clinical and laboratory indices (Tab. 5, Fig. 2, Ref. 31).

Evaluating the relationship between nasal obstruction and mean platelet volume by using acoustic rhinometry in patients with septum deviation.

BACKGROUND: Nasal airway obstruction is a common cause of upper airway obstruction. It is associated strongly with obstructive and hypoxic manifestations. Mean platelet volume (MPV) levels increase in hypoxic conditions. MPV is one of the platelet activation indices which re!ects the platelet production rate. We aimed to evaluate the relationship between MPV levels and nasal septal deviation (NSD) by using acoustics rhinometry in patients with septum deviation. METHODS: We performed a retrospective study of 51 patients with NSD and 58 healthy age matched subjects as control group. The diagnosis of patients with NSD was based on anterior rhinoscopy, endoscopic nasal examination and acoustics rhinometry. All the patients underwent Cottle- or Killian-type septoplasty under general anesthesia. Blood samples were collected before nasal septoplasty. RESULTS: MPV and platelet distribution width (PDW) levels were significantly higher and mean platelet count was lower in patients with NSD than the control group. A negative correlation was found between MPV, NDVol2 (volume2 of non-deviated side of the nose) and TNDVol (total volume of non-deviated side of the nose) values. CONCLUSION: MPV values increase in patients with NSD. Moreover, this increase was found in relation with the severity of obstruction.