The relationship between the atherosclerotic cardiovascular disease risk score used in the prediction of cardiovascular disease risk and endocan.

OBJECTIVE: To date, there have been no studies investigating whether or not there is a correlation between the serum endocan level and the atherosclerotic cardiovascular disease (ASCVD) risk score that is frequently used in the determination of the risk of cardiovascular disease. If a single parameter such as endocan can provide reliable results which could be used in the prediction of the cardiovascular disease risk, the workload of the clinician would be lightened. The aim of this study was to investigate whether or not there is an association between the serum endocan level and the ASVCD risk score. MATERIALS AND METHODS: This prospective, cross-sectional study included individuals age 40-79 years with risk factors calculated using the ASVCD score and individuals without any of those risk factors. In accordance with ASCVD risk calculation, each participant was questioned with respect to age, gender, height, weight, and lifestyle habits such as smoking, diseases, and medications. Systolic blood pressure, diastolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and serum endocan levels were measured and recorded. The serum endocan levels and ASCVD scores were compared. RESULTS: The study included 205 individuals, comprising 92 (44.9%) males and 113 (55.1%) females with a mean age of 50.7 ± 7.6 years. The 10-year atherosclerosis risk was determined as mean 6.32% ± 5.9% (range, 0.3%-27.3%). The mean serum endocan level was calculated as 1109.6 ± 1479.7 ng/mL. As the ASCVD risk score increased, no increase was detected in the serum endocan level. CONCLUSION: The results of the study suggested that the serum endocan level is not suitable for use in place of the ASCVD risk score as a predictor of cardiovascular disease risk.

Evaluation of the Relation between Vitamin D and Serum Omentin and Vaspin Levels in Women.

INTRODUCTION: Vitamin D deficiency is a common health problem seen worldwide. Adipokines released from adipose tissue play important roles in the control of appetite and satiety, modulation of body fat distribution, regulation of insulin sensitivity and secretion, control of blood pressure, and regulation of endothelial functions and inflammation. The aim of the present study is to investigate how vitamin D levels affect serum vaspin and omentin levels. MATERIALS AND METHODS: This is a cross-sectional study design. A total of 77 female volunteers were included in the study, and they were divided into 3 groups according to vitamin D levels. Relation of vitamin D with serum vaspin and omentin levels was determined in these groups. RESULTS: Serum omentin, vaspin and parathyroid hormone (PTH) levels differed significantly between the groups (p<0.001, p<0.001, p=0.001, respectively). Omentin levels correlated significantly and negatively with the vitamin D and vaspin levels, but there was a significant positive correlation between omentin and PTH (r=-0.626, p<0.001; r=-0.867, p<0.001; r=0.461, P<0.001, respectively). A significant positive correlation was detected between vaspin levels and vitamin D, whereas omentin and PTH levels correlated negatively and significantly (r=0.374, p<0.001; r=-0.867, p<0.001; r=-0.374, p=0.002, respectively). CONCLUSIONS: Vitamin D may affect the release of adipokines from the adipose tissue, and this effect may be in a negative or positive manner. This effect of vitamin D may probably be mediated via vitamin D receptors exhibited in the adipose tissue, or via mechanisms not identified yet. The results of this study suggested that there was a significant, positive correlation between serum vitamin D levels and vaspin, whereas a significant, negative correlation between vitamin D levels and omentin. Further studies on larger series are needed in order to confirm these results.

Frequency and determinants of erectile dysfunction in Turkish diabetic men.

BACKGROUND: Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance. ED is observed more frequently and manifests earlier in diabetic patients compared to the normal population. MATERIAL AND METHODS: One hundred and seventeen consecutive male type 2 diabetes patients seen in our Diabetes Outpatient Clinic were included in our study and these patients were evaluated in terms of the presence and duration of ED, treatment and response to treatment of ED, duration of diabetes mellitus, HbA1c levels, and the presence of microalbuminuria, estimated from 24-hour urine collections. RESULTS: The patients included in our study were divided into three groups: Patients with no ED, mild-to-moderate ED, and severe ED. Twenty-nine patients (24.8%) fell in the no ED group, 28 (23.9%) in the mild-to-moderate ED group, and 60 (51.3%) in the severe ED group. There were statistically significant differences between these three groups in terms of age ( P = 0.015) and duration of diabetes mellitus ( P = 0.03). The groups were similar in terms of microalbuminuria measured from 24-hour urine collections and HbA1c levels ( P = 0.328 and P = 0.905, respectively). Twenty-three of the 88 patients with ED (26.1%) were on ED treatment and 43.5% of these patients reported benefit from the therapy. CONCLUSION: Age and duration of diabetes were the main determinants of the presence and severity of ED in male Turkish type 2 diabetic patients. The HbA1c levels were higher in patients with ED, but the differences in levels between the groups did not reach statistical significance.

The effects of long term fasting in Ramadan on glucose regulation in type 2 diabetes mellitus.

INTRODUCTION: For Ramadan fasting, observing Muslims do not eat or drink between sunrise and sunset during Ramadan, Islam's holy month of the year according to the lunar calendar. In 2011, fasting patients with diabetes fasted for an average of 16.5 hours per day, having 2 meals between sunset and sunrise for a month. We aimed to evaluate the impact of extended fasting on glucose regulation and observe possible complications of extended fasting in type 2 diabetes mellitus patients. PATIENTS AND METHODS: We conducted a randomized, retrospective, observational study. Patients who presented at the Diabetes Clinic during the 15 days before and after Ramadan in August 2011 Istanbul, whose hemoglobin A1c, fasting plasma glucose, postprandial plasma glucose, weight and height value examinations and follow-up were completed were included in the study. FINDINGS: Seventy-six diabetes patients who fasted during Ramadan (fasting group) and 71 patients with diabetes who did not fast (non-fasting group) were included in the study. These two groups with similar demographic characteristics were compared before and after Ramadan. HbA1c, fasting and postprandial plasma glucose, body mass index, weight and adverse events were evaluated. No statistically significant difference was observed among the fasting and the non-fasting groups. There was no difference between the pre and post-Ramadan values of the fasting group. CONCLUSIONS: We could not find any negative effects of extended fasting on glucose regulation of patients with diabetes who are using certain medications. No serious adverse event was observed. We failed to demonstrate benefits of increasing the number of meals in patients with diabetes.

Association of calcium channel blocker use with lower hemoglobin levels in chronic kidney disease.

AIM: To search whether calcium channel blockers (CCBs) are associated with lower hemoglobin levels in chronic kidney disease (CKD) patients who are not on renal replacement therapy (RRT), vitamin D and anti-anemic treatment. PATIENTS AND METHODS: CKD patients were classified into two groups. Patients on CCBs treatment (103 patients) and patients not using CCBs (104 patients) were compared cross-sectionally regarding clinical findings, complete blood count (CBC), biochemistry and regular medication use. Patients with polycystic kidney disease, comorbidities that could influence CBC other than iron deficiency of obscure origin, patients receiving RRT, erythropoietin (EPO), vitamin D, phosphate binders and drugs that could influence CBC were excluded. Under dependent variable of CCB use, all significantly different independent variables were subjected to multivariate binary logistic regression analysis (MBLRA). RESULTS: Lower hemoglobin, lower bilirubinemia, higher serum EPO, higher systolic blood pressure were observed in CCB users. Two groups were similar concerning age, gender, BMI, CKD etiology, CKD stage, pretibial edema prevalence, cardiothoracic index, diastolic blood pressure, corrected reticulocyte count, BUN, creatinine, eGFR, proBNP, parathormone, alkaline phosphatase, phosphorous, corrected calcemia, sCRP, relative EPO deficiency and prevalence of relative EPO deficient patients. Groups were comparable regarding comorbidities, types and usage frequencies of all antihypertensive medications other than CCBs. Higher systolic blood pressure and lower hemoglobin were significantly associated with CCB use after MBLRA. CONCLUSIONS: Hemoglobin was significantly lower in CCB users compared to non-users, among CKD patients who did not receive RRT, EPO, phosphate binders, vitamin D, iron, vitamin B12 and folic acid.