Polymorphisms of lipid metabolism enzyme-coding genes in patients with diabetic dyslipidemia.

OBJECTIVE: The polymorphisms/mutations of genes encoding proteins and enzymes involved in lipoprotein metabolism play important roles in the development of diabetic dyslipidemia. The aim of our study was to investigate the effects of LPL (rs320), LIPC (rs2070895), SCARB1 (rs5888), LCAT (rs2292318), CETP (rs708272), ADIPOQ (rs1501299), RETN (rs3745367), PON1 (rs662), and MNSOD (rs4880) gene polymorphisms on lipid metabolism and diabetic dyslipidemia. METHODS: This case-control study included 217 patients with diabetic dyslipidemia and 212 healthy age- and gender-matched individuals. Genomic DNA isolation was performed from blood samples, and genotype analysis was performed using melting curve analysis on a LightCycler® 480 Instrument. The chi-square test was used to compare genotype distribution and allele frequencies between the groups. RESULTS: Significant associations were observed between LPL (rs320) (p<0.001), LIPC (rs2070895) (p<0.001), SCARB1 (rs5888) (p<0.001), LCAT (rs2292318) (p<0.001), CETP (rs708272) (p<0.001), ADIPOQ (rs1501299) (p=0.01), RETN (rs3745367) (p<0.001), and MNSOD (rs4880) (p<0.001) polymorphisms and diabetic dyslipidemia. However, no association was observed between PON1 (rs662) polymorphisms and diabetic dyslipidemia (p=0.611). CONCLUSION: LPL (rs320), LIPC (rs2070895), SCARB1 (rs5888), LCAT (rs2292318), CETP (rs708272), ADIPOQ (rs1501299), RETN (rs3745367), and MNSOD (rs4880) polymorphisms play an important role in basic molecular metabolism in diabetic dyslipidemia. Therefore, these polymorphisms may be used as a predictive marker for diabetic dyslipidemia in high-risk patients.

LDLR C1725T Gene Polymorphism Frequency in Type 2 Diabetes Mellitus Patients With Dyslipidemia.

BACKGROUND: Dyslipidemia has a substantial role in the development of cardiovascular diseases in patients with type 2 diabetes mellitus (T2DM). Determining the genetic profile of T2DM patients with dyslipidemia is important in order to reduce the risk of microvascular and macrovascular complications. Low-density lipoprotein receptor (LDLR) plays a critical role in plasma lipoprotein hemostasis. LDLR mutations/polymorphisms cause changes at the lipoprotein level. The objective of this study is to determine the frequency of LDLR (rs179989) polymorphisms in Turkish T2DM patients with dyslipidemia. METHODS: The study group consisted of 217 T2DM patients with dyslipidemia including 28 cases with myocardial infarction and 212 healthy controls. Genomic DNA was isolated from venous blood samples and genotype analysis was carried out on the LightCycler® 480 instrument. The χ2 test was used to compare genotype distributions. RESULTS: There were no significant differences in the frequency or allelic distribution of the LDLR C1725T (rs1799898) genotype between the type 2 diabetic dyslipidemia patients and the control group (P > 0.05). CONCLUSION: LDLR C1725T polymorphism was not associated with lipid parameters, and dyslipidemia in T2DM patients.

Can metabolic control variables of diabetic patients predict their quality of life?

The type and the complexity of regimen aimed at achieving better glycemic control may impact patient's health-related quality of life (HRQoL) in diabetic patients. But, the relationship between HbA1c levels of diabetic patients and their HRQoL is not clear. Our study aims to determine whether metabolic control variables can predict HRQoL or not and also the impact of hypertension (HT) on HRQoL in type II diabetic patients. A total of 469 patients with type II diabetes and 134 control subjects were studied. Medical Outcomes Study Short-Form-General Health Survey (SF-36) questionnaire was used as a health survey tool to measure the QoL of patients in the study. SF-36 includes 8 individual subscales and two summary scales (physical component summary [PCS] and mental component summary [MCS]). Age, gender, fasting blood glucose, postprandial blood glucose, HbA1c, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride, total cholesterol, Apolipoprotein B (apoB), non-HDL-C, and body mass index values of the subjects were recorded. For statistical evaluation, SPSS (Statistical Package for the Social Sciences) 15 under Windows 7 was used. MCS values of patients group were statistically lower than control group (P < .05). There was no significant difference in PCS values between groups (P > .05). Diabetic patients with HT had significantly lower PCS and MCS values than those without HT. In addition, there was a negative correlation between HbA1c level and PCS and MCS values (P < .05). Hypertensive diabetic patients had significantly higher fasting blood glucose, postprandial blood glucose, HbA1c, HDL-C, LDL-C, total cholesterol, and body mass index values than hypertensive control subjects (P < .05). Normotensive diabetic patients also had significantly lower PCS value than normotensive control subjects (P < .05). But, MCS value was not different between groups (P > .05). PCS values in diabetic male patients were significantly higher than in diabetic female patients (P < .05). MCS value did not differ by gender in diabetic patients (P > .05). In our study, it is clear that diabetes affected the patients' HRQoL. In addition, we showed negative correlations between HbA1c levels and PCS and MCS values. There was a significant difference in PCS scores between genders in patients with diabetes. But, there was no significant difference in PCS and MCS values by age in diabetic patients. And having concomitant HT in diabetic patients causes a decrease in both MCS and PCS scores. Thus, HT is an important factor that should be considered in QoL of the diabetic patients.

Effects of Type 2 Diabetes on Otoacoustic Emissions and the Medial Olivocochlear Reflex.

OBJECTIVE: To demonstrate if cochleopathy in patients with type 2 diabetes with normal audiometric hearing threshold can be detected with otoacoustic emissions or medial olivocochlear (MOC) reflex measurements. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary university teaching hospital. METHODS: The study involved 40 type 2 diabetic patients and 24 healthy volunteers. All participants who showed normal otoscopic findings, hearing thresholds, and acoustic admittance were included. Cochlear activity of participants was evaluated by means of distortion product otoacoustic emissions (DPOAEs) and transient otoacoustic emissions (TOAEs). The MOC reflex was evoked with contralateral acoustic stimulation and recorded with DPOAEs and TOAEs. RESULT: A comparison of DPOAE and TOAE levels with a t test between patient and control groups revealed no significant difference (P > .05). A comparison of the MOC reflex response between the 2 groups also revealed no statistically significant difference (P > .05). CONCLUSION: Although decreased OAE amplitude levels were found in diabetic patients, there was no statistically significant difference in OAEs and MOC reflex. Additional studies are needed to evaluate the role of OAEs and MOC reflex in normal-hearing patients with diabetes.

Rate of blood pressure control and antihypertensive treatment approaches in diabetic patients with hypertension.

OBJECTIVES: Hypertension is a common co-morbidity in patients with type 2 diabetes. Management of hypertension is of paramount importance in reducing macro- and microvascular complications of diabetes. The aim of this study is to determine the rate of blood pressure control (<140/85 mmHg) in diabetic patients with hypertension, and to evaluate the prescribing pattern of antihypertensive medications. STUDY DESIGN: This was a prospective, cross-sectional, observational study conducted in a tertiary centre in Turkey. Of 707 patients with diabetes, 500 hypertensive patients were evaluated to determine control of hypertension and treatment attitudes. Logistic regression analysis was used to evaluate the likelihood of prescription of each class of antihypertensive medications for the presence of macro- and microvascular complications. RESULTS: Most of the patients (95%) were on antihypertensive therapy. Only 41% achieved target blood pressure values (<140/85 mmHg). Renin angiotensin system (RAS) blockers were the most frequently (82.4%) prescribed antihypertensive agents, and a combination of RAS blockers and diuretics were the most commonly preferred combination therapy. Most of the patients were on 1 antihypertensive drug or a combination of 2 drugs (39.5% and 44.7%, respectively). Patients with coronary artery disease were more likely to receive beta blockers (Odds ratio=3.6, 95% confidence interval=2.3-5.6; p<0.001). CONCLUSION: Although most of the diabetic hypertensive patients were on hypertensive therapy, more than half had uncontrolled blood pressure.

Does hyperandrogenism affect the otoacoustic emissions and medial olivocochlear reflex in female adults?

HYPOTHESIS: To evaluate the effects of hyperandrogenism on otoacoustic emission levels and the medial olivocochlear reflex in adult female subjects. BACKGROUND: Women have a hearing advantage over men. Otoacoustic emission levels tend to be higher in female subjects, in both newborns and adults. This discrepancy has been presumed to result from prenatal androgen exposure in male subjects. METHODS: The study involved 37 polycystic ovary syndrome patients who were referred from the endocrinology department and 26 healthy volunteers. All participants who showed normal otoscopic findings, hearing thresholds, and acoustic admittance were included. All polycystic ovary syndrome patients showed biochemical signs of hyperandrogenism. Cochlear activity of participants was evaluated by means of distortion product otoacoustic emissions and transient otoacoustic emissions. The medial olivocochlear reflex was evoked with contralateral acoustic stimulation and recorded with distortion product otoacoustic emissions and transient otoacoustic emissions. RESULTS: Neither distortion products nor transient otoacoustic emission levels showed a statistically significant difference between the right and left ears (p > 0.05). Comparisons of distortion products and transient otoacoustic emission levels between the patient and control groups showed no statistically significant difference (p > 0.05). Comparison of the medial olivocochlear reflex response between the 2 groups also revealed no statistically significant difference (p > 0.05). CONCLUSION: Hyperandrogenism did not seem to influence otoacoustic emission levels or the medial olivocochlear reflex response in adult female subjects.

The evaluation of coagulation parameters and vessel involvement in Behcet' s disease. A clinical experience of Behcet' s disease: study of 152 cases.

Behcet´s disease (BD) is accepted as a systemic vasculitis. Vasculitis is observed  predominantly on the venous system. Vessel involvement is frequently seen in males. This study was planned retrospectively evaluate demographic features, clinical features, vessel involvements in BD. Furthermore, we aimed to prospectively compare consecutively chosen patients with and without thrombosis and healthy volunteers in terms of their biochemical, immunological, coagulation parameters. One hundred fifty-two Behcet´s patients were retrospectively evaluated. Blood samples were collected from 52 consecutively chosen patients and 41 healthy subjects. Papulopustular skin lesions, eye involvement and venous lesions were detected frequent in males. In terms of evaluated parameters (biochemical parameters, coagulation parameters, C-reactive protein, erythrocyte sedimentation rate, anticardiolipin antibodies, antinuclear antibody positivity) was not found a significant difference among groups (patients without thrombosis, healthy control subjects, patients with thrombosis). We detected statistically significant difference in terms of factor V levels between patient and control group. The tendency to thrombosis in patients with BD is well known. The endothelial lesion, increased procoagulant activity, hypofibrinolysis were found to be responsible from these events. In our study, there was no significant difference in terms of coagulation parameters between the patients without and with thrombosis.

Therapeutic potential of an anti-diabetic drug, metformin: alteration of miRNA expression in prostate cancer cells.

BACKGROUND AND AIMS: Prostate cancer is the most commonly diagnosed cancer in males in many populations. Metformin is the most widely used anti-diabetic drug in the world, and there is increasing evidence of a potential efficacy of this agent as an anti-cancer drug. Metformin inhibits the proliferation of a range of cancer cells including prostate, colon, breast, ovarian, and glioma lines. MicroRNAs (miRNAs) are a class of small, non- coding, single-stranded RNAs that downregulate gene expression. We aimed to evaluate the effects of metformin treatment on changes in miRNA expression in PC-3 cells, and possible associations with biological behaviour. MATERIALS AND METHODS: Average cell viability and cytotoxic effects of metformin were investigated at 24 hour intervals for three days using the xCELLigence system. The IC50 dose of metformin in the PC-3 cells was found to be 5 mM. RNA samples were used for analysis using custom multi-species microarrays containing 1209 probes covering 1221 human mature microRNAs present in miRBase 16.0 database. RESULTS: Among the human miRNAs investigated by the arrays, 10 miRNAs were up-regulated and 12 miRNAs were down-regulated in the metformin-treated group as compared to the control group. In conclusion, expression changes in miRNAs of miR-146a, miR-100, miR-425, miR-193a-3p and, miR-106b in metformin-treated cells may be important. This study may emphasize a new role of metformin on the regulation of miRNAs in prostate cancer.

Is there any association between the Ser326Cys polymorphism of the 8-oxoguanine glycosylase 1 (OGG1) gene and risk of colon polyp and abnormal glucose tolerance in acromegaly patients?

AIM: Evidence arising from experimental studies indicates an association between increased levels of the growth hormone/insulin-like growth factor 1 and oxidative stress. The association of the Ser326Cys polymorphism in the 8-oxoguanine glycosylase (OGG1) gene with a colon carcinoma and diabetes mellitus has been examined. The aim of the study was to compare the genotypic distribution of OGG1 Ser326Cys between acromegaly patients and nonacromegalic subjects and to explore whether this polymorphism is associated with a colon polyp risk and abnormal glucose tolerance. METHODS: We examined 98 acromegaly patients, and 99 healthy subjects who can be compared in terms of age and gender. All participants were evaluated by anthropometric and biochemical measurements. Also, a 75-g oral glucose test and colonoscopy was applied to the patients. Genomic DNA was isolated from peripheral blood leucocytes and the genotype was assessed by melting temperature analyses after using a real-time polymerase chain reaction protocol. RESULTS: Colon polyps were detected in 13 (30.2%) of 43 patients who underwent the colonoscopy. Except for diastolic blood pressure, clinical and biochemical characteristics were similar between the patients diagnosed with and without a colon polyp. A higher proportion of acromegaly patients had the Ser326Ser genotype when compared to the control group (p=0.007). Genotypes were similar between the patients with a normal glucose tolerance and an abnormal glucose tolerance (p=0.774). The frequency of the Cys allele was significantly higher in patients with polyps than those without a polyp (38.5% vs. 18.3%) (p=0.029). CONCLUSION: Our results suggest that the Cys allele may influence the colon polyp risk in acromegaly patients. Large-scale studies with acromegaly patients are required to show whether being a carrier of the Cys allele is associated with the risk of a colorectal polyp.

Miscarriage, and TNF-α and osteopontin relationship in women patients with Hashimoto's thyroiditis.

OBJECTIVE: Infertility and reproductive impairment can be compromised by abnormalities in both endocrine and immune system. TNF-α promotes apoptotic cell death in fetal membrane tissues and pro-inflammatory, proapoptotic, and procoagulant properties of TNF-α probably contribute to widely accepted abortogenic profile of this cytokine. The aim of this study was to assess the alteration in the levels of TSH, FT3, FT4, TNF-α, osteopontin in pregnant and controls. METHODS: Study subjects were 28 pregnant women, 28 non-pregnant women, and 28 healthy controls. All subjects underwent venous blood drawing for levels of TNF-α, osteopontin, and also hormonal assays including the levels of anti-TPO, anti-TG antibodies, TSH, FT3, FT4. RESULTS: Both patient and control groups are similar in terms of age. Pregnancy age in conceived patients is 23.64 ± 2.040. No statistically meaningful relation was found in correlation analysis between TNF-α and osteopontin among the groups (p = 0.963). Anti-thyroglobuline antibody and anti-microsomal antibody levels were found to be higher in patients with non-pregnant patients with Hashimoto thyroiditis than the control group (p < 0.001). No statistically meaningful relation was found in terms of TNF-α (p = 0.66) and osteopontin serum levels (p = 0.50) in patient groups with or without miscarriage history. CONCLUSIONS: In our study, no statistically meaningful relation was found in terms of TNF-α and osteopontin serum levels in patient groups with and without miscarriage history.

Fibrosing mediastinitis and thrombosis of superior vena cava associated with Behçet's disease.

We present CT, MRI and venography findings in 13-year boy with mediastinal fibrosis and superior vena cava (SVC) thrombosis associated with Behçet's disease. Fibrosing mediastinitis is an excessive fibrotic reaction that occurs in the mediastinum and may lead to compression of mediastinal structures (especially vascular). This condition is usually idiopathic, though many (and perhaps most) cases in the USA are thought to be caused by an abnormal immunologic response to Histoplasma capsulatum infection. SVC syndrome secondary to extrinsic compression by mediastinal fibrosis combined with Behçet's disease has rarely been described. Radiological investigations of this syndrome are necessary to avoid a useless anticoagulant therapy.