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    Is Urinary Kidney Injury Molecule-1 a Noninvasive Marker for Renal Scarring in Children With Vesicoureteral Reflux?
    (Elsevier Science Inc, 2013) Toker, Aysun; Ziypak, Tevfik; Orsal, Ebru; Laloglu, Esra; Bedir, Fevzi; Aksoy, Yilmaz
    OBJECTIVE To examine whether (1) levels of urinary kidney injury molecule-1 (KIM-1), a transmembrane protein and biomarker for renal tubular damage, increase in children with of vesicoureteral reflux (VUR), and (2) if KIM-1 predicts the grade of renal scarring in children with VUR. METHODS The study included 59 VUR patients with renal scarring, 5 VUR patients without renal scarring and 25 healthy controls aged 1 to 17 years. Dimercaptosuccinic acid scans were performed for determination of scarring and graded by 3 independent, blinded pediatric urologists for renal scarring according to the Randomized Intervention for Children with VUR study criteria. Spot urine samples were obtained. Urinary KIM-1 and creatinine levels were measured and the KIM-1/creatinine ratio was calculated. RESULTS Urine geometric mean KIM-1 levels (ng/mg creatinine) were significantly higher in VUR patients than in healthy controls (P = .018). Although the correlation between VUR grade and geometric mean KIM-1 levels was not significant, a positive correlation was found for scarring grade and geometric mean KIM-1 levels (r = .30, P = .02). When the patients were divided by subgroups according to scarring grade (group I, grade 1; group II, grades 2 and 3; group III, grade 4), the log KIM-1 in group III was significantly higher than in group I (P = .004). CONCLUSION Urinary KIM-1 levels might be used as a noninvasive marker, particularly in showing severe scarring in children with VUR. UROLOGY 81: 168-172, 2013. (C) 2013 Elsevier Inc.
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    Oxidative stress and insulin resistance in policemen working shifts
    (Springer, 2016) Demir, Irfan; Toker, Aysun; Zengin, Selcuk; Laloglu, Esra; Aksoy, Hulya
    Shift work is a work schedule involving irregular or unusual hours, compared to those of a normal daytime work schedule. In developed countries, night shift work is very common. In several cities of our country, 12/24 shift system is implemented in police organization. While night shift work composes half of the 20 shift in a month, in ergonomic shift system, an alternative shift schedule, shift work can be performed in three shifts in a day. In this study, we aimed to investigate the effects of 12/24 shift work system on insulin resistance and oxidative stress and systemic inflammation. Two hundred and four 12/24 shift workers (age 44.3 +/- A 5.6 years) and 193 ergonomic shift workers (age 42.6 +/- A 5.5 years) were included to study. Serum oxidized LDL (ox-LDL), neutrophil gelatinase lipocalin-2 (NGAL) as oxidative stress markers, glucose, insulin, ferritin, high-sensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate values were measured. Homeostasis model assessment for insulin resistance (HOMA-IR) was calculated to evaluate insulin resistance. Serum ox-LDL, HOMA-IR, hsCRP and NGAL levels in 12/24 shift system were found to be significantly higher compared with ergonomic shift workers (p < 0.0001, p = 0.02, p = 0.03, p = 0.02, respectively). When evaluated all subjects, weak but significant correlation was found between HOMA-IR with ox-LDL (r = 0.12, p = 0.01), hsCRP (r = 0.17, p = 0.001) and ferritin (r = 0.15, r = 0.003). Also in 12/24 shift work group, there were significant correlations between HOMA-IR with hsCRP (r = 0.17, p = 0.01) and ferritin (r = 0.25, p = 0.0001). It may be concluded that 12/24 shift system might give rise to insulin resistance and oxidative stress. Additionally, workers in this system may under risk of systemic inflammatory response. Working hours must be arranged in accordance with the physiological rhythm.