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Öğe Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis(Springer London Ltd, 2018) Cure, Erkan; Icli, Abdullah; Uslu, Ali Ugur; Sakiz, Davut; Cure, Medine Cumhur; Baykara, Rabia Aydogan; Yavuz, FatmaAnkylosing spondylitis (AS) is associated with an increased risk of atherosclerotic cardiovascular disease (ACD). The atherogenic index of plasma (AIP), which is the logarithmic transformation of the plasma triglyceride (TG) level to the high-density lipoprotein level (HDL) ratio, has been suggested to be a novel marker in the identification of atherosclerosis risk. Therefore, this study aims to determine if the AIP can act as an accurate marker for the detection of subclinical atherosclerosis. Fifty-two male patients with AS and 52 age-, gender-, and body mass index (BMI)-matched healthy control subjects were included in the study. For each patient, AIP and total cholesterol (TC)/HDL values were calculated and carotid artery intima-media thickness (cIMT) was measured. The mean (SD) cIMT and median (range) AIP values for AS patients were higher than that of the healthy control subjects (0.60 +/- 0.18 vs. 0.51 +/- 0.10, p = 0.003 and 0.23 [- 0.32 to 0.85] vs. 0.09 [- 0.53 to 0.49], p = 0.007, respectively). A positive correlation was found between the patients' cIMT and AIP values (r = 0.307, p = 0.002) and TC/HDL values (r = 0.241, p = 0.014). Regression analysis revealed an independent association between the subclinical atherosclerosis and AIP (beta [beta] = 0.309, p = 0.002). There were no independent correlations between subclinical atherosclerosis and TC (beta = 0.245, p = 0.065), TG (beta = 0.185, p = 0.515), HDL (beta = 0.198, p = 0.231), TC/HDL (beta = 0.032, p = 0.862), and low-density lipoprotein (LDL) (beta = 0.151, p = 0.246). A strong and independent correlation exists between AIP and cIMT values. Therefore, the AIP could serve as a better marker than the TC/HDL ratio for the detection of subclinical atherosclerosis in AS patients.Öğe Endocan Levels and Subclinical Atherosclerosis in Patients With Systemic Lupus Erythematosus(Sage Publications Inc, 2016) Icli, Abdullah; Cure, Erkan; Cure, Medine Cumhur; Uslu, Ali Ugur; Balta, Sevket; Mikhailidis, Dimitri P.; Ozturk, CengizSystemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology. A major cause of morbidity and mortality in SLE is accelerated atherosclerosis. Endothelial-specific molecule 1 (endocan) is a potential predictor of vascular events and is expressed in response to inflammatory cytokines in endothelial cells. We investigated the relationship between endocan and carotid intima-media thickness (cIMT) as a marker of early atherosclerosis. We included 44 women with SLE and 44 healthy women as controls. Disease severity of SLE was evaluated using the SLE Disease Activity Index. Endocan, C-reactive protein, erythrocyte sedimentation rate (ESR), and lipid panel were measured. The cIMT was 0.70 (range: 0.45-1.20) mm in patients with SLE and 0.40 (0.25-0.60) mm in controls (P < .001). Endocan value was 1.6 +/- 0.9 ng/mL in controls and 2.2 +/- 1.0 ng/mL in patients with SLE (P = .014). Endocan levels were positively correlated with cIMT (r = .469, P < .001), body mass index (r = .373, P = .013), and ESR (r = .393, P = .008). Endocan level may be associated with subclinical atherosclerosis in SLE. Consequently, endocan levels may be a promising clinical tool for patients with SLE as a guide for preventive strategy.Öğe Ischemia Modified Albumin Levels in Rheumatoid Arthritis(Wiley, 2015) Uslu, Ali Ugur; Kucuk, Adem; Balta, Sevket; Arslan, Sevket; Tekin, Levent; Kucuksen, Sami; Toker, Aysun[Abstract Not Availabe]Öğe Ischemia-Modified Albumin and Atherosclerosis in Patients With Familial Mediterranean Fever(Sage Publications Inc, 2016) Kucuk, Adem; Uslu, Ali Ugur; Arslan, Sevket; Balta, Sevket; Ozturk, Cengiz; Uysal, Saliha; Yilmaz, RamazanThe constriction of vessels due to atherosclerotic lesions causes hypoxia/ischemia and oxidative changes resulting in transformation of free albumin to ischemia-modified albumin (IMA) in the circulation and increased carotid intima-media thickness (cIMT). We investigated the reliability of IMA increase in evaluating atherosclerosis in patients with familial Mediterranean fever (FMF) compared with cIMT. Patients with FMF (n = 58) diagnosed by the Tel-Hashomer criteria in attack-free period and 38 healthy people were included in the study. Patient demographics as well as the clinical and laboratory characteristics of the healthy controls and patients with FMF were noted. The IMA levels and cIMT in patients with FMF were 0.30 +/- 0.09 absorbance units (ABSUs) and 1.12 +/- 0.27 mm, respectively, and in the control group, IMA levels and cIMT were 0.25 +/- 0.07 ABSU and 0.74 +/- 0.26 mm, respectively. The IMA levels and cIMT were significantly higher in patients with FMF than in controls (P = .020 and P < .0001, respectively). The IMA values showed positive correlation with cIMT in patients with FMF(r = .302, P = .041). Our results reveal that IMAan oxidative stress markermay be an indicator of atherosclerosis in patients with FMF. This finding deserves further investigation.Öğe A novel marker relationship between carotid intima-media thickness and disease activity score-28 in patients with rheumatoid arthritis: human endothelial cell-specific molecule-1(Tubitak Scientific & Technological Research Council Turkey, 2019) Tuzcu, Goksel; Uslu, Ali Ugur; Tuzcu, Ayca; Baykara, Rabia Aydogan; Omma, Ahmet; Kucuk, AdemBackground/aim: Human endothelial cell-specific molecule-1 (endocan) is a marker of vascular endothelial dysfunction that may be used in the evaluation of inflammatory-associated atherosclerotic lesions. Endocan may be a marker for the evaluation of atherosclerosis and disease activity in rheumatoid arthritis (RA) patients. Materials and methods: We included 39 RA patients assessed according to the American College of Rheumatology/European League Against Rheumatology 2010 diagnostic criteria and recruited 30 age- and sex-matching healthy subjects for the control group. Results: Endocan values were 14.11 +/- 3.27 for the RA patients and 12.10 +/- 2.92 for the controls. The endocan values of the patients were significantly higher than those of the control group (P = 0.009). In the correlation analysis, endocan showed a significantly positive correlation with disease activity score-28 (r = 0.386, P = 0.029) and carotid intima-media thickness (cIMT) (r = 0.419, P = 0.008). Linear regression analysis revealed that there was an independent relationship between endocan and cIMT (P = 0.029). Conclusion: Endocan can be a marker for early atherosclerosis and disease activity in RA patients.Öğe Novel myokine: irisin may be an independent predictor for subclinic atherosclerosis in Behcet's disease(Bmj Publishing Group, 2016) Icli, Abdullah; Cure, Erkan; Cure, Medine Cumhur; Uslu, Ali Ugur; Balta, Sevket; Arslan, Sevket; Sakiz, DavutBehcet's disease (BD) is a vasculitic and inflammatory disease causing endothelial dysfunction. Irisin is a metabolic hormone related to insulin resistance and endothelial functions. In this study, we investigated the relationship between irisin and carotid intima-media thickness (cIMT), which is a marker of atherosclerosis in patients with BD. 48 patients with BD and 50 healthy individuals were enrolled in the study. Disease severity was evaluated by BD current activity form. Irisin, glucose, insulin, C reactive protein, erythrocyte sedimentation rate and lipid panel were examined in all patients. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was used to calculate insulin resistance. A simple and inexpensive cIMT test was used as indicator of atherosclerosis. cIMT was 0.62 (0.45-1.05) mm in the patients, while it was 0.38 (0.25-0.65) mm in the control group (p<0.001). Irisin value was found to be 197.3 (24.8-834.2) ng/mL in the control group, while it was 85.4 (4.7-471.1) ng/mL in the patient group (p=0.007). There was a negative correlation between irisin level and cIMT (r=-0.511, p<0.001) and HOMA-IR (r=-0.371, p=0.009). Decreased irisin levels (OR 0.996, 95% CI 0.992 to 1.000, p=0.041), male gender (OR 7.634, 95% CI 1.415 to 41.191, p=0.018), and HOMA-IR (OR 2.596, 95% CI 1.451 to 4.643, p=0.001) are independent risk factors for cIMT in patients with BD. We detected a very strong relationship between cIMT, which is an indicator of subclinical atherosclerosis, and decreased irisin levels in patients with BD. BD is characterized by chronic inflammation, and low serum irisin levels in BD may be related to atherosclerosis.Öğe Plasma Atherogenic Index is an Independent Indicator of Subclinical Atherosclerosis in Systemic Lupus Erythematosus(Aves, 2017) Uslu, Ali Ugur; Kucuk, Adem; Icli, Abdullah; Cure, Erkan; Sakiz, Davut; Arslan, Sevket; Baykara, Rabia AydoganObjective: Systemic lupus erythematosus (SLE) is characterized by chronic inflammation. Plasma atherogenic index (PAI) is a valuable marker for the cardiovascular disease and cardiac risk. The aim of this study was to evaluate the role and clinical use of PAI in atherosclerosis and the cardiac risk in SLE patients. Materials and Methods: We included 56 female SLE patients who were selected according to the American College of Rheumatology (1997) diagnosis criteria. Furthermore, we selected age-and body mass index (BMI)-matched 56 female healthy individuals. PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. We used carotid intima media thickness (cIMT) as an inflammatory marker because of its widespread use. The lipid and other biochemical parameters of patient and control groups were examined. Results: The PAI and cIMT values of SLE patients were 0.04 +/- 0.23 and 0.78 +/- 0.18 mm, respectively. Besides, for the control group, the PAI value was -0.09 +/- 0.20 and cIMT value was 0.50 +/- 0.15 mm (p=0.002, p<0.001; respectively). There was a strong correlation between cIMT and PAI (r=0.273, p=0.003). According to the multiple logistic regression analysis, we found that PAI value is an independent factor for cIMT in SLE patients (odds ratio: 2.6, 95 % confidence interval; 1.506-4.374; p=0.029). Conclusions: We determined that PAI can be used as an independent indicator for subclinical atherosclerosis in SLE patients.Öğe The Relationship Between Atherogenic Index and Carotid Artery Atherosclerosis in Familial Mediterranean Fever: A Pilot Study(Sage Publications Inc, 2017) Icli, Abdullah; Cure, Erkan; Uslu, Ali Ugur; Sakiz, Davut; Cure, Medine Cumhur; Ozucan, Miyase; Baykara, Rabia AydoganFamilial Mediterranean fever (FMF) is a disease characterized by chronic inflammation. Atherogenic index of plasma (AIP) is a logarithmic value of the triglyceride to high-density lipoprotein cholesterol ratio and it is a good marker for atherosclerotic heart disease and cardiac risk. In this study, we investigated subclinical atherosclerosis and cardiac risks in patients with FMF. Patients with FMF (78 men and 84 women) and healthy controls (74 men and 82 women) were included in this study. The AIP values of the patients were calculated and carotid intima-media thicknesses (cIMTs) were measured. The cIMT (P < .001) and AIP (P < .001) values of patients with FMF were higher than the values of the control group. There was a positive correlation between cIMT and AIP values (r = .304, P < .001). In regression analysis, we detected an independent relationship between cIMT and AIP ( = .248, P = .001). Atherogenic index of plasma may be highly correlated with the subclinical atherosclerosis. Particularly, male patients with FMF may have a high cardiac risk.Öğe Relationship between prevalence and severity of restless legs syndrome and anemia in patients with systemic lupus erythematosus(Wiley, 2017) Kucuk, Adem; Uslu, Ali Ugur; Yilmaz, Ramazan; Salbas, Ender; Solak, Yalcin; Tunc, RecepAim: Our aim was to evaluate the relationship between the prevalence and severity of restless legs syndrome (RLS) and the anemia in patients with systemic lupus erythematosus (SLE). Methods: This was a case-control study which was conducted at the rheumatology clinic of a university affiliated hospital, including 62 patients with SLE and 62 age-and sex-matched healthy controls. The patients were divided into two groups in terms of their hemoglobin levels. The criterion for anemia was hemoglobin level lower than 12 g/dL in females and 13 g/dL in males. Results: Nineteen patients (30.6%) in the patient group were diagnosed with RLS, and International RLS Study Group Rating Scale (IRLSSG-RS) score was 10.7 +/- 9.5 (median: 10.0 [range: 0.0-30.0]). Three subjects (4.8%) in the control group had RLS, and the IRLSSG-RS score was 0.7 +/- 3.3 (median: 0.0 [range: 0.0-18.0]). The prevalence of RLS and the IRLSSG-RS score were higher in the patient group than those in the control group (P < 0.001). Ten SLE patients (50%) with anemia had RLS, and their IRLSSG-RS score was 14.5 +/- 9.9 (median: 21.0 [range: 11.0-30.0]). Nine SLE patients (21.4%) without anemia had RLS and their IRLSSG-RS was 9.0 +/- 8.9 (median: 21.0 [range: 11.0-24.0]). Significant differences were present in the prevalence of RLS and the IRLSSG-RS score between SLE patients with and without anemia (P = 0.024, P = 0.044, respectively). Conclusion: The present study demonstrated that the prevalence of RLS was higher in patients with SLE than that of the normal population. Results of this study also suggested that anemia was associated with higher frequency of and more severe RLS in patients with lupus.Öğe The relationship of serum visfatin levels with clinical parameters, flow-mediated dilation, and carotid intima-media thickness in patients with ankylosing spondylitis(Tubitak Scientific & Technological Research Council Turkey, 2021) Aydogan Baykara, Rabia; Kucuk, Adem; Tuzcu, Ayca; Tuzcu, Goksel; Cure, Erkan; Uslu, Ali Ugur; Omma, AhmetBackground/aim: Atherosclerotic heart diseases can occur at an early age in patients with ankylosing spondylitis (AS). Flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT) values are reliable markers for early detection of subclinical atherosclerosis in patients with AS. We aimed to investigate the relationship between visfatin levels and indirect markers of subclinical atherosclerosis and endothelial dysfunction in patients with AS. Materials and methods: Forty-two patients diagnosed with AS and 42 age, sex, and body mass index (BMI)-matched controls were included in the study. Visfatin levels, FMD, and cIMT were measured using appropriate methods. Results: Visfatin levels of the patients were significantly higher than controls (p < 0.001). FMD values in patients with AS were significantly lower (p = 0.007) whereas cIMT were significantly higher than the controls (p = 0.003). There was a negative relationship between FMD with visfatin levels (p = 0.004), BASDAI (p = 0.010), and BASFI (p = 0.007). There was a positive relationship between cIMT with visfatin (p = 0.005), BASDAI (p < 0.001), and BASFI (p < 0.001). There was a positive relationship between visfatin with BASDAI (p < 0.001), and BASFI (p < 0.001). Conclusion: Visfatin levels are increased and associated with impaired FMD and increased cIMT in patients with AS. Increased visfatin levels may be associated with subclinical atherosclerosis in AS.Öğe The role of neutrophil lymphocyte ratio to leverage the differential diagnosis of familial Mediterranean fever attack and acute appendicitis(Korean Assoc Internal Medicine, 2016) Kucuk, Adem; Erol, Mehmet Fatih; Senel, Soner; Eroler, Emir; Yumun, Havvanur Alparslan; Uslu, Ali Ugur; Erol, Asiye MukaddesBackground/Aims: Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by attacks of fever and diffuse abdominal pain. The primary concern with this presentation is to distinguish it from acute appendicitis promptly. Thus, we aimed to evaluate the role of neutrophil lymphocyte ratio (NLR) to leverage the differential diagnosis of acute FMF attack with histologically proven appendicitis. Methods: Twenty-three patients with histologically confirmed acute appendicitis and 88 patients with acute attack of FMF were included in the study. NLR, C-reactive protein and other hematologic parameters were compared between the groups. Results: Neutrophil to lymphocyte ratio was significantly higher in patients with acute appendicitis compared to the FMF attack group (8.24 +/- 6.31 vs. 4.16 +/- 2.44, p = 0.007). The performance of NLR in diagnosing acute appendicitis with receiver operating characteristic analysis with a cut-off value of 4.03 were; 78% sensitivity, 62% specificity, and area under the curve 0.760 (95% confidence interval, 0.655 to 0.8655; p < 0.001). Conclusions: This study showed that NLR, the simple and readily available inflammatory marker may have a useful role in distinguishing acute FMF attack from acute appendicitis.Öğe Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio(Wiley, 2015) Uslu, Ali Ugur; Kucuk, Adem; Sahin, Ali; Ugan, Yunus; Yilmaz, Ramazan; Gungor, Tayfun; Bagcaci, SinanAimRheumatoid arthritis (RA) is an inflammatory autoimmune disease with unknown etiology and systemic involvement. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are two new inflammatory markers used in the assessment of systemic inflammation. The aim here is to study NLR and PLR in patients with RA to investigate their relation with Disease Activity Score of 28 joints (DAS-28). MethodsThe study included 104 patients with RA and a control group of 51 age- and gender-matched healthy subjects. We divided the patients into two groups according to the DAS-28 score. Group 1 included patients with a score of lower than 2.6 by the DAS-28 (patients in remission) and Group 2 included patients with a score of 2.6 and higher (patients with active disease). ResultsNLR was 2.120.83 in the patient group and 1.58 +/- 0.57 in the control group. PLR was 136.50 +/- 53.52 in the patient group and 114.84 +/- 29.41 in the control group. There was a statistically significant difference in NLR and PLR between the patient and control groups (P0.0001 and P=0.001, respectively). Patients in Group 1 had an NLR of 1.84 +/- 0.61 and a PLR of 119.25 +/- 41.77. Patients in Group 2 had an NLR of 2.29 +/- 0.90 and a PLR of 147.28 +/- 56.96. There was a statistically significant difference in NLR and PLR between the two groups (P=0.003 and P=0.005 respectively). A correlation was observed between NLR and PLR by DAS-28 (r=0.345, P0.0001 and r=0.352, P0.0001, respectively). ConclusionsThe present study showed us that NLR and PLR were two new inflammatory markers which could be used to assess disease activity in patients with RA.
