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Öğe Adrenomedullin and leptin levels in diabetic retinopathy and retinal diseases(Karger, 2005) Er, H; Doganay, S; Özerol, E; Yürekli, MPurpose: Proliferative and vascular retinal diseases are important cause of irreversible blindness. Consistent features of these diseases are endothelial dysfunction and angiogenesis. Adrenomedullin (ADM) is a multifunctional vasorelaxant peptide. Leptin is a recently discovered metabolic peptide that regulates energy metabolism in human In the present study, we aimed to investigate the possible roles of adrenomedullin and leptin in the pathophysiology of diabetic and proliferative diseases. Methods: Ten patients with proliferative diabetic retinopathy (57.1 years, 5 female and 5 male) and 8 patients (51 years, 5 female and 3 male) with other retinal diseases including macular hole and epiretinal membrane were included in this study. All the patients had undergone pars plana vitrectomy for complications of the diseases. Vitreous samples were collected by vitreous tap during the vitrectomy. Adrenomedullin analysis was made by using reverse-phase high-performance liquid chromatography (HPLC). Leptin was measured by enzyme-linked immunosorbent assay (ELISA). Body mass index (BMI) [weight (kg)/height (m(2))] was calculated for each group. The Mann-Whitney U test was used for statistics. Results: The age, gender ratio and BMI were not substantially different between the two groups. The mean vitreous adrenomedullin levels (63.9 +/- 7.1 pmol/l) were significantly higher (p < 0.05) in group I than in group II (34.25 +/- 3.0 pmol/l). Leptin levels in vitreous (4.54 +/- 1.6 ng/ml) were also significantly higher (p < 0.05) in patients with diabetic retinopathy than in those without diabetes (1.83 +/- 0.5 ng/ml). Conclusion: Increased adrenomedullin and leptin levels in vitreous humor might be a possible newly associated factor in the course of vascular and proliferative retinal diseases. Copyright (C) 2005 S. Karger AG, Basel.Öğe The comparison of nail and serum trace elements in patients with epilepsy and healthy subjects(Pergamon-Elsevier Science Ltd, 2004) Ilhan, A; Özerol, E; Güleç, M; Isik, B; Ilhan, N; Ilhan, N; Akyol, ÖThe objective of this prospective study was to determine the levels of manganese (Mn), copper (Cu), and zinc (Zn) levels in both nail and serum from patients with epilepsy. For this purpose, levels of these elements were measured in 31 patients with epilepsy and 19 healthy subjects. Element analyses were carried out by atomic absorption spectrophotometer (AAS). Increased Mn levels were detected in nail of patients with epilepsy compared to healthy controls (P<.008). The main nail Zn and Cu levels were found to be unchanged in epileptic patients compared to control subjects. There were no significant differences in serum Mn and Zn levels between epileptic patients and control subjects. However, there was a statistically significant increase in serum Cu levels in patients with epilepsy in comparison with control group (P<.009). Our results demonstrate that some trace element levels may vary in epileptic patients, and because of the more stable status, the analysis of these element levels in some tissues such as nail might be superior to serum analysis. (C) 2003 Elsevier Inc. All rights reserved.Öğe Determination of copper, zinc and manganese in nail and serum from patients with migraine(Dustri-Verlag Dr Karl Feistle, 2003) Özerol, E; Ulvi, H; Ilhan, N; Güleç, M; Ilhan, A; Akyol, ÖMetallo-enzymes contain trace elements in their molecular structure to be metabolically active. Manganese-superoxide dismutase (Mn SOD) contains Mn and copper, zinc-superoxide dismutase (Cu, Zn SOD) contains Cu. and Zn as prosthetic groups. There have been some studies on the oxidant/anti oxidant status of patients with migraine. In the present study, the levels of copper, zinc and manganese in nail and serum were investigated in 53 patients with migraine and 19 healthy subjects. Copper, Zn and Mn levels were measured by atomic absorption spectrophotometry and results obtained were statistically compared. The concentration of Mn in nail and serum was significantly higher in migraine patients than those of control subjects. Although Zn and Cu concentrations in nail were increased in migraine group compared to control group, the difference was not statistically significant. There was a statistically significant increase in Cu level (p < 0.02) and decrease in Zn level in serum from patients with migraine compared to those of control group. The unchanged or increased levels of trace elements, which play important roles as prosthetic groups in SOD, in both nail and serum may suggest that the antioxidant enzyme activities are not negatively affected from the changes. The results obtained are discussed in the light of the literature on the relationship between migraine and trace elements plus antioxidant systems.Öğe Effect of smoking on serum concentrations of total homocysteine, folate, vitamin B12, and nitric oxide in pregnancy(Karger, 2004) Özerol, E; Özerol, I; Gökdeniz, R; Temel, I; Akyol, OObjective: Nitric oxide (NO) is a potent vasodilator released by endothelial cells that plays an important role in modulating maternal and fetal vascular tone in normal pregnancy. Lower plasma levels of vitamins may result in hyperhomocysteinemia, a known risk factor in pregnancy. The aim of this study was to investigate whether there are alterations in the serum levels of total homocysteine (tHcy), folate, vitamin B-12, and total nitrite, as an index of NO, in smoking as compared with age-matched nonsmoking pregnant women. Methods: Thirty-three women (19 smoking and 14 nonsmoking) between 16 and 22 weeks of their gestation were included in this study. The serum tHcy levels were analyzed by using an enzyme-linked immunosorbent assay kit. Vitamin B12 and folate values were measured by means of DPC kits. Total nitrite was measured by Griess reaction as an index of endogenous NO production. Results: The serum tHcy concentrations were significantly increased in smoking as compared with nonsmoking pregnant women (p<0.001). The folate and vitamin B-12 concentrations were lower in smoking than in nonsmoking pregnant women, but only the differences in folate concentrations were statistically significant (p<0.001). The tHcy concentrations showed a significant negative correlation with folate in the smoking pregnant women. The serum total nitrite concentrations were lower in smoking than in nonsmoking pregnant women (p<0.05). In addition, the serum nitrite levels in smoking pregnant women had significant negative correlations with tHcy and positive correlations with folate and vitamin B-12 levels. Conclusions: In the light of our findings, we propose that smoking might enhance the vasoconstrictor capacity in pregnant women by increased tHcy concentrations and by a simultaneous decrease in the production of NO which is a vasodilator compound. Copyright (C) 2004 S. Karger AG, Basel.Öğe Serum homocysteine level is increased and correlated with endothelin-1 and nitric oxide in Behcet's disease(Bmj Publishing Group, 2002) Er, H; Evereklioglu, C; Cumurcu, T; Türköz, Y; Özerol, E; Sahin, K; Doganay, SBackground/aims: Beligei's disease (BD) is a systemic inflammatory vasculitis of young adults with unknown aetiology, characterised by endothelial dysfunction and occlusion in both deep venous and retinal circulation. Ocular involvement occurs in 70% of cases and is characterised by periphlebitis, periarteritis, vascular occlusion, and thrombosis leading to blindness despite vigorous treatment. Endothelin-1 (ET-1) is a vasoconstricting peptide while nitric oxide (NO) is a relaxing molecule and both are released by endothelium for blood flow regulation. Homocysteinaemia is a newly defined term connected to the increased risk of atherothrombotic and atherosclerotic systemic and retinal vascular occlusive diseases, and its role in the course of BID has not been previously described. The authors aimed to detect serum total homocysteine (tHcy), ET-1, and NO in BID and to assess if tHcy, ET-1, and NO are associated with ocular BD or disease activity. Methods: 43 consecutive patients with ocular (n = 27) or non-ocular (n = 16) BD (36.95 (SD 9.80) years, 22 male, 21 female) satisfying international criteria, and 25 age and sex matched healthy control subjects (37.88 (8.73) years, 13 male, 12 female) without a history of systemic or retinal venous thrombosis were included in this study. Patients were examined by two ophthalmologists with an interest in BID. Serum tHcy, ET-1, and NO concentrations were measured in both groups. Hype rhomocysteinaemia was defined as a tHcy level above the 95th percentile in the control group. Patients were divided into active and inactive period by acute phase reactants including (X, antitrypsin, alpha(2), macroglobulin, erythrocyte sedimentation rate, and neutrophil count. Results: The overall mean serum tHcy, ET-1, and NO levels were significantly higher in patients with BD than in control subjects (tHcy = 15,83 (4.44) v7.96 (2.66) ng/ml, p <0.001; ET-1 = 17.47 (4.33) v 5.74 (2.34) mumol/ml, p <0.001; NO = 37.60 (10.31) v 27.08 (7.76) mumol/l, p <0.00 1). Serum I tHcy, ET-1, and NO levels were significantly higher in active patients than in inactive patients and control subjects. In addition, among patients with ocular BID, the mean tHcy levels were significantly increased and correlated with ET-1 and NO levels when compared with non-ocular disease and control subjects. All acute phase reactant levels were significantly higher in active period than in inactive stage and controls. Conclusions: Elevated tHcy may be responsible for the endothelial damage in BD and may be an additional risk Factor for the development of retinal vascular occlusive disease, contributing to the poor visual outcome in these patients. Assessment of tHcy may be important in the investigation and management of patients with BD, especially with ocular disease.Öğe Serum leptin concentration is increased in patients with Behcet's syndrome and is correlated with disease activity(Blackwell Publishing Ltd, 2002) Evereklioglu, C; Inalöz, HS; Kirtak, N; Doganay, S; Bülbül, M; Otlu, B; Özerol, EBackground Behcet's syndrome is a systemic, relapsing immuno-inflammatory disease with a generalized vasculitis of the microvasculature endothelial dysfunction. Leptin, a recently discovered neuroendocrine hormone, is a metabolic peptide that appears to be involved. Serum proinflammatory cytokines upregulate leptin levels and leptin itself directly induces nitric oxide production from endothelial cells with its specific receptors. Objectives To detect changes of serum leptin concentrations in patients with Behcet's syndrome compared with age- and sex-matched healthy volunteers by using enzyme-linked immunosorbent assay. We also investigated whether disease activity or the duration of Behcet's syndrome correlates with leptin concentration. Methods Thirty-five consecutive patients with Behcet's syndrome (41.2 +/- 8.4 years, 16 male, 19 female) and 20 age- and sex-matched healthy control subjects (40.4 +/- 10.91 years, nine male, 11 female) were included in this study. The body mass index (BMI) [weight (kg) height(-1) (m(2) )] was calculated for subjects at study enrolment. We measured serum leptin with a leptin enzyme immunoassay kit, and acute-phase reactants, including erythrocyte sedimentation rate, alpha(1) -antitrypsin, alpha(2) -macroglobulin and neutrophil count. The Mann-Whitney U -test was used for statistical analysis and P < 0.05 was considered significant. Values were expressed as mean +/- SD. Results The gender ratio, age and BMI were not substantially different among Behcet's patients and controls. The mean serum leptin concentrations in patients with Behcet's syndrome (16.8 +/- 7.49 ng mL(-1) ) were significantly (P < 0.001) higher than in healthy control volunteers (7.5 +/- 2.77 ng mL(-1) ). Active Behcet's patients had significantly (P = 0.001) higher leptin concentrations (20.5 +/- 7.99 ng mL(-1) ) when compared with patients in inactive periods (12.8 +/- 4.43 ng mL(-1) ). In addition, patients with longer disease duration (mean, 20.1 +/- 5.15 years) had also significantly (P = 0.013) higher leptin concentrations (20.2 +/- 8.52 ng mL(-1) ) than those with shorter disease duration (13.4 +/- 4.52 ng mL(-1) ) (mean, 7.4 +/- 3.29 years). All acute-phase reaction parameters were found to be significantly (for each, P < 0.01) increased in active disease. Conclusions Leptinmay have a role in modulating endothelial function and may be involved in mechanisms for vessel endothelium repair, during an exacerbation as well as in chronic disease.Öğe Serum leptin concentrations are decreased and correlated with disease severity in age-related macular degeneration(Nature Publishing Group, 2003) Evereklioglu, C; Doganay, S; Er, H; Çekmen, M; Özerol, E; Otlu, BBackground Age-related maculopathy (ARM) or degeneration (ARMD) is the leading cause of irreversible blindness in developed countries. Despite several studies on the morphology of ARMD, the aetiology is unknown and factor(s) contributing to the pathogenesis remain to be characterised. More recent studies have demonstrated that cholesterol esters and lipids are present within Bruch's membrane deposits and drusen, and dietary fat intake is associated with ARMD. The product of Ob gene, leptin, is a recently discovered peptide participating in human metabolism. There is a direct relationship between serum leptin and diet, and lipoprotein metabolism, but the role of leptin in the course of ARMD has not previously been investigated. Purpose This cross-sectional case-control study investigated whether serum leptin level was associated with ARMD as a new possible risk factor and to assess its relationship with disease severity. Methods A total of 32 patients with ARM or ARMD (17 men, 15 women) and 20 age- and sex-matched healthy control subjects without ARMD (11 men, nine women) from a similar ethnic background were enrolled in this multicentre study. Body mass index (BMI) (weight (kg)/height (m(2))) was calculated for each group. The presence of maculopathy was assessed on the basis of colour fundus photographs using an international classification system. Patients were classified as early-ARM (n = 16) or late-ARMD (n = 16) using clinical examination and grading of photographs. Serum leptin levels were measured by an enzyme-linked immunosorbent assay kit. The Mann-Whitney U test or chi(2) test was used for statistics as indicated, and P<0.05 was considered to be significant. Results The age, sex ratio, and BMI between groups were comparable. Patients with maculopathy had significantly (P<0.001) lower leptin levels (mean +/- SD, 6.01 +/- 2.55 ng/ ml) than control subjects (13.21+/- 2.27 ng/ml). In addition, late-ARMD patients had significantly lower leptin levels (3.81 +/- 0.58 ng/ ml) than early-ARM patients (8.21 +/- 1.68 ng/ml, P<0.001) or control subjects (P<0.001). Conclusion Leptin seems to be a possible newly associated factor in the course of ARM and may be involved in the lipid composition of the macular lesions, especially in late-ARMD.Öğe Serum nitrate and nitrite levels in patients with rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis(British Med Journal Publ Group, 2002) Ersoy, Y; Özerol, E; Baysal, Ö; Temel, I; MacWalter, RS; Meral, Ü; Altay, ZEObjective: To assess and compare serum nitrate and nitrite levels in patients with ankylosing spondylitis (AS), rheumatoid arthritis (RA), and osteoarthritis (OA). Methods: Thirty five patients with RA, 32 patients with AS, and 36 patients with OA were entered into this study. In addition, 30 healthy volunteers acted as a control group. Concentrations of nitrate and nitrite in serum were determined by direct and indirect Griess reactions. C reactive protein and erythrocyte sedimentation rate levels were determined as markers of systemic activity of disease (SAD) in RA and AS groups. Results: Serum nitrate and nitrite levels were found to be higher in patients with AS and RA than in the OA group (p <0.01). In addition, serum nitrate and nitrite levels were higher in all three groups than in the control group (p <0.01). Moreover, serum nitrate and nitrite levels were higher in patients who had SAD than in those who had not in the RA and AS groups (p <0.01 and p <0.05, respectively), and there was a correlation between serum nitrate and nitrite concentrations and SAD variables in patients with RA (Spearman's r(s)=0.414, p <0.05 and r(s)=0.408, p <0.05, respectively) and AS (r(s)=0.421, p <0.05 and r(s)=0.412, p <0.05, respectively). Conclusion: The findings suggest that nitrate and nitrite production is enhanced in patients with inflammatory arthritis compared with OA. In addition, serum nitrate and nitrite levels are enhanced in patients with RA, AS, and OA compared with healthy subjects. Furthermore, there is a correlation between the SAD variables and serum nitrate and nitrite levels in patients with RA and AS.
