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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 Adrenomedullin and nitrite levels in children with Bartter syndrome(Springer-Verlag, 2000) Balat, A; Çekmen, M; Yürekli, M; Kutlu, O; Islek, I; Sönmezgöz, E; Çakir, MChildren with Bartter syndrome have lower than normal vascular reactivity with normotension in spite of biochemical and hormonal abnormalities which are typical of hypertension. Nitric oxide (NO) is a potent endogenous vasodilator, and plays an important role in the control of vascular tone. Adrenomedullin (AM) is a novel hypotensive peptide originally isolated from human pheochromocytoma. The possible role of NO and PLM in maintaining this reduced vascular reactivity was examined by studying plasma and urinary nitrite, a stable metabolite of NO, and AM levels in ten children with Bartter syndrome, ten healthy controls, and five children with hypokalemia of causes other than Bartter syndrome (pseudo-Bartter). Urinary excretion of nitrite (mu mol/mg urinary creatinine) was 8.9.+/-1.2 in children with Bartter syndrome, 4.7.+/-0.9 in healthy controls, and 2.9.+/-0.8 in pseudo-Bartter (P<0.05). Plasma nitrite levels (mol/l) were 101.9+/-23.4, 59.9+/-14.7, and 65.0+/-29.7, respectively (P>0.05), in the three groups. Urinary excretion of AM (pmol/mg urinary creatinine) was 187+/-40, 65+/-10, and 160+/-50, respectively (P<0.05), in the three groups. Plasma AM levels were 47.4+/-1.8, 39.9+/-5.9, and 42.4+/-3.9, respectively (P>0.05), in the three groups. The same parameters were repeated in the two groups of controls and in the Bartter patients in the 6th month of therapy. Urinary nitrite and AM levels were still higher in the Bartter patients than in the other groups. We conclude that in Bartter syndrome the increased NO production may be responsible for the reduced vascular response of the disease. Initially, increased levels of AM in Bartter syndrome and pseudo-Bartter may be a compensatory response to acute hypokalemia; however, continuation of a high level of urinary excretion of AM in children with Bartter syndrome may suggest also the possible role of AM in the reduced vascular response of the disease.Öğe Adrenomedullin and nitrite levels in children with dilated cardiomyopathy(Springer-Verlag, 2003) Kilinç, M; Balat, A; Çekmen, M; Yürekli, M; Yilmaz, K; Sahinöz, SDilated cardiomyopathy (DCM) is an important cause of chronic congestive cardiac failure in children. In patients with idiopathic DCM, endothelium vasomotor function is disturbed. There are many studies on the roles of nitric oxide (NO) and adrenomedullin (AM) in adult patients with DCM. However, to our knowledge, no studies have investigated the level of AM and NO in children with idiopathic DCM. We determined plasma and urinary AM and total nitrite concentrations in children with idiopathic DCM and investigated the correlation between these and other clinical and laboratory findings. Eleven patients with DCM, ranging in age from 5 month to 14 years, were compared to 10 healthy age- and sex-matched controls. Plasma (pmol/ml) and urinary (pmol/mg creatinine) AM levels were significantly lower than in the healthy controls (19.55 +/- 2.36 vs 51.61 +/- 7.22 and 28.29 +/- 20.66 vs 68.87 +/- 40.23, respectively; p < 0.001). Plasma and urinary AM levels were negatively correlated with ejection fraction (EF) and fractional shortening (FS). The plasma (Mmol/L) and urinary nitrite levels (Mmol/mg creatinine) were not different between patients and controls [50.90 +/- 17.50 vs 53.40 +/- 26.05 (p > 0.05) and 1.98 +/- 1.24 vs 2.75 +/- 1.68 (p > 0.05), respectively]. In our study, the first to analyze AM and nitrite levels in children with DCM, plasma and urinary AM levels were found to be decreased. A possible explanation for this reduction could be depletion of the viable myocyte population. However, this hypothesis must be clarified by further studies.Öğe Adrenomedullin and nitrite levels in children with minimal change nephrotic syndrome(Springer-Verlag, 2000) Balat, A; Çekmen, M; Yürekli, M; Gülcan, H; Kutlu, O; Türköz, Y; Yologlu, SNitric oxide (NO) serves many functions within the kidney, and recent evidence suggests that NO contributes to glomerular injury. Adrenomedullin (AM) is a novel hypotensive peptide originally isolated from human pheochromocytoma. Recent studies showed that plasma AM concentrations correlated with the extent of proteinuria. We have examined the possible role of these two agents by studying plasma and urinary total nitrite (NO-(2) + NO-(3)) and AM levels in children with minimal change nephrotic syndrome (MCNS). In comparison with healthy controls, children with MCNS had increased urinary nitrite excretion (mu mol/mg urinary creatinine), irrespective of whether the disease was in relapse or remission (3.2+/-0.2 in relapse, n=13; 1.9+/-0.3 in remission, n=12; 1.0+/-0.2 in controls, n=10, P<0.05). Plasma nitrite levels (mol/l) were high in relapse compared with controls (53.2+/-8.7 vs 32+/-4.0, P<0.05). Plasma AM levels (pmol/ml) were decreased in relapse (27.6+/-1.4 in relapse, 43.3+/-1.2 in remission, 41.5+/-1.6 in controls, P<0.05). Urinary AM levels (pmol/mg urinary creatinine) were significantly higher in relapse than in remission and in controls (156+/-43 in relapse, 56+/-18 in remission, 36+/-16 in controls, P<0.05). Our data indicate that NO may play a role in mediating the clinical manifestations of MCNS in children. However, changes in AM levels may be the result of heavy proteinuria.Öğe Adrenomedullin and nitrite levels in children with primary nocturnal enuresis(Springer, 2002) Balat, AE; Çekmen, M; Yürekli, M; Gül, AK; Özbek, E; Korkut, M; Tarakçioglu, MPrimary nocturnal enuresis (PNE) is the most common type of nocturnal enuresis in children, but its etiology remains unclear. Recent studies indicated the differences in urinary electrolytes in enuretic children, and stressed the existence of a renal tubular maturation defect. In this study, 30 children (aged 6-12 years) with PNE were investigated in comparison with 18 healthy controls. We evaluated plasma antidiuretic hormone, electrolytes, 24-h urine volume, osmolarity, and urinary electrolytes. Unlike other studies, we firstly assessed the plasma and urinary adrenomedullin (AM) and total nitrite levels, a stable product of nitric oxide (NO), and investigated their relationship with urinary electrolytes. The plasma AM and total nitrite levels were significantly lower than controls. Urine volume (24-h) and potassium excretion were higher than in controls. However, 24-h urinary osmolarity and excretion of AM were significantly lower than in controls. Our results indicate that there may be a problem in renal regulation of potassium in children with PNE. Although decreased levels of AM and total nitrite may be a compensatory response to abnormal potassium and water excretion, further investigations are required to exclude whether the renal synthesis of AM and NO are also deficient in these children.Öğe Adrenomedullin and total nitrite levels in children with acute rheumatic fever(Pergamon-Elsevier Science Ltd, 2005) Balat, A; Kilinc, M; Cekmen, MB; Güler, E; Yürekli, M; Sahinöz, S; Coskun, YObjective: To investigate the levels of adrenomedullin (AM) and total nitrite, a stable product of nitric oxide (NO), in children with acute rheumatic fever (ARF). Design and methods: Eleven children with ARF were investigated in comparison with 14 healthy controls. Adrenomedullin was detected by HPLC, while total nitrite was quantitated by the Griess reaction. Results: Plasma urinary AM and total nitrite levels were significantly higher in children with ARE, irrespective of whether they were in the acute or convalescent phase of disease. Plasma AM (pmol/mL) levels were 49.19 +/- 3.23 in the acute phase, 44.52 +/- 4.26 in the convalescent phase, 35.49 +/- 3.43 in controls, and urinary AM excretion (pmol/mg creatinine) was 43.45 +/- 18.40 in the acute phase, 32.38 +/- 15.37 in the convalescent phase, and 24.84 +/- 11.38 in controls. Plasma total nitrite levels (mu mol/L) were 75.37 +/- 13.13 in the acute phase, 59.81 +/- 12.78 in the convalescent phase, and 41.09 +/- 10.27 in controls. Urinary total nitrite excretion (mu mol/mg creatinine) was 3.82 +/- 1.56 in the acute phase, 2.15 +/- 0.58 in the convalescent phase, and 1.33 +/- 0.61 in controls. The differences were statistically significant for all (P < 0.05). Conclusion: This study considered that AM and NO may have a role in the immunoinflammatory process of ARF. (c) 2005 The Canadian Society of Clinical Chemists. All rights reserved.Öğe Adrenomedullin and total nitrite levels in children with familial Mediterranean fever(Blackwell Publishing, 2006) Balat, A; Islek, I; Çekmen, M; Yürekli, M; Tekin, D; Muslu, A; Sahinöz, SAim: Familial Mediterranean fever (FMF) is the most frequent periodic syndrome characterised by recurrent attacks of polyserositis. However, recent studies revealed that there might be an ongoing subclinical inflammation between the attacks. As nitric oxide (NO) and adrenomedullin (AM) are both synthesised in the endothelium, and mediates many functions within immune system, we considered them to be an interesting target of investigation in FMF. Methods: Fifteen children with FMF receiving regular colchicine, ranging in age from 3 to 16 years, were investigated in comparison with 15 healthy age- and sex-matched controls. The mean age of the patients was 9.7 +/- 3.9 years. Total nitrite, a stable product of NO, was quantitated by means of the Griess reaction, while AM was measured by HPLC. Results: Plasma-urinary AM and total nitrite levels were significantly higher in children with FMF. Plasma AM levels (pmol/mL) in patients and controls were 40.95 +/- 5.99 vs. 34.86 +/- 5.24, P < 0.05, and urinary AM excretion (pmol/mg creatinine) was 51.16 +/- 28.15 vs. 37.5 +/- 24.26, P < 0.05 respectively. Plasma total nitrite levels (mu mol/L) in patients and controls were 44.80 +/- 10.36 vs. 32.13 +/- 9.28, P < 0.05, and urinary nitrite excretion (mu mol/mg creatinine) was 2.24 +/- 1.71 vs. 1.09 +/- 0.96, P < 0.05 respectively. Conclusion: This study considered that AM and NO may have a role in the immuno-inflammatory process of FMF, although, whether these act to preserve, or protect against, further inflammatory injury is not clear. Our results further supports the hypothesis that these patients have subclinical inflammation between attacks.Öğe Adrenomedullin and total nitrite levels in children with Henoch-Schonlein purpura(Springer, 2003) Islek, I; Balat, A; Çekmen, M; Yürekli, M; Muslu, A; Sahinöz, S; Sivasli, ENitric oxide (NO) is synthesized from endothelium and has an important role in the control of vascular tonus. Adrenomedullin (AM) is a potent vasodilator, and cytoprotective peptide is produced not only in adrenal medulla, but also in the vascular smooth muscle and endothelial cells. To investigate the endothelial synthesis of AM and NO, and endothelial injury in Henoch-Schonlein purpura (HSP), we measured their levels in 16 children with HSP, who were evaluated during the acute and remission phases, and compared with 12 healthy controls. Plasma AM levels (pmol/ml) were significantly higher in acute phase children (46.87+/-11.49) than in those in remission (35.59+/-12.39, p<0.01) and controls (30.70+/-9.12, p<0.001). Similarly, plasma total nitrite levels (mumol/l) were higher in acute phase patients (47.50+/-12.30) than in those in remission (35.94+/-10.08, p<0.005) and controls (34.56+/-11.51, p<0.05). Urinary excretion of AM (pmol/mg creatinine) was higher in acute phase patients (53.85+/-23.22) than in remission patients (29.97+/-9.33, p<0.01) and controls (37.43+/-15.78, p<0.05). Patients had increased urinary nitrite excretion (mumol/mg creatinine) in acute phase (2.39+/-1.18) compared to those in remission (1.53+/-0.90, p<0.05) and controls (1.05+/-0.61, p<0.005). There was no significant difference between remission phase and controls in AM and nitrite levels (p>0.05). This study concluded that AM and NO may have a role in the immunoinflammatory process of HSP, especially in the active stage, although whether this perpetuates, or protects against, further vascular injury is not clear. Further studies are needed to clearly establish the roles of AM and NO in the pathogenesis of HSP.Öğe Pathophysiological role of nitric oxide and adrenomedullin in autism(John Wiley & Sons Ltd, 2003) Zoroglu, SS; Yürekli, M; Meram, I; Sögüt, S; Tutkun, H; Yetkin, Ö; Sivasli, ESeveral studies indicate that nitric oxide (NO) is involved in the aetiopathogenesis of many neuropsychiatric disorders such as schizophrenia, bipolar disorder, depression, Alzheimer's disease, Hungtington disease and stroke. Although it has not been investigated yet, several recent studies proposed that NO may have a pathophysiological role in autism. Adrenomedullin (AM), a recently discovered 52-amino acide peptide hormone, induces vasorelaxation by activating adenylate cyclase and also by stimulating NO release. AM immune reactivity is present in the brain consistent with a role as a neurotransmitter. It has been stated that NO and AM do function in the regulation of many neurodevelopmental processes. We hypothesized that NO and AM activities have been affected in autistic patients and aimed to examine these molecules. Twenty-six autistic patients and 22 healthy control subjects were included in this study. AM and total nitrite (a metabolite of NO) levels have been measured in plasma. The mean values of plasma total nitrite and AM levels in the autistic group were significantly higher than control values, respectively (p < 0.001, p = 0.028). There is no correlation between total nitrite and AM levels (r = 0.11, p = 0.31). Certainly, this subject needs much further research investigating autistic patients in earlier periods of life and with subtypes of the disorder. Copyright (C) 2002 John Wiley Sons, Ltd.Öğe Plant growth hormone production from olive oil mill and alcohol factory wastewaters by white rot fungi(Kluwer Academic Publ, 1999) Yürekli, F; Yesilada, O; Yürekli, M; Topcuoglu, SFIn this study, olive oil mill and alcohol factory wastewaters have been tested as growth media for the production of plant growth hormones. Funalia trogii ATCC 200800 and Trametes versicolor ATCC 200801 have been tested. Gibberellic acid (GA(3)), abscisic acid (ABA), indole acetic acid (IAA), and cytokinin were determined in the culture media of these fungi. Both organisms produced enhanced levels of all three hormones in the presence of either of the wastewaters.Öğe Plasma and urinary adrenomedullin levels in children with acute pyelonephritis(Blackwell Publishing, 2005) Kalman, S; Buyan, N; Yürekli, M; Özkaya, O; Bakkaloglu, S; Söylemezoglu, OAim: Adrenomedullin (AM), a novel peptide recently isolated from pheochromocytoma, eliciting vasorelaxing activity, is the strongest among all known peptides. AM has been detected in the adrenal medulla, cardiac tissue, lung and kidney. Immunohistochemical studies have demonstrated the localization of AM in glomeruli, tubules and collecting cells of the kidney. Clinically, plasma and urinary AM levels are altered in patients with different renal disease. The present study aims to determine plasma and urinary AM levels in children with acute pyelonephritis (APN) and compare the results with a control group. Materials and Methods: The study group was comprised of 19 patients with APN aged 11.6 +/- 3.7 months (range, 6-18 months) and the control group consisted of 16 cases aged 11.5 +/- 3.2 months (range, 7-16 months). Acute pyelonephritis was diagnosed by clinical, laboratory and imaging methods. Plasma and urinary AM levels were measured by high performance liquid chromotography (HPLC). Results: The plasma AM levels were lower in APN patients (33.40 +/- 2.27 pmol/mL) than in the control group (43.76 +/- 4.27 pmol/mL) (P < 0.001), whereas the urinary AM levels were higher in APN patients (248.58 +/- 140.63 pmol/mg urinary creatinine) than in the control group (49.42 +/- 45.23 pmol/mg) (P < 0.001). Coefficients of correlation between urinary AM levels and C-reactive protein and white blood cells were statistically significant (r = 0.472, P = 0.041; r = 0.555, P = 0.014, respectively). Conclusion: Adrenomedullin, a smooth muscle relaxant peptide that is synthesized in urinary tract tissue might have a role in acute pyelonephritis. However, the importance of AM in the pathogenesis of acute pyelonephritis remains to be determined by further detailed studies.Öğe Plasma and urinary adrenomedullin levels in children with renal parenchymal scar and vesicoureteral reflux(Springer, 2005) Kalman, S; Buyan, N; Yürekli, M; Özkaya, O; Bakkaloglu, S; Söylemezoglu, OAdrenomedullin (AM) is a strong vasodilator peptide with proven antimitogenic and antiproliferative effects in renal mesangial cells, as well as diuretic and natriuretic actions. Its gene expression is stimulated by endotoxins (lipopolysacharides) and cytokines. Consequently, its plasma and urinary levels are known to deviate from normal levels in many renal diseases. The purpose of this study is to determine plasma and urinary AM levels in children with renal parenchymal scar (RPS) and vesicoureteral reflux (VUR). The study was carried out on 74 children with recurrent urinary tract infections, arranged in groups: 25 patients with RPS with VUR (group I), 16 patients with RPS without VUR (group II), 12 patients with VUR without RPS (group III) and 21 healthy children as the control group. Plasma and urinary AM concentrations were both determined by high performance liquid chromotography (HPLC). Plasma AM was measured as picomoles per milliliter (pM/ml) and urinary AM as pM/mg urinary creatinine. In addition, serum creatinine, creatinine clearance and fractional sodium excretion (FENa) were measured. All cases with RPS and VUR had normal blood pressure levels. The plasma AM levels were higher, although not significantly, in the control group (56.2 +/- 14.0 pM/ml) than in group I (50.6 +/- 4.2 pM/ml), group II (49.6 +/- 3.7 pM/ml) and group III (50.6 +/- 3.6 pM/ml) ( P =0.162). The urinary AM levels were higher in the control group (80.1 +/- 33.9 pM/mg) than in the three study groups (52 +/- 7.6 pM/mg, 58.6 +/- 7.5 pM/mg and 44.2 +/- 6.4 pM/mg; P =0.003, P =0.002 and P =0.002, respectively). There were no differences among the 4 groups (group I, group II, group III and the control group) in terms of FENa and creatinine clearance ( P > 0.05 and P > 0.05, respectively). The finding that diminished urinary AM levels in patients with RPS and VUR implies that AM can be a prognostic factor in the long-term follow-up of cases with these diseases.Öğe The possible pathophysiological role of plasma nitric oxide and adrenomedullin in schizophrenia(Pergamon-Elsevier Science Ltd, 2002) Zoroglu, SS; Herken, H; Yürekli, M; Uz, E; Tutkun, H; Savas, HA; Bagci, CEvidence is accumulating for a possible role of nitric oxide (NO) in schizophrenia. Adrenomedullin (AM) induces vasorelaxation by activating adenylate cyclase and also by stimulating the release of NO. AM immune reactivity is present in the brain consistent with a role as neurotransmitter. We aimed to examine plasma levels of nitrite (a metabolite of NO) and AM in schizophrenic patients. Eighty-two patients with schizophrenia and 21 healthy control subjects were included in this study. DSM-IV diagnosis of chronic schizophrenia was established on the basis of independent structured clinical interviews and review of records by two qualified psychiatrists which included the Brief Psychiatric Rating Scale (BPRS), The Scale for the Assessment of Negative Symptoms (SANS) and The Scale for the Assessment of Positive Symptoms (SAPS). Total nitrite and AM have been studied in plasma. The mean values of plasma nitrite and AM levels in schizophrenic group were significantly higher than control values, respectively (P = 0.03, P < 0.0001). AM levels of schizophrenic patients were three fold higher than controls. In correlation analyses, there were statistically significant positive correlations between AM level and SAPS-delusion subscale (r = 0.27, P = 0.04); SAPS-bizarre behavior subscale (r = 0.28, P = 0.03) and SAPS-total (r = 0.36, P = 0.005). There is no correlation between total nitrite and AM levels (r = 0.11, P = 0.31). Both NO and AM may have a pathophysiological role in schizophrenia, and clinically symptomatology and prognosis of schizophrenia. This subject needs further study including treatment response and subtypes of schizophrenia. (C) 2002 Elsevier Science Ltd. All rights reserved.Öğe Possible role of nitric oxide and adrenomedullin in bipolar affective disorder(Karger, 2002) Savas, HA; Herken, H; Yürekli, M; Uz, E; Tutkun, H; Zoroglu, SS; Özen, MENitric oxide (NO) has been implicated to play a role in the pathogenesis of depressive disorders. Adrenomedullin (AM) induces vasorelaxation by activating adenylate cyclase and also by stimulating the release of NO. AM immune reactivity is present in the brain, consistent with a role as neurotransmitter. Therefore, it is suggested that these two molecules may play a role together in the brain. We aimed to examine AM and NO in bipolar affective disorder (BPAD). Forty-four patients with BPAD and 21 healthy control subjects were included in this study. DSM-IV diagnosis of bipolar affective disorder (type 1, manic episodes) was independently established by two psychiatrists and the Turkish version of the Bech-Rafaelson Mania Scale was administered. Also, a semistructured form was used to ascertain several sociodemographic and clinical variables of the patients. AM and NO were studied in plasma. The mean value of plasma NO levels in the BPAD group of 46.58 +/- 13.97 mumol/l was significantly higher than that of controls (31.81 +/- 8.14 mumol/l) (z = -4.15, p = 0.000). Mean plasma AM levels were found to be increased in patients with BPAD (35.13 +/- 5.26 pmol/l) compared to controls (16.22 +/- 3.02 pmol/l) (z = -6.16, p = 0.000). AM levels of BPAD patients were approximately 2-fold higher than controls. AM levels were positively correlated with the duration of hospitalization for the current episode and negatively correlated with the total duration of illness. Both NO and AM may have a pathophysiological role in BPAD (type I, manic episodes) and the clinical symptomatology and prognosis of BPAD. Copyright (C) 2002 S. Karger AG, Basel.Öğe Urinary adrenomedullin levels are increased and correlated with plasma concentrations in patients with Behcet's syndrome(Wiley-Blackwell, 2002) Evereklioglu, C; Özbek, E; Er, H; Çekmen, M; Yürekli, MBackground: The objective was to measure urinary adrenomedullin (AM) levels in patients with active or inactive Behcet's syndrome and compare them to levels in healthy control subjects. Methods: Forty-five consecutive patients with Behcet's syndrome (20 men and 25 women with a mean age of 37.7 +/- 10.8 years) and 20 age- and sex-matched healthy hospital staff volunteers as control subjects (nine men and 11 women with a mean age of 36.2 +/- 10.4 years) were studied. Urinary and plasma AM concentrations were measured by high-performance liquid chromatography. We also investigated whether disease activity correlates with urinary and plasma AM levels. The Mann-Whitney U -test was used in statistical analysis and the values were expressed as mean +/- SD. Results: Urinary excretion of AM (pmol per mg urinary creatinine) in patients with Behcet's syndrome (81.3 +/- 35.1) was significantly higher (P < 0.001) than in control subjects (31.2 +/- 16.1). Plasma AM levels (pmol/L) in patients with Behcet's syndrome and controls were 69.1 +/- 19.2 and 20.7 +/- 11.8, respectively; the difference was significant (P < 0.001). Although active Behcet's syndrome patients (n = 22) had higher urinary AM levels (92.1 +/- 41.1) compared to inactive (n = 23; 70.8 +/- 32.2), the difference was not significant (P > 0.05). Plasma AM levels in active Behcet's syndrome patients (77.5 +/- 21.2) were also higher than in inactive (61.6 +/- 17.3), but the difference was not significant (P > 0.05). Conclusion: Urinary AM levels were higher in Behcet's patients than in control subjects. Urinary AM levels were correlated with plasma AM levels. The results suggest that the higher AM levels found in the urine may be produced by the kidney as a result of the stimulation of inflammation during the course of Behcet's syndrome, or may come from plasma, as plasma AM levels were increased. However, the exact sites of AM synthesis by the kidney (e.g. glomeruli, blood vessels and/or tubular cells) could not be determined in this study. Further studies in this respect are necessary.
