Serum soluble lectin-like oxidized low-density lipoprotein receptor-1 levels in patients with restless legs syndrome.

OBJECTIVE: The aim of this study was to assess the predisposition for atherosclerosis in patients with RLS through serum sLOX-1 (serum Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1) measurements. BACKGROUND: Recent epidemiological studies have suggested an association of RLS with certain chronic conditions such as diabetes mellitus (DM), obesity, hypertension (HT), and hyperlipidemia. LOX-1 is expressed in endothelial cells, macrophages, and in smooth muscle cells under the effect of proatherogenic conditions. METHODS: This study was a prospective, cross-sectional, case-controlled. We measured the serum sLOX-1 levels in 37 restless legs syndrome patients and 38 controls. RESULTS: Serum sLOX-1 level was significantly lower in the patient group. The two groups were similar in glucose, HbA1c, creatinine, LDL cholesterol, TG, HDL, total protein, albumin, AST, ALT, GGT, ALP, HGB, HCT, MCV, transferrin saturation rate (TSR), ferritin, CRP, TSH, FT4, FT3, B12, and folic acid levels. Also the two groups were similar with respect to age at menarche, number of previous births, number of abortions and/or curettage, total duration of breastfeeding, percentage of patients in menopause, and age at menopause. CONCLUSION: Our results may suggest a lower atherosclerotic risk among RLS patients as compared to the general population (Tab. 3, Ref. 33).

Evaluation of the Relation between Vitamin D and Serum Omentin and Vaspin Levels in Women.

INTRODUCTION: Vitamin D deficiency is a common health problem seen worldwide. Adipokines released from adipose tissue play important roles in the control of appetite and satiety, modulation of body fat distribution, regulation of insulin sensitivity and secretion, control of blood pressure, and regulation of endothelial functions and inflammation. The aim of the present study is to investigate how vitamin D levels affect serum vaspin and omentin levels. MATERIALS AND METHODS: This is a cross-sectional study design. A total of 77 female volunteers were included in the study, and they were divided into 3 groups according to vitamin D levels. Relation of vitamin D with serum vaspin and omentin levels was determined in these groups. RESULTS: Serum omentin, vaspin and parathyroid hormone (PTH) levels differed significantly between the groups (p<0.001, p<0.001, p=0.001, respectively). Omentin levels correlated significantly and negatively with the vitamin D and vaspin levels, but there was a significant positive correlation between omentin and PTH (r=-0.626, p<0.001; r=-0.867, p<0.001; r=0.461, P<0.001, respectively). A significant positive correlation was detected between vaspin levels and vitamin D, whereas omentin and PTH levels correlated negatively and significantly (r=0.374, p<0.001; r=-0.867, p<0.001; r=-0.374, p=0.002, respectively). CONCLUSIONS: Vitamin D may affect the release of adipokines from the adipose tissue, and this effect may be in a negative or positive manner. This effect of vitamin D may probably be mediated via vitamin D receptors exhibited in the adipose tissue, or via mechanisms not identified yet. The results of this study suggested that there was a significant, positive correlation between serum vitamin D levels and vaspin, whereas a significant, negative correlation between vitamin D levels and omentin. Further studies on larger series are needed in order to confirm these results.

Association of calcium antagonist use with lower hemoglobin levels in hemodialysis patients.

AIM: Objective of the present study was to investigate whether calcium antagonist use is associated with lower hemoglobin levels and/or higher erythropoiesis stimulating agent (ESA) requirement in hemodialysis patients. METHODS: A total of 130 adult hemodialysis patients were classified into two groups based on calcium antagonist usage for a period of at least 3 months as calcium antagonist users and calcium antagonist non-users. The two groups were compared cross-sectionally in a retrospective manner in terms of demographics, chronic kidney disease aetiologies, Charlson's Comorbidty Index, blood pressure, type of dialysis access, interdialytic body weight gain, cardiothoracic index, complete blood count, biochemistry, regular medication use and consumption of ESA. All independent variables that were different between the groups were subjected to logistic regression analysis. Linear regression analysis with dependent variable of hemoglobin value was also performed RESULTS: ESA consumption and blood pressure were higher, diabetic nephropathy, doxazosin and ACE inhibitor use were more frequent, and hemoglobin was lower in the calcium antagonist users. After logistic regression analysis, diabetic nephropathy, doxazosin use, ACE inhibitor use and lower hemoglobin were associated with calcium antagonist use. After lineer regression analysis, Age, BMI, gender, predialysis creatinine value, dialysis duration, systolic and diastolic blood pressure, doxazosin use, diabetes mellitus and diabetic nephropathy were not related with hemoglobin value. But, higher amount of ESA consumption, ACE inhibitor use and calcium antagonist use were significantly associated with lower hemoglobin value. CONCLUSION: CA use was associated with lower hemoglobin levels in our hemodialysis patient population.

The effects of long term fasting in Ramadan on glucose regulation in type 2 diabetes mellitus.

INTRODUCTION: For Ramadan fasting, observing Muslims do not eat or drink between sunrise and sunset during Ramadan, Islam's holy month of the year according to the lunar calendar. In 2011, fasting patients with diabetes fasted for an average of 16.5 hours per day, having 2 meals between sunset and sunrise for a month. We aimed to evaluate the impact of extended fasting on glucose regulation and observe possible complications of extended fasting in type 2 diabetes mellitus patients. PATIENTS AND METHODS: We conducted a randomized, retrospective, observational study. Patients who presented at the Diabetes Clinic during the 15 days before and after Ramadan in August 2011 Istanbul, whose hemoglobin A1c, fasting plasma glucose, postprandial plasma glucose, weight and height value examinations and follow-up were completed were included in the study. FINDINGS: Seventy-six diabetes patients who fasted during Ramadan (fasting group) and 71 patients with diabetes who did not fast (non-fasting group) were included in the study. These two groups with similar demographic characteristics were compared before and after Ramadan. HbA1c, fasting and postprandial plasma glucose, body mass index, weight and adverse events were evaluated. No statistically significant difference was observed among the fasting and the non-fasting groups. There was no difference between the pre and post-Ramadan values of the fasting group. CONCLUSIONS: We could not find any negative effects of extended fasting on glucose regulation of patients with diabetes who are using certain medications. No serious adverse event was observed. We failed to demonstrate benefits of increasing the number of meals in patients with diabetes.

Association of calcium channel blocker use with lower hemoglobin levels in chronic kidney disease.

AIM: To search whether calcium channel blockers (CCBs) are associated with lower hemoglobin levels in chronic kidney disease (CKD) patients who are not on renal replacement therapy (RRT), vitamin D and anti-anemic treatment. PATIENTS AND METHODS: CKD patients were classified into two groups. Patients on CCBs treatment (103 patients) and patients not using CCBs (104 patients) were compared cross-sectionally regarding clinical findings, complete blood count (CBC), biochemistry and regular medication use. Patients with polycystic kidney disease, comorbidities that could influence CBC other than iron deficiency of obscure origin, patients receiving RRT, erythropoietin (EPO), vitamin D, phosphate binders and drugs that could influence CBC were excluded. Under dependent variable of CCB use, all significantly different independent variables were subjected to multivariate binary logistic regression analysis (MBLRA). RESULTS: Lower hemoglobin, lower bilirubinemia, higher serum EPO, higher systolic blood pressure were observed in CCB users. Two groups were similar concerning age, gender, BMI, CKD etiology, CKD stage, pretibial edema prevalence, cardiothoracic index, diastolic blood pressure, corrected reticulocyte count, BUN, creatinine, eGFR, proBNP, parathormone, alkaline phosphatase, phosphorous, corrected calcemia, sCRP, relative EPO deficiency and prevalence of relative EPO deficient patients. Groups were comparable regarding comorbidities, types and usage frequencies of all antihypertensive medications other than CCBs. Higher systolic blood pressure and lower hemoglobin were significantly associated with CCB use after MBLRA. CONCLUSIONS: Hemoglobin was significantly lower in CCB users compared to non-users, among CKD patients who did not receive RRT, EPO, phosphate binders, vitamin D, iron, vitamin B12 and folic acid.

Idiopathic portal hypertension during a catastrophic attack in a patient with primary antiphospholipid syndrome.

A 43-year old male patient with hyponatremic hypertensive syndrome was diagnosed as catastrophic primary antiphospholipid syndrome (PAPS). He subsequently developed hepatosplenomegaly. The patient also carried thrombophilia- and haemochromatosis-associated gene mutations. Further investigations upon persistence of splenomegaly indicated development of idiopathic portal hypertension.

Acute effect of low-flux hemodialysis process on the results of the interferon-gamma-based QuantiFERON-TB Gold In-Tube test in end-stage renal disease patients.

BACKGROUND: Screening for latent tuberculosis infection before solid organ transplantation is mandatory, but this is not so easy in uremic patients on hemodialysis (HD) treatment. The newly developed interferon-gamma (IFN-gamma)-based QuantiFERON((R))-TB Gold In-Tube test (QFT-G) seems to be superior to the other available tests. Objective. To investigate the acute effect of the low-flux HD process on the results of the QFT-G assay. METHODS: A total of 56 HD patients participated in this prospective study. They were dialyzed under low-flux HD for at least 1 month before blood sampling for QFT-G assay. This assay was performed before and after the 4-h low-flux HD session. RESULTS: Compared with the pre-dialysis level, there was an obvious reduction in the IFN-gamma production level (in response to the TB-antigen cocktails) after the HD process (P=0.00). The pre-dialysis test result was negative in 21 (37.5%), positive in 33 (58.9%), and indeterminate in 2 (3.6%) patients. One pre-dialysis negative result changed to positive after the HD process. On the other hand, 7 pre-dialysis positive and 2 indeterminate results become negative after HD (P=0.012). CONCLUSION: In order to maintain the sensitivity of QFT-G assay in chronic renal failure patients on low-flux HD treatment, it is better to perform the test immediately before (not after) the HD process.