Asymmetric dimethylarginine contributes to airway nitric oxide deficiency in patients with COPD.

INTRODUCTION: Asymmetric dimethylarginine (ADMA) and nitric oxide (NO) show their mechanism of action reciprocally, the balance between these molecules contributes to the tight regulation of airways tone and function. OBJECTIVES: The aim of this study to determine the serum levels of ADMA and NO in patients with chronic obstructive pulmonary disease (COPD) and establish whether their level vary in relation to forced expiratory volume in 1s (FEV1 ), to assess their role in pathophysiology of COPD. MATERIALS AND METHODS: This study consisted of 58 patients with COPD and 30 healthy subjects. Serum ADMA and NO levels were measured using enzyme-linked immunosorbent assay and the colorimetric method, respectively. RESULTS: Serum ADMA levels were significantly higher, however, NO levels were lower in patients with COPD compared with controls. ADMA levels were inversely correlated with NO levels. Serum ADMA and NO were significantly correlated with FEV1 . Multivariable logistic regression analysis revealed that serum ADMA and NO were independently and significantly associated with the presence of COPD. Multiple linear regression analysis showed that COPD was positively associated with ADMA, additionally COPD and ADMA were independently and inversely associated with NO. NO levels were decreased, ADMA levels were increased compliant with progression of COPD stages. CONCLUSION: While circulating ADMA is higher, NO is lower in COPD and both show a strong correlation to the degree of airflow limitation. ADMA seems to be a possible new marker of prognosis of COPD and can be a novel therapeutic target for the treatment of COPD.

Serum YKL-40: a potential biomarker for psoriasis or endothelial dysfunction in psoriasis?

Psoriasis is a disease that can contribute to a risk of atherosclerosis. In several studies, impaired endothelial dysfunction (ED) is correlated with psoriasis. Serum YKL-40 is a new inflammatory biomarker of vascular damage, like ED and cardiovascular diseases. The aim of the study was to compare relevance of serum YKL-40 levels in psoriasis patients and healthy subjects according to ED diagnosis and identifiable cardiovascular risk factors. Sixty (31 female, 29 male) patients with plaque psoriasis, and 30 (18 female, 12 male) healthy controls were selected according to whether they had at least one or no identifiable risk factors for cardiovascular disease. All subjects were evaluated ultrasonographically for endothelial function and diagnosed as with or without ED and all groups compared for serum YKL-40 levels. YKL-40 levels of psoriatic patients with ED were higher than healthy controls with ED (P = <0.05). There were no statistical differences in between subjects without ED. YKL-40 levels of patients over age of 40 were higher than younger ones (P < 0.05). But in healthy controls, there were no differences. In comparison of cardiovascular risk-positive (RP) patients and RP healthy subjects, YKL-40 levels were higher in RP patients (P = <0.05). The elevation of plasma YKL-40 in psoriasis can be associated not only with inflammation of the disease, but also with ED. YKL-40 can be used as a marker for predicting and preventing cardiovascular diseases in RP psoriatic patients with age above 40.

Relationship between plasma chemerin levels and disease severity in COPD patients.

BACKGROUND AND AIMS: Chronic inflammation of the lung is a characteristic finding in chronic obstructive pulmonary disease (COPD). The protein chemerin has been identified in inflammatory fluid and in inflamed tissues. This study aimed to determine the association between serum chemerin levels and the severity of COPD. METHODS: Forty-three COPD patients and 38 healthy subjects were enrolled in this study. Fasting plasma samples were obtained from the patient and the control group. Serum chemerin levels were measured using a commercial enzyme-linked immunosorbent assay. C-reactive protein levels, the erythrocyte sedimentation rate, and fibrinogen analysis were used to assess the inflammation status of the patients. Spirometric measurements with reversibility testing were performed in all the subjects. RESULTS: Serum chemerin levels were significantly elevated in the COPD patients (6.44 ± 0.52 vs 5.22 ± 0.59; P < 0.001). A Mann-Whitney U-test revealed that the serum chemerin levels of stage 2 COPD patients were higher than those of stage 1 and 3 COPD patients (P = 0.651). Cigarette smoking and plasma chemerin relation was also understudied; however, there was no significant relationship between current smokers and ex-smokers (P > 0.05). Pearson's correlation analysis indicated that serum chemerin levels were positively correlated only with total cholesterol (T. cholesterol) (P < 0.05, r = 0.382). In the linear regression analysis, chemerin levels were associated with age (ß = 0.321), triglycerides (ß = 0.299) and T. cholesterol (ß = 0.555). CONCLUSION: Our study points to a relation between plasma chemerin levels and COPD. Larger patient groups are needed to verify the role of chemerin in the severity of COPD.

Can low brain-derived neurotrophic factor levels be a marker of the presence of depression in obese women?

OBJECTIVE: Depression is a common condition in obese women that can result in severe impairment of their physical and social functioning. A deficiency of brain-derived neurotrophic factor (BDNF) is involved in the mechanism of depression. The aim of this study is to investigate whether BDNF levels differ between obese female patients and healthy controls and whether BDNF levels alter with affective states in depressive obese women. METHODS: The study group included 40 obese, 40 preobese, and 40 normal weight women. BDNF levels were measured with an enzyme-linked immunosorbent assay in patient and control groups. For identifying the depression and anxiety status, Beck Depression/Anxiety Inventories were used; and for the evaluation of cognitive functions, the mini-mental state examination was used. RESULTS: BDNF levels were significantly lower in obese patients compared to the control group (P<0.01). BDNF levels were significantly lower in obese patients with depression compared to the obese patients without depression (P<0.05). The Beck Depression Inventory showed a negative correlation with BDNF (r=-0.044; P<0.01) and a positive correlation with the Beck Anxiety Inventory (r=0.643; P<0.001), vitamin B12 levels (r=0.023; P<0.001), and insulin levels (r=0.257; P<0.05) in obese patients. When receiver operating characteristic curve analysis was used to analyze the suitability of BDNF to identify depression in obese women, the area under the curve for BDNF, 0.756, was found to be significant (P=0.025). BDNF levels lower than 70.2 pg/mL were associated with a higher prevalence of depressive symptoms. CONCLUSION: The results of our study suggest that the decrease in BDNF levels can be used as a marker for depression diagnosis in obese patients.

Omentin and chemerin and their association with obesity in women with polycystic ovary syndrome.

We aimed to investigate whether overweight/obesity is associated with omentin and chemerin. The study group consisted of 81 women with Polycystic ovarian syndrome (PCOS) (41 lean, BMI < 25 kg/m² and 40 overweight or obese, BMI > 25 kg/m²) and 61 healthy subjects (31 lean, BMI < 25 kg/m² and 30 overweight or obese, BMI > 25 kg/m²; control group). The clinical, endocrine, metabolic parameters, plasma omentin and chemerin levels were measured in patients and compared to control. In all subjects with PCOS (n = 80), serum chemerin levels were higher compared with those of the controls (n = 58) (7.71 ± 1.78 ng/mL versus 6.94 ± 0.82 ng/mL, p = 0.003). However, serum omentin levels were not significantly different between the PCOS subjects and the controls (1.55 ± 0.43 ng/mL versus 1.69 ± 0.37 ng/mL, p = 0.056). The mean chemerin concentrations were significantly elevated in the obese PCOS group compared with the obese control subjects (8.98 ± 1.45 ng/mL versus 7.02 ± 0.67 ng/mL, p = 0.000) and the nonobese PCOS group compared with the obese control subjects (6.57 ± 1.17 ng/mL versus 7.02 ± 0.67 ng/mL, p = 0.000). In conclusion, fat mass seems to be the main determinant factor of increased chemerin and decreased omentin in women with PCOS.

Elevated circulating levels of YKL-40 are a marker of abnormal glucose tolerance in women with polycystic ovary syndrome.

OBJECTIVE: This study investigates human cartilage glycoprotein-39 (YKL-40) levels in patients with polycystic ovary syndrome (PCOS) and controls, and tests their relationship with metabolic and hormonal parameters. DESIGN: Clinical study carried out in a university hospital in Tekirdag, Turkey. PATIENTS: Eighty-five women with PCOS and normal glucose tolerance (NGT) and twenty-five women with PCOS and abnormal glucose tolerance (AGT), diagnosed according to Rotterdam criteria, and fifty-nine healthy women. MEASUREMENTS: YKL-40 levels, fasting hormone levels and metabolic parameters were investigated in all subjects. RESULTS: We showed increased YKL-40 levels in women with PCOS compared to controls. (152·57 ± 3·96 µg/l vs 98·16 ± 1·6 µg/l, P < 0·000). YKL significantly correlated with BMI (r = 0·344; P < 0·000), 2-h glucose (r = 0·193; P = 0·012), HOMA-IR (r = 0·268; P < 0·000) and fasting insulin (r = 0·310; P < 0·000), but not with waist/hip ratio (r = 0·016; P = 0·832) and fasting glucose (r = 0·108; P = 0·832). When ROC curve analysis was used to analyse the suitability of YKL-40 to identify glucose intolerance in women with PCOS, area under curve for YKL-40 was found to be significant (AGT-PCOS: AUC 0·632, P = 0·046). CONCLUSION: Plasma YKL-40 levels increased in patients with PCOS compared to healthy subjects. Moreover, there was a significant difference in YKL-40 levels between AGT-PCOS and NGT-PCOS subjects. Subsequently, we also found that YKL-40 levels above the cut-off point may help the clinician to predict abnormal glucose tolerance in patients with PCOS.