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Öğe Benefits of the Neutrophil-to-Lymphocyte Ratio for the Prediction of Gestational Diabetes Mellitus in Pregnant Women(Johann Ambrosius Barth Verlag Medizinverlage Heidelberg Gmbh, 2014) Yilmaz, H.; Celik, H. T.; Namuslu, M.; Inan, O.; Onaran, Y.; Karakurt, F.; Ayyildiz, A.Aims: There is growing consensus in the literature that inflammation plays a central role in the pathophysiology of obesity, Type 2 Diabetes Mellitus (T2DM), Gestational Diabetes Mellitus (GDM) and cardiovascular complications. Measuring the neutrophil-to-lymphocyte ratio (NLR) provides a simple inexpensive method for the assessment of inflammatory status. We investigated the predictive value of pre-procedural (before the oral glucose tolerance test (OGTT)) NLR on the development of GDM in pregnancy. Methods: 42 women with GDM and 68 women without GDM were included in the study. Complete Blood Count and biochemical tests were followed by a diagnostic 4-point 100-g-OGTT within 2 weeks. GDM was diagnosed by the Carpenter and Coustan criteria. The NLR was calculated from the data. Results: The mean NLR level was significantly higher in GDM women (3.00 +/- 0.83 vs. 2.26 +/- 0.43 p < 0.001, respectively). In ROC analysis, NLR > 2.93 had 76.2 % sensitivity and 94.1 % specificity in predicting GDM. Logistic regression analysis showed that elevated NLR (OR: 5.512, 95 % CI: 1.352-22.475, p = 0.017) was an independent variable for predicting GDM in pregnancy. Conclusions: An elevated NLR level is a powerful and independent predictor of GDM. The results of this study suggested that inflammation plays a central role in the pathogenesis of GDM.Öğe Ca 125 Levels and LV Function in Patients with ESRD Treated with Maintenance Hemodialysis Patients(Excerpta Medica Inc-Elsevier Science Inc, 2014) Yilmaz, H.; Bilgic, M. A.; Gurel, O. Malcok; Sahiner, E.; Celik, H. T.; Bavbek, N.; Akcay, A.[Abstract Not Available]Öğe Can Galectin-3 Be A New Biomarker to Detect Diastolic Dysfunction in HD Patients?(Excerpta Medica Inc-Elsevier Science Inc, 2014) Gurel, O. Malcok; Yilmaz, H.; Celik, H. T.; Namuslu, M.; Bilgic, M. A.; Bavbek, N.; Akcay, A.[Abstract Not Available]Öğe Increased levels of galectin-3 were associated with prediabetes and diabetes: new risk factor?(Springer, 2015) Yilmaz, H.; Cakmak, M.; Inan, O.; Darcin, T.; Akcay, A.Purpose Galectin-3 (Gal-3) is a marker of cardiac fibrosis and predicts incident heart failure. Gal-3-deficient mice are resistant to multiple low-dose streptozotocin-induced diabetes. Recent experimental studies suggested an important role for Gal-3 in the regulation of adiposity, metaflammation and type 2 diabetes. This study aimed to examine the relationship between Gal-3 and newly diagnosed prediabetes and diabetes. Methods Gal-3 concentrations were measured in 118 participants and 56 age-and sex-matched healthy controls. All subjects underwent a 75-g oral glucose tolerance test and were stratified into normal, prediabetic, and diabetes mellitus subgroups. DM was defined as a plasma glucose level >= 126 mg/dL in the fasting state or >= 200 mg/dL in the second hour after glucose loading. Impaired fasting glucose was defined as an FPG level of 100-125 mg/dL, and impaired glucose tolerance was defined as a 2-h plasma glucose level of 140-199 mg/dL. Results Sixty-one patients had prediabetes (Group 1), 57 had diabetes (Group 2), and 56 had neither diabetes nor prediabetes (Group 3). Gal-3 levels correlated with FPG (r = 0.787, P < 0.01), 2hPG (r = 0.833, P < 0.01), CRP (r = 0.501, P < 0.01), and HOMA-IR (r = 0.518, P < 0.01). Gal-3 levels were higher in Group 2 than in Groups 1 and 3 [1,053.9 (358.1) and 744.1 (119.3) vs. 481.7 (175.4) pg/mL; P < 0.001]. Gal-3 is an independent predictor of diabetes in multivariate logistic analysis. In ROC analysis, a Gal-3 cutoff value of 803.55 pg/mL diagnoses diabetes with a sensitivity of 80.7 % and a specificity of 85.5 % (AUC = 0.912). Conclusions Gal-3 is a promising biomarker for detecting prediabetes and diabetes.Öğe Increased Serum Levels Of GDF-15 are Associated with Cardiovascular Death, Subclinic Atherosclerosis in Patients on Maintenance Hemodialysis(Excerpta Medica Inc-Elsevier Science Inc, 2014) Yilmaz, H.; Celik, H. T.; Gurel, O. M.; Bilgic, M. A.; Namuslu, M.; Bozkurt, H.; Ayyildiz, A.[Abstract Not Available]Öğe Increased serum levels of GDF-15 associated with mortality and subclinical atherosclerosis in patients on maintenance hemodialysis(Urban & Vogel, 2015) Yilmaz, H.; Celik, H. T.; Gurel, O. M.; Bilgic, M. A.; Namuslu, M.; Bozkurt, H.; Ayyildiz, A.Background/aims. Increased carotid intima-media thickness (CIMT) was shown to be an independent predictor of cardiovascular (CV) mortality in dialysis patients and the general population. Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor superfamily, is produced by cardiomyocytes and atherosclerotic lesions under stress conditions such as inflammation. We assessed associations between serum concentrations of GDF-15, mortality, and CIMT for subclinical atherosclerosis in hemodialysis (HD) patients. Methods. A total of 87 patients on maintenance hemodialysis and 45 sex-and age-matched healthy controls were included in this prospective study. Serum GDF-15 levels were measured by ELISA. CIMT was assessed by Doppler ultrasonography. The association between serum GDF-15 levels and mortality was assessed using Cox regression analysis with serum levels categorized into two groups according to the median value (328.18 pg/ml). Patients were followed for 2 years and cause-specific and all-cause mortality were determined. Results. The median level of serum GDF-15 was significantly higher in HD patients than controls [ 328 (198-522) vs. 176 (101-289) pg/ml, p<0.01, respectively]. Serum GDF-15 levels were correlated to CIMT (r=0.607, p<0.001), C-reactive protein (CRP; r=0.250, p=0.010), HD duration (r=0.376, p=0.004), and serum albumin (r=-0.156, p=0.030). The multivariate analysis revealed that GDF-15 was found to be an independent variable of CIMT in HD patients. In the study, the serum GDF-15 level was an independent marker of all-cause of mortality when adjusted for age, CRP, and history of diabetes mellitus. Conclusion. The relationship between serum GDF-15, mortality, and carotid artery thickening suggests that GDF-15 may be a novel marker of atherosclerosis, inflammation, and malnutrition in HD patients.Öğe Relationship Between Coronary Angiography Results And Levels Of Lipoprotein Phospholipase A2 And High-Sensitivity C-Reactive Protein(Excerpta Medica Inc-Elsevier Science Inc, 2014) Ayyildiz, A.; Yilmaz, H.; Celik, H. T.; Erdamar, H.; Namuslu, M.; Gurel, O. M.; Akcay, A.[Abstract Not Available]Öğe Relationship of galectin-3 to left ventricular geometry and hypertrophy in chronic hemodialysis patients(Urban & Vogel, 2015) Yilmaz, H.; Gurel, O. M.; Celik, H. T.; Bozkurt, A.; Yildirim, M. E.; Bilgic, I.; Bilgic, M. A.Aim and background. Galectin-3 (Gal-3) is used to determine the prognosis of heart failure. Some studies revealed that Gal-3 promoted cardiac hypertrophy but there is no study in which the relationship between -Gal-3 and left ventricular hypertrophy (LVH) geometry in patients without diastolic and systolic function impairment has been explored. The aim of the study was to analyze associations between plasma Gal-3 levels, LVH, and LV geometry in maintenance hemodialysis (HD) patients without systolic and diastolic dysfunction. Patients and methods. The study group included 105 patients (53 women and 52 men)-with an average age of 58.2+/-12.6 years, treated with HD for an average of 45+/-32 months-and 60 healthy controls. The Gal-3 and other biochemical parameters were measured and color Doppler echocardiography was performed. For this study LVH was considered present when the LV mass index (LVMI) exceeded 95 g/m(2) in women and 115 g/m(2) in men. Left ventricular geometry was classified into the four groups on the basis of left ventricular mass and relative wall thickness (RWT). Results. Concentric hypertrophy (CH, 40.9%, n= 43) was the commonest geometric pattern in our study. The Gal-3 levels in CH patients were not different from the patients with eccentric hypertrophy (EH). Plasma levels of Gal-3 correlated with LVMI (r= 0.617, p< 0.001), parathyroid hormone (PTH, r= 0.408, p< 0.001), uric acid (r= 0.281, p = 0.004), C-reactive protein (CRP, r= 0.412, p< 0.001), and RWT (r= 0.281, p = 0.004) but were inversely correlated with albumin (r=-0.466, P< 0.001) in the whole group. Plasma levels of Gal-3 were associated with LVMI (r= 0.812, P< 0.001), RWT (r= 0.318, p = 0.001), and CRP(r= 0.381, p< 0.001) in maintenance hemodialysis patients. Conclusion. The Gal-3 level is related to left ventricular hypertrophy and it is independent of left ventricle geometry. The relationship between LVH and Gal-3 might be direct or it may also be inflammation-related.Öğe Serum galectin-3 levels in women with PCOS(Springer, 2014) Yilmaz, H.; Celik, H. T.; Ozdemir, O.; Kalkan, D.; Namuslu, M.; Abusoglu, S.; Atalay, C. R.Aim Galectin-3 (Gal-3) plays a role in modulation of adiposity, glucose hemostasis and inflammation. The association between Gal-3 and the polycystic ovary syndrome (PCOS), is not investigated. We aimed to evaluate galectin-3 levels in serum and their relation with hyperandrogenism and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) and in control subjects. Materials and methods 56 women with PCOS were enrolled along with a control group of 41 healthy women, matched for age and body mass index. We measured hormonal and metabolic parameters, as well as the serum galectin-3 concentration of each participant. We estimated the IR according to the homeostasis model assessment-insulin resistance (HOMA-IR). Results Women with PCOS had higher levels of serum Gal-3 compared to healthy individuals 3,588.77 +/- 1,566.94 vs 2,491.33 +/- 812.04, P < 0.001). Serum Gal-3 levels were correlated with progesterone (r = 0.241, P = 0.025), hirsutism score (r = 0.296, P = 0.006), insulin (r = 0.479, P = 0.028), HOMA-IR (r = 0.514, P = 0.017), dehydroepiandrosterone sulfate (r = 0.246, P = 0.022), testosterone (r = 0.252, P = 0.019), and free testosterone (r = 0.306, P = 0.004). Conclusion Galectin-3 levels are higher in patients with PCOS, and there is a positive correlation between galectin-3 level and IR, androgen levels and hirsutismus scores. Gal-3 may be a new mediator of PCOS via IR, hyperandrogenism.Öğe Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity(Elsevier Sci Ltd, 2015) Yilmaz, H.; Ucan, B.; Sayki, M.; Unsal, I.; Sahin, M.; Ozbek, M.; Delibasi, T.Background: There is growing consensus in the literature that inflammation plays a central role in the pathophysiology of obesity and type 2 diabetes mellitus (T2DM) and cardiovascular complications. Neutrophil-to-lymphocyte ratio (NLR) provides a simple method for assessment of inflammatory status and it is a new, inexpensive marker. The aim of the present study was to investigate the predictive value of preprocedural (before the OGTT) NLR on development of type 2 diabetes (T2DM) in morbid obesity patients (MOP). Methods: 306 MOP (body mass index >= 40 kg/m(2)) and 95 normal weight patients with normal OGTT [ fasting plasma glucose (FPG) < 100 mg/dL. Two-hour glucose during OGTT < 140 mg/dL] were evaluated in this study. Results: The mean +/- SD NLR of MOP was significantly higher than that of patients with normal weight healthy patients (3.67 +/- 0.95 vs. 1.82 +/- 1.02, P < 0.001, respectively). In receiver operating characteristics curve analysis, NLR > 3.12 had 79.2% sensitivity and 64.9% specificity in predicting T2DM. Logistic regression analysis showed that elevated NLR (OR: 2.577, 95% CI: 1.363-4.872, P = 0.004) was an independent variable for predicting T2DM in MOP. Conclusions: MOP have higher NLR than healthy controls. High NLR is a powerful and independent predictor of T2DM in MOP. Elevated NLR levels are usually considered as an inflammatory marker. The results of this study suggested that inflammation plays a role in the pathogenesis of T2DM with MOP. (C) 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.
