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Öğe Comparisons of clinical and inflammatory parameters of metabolically healthy and unhealthy obese with healthy lean body individuals in Turkish adults(Carbone Editore, 2015) Türker, Yasemin; Baltacı, Davut; Türker, Yasin; Öztürk, Serkan; Iliev, DarkoAims: Aimed to determine the frequency, demographic, clinical and inflammatory parameters of metabolically healthy obese (MHO), metabolically unhealthy obese (MuHO) and metabolically healthy lean body individuals (MHLB). Materials and methods: The cross-sectional study was carried out between February 2013 and January 2014. The consecutive patients who admitted to outpatient clinic of obesity and check-up of family medicine, Duzce University, school of medicine, were enrolled. The socio-demographic features and medical history, anthropometric measurements, blood pressure records, blood samples and body fat analysis of total of 1958 patients were obtained. The patients were assigned into three groups as: MHO. MuHO and MHLB. Results: A total of 1958 patients were included. Mean homeostatic model assessment of insulin resistance (HOMAIR) value was significantly higher in subjects with MuHO than with MHO and MHLB (p<0.001 and p<0.001, respectively). Mean high density lipoprotein cholesterol (HDL-chol) was significantly lower in subjects with MuHO than in both MHO and MHLB (p<0.001). Mean low density lipoprotein cholesterol (LDL-chol) and total cholesterol was significantly higher in MuHO subjects than in MHO and MHLB (p=0.001 and p<0.001; p=0.002 and p<0.001), and lower in MHLB subjects than MHO and MuHO subjects (p<0.001 and p<0.001). Mean high-sensitivity C-reactive protein level was significantly different between groups (p<0.001), and lowest mean level was observed in subjects with MHLB (1.49 +/- 2.27 mg/dL) and highest mean level was observed in subjects with MuHO (5.32 +/- 5.71 mg/dL). Similarly, mean uric acid level was significantly higher in subjects with MuHO than in those with MHO and MHLB (p<0.001 and p<0.001. respectively). Mean uric acid level in MHLB group was lower than MHO and MuHO (p<0.001 and p<0.001, respectively). Conclusion: Obese individuals with metabolically healthy carried high risk for cardiovascular diseases and subclinical inflammation as well as metabolically unhealthy obese individuals, but carried greater risk than individuals with metabolically healthy lean body.Öğe Complete dissection of left anterior descending artery in a young woman after myocardial infarction(2012) Özhan, Hakan; Bulur, Serkan; Kayapinar, Osman; Türker, YasinSpontaneous coronary artery dissection (SCAD) is a rare clinical condition that causes acute coronary syndrome and sudden cardiac death. Herein, we report a case of left anterior descending artery dissection after myocardial infarction. On the third day of myocardial infarction after successful thrombolysis, the patient had recurrent chest pain without any ST wave elevation. She was referred to our clinic for coronary angiography which showed completely dissected left anterior descending (LAD) artery. She was referred to a tertiary centre with intravascular ultrasonography (IVUS) capability. Her control angiogram showed restored flow with only minimal dissection (so IVUS was not performed) in the mid LAD. The lesions in the distal and mid LAD were stented. The final angiogram showed TIMI-III flow. Percutaneous coronary intervention is the first choice of treatment in patients with single-vessel spontaneous coronary artery dissection with ongoing signs of ischemia.Öğe Incremental effects of restless legs syndrome on nocturnal blood pressure in hypertensive patients and normotensive individuals(2012) Erden, Emine C.; Erden, Ismail; Türker, Yasin; Sivri, Nasir; Dikici, Süber; Ozşahin, MustafaBackground: Few studies have evaluated the role of restless legs syndrome (RLS) in the development of nondipping 24 h blood pressure (BP) patterning/sleep-time hypertension, which has been shown to be an independent predictor of cardiovascular risk. These were indirect studies that had reported the relation between BP and RLS attacks during polysomnographic investigations in the lab. The aim of the present study was to assess the relationship between RLS, which was diagnosed clinically, and night-time BP patterns in a relatively large young cohort who had not been treated before. Patients and methods: After applying the exclusion criteria, this cross-sectional study included 230 consecutive patients with never-treated hypertension who presented to our institution for initial evaluation of hypertension. RLS was assessed using a self-administered questionnaire based on the International Restless Legs Study Group criteria. The questions on RLS were completed by 214 patients and ambulatory BP monitoring was carried out for all patients. Results: In the study group, 133 patients were diagnosed as hypertensive (53.4% nondippings) and 81 patients as normotensives (54.3% nondippings). RLS was present in 61 patients (28.5%) in the total sample. The prevalence of RLS, overall, was significantly higher in nondippings compared with dippings (34.7 vs. 21.2%, respectively; P=0.028). Logistic regression analysis showed that the RLS is an independent determinant for both hypertension (odds ratio=0.43, 95% confidence interval=0.21-0.83; P=0.013) and the nondipping BP patterns (odds ratio=1.96, 95% confidence interval=1.05-3.67; P=0.035). Conclusion: We have shown that clinically diagnosed RLS was associated with the nondipping pattern, which has been shown to be an independent predictor of cardiovascular risk. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.Öğe Investigation of relationship of visceral body fat and inflammatory markers with metabolic syndrome and its components among apparently healthy individuals(E-Century Publishing Corp, 2015) Türker, Yasemin; Baltacı, Davut; Türker, Yasin; Öztürk, Serkan; Sönmez, Cemil IşıkMetabolic syndrome is a cluster of disorders and great risk for cardiovascular diseases. We aimed to investigate association between severity of metabolic syndrome (MetS) and anthropometric measurements, and to evaluate correlation of MetS and its components with metabolic deterioration and inflammatory indexes. The cross-sectional study enrolled 1474 patients with obesity and overweight. The patients were grouped as MetS and Non-MetS, and were sub-grouped as group 1 (three criteria), 2 (four criteria) and 3 (>= five criteria) according to NCEP ATP III. Mean age was 38.7 +/- 11.9 years and BMI was 35.1 +/- 6.3 kg/m(2). Lipid profile, anthropometric and blood pressure measurements, liver function tests, bioelectric impedance body fat compositions, insulin resistance and HbA1c, and spot urinary albumin-creatinine ratio were significantly different between groups of MetS and Non-MetS. Age, lipid profile, bioelectric impedance fat analyses, BMI, blood pressure values, glucose, insulin resistance, uric acid and hs-CRP levels were significantly different between groups of MetS component groups. ROC analysis revealed that hs-CRP was found to be more predictive for severity of metabolic syndrome components 3 and 4 (P=0.030); uric acid and visceral fat were more actual to predict severity of metabolic syndrome between 3 and 5 MetS components, (P=0.006) and uric acid was detected as more actual to predict severity of MetS between 4 and 5 components (P=0.023). In conclusion, uric acid, hs-CRP and visceral body fat composition were useful to predict to severity of MetS in primary care.Öğe Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome?(2015) Bahadır, Anzel; Baltacı, Davut; Türker, Yasemin; Türker, Yasin; Iliev, Darkov; Öztürk, SerkanObjective: Obesity causes subclinical inflammation. Leukocyte count and high-sensitivity C-reactive protein (hs-CRP) are used to indicate inflammation in clinical practice. Also, inflammatory markers are evaluated as important indicators of cardiovascular risk in patients with obesity and metabolic syndrome (MetS). We aimed to investigate the usage of the neutrophil-lymphocyte ratio (NLR) as an inflammatory marker in obese patients with and without MetS. Methods: The study included a total of 1267 patients. The patients were assigned groups according to degree of obesity and status of MetS. Metabolic and inflammatory markers were compared between groups, and correlation analysis was performed. Results: Leukocyte count and hs-CRP were significantly different (p<0.001), but NLR was not different between body mass index (BMI) groups (p=0.168). Both lymphocyte and neutrophil counts were significantly increased with increased degree of obesity (p<0.001, p=0.028, respectively). Leukocyte, neutrophil, and lymphocyte counts and hs-CRP level showed a significant correlation with BMI (r=0.198, p<0.001; r=0.163, p<0.001; r=0.167, p<0.001; r=0.445, p<0.001, respectively), whereas NLR was not correlated with BMI (r=0.017, p=0.737). Only a significant association between a MetS severity of 5 and 4 with hs-CRP level was observed (p=0.028), whereas there was no statistically significant association for leukocyte count and NLR (p=0.246; p=0.643, respectively). Conclusion: NLR was not a good indicator of inflammation, while leukocyte and hs-CRP were more useful biomarkers to indicate inflammation in non-diabetic patients with obesity and MetS. (Anatol J Cardiol 2015; 15: 816-22) Keywords: metabolic syndrome, neutrophil-lymphocyte ratio, obesity, inflammationÖğe MELEN study: Rationale, methodology and basic results(2011) Aydın, Yusuf; Özhan, Hakan; Albayrak, Sinan; Türker, YasinAim: The aim of the Melen Study was to investigate the cardiovascular risk profile of Turkish adults by utilizing newest techniques. Besides prevalence and types of endemic goiter will be established which was an important health problem in the Black sea region Method: The study was conducted on 2230 participants (1427 women, 803 men with a mean age of 49). The participants underwent a Doppler Ultrasound examination of carotid intima media thickness, echocardiographic examination, ECG recording, bioempedance meter analysis of body composition, pulmonary function test and various biochemical analysis. Result: Twenty nine percent of the population had hypertension, 12% had diabetes mellitus and 17% were smokers. Thyroid ultrasonography revealed that 29% of the cohort had goiter. Echocardiographic measurements showed that 39% of the participants had diastolic dysfunction. Comparison of males with females showed that men had significantly higher visceral fat, triglyceride, hemoglobin and CIMT whereas women had higher mean diastolic blood pressure, HDL and total cholesterol. Conclusion: According to the histories of patients, hypertension, diabetes mellitus and smoking were very frequent among Turkish adults. Among the objectively measured variables, diastolic dysfunction, visceral adiposity and goiter were strikingly high.
