The Relation Between Blood Pressure Reverse-Dipping and Neutrophil to Lymphocyte Ratio in Hypertensive Patients

Reverse dipper hypertension and neutrophil to lymphocyte ratio (NLR) has been investigated as a predictor for cardiovascular risk. The relationship between NLR and other circadien blood pressure (BP) patterns has been showed. The aim of this study was to investigate the relation between NLR and BP reverse dipper pattern in patients with hypertension. 144 hypertensive patients (66 males, 78 females) were enrolled the study. BP patterns were evaluated with 24-h ambulatory BP monitoring (ABPM). Baseline NLR was measured by dividing neutrophil count to lymhocyte count. There was significantly increased NLR in reverse dippers (2,36±1,68 ) than dippers (1,81±0,69) of hypertension (p=0,040 ). NLR was negatively correlated with the decline rate of nocturnal systolic BP(r=-0,193;p=0.021) and diastolic BP( r=-0,160; p=0,057). Our study provides a possible association between NLR and reverse dipper pattern, but to report NLR as an independent predictor of reverse dipper pattern further studies are requiredRevers dipper hipertansiyon ve nötrofil/lenfositoranı(NLR),kardiyovasküler risk öngördürücüsü olarak araştırılmaktadır.NLR ve diğer sirkadyen kanbasıncı paternleri arasındaki ilişki gösterilmiştir.Bu çalışmanın amacı hipertansif hastalarda nötrofil lenfosit oranı ile revers dipper kan basıncı paterni arasındaki ilişkiyi değerlendirmektir.Çalışmaya 144 (66erkek,78kadın) hipertansif hasta alındı.Kan basıncı paternleri 24 saat ambulatuar kan basıncı ile değerlendirildi.Nötrofil lenfosit oranı,nötrofil sayısı lenfosit sayısına bölünerek ölçüldü.Revers dipper hipertansiyonlularda dipper hipertansiyonlulara göre nötrofil lenfosit oranında anlamlı artış vardı. (sırasıyla2.36±1,68ve1,81±0,69,p=0,040). Nötrofil lenfosit oranı ile sistolik (r=-0,193;p=0.021vediyastolik(r=-0,160;p=0,057)kan basıncı düşme oranları arasında negatif korelasyon vardı.Çalışmamız NLR ve revers dipper patern arasında olası bir ilişki sunmaktadır ancak nötrofil lenfositoranını,revers dipper paternin bağımsız öngörücüsü olarak rapor etmek için daha ileri çalışmalar gereklidir

Relationship of left ventricular mass to insulin sensitivity and body mass index in healthy individuals

Nur, Omer/0000-0002-9566-041XWOS: 000240232600002PubMed: 16970048Objective-The objective of this study was to investigate the contribution of insulin resistance, hyperinsulinaemia and obesity, independently of other major factors, to changes in left ventricular mass a cardiovascular risk indicator, in a healthy population without co-morbid states such as diabetes or hypertension. Methods and results-This cross-sectional relational study was perfomed in 153 healthy subjects, comprising 76 men and 77 women with ages ranging from 23 to 67 years. All of them were normotensive and had a normal oral glucose tolerance test, none had cardiovascular disease and none were taking any medication. Weight, height and waist circumference were measured and BMI was calculated.A blood sample was drawn in the fasting state: plasma glucose, insulin, serum total and high density lipoprotein (HDL), low density lipoprotein cholesterol and triglycerides were measured. Insulin resistance was determined by the 'Homeostasis Assessment Model' (HOMA-IR). Subjects were studied by echocardiography. The left ventricular mass was calculated by using the anatomically validated formula of Devereux et al. Results - Left ventricular mass significantly and positively correlated with BMI, age, systolic and diastolic blood pressure and fasting blood glucose. The correlation of left ventricular mass with fasting blood glucose was not maintained after controlling for BMI. BMI, fasting blood glucose, HOMAIR, systolic and diastolic blood pressure showed significant differences with higher values for people with left ventricular hypertrophy. The logistic regression analysis showed a strong association between left ventricular hypertrophy and BMI (p < 0.05). Conclusion - Insulin resistance and fasting insulin is not associated with left ventricular hypertrophy in healthy people, independent of obesity. Obesity appears to be an independent risk factor for left ventricular hypertrophy

Frequency of microalbuminuria and its relationship with other atherosclerotic risk factors in nondiabetic hypertensive patients

WOS: 000254243500037PubMed: 17513234

The relationship among asymmetric dimethylarginine (ADMA) levels, residual renal function, and left ventricular hypertrophy in continuous ambulatory peritoneal dialysis patients

WOS: 000256352500009PubMed: 18569913Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of endothelial-based nitric oxide synthase. Its level is increased by end stage renal disease. However, most studies showing an increase in ADMA in dialysis patients have focused on hemodialysis. Results with peritoneal dialysis patients have been more inconclusive. Recent studies suggest that ADMA may be a new cardiovascular risk factor. The aim of the present study was to evaluate the relationship between ADMA levels, residual renal function, and left ventricular hypertrophy in peritoneal dialysis patients. Serum ADMA measurements and echocardiographic evaluations were performed in 54 peritoneal dialysis patients and 26 healthy volunteers. Residual renal function was measured in peritoneal dialysis patients by urea clearance from a urine collection. Thirty-two of the 54 peritoneal dialysis patients had residual renal function. ADMA levels of the peritoneal dialysis group were found to be significantly higher than those of healthy individuals (p = 0.03). Within the peritoneal dialysis group, ADMA levels of patients with residual renal function were significantly lower than those without residual renal function (p = 0.01), though they were still higher than the ADMA levels of the control group (p=0.04). Serum levels of ADMA were positively correlated with left ventricular mass index (r = 0.29, p = 0.01) and negatively correlated with early mitral inflow velocity (Em) (r = -0.28, p = 0.01), Em/Late mitral inflow velocity (Am) (r = -0,32, p = 0.00), and isovolumetric relaxation time (r = -0.30, p = 0.01). In conclusion, increased ADMA levels seem to be associated with left ventricular hypertrophy in peritoneal dialysis patients, and residual renal function may lead to a reduction of serum ADMA levels

The relationship of visfatin levels to inflammatory cytokines and left ventricular hypertrophy in hemodialysis and continuous ambulatory peritoneal dialysis patients

WOS: 000258002700006PubMed: 18661412Visfatin was recently defined as an adipocytokine; however, the pathophysiological role of visfatin is not completely understood. A few studies suggest that visfatin may be a new proinflammatory adipocytokine. The aim of the present study was to compare serum visfatin levels between hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patients and evaluate the relationship between visfatin levels to IL-6, TNF-alpha, and left ventricular hypertrophy. Serum visfatin, IL-6, and TNF-alpha levels were measured by using the ELISA method, and echocardiographic evaluations were performed in 31 hemodialysis patients, 30 CAPD patients, and 21 healthy volunteers. Serum visfatin levels were higher in the CAPD group (265.27 +/- 387.86 ng/mL) than hemodialysis (97.68 +/- 244.96 ng/mL,) and control (41.33 +/- 48.87 ng/mL) groups (p = 0.04, p = 0.01, respectively). No significant difference was observed between the hemodialysis and control groups. In univariate analysis, visfatin levels were positively correlated with IL-6 (r = 0.24, p = 0.03), TNF-alpha (r = 0.34, p = 0.002), and BMI (r = 0.26, p = 0.03) and negatively correlated with some left ventricular diastolic parameters [ Em and Em/Am (r =-0.305, p = 0.01), (r =-0.251, p = 0.03), respectively]. No relationship was found between visfatin and left ventricular mass index. In the linear regression analysis, visfatin levels independently related with TNF-((beta = 0.369, p = 0.001) and IL-6 (beta = 0.284, p = 0.015). This study has found significantly higher levels of serum visfatin in CAPD patients when compared to healthy individuals. Increased visfatin levels seem to associate with proinflammatory cytokines such as IL-6 or TNF-alpha. As for the effects of on left ventricular structure and functions, visfatin might have negative effects on left ventricular diastolic function parameters but have no effects on left ventricular mass index

The relationship between adiponectin levels and proinflammatory cytokines and left ventricular mass in dialysis patients

WOS: 000269100900007PubMed: 19384839Introduction: Adiponectin is increased in end-stage renal disease. However, efforts to clarify the cause of that increase and its clinical effects have been inconclusive. The aim of this study was to compare serum adiponectin levels of dialysis patients against healthy individuals and evaluate the relationship among adiponectin levels, IL-6, TNF-alpha and left ventricular mass index (LVMI). Methods: Adiponectin, IL-6 and TNF-a measurements and echocardiographic evaluations were performed in 36 hemodialysis, 30 continuous ambulatory peritoneal dialysis (CAPD) patients and 22 healthy volunteers. Adiponectin, IL-6 and TNF-alpha levels were measured by ELISA. Results: Adiponectin was found to be higher in hemodialysis (52.78 +/- 18.01 ng/mL) and CAPD (52.96 +/- 17.53 ng/mL) groups than controls (28.36 +/- 13.20 ng/ mL; p = 0.0003, p = 0.0003, respectively). No difference was observed between the hemodialysis and CAPD groups. Adiponectin was positively correlated with IL-6 (r = 0.293, p = 0.02), TNF-alpha (r = 0.458, p = 0.0003) and LVMI (r = 0.283, p = 0.02). In the partial correlation analysis, by controlling for body mass index, the correlation between adiponectin and TNF-alpha (r = 0.466, p = 0.0003) persisted. When IL- 6 was controlled with TNF- a, the relation between adiponectin and LVMI disappeared (r = 0.145, p = 0.30). In the linear regression analysis, with adiponectin as the dependent variable, and IL-6, TNF-alpha and body mass index as independent variables, a significant relationship was found between adiponectin and TNF-alpha (beta = 0.488, p = 0.001). Conclusions: Increased adiponectin seems to be associated with increased proinflammatory cytokines in dialysis patients, and this relationship suggests adiponectin may have a role in the development of left ventricular hypertrophy

Renal cell carcinoma associated immunosuppressive therapy: a case report with Wegener's granulomatosis

Development of uroepithelial tumors after cyclophosphamide and azathioprine therapy in Wegener's granulomatosis (WG) have been reported in the literature but renal cell carcinoma (RCC), rarely. RCC associated with WG has been previously reported in a few cases. Most of them have simultaneous diseases. Here, we report a case, which developed RCC 8 years after initiation of WG. Long-term immunosuppressive treatment is a risk factor for the development of malignancies; it should be suggested that RCC in our patient might be due to immunosuppressive therapy

The relationship between vascular endothelial growth factor (VEGF) and microalbuminuria in patients with essential hypertension

WOS: 000259221300003PubMed: 18758126Objective The existence of microalbuminuria (MAU) in patients with essential hypertension is a strong indicator of microvascular damage. Although endothelial dysfunction and increased vascular permeability both have a role in the development of MAU, its ethiopathogenesis in hypertensive patients is not yet clearly understood. Vascular endothelial growth factor (VEGF) is the most important regulator of pathological or physiological angiogenesis and it additionally leads to increased vascular permeability. This study aims to assess the relationship of serum VEGF levels to MAU in non-complicated, newly-diagnosed essential hypertensive patients (EHs). Methods This study included 30 newly-diagnosed EHs with MAU, 46 newly-diagnosed EHs without MAU and 46 healthy controls. None of the EHs had diabetes, renal impairment or atherosclerotic diseases. Serum VEGF levels were measured using the ELISA method. Results Serum levels of VEGF were significantly higher in EHs with MAU when compared with patients without MAU (225.15+/-109.34 pg/mL versus 166.78+/-114.35 pg/mL, p: 0.04) or controls (225.15+/-109.34 pg/mL versus 144.91+/-96.60 pg/mL, p: 0.007). On the other hand, no significant difference was observed between the non-MAU and control groups. In the univariate analysis, serum levels of VEGF, were positively correlated with systolic blood pressure (R: 0.253 p: 0.001), diastolic blood pressure (R: 0.162 p: 0.04), mean arterial pressure (R: 0.239 p: 0.002), creatinine clearance (R: 0.172 p: 0.04) and MAU (R: 0.338 p: 0.002). In the multiple linear regression analysis, VEGF levels were independently related to MAU (beta: 0.248, p: 0.02). Conclusion VEGF levels are higher in EHs in the presence of MAU. These high values may be important in the early diagnosis of vascular damage in EHs. Additionally, VEGF may increase glomerular permeability and lead to MAU in EHs

Could nephrotoxicity due to colistin be ameliorated with the use of N-acetylcysteine?

WOS: 000286194400017PubMed ID: 20845026The protective effect of N-acetylcysteine (NAC) on nephrotoxicity due to contrast nephropathy and reperfusion-induced ischemia has been reported in experimental models. However, its efficacy on colistin-induced nephrotoxicity has not been elucidated yet. The primary aim of this study was to evaluate the nephrotoxic effect of colistin and to investigate the possible protective effect of NAC on colistin-induced nephrotoxicity. The secondary aim was to research the systemic effects of nephrotoxicity-induced oxidative stress on the lung. Eighteen female Sprague-Dawley rats were randomly assigned and were given (a) 1 ml/kg sterile saline, (b) 300,000 IU/kg/day colistin, and (c) 300,000 IU/kg/day colistin and 150 mg/kg NAC for six consecutive days. Plasma blood urea nitrogen (BUN), creatinine, urinary creatinine, urinary protein, plasma TNF-alpha levels, renal tissue superoxide dismutase (SOD) and malondialdehyde (MDA) activity and immunocytochemical findings were evaluated. Colistin exerted nephrotoxicity and achieved a significant increase in plasma BUN and creatinine levels and renal tissue SOD levels. NAC exhibited no significant effect on biochemical parameters but reduced renal tissue SOD level and reversed immunocytochemical staining of inducible nitric oxide synthase (i-NOS) and neurotrophin-3. Increased oxidative stress in the lung tissue of the rats treated with colistin has also been documented. Additionally, NAC significantly reduced the immunostaining of endothelial NOS (e-NOS) and i-NOS in the lung tissue. Colistin-induced renal toxicity may be attributable to oxidative damage. The combined treatment of colistin plus NAC seems to have a beneficial role in restoration of the oxidant injury which may be related to its antioxidant effect.Internal Medicine Postgraduate Education Society (IMSED)The authors do not have any personal relationships to disclose which may affect the present work. The study was supported by a grant from the Internal Medicine Postgraduate Education Society (IMSED)

Association of neutrophil-to-lymphocyte ratio and microalbuminuria in patients with normal eGFR

Aims. The aim of this study was to evaluate the association between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and microalbuminuria in patients with normal estimated glomerular filtration rate (eGFR)