ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
The Relationship Between Levels Of Plasma Homocysteine And Presence Of Coronary Artery Disease And Endothelial Dysfunction In Type Ii Diabetic Patients
Dr. Emil ALİYEV,a Dr. İstemihan TENGİZ,a Dr. Ertuğrul ERCAN,a Dr. Cevad ŞEKURİ,b Dr. Murat TÜMÜKLÜ,c Dr. Mustafa AKIN,c Dr. İstemi NALBANTGİLc
aKardiyoloji Kliniği, Central Hospital,
bKardiyoloji Kliniği, Kent Hastanesi,
cKardiyoloji AD, Ege Üniversitesi Tıp Fakültesi, İZMİR
Objective: The causal relationship between hyper-homocysteinemia and cardiovascular morbidity and mortality is not clear. In this study, the relationship between levels of plasma homocysteine and the presen-ce of coronary artery disease and endothelial dysfunction in type II diabetic patients was evaluated.
Material and Methods: The study group consisted of 50 type II diabetic patients who underwent exercise stress testing or thallium-201 myocardial perfusion imaging for the diagnosis of CAD. The study group was divided into two groups according to myocardial ischemic signs and angiographic Findings: Group I (n= 25), patients with CAD or Group II (n= 25), patients without CAD. Plasma homocysteine levels were compared among these groups. In addition, the study population was divided into two groups according to their plasma homocysteine levels: Group H (n= 23), patients with hyper-homocysteinemia or Group N (n= 27), patients with normo-homocysteinemia. Flow-mediated dilatation (FMD) and nitrate-induced dilatation (NID) as markers of the endothelial functions were compared among these different groups.
Results: Male gender was dominant in Group I and patients with hyper homocysteinemia. Other clinical features such as lipid profiles, haemoglobin A1c, fibrinolytic and inflammatory activation markers did not different among the groups. Plasma homocysteine levels were significantly higher in Group I than in Group II (16.4 ± 5.1 and 9.2 ± 2.2 mmol/L, respectively; p< 0.0001). In the second analysis evaluating the effect of hyper-homocysteinemia on endothelial function, determinations of FMD and NID were similar in Groups H and N.
Conclusion: Our findings show what appears to be a synergistic contribution of hyper-homocysteinemia on the development of CAD in type II diabetic patients. The detection of hyper homocysteinemia may be important for the prediction of risk in diabetic patients. In addition, it may provide new approaches for primary and secondary prevention.Keywords: Homocysteine, diabetes mellitus, coronary arteriosclerosisTurkiye Klinikleri J Med Sci 2005, 25:609-616
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