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    Association of fetuin - A levels with carotid intima media thickness and valvular calcification in hemodialysis and peritoneal dialysis patients
    (2013) Solak Y.; Inal A.; Atalay H.; Kayrak M.; Biyik Z.; Türkmen K.; Yeksan M.
    Background: Fetuin-A is a negative acute-phase reactant which prevents vascular calcification. Coronary artery disease (CAD) is the most important cause of mortality in patients undergoing renal replacement therapy (RRT). The key element of cardiovascular disease (CVD) seen in end-stage renal disease patients who are on dialysis treatment is accelerated calcific atherosclerosis. There are a limited number of studies in which HD and PD is compared in terms of fetuin-A level. OBJECTIVE: We aimed to investigate the association of serum fetuin-A level with valvular calcification and predictors of CAD in hemodialysis (HD) and peritoneal dialysis (PD) patients. MATERIAL and METHODS: 39 HD (24 males, 15 females) and 39 PD (25 males, 14 females) patients were included in the study. We determined carotid artery intima media thickness (CIMT) and evaluated heart valve calcification via echocardiography. We also measured serum fetuin-A level, CRP, ferritin, fibrinogen and serum albumin level. According to fetuin-A level, patients were stratified into quartiles. RESULTS: Fetuin-A level was significantly lower in HD patients when compared with that of PD patients (28.6±5.934 ng/ml, 32±4.8 ng/ml respectively p<0.001). There was a significant negative correlation between CIMT and fetuin-A level. CIMT was found to be lower in PD patients than in HD patients. We found a positive correlation between fetuin-A and dialysis adequacy and albumin level. There was a negative correlation of fetuin-A with age, fibrinogen, ferritin and CRP. Fetuin-A level was lower in patients with aortic calcification. Conclusion: Fetuin-A level was found to be lower in HD patients. Fetuin-A may be a novel marker for CVD in patients undergoing RRT.
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    Thyroid hormon levels in patients with acute exacerbation of chronic obstructive pulmonary disease
    (2007) Uzun K.; Atalay H.; Inal A.
    Aim; The severity of airway obstruction in chronic obstructive pulmonary diseases (COPD) is associated with impairment of thyroid gland function. Methods; We evaluated thyroid abnormalities in patients with COPD and relationship between pulmonary function tests, arterial blood gases and thyroid functions. Results; There was no significant difference in mean levels of TSH, FT3 and FT4 between COPD and control group. Serum level of TSH was lower than normal limits in 20 of 62 patients with COPD. Serum level of FT3 was higher than normal limits in 2 of 20 patients with lower TSH level. In control group, TSH was lower than normal limits in 2 patients, but FT3 was normal in these patients. There was significant difference according to percentage of cases with TSH less than minimum values and FT3 higher than maximum values between COPD and control group. Conclusion; we have demonstrated that both clinic and subclinic hyperthyroidism were higher in patients with COPD exacerbations than cases without COPD.