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    Diastolic functions and myocardial performance index in obese patients with or without metabolic syndrome: A tissue Doppler study
    (2010) Koç F.; Tokaç M.; Kaya C.; Kayrak M.; Yazici M.; Karaba? T.; Vatankulu M.A.
    Objectives: This study was designed to evaluate left ventricular (LV) diastolic functions and myocardial performance index (MPI) in obese individuals with or without metabolic syndrome (MetS). Study design: The study included 44 obese subjects with MetS (16 men; 28 women; mean age 46±7 years) and 32 obese subjects without MetS (16 men, 16 women; mean age 43±9 years). Diagnosis of MetS was based on the ATP III criteria. Obesity was defined with a body mass index (BMI) of ?30 kg/m2. All the subjects underwent echocardiography and tissue Doppler imaging to determine LV diastolic functions and MPI. Clinical and echocardiographic characteristics of obese subjects were compared with those of a control group consisting of 21 healthy, nonobese individuals (10 men, 11 women; mean age 42±4 years). Results: Waist circumference, weight, and BMI were similar in the two obese groups. Control subjects and obese subjects without MetS had similar systolic and diastolic blood pressures, fasting blood glucose, triglyceride, and HDL cholesterol levels, but all these significantly differed in patients with MetS. Left ventricular mass, mass index, and diastolic parameters were similar in the two obese groups, but differed significantly from the controls (p<0.05). Body mass index was correlated with the LV mass (r=0.42, p=0.001) and mass index (r=0.33, p=0.001). Left ventricular MPI was similar in the two obese groups with (0.59±0.10) and without (0.59±0.11) MetS, but was higher compared to the control group (0.48±0.06, p<0.05). Left ventricular MPI was correlated with BMI, waist circumference, LV mass, and mass index (r=0.24, p=0.02; r=0.30, p=0.005; r=0.31, p=0.002; r=0.21, p=0.04, respectively). Conclusion: Our findings demonstrate that obesity with or without MetS affects LV MPI. In addition, LV MPI showed significant correlations with BMI, waist circumference, and LV mass.
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    Ghrelin, resistin and leptin levels in patients with metabolic syndrome [Metabolik sendromlu hastalarda grelin, rezistin ve leptin düzeyleri]
    (2011) Koç F.; Tokaç M.; Kocabaş V.; Kaya C.; Büyükbaş S.; Erdem S.; Karaba? T.
    Aim: This study was designed to compare the fasting ghrelin, leptin and resistin levels between metabolic syndrome (MS) patients with healthy controls. Method: This trial was performed on 21 patients with MS (7 men; mean age, 44±4 years) and 17 healthy controls (8 men; mean age, 43±3 years). Diagnosis of MS was defined based on National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III criteria. Patients meeting at least 3 of the MS criteria, with a body mass index (BMI) ?30 kg/m2 were included in the MS group. Among healthy volunteers, those with a BMI<30 kg/m2 were selected as the control group. Plasma ghrelin, serum leptin and resistin concentrations were measured by ELISA method. Result: Ghrelin levels were similar between MS and control groups. There was a negative correlation detected between ghrelin levels with BMI and leptin levels (r=-.54, P=.01 and r=-.56, P=.009, respectively). Resistin levels were found similar between MS with control groups. Leptin levels were significantly higher at the MS group than control group (35±17 ng/ml vs. 14±8 ng/ml, P=.001). Leptin levels had a positive correlation with BMI (r=.56; P=.008). Conclusion: We have demonstrated that leptin levels in MS group were higher than control group. However, ghrelin and resistin levels were similar to control group. In addition, we have showed leptin levels has a positive correlation with BMI and a negative correlation with ghrelin levels.
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    The relation of HOMA index with endothelial functions determined by flow mediated dilatation method among hyperglycemic patients
    (2007) Karaba? T.; Kaya A.; Yavuz S.; Kaya C.; Koc F.; Yeter E.
    Aims/Objective: To research the relation between "homeostasis model assessment of insulin resistance index (HOMA-IR)" and endothelial functions, determined by the flow mediated dilatation (FMD) method with brachial artery ultrasound and the atherosclerotic factors influencing these values among hyperglycemic patients taking the same type of oral antidiabethics (sulphonylurea). Method: Seventy type-2 diabetes mellitus patients (33 males and 37 females, mean age 53.5 ± 8.5 years) who took the same oral antidiabetic drugs, and 40 people (22 males, 18 females, mean age 46.9 ± 14.6 years) as control group who had no hypertension and no cardiovascular disease were included in the study. The HOMA-IR of the patients was calculated. Patients who had HOMA-IR ? 3.6 were assumed as insulin resistance (IR) existing and who had HOMA-IR < 3.6 were not existing. The groups were divided into the IR existing (group 1) and IR not existing (group 2). Endothelium dependent dilatation (FMD) values of the groups and the controls were calculated as percentage increase as to basic values in reactive hyperemia phase. Results: FMD percentages among group 1 were significantly lower than the control group (p < 0.05). No difference was observed between group 2 and the control group (p > 0.05). Percentage increase between the basic level and reactive hyperemy phase was not found statistically significant (p > 0.05) between group 1 and 2. While the main factors influencing FMD percantages were total cholesterol, triglyceride, high-density lipoprotein, and low-density lipoprotein levels for group 1. No parameter could be found affecting the related percentages for group 2. Conclusion: While endothelial functions, determined by FMD method, were impaired with hyperglycemic patients whose HOMA-IR was ? 3.6; it was normal among hyperglycemics whose HOMA-IR was < 3.6.