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    Evaluation of serum endothelial cell-specific molecule-1 levels and carotid intima-media thickness in patients with ankylosing spondylitis
    (Walter De Gruyter Gmbh, 2016) Turkon, Hakan; Gokmen, Ferhat; Uysal, Sema; Akbal, Ayla; Inceer, Besir Sahin; Resorlu, Mustafa; Gokmen, Esra
    Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disease and the increased mortality in these patients is largely caused by cardiovascular diseases. Endothelial cell-specific molecule-1 (ESM-1) is a novel marker to assess endothelial dysfunction and expressed by the vascular endothelium. In this study, the serum ESM-1 levels in patients with AS and the possible association between serum ESM-1 and carotid intima-media thickness (CIMT) as a marker of atherosclerosis was evaluated. Methods: A total of thirty-seven patients with AS and thirty healthy control subjects were included in this study. ESM-1, erythrocyte sedimentation rate(ESR), C-reactive protein (CRP) and CIMT were measured in all subjects. ESM-1 levels were measured by ELISA method. The disease activity of patients with AS were assessed using questionnaires Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Results: Serum ESM-1 levels were lower in AS patients than in healthy controls. However, there was no statistically significant difference between ESM-1 levels (304.3 +/- 185.2 vs. 373.9 +/- 206.9 ng/L, respectively; p=0.064). Patients with AS had significantly higher CIMT levels compared with controls (0.77 +/- 0.16 vs. 0.53 +/- 0.09 mm, respectively; p<0.001). While a statistically significant positive correlation was detected in all subjects between CIMT levels and ESR, CRP (r=0.378, p=0.002, r=0.547, p<0.001, respectively), no significant correlation was detected between serum ESM-1 levels and ESR, CRP, BASDAI, BASFI and CIMT. Conclusion: The results showed that CIMT values in AS patients were increased when compared to control group. There was no correlation among ESM-1 levels, disease activity and CIMT. In order to reveal the pathological role of the ESM-1 levels in patients with AS need more studies.
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    Neutrophil-Lymphocyte Ratio Connected to Treatment Options and Inflammation Markers of Ankylosing Spondylitis
    (Wiley, 2015) Gokmen, Ferhat; Akbal, Ayla; Resorlu, Hatice; Gokmen, Esra; Guven, Mustafa; Aras, Adem Bozkurt; Erbag, Gokhan
    BackgroundIn recent years, white blood cells (WBCs) and their subtypes have been studied in relation to inflammation. The aim of our study was to assess the relationship between neutrophil-lymphocyte ratio (NLR) and ankylosing spondylitis (AS). Materials and methodsWe enrolled a total of 177 patients, 96 AS and 81 healthy controls. Complete blood count, WBC, neutrophil and lymphocyte levels were measured, and the NLR was calculated. In the assessment of AS, we used the erythrocyte sedimentation rate, C-reactive protein (CRP), the Bath Ankylosing Spondylitis Disease Activity Index, and the Bath Ankylosing Spondylitis Functional Index. ResultsIn the present study, 96 AS and 81 healthy individuals were enrolled. The mean age was 43.8 12.9 and 46.5 +/- 11.2 years, respectively. Mean disease duration of AS patients was 6.9 +/- 5.6 years (median = 5, min-max = 1-25). The patients with AS had a higher NLR than the control individuals (mean NLR, 2.24 +/- 1.23 and 1.73 +/- 0.70, respectively, P < 0.001). A statistically significant positive correlation was observed between NLR and CRP (r = 0.322, P = 0.01). The patients receiving antitumor necrosis factor therapy had a lower NLR than the patients receiving nonsteroidal anti-inflammatory drug therapy (mean NLR, 1.71 +/- 0.62 and 2.41 +/- 1.33, respectively, P = 0.02). ConclusionNLR may be seen as a useful marker for demonstrating inflammation together with acute phase reactants such as CRP and in evaluating the effectiveness of anti-TNF- therapy.
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    Number of Metabolic Syndrome Risk Factors is Related to Carotid Intima-Media Thickness in Rheumatoid Arthritis Patients
    (Turkish League Against Rheumatism, 2015) Gokmen, Ferhat; Temiz, Ahmet; Akbal, Ayla; Sen, Hacer; Zateri, Coskun; Gokmen, Esra; Bozkurt, Emre
    Objectives: This study aims to investigate the relationship between carotid intima-media thickness (CIMT) and clinical and metabolic variables in rheumatoid arthritis (RA) patients. Patients and methods: The study included 76 RA patients (18 males, 58 females; mean age 50.1+/-9.8 years; range 21 to 69 years) and 42 control subjects (11 males, 31 females; mean age 49.2+/-9.7; range 28 to 66 years). Erythrocyte sedimentation rate, C-reactive protein, and disease activity score were used to assess disease activation. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies, and metabolic syndrome components (fasting blood glucose, high density lipoprotein-cholesterol, triglyceride, blood pressure, and waist circumference) were measured. Results: Mean disease duration was 6.9+/-6.5 years. Patients with RA had higher CIMT than the controls (0.8+/-0.1 and 0.6+/-0.2, respectively; p< 0.001). Statistically significant positive correlations were observed between CIMT and age, erythrocyte sedimentation rate, C-reactive protein, and systolic and diastolic blood pressure. The CIMT in RA patients having metabolic syndrome risk components ranging from one to four were 0.76+/-0.16, 0.82+/-0.14, 0.86+/-0.13, and 0.92+/-0.13, respectively. CIMT was positively correlated with the number of metabolic syndrome risk components. Conclusion: Our study has shown elevated CIMT in RA. Presence of metabolic syndrome components in RA patients increases tendency to atherosclerosis and constitutes a severe risk for cardiovascular disease.