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Öğe The effects of a single dialysis session on serum hepcidin levels(Walter De Gruyter Gmbh, 2024) Oguzman, Hamdi; Tekce, Buket Kin; Tekce, Hikmet; Bugdayci, GulerObjectives Hepcidin plays an important role in regulating iron metabolism. Elevated levels of hepcidin in renal failure contribute to the development of anemia. We aimed to evaluate the association between hepcidin and inflammation in hemodialysis patients and how dialysis affects hepcidin levels.Methods Hepcidin clearance with hemodialysis was investigated by measuring hepcidin concentrations by enzyme-linked immunosorbent assay (ELISA) method before and after hemodialysis of 40 patients in a single dialysis session. Hemogram parameters and ferritin, iron, total iron binding capacity (TIBC), and C-reactive protein (CRP) were measured and evaluated their relations with predialysis hepcidin levels.Results Hepcidin levels decreased significantly with dialysis treatment (p=0.009). Median hepcidin concentration before dialysis was measured as 330 ng/mL (83-459) and post-dialysis median hepcidin concentration was 250 ng/mL (94-384). There was a significant correlation between predialysis hepcidin levels and ferritin (r=0.858, p<0.001), TIBC (r=-0.451, p=0.004), and MCV (r=0.384, p=0.016). It was found that increases in ferritin levels in time were positively correlated with hepcidin before dialysis.Conclusions We think that understanding the removal of the hepcidin by dialysis, which causes a decrease in the amount of iron available in the anemia, is important in managing future therapy.Öğe Evaluation of Serum Creatinine Levels with Reference Change Value in Patients Receiving Colistin Treatment(Oxford Univ Press, 2023) Cinpolat, Havva Yasemin; Alkan, Sevil; Altinisik, Hatice Betul; Cakir, Dilek Ulker; Oguzman, HamdiObjective In this study, we aimed to evaluate the serum creatinine (SCr) levels with the reference change value (RCV) in patients receiving colistin treatment. Methods We retrospectively recorded the SCr levels of 47 patients receiving colistin treatment before treatment and on days 3 and 7 after treatment. RCV was calculated with the asymmetrical RCV formula (Z = 1.64, P < .05). Percent (%) increase in the SCr results of the patients was compared with RCV and values exceeding RCV were regarded as statistically significant. Results The RCV was calculated as 15.6% for SCr. Compared with pretreatment values, SCr value on day 3 was 32/47 and on day 7 it was 36/47; as these results exceeded RCV, they were considered statistically significant. Conclusion Use of RCV in the interpretation of results between serial measurements will provide a more rapid and sensitive method when making decisions.Öğe The first involved joints and associated factors in patients with rheumatoid arthritis(Turkish League Against Rheumatism, 2024) Pekdiker, Mete; Oguzman, HamdiObjectives: This study aimed to investigate the first involved joints and associated factors in Turkish patients with rheumatoid arthritis (RA). Patients and methods: This retrospective cross-sectional study included 300 newly diagnosed and disease-modifying antirheumatic drug-na & iuml;ve RA patients (240 females, 60 males; mean age: 54 +/- 1.2 years; range, 18 to 82 years). Baseline demographic, clinical, and laboratory data were evaluated between January 2022 and December 2022. The patients were divided into four groups according to autoantibody profile: antibody-negative patients (Group 1; both RF and anti-CCP were negative in this group of patients), RF-positive patients (Group 2), anti-CCP-positive patients (Group 3), and patients with dual seropositivity with RF and antiCCP (Group 4). The patients were also divided into two groups according to the size of the first affected joint: patients with SJI at diagnosis and patients without SJI involvement at diagnosis. Results: Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody positivity rates were 40.3% and 35.6%, respectively. The mean lag time to diagnosis was 25 +/- 36 months. At the disease onset, 20% of patients did not have small joint involvement (SJI). Seronegative patients tended to be female (p=0.001), had longer lag time (p=0.001), and had lower levels of C-reactive protein (p=0.025), white blood count (p=0.005), and neutrophil/lymphocyte ratio (p=0.001) compared to the dual seropositive group. Patients presenting with SJI had a younger age (p=0.002), tended to be female (p=0.001), and had lower RF (p=0.034) and anti-CCP (p=0.031) positivity. Only age (p=0.005) and dual seronegativity (RF and anti-CCP; p=0.035) were the independent predictors of SJI in multivariate analysis. Conclusion: The decreasing age and seronegative status were defined as independent risk factors of SJI at the onset of RA. Population-based, prospective studies are needed for earlier diagnosis.Öğe The leucine-rich-2-glycoprotein-1 levels in patients with multiple myeloma(Karger, 2023) Kacmaz, Murat; Oguzman, HamdiIntroduction: Angiogenesis is considered important in the pathogenesis of multiple myeloma (MM), as well as in the targeted treatment of the disease. Leucine-rich-alpha 2-glycoprotein 1 (LRG1) is a protein that participates in angiogenesis and its effect on solid organ tumors has been investigated recently. This study aimed to investigate the relationship between MM and LRG1. Methods: The MM patients who admitted to Hatay Mustafa Kemal University Hematology Clinic between September 2021 and October 2022 were included in the study. The study consists of a total of 4 groups: newly diagnosed MM (NDMM), relapsed refractory MM (RRMM), MM in remission (Rem-MM), and control group. Demographic data were retrieved from hospital records. Blood samples of our study groups were centrifuged at 1500 x g for 10 minutes and serum were collected. LRG1, IL-6, IL-8, TGF-ss 1, HIF-1 alpha, FGF-2, and VEGF levels were analyzed in all groups by ELISA method and statistical analysis was performed. Results: A total of 112 individuals, including NDMM (n:27), RRMM (n:18), Rem-MM (n:42), and control group (n:25), were enrolled in the study. Based on the analyses, the NDMM group exhibited significantly elevated levels of LRG1 (p<0.001), TGF-1 (p<0.001), and HIF-1 alpha (p=0.046, p<0.001, and p=0.003 compared to the RRMM, Rem-MM, and Control groups, respectively) compared to the other groups. LRG1 levels were positively correlated with creatinine (r:0.363, p=0.001), calcium (r:0.344, p=0.001), total protein (r:0.473, p<0.001), erythrocyte sedimentation rate (r:0.547, p<0.001), lactate dehydrogenase (r: 0.321, p=0.003), beta-2-microglobulin (r:0.312, p=0.017), IL-6 (r:0.478, p<0.001), IL-8 (r:0.240, p=0.03), TGF-ss 1 (r:0.521, p<0.001), and HIF-1a (r:0.321, p=0.003) levels, and were negatively correlated with hemoglobin (r:-0.512, p<0.001) and albumin (r:-0.549, p<0.001) levels. Receiver Operating Characteristics (ROC) analysis revealed the association of LRG1 with the highest AUC value of 0.959 (95% CI: 0.904-1, p<0.001) and the optimal cut-off value of 534.95 ng/mL (sensitivity: 93% and specificity: 99%) in the NDMM group compared to the control group. Discussion/Conclusion: In this study, providing data for the first time on LRG1 levels in the setting of MM. LRG1 levels were found to be significantly higher in NDMM patients and in our study discriminate this patient population from significant difference in FGF-2 and VEGF levels was observed in any group. While the results of TGF-ss 1, HIF-1 alpha, IL-6, and IL-8 analysis in our study's NDMM group were similar to previous studies [44-47], the results of FGF-2 and VEGF analysis appear to be conflicting [48-50]. Another result that contradicted previous studies was observed in the RRMM group. It is puzzling that only IL-6 levels were found to be higher than the control group in the results of cytokine analysis in the RRMM group, where a more aggressive disease course was expected compared to the NDMM group. We think the main reason for the differences is because the samples were analyzed from peripheral blood samples, and the study group numbers were not entirely uniform. There are certain limitations of our study. Analyses based on peripheral blood samples can be considered as a limitation. However, there are contradicting studies on the matter. A randomized controlled study of cytokines in MM found no difference between bone marrow and peripheral blood results [50], nevertheless, another comparative study found that bone marrow cytokine levels were higher than peripheral blood [51]. Another limitation of our study can be considered that bone marrow (BM) microvascular density measurements were not performed for the evaluation of angiogenesis. Another limitation of our study is the small sample size in the control group. However, we conducted a pilot study with 7 healthy individuals before the main study, and the mean LRG1 value we obtained was 188.9 +/- 50.8. Subsequently, when the control group was expanded to include 25 individuals, the calculated mean LRG1 value was 189.4 +/- 50.2. Based on these findings, we believe that increasing the sample size in the control group will not result in statistically significant changes in the observed results. Although the lack of data on survival analysis can be considered as a final limitation, the aim of this study was to reveal the descriptive features of MM within the study period, rather than evaluating the effect of LRG1 and other cytokines on survival in MM. Conclusion To our knowledge, this study was the first to analyze LRG1 in MM patients. In this way, we found that the LRG1 level was significantly increased in NDMM. In addition, we found that increase in LRG1 levels was correlated with laboratory parameters which are of considerable importance in the diagnosis, treatment, and prognosis of myeloma. In ROC curves analysis, we found that LRG1 showed a reasonable ability with high sensitivity and specificity in NDMM. These results suggested that LRG1 may play an important role in MM. Therefore, we consider that LRG1 should be evaluated in terms of diagnosis, stage, follow-up, prognosis, and treatment goal in future studies.Öğe The role of pentraxin 3 and oxidative status in the prognosis of multiple myeloma(Sage Publications Ltd, 2024) Oguzman, Hamdi; Kacmaz, MuratMultiple myeloma (MM) is a bone marrow malignancy characterized by plasma cell proliferation. It was aimed to investigate pentraxin 3 (PTX3) levels, oxidative/antioxidative status, and their correlation in MM. In the study, four groups were established, including newly diagnosed MM (NDMM), MM in remission (Rem-MM), relapsed/refractory MM (RRMM) patients, and a healthy control group. PTX3 levels were measured using enzyme-linked immunosorbent assay, and the total antioxidant status (TAS) and total oxidant status (TOS) were assessed with an autoanalyzer. The oxidative stress index (OSI) was calculated using the formula: OSI (arbitrary unit) = TOS (mu mol H2O2 Eq/L)/TAS (mmol Trolox Eq/L) x 100. The study involved comparing PTX3, TAS, TOS, and OSI levels among these four groups. PTX3 levels were significantly elevated in NDMM and RRMM groups compared to controls and the Rem-MM group (NDMM vs control; p < 0.001, NDMM vs Rem-MM; p < 0.001, RRMM vs control; p < 0.001, and RRMM vs Rem-MM; p = 0.006). TAS was higher in NDMM and RRMM groups versus controls (p = 0.009 and p < 0.001, respectively), and TOS was higher in rem-MM group versus NDMM and control groups (p < 0.001 and p = 0.016, respectively). OSI was higher in the Rem-MM group than in NDMM and RRMM groups (p < 0.001 and p = 0.009, respectively). Multivariate analysis confirmed associations between MM groups and PTX3 levels. Receiver operating characteristic analysis revealed high specificity (90%) and sensitivity (79%) for PTX3 in NDMM at a >0.56 ng/mL cut-off value. This study suggests that PTX3 levels may have diagnostic and prognostic potential in MM and its relationship with oxidative stress requires further exploration.
