The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects

Güneri, Sema; SÖZMEN, Eser; SUSAM, İbrahim; GÖLDELİ, Esin; SOYSAL, Dilek; ÇEVİK, Çetin; SAVAŞ, EMİNE SUMRU

The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects

Dilek SOYSAL, (İzmir Atatürk Eğitim ve Araştırma Hastanesi, İç Hastalıkları Kliniği, İzmir, Türkiye)

EMİNE SUMRU SAVAŞ, (İzmir Atatürk Eğitim ve Araştırma Hastanesi, İç Hastalıkları Kliniği, İzmir, Türkiye)

İbrahim SUSAM, (Atatürk Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, İzmir, Türkiye)

Çetin ÇEVİK, (İzmir Atatürk Eğitim ve Araştırma Hastanesi, İç Hastalıkları Kliniği, İzmir, Türkiye)

Esin GÖLDELİ, (Ege Üniversitesi, Tıp Fakültesi, Farmakoloji Anabilim Dalı, İzmir, Türkiye)

Eser SÖZMEN, (Ege Üniversitesi, Tıp Fakültesi, Biyokimya Anabilim Dalı, İzmir, Türkiye)

Sema GÜNERİ (Dokuz Eylül Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İzmir, Türkiye)

Anadolu Kardiyoloji Dergisi

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Yıl: 2003 Cilt: 3 Sayı: 1 Sayfa Aralığı: 26 - 34 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects

Öz:

Amaç: Bu çalışmada koroner arter hastalığı (KAH)'nda, kardiyak sendrom X'de ve sağlıklu bireylerde plazma total homosistein (tHcy),kardiyak risk faktörleri ve serum total nitrit ilişkisi araştırıldı. Yöntem:Otuz-yetmiş beş yaş arasında 42 KAH, 22 kardiyak sendrom X ve 30 sağlıklı birey çalışmaya alındı.Tüm olgularda usulüne uygun biçimde plazma tHcy, serum total nitrit ve kardiyak risk faktörleri çalışıldı.Sonuçlar gruplar arasında karşılaştırıldı. Total Hcy ,total nitrit ve kardiyak risk faktörlerinin kendi aralarındaki, KAH ve kardiyak sendrom X ile olan bağıntıları incelendi.Bulgular:Yaşa göre düzeltme yapılarak uygulanan istatistik değerlendirmede, sağa çarpık dağılım gösteren plazma tHcy'in mediyan değeri koroner arter hastalarında kardiyak sendrom X ve kontrol grubuna göre yüksek (p<0.001), serum total nitritin medyan değeri ise düşük (p<0.05) bulundu. Tüm grupların linear regresyon analizinde , tHcy ile yaş arasında orta derecede anlamlı pozitif bağıntı ($beta$=0.34,p=0.002), tHcy ile kadın cinsiyet arasında zayıf derecede anlamlı ters bağıntı ($beta$=-0.24,p=0.032) saptandı.Yaşın, cinsiyetin ve kliniğin kontrol altına alındığı bölümsel korelasyon analizinde tHcy ile LDL kolesterol ve trigliserdiler arasında orta derecede anlamlı pozitif korelasyon (r=0.29, p=0.01 ve r=0.27,p=0.016), total nitrit ile HDL kolesterol ve fibrinogen arasında zayıf derecede anlamlı pozitif korelasyon(r=0.23, p=0.040 ve r=0.24, p=0.030) ve total nitrit ile LDL kolesterol arasında orta derecede anlamlı ters korelasyon (r=0.37, p=0.001) saptandı. Aşamalı iki yünlü regresyon analizinde total nitrit ve tHcy arasında anlamlı ters bağıntı saptandı. ($beta$=-0.45). Bu bağıntıda HDL kolesterolün belirleyiciliği ($beta$=-0.45,p=0.044, $R^2$=%36.2) bulundu. Total Hcy ve total nitritin KAH ve kardiyak sendrom X ile bağımsız ilişkisini araştırdığımız lojistik regresyon analizinde , logaritmik transformasyon uygulanmış tHcy konsantrasyonunda bir birimlik standart sapma ile koroner arter hastalığı için risk oranı (OR=0.82), total nitritde (OR=1.08) bulundu. Her iki olasılıklar oranı da anlamlıydı, sırasıyla (p=0.013 ve p=0.020. Aynı model kullanılarak tHcy ve total nitritin kardiyak sendrom X ile bağımsız ilişkisi araştırıldı ve anlamlı bulunmadı, sırasıyla (p=0.221 ve p=0.112) Sonuç: Hiperhomosisteinemi ve diğer kardiyak risk faktörlerinin varlığında düşük nitrit seviyeleri endotel disfonksiyonun bir göstergesi olabilir.Çalışma sonuçlarımızz sağlıklı kontrollere göre KAH'da endotel disfonksiyonunu desteklerken, kardiyak sendrom X hastaları için yeterli bulunmamıştır.

Anahtar Kelime: Koroner arteriyoskleroz Nitritler Risk faktörleri Homosistein Sendrom X Koroner hastalık

Konular: Kalp ve Kalp Damar Sistemi

Koroner arter hastalığı, vasküler sendrom X ve sağlıklı olgularda plazma homosistein, koroner risk faktörleri ve serum nitrit ilişkisi

Öz:

Objective: We evaluated the association of plasma total homocysteine (tHcy), cardiac risk factors and total nitrite in coronary artery disease (CAD) patients, cardiac syndrome X patients and in healthy subjects. Methods: Forty two CAD, 22 cardiac syndrome X patients and 30 healthy subjects, aged 30 to 75 years were included into the study. Blood samples of tHcy, serum total nitrite and cardiac risk factors were studied appropriately. The results were compared between the groups. The independent contributions of tHcy and total nitrite to CAD and cardiac syndrome X and their interactions with cardiac risk factors were evaluated. Results: After adjusting for age, median values of tHcy and total nitrite were evaluated for their skewness. Coronary artery disease patients had higher median plasma tHcy levels than cardiac syndrome X patients (p<0.001) and healthy subjects (p<0.001) and lower serum total nitrite levels than patients in the two other groups (p<0.05), respectively. Using a univariate linear regression analysis tHcy had a moderately significant positive correlation with age ($beta$=0.34, p=0.002) and a weakly significant inverse correlation with female gender ($beta$=-0.24, p=0.032). Using a partial correlation analysis by controlling for age, gender and clinical situations tHcy had a positive but moderately significant correlation with LDL cholesterol (r=0.23, p=0.01) and triglycerides (r=0.27, p=0.016). Total nitrite had a positive but weakly significant correlation with HDL cholesterol (r=0.23, p=0.04) and fibrinogen (r=0.24, p=0.03) and an inverse but moderately significant correlation with LDL cholesterol (r=-0.37,p=0.001). Using a multivariate stepwise regression analysis total nitrite was inversely and significantly associated with tHcy ($beta$=-0.45) in the control group.The contribution of HDL cholesterol to the association was $beta$=-0.45, p=0.044, $R^2$=36.2%, HDL cholesterol with fibrinogen -$beta$=-0.45, p=0.05, $R^2$=36.6% and HDL cholesterol with LDL cholesterol -$beta$=-0.45, p=0.05, $R^2$=36.3%. In a forward stepwise logistic regression analysis the age adjusted odds ratio (OR) for coronary artery disease per standard deviation change in log- transformed tHcy concentration was- 0.82, p=0.013 and in total nitrite concentration was- 1.08, p=0.02. Using the same model neither tHcy nor total nitrite was associated with cardiac syndrome X (p=0.221 and p=0.112), respectively. Conclusion: The low nitrite levels can be a marker of endothelial dysfunction in the presence of hyperhomocysteinemia and other cardiac risk factors. Our results might support endothelial dysfunction in CAD but not in cardiac syndrome X patients.

Anahtar Kelime: Syndrome X Coronary Disease Coronary Arteriosclerosis Nitrites Risk Factors Homocysteine

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	SOYSAL D, SAVAŞ E, SUSAM İ, ÇEVİK Ç, GÖLDELİ E, SÖZMEN E, Güneri S (2003). The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. , 26 - 34.
Chicago	SOYSAL Dilek,SAVAŞ EMİNE SUMRU,SUSAM İbrahim,ÇEVİK Çetin,GÖLDELİ Esin,SÖZMEN Eser,Güneri Sema The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. (2003): 26 - 34.
MLA	SOYSAL Dilek,SAVAŞ EMİNE SUMRU,SUSAM İbrahim,ÇEVİK Çetin,GÖLDELİ Esin,SÖZMEN Eser,Güneri Sema The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. , 2003, ss.26 - 34.
AMA	SOYSAL D,SAVAŞ E,SUSAM İ,ÇEVİK Ç,GÖLDELİ E,SÖZMEN E,Güneri S The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. . 2003; 26 - 34.
Vancouver	SOYSAL D,SAVAŞ E,SUSAM İ,ÇEVİK Ç,GÖLDELİ E,SÖZMEN E,Güneri S The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. . 2003; 26 - 34.
IEEE	SOYSAL D,SAVAŞ E,SUSAM İ,ÇEVİK Ç,GÖLDELİ E,SÖZMEN E,Güneri S "The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects." , ss.26 - 34, 2003.
ISNAD	SOYSAL, Dilek vd. "The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects". (2003), 26-34.

APA	SOYSAL D, SAVAŞ E, SUSAM İ, ÇEVİK Ç, GÖLDELİ E, SÖZMEN E, Güneri S (2003). The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. Anadolu Kardiyoloji Dergisi, 3(1), 26 - 34.
Chicago	SOYSAL Dilek,SAVAŞ EMİNE SUMRU,SUSAM İbrahim,ÇEVİK Çetin,GÖLDELİ Esin,SÖZMEN Eser,Güneri Sema The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. Anadolu Kardiyoloji Dergisi 3, no.1 (2003): 26 - 34.
MLA	SOYSAL Dilek,SAVAŞ EMİNE SUMRU,SUSAM İbrahim,ÇEVİK Çetin,GÖLDELİ Esin,SÖZMEN Eser,Güneri Sema The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. Anadolu Kardiyoloji Dergisi, vol.3, no.1, 2003, ss.26 - 34.
AMA	SOYSAL D,SAVAŞ E,SUSAM İ,ÇEVİK Ç,GÖLDELİ E,SÖZMEN E,Güneri S The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. Anadolu Kardiyoloji Dergisi. 2003; 3(1): 26 - 34.
Vancouver	SOYSAL D,SAVAŞ E,SUSAM İ,ÇEVİK Ç,GÖLDELİ E,SÖZMEN E,Güneri S The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects. Anadolu Kardiyoloji Dergisi. 2003; 3(1): 26 - 34.
IEEE	SOYSAL D,SAVAŞ E,SUSAM İ,ÇEVİK Ç,GÖLDELİ E,SÖZMEN E,Güneri S "The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects." Anadolu Kardiyoloji Dergisi, 3, ss.26 - 34, 2003.
ISNAD	SOYSAL, Dilek vd. "The association of plasma homocysteine, cardiac risk factors and serum nitrite in patients with coronary artery disease, cardiac syndrome X and healthy subjects". Anadolu Kardiyoloji Dergisi 3/1 (2003), 26-34.