IMPACT OF SERUM HOMOCYSTEIN, LIPOPROTEIN (A), AND DIHYDROEPIANDROSTENEDION SULPHATE LEVELS ON VASCULAR ENDOTHELIAL DYSFUNCTION IN THE ELDERLY
Journal Name:
- İstanbul Tıp Fakültesi Dergisi
Key Words:
Keywords (Original Language):
| Author Name | University of Author | Faculty of Author |
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Abstract (2. Language):
Objective: Vascular endothelial dysfunction (VED) is an important factor in the development of atherosclerosis.
There are evidences about association of aging with VED. In this study, our aim is to identify if serum levels of homocystein,
lipoprotein (a), apolipoproteins and dihydroepiandrostenedion sulphate interfere with vascular endothelial
function in elderly.
Materials and Methods: Sixty-seven hypertensive elderly patients and 35 hypertensive middle-aged patients were
included into the study. Patients with diabetes and other cardiovascular risk factors were excluded. We compared flow
mediated vasodilation of the brachial artery (BA) (FMD%) and carotid artery intima media thickness (CAIMT) of the patients with their ages, body mass indexes, systolic and diastolic blood pressures, serum lipids, glucose, creatinine,
lipoprotein (a), homocystein and dihydroepiandrostenedion sulphate (DHEAS) levels.
Results: FMD% was found inversely correlated with age and CAIMT (p<0.001, r = -0.317, p<0.001, r = -0.350).
No significant relation was found between FMD% and serum homocystein, lipoprotein (a) and DHEAS levels.
FMD% was found inversely correlated with baseline BA diameter (p = 0.014, r = -0.243) which was significantly
higher in old-age group (4.06 ± 0.50 mm vs 3.73 ± 0.55 mm, p=0.005, t = 2.927). We correlated baseline BA diameter
with FMD% in our old-age group to look for any possible relation between them independent from aging.
Spearman’s correlation test revealed no association (p=0.286).
Conclusion: It seems that changes in serum homocystein, lipoprotein (a) and DHEAS levels in advancing age do
not cause significant VED in the elderly.
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Abstract (Original Language):
Amaç: Vasküler endotelyal disfonksiyon (VED) ateroskleroz gelifliminde önemli bir etkendir. VED ile yafllanma
aras›nda iliflki oldu¤una dair veriler mevcuttur. Bu çal›flmadaki amac›m›z, yafll›da ortaya ç›kan VED’e serum homosistein,
lipoprotein (a) ve dihidroepiandrostenedion sülfat (DHEAS) düzeylerindeki de¤iflikliklerin katk›s›n›n
olup olmad›¤›n›n araflt›r›lmas›d›r.
Gereç ve yöntem: Tümü hipertansif olan 67 ileri yafll› ve 35 orta yafll› hasta çal›flmaya dahil edildi. Diyabet ve di-
¤er kardiyovasküler risk faktörleri olan hastalar çal›flmaya al›nmad›. Hastalar›n brakiyal arterlerinde oluflturulan geçici
iskemi sonras› ortaya ç›kan vazodilatasyon (flow mediated dilation, FMD) düzeyi ve karotis arterlerinin intima
media kal›nl›klar› (KAIMK), yafl, vücut kitle indeksi, sistolik ve diyastolik kan bas›nc›, serum lipid, glukoz, kreatinin,
lipoprotein (a), homosistein ve DHEAS düzeyi ile karfl›laflt›r›ld›.
Bulgular: FMD’nin yafl ve KAIMK ile ters orant›l› oldu¤u bulundu (p<0,001, r = -0,317, p<0,001, r = -0,350).
FMD ile serum homosistein, lipoprotein (a) ve DHEAS de¤erleri aras›nda anlaml› bir iliflkiye rastlan›lmad›. D›fllanma
kriterleri ve gruplar›n homojenizasyonu sonucu FMD ile hastalar›n di¤er biyoflimik parametreleri, VK‹ ve
kan bas›nçlar› aras›nda anlaml› bir iliflki bulunmad›. FMD ile brakiyal arter bazal çap› birbirleriyle ters orant›l› bulundu
(p=0,014, r = -0,243). Brakiyal arter bazal çap› yafll›larda anlaml› olarak daha geniflti (4,06 ± 0,50 mm’ye
karfl› 3,73 ± 0,55 mm, p=0,005, t = 2,927). Bu nedenle ileri yaflta ortaya ç›kan VED’in bazal arter çap›ndaki de¤iflimle
alakal› olup olmad›¤›n› anlamak için ileri yafl grubundaki hastalarda bu iliflki tekrar araflt›r›ld›. Spearman’s korelasyon
testi anlaml› sonuç vermedi (p=0,286).
Sonuç: Serum homosistein, lipoprotein (a) ve DHEAS düzeylerindeki de¤iflikliklerin, ileri yaflta ortaya ç›kan
VED’e katk›da bulunmad›¤› düflünülmektedir
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