Timpanoskleroz Hastalarında Serum Fetuin-A, Paratiroid Hormon ve Elektrolit Düzeylerinin Değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı timpanoskleroz TS hastalarında serum fetuin-A, paratiroid hormon PTH ve elektrolit düzeylerini araştırmaktır.Gereç ve Yöntemler: Çalışmaya Yirmi bir TS hastası ve 21 asemptomatik sağlıklı gönüllü dahil edildi. Çalışmamızda iki grup vardı: kronik otitis media ameliyatı geçirmiş ve timpanosklerotik plakları olan hastaları içeren TS grubu n = 21 ; ve kulak problemi olmayan sağlıklı bireyleri içeren kontrol grubu n = 21 . Serumdaki elektrolit, PTH ve fetuin-A düzeyleri ölçüldü ve sonuçlar iki grup arasında karşılaştırıldı.Bulgular: Çalışmaya yaşları 28 ile 47 ortalama 38.6±2.3 arasında değişen 21 hasta 12 kadın, 9 erkek ile 27-49 arasında ortalama 38.8±1.8 değişen 21 sağlıklı kontrol grubu 11 kadın, 10 erkek dahil edildi. Serum kalsiyum ve fosfor düzeyleri karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı bir fark bulunmadı. P=0.23, P=0.82 Serum fetuin-A ve PTH düzeyleri bakımından gruplar arasında istatistiksel olarak anlamlı farklılık saptanmadı. P=0.36, P=0.28 . İşitme seviyeleri ile serum fetuin-A düzeyleri arasında orta düzeyde pozitif korelasyon saptandı. R:0.66 .Sonuç: Timpanosklerozu olan hastalarda düşük serum fetuin-A seviyeleri hastalığın patofizyolojisi üzerinde etkili olabilir, ancak bu gözlemler istatistiksel olarak anlamlı değildi. Fetuin-Aʼnın TS üzerindeki etkilerini doğrulamak için serum ve doku Fetuin-A seviyelerini kullanan çok sayıda denek üzerinde ileri çalışmalar tasarlanmalıdır

Anahtar Kelimeler

• Timpanoskleroz, Fetuin-A, Kalsifikasyon

Evaluation of Serum Fetuin-A, Parathyroid Hormone and Electrolyte Levels in Patients with Tympanosclerosis

Abstract

Objective: This study aimed to investigate serum fetuin-A, parathyroid hormone PTH , and electrolyte levels in patients with tympanosclerosis TS .Material and Methods: Twenty-one patients with TS and 21 asymptomatic healthy volunteers were included in the study. There were two groups in our study: a TS group n=21 , comprising patients who underwent surgery for chronic otitis media and had tympanosclerotic plaques; and a control group n=21 , comprising healthy individuals without ear problems. The electrolyte, PTH, and fetuin-A levels in the serum were measured, and the results were compared between the two groups.Results: Twenty-one patients 12 women, nine men aged between 28 and 47 average 38.6 , and 21 volunteers 11 women, ten men aged between 27 to 49 average 38.8 , were included in the study. When the levels of calcium and phosphorus were compared, no statistically significant difference was found between the groups p=0.23, p=0.82 . There was no statistically significant difference in serum fetuin-A and PTH levels between the patient and control groups p=0.36, p=0.28 . There was a moderate positive correlation in the correlation test between the level of hearing and serum fetuin-A R value: 0.66 .Conclusion: The low serum fetuin-A levels in patients with tympanosclerosis may have an effect on the pathophysiology of the disease, but these observations were not statistically significant. Further studies on large number of subjects using serum and tissue Fetuin-A levels should be designed to affirm the effects of Fetuin-A on TS

Keywords

• Tympanosclerosis, Fetuin-A, Calcification

References

1. Asiri S, Hasham A, al Anazy F, Zakzouk S, Banjar A. Tympanosclerosis: Review of literature and incidence among patients with middle ear infection. J Laryngol Otol 1999; 113:1076-80.
2. Wielinga EW, Kerr AG. Tympanosclerosis [Review]. Clin Otolaryngol Allied Sci 1993; 18:341-9.
3. Raustyte G, Hermansson A. Development of MS during acute otitis media caused by Streptococcus pneumoniae and nontypeable Haemophilus influenza: A clinical otomicroscopical study using the rat model. Medicine 2005; 41:661-7.
4. sclerotic degeneration. Eur Arch Otorhinolaryngol 2002; 259: 180-3.
5. de Carvalho Leal M, Ferreira Bento R, da Silva Caldas Neto S, Caldas N, Alves Peixoto C, Delgado Lessa FJ, Souza Leão RS, Bezerra T. Influence of hypercalcemia in the formation of tympanosclerosis in rats. Otol Neurotol 2006; 27:27-32.
6. Schafer C, Heiss A, Schwarz A, Westenfeld R, Ketteler M, Floege J, Muller-Esterl W, Schinke T, Jahnen-Dechent W. The serum protein alpha 2-Heremans-Schmid glycoprotein/fetuin-A is a systemically acting inhibitor of ectopic calcification. J Clin Invest 2003; 112:357-66.
7. Price PA, Lim JE. The inhibition of calcium phosphate precipitation by fetuin is accompanied by the formation of a fetuin-mineral complex. J Biol Chem 2003; 278: 22144-52.
8. Heiss A, DuChesne A, Denecke B, Grötzinger J, Yamamoto K, Renné T, Jahnen-Dechent W. Structural basis of calcification inhibition by alpha 2-HS glycoprotein/ fetuin-A. Formation of colloidal calciprotein particles. J Biol Chem 2003; 278:13333-41.

9. Schinke T, Amendt C, Trindl A, Pöschke O, Müller- Esterl W, Jahnen-Dechent W. The serum protein alpha2- HS glycoprotein/fetuin inhibits apatite formation in vitro and mineralizing calvaria cells. A possible role in mineralization and calcium homeostasis. J Biol Chem 1996; 271:20789-96.
10. Zhang S, Ma F, Pan T, Ke J, Zhang K, Song Y, Jiang L. Clinical analysis of tympanosclerosis: Characteristics and treatment. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 29(14):1238-42.
11. Kinney SE. Postinflammatory ossicular fixation in tympanoplasty. Laryngoscope 1978; 88:821-38.
12. Gibb AG, Pang YT. Current considerations in the etiology and diagnosis of tympanosclerosis. Eur Arch Otorhinolaryngol 1994; 251:439-51.
13. Özkan M, Yarıktaş M, Aynali G, Unal F, Yasan H, Tuz M, Ciris M. Effects of calcium-rich diet in experimentally induced otitis media subtypes in the formation of tympanosclerosis in rats. International journal of advanced otology 2012; 8(2):231-8.
14. Forséni Flodin M, Hultcrantz M. Possible inflammatory mediators in tympanosclerosis development. Int J Pediatr Otorhinolaryngol 2002; 63(2):149-54.
15. Mann W, Beck C, Schaefer HE. The significance of calcium channel blockers in rat experimental tympanosclerosis. Arch Otorhinolaryngol 1987; 243:382- 6.
16. Bhaya MH, Schachern PA, Morizono T, Paparella MM. Pathogenesis of tympanosclerosis. Otolaryngol Head Neck Surg 1993; 109:413-20.
17. Tos M. Pathogenesis of tympanosclerosis. In: Tos M. (ed). Surgical solutions to conductive hearing loss, Stuttgart: Thieme Verlag, 2000: 4-7.
18. Goltzman D, Mannstadt M, Marcocci C. Physiology of the Calcium-Parathyroid Hormone-Vitamin D Axis. Front Horm Res 2018; 50:1-13.
19. Choi HS, Kim SH, Rhee Y, Cho MA, Lee EJ, Lim SK. Serum parathyroid hormone is associated with carotid intima-media thickness in postmenopausal women. Int J Clin Pract 2008; 62(9):1352-7.
20. Nuzzo V, Tauchmanovà L, Fonderico F, Trotta R, Fittipaldi MR, Fontana D, Rossi R, Lombardi G, Trimarco B, Lupoli G. Increased intima-media thickness of the carotid artery wall, normal blood pressure profile and normal left ventricular mass in subjects with primary hyperparathyroidism. Eur J Endocrinol 2002; 147(4):453- 9.
21. Reis JP, von Mühlen D, Michos ED, Miller ER 3rd, Appel LJ, Araneta MR, Barrett-Connor E. Serum vitamin D, parathyroid hormone levels, and carotid atherosclerosis. Atherosclerosis 2009; 207(2):585-90.
22. Hendig D, Schulz V, Arndt M, Szliska C, Kleesiek K, Götting C. Role of serum fetuin-A, a major inhibitor of systemic calcification, in pseudoxanthoma elasticum. Clin Chem 2006; 52(2):227-34.
23. Ketteler M, Bongartz P, Westenfeld R, Wildberger JE, Mahnken AH, Böhm R, Metzger T, Wanner C, Jahnen- Dechent W, Floege J. Association of low fetuin-A (AHSG) concentrations in serum with cardiovascular mortality in patients on dialysis: A cross-sectional study. Lancet 2003; 361(9360):827-33.
24. Brylka L, Jahnen-Dechent W. The role of fetuin-A in physiological and pathological mineralization. Calcif Tissue Int 2013; 93(4):355-64.
25. Chen NX, O’Neill KD, Chen X, Moe SM. Annexin- mediated matrix vesicle calcification in vascular smooth muscle cells. J Bone Miner Res 2008; 23(11):1798-805.
26. Wallin R, Schurgers LJ, Loeser RF. Biosynthesis of the vitamin K-dependent matrix Gla protein (MGP) in chondrocytes: A fetuin-MGP protein complex is assembled in vesicles shed from normal but not from osteoarthritic chondrocytes. Osteoarthritis Cartilage 2010; 18(8):1096- 103.
27. Chen NX, O’Neill KD, Moe SM. Matrix vesicles induce calcification of recipient vascular smooth muscle cells through multiple signaling pathways. Kidney Int 2018; 93(2):343-54.
28. Matsui I, Hamano T, Mikami S, Inoue K, Shimomura A, Nagasawa Y, Michigami T, Ohnishi T, Fujii N, Nakano C, Kusunoki Y, Kitamura H, Iwatani H, Takabatake Y, Kaimori JY, Matsuba G, Okoshi K, Kimura-Suda H, Tsubakihara Y, Rakugi H, Isaka Y. Retention of fetuin-A in renal tubular lumen protects the kidney from nephrocalcinosis in rats. Am J Physiol Renal Physiol 2013; 304(6):751-60.
29. Mori K, Ikari Y, Jono S, Emoto M, Shioi A, Koyama H, Shoji T, Ishimura E, Inaba M, Hara K, Nishizawa Y. Fetuin-A is associated with calcified coronary artery disease. Coron Artery Dis 2010; 21(5):281-5.
30. Demiryurek BE, Gundogdu AA. Serum Fetuin-A levels in patients with bilateral basal ganglia calcification. Neurosci Lett 2018; 666:148-52.
31. Wu YX, Li CY, Deng YL. Patients with nephrolithiasis had lower fetuin-A protein level in urine and renal tissue. Urolithiasis 2014; 42(1):29-37.
32. Westenfeld R, Schäfer C, Krüger T, Haarmann C, Schurgers LJ, Reutelingsperger C, Ivanovski O, Drueke T, Massy ZA, Ketteler M, Floege J, Jahnen-Dechent W. Fetuin-A protects against atherosclerotic calcification in CKD. J Am Soc Nephrol 2009; 20(6):1264-74.