Romatizmal mitral darlığında fetuin-A düzeyleri ve ekokardiyografi bulguları ile ilişkisi Türkçe

Öz

Amaç: Fetuin-A, dolaşımda bulunan, distrofik vasküler ve valvüler kalsifikasyon oluşumunu önleyen bir akut faz proteinidir. Bu çalışmanın amacı, Romatizmal Mitral Darlığı olan hastalarda serum fetuin-A düzeylerinin sağlıklı kişilere göre ne yönde değiştiğini ve ekokardiyografi bulguları ile ilişkili olup olmadığını belirlemektir.Materyal ve metod: Tanısı Ekokardiyografi ile konmuş, Romatizmal Mitral Darlığı olan elli hasta ve yaş ve cinsiyet karşılaştırmalı elli iki sağlıklı kişi çalışmaya dahil edildi. Her bireyin serum Fetuin-A düzeyi ELISA metodu ile ölçüldü.Bulgular: Hastalar ile kontrol grubu arasında serum Fetuin-A düzeyleri yönünden anlamlı fark yoktu sırasıyla 29,35±6,41 ng/mL ve 27,64±6,35 ng/mL; p=0,262 . Hastalarda Ekokardiyografi ile belirlenen Wilkins kalsifikasyon skoru ile serum Fetuin-A düzeyleri arasında anlamlı korelasyon bulunmadı.Sonuç: Hastaların kullanmakta oldukları antimikrobiyal ve antiinflamatuar ilaçların etkisiyle serum FetuinA düzeylerinin düşmesi önlenmiş olabilir. İki boyutlu Ekokardiyografi ile değerlendirildiğinde Mitral kapaktaki kalsifikasyonun derecesi ile serum fetuin-A düzeyi arasında anlamlı bir ilişki bulunmamıştır

Anahtar Kelimeler

• Fetuin-A,romatizmal kalp kastalığı,ekokardiyografi

Fetuin-A levels in rheumatismal mitral stenosis and its relationship with echocardiographic findings

Öz

Background: Fetuin-A is an acute phase protein that exists in circulation and prevents the formation of dystrophic vascular and valvular calcification. The aim of this study was to determine how serum fetuin-A levels changed in Rheumatic Mitral Stenosis patients when compared to healthy control subjects and whether it was associated with echocardiographical data.Methods: Fifty Rheumatic Mitral Stenosis patients diagnosed by echocardiography and age-sex matched fifty-two control subjects were included into the study. Serum fetuin-A level of each subject was measured by ELISA method.Results: There was no significant difference between patients and controls in serum fetuin-A levels respectively 27,64±6,35 ng/mL and 29,35±6,41 ng/mL; p=0,262 . In additon, no significant correlation was found between Wilkins calcification score determined by echocardiography and serum fetuin-A levels in patients.Conclusions: Decrease of serum fetuin-A levels might have been inhibited due to the usage of antimicrobial and antiinflammatory drugs of patients. A significant relationship wasn't found when serum fetuin-A levels and calcification in the mitral valve determined by ecocardiographic data were correlated in these patients

Anahtar Kelimeler

• Fetuin-A,rheumatismal heart disease,echocardiography

Kaynakça

1. ) Arnaud P, Kalabay L. Alpha2-HS glycoprotein: a protein in search of a function. Diabetes Metab Res Rev. ; 18(4): 311-4. ) Ketteler M, Bongartz P, Westenfeld R, et al. J. Association of low fetuin-A (AHSG) concentrations in serum with cardiovascular mortality in patients on dialysis: a cross-sectional study. Lancet. 2003; (9360): 827-33.
2. ) Reynolds JL, Skepper JN, McNair R, et al. Multifunctional roles for serum protein fetuin-a in inhibition of human vascular smooth muscle cell calcification. J Am Soc Nephrol. 2005; 16 (10): 2920-30.
3. ) Schafer C, Heiss A, Schwarz A, et al. The serum protein alpha 2-Heremans-Schmid glycoprotein/fetuin- A is a systemically acting inhibitor of ectopic calcification. J Clin Invest. 2003; 112(3): 357-66.
4. ) Carapetis JR, Steer AC, Mulholland EK, Weber M. (et al). The global burden of group A streptococcal diseases. Lancet Infect Dis. 2005; 5(11): 685-94.
5. ) Pedrazzini GB, Faletra F, Vassalli G, et al. Mitral regurgitation. Swiss Med Wkly. 2010; 140(3-4): 36-43.
6. ) Chandrashekhar Y, Westaby S, Narula J. Mitral stenosis. Lancet. 2009; 374: 1271-83.
7. ) Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989; 2: 358
8. ) Ali SK, Eldaim IN, Osman SH, et al. Clinical and echocardiographic features of children with rheumatic heart disease and their serum cytokine profile. Pan Afr Med J. 2012; 13: 36.

9. ) Davutoglu V, Celik A, Aksoy M. Contribution of selected serum inflammatory mediators to the progression of chronic rheumatic valve disease, subsequent valve calcification and NYHA functional class. J Heart Valve Dis. 2005; 14(2): 251-6.
10. ) Wilkins GT, Weyman AE, Abascal VM, et al. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J. ; 60(4): 299. ) 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(24): 52.
11. ) Cagli K, Basar N, Cagli K, et al. Association of serum fetuin-A with valvular calcium concentration in rheumatic mitral valve disease. J Heart Valve Dis. 2010; 19(5): 636
12. ) Afsar CU, Uzun H, Yurdakul S, et al. Association of serum fetuin-A levels with heart valve calcification and other biomarkers of inflammation among persons with acute coronary syndrome. Clin Invest Med. 2012; 35(4): 15.
13. ) Ix JH, Chertow GM, Shlipak MG, et al. Association of fetuin-A with mitral annular calcification and aortic stenosis among persons with coronary heart disease: data from the Heart and Soul Study. Circulation. 2007; 115(19): 9.
14. ) Kaden JJ, Reinöhl JO, Blesch B, et al. Systemic and local levels of fetuin-A in calcific aortic valve stenosis. Int J Mol Med. 2007; 20(2): 193-7.
15. ) Wang AY, Woo J, Lam CW, et al. Associations of serum fetuin-A with malnutrition, inflammation, atherosclerosis and valvular calcification syndrome and outcome in peritoneal dialysis patients. Nephrol Dial Transplant. 2005; 20(8): 1676-85.
16. ) El-Shehaby AM, Zakaria A, El-Khatib M, et al. Association of fetuin-A and cardiac calcification and inflammation levels in hemodialysis patients. Scand J Clin Lab Invest. 2010; 70(8): 575-82.
17. ) Adamczyk T, Mizia-Stec K, Mizia M, et al. Biomarkers of calcification and atherosclerosis in patients with degenerative aortic stenosis in relation to concomitant coronary artery disease. Pol Arch Med Wewn. 2012; 122(1-2): 14-21.