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Article Serum Asporin Levels in Maintenance Hemodialysis Patients Without Osteoarthritis(Galenos Publishing House, 2023) Dursun, Ali Doğan; Dursun, Ali Doğan; Demir, Canan; Demir, Canan; Dursun, Ali Doğan; Demir, Canan; Basic Sciences; Basic SciencesAims: Several human and experimental studies have shown that small leucine-rich proteoglycans might play a significant role in inflammation and fibrosis in various renal diseases. However, as far as we know, no study has reported asporin levels in patients with advanced renal disease. The primary aim of this study was to determine serum asporin levels in hemodialysis (HD) patients without symptomatic osteoarthritis. Methods: This single-center, cross-sectional study prospectively enrolled maintenance HD patients and healthy control subjects. Subjects with clinically clear osteoarthritis were excluded. Serum asporin level was measured via Human ASPN (Asporin) ELISA Kit (Elabscience Biotechnology Inc. Houston, Texas, USA) in fasting blood samples. Results: The study included 25 (mean age: 43.3±13.5 years, 60% were females) patients and 29 control subjects (mean age: 38.0±8.8 years, 37.9% were females). Patients and controls were similar in age and sex. Serum asporin levels were significantly higher in HD patients compared with the controls 2.4 (0.9-4.8) ng/mL vs. 0.3 (0.2-0.6) ng/mL, respectively, p<0.001). Asporin levels were not correlated with age (r=0.344, p=0.092) and the duration of HD (r=0.385, p=0.077). Among HD patients, asporin level was not significantly correlated with C-reactive protein, parathyroid hormone, calcium, or phosphorus levels. Conclusions: This study showed that serum asporin levels were significantly elevated in patients undergoing HD. Further studies must elucidate the possible origins of increased asporin in these patients.Article The Impact of Smoking on Inflammation Indices: a Cross-Sectional Study(2023) Demir, Canan; Demir, Mehmet EminWe aim to investigate the association between smoking and systemic inflammation index (SII), the platelet-to-lymphocyte ratio (PLR), and the neutrophil-to- lymphocyte ratio (NLR) which are derivated from whole blood count. A total of 188 individuals who admitted to organ transplant outpatient polyclinics as donor candidates were included in this retrospective cross-sectional study. Donor candidates were divided into two groups; smokers and non-smokers. SII, PLR, and NLR were formulated from their hemogram during the preparation for donation. Serum C-reactive protein, uric acid, and creatinine levels were also compared between the two groups. P<0.05 was assumed as statistically significant. Seventy-five of 188 individuals (39.9%) were smokers. Smokers were older compared to nonsmokers and the mean smoking longevity was 21.14±12.92 years. SII, NLR, PLR, and CRP levels were higher in the smokers (p=0.020, p=<0.001, p=<0.001, and p=0.038, respectively). Smoking longevity had an impact on SII, PLR, NLR, and CRP (all p<0.001). Serum creatinine (and estimated glomerular filtration rate) had correlated with smoking and regression analysis indicated smoking was associated with high levels of serum creatinine (r=0.323, p<0.001, and r2=104). Smoking was a predictor for high levels of uric acid (p<0.001, r2=0.093). Smoking is associated with an increased inflammation status driven by changes in the immune response. The basic inflammation indices SII, NLR, and PLR, which can be derivated from whole blood count, and additionally CRP may be useful in the assessment of the inflammation status of smokers.Article Citation - WoS: 5Citation - Scopus: 5Serum Irisin Levels and Osteoporosis in Patients With Advanced Chronic Kidney Disease and Renal Transplant Recipients(Springer, 2023) Demir, Canan; Dursun, Ali Dogan; Sariyildiz, Guelcin Tuerkmen; Arslan, Aykut IlkerAimTo elucidate the association of serum irisin levels with bone mineral density (BMD) and calcium-phosphorus metabolism parameters in chronic kidney disease (CKD) patients and renal transplant recipients (RTRs).MethodsThis is a cross-sectional study involving CKD patients and RTRs. Healthy volunteers served as controls. Age, gender, and dialysis vintage were recorded. Serum irisin, creatinine, glucose, calcium, albumin, 25(OH) vitamin D, ferritin, C-reactive protein, A1C, and lipid profile were studied in all participants. Estimated glomerular filtration rate (eGFR), corrected calcium, and body mass index (BMI) were calculated.ResultsOverall, 49 patients (23 hemodialysis, 26 RTRs) and 25 control subjects were included. In hemodialysis (HD) group, 8 patients (34.8%) had osteoporosis, and 12 patients (52.2%) had osteopenia. In RTR group, 3 patients (11.5%) had osteoporosis, while 15 patients (57.7%) had osteopenia. Among controls, one had osteoporosis, and 7 had osteopenia. There was no significant difference between HD and RTRs; however, osteoporosis rate was significantly lower in control subjects. BMD measurements (femur and lumbar T- and Z-scores) were comparable between HD and RTR groups. Control group DEXA values were similar to RTRs; however, they were significantly higher compared to HD group. 25(OH) vitamin D levels were comparable between the HD and RTR groups, and these were significantly lower compared to values of the control group. Mean serum irisin level was 426.6 +/- 191.2 pg/mL in hemodialysis group, 342.6 +/- 174.8 in the RTR group, and 208.0 +/- 186.1 in controls. Serum irisin levels were similar in RTR and HD groups, but their values were significantly higher compared to controls. When we compared serum irisin levels between patients with and without osteoporosis in the whole cohort and hemodialysis and RTR groups, there was no difference. Serum irisin was positively correlated with lumbar T-score both in hemodialysis and RTR groups.ConclusionOur study is the first in the literature revealing the positive correlation of serum irisin level with femur T-score in RTRs. Serum irisin level was also positively correlated with femur T-scores in hemodialysis patients.
