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Article Diabetes and Chronic Kidney Disease in Turkey (DIAKIT): A Cross-Sectional Cohort Study(BMC, 2025) Arici, Mustafa; Ates, Kenan; Yildiz, Alaattin; Odabas, Ali R.; Tokgoz, Bulent; Sezer, Siren; Altun, BulentBackground Chronic kidney disease (CKD) is a global public health problem with increasing disease burden affecting nearly 10% of adult population worldwide. We aimed to detect the prevalence of CKD, patients' distribution among CKD stages, and factors associated with having CKD in diabetic patients in Turkey. Methods This cross-sectional study, conducted in 2022, included 1591 patients with diabetes (mean age, 63 +/- 10 years; female: 65.5%) from the Cappadocia Cohort study. CKD was diagnosed by an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2) or urinary albumin-to-creatinine ratio (UACR) >= 30 mg/g, which was measured in spot urine samples collected in the morning for three consecutive days. Results In this cohort of adult diabetic patients, the prevalence of CKD was 25.1%. More than half of the diabetic patients with CKD (53.8%) had albuminuria without a decrease in eGFR, 28.1% had decreased eGFR without albuminuria, and 18.2% had both albuminuria and decreased eGFR. While the percentage of CKD patients who are female vs. male was 60% vs. 40%, CKD prevalence was higher in males (29.2%) than in females (22.9%) (P = 0.007). Among patients with CKD, only 9.4% were aware that they had CKD. Age, male sex, HbA1c, triglyceride, uric acid, C-reactive protein, and hypertension Grade 1, 2 and 3 were associated with the presence of CKD, with uric acid showing the strongest association. Conclusions More than half of our patients with CKD would not have been diagnosed if urinary albumin excretion was not measured. Early detection of CKD by regular screening of diabetic patients using both UACR and eGFR measurements is essential for early diagnosis and prompt treatment to slow down disease progression.Article Citation - WoS: 1Citation - Scopus: 1Outcomes of Transcatheter Aortic Valve Implantation in Patients With and Without Diabetes Mellitus(Soc Brasil Cirurgia Cardiovasc, 2024) Ayhan, Huseyin; Guney, Murat Can; Keles, Telat; Bozkurt, EnginIntroduction: Diabetes mellitus (DM) in patients undergoing cardiac transcatheter or surgical interventions usually is correlated with poor outcomes. Transcatheter aortic valve implantation (TAVI) has been developed as a therapy choice for inoperable, high-, or intermediate-risk surgical patients with severe aortic stenosis (AS). Objective: To evaluate the impact of DM and hemoglobin A1c (HbA1c) on outcomes and survival after TAVI. Methods: Five hundred and fifty-two symptomatic severe AS patients who underwent TAVI, of whom 164 (29.7%) had DM, were included in this retrospective study. Follow-up was performed after 30 days, six months, and annually. Results: The device success and risks of procedural-related complications were similar between patients with and without DM, except for acute kidney injury, which was more frequent in the DM group (2.4% vs. 0%, P=0.021). In-hospital and first-year mortality were similar between the groups (4.9% vs. 3.6%, P=0.490 and 15.0% vs. 11.2%, P=0.282, respectively). There was a statistical difference between HbA1c >= 6.5 and HbA1c <= 6.49 groups in total mortality (34.4% vs. 15.8%, P<0.001, respectively). The only independent predictors were Society of Thoracic Surgeons score (hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.09-1.51; P=0.003) and HbA1c level >= 6.5 (HR 10.78, 95% CI 2.58-21.50; P=0.003) in multivariable logistic regression analysis. Conclusion: In this study, we conclude that DM was not correlated with an increased mortality risk or complication rates after TAVI. Also, it was shown that mortality was higher in patients with HbA1c >= 6.5, and it was an independent predictor for long-term mortality.Article Citation - WoS: 7Citation - Scopus: 9Ozone Administration Reduces Myocardial Ischemia Reperfusion Injury in Streptozotocin Induced Diabetes Mellitus Rat Model(Dove Medical Press Ltd, 2024) Gülcan, M.B.; Demirtaş, H.; Özer, A.; Yığman, Z.; Dursun, A.D.; Arslan, M.; Oktar, G.L.Objective: This study aimed to demonstrate whether ozone has cardioprotective effects on the myocardial ischemia-reperfusion injury (IRI) in rats with streptozotocin(STZ)-induced diabetes. Methods: A total of 38 male Wistar Albino rats were divided into five groups as follows: control group (group C,n=6), diabetic group (group D,n=6), diabetic ozone group (group DO,n=6), diabetic-ischemia/reperfusion (group DIR,n=6), diabetic-ischemia/reperfusion-ozone (group DIRO,n=6). Six rats died during this period and two died because of surgical complications. A myocardial ischemia-reperfusion model was created using a thoracotomy incision from 4th intercostal space. The LAD was ligated using an 8–0 prolene suture for 30min. Ozone was administered intraperitoneally(1mg/kg) 5min before reperfusion. The reperfusion time was 120 min. At the end of the reperfusion procedure, myocardial tissue histopathological examinations, and serum biochemical analyses were performed. Results: The percentage of TUNEL(+) cardiomyocytes/HPF was significantly higher in the DIR group than in the C, D, and DO groups. Conversely, TUNEL positivity was significantly lower in the DIRO group than in the DIR group. The IRI score was significantly higher in the DIR and DIRO groups than that in the C, D, and DO groups. In contrast, the IRI damage score in the DIRO group was significantly lower than that in the DIR group. Serum MDA levels were significantly higher in the DIR group than in the C, D, and DO groups. Similarly, MDA levels were significantly higher in the DIRO group than in the C and D groups. CAT activity was significantly higher in the DIR group than in the C and D groups. SOD activity was significantly higher in the DIR group than in the C and DO groups. Conclusion: Our study showed that ozone exerts cardioprotective effects in STZ-induced diabetic rats through its antioxidant role against oxidative stress. Both biochemical and histological analyses clearly revealed that ozone has beneficial effects against IRI in the diabetic rat myocardium. © 2024 Gülcan et al.Article Citation - WoS: 7Ozone Administration Reduces Myocardial Ischemia Reperfusion Injury in Streptozotocin-Induced Diabetes Mellitus Rat Model(Baycinar Medical Publishing, 2024) Gulcan, M.B.; Demirtas, H.; Ozer, A.; Yıgman, Z.; Dursun, A.D.; Arslan, M.; Oktar, G.L.Objective: This study aimed to investigate the effects of ozone therapy on myocardial ischemia/reperfusion injury in a diabetic rat model. Methods: The experimental study included 38 male Wistar Albino rats weighing between 200 and 250 g. The rats were randomly assigned to five groups. The sham group included six rats, while the other groups had eight rats each. The other groups were the diabetic ozone group, the diabetic group, the diabetic ischemia/reperfusion group (DIR), and the diabetic ischemia/reperfusion ozone group (DIRO). A total of 32 rats received 65 mg/kg streptozotocin, and a week after the administration, diabetes was confirmed by measuring blood sugar. The rats were fed ad libitum for 40 days to reveal macrovascular complications of diabetes. Malondialdehyde, catalase, superoxide dismutase, paraoxonase-1, total oxidative status, total antioxidant status, and oxidative stress index were assessed. A TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assay was employed to assess apoptosis. Results: Histologic and biochemical assessments showed the benefits of ozone in myocardial ischemia/reperfusion injury in diabetic rats. The DIRO group was found to be superior to the DIR group. Conclusion: Ozone has cardioprotective effects in streptozotocin-induced diabetic rats through its antioxidant properties against oxidative stress. The study is unique in terms of ozone’s protective effects in diabetic rats against myocardial ischemia/reperfusion injury. However, further studies are needed to confirm our findings. © (2024), (Baycinar Medical Publishing). All rights reserved.
