Diyagonal kulak memesi kırışması artmış ortalama trombosit hacmi ile ilişkilidir

Year 2018, Volume: 15 Issue: 3, 134 - 139, 12.12.2018

Selim Kul , Muhammet Raşit Sayın , İhsan Dursun , Sinan Şahin , Doğuş Hemşinli Cihan Aydın , Ahmet Hakan Ateş

Abstract

Giriş: Diagonal Kulak Memesi Kırışıklığı (KMK), aterosklerozun bir işareti olarak kabul edilir. Trombositler aterosklerotik lezyonların başlamasında ve sonrasında oluşan komplikasyonlarda önemli rol oynarlar. Ortalama trombosit hacmi (OTH), trombosit aktivasyonunun bir göstergesidir. Bu çalışmada KMK’lı bireylerde OTH’nin değerlendirilmesi amaçlandı.

Materyal ve Metod: Çalışmaya KMK olan 75 hasta (28K; ort. yaş: 59±10 yıl) ve KMK olmayan 54 hasta (23 K; yaş: 56±11 yıl) alındı. Klinik ve demografik özellikler, OTH, lökosit sayısı, hemoglobin düzeyi, trombosit sayısı ve plateletkrit düzeyi gruplar arasında karşılaştırıldı.

Sonuç: Klinik ve demografik özellikler her iki grupta benzer bulundu. Hemoglobin (13,7±1,3 g/dL vs 13,8±1,40 g/dL; p=0,782), lökosit (7,01±1,57 x103mm-3 vs 7,26±1,63 x103mm-3; p=0,429), trombosit (240±57 x103mm-3 vs 246±59 x103mm-3; p=0,617) ve plateletkrit (0,207±0,048 % vs 0,196±0,046 %; p=0,258) değerleri arasında iki grup arasında istatistiksel olarak anlamlı fark saptanmadı. KMK olan grupta OTH; KMK olmayan gruba göre istatistiksel olarak anlamlı derecede daha yüksek bulundu (8,69±0,95 fL vs 7,96±0,75 fL; p<0,0001). Yapılan korelasyon analizinde KMK ile OTH arasında anlamlı ancak orta düzeyde bir ilişki saptandı (p<0,001; r = 0,356).

Tartışma: KMK olan grupta OTH artmış olarak izlendi. Sonuçlarımız, artan trombosit aktivitesinin KMK olanlarda, KMK olmayanlara göre daha fazla görülen koroner arter hastalığının patofizyolojisinde rol oynayabileceğini düşündürmektedir.

Keywords

Kulak memesi kırışıklığı, Subklinik ateroskleroz, Trombosit hacmi

Diagonal earlobe crease is associated with increased mean platelet volume

Abstract

Background: Diagonal earlobe crease (DEL) is considered a sign of atherosclerosis. Platelets play an important role in the onset and subsequent complications of atherosclerotic lesions. Mean platelet volume (MPV) is an indicator of platelet activation. In this study, we aimed to evaluate MPV in DEL individuals.

Material and Methods: Seventy-five patients with DEL (28F; mean age: 59±10 years) and 54 patients without DEL (23F; mean age: 56±11 years) were included in this study. Clinical and demographic characteristics, MPV, leukocyte counts, hemoglobin levels, platelet counts and plateletcrit levels were compared between the two groups.

Results: Clinical and demographic characteristics were similar between the two groups. Hemoglobin levels (13.7±1.3 g/dL vs. 13.8±1.40 g/dL; p=0.782), leukocyte counts (7.01±1.57 x103mm-3 vs. 7.26±1.63 x103mm-3; p=0.429), platelet counts (240±57 x103mm-3 vs. 246±59 x103mm-3; p=0.617) and plateletcrit levels (0.207±0.048 % vs. 0.196±0.046%; p=0.258) were comparable between the two groups. MPV was significantly higher in the DEL group compared to non-DEL group (8.69±0.95 fL vs 7.96±0.75 fL; p<0.0001). Correlation analysis showed a significant but moderate correlation between DEL and MPV (p<0.0001; r = 0.356).

Conclusion: MPV is elevated in patients with DEL. Considering the effects of platelets on atherosclerosis as well as their close relation to other risk factors, MPV may be an important predisposing factor for atherosclerosis in patients with DEL.

Keywords

Diagonal earlobe crease, Platelet volume, Subclinical atherosclerosis

References

• Referans 1. Lichstein E, Chadda KD, Naik D, Gupta PK. Diagonal ear-lobe crease: prevalence and implications as a coronary risk factor. N Engl J Med 1974;290:615–6.
• Referans 2. Frank ST. Aural sign of coronary-artery disease. N Engl J Med 1973;289:327–8.
• Referans 3. Shrestha I, Ohtsuki T, Takahashi T, Nomura E, Kohriyama T, Matsumoto M. Diagonal ear-lobe crease is correlated with atherosclerotic changes in carotid arteries. Circ J 2009;73:1945–9.
• Referans 4. Celik S, Erdog an T, Gedikli O, Kiris¸ A, Erem C. Diagonal ear-lobe crease is associated with carotid intima-media thickness in subjects free of clinical cardiovascular disease. Atherosclerosis 2007;192:428–31
• Referans 5. Massberg S, Schulz C, Gawaz M. Role of platelets in the pathophysiology of acute coronary syndrome. Semin Vasc Med 2003;3:147-62.
• Referans 6. Thombson CB, Eaton K, Princiotta SM, Rushin CA, Valeri CR. Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity, and function. Br J Haematol 1982;50:509-19.
• Referans 7. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost 2003;9:177-90.
• Referans 8.Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost 2003;9:177190.
• Referans 9. Tranchesi B Jr, Barbosa V, de Albuquerque CP, et al: Diagonal ear lobe crease as a marker of the presence and extent of coronary atherosclerosis. Am J Cardiol 1992;70:1417–1420.
• Referans 10. Kirkham N, Murrells T, Melcher DH, et al: Diagonal earlobe creases and fatal Cardiovascular disease: a necropsy study. Br Heart J 1989;61:361–364.
• Referans 11. Elliott WJ, Karrison T: Increased all-cause and cardiac morbidity and mortality associated with the diagonal earlobe crease: a prospective cohort study. Am J Med 1991;91: 247–254.
• Referans 12. Ziyrek M, Şahin S, Özdemir E, Acar Z, Kahraman S. Diagonal earlobe crease associated with increased epicardial adipose tissue and carotid intima media thickness in subjects free of clinical cardiovascular disease.Turk Kardiyol Dern Ars. 2016 Sep;44(6):474-80.
• Referans 13 . Koyama T, Watanabe H, Ito H. he association of circulating inflammatory and oxidative stress biomarker levels with diagonal earlobe crease in patients with atherosclerotic diseases. J Cardiol. 2016 Apr;67(4):347-51.
• Referans 14. Levent Korkmaz, Mustafa Tarık Ağaç, Hakan Erkan, et al: Association between Diagonal Earlobe Crease and Cardio-Ankle Vascular Index in Asymptomatic hypertensive Patients. Med Princ Pract 2013;22:530–534.
• Referans 15. Edston E. The earlobe crease, coronary artery disease, and sudden cardiac death: an autopsy study of 520 individuals. Am J Forensic Med Pathol. 2006 Jun;27(2):129-33.
• Referans 16. Evrengül H, Dursunoğlu D, Kaftan A, Zoghi M, Tanriverdi H, Zungur M, Kiliç M. Bilateral diagonal earlobe crease and coronary artery disease: a significant association. Dermatology. 2004;209(4):271-5.
• Referans 17. Shmilovich H, Cheng VY, Rajani R, Dey D, Tamarappoo BK, Nakazato R, Smith TW, Otaki Y, Nakanishi R, Gransar H, Paz W, Pimentel RT, Hayes SW, Friedman JD, Thomson LE, Berman DS. Relation of diagonal ear lobe crease to the presence, extent, and severity of coronary artery disease determined by coronary computed tomography angiography. Am J Cardiol. 2012 May 1;109(9):1283-7.
• Referans 18. Sapira JD. Earlobe creases and macrophage receptors. South Med J. 1991 Apr;84(4):537-8.
• Referans 19. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost 2003;9:177–90.
• Referans 20. Broadley AJ, Gapper P, Schmitt M, Frenneaux MP. Supine rest reduces platelet activation and aggregation. Platelets 2003;14:3–7.
• Referans21. Pizzulli L, Yang A, Martin JF, Luderitz B. Changes in platelet size and count in unstable angina compared tostable angina or non-cardiac chest pain. Eur Heart J 1998;19:80–4.
• Referans 22. Jagroop IA, Mikhailidis DP. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2003;120 (1):169–70.
• Referans23. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157–61.
• Referans 24. Coban E, Bostan F, Ozdogan M. The mean platelet volume in subjects with impaired fasting glucose. Platelets 2006; 17:67–9.
• Referans 25. Hekimsoy Z, Payzin B, Ornek T, Kandogan G. Mean platelet volume in type 2 diabetic patients. J Diabetes Complications 2004;18:173–6.
• Referans 26. Brown AS, Hong Y, de Belder A, Beacon H, Beeso J, Sherwood R, et al. Megakaryocyte ploidy and platelet changes in human diabetes and atherosclerosis. Arterioscler Thromb Vasc Biol 1997;17:802–7.
• Referans 27. Sharpe PC, Trinick T. Mean platelet volume in diabetes mellitus. Q J Med 1993;86:739–42.
• Referans 28. Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY. Platelet indexes in relation to target organ damage in high-risk hypertensive patients A substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol 2004;44:415–22.29. Coban E, Ozdogan M, Yazcıoglu G, Akcit F. The mean platelet volume in patients with obesity. Int J Clin Pract Aug 2005;59 (8):981–2.