Obstrüktif Koroner Arter Hastalığı İle Serum 25-OH Vitamin D, Fetuin-A, Matrix Gla Protein Ve ADMA Düzeyleri Arasındaki İlişki

Yıl 2022, Cilt: 9 Sayı: 3, 393 - 396, 30.09.2022

Uğur Taşkın , Hakan Tıkız

https://doi.org/10.34087/cbusbed.1096591

Öz

Giriş ve Amaç: Bu çalışmada ateroskleroz etyolojisinde rol oynadığı ileri sürülen 25OH-vitamin D, Matrix Gla Protein (MGP), Fetuin-A, Asimetrik Dimetil Arjinin (ADMA) belirteçleri ile koroner arter hastalığı arasındaki ilişki araştırıldı.
Gereç ve Yöntemler: Bu amaçla çalışmaya koroner arter hastalığı ön tanısı ile koroner anjiyografi işlemi uygulanmış olan ve normal koroner arter saptanan 40 olgu ile, en az bir koroner arterinde %70 ve üzerinde darlık saptanan 40 olgu olmak üzere toplam 80 olgu dahil edildi.
Bulgular: Kan MGP düzeyleri koroner arter hastalığı olan grupta kontrol grubuna kıyasla anlamlı olarak yüksek olarak gözlenirken (sırasıyla 2082,79±329,75 pg/ml ve 1853,42±285,82 pg/ml, p=0,001), Fetuin-A düzeylerinin kontrol grubunda, koroner arter hastalığı grubuna kıyasla anlamlı derecede düşük olduğu gözlendi (sırasıyla 60,54±28,61 ng/ml ve 78,61±20,45 ng/ml, p=0,002). Her iki gruptaki hastaların %85’inde 25OH-vitamin D seviyeleri düşük düzeylerde izlenmekle beraber, her iki grup arasında istatistiksel olarak anlamlı olarak fark saptanmadı (sırasıyla 20,27±12,65 ng/ml ve 20,64±7,32 ng/ml, p=0,875). Kan ADMA seviyeleri incelendiğinde ise yine gruplar arasında istatistiksel olarak anlamlı bir fark gözlenmedi (grup 1; 0,099±0,053 umol/l ve grup 2; 0,089±0,051 umol/l, p>0,05). Sonuç olarak; 25OH-vitamin D ve ADMA değerleri ile koroner arter hastalığı arasında anlamlı bir ilişki saptanmazken, MGP ve Fetuin-A'nın tıkayıcı koroner arter hastalığında belirteç olabileceği gözlendi.
Sonuç: Bizim çalışmamızda tıkayıcı koroner arter hastalığı tanısında MGP ve Fetuin-A biyobelirteçlerinin yol gösterici olduğu gözlenmiştir. Bu bulgular ışığında MGP ve Fetuin-A düzeylerinin koroner arter hastalığı tanısında kullanımının değerlendirilmesi için benzer altyapılı ve daha geniş popülasyonlarla yapılacak yeni çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Koroner Arter Hastalığı, 25OH-vitamin D, Fetuin-A, MGP, ADMA, Koroner Arter Hastalığı, 25OH-vitamin D, Fetuin-A, MGP, ADMA

Destekleyen Kurum

T.C. CELAL BAYAR ÜNİVERSİTESİ BİLİMSEL ARAŞTIRMA PROJELERİ KOORDİNATÖRLÜĞÜ

Proje Numarası

2012-091

Teşekkür

Bu çalışmanın gerçekleştirilmesinde proje desteği sağlayan Celal Bayar Üniversitesi Bilimsel Araştırmalar Komisyonuna ve değerli çalışanlarına çok teşekkür ederiz.

The Relationship Between Obstructive Coronary Artery Disease and Serum 25-OH Vitamin D, Fetuin-A, Matrix Gla Protein, and ADMA Levels

Öz

Objective: In this study, the relationship between the markers of 25OH-vitamin D, Matrix Gla Protein (MGP), Fetuin-A, Asymmetric Dimethyl Arginine (ADMA), which are suggested to play a role in the etiology of atherosclerosis, and coronary artery disease was investigated.
Materials and Methods: For this purpose, a total of 80 patients, including 40 patients with normal coronary artery and 40 patients with 70% or more stenosis in at least one coronary artery, who underwent coronary angiography with a preliminary diagnosis of coronary artery disease, were included in the study.
Results: While blood MGP levels were observed to be significantly higher in the coronary artery disease group compared to the control group (2082.79±329.75 pg/ml and 1853.42±285.82 pg/ml, p=0.001, respectively), Fetuin-A levels in the control group group was significantly lower than the coronary artery disease group (60.54±28.61 ng/ml and 78.61±20.45 ng/ml, respectively, p=0.002). Although 25OH-vitamin D levels were observed at low levels in 85% of the patients in both groups, no statistically significant difference was found between the two groups (20.27±12.65 ng/ml and 20.64±7.32 ng/ml, respectively). ml, p=0.875). When blood ADMA levels were examined, no statistically significant difference was observed between the groups (group 1; 0.099±0.053 umol/l and group 2; 0.089±0.051 umol/l, p>0.05). As a result; While no significant relationship was found between 25OH-vitamin D and ADMA values and coronary artery disease, it was observed that MGP and Fetuin-A could be markers for occlusive coronary artery disease.
Conclusion: In our study, it was observed that MGP and Fetuin-A biomarkers were guiding in the diagnosis of occlusive coronary artery disease. In the light of these findings, new studies with a similar background and larger populations are needed to evaluate the use of MGP and Fetuin-A levels in the diagnosis of coronary artery disease.

Anahtar Kelimeler

25OH-vitamin D, Fetuin-A, MGP, ADMA, coronary artery disease

Proje Numarası

2012-091

Kaynakça

• Mehta, P.K, Wei, J, Wenger, N.K, Ischemic heart disease in women: A focus on risk factors, Trends in Cardiovascular Medicine, 2015, 25(2), 140, 151.
• Elizabeth, G.N, Eugene, B, A tale of coronary artery disease and myocardial infarction, New England Journal of Medicine, 2012, 366(1), 54, 63.
• Alexopoulos, N, Raggi, P, Calcification in atherosclerosis, Nature Reviews Cardiology, 2009, 6.11, 681-688.
• Ketteler, M, Schlieper, G, Floege, J, Calcification and cardiovascular health: new insights into an old phenomenon, Hypertension, 2006, 47, 1027–1034.
• Sibal, Latika, et al., The role of asymmetric dimethylarginine (ADMA) in endothelial dysfunction and cardiovascular disease, Current cardiology reviews,2010, 6.2, 82-90.
• Menezes, Arthur, R, et al., Vitamin D and atherosclerosis, Current opinion in cardiology, 2014, 29.6, 571-577.
• Xie, W.M, et al., Association between fetuin‐A and prognosis of CAD: A systematic review and meta‐analysis, European Journal of Clinical Investigation, 2019, 49.5, e13091.
• Bilgir, O, et al., Decreased serum fetuin-A levels are associated with coronary artery diseases, Internal medicine, 2010, 49.13, 1281-1285.
• Vörös, K, et al., Serum fetuin‐A in metabolic and inflammatory pathways in patients with myocardial infarction, European journal of clinical investigation, 2011, 41.7, 703-709.
• Zhao, Z-W, et al., Serum fetuin-A levels are associated with the presence and severity of coronary artery disease in patients with type 2 diabetes, Biomarkers, 2013, 18.2, 160-164.
• Thomsen, S.B, Rathcke, C.N, Zerahn, B, Vestergaard, H, Increased levels of the calcification marker Matrix Gla Protein and the inflammatory markers YKL-40 and CRP in patients with type 2 diabetes and ischemic heart disease, Cardiovascular Diabetology, 2010, 9, 86.
• Dalmeijer, G.W, et al., Matrix Gla protein species and risk of cardiovascular events in type 2 diabetic patients, Diabetes care, 2013, 36.11, 3766-3771.
• Braam, L.A, Dissel, P, Gijsbers, B.L, Spronk, H.M, Hamulyak, K, Soute, B.A, Debie, W, Vermeer, C, Assay for human matrix gla protein in serum: potential applications in the cardiovascular field, Arteriosclerosis Thrombosis in Vascular Biology, 2000, 20, 1257-1261.
• Schurgers, L.J, Cranenburg, E.C, Vermeer, C, Matrix Gla-protein: the calcification inhibitor in need of vitamin K, Thrombosis Haemostasis, 2008, 100, 593-603.
• Verdoia, M, et al., Vitamin D deficiency is independently associated with the extent of coronary artery disease, European journal of clinical investigation, 2014, 44.7, 634-642.
• Kunadian, V, et al., Vitamin D deficiency and coronary artery disease: a review of the evidence, American heart journal, 2014, 167.3, 283-291.
• Manousaki, D, et al., Mendelian randomization studies do not support a role for vitamin D in coronary artery disease, Circulation: Cardiovascular Genetics, 2016, 9.4, 349-356.
• Hekimsoy, Z, et al., Vitamin D status among adults in the Aegean region of Turkey, BMC Public Health, 2010, 10.1, 1-7.
• Xuan, C, et al., Levels of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, and risk of coronary artery disease: A meta-analysis based on 4713 participants, European journal of preventive cardiology, 2016, 23.5, 502-510.