Person: KOÇ, MEHMET
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KOÇ
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MEHMET
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Publication Open Access Circulating endothelial cells are associated with future vascular events in hemodialysis patients(ELSEVIER SCIENCE INC, 2005-03) KOÇ, MEHMET; Koc, M; Richards, HB; Bihorac, A; Ross, EA; Schold, JD; Segal, MSBackground. Endothelial dysfunction and injury are thought to have a key role in the pathogenesis of cardiovascular disease. We hypothesized that the presence of circulating endothelial cells, as a reflection of ongoing endothelial injury, might provide a novel means for predicting cardiovascular events in hemodialysis subjects who are known to be at marked increased risk for cardiovascular disease. Methods. Circulating endothelial cell number was determined in 29 hemodialysis patients who were then followed for vascular events for 470 172 days. In a second cohort of 44 hemodialysis patients, circulating endothelial cell number was correlated with markers of inflammation, namely high sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, IL-10, and monocyte chemoattractant protein-1 (MCP-1), and endothelial dysfunction, soluble vascular cellular adhesion molecule-1 (VCAM-1). Results. Seven of the 19 subjects with elevated circulating endothelial cells (defined as > 19 cells per mL) had cardiovascular (N = 5) or vascular (N = 5) events during follow-up, whereas no events occurred in subjects with a low number of circulating endothelial cells (less than or equal to19 CECs per mL) (P = 0.04 by Fisher Exact Test). In the second cohort, the number of circulating endothelial cells was independent of all markers of inflammation and endothelial dysfunction. Conclusion. In this hemodialysis population, an increase in circulating endothelial cells was found to predict the development of cardiovascular and vascular events, and to be independent of other known markers of inflammation or endothelial dysfunction. These studies suggest that circulating endothelial cells may be a novel way to assess endothelial health and cardiovascular risk. Further studies to investigate the utility of circulating endothelial cells in predicting cardiovascular risk are needed.Publication Metadata only Waist circumference is associated with carotid intima media thickness in peritoneal dialysis patients(SPRINGER, 2013) VELİOĞLU, ARZU; Asicioglu, Ebru; Kahveci, Arzu; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin IshakAtherosclerosis is responsible for the high mortality rate in end-stage renal disease patients. Defining risk factors for atherosclerosis may lead to reduction in cardiovascular disease through modification of these factors. Peritoneal dialysis (PD) patients are subjected to high glucose loads on a daily basis, which results in considerable weight gain and an increase in waist circumference (WC). WC as an indicator of abdominal obesity is a risk factor for atherosclerosis in the general population. Carotid artery intima media thickness (CIMT) measurement is a reliable method for the detection of early atherosclerosis. The aim of this study was to investigate the relationship between WC and CIMT and to define risk factors associated with CIMT in PD patients. Fifty-five PD patients and 40 healthy controls were included. Atherosclerosis was assessed using measurement of CIMT. Fasting blood was collected for analysis. Anthropometric parameters (age, weight, BMI, and WC) were measured. Peritoneal dialysis patients had higher WC (93.9 +/- A 1.7 vs. 87.3 +/- A 1.2 cm, p < 0.05) and CIMT (0.70 +/- A 0.02 vs. 0.57 +/- A 0.01 mm, p < 0.01) than the control group. On univariate analysis, age, WC, plaque formation, and D/P creatinine were positively correlated with CIMT, whereas residual renal function, albumin, ultrafiltration volume, and D/D0 glucose were negatively correlated. On multivariate analysis, only age, WC, and plaque formation showed correlation (p < 0.001). Carotid artery intima media thickness is associated with age, plaque formation, and WC in PD patients. WC measurement is a simple, inexpensive, reproducible, and reliable method of evaluating atherosclerosis risk in PD patients and should be assessed at every visit. Appropriate counsel should be provided to patients with greater WC who are deemed to be at risk for atherosclerosis.Publication Metadata only Elevated Plasma Levels of PAI-1 Predict Cardiovascular Events and Cardiovascular Mortality in Prevalent Peritoneal Dialysis Patients(TAYLOR & FRANCIS LTD, 2009) ARIKAN, İZZET HAKKI; Arikan, Hakki; Koc, Mehmet; Tuglular, Serhan; Ozener, Cetin; Akoglu, EmelBackground. Elevated plasminogen activator inhibitor-1 (PAI-1) levels are associated with increased cardiovascular (CV) risk in the general population. It has been shown that peritoneal dialysis (PD) patients have increased plasma levels of PAI-1. The aim of this study was to investigate whether PAI-1 independently predicted CV outcome in PD patients. Material and Methods. Seventy-two PD patients (53% females, mean age 49.9 +/- 16.1 years) were studied. Twelve patients who underwent kidney transplantation and 14 patients who transferred to hemodialysis during follow-up were excluded from the analysis. The remaining 46 patients (54% female, mean age 54 +/- 16 years, dialytic age 42 +/- 30 months) were followed a mean time of 45.4 +/- 19.4 months (range 8-71 months). Baseline PAI-1, clinical, and laboratory parameters were assessed in all patients. Survival analyses were made with Kaplan-Meier and Cox regression analysis, with all-cause mortality and CV mortality and CV events (CVEs) as clinical end points. Results. During the follow-up, 29 patients died (17 from CV causes), and 28 fatal and non-fatal CVEs were recorded. The patients were divided according to plasma PAI-1 levels (i.e., <= or >41 ng/mL). The significant independent predictors of all-cause of mortality were age (>60 years; p = 0.018), CRP (>5 mg/L; p = 0.015), and serum albumin (<3.5 g/L; p = 0.011). Multivariable Cox regression analysis showed that plasma PAI-1 >41 ng/mL was independently predictive of higher CV mortality (p = 0.021) and CVEs (p = 0.001). The only other independent predictor of CV mortality was only CRP (>5 mg/L; p = 0.008). Conclusions. Plasma levels of PAI-1 >41 ng/mL is a significant predictor of CV mortality and CVEs in PD patients.Publication Metadata only Fibroblast Growth Factor-23 Levels Are Associated With Uric Acid But Not Carotid Intima Media Thickness in Renal Transplant Recipients(ELSEVIER SCIENCE INC, 2014) VELİOĞLU, ARZU; Asicioglu, E.; Kahveci, A.; Arikan, H.; Koc, M.; Tuglular, S.; Ozener, C.Introduction. Cardiovascular disease (CVD) is the leading cause of mortality in chronic kidney disease (CKD) patients. Fibroblast growth factor-23 (FGF-23) is associated with atherosclerosis and cardiovascular mortality in CKD patients and healthy subjects. However, data in renal transplant recipients (RTR) are scarce. We aimed to determine factors associated with FGF-23 and to explore its relationship to atherosclerosis. Methods. Forty-six patients and 44 controls were included. FGF-23 was measured from plasma. Carotid intima media thickness (CIMT) was evaluated ultrasonographically. Results. Patients had higher waist circumference (WC; 92.2 +/- 14.9 vs 85.3 +/- 11.0 cm; P < .05), glucose (99.8 +/- 17.2 vs 90.3 +/- 6.5 mg/dL; P < .01), creatinine (1.43 +/- 0.6 vs 0.86 +/- 0.1 mg/dL; P < .01), triglyceride (160.4 +/- 58.9 vs 135.6 +/- 59.8 mg/dL; P < .05), white blood cells (WBC; 7938.6 +/- 2105.2 vs 6715.7 +/- 1807.5 WBC/mm(3); P < .01), ferritin (217.0 +/- 255.8 vs 108.3 +/- 142.4 ng/mL; P < .05), uric acid (6.5 +/- 1.6 vs 4.7 +/- 1.3 mg/dL; P < .01), C-reactive protein (CRP; 8.2 +/- 18.2 vs 5.3 +/- 7.9 mg/L; P < .01), parathyroid hormone (PTH; 89.7 +/- 59.2 vs 44.1 +/- 16.7 pg/mL; P < .01), and alkaline phosphatase (ALP; 162.5 +/- 86.6 vs 74.2 +/- 21.9 U/L; P < .01). FGF-23 was higher in patients (11.7 +/- 7.2 vs 9.6 +/- 6.8 pg/mL; P < .05). CIMT was similar (0.58 +/- 0.09 vs 0.57 +/- 0.1 mm; P > .05). WC, creatinine, and uric acid were positively correlated with FGF-23, whereas albumin showed negative correlation. On multivariate analysis only creatinine and uric acid were determinants of FGF-23. Conclusion. FGF-23 levels are associated with uric acid in RTR. Larger studies are needed to confirm this finding.