Esin AVŞAR, Sebahat ÖZDEM, Betül YILMAZ, Erkan ÇOBAN, Yusuf AKAR

Hipertansif Retinopatisi Olan Hastalarda Seruloplazmin Düzeyleri

Amaç: Hipertansif retinopati HR hipertansiyonun en sık görülen göz komplikasyonudur. Hipertansif retinopati gelişiminin patolojik mekanizmaları henüz tam olarak belirlenememiştir. Kan basıncı yüksekliğine ilave olarak oksidatif stres gibi diğer patolojik mekanizmalar da sorumlu olabilir. Daha önceden yapılan çalışmalar artmış serum seruloplazmin düzeylerinin oksidatif stresin bir göstergesi olduğunu göstermiştir. Bundan dolayı, bu çalışma şu sorulara cevap bulmak amacıyla yapıldı; i HR’de seruloplazmin düzeyi değişir mi? ii HR evresi ile seruloplazmin düzeyleri arasında bir ilişki var mıdır?Gereç ve Yöntemler: Bu çalışmaya HR’si olan 90 hipertansiyon hastası alındı. Hipertansif hastalar Keith- Wagener-Barker sınıflandırmasına göre iki gruba ayrıldı. Grup 1 evre 1 HR’si olan 45 hastadan, Grup 2 evre 2 HR’si olan 45 hastadan oluşturuldu. Kontrol grubu olarak, yaş, cinsiyet ve vücut kitle indeksi açısından benzer 45 sağlıklı kişi alındı. Çalışma gruplarında serum seruloplazmin düzeyi ölçüldü.Bulgular: Grup 2’deki seruloplazmin düzeyi Grup 1’dekinden 32,06±4,88 karşı 29,54±3,05, p

Anahtar Kelimeler:

Hipertansiyon, Hipertansif Retinopati, Oksidatif Stres, Seruloplazmin

Levels of Ceruloplasmin in Patients with Hypertensive Retinopathy

Objective: Hypertensive retinopathy HR is the most common eye complication of hypertension. The pathological mechanisms of HR development are not fully established. In addition to high blood pressure, other pathological mechanisms such as oxidative stress may also be responsible. Previous studies have shown that elevated serum ceruloplasmin levels are indicative of oxidative stress. Therefore, this study was designed to answer the following questions; i Do ceruloplasmin levels change in HR?; ii Is there any relation between the degree of HR and ceruloplasmin levels?Material and Methods: This study included 90 hypertensive patients with HR. The hypertensive patients were divided into two groups according to the Keith-Wagener-Barker classification. Group 1 comprised 45 patients with grade I HR, and Group 2 comprised 45 patients with grade II HR. We selected 45 healthy subjects matched for age, sex, and body mass index for the control group. The serum ceruloplasmin level was measured in the study groups.Results: The level of ceruloplasmin in Group 2 was significantly higher than in group 1 32.6±4.88 vs. 29.54±3.05, p

Keywords:

Hypertension, Hypertensive Retinopathy, Oxidative Stress, Ceruloplasmin,

PDF

___

1. Türk Hipertansiyon Uzlaşı Raporu 2019. Turk Kardiyol Dern Ars 2019; 47(6):535-46.
2. James PA, Oparil S, Carter BL, Cushman WC, DennisonHimmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC Jr, Svetkey LP, Taler SJ, Townsend RR, Wright JT Jr, Narva AS, Ortiz E. 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee (JNC 8). JAMA 2014; 311(5): 507-20.
3. Stryjewski TP, Papakostas TD, Vavvas D. Proliferative hypertensive retinopathy. JAMA Ophthalmol 2016; 134: 345-6.
4. Harjasouliha A, Raiji V, Gonzalez JMG. Review of hypertensive retinopathy. Disease-a-Month 2017; 63(3): 63-9.
5. Betteridge DJ. What is oxidative stress? Metabolism 2000; 49(2 Suppl 1):3-8.
6. Sinha N, Dabla PK. Oxidative stress and antioxidants in hypertension-a current review. Curr Hypertens Rev 2015; 11(2):132-42.
7. Rochette L, Zeller M, Cottin Y, Vergely C. Diabetes, oxidative stress and therapeutic strategies. Biophys Acta 2014; 1840(9):2709-29.
8. Gupta RK, Patel AK, Shah N, Chaudhary AK, Jha UK, Yadav UC, Gupta PK, Pakuwal U. Oxidative stress and antioxidants in disease and cancer: A review. Asian Pac J Cancer Prev 2014; 15(11):4405-09.
9. Cousins RJ. Absorption, transport, and hepatic metabolism of copper and zinc: Special reference to metallothionein and ceruloplasmin. Physiol Rev 1985; 65 (2):238-309.
10. Hellman NE, Gitlin JD. Ceruloplamin metabolism and function. Annu Rev Nutr 2002; 22:439-58.
11. Mateescu M, Chahine R, Roger S, Atanasiu R, Yamaguchi N, Lalumie`re G, Nadeau R. Protection of myocardial tissue against deleterious effects of oxygen free radicals by ceruloplasmin. Arzneimittel-Forsch Drug Research 1995; 45:476-80.
12. Fox PL, Mukhopadhyay C, Ehrenwald E. Structure, oxidant activity, and cardiovascular mechanisms of human ceruloplasmin. Life Sci 1995; 56(21):1749-58.
13. Wilson Tang WH, Wu Y, Hartiala J, Fan Y, Stewart AFR, Roberts R, McPherson R, Fox PL, Allaye H, Hazen SL. Clinical and genetic association of serum ceruloplasmin with cardiovascular risk. Arterioscler Thromb Vasc Biol 2012; 32(2):516-22.
14. Shukla N, Maher J, Masters J, Angelini GD, Jeremy JY. Does oxidative stress change ceruloplasmin from a protective to a vasculopathic factor? Atherosclerosis 2006; 187:238-50.
15. Inoue K, Sakano N, Ogino K, Sato Y, Wang DH, Kubo M, Takahashi H, Kanbara S, Miyatake N. Relationship between ceruloplasmin and oxidative biomarkers including ferritin among healthy Japanese. J Clin Biochem Nutr 2013; 52:160-6.
16. Turgut A, Özler A, Görük NY, Tunc SY, Evliyaoglu O, Gül T. Copper, ceruloplasmin and oxidative stress in patients with advanced-stage endometriosis. Eur Rev Med Pharmacol Sci 2013; 17(11):1472-8.
17. Karaca M, Coban E, Ozdem S, Unal M, Salim O, Yucel O. The association between endothelial dysfunction and hypertensive retinopathy in essential hypertension. Med Sci Monit 2014; 20:78-82.
18. Coban E, Adanir H, Bilgin D. The association of mean platelet volume levels with hypertensive retinopathy. Platelets 2008; 19(2):115-8.
19. Coban E, Nizam I, Topal C, Akar Y. The association of low-grade systemic inflammation with hypertensive retinopathy. Clin Exp Hypertens 2010; 32(8):528-31.
20. Coban E, Alkan E, Altuntas S, Akar Y. Serum ferritin levels correlate with hypertensive retinopathy. Med Sci Monit 2010; 16(2):CR92-5.
21. Kowluru RA, Mishra M. Oxidative stress, mitochondrial damage and diabetic retinopathy. Biochim Biophys Acta 2015; 1852:2474-83.
22. Wu Y, Tang L, Chen B. Oxidative stress: implications for the development of diabetic retinopathy and antioxidant therapeutic perspectives. Oxid Med Cell Longev 2014; 752387.
23. Hartnett ME, Stratton RD, Browne RW, Rosner BA, Lanham RJ, Armstrong D. Serum markers of oxidative stress and severity of diabetic retinopathy. Diabetes Care 2000; 23:234-40.
24. Nowak M, Wielkoszyński T, Marek B, Kos-Kudła B, Świętochowska E, Siemińska L, Nowak K. Antioxidant potential, paraoxonase 1, ceruloplasmin activity and C-reactive protein concentration in diabetic retinopathy. Clinical and experimental medicine 2010; 10(3):185-92.
25. Kaur S, Singh P, Grewal RK, Kaur N, Agarwal A. Serum haptoglobin, ceruloplasmin and CRP levels: Markers of diabetic retinopathy. Global Journal of Medical Research 2012; 12:7-9.
26. Keith NM, Wagener HP, Barker NW. Some different types of essential hypertension; Their course and prognosis. Am J Med Sci 1939; 197:332-43.
27. Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Task Force Members. 2013 ESH/ESC guidelines for the management of arterial hypertension: The kask force for the management of arterial hypertension of the european society of hypertension (ESH) and of the european society of cardiology (ESC). J Hypertens 2013; 31 (7):1281-357.
28. Türkiye Endokrinoloji ve Metabolizma Derneği. Temd dislipidemi tanı ve tedavi kılavuzu 2018, Ankara.
29. Karaca M, Coban E, Felek R, Unal M. The association of oxidative stress with hypertensive retinopathy. Clin Exp Hypertens 2013; 35(1):16-9.
30. Minuz P, Patrignani P, Gaino S, Seta F, Capone ML, Tacconelli S, Degan M, Faccini G, Fornasiero A, Talamini G, Tommasoli R, Arosio E, Santonastaso CL, Lechi A, Patrono C. Determinants of platelet activation in human essential hypertension. Hypertension 2004; 43(1):64-70.