Ömer Faruk Özer, Cumali Karatoprak, Mustafa Çakırca, İskender Ekinci, Selin Yurdakul, Elif Ece Doğan

D Vitamini Eksikliği ile Endotel Disfonksiyonu Göstergelerinden Serum Endocan ve Asimetrik Dimetilarjinin Düzeyleri Arasındaki İlişki

Amaç: Güncel çalışmalar D vitamini eksikliğinin Alzheimer hastalığı, Parkinson hastalığı, multipl skleroz, diyabet ve kardiyovasküler hastalıklar gibi birçok hastalığın oluşumunda rolü olabileceğini göstermektedir. Biz de bu çalışmada kronik hastalık öyküsü olmayan bireylerde D vitamini düzeyi ile erken kardiyovasküler risk belirteçleri olan serum endokan ve asimetrik dimetilarjinin (ADMA) düzeyleri arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: İki katılımcı grubu oluşturuldu: D vitamini düzeyi 30 ng/ml olanlardan oluşan Grup 2 (n=35). İki grup beden kitle indeksi (BKİ) ile serum D vitamini, endokan ve ADMA düzeyleri bakımından karşılaştırıldı. Bulgular: İki grup arasında yaş, cinsiyet ve BKİ bakımından anlamlı fark olmadığı saptandı (sırasıyla p=0,67; p=0,69; p=0,052). Ortalama serum ADMA düzeyi Grup 1 için 104,5±44 μmol/L, Grup 2 için 90,42±29 μmol/L olarak tespit edildi (p=0,31). Ortalama endokan düzeyi ise Grup 1 için 549,5±245 ng/L, Grup 2 için 465,99±207 ng/L idi (p=0,12). Vitamin D düzeyi ile endokan düzeyi arasında anlamlı negatif korelasyon saptandı (r=-0,26; p=0,02). Tartışma ve Sonuç: D vitamini düzeyi düşük katılımcılarda anlamlı bir farklılık gözlenmemiştir. Buna göre, D vitamini eksikliğinin endotel disfonksiyonuna bir etkisinin saptanamadığı söylenebilir.

The Relationship between Vitamin D Deficiency and Levels of Serum Endocan and Asymmetric Dimethylarginine as Indicators of Endothelial Dysfunction

Aim: Recent studies show that vitamin D deficiency may play a role in the pathogenesis ofvarious diseases, including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, diabetesmellitus, and cardiovascular diseases. In this study, we aimed to investigate the relationship between vitamin D levels and levels of serum endocan and asymmetric dimethylarginine (ADMA)as early cardiovascular risk markers in individuals with no history of chronic illness.Materials and Methods: Two groups of participants were formed: Group 1 consisting of individuals with a vitamin D level 30 ng/ml (n=35). The two groups were compared in terms of body mass index (BMI) and levelsof serum vitamin D, endocan, and ADMA.Results: No significant difference was found between the groups in terms of age, sex, and BMI(p=0.67, p=0.69, p=0.052, respectively). The mean serum ADMA level was 104.5±44 μmol/L forGroup 1 and 90.42±29 μmol/L for Group 2 (p=0.31). The mean endocan level was 549.5±245ng/L for Group 1 and 465.99±207 ng/L for Group 2 (p=0.12). There was a significant negativecorrelation between vitamin D and endocan levels (r=-0.26, p=0.02).Discussion and Conclusion: No significant difference was observed in participants with lowlevels of vitamin D. Accordingly, vitamin D deficiency was not found to have a significant effecton endothelial dysfunction.

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1. Bikle D. Nonclassic actions of vitamin D. J Clin Endocrinol Metab. 2009;94:26–34.
2. Haussler MR, Whitfield GK, Haussler CA, Hsieh JC, Thompson PD, Selznick SH, et al. The nuclear vitamin D receptor: biological and molecular regulatory properties revealed. J Bone Miner Res. 1998;13:325–49.
3. Mozos I, Marginean O. Links between vitamin D deficiency and cardiovascular diseases. Biomed Res Int. 2015;2015:109275.
4. Tousoulis D, Georgakis MK, Oikonomou E, Papageorgiou N, Zaromitidou M, Latsios G, et al. Asymmetric dimethylarginine: clinical significance and novel therapeutic approaches. Curr Med Chem. 2015;22:2871–901.
5. Balta S, Mikhailidis DP, Demirkol S, Ozturk C, Celik T, Iyisoy A. Endocan: a novel inflammatory indicator in cardiovascular disease? Atherosclerosis. 2015;243:339– 43. 6. Holick MF. The vitamin D epidemic and its health consequences. J Nutr. 2005;135:2739S–48S.
7. Schwalfenberg G. Not enough vitamin D: health consequences for Canadians. Can Fam Physician. 2007;53:841–54.
8. Haliloglu O, Kasaci T, Yavuz D. Seasonal vitamin D status and endothelial function in healthcare workers. Turk J Med Sci. 2016;46:72–8.
9. Li YC, Amling M, Pirro AE, Priemel M, Meuse J, Baron R, et al. Normalization of mineral ion homeostasis by dietary means prevents hyperparathyroidism, rickets, and osteomalacia, but not alopecia in vitamin D receptorablated mice. Endocrinology. 1998;139:4391–6.
10. Mathieu C, Gysemans C, Giulietti A, Bouillon R. Vitamin D and diabetes. Diabetologia. 2005;48:1247–57.
11. Abbas MA. Physiological functions of vitamin D in adipose tissue. J Steroid Biochem Mol Biol. 2017;165:369–81.
12. Yetley EA. Assessing the vitamin D status of the US population. Am J Clin Nutr. 2008;88:558S–64S.
13. Holick MF. Vitamin D: extraskeletal health. Endocrinol Metab Clin North Am. 2010;39:381–400.
14. London GM, Guerin AP, Verbeke FH, Pannier B, Boutouyrie P, Marchais SJ, et al. Mineral metabolism and arterial functions in end-stage renal disease: potential role of 25-hydroxyvitamin D deficiency. J Am Soc Nephrol. 2007;18:613–20.
15. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002;110:229–38.
16. Bouillon R, Bischoff-Ferrari H, Willett W. Vitamin D and health: perspectives from mice and man. J Bone Miner Res. 2008;23:974–9.
17. Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ. 2014;348:g2035.
18. Al Mheid I, Patel RS, Tangpricha V, Quyyumi AA. Vitamin D and cardiovascular disease: is the evidence solid? Eur Heart J. 2013;34:3691–8.
19. Schulze F, Lenzen H, Hanefeld C, Bartling A, Osterziel KJ, Goudeva L, et al. Asymmetric dimethylarginine is an independent risk factor for coronary heart disease: results from the multicenter Coronary Artery Risk Determination investigating the Influence of ADMA Concentration (CARDIAC) study. Am Heart J. 2006;152:493.e1–8.
20. Beltowski J, Kedra A. Asymmetric dimethylarginine (ADMA) as a target for pharmacotherapy. Pharmacol Rep. 2006;58:159–78.
21. Ngo DT, Sverdlov AL, McNeil JJ, Horowitz JD. Does vitamin D modulate asymmetric dimethylarginine and C-reactive protein concentrations? Am J Med. 2010;123:335–41.
22. Abu El Maaty MA, Hassanein SI, Hanafi RS, Gad MZ. Insights on vitamin D’s role in cardiovascular disease: investigating the association of 25-hydroxyvitamin D with the dimethylated arginines. J Nutr Sci Vitaminol (Tokyo). 2013;59:172–7.
23. Gungor A, Palabiyik SS, Bayraktutan Z, Dursun H, Gokkaya N, Bilen A, et al. Levels of endothelial cell-specific molecule-1 (ESM-1) in overt hypothyroidisim. Endocr Res. 2016;41:275–80.
24. Atis O, Keles M, Cankaya E, Dogan H, Aksoy H, Akcay F. Vitamin D treatment effect on serum endocan and highsensitivity C-reactive protein levels in renal transplant patients. Prog Transplant. 2016;26:335–9.
25. Vallance P, Leone A, Calver A, Collier J, Moncada S. Accumulation of an endogenous inhibitor of nitric oxide synthesis in chronic renal failure. Lancet. 1992;339:572–5.