Hipertansif Hastalara Uygulanan Farklı Tedavi Metodlarının Apelin (AP) ve Asimetrik Dimetilarjinin (ADMA) Serum Konsantrasyonları Üzerine Etkisinin Değerlendirilmesi

Amaç: Hipertansiyon çok önemli bir sağlık sorunudur. Apelin (AP); kardiyovasküler sistemin düzenlenmesinin yanı sıra kan basıncı ve kardiak fonksiyonlarının kontrolünde rol aldığı düşünülen yeni bir multifonksiyonel peptidtir. Mevcut kanıtlar Asimetrik Dimetilarjinin (ADMA)’nin nitrik oksit (NO) sentaz inhibitörü ile rekabet halinde olan endojen bir peptit olduğunu göstermektedir. Patofizyolojik konsantrasyonlarda vasküler nitrik oksit (NO) üretimini baskılayan ADMA inhibitörleri bulunmuştur. Fakat esansiyel hipertansiyonda ki ADMA ve apelin seviyeleri ve bunların birbirleriyle olan ilişkileri ve farklı sınıflardan antihipertansif ilaçların endoteliyal fonksiyonları kapsayan bu parametrelerin üzerine olan etkileri hakkında henüz net bir bilgi yoktur. Bu çalışmada esansiyel hipertansiyon tedavisinde kullanılan çeşitli yöntemlerde ki ADMA ve apelinin düzeylerinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu araştırma Al-Yarmouk Eğitim Hastanesinde 2007-2008 yıllarını kapsayan dönemsel bir çalışmadır. Çalışmamız hipertansif hastalarda AP ve ADMA düzeylerinin belirlenmesini içermektedir. 80 hipertansif hasta (G1 ve G2 grupları) bu çalışmaya dahil edilmiş olup uygulanan tedavi metoduna göre sınıflandırılmıştır; kaptopril tedavisi uygulananlar, G1 (n=40); ve atenolol tedavisi uygulananlar, G2 (n=40). Hasta sayısına denk sağlıklı (n=80) bireylerde control grubunu oluşturmuştur. Bulgular: Hipertansif hastalar (G1 ve G2) kontrol grubu (G3) ile kıyaslandığında, serum AP seviyelerinde önemli derecede azalma, serum ADMA seviyelerinde ise önemli oranda yükselme olduğu belirlenmiştir (p< 0.001). Ayrıca hipertansif tedavi metodları; atenolol (G2) ve captopril (G1) uygulanan iki hasta grubu kıyaslandığında bu iki parametre arasında da önemli farklılıklar bulunmuştur (p< 0.001). AP’nin, ADMA ile negatif bir korelasyon gösterdiği bulunmuştur. (G1 için; r = -0.9, p

Anahtar Kelimeler:

Hipertansiyon, apelin, asimetrik dimetilarjinin, kaptopril, atenelol

Serum concentration of Apelin and Asymmetric Dimethylarginine in hypertensive patients on different modalities of treatment

Purpose: Hypertension (HTN) is considered a major health problem. Apelin (AP) a novel multifunction peptide implicated in regulation of the cardiovascular system, including blood pressure and cardiac function control, Evidence has accumulated that asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide (NO) synthase. ADMA inhibits vascular NO production at concentrations found in pathophysiological conditions. However, there is no data about ADMA and apelin levels in essential hypertension and any relationship between them and the effect of antihypertensive drugs from various classes on these parameters of endothelial function. The aim of this study is to assess the status of Apelin and Assymetric DiMethyl Arginine in essential Hypertension on various modalities of treatment. Methods: The present study is a cross-sectional study (2007/2008) at Al-Yarmouk Teaching Hospital. Includes measurement of serum AP and ADMA in patients with hypertension. a total of 80 patients with HTN were involved in this study, they were classified according to modality of treatment as Hypertensives on captopril G1: (n=40); Hypertensives on atenolol G2: (n=40). A matching group of eighty apparently healthy volunteers who were included as controls (n=80. Results: Serum AP was significantly reduced and serum ADMA was significantly elevated in hypertensive patients (G1 & G2) as compared with controls (G3) (p < 0.001), also the above significant alteration in these two parameters was found when hypertensives on atenolol (G2) were compared with hypertensives on captopril (G1) (p < 0.001). AP was negatively correlated with ADMA (r = -0.9, p

Keywords:

hypertension, Apelin, asymmetric dimethyl arginine, captopril, atenelol,

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Yazışma Adresi / Address for Correspondence: Dr. Faisal Gh. Al-Rubaye Al-Nahrain University Dept of Chemistry and Biochemistry Baghdad , IRAQ e-mail: faisal3ghazi@yahoo.com geliş tarihi/received: 06.07.2012 kabul tarihi/accepted:09.08.2012