HELİKOBAKTER PYLORİ ERADİKASYONU İLE AZALAN ASİMETRİK DİMETİLARJİNİN (ADMA) VE ENDOTELİN-1 (ET-1) SEVİYELERİNİN İLİŞKİLENDİRİLMESİ
Giriş: H.pylori enfeksiyonu olan dispepsili hastalarda, H.pylori eradikasyonu sonrası kandaki asimetrik dimetilarjinin ve endotelin-1 seviyelerini belirlemek. Gereç ve Yöntem: H.pylori enfeksiyonu olan ve herhangi bir kardiyovasküler risk grubunda olmayan kişiler çalışmaya alınmıştır. H.pylori enfeksiyonu tanısı üre nefes testi ve histolojiye dayanılarak konulmuştur. Açlık glikozu, serum lipidleri, ADMA ve ET-1 çalışılmıştır. Olguların vücut kütle indeksi ve bel çevreleri ölçülmüştür. Hastalara 14 gün boyunca üçlü eradikasyon tedavisi verilmiştir. Tedaviden 2 hafta sonra üre nefes testi ve kan tetkikleri tekrarlanmıştır. Bulgular: 43 olguda H.pylori enfeksiyonu başarılı bir şekilde eradike edildi. Plazma ADMA ve ET-1 konsantrasyonları H.pylori eradikasyonundan sonra belirgin bir şekilde azaldı. (Sırasıyla, 2.55±0.7’ye 2.22±0.6 μmol/L p=0.018; 76.4±13.3’e 70.2±10.5 pg/mL, p=0.039) Sonuç: H.pylori eradikasyonu, azalan ADMA ve ET-1 konsantrasyonları ile ilişkilidir. H.pylori eradikasyonu ülser iyileşmesini arttırmanın yanında ADMA ve ET-1 konsantrasyonları ile ilişkili olarak, endotel disfonkisyonunu da iyileştirebildiği gözlemlenmiştir.
HELICOBACTER PYLORI ERADICATION IS ASSOCIATED WITH DECREASED LEVELS OF ASYMMETRIC DIMETHYLARGININE (ADMA) AND ENDOTHELIN-1 (ET-1)
Introduction: To determine the effect of Helicobacter pylori (H.pylori) eradication on blood levels of asymmetricdimethylarginine (ADMA) and endothelin-1 (ET-1) in patients with H.pylori-induced dyspepsia.Material and Methods: H.pylori infected 43 patients without any classical cardiovascular (CV) risk factors wereincluded in study. The infection of H.pylori was based on the presence of both 14C urea breath test (UBT) andhistology. Fasting glucose, serum lipids, ADMA and ET-1 were examined. Body mass index (BMI) and waistcircumference were measured. Patients with H.pylori-induced dyspepsia were undertaken triple eradicationtherapy for 14 days. Two weeks after the treatment, 14C UBT was re-examined and blood tests were repeated.Results: In 43 patients, H. pylori infection was successfully eradicated. Plasma ADMA and ET-1 concentrationswere decreased significantly after the eradication of H.pylori (2.55±0.7 vs. 2.22±0.6 μmol/L, p=0.018; 76.4±13.3vs. 70.2±10.5 pg/mL, p=0.039, respectively).Conclusion: Eradication of H.pylori was associated with the decreased ADMA and ET-1 concentrations. Thus,eradication of H.pylori infection not only improves ulcer healing, but may also reduce the endothelial dysfunction.
___
- Franceschi F, Gasbarrini A. Helicobacter pylori and extragastric diseases. Best Pract Res Clin Gastroenterol 2007;21(2):325-34.
- Moyaert H, Franceschi F, Roccarina D, Ducatelle R, Haesebrouck F, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection: other Helicobacters. Helicobacter 2008; 13 (Suppl 1): 47-57.
- Danesh J, Youngman L, Clark S, Parish S, Peto R, Collins R. Helicobacter pylori infection and early onset myocardial infarction: case-control and sibling pairs study. BMJ 1999 ;319(7218):1157-62.
- Ayada K, Yokota K, Kobayashi K, Shoenfeld Y, Matsuura E, Oguma K. Chronic infections and atherosclerosis. Ann N Y Acad Sci 2007; 1108: 594-602.
- Yamamoto M. Development of atherosclerosis and infectious agents.Intern Med 2003;42 (7): 547-8.
- Oshima T, Ozono R, Yano Y, Oishi Y, Teragawa H, Higashi Y, et al. Association of Helicobacter pylori infection with systemic inflammation and endothelial dysfunction in healthy male subjects. J Am Coll Cardiol 2005; 45(8): 1219-22.
- Yoshikawa H, Aida K, Mori A, Muto S, Fukuda T. Involvement of Helicobacter pylori infection and impaired glucose metabolism in the increase of brachial-ankle pulse wave velocity.Helicobacter 2007; 12(5): 559-66.
- Saijo Y, Utsugi M, Yoshioka E, Horikawa N, Sato T, Gong Y, et al. Relationship of Helicobacter pylori infection to arterial stiffness in Japanese subjects. Hypertens Res 2005; 28 (4): 283-92.
- Marra M, Bonfigli AR, Bonazzi P, Galeazzi R, Sirolla C, Testa I, et al. Asymptomatic Helicobacter pylori infection increases asymmetric dimethylarginine levels in healthy subjects. Helicobacter 2005;10(6):609-14.
- Zhang Z, Zou YY, Zhou Y, Zhou H, Li YJ. The Aggravatory Effect of Nicotine on Helicobacter pylori-induced Gastric Mucosa Injury: Role of Asymmetric Dimethylarginine. J Clin Gastroenterol 2009;43(3):261-6.
- Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 1993;362(6423) : 801-9.
- Boger RH. Asymmetric dimethylarginine (ADMA): a novel risk marker in cardiovascular medicine and beyond. Ann Med 2006;38(2):126-36.
- Boger RH, Maas R, Schulze F, Schwedhelm E. Elevated levels of asymmetric dimethylarginine (ADMA) as a marker of cardiovascular disease and mortality. Clin Chem Lab Med 2005;43(10):1124-9.
- Barton M, Yanagisawa M. Endothelin: 20 years from discovery to therapy. Can J Physiol Pharmacol 2008;86(8):485-98.
- Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology 2006 ;130(5):1466-79.
- Valkonen VP, Paiva H, Salonen JT, Lakka TA, Lehtimaki T, Laakso J, et al. Risk of acute coronary events and serum concentration of asymmetrical dimethylarginine. Lancet 2001;358(9299):2127-8.
- Goraca A. New views on the role of endothelin (minireview). Endocr Regul 2002;36(4):161-7.
- Morelli S, Ferri C, Di Francesco L, Baldoncini R, Carlesimo M, Bottoni U, et al. Plasma endothelin-1 levels in patients with systemic sclerosis: influence of pulmonary or systemic arterial hypertension. Ann Rheum Dis 1995;54(9): 730-4.
- Dhaun N, Goddard J, Kohan DE, Pollock DM, Schiffrin EL, Webb DJ. Role of endothelin-1 in clinical hypertension: 20 years on. Hypertension 2008;52(3):452-9.
- Masuda E, Kawano S, Michida T, Tsuji S, Nagano K, Fusamoto H, et al. Plasma and gastric mucosal endothelin-1 concentrations in patients with peptic ulcer. Dig Dis Sci 1997; 42(2):314-8.
- Chang FY, Chen CY, Lu CL, Luo JC, Lu RH, Lee SD. Response of blood endothelin-1 and nitric oxide activity in duodenal ulcer patients undergoing Helicobacter pylori eradication. World J Gastroenterol 2005; 11(7): 1048–51.
- ISSN: 1305-5151
- Başlangıç: 1995
- Yayıncı: İzmir Bozyaka Eğitim ve Araştırma Hastanesi
Sayıdaki Diğer Makaleler
NON-ALKOLİK STEATOHEPATİT TEDAVİSİNDE N-ASETİL SİSTEİN KULLANIMI
Bilge BAŞ, Erkan OYMACI, Haydar ADANIR
İZOLE HİPOGLİSEMİ NEDENİ: SHEEHAN SENDROMU (SS)
Emre GEZER, Gökçen ÜNAL KOCABAŞ, Arif YÜKSEL
Yusuf ŞENOĞLU, Ali TEKİN, Gizem DEMİR ŞENOĞLU
Bumin ÖRS, Yasin CEYLAN, Ömer KORAŞ, Kutsan ÇÖKTÜ, HAKAN MURAT ARSLAN, Süleyman MİNARECİ, Timuçin ŞİPAL, BÜLENT GÜNLÜSOY
Arif YÜKSEL, Bülent ALKAN, Didem YÜKSEL, Ege KARAMANCI, Oktay BİLGİR, Giray BOZKAYA, Erhan ERGİN
Arif YÜKSEL, Erhan ERGİN, Bülent ALKAN, Didem YÜKSEL, Giray BOZKAYA, Ege KARAMANCI, Oktay BİLGİR