Ercüment ÖLMEZ, Feral ÖZTÜRK, Hasan Berat CİHAN, Çetin ÖZTÜRK, Cengiz ÇOLAK, Nevzat ERDİL, Bektaş BATTALOĞLU, Vedat NİSANOĞLU

Radial arter aterosklerozunda antioksidan enzimler ve 6-sülfatoksimelatoninin rolü

Amaç: Çalışmamızda koroner arter cerrahisinde greft olarak kullanılan radial arterlerde aterosklerotik tutulum oranları ve radial arter aterosklerozu oluşumunda 6-sülfatoksimelatonin ve antioksidan enzimlerin etkileri araştırıldı. Çalışma planı: Koroner arter cerrahisinde radial arteri greft olarak kullanılan 25 hasta (22 erkek 3 kadın; ort. yaş 56±3; dağılım 42-67) çalışmaya alındı. Radial arter kesitlerinde histopatolojik olarak değişik derecede ateroskleroz saptanan 10 hastanın (grup 1) verileri, ateroskleroz saptanmayan 15 hastanın (grup 2) verileriyle prospektif olarak karşılaştırıldı. Hastaların yaş, cinsiyet, hipertansiyon, diabetes mellitus, obezite, sigara içme ve periferik arteryel hastalık varlığını içeren ateroskleroz risk faktörleri kaydedildi. Hastaların kan örnekleri alınarak ayrıntılı lipid profili (kolesterol, trigliserid, lipoprotein analizleri), C-reaktif protein (CRP) düzeyi ve antioksidan enzimleri (katalaz, glutatyon peroksidaz, süperoksid dismutaz) incelendi. İdrar örneklerinde 6-sülfatoksimelatonin düzeyleri saptandı.Bulgular: Histopatolojik incelemede, grup 1 hastaların dördünde derece 1 ateroskleroz tespit edilirken, üçünde derece 2, ikisinde derece 3, birinde derece 4 aterosklerotik değişiklikler görüldü. İki grupta serum total kolesterol, trigliserid, HDL-kolesterol, LDL-kolesterol, VLDL-kolesterol, lipoprotein (a) ve CRP düzeyleri benzer bulundu (p>0.05). Grup 1'deki serum apoprotein A ve apoprotein B düzeyi grup 2'den daha yüksekti (p0.05).Sonuç: Bu sonuçlar, istatistiksel olarak anlamlı olmamakla beraber, yüksek oksidatif stres ile birlikte düşük melatonin düzeylerinin radial arter aterosklerozunda rolü olabileceğini düşündürmektedir.

The role of antioxidant enzymes and 6-sulphatoxymelatonin in radial artery atherosclerosis

Background: We evaluated the incidence of atherosclerosis in radial artery grafts used for coronary artery bypass surgery and the influence of 6-sulphatoxymelathonin and antioxidant enzymes on atherosclerosis of the radial artery. Methods: The study included 25 patients (22 males 3 females; mean age 56±3 years; range 42 to 67 years) in whom radial artery was used for elective coronary artery bypass grafting. Data from 10 patients with histopathological evidence for atherosclerosis of the radial artery (group 1) were prospectively compared with those of 15 patients without atherosclerosis (group 2). Risk factors for atherosclerosis including age, gender, the presence of hypertension, diabetes mellitus, obesity, smoking, and peripheral artery disease were recorded. Detailed blood lipid profile (triglyceride, cholesterol, and lipoprotein analyses), C-reactive protein, and antioxidant enzyme levels (catalase, glutathione peroxidase, and superoxide dismutase), and urine 6-sulphatoxymelatonin levels were determined.Results: In group 1, histopathological examination of the radial artery wall revealed atherosclerotic changes of grade 1 in four patients, grade 2 in three patients, grade 3 in two patients, and grade 4 in one patient. Serum levels of triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, lipoprotein (a), and C-reactive protein were similar in both groups (p>0.05). Serum apoprotein A and apoprotein B levels were significantly higher in group 1 (p0.05).Conclusion: Our results suggest that, although not statistically significant, higher oxidative stress and decreased melatonin levels may play a role in radial artery atherosclerosis.

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