Öz
Aim: Chronic venous insufficiency (CVI) is a common but neglected pathology of the cardiovascular system with high diagnosis and treatment costs and negative effects on patients' quality of life. Endocan is a dermatan sulfate proteoglycan and secreted by activated vascular endothelium. We hypothesized that higher Endocan levels may be associated with the pathophysiology of CVI. Thus, in the current study, we aimed to assess the relationship between serum Endocan levels and CVI.
Materials and Methods: Forty-four patients with CVI and 50 age- and gender- matched subjects were enrolled into the study. The baseline clinical characteristics of the patients were obtained and serum Endocan levels were calculated.
Results: The mean Endocan level and mean triglyceride (TG) level were significantly higher in the CVI (+) group compared to the CVI (-) group (p<0.001 and p=0.001, respectively). In multivariate logistic regression analysis; Endocan (p<0.001, Odds ratio (OR) = 3.48, 95% Confidence interval (C.I.) = 1.54–8.16), and TG (p=0.009, OR = 1.85, 95% C.I. = 1.36–3.55) were found to be independent predictors of CVI. ROC analysis was performed to find out the ideal Endocan cut-off value for predicting CVI. An Endocan value of >2.58 ng/mL has 92.4% sensitivity, 76.6% specificity for the prediction of the CVI (AUC 0.841, (p<0.001)).
Conclusions: In the present study, we evaluated the relationship between serum Endocan levels and CVI. Our findings suggest that increased Endocan levels may be involved in the pathogenesis of CVI.
Anahtar Kelimeler
Endocan chronic venous insufficiency endothelial dysfunction
Kaynakça
- Bergan JJ, Schmid-Schonbein GW, Smith PD, Nicolaides AN, Boisseau MR, Eklof B. Chronic venous disease. N Engl J Med 2006; 355: 488-98.
- Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation 2014; 130: 333-46.
- Raffetto JD, Khalil RA. Mechanisms of varicose vein formation: valve dysfunction and wall dilation. Phlebology 2008; 23: 85-98.
- Constans J, Conri C. Circulating markers of endothelial function in cardiovascular disease. Clin Chim Acta 2006; 368: 33-47.
- Eklof B, Rutherford RB, Bergan JJ, et al. Revision of the CEAP classification for chronic venous disorders: Consensus statement. J Vasc Surg 2004; 40: 1248-52.
- Sarrazin S, Adam E, Lyon M, et al. Endocan or endothelial cell specific molecule-1 (ESM-1): a potential novel endothelial cell marker and a new target for cancer therapy. Biochim Biophys Acta Rev Cancer 2006; 1765: 25-37.
- Bechard D, Scherpereel A, Hammad H, et al. Human endothelial-cell specific molecule-1 binds directly to the integrin CD11a/CD18 (LFA-1) and blocks binding to intercellular adhesion molecule-11. J Immunol 2001; 167: 3099-106.
- Aparci M, Isilak Z, Uz O, Yalcin M, Kucuk U. Endocan and endothelial dysfunction. Angiology 2015; 66: 488–9.
- Zhang SM, Zuo L, Zhou Q, et al. Expression and distribution of endocan in human tissues. Biotech Histochem 2012; 87: 172–8.
- Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015; 16 (3): 233-70.
- Rabe E, Guex JJ, Puskas A, Scuderi A, Fernandez Quesada F. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol 2012; 31: 105-15.
- Nicolaides AN, Allegra C, Bergan J, et al. American venous forum. Management of chronic venous disorders of the lower limbs: guidelines according to scientific evidence. Int Angiol 2008; 27: 1-59.
- Canonico S, Gallo C, Paolliso G, et al. Prevalence of varicose veins in an Italian elderly population. Angiology 1998; 49: 129-35.
- Fowkes FG, Evans CJ, Lee AJ. Prevalence and risk factors of chronic venous insufficiency. Angiology 2001; 52: 5-15.
- Jawien A. The influence of environmental factors in chronic venous insufficiency. Angiology 2003; 54: 19-31.
- Georgescu A, Alexandru N, Popov D, et al. Chronic venous insufficiency is associated with elevated level of circulating microparticles. J Thromb Haemost 2009; 7: 1566-75.
- Pocock ES, Alsaigh T, Mazor R, Schmid-SchoÈnbein GW. Cellular and molecular basis of venous insufficiency. Vasc Cell 2014; 6: 24.
- Hadi HA, Carr CS, Al Suwaidi J. Endothelial dysfunction: cardiovascular risk factors, therapy, and outcome. Vasc Health Risk Manag 2005; 1: 183-98.
- Budzyń M, Iskra M, Turkiewicz W, Krasiński Z, Gryszczyńska B, Kasprzak MP. Plasma concentration of selected biochemical markers of endothelial dysfunction in women with various severity of chronic venous insufficiency (CVI)-A pilot study. PLoS One 2018; 13 (1): e0191902.
- Bryan LJ, Callas PW, Criqui MH, Cushman M. Higher soluble P-selectin is associated with chronic venous insufficiency: The San Diego Population Study. Thromb Res 2012; 130 (5): 716-9.
- Auzky O, Lanska V, Pitha J, Roztocil K. Association between symptoms of chronic venous disease in the lower extremities and cardiovascular risk factors in middle-aged women. Int Angiol 2011; 30 (4): 335-41
Öz
Amaç: Kronik venöz yetmezlik (KVY), kardiyovasküler sistemin yüksek tanı ve tedavi maliyetleri ile hastaların yaşam kalitesi üzerinde olumsuz etkileri olan, yaygın fakat ihmal edilmiş bir patolojisidir. Endokan bir dermatan sülfat proteoglikandır ve aktif damar endoteli tarafından salgılanır. Yüksek Endokan seviyeleri ile KVY patofizyolojisi arasında ilişkili olabileceğini varsaydık. Bu nedenle bu çalışmada serum Endokan düzeyleri ile KVY arasındaki ilişkiyi değerlendirmeyi amaçladık.
Gereç ve Yöntem: Kronik venöz yetmezliği olan kırk dört hasta ile yaş ve cinsiyet uyumlu 50 olgu çalışmaya dahil edildi. Hastaların başlangıç klinik özellikleri kaydedildi ve serum Endokan düzeyleri hesaplandı.
Bulgular: Ortalama Endokan düzeyi ile ortalama trigliserit (TG) düzeyi, KVY (+) grubunda KVY (-) grubuna göre anlamlı olarak yüksekti (sırasıyla p <0,001 ve p = 0,001). Çok değişkenli lojistik regresyon analizinde; Endokan (p <0,001, Oran oranı (OR) = 3,48, %95 Güven aralığı (CI) = 1,54–8,16) ve TG (p = 0,009, OR = 1,85, %95 CI = 1,36-3,55)' nin bağımsız KVY prediktörleri oldukları bulundu.
KVY tahmininde ideal Endokan kesme değerini bulmak için ROC analizi yapıldı. > 2,58 ng/ml’lik bir Endokan değeri, KVY tahmini için %92,4 duyarlılığa, %76,6 özgüllüğe sahiptir (AUC 0,841, p <0,001).
Sonuçlar: Bu çalışmada, serum Endocan seviyeleri ile KVY arasındaki ilişkiyi değerlendirdik. Bulgularımız, artmış Endokan düzeylerinin KVY patogenezinde rol oynayabileceğini göstermektedir.
Anahtar Kelimeler
Kaynakça
- Bergan JJ, Schmid-Schonbein GW, Smith PD, Nicolaides AN, Boisseau MR, Eklof B. Chronic venous disease. N Engl J Med 2006; 355: 488-98.
- Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation 2014; 130: 333-46.
- Raffetto JD, Khalil RA. Mechanisms of varicose vein formation: valve dysfunction and wall dilation. Phlebology 2008; 23: 85-98.
- Constans J, Conri C. Circulating markers of endothelial function in cardiovascular disease. Clin Chim Acta 2006; 368: 33-47.
- Eklof B, Rutherford RB, Bergan JJ, et al. Revision of the CEAP classification for chronic venous disorders: Consensus statement. J Vasc Surg 2004; 40: 1248-52.
- Sarrazin S, Adam E, Lyon M, et al. Endocan or endothelial cell specific molecule-1 (ESM-1): a potential novel endothelial cell marker and a new target for cancer therapy. Biochim Biophys Acta Rev Cancer 2006; 1765: 25-37.
- Bechard D, Scherpereel A, Hammad H, et al. Human endothelial-cell specific molecule-1 binds directly to the integrin CD11a/CD18 (LFA-1) and blocks binding to intercellular adhesion molecule-11. J Immunol 2001; 167: 3099-106.
- Aparci M, Isilak Z, Uz O, Yalcin M, Kucuk U. Endocan and endothelial dysfunction. Angiology 2015; 66: 488–9.
- Zhang SM, Zuo L, Zhou Q, et al. Expression and distribution of endocan in human tissues. Biotech Histochem 2012; 87: 172–8.
- Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015; 16 (3): 233-70.
- Rabe E, Guex JJ, Puskas A, Scuderi A, Fernandez Quesada F. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol 2012; 31: 105-15.
- Nicolaides AN, Allegra C, Bergan J, et al. American venous forum. Management of chronic venous disorders of the lower limbs: guidelines according to scientific evidence. Int Angiol 2008; 27: 1-59.
- Canonico S, Gallo C, Paolliso G, et al. Prevalence of varicose veins in an Italian elderly population. Angiology 1998; 49: 129-35.
- Fowkes FG, Evans CJ, Lee AJ. Prevalence and risk factors of chronic venous insufficiency. Angiology 2001; 52: 5-15.
- Jawien A. The influence of environmental factors in chronic venous insufficiency. Angiology 2003; 54: 19-31.
- Georgescu A, Alexandru N, Popov D, et al. Chronic venous insufficiency is associated with elevated level of circulating microparticles. J Thromb Haemost 2009; 7: 1566-75.
- Pocock ES, Alsaigh T, Mazor R, Schmid-SchoÈnbein GW. Cellular and molecular basis of venous insufficiency. Vasc Cell 2014; 6: 24.
- Hadi HA, Carr CS, Al Suwaidi J. Endothelial dysfunction: cardiovascular risk factors, therapy, and outcome. Vasc Health Risk Manag 2005; 1: 183-98.
- Budzyń M, Iskra M, Turkiewicz W, Krasiński Z, Gryszczyńska B, Kasprzak MP. Plasma concentration of selected biochemical markers of endothelial dysfunction in women with various severity of chronic venous insufficiency (CVI)-A pilot study. PLoS One 2018; 13 (1): e0191902.
- Bryan LJ, Callas PW, Criqui MH, Cushman M. Higher soluble P-selectin is associated with chronic venous insufficiency: The San Diego Population Study. Thromb Res 2012; 130 (5): 716-9.
- Auzky O, Lanska V, Pitha J, Roztocil K. Association between symptoms of chronic venous disease in the lower extremities and cardiovascular risk factors in middle-aged women. Int Angiol 2011; 30 (4): 335-41
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Aralık 2020 |
| Gönderilme Tarihi | 6 Temmuz 2020 |
| Yayımlandığı Sayı | Yıl 2020Cilt: 59 Sayı: 4 |
