This study investigated the role of plasma adropin levels to show endothelial dysfunction in individuals with type 2 diabetes mellitus and to compare these with flow-mediated dilatation. A total of 92 individuals with diagnosed type 2 diabetes mellitus were included and divided into 2 groups according to their brachial flow-mediated dilatation. The endothelial dysfunction group consisted of 46 participants with flow-mediated dilatation change of less than 7%, whereas 46 participants with flow-mediated dilatation change of more than 7% were accepted as the nonendothelial dysfunction group. Venous blood samples were taken from all study participants, and plasma adropin levels were measured using an enzyme-linked immunosorbent assay kit. The mean flow-mediated dilatation values were 13.2% ± 4.9% in the nonendothelial dysfunction group, and 3.5% ± 3.4% in the endothelial dysfunction group. Mean hemoglobin A1c levels were significantly higher in the endothelial dysfunction group than in the nonendothelial dysfunction group (8.7% ± 1.9% vs 7.9% ± 1.6%, respectively; P < 0.038). Mean plasma adropin levels were 3.04 ± 0.79 ng/mL in the endothelial dysfunction group and 4.67 ± 1.43 ng/mL in the nonendothelial dysfunction group; P < 0.001. Plasma adropin levels showed no correlation with body mass index (r = -0.072, P = 0.497) but were positively correlated with flow-mediated dilatation values (r = 0.537, P < 0.001). In the linear regression analysis, adropin and hemoglobin A1c were independent risk factors for endothelial dysfunction in individuals with type 2 diabetes mellitus. Adropin is a new marker for use in demonstrating endothelial dysfunction.

Summary: The pathophysiology of cardiac syndrome X (CSX) is still unclear, but most patients with CSX have endothelial dysfunction. It has been shown that adropin uniquely effects the regulation of endothelial function. The purpose of the study was to evaluate the role of adropin in CSX. Eighty‐six consecutive cardiac syndrome X‐diagnosed patients and 86 age‐sex matched healthy subjects were enrolled into the study. Serum adropin levels, nitrite/nitrate levels were measured in each subject. The adropin levels were significantly lower in patients with CSX than healthy subjects (1.7 ± 0.8 ng/mL and 3.4 ± 1.8 ng/mL, respectively; P < 0.001). The BMI values of patients with CSX were significantly higher than control subjects (28.1 ± 2.4 kg/m² and 26.0 ± 3.7 kg/m², respectively; P < 0.001). Plasma nitrite/nitrate levels were lower in patients with CSX than control subjects (15.9 ± 1.6 μmol/L vs. 25.4 ± 2.8 μmol/L, respectively; P < 0.001), and they have a significantly positive correlation with plasma adropin levels (r = 0.463, P < 0.001). In the multiple linear regression analysis, nitrite/nitrate levels, BMI, and adropin were found to be independent risk factors for CSX. A ROC curve is used to identify the ability of adropin levels to predict the cardiac syndrome X. The area under the ROC curve was 0.854 for adropin levels (P = 0.0001). The sensitivity and specificity values of adropin levels were 90.7 and 70.9%, respectively (cut‐off value 2.73). In conclusion, lower serum adropin levels were associated with CSX. Adropin is an independent risk factor for CSX.

Red blood cell distribution width (RDW) has been reported to be a marker of morbidity and mortality for some cardiovascular and pulmonary diseases. We aimed to evaluate RDW values in otherwise healthy smokers. Two hundred and twenty consecutive subjects with current smoking and 230 age- and gender-matched healthy subjects without smoking history were enrolled. Number of cigarettes smoked per day and duration of smoking, evaluated as pack years, were recorded. Complete blood count, high-sensitivity C-reactive protein (hs-CRP) levels and lipid profile were analyzed in all study participants. The mean RDW values were higher in smokers than in nonsmokers (13.9±1.2 vs. 13.1±0.8, p<0.0001). The mean leukocyte count, mean platelet volume and hs-CRP levels were also significantly greater in smokers when compared to nonsmokers (8440±1.750 vs. 7090±1550, p<0.0001; 8.7±0.8 fL vs. 8.3±0.6 fL, p<0.0001; 2.42±0.53 mg/L vs. 1.46±0.52 mg/L, p<0.0001, respectively). Significant positive correlations between RDW and number of cigarettes smoked per day and between RDW and duration of smoking were identified (r=0.565 and r=0.305, respectively). Elevated RDW is associated with cigarette smoking and may be a useful indicator of inflammatory activity in smokers.

Data on the burden of heart failure (HF) outside western countries are limited, but available data suggest it may present differently in other countries. The aim of this study was to examine the incidence, prevalence, and survival rates of HF in Türkiye, with a specific focus on how these rates vary according to age, sex, comorbidities, and socioeconomic status (SES). We harnessed the extensive National Electronic Database of the Turkish Ministry of Health, covering Turkey's entire population from January 1, 2016, to December 31, 2022, to identify 2,722,151 cases of HF and their associated comorbidities using ICD-10 codes. Analyzing the primary endpoint of all-cause mortality, our study utilized anonymized data to examine patient demographics, comorbidities, socioeconomic status, and survival patterns, employing statistical techniques to delve into relationships and trends. The data were segmented by gender, socioeconomic status, and age, involving cross-tabulations and statistical metrics to explore connections, odds ratios, and survival rates. The estimated prevalence of HF was 2.114% in Türkiye at the end of 2022, with an annual incidence ranging between 3.00 and 6.06 per 1000 person years. Females were older than males (69.8 ± 13.9 years vs. 66.8 ± 13.9 years, respectively). The most common comorbidities were congenital heart diseases and anemia under the age of 20, and hypertension and atherosclerotic cardiovascular disease in the adult population. Only 23.6% (643,159/2,722,151) of patients were treated with any triple guideline-directed medical therapy (GDMT) and 3.6% (96,751/2,722,151) of patients were on quadruple GDMT. The survival rates for patients with HF at 1, 5, and 7 years were 83.3% (95% CI: 83.2–83.3), 61.5% (95% CI: 61.4–61.6), and 57.7% (95% CI: 57.6–57.8) among females, and 82.1% (95% CI: 82.0–82.2), 58.2% (95% CI: 58.1–58.3), and 54.2% (95% CI: 54.0–54.3) among males. Despite a tendency for an increase from the highest to the lowest SES, the prevalence of HF and mortality were paradoxically lowest in the lowest SES region. The prevalence, incidence, and survival rates of HF in Türkiye were comparable to western countries, despite the notable difference of HF onset occurring 8–10 years earlier in the Turkish population. Drug usage statistics indicate there is a need for effective strategies to improve treatment with GDMT. None.

Objectives: In this study our aim was to evaluate the relationship between degree of fluid status and arterial stiffness measured by pulse wave velocity (PWV) in peritoneal dialysis (PD) patients. Fluid status was determined by different methods including fluid overload measured by bioimpedance (Body Composition Monitor, BCM), calf normalized resistivity (CNR), plasma N-terminal fragment of B-type natriuretic peptide (NT-proBNP) and extracellular to intracellular water ratio (ECW/ICW). Methods: Sixty PD patients were evaluated. They were stratified into normo- and hypervolemic groups according to their fluid overload (FO). CNR was calculated from resistance at 5 kHz using calf bioimpedance spectroscopy. Arterial stiffness was assessed by PWV. Additionally, all patients underwent transthoracic echocardiography and had levels of NT-proBNP measured. Results: PWV was higher in the hypervolemic compared to normovolemic patients (9.99 ± 2.4 m/sec vs 7.48 ± 2.3 m/sec, p < 0.001). Hypervolemic patients had higher NT-proBNP levels (3065 ± 981 pg/mL vs 1095 ± 502 pg/mL, p < 0.001), a higher ratio of ECW/ICW; (0.93 ± 0.11 vs 0.81 ± 0.08, p < 0.001) and lower CNR (13.7 ± 2.4 vs 16.0 ± 3.3 W m³/kg^*10⁻², p = 0.005). NT-pro BNP level, ECW/ICW ratio, relative FO, and left ventricular (LV) mass index were positively and CNR negatively correlated with PWV. Relative FO and CNR independently predicted PWV in multivariate analysis adjusted for age, duration of PD, body mass index and mean arterial pressure. Conclusions: Arterial stiffness is increased in fluid-overloaded PD patients. Our results indicated that fluid status is an independent predictor of PWV.