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Öğe Autoimmune activation as a determinant of atrial fibrillation among Turks A prospective evaluation(Lippincott Williams & Wilkins, 2018) Simsek, Baris; Altay, Servet; Ozbilgin, Nazmiye; Onat, AltanAlthough low-grade inflammation has been linked to the prediction of atrial fibrillation (AF), evidence from some reports suggest that autoimmune activation might potentially be a relevant mechanism. We assessed the predictive value of inflammation and other markers for the risk of incident AF. A score of age-controlled anthropometric, lipid, and nonlipid variables was compared in participants with recorded nonvalvular persistent/permanent AF (n=110) to those of a nested cohort sample (n=1126) of the Turkish Adult Risk Factor study. Available values preceding by 2 (1) years the development of AF were used regarding incident AF (n=87) in multivariable regression. Comparing age-controlled inflammation and other markers across the 2 groups, low apolipoprotein (apo) B and total cholesterol levels differed highly significantly in each sex. Moreover, low-density lipoprotein (LDL)-cholesterol and fasting insulin concentrations were significantly lower, sex hormone binding globulin (SHBG), glucose and systolic blood pressure higher in women alone, while C-reactive protein levels were similar. A model of multivariable logistic regression analyses for overall AF and 2 models for incident AF demonstrated a consistent inverse predictive value for apoB in each gender [relative risk (RR) 0.44 (95% confidence interval (CI), 95% CI 0.30-0.66], along with age, as main determinants. SHBG in females and waist circumference in males were further significantly associated with initial AF. Never smoking (compared with ever smoking) tended to predict AF. These findings, collectively, are highly consistent with an autoimmune process in which damaged epitope of apoB due to proinflammatory state emerge as a basic mechanism in the development of AF. ApoB level is likely only apparently reduced due to partial escape from assay.Öğe Cardiovascular disease risk in psoriatic arthritis-common soil due to proinflammatory state and autoimmune activation: comment on the article by Polachek et al(Wiley, 2017) Onat, Altan; Altay, Servet; Karakoyun, Suleyman[Abstract Not Available]Öğe High-Normal Thyroid-Stimulating Hormone in Euthyroid Subjects is Associated with Risk of Mortality and Composite Disease Endpoint only in Women(TERMEDIA PUBLISHING HOUSE LTD, 2018) Altay, Servet; Onat, Altan; Can, Gunay; Tusun, Eyyup; Simsek, Baris; Kaya, AdnanIntroduction: The aim of the study was to evaluate whether serum thyroid-stimulating hormone (TSH) within the normal range in euthyroid subjects (having normal free triiodothyronine (fT3) and thyroxine (fT4)) is related to the risk of overall mortality or a composite endpoint of death and nonfatal events. Material and methods: In 614 middle-aged adult hospital screenees, free of uncontrolled diabetes at baseline, the association of sex-specific TSH tertiles with death was prospectively assessed using Cox regression, with the composite endpoint assessed using logistic regression in adjusted analyses, stratified by gender. Results: In total, 64 deaths and additional incident nonfatal events in 141 cases were recorded at a mean 7.55 years' follow-up. Multivariable linear regression revealed TSH to be significantly associated among men with age (p = 0.006), but in women inversely with fT3 and fT4 (p < 0.001, and p = 0.024 respectively). In logistic regression analysis, adjusted for age, fT3, fT4, systolic blood pressure and serum total cholesterol, sex-specific baseline TSH tertiles were associated in men neither with the risk of death nor with composite endpoint. In contrast, in women, the highest compared with the bottom TSH tertile predicted the risk of composite endpoint (relative risk: 2.02, 95% CI: 1.07-3.82) and, much more strongly, the mortality risk, independently of fT4 increments. Conclusions: The significant association of higher range of normal serum TSH in euthyroid middle-aged adults with the risk of death and nonfatal adverse outcomes in women alone cannot be accounted for by the action of thyroid hormone and is consistent with involvement of TSH in the pro-inflammatory state.Öğe Low acylation stimulating protein levels are associated with cardiometabolic disorders-secondary to autoimmune activation?(Turkish Soc Cardiology, 2017) Onat, Altan; Altay, Servet; Yuksel, Murat; Karadeniz, Yusuf; Can, Gunay; Yuksel, Husniye; Ademoglu, EvinObjective: We investigated the possible association of serum acylation stimulating protein (ASP) with cardiometabolic disorders and the evidence of autoimmune activation. Methods: Population-based randomly selected 1024 participants were cross-sectionally and prospectively analyzed. ASP concentrations were measured with a validated ELISA kit. Correlations were sought separately in subjects with no cardiometabolic disorders (n=427) designated as healthy. Results: ASP was positively correlated with total testosterone and inversely correlated with platelet activating factor (PAF), PAF-acetylhydrolase (AH), in each gender, and positively correlated in healthy men with lipoprotein [Lp](a) and apolipoprotein B. Correlations of ASP with PAF values =22 nmol/L were abolished, contrasted to a strongly inverse one in subjects with PAF Conclusion: Findings can be explained by the notion of operation of immune responses against both ASP and oxidized PAF-like lipids of Lp(a) to yield for reduced values and increased likelihood of cardiometabolic disorders.Öğe Low Serum Uric Acid Predicts Risk of a Composite Disease Endpoint(Mdpi, 2021) Ozpamuk-Karadeniz, Fatma; Karadeniz, Yusuf; Kaya, Adnan; Altay, Servet; Can, Gunay; Onat, AltanBackground and objectives: Mortality may increase in hypouricemia as well as inhyperuricemia. We assessed the predictive value of low serum uric acid (SUA) levels on the risk of overall mortality or a composite endpoint of death and nonfatal events. Materials and Methods: In 1013 community-based middle-aged adults, free of uncontrolled diabetes and coronary heart disease at baseline, the association of sex-specific SUA tertiles with defined outcomes was evaluated prospectively by logistic regression, stratified to gender and presence of type-2 diabetes, using recent criteria. Results: Totally, 43 deaths and additional incident nonfatal events in 157 cases were recorded at a median 3.4 years' follow-up. Multivariable linear regression disclosed SUA to be significantly associated among non-diabetic individuals positively with creatinine, triglycerides, and body mass index in women further with fasted glucose. In multivariable-adjusted logistic regression analysis, sex-specifically dichotomized baseline uric acid (<5.1 and <4.1 mg/dL vs. higher values) significantly predicted the non-fatal events in the whole sample (relative risk (RR) 1.51 [95% confidence interval (CI) 1.02; 2.26]), as well as in men, while composite endpoint in the whole sample tended to rise (RR 1.38). Compared with the intermediate one, the top and bottom SUA tertiles combined tended to confer mortality risk (RR 2.40 [95% CI 0.89; 6.51]). Adverse outcomes in diabetic women were predicted by tertiles 2 and 3. Conclusions: Inverse association of SUA with adverse outcomes, especially in men, is consistent with the involvement of uric acid mass in autoimmune activation. The positive association of uric acid with adverse outcomes in diabetic women is likely mediated by concomitant high-density lipoprotein dysfunction.Öğe Modulators of J-Shaped Association of HbA1c Levels with Mortality in Adults(Karger, 2016) Altay, Servet; Onat, Altan; Kaya, Adnan; Tusun, Eyyup[Abstract Not Available]Öğe Shared underlying dynamics between heart failure and cancer: autoimmune activation?(Wiley, 2016) Altay, Servet; Onat, Altan; Kaya, Aysem[Abstract Not Available]
