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    Intensive Lipid Reduction and Proinflammatory Markers in the MODEST Study
    (Galenos Yayincilik, 2010) Kanat, Mustafa; Yildiz, Ozcan; Tunckale, Ayd N.; Ceyhan, Banu Ozturk; Karagoz, Yalcin; Altuntas, Yuksel; Oguz, Aytekin
    Objective: Statin therapy is well known to reduce inflammatory markers such as tumor necrosis factor-alpha (TNF-alpha), interleukin 6 (IL-6), high-sensitivity C-reactive protein (hsCRP). However, whether this relationship is maintained in the setting of targeting very low levels of LDL (<70 mg dl) in patients with type 2 diabetes has not been clearly established. Materials and Methods: We measured hsCRP, IL-6, and TNF-alpha in 43 subject enrolled into the multicenter, open-label, crossover prospective study evaluating the effects of lipid-lowering treatment on steroid synthesis in patients with type 2 diabetes (MODEST study). Subjects with diabetes and coronary artery disease were treated with 80 mg of atorvastatin for 12 weeks. The effect of treatment on pro-inflammatory markers was assessed after 12 weeks. Results: High-dose atorvastatin treatment significantly reduced the plasma levels of IL-6 and hsCRP (p<0.05, p<0.001, respectively), but not of TNF-alpha (p=0.051). Conclusion: Atorvastatin treatment targeting very low LDL-cholesterol level reduced the levels of several important inflammatory markers in patients with type 2 diabetes and coronary heart disease.
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    What have we learned from Turkish familial hypercholesterolemia registries (A-HIT1 and A-HIT2)?
    (ELSEVIER IRELAND LTD, 2018) Kayikcioglu, Meral; Tokgozoglu, Lale; Dogan, Volkan; Ceyhan, Ceyhun; Tuncez, Abdullah; Kutlu, Merih; Onrat, Ersel; Alici, Gokhan; Akbulut, Mehmet; Celik, Ahmet; Yesilbursa, Dilek; Sahin, Tayfun; Sonmez, Alper; Ozdogan, Oner; Temizhan, Ahmet; Kilic, Salih; Bayram, Fahri; Sabuncu, Tevfik; Coskun, Fatma Yilmaz; Ildizli, Muge; Durakoglugil, Emre; Kirilmaz, Bahadir; Yilmaz, Mehmet Birhan; Yigit, Zerrin; Yildirim, Aytul Belgi; Gedikli, Omer; Topcu, Selim; Oguz, Aytekin; Demir, Mesut; Yenercag, Mustafa; Yildirir, Aylin; Demircan, Sabri; Yilmaz, Mehmet; Kaynar, Leyla Gul; Aktan, Melih; Durmus, Rana Berru; Gokce, Cumali; Ozcebe, Osman Ilhami; Akyol, Tulay Karaagac; Okutan, Harika; Sag, Saim; Gul, Ozen Oz; Salcioglu, Zafer; Altunkeser, Bulent Behlul; Kuku, Irfan; Yasar, Hurriyet Yilmaz; Kurtoglu, Erdal; Kose, Melis Demir; Demircioglu, Sinan; Pekkolay, Zafer; Ilhan, Osman; Can, Levent H.
    Background and aims: Familial hypercholesterolemia (FH) is a common genetic disease of high-level cholesterol leading to premature atherosclerosis. One of the key aspects to overcome FH burden is the generation of largescale reliable data in terms of registries. This manuscript underlines the important results of nation-wide Turkish FH registries (A-HIT1 and A-HIT2). Methods: A-HIT1 is a survey of homozygous FH patients undergoing low density lipoprotein (LDL) apheresis (LA). A-HIT2 is a registry of adult FH patients (homozygous and heterozygous) admitted to outpatient clinics. Both registries used clinical diagnosis of FH. Results: A-HIT1 evaluated 88 patients (27 +/- 11 years, 41 women) in 19 centers. All patients were receiving regular LA. There was a 7.37 +/- 7.1-year delay between diagnosis and initiation of LA. LDL-cholesterol levels reached the target only in 5 cases. Mean frequency of apheresis sessions was 19 +/- 13 days. None of the centers had a standardized approach for LA. Mean frequency of apheresis sessions was every 19 +/- 13 (7-90) days. Only 2 centers were aware of the target LDL levels. A-HIT2 enrolled 1071 FH patients (53 +/- 8 years, 606 women) from 31 outpatients clinics specialized in cardiology (27), internal medicine (1), and endocrinology (3); 96.4% were heterozygous. 459 patients were on statin treatment. LDL targets were attained in 23 patients (2.1% of the whole population, 5% receiving statin) on treatment. However, 66% of statin-receiving patients were on intense doses of statins. Awareness of FH was 9.5% in the whole patient population. Conclusions: The first nationwide FH registries revealed that FH is still undertreated even in specialized centers in Turkey. Additional effective treatment regiments are urgently needed.