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    Concordance of LDL-C Estimating Equations with Direct Enzymatic Measurement in Diabetic and Prediabetic Subjects
    (Mdpi, 2023) Bolat, Serkan; Zararsiz, Gozde Erturk; Dogan, Kuebra; Kochan, Necla; Yerlitas, Serra I.; Cephe, Ahu; Zararsiz, Gokmen
    Low-density lipoprotein cholesterol (LDL-C) is a well-established biomarker in the management of dyslipidemia. Therefore, we aimed to evaluate the concordance of LDL-C-estimating equations with direct enzymatic measurement in diabetic and prediabetic populations. The data of 31,031 subjects included in the study were divided into prediabetic, diabetic, and control groups according to HbA1c values. LDL-C was measured by direct homogenous enzymatic assay and calculated by Martin-Hopkins, Martin-Hopkins extended, Friedewald, and Sampson equations. The concordance statistics between the direct measurements and estimations obtained by the equations were evaluated. All equations evaluated in the study had lower concordance with direct enzymatic measurement in diabetic and prediabetic groups compared to the non-diabetic group. Even so, the Martin-Hopkins extended approach demonstrated the highest concordance statistic in diabetic and prediabetic patients. Further, Martin-Hopkins extended was found to have the highest correlation with direct measurement compared with other equations. Over the 190 mg/dL LDL-C concentrations, the equation with the highest concordance was again Martin-Hopkins extended. In most scenarios, the Martin-Hopkins extended performed best in prediabetic and diabetic groups. Additionally, direct assay methods can be used at low values of the non-HDL-C/TG ratio (<2.4), as the performance of the equations in LDL-C estimation decreases as non-HDL-C/TG decreases.
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    Protective effect of ursodeoxycholic acid and resveratrol against tacrolimus induced hepatotoxicity
    (Taylor & Francis Ltd, 2023) Koc, Suleyman; Aktas, Ahmet; Sahin, Bilal; Ozer, Hatice; Zararsiz, Gozde Erturk
    Tacrolimus (TAC) is a potent and well-tolerated immunosuppressive drug, but serious side effects including nephrotoxicity and hepatotoxicity have been reported. Ursodeoxycholic acid (UDCA) and resveratrol (RSV) exhibit hepatoprotective effects in liver diseases. We investigated the hepatoprotective effect of UDCA and RSV against TAC induced hepatotoxicity. We divided 40 male rats into five equal groups: A) control group, B) TAC group, C) TAC + UDCA group, D) TAC + RSV group, E) TAC + UDCA + RSV group. We administered 0.5 mg/kg TAC once daily, 25 mg/kg UDCA twice daily and 10 mg/kg RSV once daily. The drugs in the experimental groups were given by gavage from the first day of the study and continued for 21 days. Histopathologic and biochemical analyses were performed on day 22. In group B, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor-alpha (TNF), interleukin-1 (IL-1), interleukin-6 (IL-6), total oxidative status (TOS) and malondialdehyde (MDA) levels were higher compared to group A, and catalase (CAT), superoxide dismutase (SOD) levels and total antioxidant status (TAS) were lower compared to group A. Severe cellular swelling, degeneration and focal necrosis were more evident in group B than in groups C-E. Histopathological improvement was observed in groups C-E, where UDCA and RSV were combined, compared to group B. We found that UDCA and RSV, together or separately, protected the liver against oxidative stress damage caused by TAC.
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    Reliability of different formulas for estimating plasma Apolipoprotein B levels in a large cohort of South European individuals
    (Elsevier Ireland Ltd, 2025) Fogacci, Federica; Tastan, Serra Ilayda Yerlitas; Zararsiz, Gozde Erturk; Dogan, Halef Okan; Balbinot, Andrea; Giovannini, Marina; Borghi, Claudio
    Background and aims: Direct measurement of apolipoprotein B (ApoB) is not always standardized and is relatively expensive, making it unavailable in several low-income settings. To address this issue, several formulas have been developed to estimate ApoB levels. Therefore, our study aims to compare the reliability of 23 formulas for estimating ApoB levels in a large cohort of South-European individuals. Methods: We retrospectively assessed 4.577 clinical records in which ApoB measurements were obtained using the same standardized method. Overall concordance was defined as the proportion of cases where the directly measured ApoB level fell within the same category as the estimated ApoB level, based on ApoB quartiles (<80 mg/dL, 80-94 mg/dL, 95-114 mg/dL, and >= 115 mg/dL). In addition, overall concordance was assessed for different lipoprotein(a) (Lp(a)) and non-high density lipoprotein cholesterol (non-HDL-C) sub-levels. Ordinary least squares linear regression analyses were performed to compare estimated and measured ApoB values. Residual error plots were generated to visualize the difference between each estimation method and the actual ApoB measurements, stratified by Lp(a) and non-HDL-C levels. Results: Plasma ApoB levels were best predicted by a non-HDL-C based formula and a formula using Friedewald's low-density lipoprotein cholesterol (LDL-C), regardless of ApoB plasma levels. Non-HDL-C levels did not significantly affect the concordance between measured and estimated ApoB across the different formulas, except at low non-HDL-C levels. Similarly, Lp(a) levels did not significantly impact concordance. However, the highest concordance level was 41 %. Conclusion: Some simple formulas based on low-cost and widely available parameters can estimate ApoB levels independently of ApoB, non-HDL-C, and Lp(a) plasma levels. This approach may be particularly useful for estimating ApoB levels in low-resource settings.