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Biomedical subjects

Selim Kilic

Publications and source records attributed to Selim Kilic.

At least 19 recordsLinked to original sources

Plasma visfatin levels in patients with newly diagnosed and untreated type 2 diabetes mellitus and impaired glucose tolerance.

Visfatin, a new adipokine, facilitates adipogenesis and has insulin-mimetic properties. We aimed to investigate the plasma visfatin levels in patients with newly diagnosed and untreated type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT), who had no obesity or hypertension. Twenty-two patients with T2DM, 18 subjects with IGT and 40 healthy controls were enrolled. Visfatin levels were measured along with the BMI, blood pressure, lipids, glucose, insulin, adiponectin and hsCRP levels, and HOMA-IR indexes. Age, sex and BMI were similar in all groups. Visfatin levels were higher in the diabetic group than the controls (p=0.01). There was no significant difference in the visfatin levels between the T2DM and IGT groups as well as IGT group and healthy controls. Plasma visfatin concentrations did not differ between men and women. Visfatin levels did not correlate with BMI, blood pressure, plasma adiponectin, insulin, hsCRP, glucose and lipid levels or HOMA-IR indexes in the three groups. These results indicate that hyperglycemia causes an increase in plasma visfatin levels and, as in people with T2DM but not with IGT, this increase gets more prominent as the glucose intolerance worsens.

Adult↗

Adiponectin and insulin resistance in young and healthy smokers.

Smoking is closely associated with insulin resistance, though the mechanism is not clear. Adiponectin, a novel anti-atherosclerotic and anti-inflammatory adipose tissue product, which is closely associated with insulin resistance, was reported to be low in smokers with cofactors for atherosclerosis. However, the effects of smoking on circulating adiponectin levels in otherwise healthy people are unknown. In this study, a case control design was implemented to search for the effect of smoking on plasma adiponectin and insulin sensitivities in healthy people. Sixty-four healthy male smokers, with no family history of hypertension and diabetes mellitus were compared with appropriate 36 age and body mass index matched controls. Both the patients and controls were the soldiers of a troop with regular daily physical activity. Plasma adiponectin, high sensitive C-reactive protein (hsCRP), insulin and lipid levels, and insulin sensitivity as assessed by homeostasis model assessment index (HOMA) of the smokers were measured and compared with those of the controls. The plasma adiponectin, hsCRP, insulin levels and HOMA indexes of the two groups were similar. These parameters were not affected by the amount of cigarettes per day. HDL-cholesterol levels were lower (p = 0.01) and systolic blood pressures were higher (p = 0.02) in the smokers. These results indicate that smoking may not affect plasma adiponectin and insulin levels in young and healthy men with high exercise capacity.

Adiponectin↗

Effects of nebivolol on platelet activation in hypertensive patients: a comparative study with metoprolol.

OBJECTIVES: We evaluated the effects of nebivolol on platelet activation in hypertensive patients by measuring mean platelet volume (MPV) and plasma soluble P-selectin (sP-sel) levels and compared with those of the patients taking metoprolol. MATERIALS AND METHODS: Eighty newly diagnosed hypertensive patients in grade 1 hypertension were enrolled in this prospective, blinded randomized study. Seventy two patients completed the study. After baseline assessment, each patient was randomly allocated to 5 mg daily dose of nebivolol (n=37, 20 male) or 100 mg daily dose of metoprolol (n=35, 18 male) and treated for 6 months. Blood pressure, heart rate, lipid profile, plasma glucose, sP-selectin levels, platelet counts and MPV were measured before and after treatment. RESULTS: At the end of 6 months, nebivolol significantly decreased MPV and plasma sP-selectin levels (7.59+/-0.78 fl vs. 7.42+/-0.74 fl, p<0.001; 1.29+/-0.46 ng/ml vs. 1.21+/-0.36 ng/ml, p=0.002, respectively) compared to those of pretreatment. Although pretreatment sP-selectin levels of the two groups were similar, posttreatment plasma sP-selectin levels were significantly reduced with nebivolol compared with those of metoprolol group (1.21+/-0.36 ng/ml vs. 1.46+/-0.30 ng/ml, p=0.008). In contrast, metoprolol treatment did not cause any significant change in platelet activation parameters after treatment. CONCLUSION: Beneficial effects of nebivolol on platelet activation were more potent than those of metoprolol. We consider that decreased platelet activation with nebivolol might play a role to reduce thrombotic risk in hypertensive patients.

Antihypertensive Agents↗

The acute effect of cigarette smoking on pattern visual evoked potentials.

Reports of tobacco-induced electrocortical activation and decrements in ocular blood flow in the acute phase indicated that this effect is mediated via nicotine's action or neuronal systems. In this study, pattern visual evoked potentials were investigated in a group of male smokers (22 right eyes of 22 subjects) in separate real smoking and sham smoking sessions. On each session, pattern visual evoked potentials were recorded before smoking, immediately after smoking, and five minutes after smoking. Latency and amplitude values for P100 peaks were assessed and analyzed in each smoking condition for both real smoking and sham smoking sessions. Real smoking significantly decreased P100 latency values (p value related to difference between pre-smoking and immediately after smoking conditions is 0.009) and increased P100 amplitude values (p value related to difference between pre-smoking and fifth minute after smoking is 0.039). Statistically no significant difference was observed in sham smoking sessions. Our results are consistent with smoking-induced stimulant effects on pattern visual evoked potentials.

Adult↗

Recovery of abnormal ejaculation by intermittent tamsulosin treatment.

PURPOSE: We assessed the impact of intermittent tamsulosin treatment on abnormal ejaculation. MATERIALS AND METHODS: This prospective study was performed between January 2001 and December 2004. It included 405 patients who were at least 50 years old with lower urinary tract symptoms. This study was divided into 2 phases. In phase 1 patients received a 0.4 mg tamsulosin capsule daily after breakfast for at least 3 months. The second phase of this study was performed in the 30 patients with abnormal ejaculation. In this phase these patients received 0.4 mg tamsulosin once daily every other day. Patients were assessed at study entry and at study week 6. RESULTS: Abnormal ejaculation was reported as retrograde ejaculation by 18 patients, as decreased volume by 7 and as absent ejaculate by 5. Ejaculatory function recovered during intermittent tamsulosin treatment in 12 patients with retrograde ejaculation and in 7 with decreased volume or absent ejaculate. As a result, 19 of 30 patients (63.3%) with abnormal ejaculation recovered. A significant improvement in retrograde ejaculation was found after intermittent tamsulosin treatment (p = 0.02). Although there were improvements in decreased volume or absent ejaculate at week 6 of intermittent treatment, these differences were not statistically significant (p = 0.42 and 0.61, respectively). CONCLUSIONS: The results of the current study, which to our knowledge is the first report of the effect of intermittent tamsulosin treatment on abnormal ejaculation, show that this treatment modality is well tolerated and provides comparable improvements for abnormal ejaculation.

Adrenergic alpha-Antagonists↗

Comparative effects of nebivolol and metoprolol on oxidative stress, insulin resistance, plasma adiponectin and soluble P-selectin levels in hypertensive patients.

OBJECTIVES: To determine the effects of nebivolol on oxidative stress, insulin resistance, adiponectin and plasma soluble P-selectin levels in hypertensive patients in comparison with metoprolol. MATERIAL AND METHODS: Eighty newly diagnosed hypertensive patients in grade 1 hypertension according to the European Society of Hypertension and European Society of Cardiology guidelines were enrolled in this prospective, blinded, randomized study. Seventy-two patients completed the study. After baseline assessment, each patient was randomly allocated to a 5 mg daily dose of nebivolol (n = 37, 20 male) or a 100 mg daily dose of metoprolol (n = 35, 18 male) and treated for 6 months. Blood pressure, heart rate, oxidative stress (malonyldialdehyde), homeostasis model assessment: insulin resistance, adiponectin and plasma soluble P-selectin levels were measured before and after treatment. RESULTS: At the end of treatment, nebivolol and metoprolol significantly decreased blood pressure and heart rate, with a more pronounced bradycardic effect of metoprolol. Nebivolol, but not metoprolol, significantly lowered oxidative stress (P = 0.03), the insulin resistance index (P = 0.003) and plasma soluble P-selectin levels (P = 0.008), and increased adiponectin levels (P = 0.04). CONCLUSION: Nebivolol, in contrast to metoprolol, improved oxidative stress, insulin sensitivity, decreased plasma soluble P-selectin and increased adiponectin levels in hypertensive patients. These beneficial effects of nebivolol may contribute to a reduction in cardiovascular risk in hypertensive patients.

Adiponectin↗

Impaired aortic elastic properties in young patients with prehypertension.

OBJECTIVES: Although hypertension has been shown to be one of the most important predictors of reduced arterial elasticity, there is not enough data about aortic elastic properties in patients with prehypertension. Accordingly, the current study was designated to evaluate aortic elastic features in young patients with prehypertension. MATERIAL AND METHODS: The study population consisted of 25 newly diagnosed prehypertensive individuals (18 men, mean age=34+/-6 years) and 25 healthy controls (16 men, mean age=33+/-6 years) eligible for the current study. Aortic strain, distensibility index and stiffness index beta were calculated from aortic diameters measured by echocardiography and blood pressures simultaneously measured by sphygmomanometry. RESULTS: Prehypertensive patients were detected to have significantly lower aortic distensibility and strain indexes than the controls: (5.77+/-1.91 vs. 8.63+/-2.67 cm dynx10, respectively, P<0.001; strain index: 13.81+/-4.50 vs. 17.47+/-4.25%, respectively, P=0.005). Aortic stiffness index beta of the prehypertensive group, however, was significantly higher than that of the control group (3.73+/-1.41 vs. 2.97+/-0.82, P=0.02). CONCLUSION: Whatever the mechanism, young patients with prehypertension have impaired aortic elasticity compared with healthy controls. This finding has suggested that the development of overt hypertension may be prevented or delayed by using the agents that have the ability to reduce arterial stiffness by regressing and/or preventing functional and structural changes on the arterial wall.

Adult↗

The effect of fluvastatin on plasma adiponectin levels in dyslipidaemia.

OBJECTIVE: There is controversy about the effects of statins on insulin resistance and plasma adiponectin. The aim of this study was to investigate the effects of fluvastatin treatment on these parameters in a group of dyslipidaemic patients who had no confounding factors for insulin resistance or alterations in plasma adiponectin. DESIGN AND PATIENTS: Forty-nine patients [27 males, 22 females; mean age 47.2 +/- 10.3 years; body mass index (BMI) 29.64 +/- 3.2 kg/m2] with dyslipidaemia and 20 controls (six males, 14 females; mean age 45.3 +/- 9.31 years; BMI 30.07 +/- 4.04 kg/m2) were enrolled. All patients were treated initially with therapeutic lifestyle changes (TLC) for 6 weeks. Six out of 49 subjects were excluded from the study. Then, 24 out of 43 patients with high blood cholesterol despite TLC were allocated to fluvastatin 80 mg daily plus TLC, and the remaining 19 patients with normal cholesterol were subjected to TLC alone for additional 12 weeks. MEASUREMENTS: Plasma adiponectin, immunoreactive insulin levels, BMI, waist circumference, blood pressure, lipids, and glucose were determined. The insulin sensitivity index was quantified using the homeostasis model assessment (HOMA). RESULTS: TLC caused significant improvement in plasma insulin (P = 0.02) and elevation in plasma adiponectin (P = 0.02). Fluvastatin treatment decreased total cholesterol and low density lipoprotein (LDL)-cholesterol significantly (P = 0.01 and P = 0.02, respectively). No significant effect of fluvastatin was observed on plasma insulin or adiponectin or on the HOMA index. CONCLUSIONS: Fluvastatin does not improve plasma adiponectin levels and insulin sensitivity, despite its beneficial effects on lipid levels. Our data, however, were limited by the fact that a more accurate method of assessing insulin sensitivity, the euglycaemic-hyperinsulinaemic glucose clamp technique, was not used.

Adiponectin↗

Prognostic significance of electrocardiographic abnormalities in diphtheritic myocarditis after hospital discharge: a long-term follow-up study.

OBJECTIVE: We aimed to investigate the long-term cardiac mortality and the relationship between cardiac mortality and electrocardiographic abnormalities in patients with diphtheritic myocarditis who survived after hospital discharge. MATERIALS AND METHODS: Between 1991 and 1996, 32 patients (all males, mean age 21.00 +/- 3.77 years) surviving diphtheritic myocarditis were included in the study and they were followed up for an average of 16.3 months (range 10.3-26.8 months) after hospital discharge. Clinical evaluation, ECG, and echocardiography were performed on admission, daily while in hospital and at the time of discharge. ECG changes were permanent during the follow-up period. The causes of death of the patients during follow-up period were inferred from the death records of the patients and talking to the people witnessing cardiac arrest. RESULTS: We observed that the patients with left bundle branch block (LBBB) and T wave inversion at hospital discharge had lower survival rates than that of the patients without these ECG changes in the long term. Although univariate Cox regression analysis identified LBBB (P = 0.001) and T wave inversion (P = 0.014) as the predictors of survival, only LBBB was an independent predictor of survival in multivariate Cox regression analysis. Adjusted hazard ratio was calculated as 13.67 for LBBB (P = 0.001; CI = 2.81-66.28). CONCLUSION: Diphtheritic myocarditis does not only demonstrate a malignant clinical course during acute phase of the disease, but also during the long-term follow-up period, especially in patients with LBBB and T wave inversion. Besides, T wave inversion and LBBB can help us to predict survival rate of the patients in long term. Moreover, LBBB is an independent predictor of long-term survival in diphtheritic myocarditis.

Adult↗

Scintigraphic imaging of endothelium-dependent vasodilation in the forearm: a preliminary report.

BACKGROUND: The diagnosis of endothelial dysfunction has been gaining clinical importance, but although endothelial function testing is available in the research setting, no technique yet exists that is simple, safe, reproducible and easily performed as a clinical screening method. The aim of this study was to design a new, scintigraphic method of imaging the flow-mediated dilation in the forearm, which represents the functional characteristic of endothelial dysfunction. METHODS AND RESULTS: The study group comprised 118 subjects in whom left forearm ischemia was induced by inflating a sphygmomanometer cuff to supra systolic pressure for 4.5 min. Later, dynamic acquisition (2 s frame/min) was initiated after the injection of technetium-99m methoxy-isobutyl isonitril into the dorsal pedal veins. Equivalent regions of interest were drawn on both arms to detect total activity counts during 1 min and the perfusion ratios (left arm/right arm) were calculated. The left arm counts (22,203.3+/-12,372.7) were significantly higher than the right arm counts (9,980.9+/-5,931.9) (p<0.001). A significant decrease in perfusion ratios was noted in the hypertension and hypercholesterolemia groups. An increase in the number of risk factors caused an insignificant decrease in perfusion ratio (p=0.346). CONCLUSION: Non-invasive evaluation of endothelium-dependent vasodilation by semiquantitative scintigraphic method using radioactive perfusion tracer provided promising results.

Adult↗

Plasma adiponectin and insulin resistance in new onset hypertension.

OBJECTIVE: The data related to association among hypertension, insulin resistance, and plasma adiponectin concentration is controversial. We aimed to evaluate the relationships among these factors in a young hypertensive group who had no confounding factors. DESIGN AND METHODS: Thirty newly diagnosed and formerly untreated hypertensive males (mean age 23.4 +/- 4.0 yr; body mass index: 24.9 +/- 2.2 kg/m2), and 60 healthy control subjects (mean age 22.5 +/- 3.2 yr; body mass index: 24.6 +/- 1.6 kg/m2) were enrolled. Insulin resistance was calculated by homeostasis model assessment (HOMA). RESULTS: The two groups were similar in terms of age, body mass index, fasting glucose, total cholesterol, HDL and LDL cholesterol, adiponectin, insulin, HOMA, and hsCRP levels. Mean triglyceride levels in hypertensive patients were significantly higher than the controls (p = 0.02). CONCLUSIONS: These results indicate that young, newly diagnosed, uncomplicated patients with hypertension have similar plasma adiponectin levels and insulin sensitivities when compared to healthy controls. We suggest that high blood pressure itself may not be associated with insulin resistance or low adiponectin levels in patients with new onset, uncomplicated hypertension.

Adiponectin↗

Some sociodemographic and diagnostic characteristics of military patients treated in the Department of Medical Oncology, Gülhane Military Medical Academy.

Today, chronic diseases have increased importance. Cancer, for which 10 million new cases are diagnosed around the world each year, is in the lead of such diseases. This study included military personnel with cancer who applied to the Department of Medical Oncology, Gülhane Military Medical Academy, in the period between 1998 and 2003, and it aims to describe some sociodemographic and diagnostic characteristics of the patients. The total number of cases was 938, which included both active duty and retired military personnel with diagnoses of cancer who were given medical care between 1998 and 2003 in the Department of Medical Oncology. For the study group, the five most common diagnoses were lung cancer, colorectal cancer, testicular cancer, non-Hodgkin's lymphoma, and Hodgkin's disease. Although the first three diagnoses among officers were lung cancer, testicular cancer, and Hodgkin's disease, those among retired officers were colorectal cancer, lung cancer, and prostate cancer. Among noncommissioned officers, the first three diagnoses were colorectal cancer, testicular cancer, and Hodgkin's disease for active duty patients and lung cancer, colorectal cancer, and gastric cancer for retired patients. In the group of privates, testicular cancer, Hodgkin's disease, and non-Hodgkin's lymphoma were the first three diagnoses. When we consider the characteristics of cancers, such as high costs of treatment, loss of manpower, and high mortality rates, prevention of cancers and early diagnosis are very important. Because the frequent types of cancers differed for groups according to age and occupation, those characteristics should be considered when cancer screening programs are being developed for the Armed Forces.

Adult↗

Prognostic value of cytology, nuclear matrix protein 22 (NMP22) test, and urinary bladder cancer II (UBC II) test in early recurrent transitional cell carcinoma of the bladder.

This study addresses the diagnostic value of the Nuclear Matrix Protein 22 (NMP22) test and the Urinary Bladder Cancer (UBC II) test, in comparison to bladder wash cytology for the detection of early recurrence of bladder cancer. Patients with transitional cell carcinoma of the bladder (TCC, n = 60) and patients with benign urological diseases (n = 30) were included in this study. Voided urine samples were divided into 2 aliquots: aliquot 1 was assayed for NMP22 and aliquot 2 was tested for UBC II. Saline bladder washings were used for cytologic examination. Urine samples from TCC patients were collected before transurethral resection and on postoperative day 10. On day 10, 15 NMP22 results and 7 UBC II results exceeded the normal ranges; 4 of the cytology samples were positive for malignancy. Based on cystoscopic findings at 3 mo post-resection, 21 of the cases were classified as early recurrence; 11 of the early recurrences had been in the elevated NMP22 group, 4 in the elevated UBC II group, and 3 in the positive cytology group at 10 days post-resection. The NMP22 test gave the highest sensitivity for detecting early recurrent tumors (11 of 21, 52%). Such high sensitivity did not occur with the UBC II test (4 of 21, 19%) or cytology (3 of 21, 14%). These differences were significant (p = 0.024 and 0.009, respectively). Thus, the NMP22 test showed superiority over the other tests for detection of early recurrence of bladder cancer.

Adult↗

A physiologic approach to decreasing upward creep of the heart during myocardial perfusion imaging.

UNLABELLED: When body position changes from erect to supine, the effect of gravity on the organs also changes and is a possible underlying mechanism for upward creep of the heart during SPECT acquisitions. We hypothesized that if we provide enough time for the organs to settle after a positional change, the range of this vertical motion causing reconstruction artifacts can be decreased. Our aim was to evaluate the effect that a 5-min bed rest on the imaging table before both rest and stress SPECT acquisitions would have on upward creep of the heart. METHODS: Before both stress and rest SPECT acquisitions, the first 101 consecutive patients (group A) had a 5-min bed rest and the remaining 99 patients (group B) did not have any bed rest after they were positioned on the imaging table. Upward creep was detected by comparing the distance between the lower edge of the image and the lowest part of the heart silhouette on the last projection image of detector 2 and the first projection image of detector 1. RESULTS: Upward creep was found in 53% (54/101) and 55% (56/101) of patients in group A and in 89% (88/99) and 86% (85/99) of patients in group B in stress and rest SPECT studies, respectively. Upward creep of the heart was decreased prominently in group A, and this decrease was statistically significant (p < 0.001). CONCLUSION: We conclude that before SPECT acquisition, at least a 5-min bed rest on the imaging table significantly decreases vertical motion of the heart.

Adolescent↗

Outpatient prescription of oral antibiotics in a training hospital in Turkey: trends in the last decade.

AIM: The aim was to evaluate the changing trends in outpatient prescription of oral antibiotic forms at a Training Hospital in the last decade. MATERIAL AND METHOD: All the outpatient prescriptions during April and May 2004 were evaluated. The diagnosis, the department of the prescriber, the count and generic name of each prescribed antibiotic were all noted. RESULTS: Of the 33,491 outpatient prescripitions, 14.9% included antibiotic (n=5004). The pediatric clinics (26.4%), Ear, Nose and Throat department (13.7%), and the department of Gyneacology and Obstetrics (10.8%) were the leading departments in antibiotic prescriptions. Upper respiratory tract infections (45.4%), urinary tract infection (11.4%) and lower respiratory tract infections (4.2%) shared the first lines of diagnosis stated. Of the antibiotic prescriptions, 96.3% included oral forms. Co-amoxiclav (26.4%), quinolones (11.7%) and cephalosporins (16.5%) were the most frequently prescribed antibiotics. Percent of antibiotic prescriptions based on microbial sensitivity test results was 7.1%. CONCLUSION: Compared with the results of the study carried out 11 years ago; though co-amoxiclav is still the most frequently prescribed antibiotic, many other changes have been observed in antibiotic prescription attitudes.

Anti-Bacterial Agents↗

The feasibility of neoadjuvant high-dose chemotherapy and autologous peripheral blood stem cell transplantation in patients with nonmetastatic high grade localized osteosarcoma: results of a phase II study.

BACKGROUND: The primary and secondary objectives of the current study were to improve the > or = 90% tumor necrosis rate and assess the toxicity profile of the neoadjuvant high-dose chemotherapy (HDC) regimen, respectively. METHODS: Twenty-two patients with AJCC Stage IIB high-grade osteosarcoma were included in the current study. Two cycles of an induction chemotherapy regimen including cisplatin, doxorubicin, and ifosfamide followed by HDC and autologous peripheral blood stem cell support or transplantation (APBSCT) were given. After engraftment was achieved, the patients underwent limb-sparing surgery (LSS) followed by three to six cycles of postoperative chemotherapy depending on the tumor necrosis rate. RESULTS: The median follow-up, the total duration of treatment, and the time to surgery were 23.7 months, 5.96 months, and 3.03 months, respectively. The necrosis rate was at least 90% in 82% of the cases. The 3-year overall survival (OS) and disease-free survival (DFS) rates were 83% and 70%, respectively. Leukopenia, anemia, thrombocytopenia, nausea and emesis, and mucositis were the most frequent Grade 3 and Grade 4 toxicities (according to the National Cancer Institute Common Toxicity Criteria [version 2.0]) of induction, high-dose, and adjuvant chemotherapies. At the time of last follow-up, no patient had died of chemotherapeutic toxicity. LSS was performed in all patients. Surgery-related complications were reported in 3 of 22 patients. Functional scoring results were excellent in eight patients, good in nine patients, fair in two patients, and poor in three patients. CONCLUSIONS: The results of the current Phase II study suggest that neoadjuvant HDC provides a greater than 90% necrosis rate with acceptable toxicity. A short duration of therapy and the feasibility of LSS in all patients are additional advantages of this approach.

Adolescent↗

Blockade of the renin-angiotensin system increases plasma adiponectin levels in type-2 diabetic patients with proteinuria.

BACKGROUND/AIMS: Adiponectin seems to be an important modulator for metabolic and vascular diseases. A case study was designed to measure plasma adiponectin levels and to investigate the effects of angiotensin-converting enzyme inhibitors on adiponectin levels in type-2 diabetic patients with proteinuria. METHODS: Forty-nine patients (28 males, 21 females) and 23 healthy volunteers (13 males, 10 females) were included in the case study. Patients with proteinuria were treated with 5 mg/day ramipril (n = 21) for 4 weeks. RESULTS: Adiponectin levels of patients were significantly lower than those of healthy volunteers (p < 0.001). There were significant negative correlations between adiponectin concentrations and insulin levels as well as the homeostasis model assessment (HOMA) index in the patient group (r = -0.655, p < 0.001; r = -0.469, p = 0.001, respectively). There was also a significant negative correlation between plasma adiponectin concentrations and the degree of proteinuria (r = -0.912, p < 0.001). Plasma adiponectin levels in patients with proteinuria (n = 21; 4.81 +/- 3.17 microg/ml) were significantly lower than those without proteinuria (n = 28; 10.25 +/- 2.03 microg/ml; p < 0.001). After the treatment period, adiponectin levels significantly increased (p < 0.001) and proteinuria, plasma insulin, and HOMA indexes significantly decreased in the treatment group (p < 0.001, p < 0.001, p = 0.002, respectively). CONCLUSIONS: The results suggest that adiponectin is inversely correlated with proteinuria and treatment with ramipril both corrects proteinuria and increases the low adiponectin levels in diabetic patients.

Adiponectin↗