Ankara Med J. 2021; 21(4): 635-644 | DOI: 10.5505/amj.2021.62444

Týkanma sarýlýðýnda oksidatif stresin yeni bir biyolojik belirteci: Dinamik tiyol-disülfid homeostazý

Fadime Güllü Haydar¹, Yavuz Otal², Gamze Avcýoðlu³, Selda Kýdak Özkaya⁴, Alp Þener⁴, Servan Gökhan⁴, Yunus Halil Polat⁵, Özcan Erel^6
1Ankara Þehir Hastanesi,Genel Cerrahi Kliniði,Ankara,Türkiye
²Ankara Þehir Hastanesi,Acil Týp Kliniði,Ankara,Türkiye
³Karadeniz Ereðli Devlet hastanesi, Týbbi Biyokimya Bölümü,Zonguldak, Turkey
⁴Yildirim Beyazit University Týp fakültesi, Acil Týp Kliniði, Ankara, Turkey
⁵Ankara Þehir Hastanesi, Gastroenteroloji Kliniði,Ankara,Türkiye
⁶Yildirim Beyazit University Týp fakültesi, Týbbi Biyokimya Kliniði, Ankara, Turkey

GÝRÝÞ ve AMAÇ: Tiyol-disülfid(TDH) homeostazý birçok hastalýkta araþtýrýlmýþtýr. Bu çalýþmanýn amacý, týkanma sarýlýðý tanýsý konan hastalarda dinamik tiyol-disülfid homeostazýný araþtýrmak ve dinamik tiyol-disülfid homeostazýný iskemi modifiye albümin ile karþýlaþtýrmaktýr
YÖNTEM ve GEREÇLER: Acil servise baþvuran 69 hasta ve 77 saðlýklý gönüllüden oluþan toplam 146 katýlýmcý çalýþmaya dahil edildi. Hastalardan baþvuru anýnda detaylý kan örnekleri alýndý.
Týkanma sarýlýðý tanýsý konulan hastalarda, baþvuru sýrasýnda Erel ve Neselioðlu tarafýndan geliþtirilen yepyeni bir yöntemle tiyol/disülfit düzeylerine bakýldý. Veriler bilgisayar sisteminde deðerlendirildi.

BULGULAR: Týkanma sarýlýðý olan hastada total tiyol (p=0,025) ve nativ tiyol (p=0,023) düzeyleri kontrol grubuna göre istatistiksel olarak anlamlý derecede düþüktü. Nativ tiyol düzeyleri ile ALP (r =-0,262, p<0,01), üre (r =-0,313, p<0,01), total bilirubin (r =-0,388, p) arasýnda anlamlý negatif korelasyon olduðu gözlendi. <0,01), direkt bilirubin (r =-0,351, p<0,01) seviyeleri. Ayný zamanda, disülfit düzeyi (p = 0,235) hasta grubunda kontrol grubuna göre daha düþüktü ancak istatistiksel olarak anlamlý deðildi. Kontrol grubunda iskemi modifiye albümin (ÝMA) deðerlerinin týkanma sarýlýðý grubuna göre daha düþük olduðu bulundu (p=0,03).
TARTIÞMA ve SONUÇ: Týkanma sarýlýðý patogenezinde total tiyol ve nativ tiyol seviyeleri azalmaktadýr. Tiyol-disülfit homeostazý, týkanma sarýlýðýnda oksidatif stresin yeni bir biyobelirteç olabilir

Anahtar Kelimeler: Týkanma sarýlýðý, tiyol-disülfid homeostazý, iskemi modifiye albümin

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A new biomarker of oxidative stress in obstructive jaundice: Dynamic thiol-disulphide homeostasis

Fadime Güllü Haydar¹, Yavuz Otal², Gamze Avcýoðlu³, Selda Kýdak Özkaya⁴, Alp Þener⁴, Servan Gökhan⁴, Yunus Halil Polat⁵, Özcan Erel^6
1Department of General Surgery,Ankara City Hospital, Ankara, Turkey
²Department of Emergency Medicine,Ankara City Hospital, Ankara, Turkey
³Department of Medical Biochemistry, Karadeniz Ereðli State Hospital,Zonguldak, Turkey
⁴Department of Emergency Medicine, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
⁵Department of Gastroenterology, Ankara City Hospital,Ankara, TURKEY
⁶Department of Medical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey

INTRODUCTION: The thiol-disulphide (TDH) homeostasis was investigated in a number of disorders. The aim of the present study is to investigate the dynamic thiol-disulphide homeostasis in patients diagnosed with obstructive jaundice and to compare the dynamic thiol-disulphide homeostasis with ischemia-modified albumin.
METHODS: A total of 146 participants who were admitted to the emergency department and who consisted of 69 patients and 77 healthy volunteers were included in the study. Detailed blood samples were obtained from the patients at the time of admission. Thiol/disulphide levels were examined using a brand-new method developed by Erel and Neselioglu on the patients diagnosed with obstructive jaundice during the admission. Data were evaluated in the computer system.

RESULTS: The levels of total thiol (p =0.025) and native thiol (p =0.023) were statistically significantly lower in the patient with obstructive jaundice than in the control group. It was observed that there was a significant negative correlation between the native thiol levels and the ALP (r =-0.262, p<0.01), urea (r =-0.313, p<0.01), total bilirubin (r =-0.388, p<0.01), direct bilirubin (r =-0.351, p<0.01) levels. At the same time, the level of disulphide (p = 0.235) was lower in the patient group than in the control group but not statistically significant. It was found that the ischemia modified albumin (IMA) values were lower in the control group than the obstructive jaundice group (p = 0.03).
DISCUSSION AND CONCLUSION: Total thiol and native thiol levels decrease in obstructive jaundice pathogenesis. Thiol-disulphide homeostasis may be a new biomarker of oxidative stress in obstructive jaundice.

Keywords: Obstructive jaundice, thiol-disulphide homeostasis, ischemia modified albumin

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