Investigation of the effects of leptin on the cardiovascular system in patients with systemic sclerosis/Sistemik skleroz'lu hastalarda leptinin kardiyovaskuler sistem uzerine etkilerinin arastirilmasi

Objective: Cardiac involvement in systemic sclerosis can be seen, and often remains silent. Leptin, which is often associated with hypertension and regulation of sympathetic tone, has been reported to contribute to the development of atherosclerosis, endothelial dysfunction and thrombosis by acting directly. The aim of this study was to investigate the effects of leptin on the cardiovascular system in patients with systemic sclerosis. Materials and Methods: Twenty-seven patients with systemic sclerosis and 28 healthy subjects as a control group were included in the study. Clinical and laboratory parameters, 24-hour Holter ECG and ambulatory blood pressure monitorings were recorded and serum leptin levels were measured in all subjects. Results: Mean leptin levels were lower in patients with systemic sclerosis than in controls. In 24-hour ambulatory blood pressure Holter recordings, the mean systolic and diastolic blood pressure, daytime systolic and diastolic blood pressure, systolic and diastolic blood pressure values at night were lower in patients when compared with controls. There was no relationship between leptin and heart rate variability parameters. A positive correlation was found between leptin levels and 24-hour ambulatory blood pressure parameters. Conclusion: Decreased serum leptin levels and increased mean heart rate in patients with systemic sclerosis may be the result of increased sympathetic tone. Key Words: Systemic sclerosis, leptin, 24-hour holter monitoring Amac: Sistemik sklerozda kardiyak tutulum gorulebilmekte ve cogunlukla da sessiz seyretmektedir. Leptin siklikla hipertansiyon ve sempatik tonusun duzenlenmesi ile iliskilidir ve leptin'in direkt etki ile ateroskleroz, endotel fonksiyon bozuklugu ve tromboz gelisiminde katkisi oldugu rapor edilmistir. Bu calismanin amaci sistemik sklerozlu hastalarda leptinin kardiyovaskuler sistem uzerine etkilerini arastirmaktir. Gerec ve Yontem: Calismaya 27 sistemik skleroz'lu hasta ile kontrol grubu olarak 28 saglikli birey alindi. Tum bireylerin klinik ve laboratuar parametreleri, 24 saatlik Holter EKG ve ambulatuvar kan basinci monitorizasyonu kaydedildi ve serum leptin duzeyleri olculdu. Bulgular: Sistemik skleroz'lu hastalarda ortalama leptin seviyeleri daha dusuk bulundu. Yirmi dort saatlik ambulatuvar tansiyon holter kayitlarinda ortalama sistolik ve diyastolik kan basinci, gunduz sistolik ve diyastolik kan basinci, gece sistolik ve diyastolik kan basinci degerleri kontrol grubuna kiyasla