Turkiye Klinikleri Journal of Internal Medicine

.: ORIGINAL RESEARCH
Effects of Isoflavones on Paraoxonase and Adiponectin in Continuos Ambulatory Peritoneal Dialysis Patients
Sürekli Ambulatuar Periton Diyalizi Hastalarında Isoflavonların Paraoksonaz ve Adiponektin Üzerine Etkileri
Elif KILIÇ KANa, Bilge AYGENb, Nevin İLHANc
aOndokuz Mayıs University Faculty of Medicine, Department of Endocrinology and Metabolism, Samsun, TURKEY
bFırat University Faculty of Medicine, Department of Nephrology, Elazığ, TURKEY
cFırat University Faculty of Medicine, Department of Medical Biochemistry, Elazığ, TURKEY
Turkiye Klinikleri J Intern Med. 2020;5(2):55-61
doi: 10.5336/intermed.2019-71604
Article Language: EN
Full Text
ABSTRACT
 Objective: The level of oxidative stress may increase improperly in chronic pathological conditions such as atherosclerosis, hypertension and uremia. Increased production of reactive oxygen radical species and/or failure of antioxidant systems contribute to the pathogenesis of chronic renal failure. The aim of this study was to investigate the effects of isoflavone, which has antioxidant properties, on oxidative-antioxidative system in patients with chronic renal failure who underwent continuous ambulatory peritoneal dialysis (CAPD). Material and Methods: Thirty patients who underwent CAPD were included in the study. Three patients were excluded from the study, two patients due to gastrointestinal complaints and one patient due to renal transplantation. The remaining 27 patients received 40 mg oral soy isoflavones (Isoflavin® tablets, Micro-Gen) twice daily for 10 weeks. The levels of total cholesterol, triglyceride, LDLcholesterol, HDL-cholesterol, hs-CRP, oxidized LDL, malondialdehyde, adiponectin, paraoxonase and arylesterase were measured and analyzed statistically before and after isoflavone treatment. Results: There was a statistically significant decrease in serum total cholesterol, LDL-cholesterol and triglyceride levels after treatment (p <0.001, p=0.005, p <0.001, respectively). There was a statistically significant decrease in hs-CRP levels, which is one of the markers of inflammation, and oxidized LDL and malondialdehyde levels, which are oxidative stress markers, compared to pretreatment levels (p <0.001, p<0.001, p=0.04, respectively). The levels of adiponectin, paraoxonase and arylesterase, which have antioxidative properties, increased significantly after treatment compared to pre-treatment levels (p=0.002, p=0.03, p <0.001, respectively). Conclusion: The use of soy isoflavones, which have antilipogenic, antihypertensive and vascular health-enhancing properties, may provide beneficial effects on inflammatory and atherogenetic processes by obtaining positive effects on antioxidative system in patients with chronic renal failure.

Keywords: Oxidative stress; inflammation; peritoneal dialysis; isoflavone; adiponectin; paraoxonase
ÖZET
 Amaç: Oksidatif stres; ateroskleroz, hipertansiyon ve üremi gibi kronik patolojik durumlarda uygunsuz şekilde artabilmektedir. Kronik böbrek yetmezliği patogenezine reaktif oksijen radikal yapımının artışı ve/veya antioksidan sistemlerin yetersizliği katkıda bulunmaktadır. Bu çalışmada ayaktan periton diyalizi uygulayan kronik böbrek yetmezliği olan hastalarda antioksidan özelliği olan izoflavonun oksidatif- antioksidatif sistem üzerine olan etkilerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya 30 adet periton diyalizi uygulayan hasta dahil edildi. İki hasta gastrointestinal yakınma, bir hasta ise renal transplantasyon uygulanması nedeniyle çalışmadan çıkarıldı. Kalan 27 hastaya günde iki kez oral yolla 40 mg soya izoflavonları (Isoflavin® tablet, Mikro-Gen) 10 hafta süresince verildi. İzoflavon tedavi öncesi ve sonrası total kolesterol, trigliserid, LDL kolesterol, HDL kolesterol, hs-CRP, okside LDL, malondialdehid, adiponektin, paraoksonaz ve arilesteraz değerleri ölçülerek istatistiksel analizleri yapıldı. Bulgular: Tedavisi sonrasında serum total kolesterol, LDL kolesterol ve trigliserid düzeylerinde tedavi öncesine göre istatistiksel olarak anlamlı azalma olduğu tespit edildi (sırasıyla; p<0,001, p=0,005, p<0,001). İnflamasyon belirteçlerinden biri olan hs- CRP ve oksidatif stres belirteçleri olan okside LDL ve malondialdehid düzeylerinde de tedavi öncesine göre istatistiksel olarak anlamlı azalmalar olduğu (sırasıyla p<0,001, p<0,001, p=0,04) saptandı. Antioksidatif özellikleri olan adiponektin, paraoksonaz, arilesteraz düzeyleri ise tedavi sonrasında tedavi öncesine göre istatistiksel olarak anlamlı (sırasıyla; p=0,002, p=0,03, p<0,001) yüksek olarak bulundu. Sonuç: Antilipojenik, antihipertansif ve vasküler sağlığı geliştirici özellikleri bulunan soya izoflavonlarının kronik böbrek yetmezlikli hastalarda kullanımı ile antioksidatif sistem üzerine olumlu etkiler elde edilerek inflamatuar, aterogenetik süreç üzerine faydalı etkiler sağlanabilir.

Anahtar Kelimeler: Oksidatif stres; inflamasyon; periton diyalizi; izoflavon; adiponektin; paraoksonaz
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