Person: GÜLTEN, MACİT
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GÜLTEN
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MACİT
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Publication Mean platelet volume is an important predictor of hepatitis c but not hepatitis b liver damage(Wolters Kluwer Medknow Publications, 2015-09-01) Eminler, Ahmet Tarık; Uslan, Mustafa Ihsan; Ayyıldız, Talat; Irak, Kader; Kıyıcı, Murat; KIYICI, MURAT; Gürel, Selim; GÜREL, SELİM; Dolar, Enver; DOLAR, MAHMUT ENVER; Gülten, Macit; GÜLTEN, MACİT; Nak, Selim Giray; NAK, SELİM GİRAY; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 0000-0002-0019-3207; 0000-0002-3208-6211; ABF-1568-2021; HLH-8209-2023; AAI-4213-2021; AAG-9177-2021Background: The mean platelet volume (MPV) is the most commonly used measure of platelet size and is a potential marker of platelet reactivity. In this study, we aimed to explore the relationship between hepatic histopathology in viral hepatitis and MPV levels, which are associated with platelet count and activity. Materials and Methods: We performed a retrospective case-control study of baseline histological and clinical parameters in chronic hepatitis B and C patients in our tertiary reference center between January 2005 and January 2011. Two hundred and five chronic hepatitis B patients and 133 chronic hepatitis C patients who underwent liver biopsy were included in the study. The patients were divided into two groups: Chronic hepatitis B and chronic hepatitis C and were additionally divided into groups of two according to histological activity index (HAI) and fibrosis scores obtained by liver biopsy results (according to the Ishak scoring system). The clinical characteristics of chronic viral hepatitis patients, including demographics, laboratory (especially MPV), and liver biopsy findings, were reviewed. Results: One hundred and forty-three patients were male (69.1%), and the mean age was 41.9 +/- 12.75 with an age range of 18-71 years in hepatitis B patients. In the classification made according to HAI, 181 patients were in the low activity group (88.3%) and 24 in the high activity group (11.7%). In the evaluation made according to fibrosis score, 169 patients were found to have early fibrosis (82.4%) and 36 were found to have advanced fibrosis (17.6%). In patients with hepatitis B, there was no statistically significant difference in terms of their MPV values between the two groups, separated according to their degree of activity and fibrosis. Sixty-three patients were male (47.3%), and the mean age was 50.03 +/- 12.75 with an age range of 19-75 years. In the classification made according to HAI, 109 patients were in low activity group (81.9%) and 24 in high activity group (18.1%). In the evaluation made according to fibrosis score, 101 patients were found to have early fibrosis (75.9%) and 32 have advanced fibrosis (24.1%). There was a statistically significant difference between the activity and fibrosis groups of the hepatitis C patients (P = 0.04 and P = 0.02, respectively). Conclusion: MPV values are more reliable in hepatitis C patients than hepatitis B for predicting the advanced damage in liver histology. This finding might be useful for the detection of early fibrosis and also starting early treatment, which is important in hepatitis C.Publication The relationship of the degree of hepatic fibrosis with hyaluronic acid, type 4 collagen, and procollagen type 3 N-terminal peptide levels in patients with chronic viral hepatitis(Galenos Yayıncılık, 2015-04-01) Irak, Kader; Eminler, Ahmet Tarık; Ayyıldız, Talat; Keskin, Murat; Nak, Selim Giray; Kıyıcı, Murat; Gürel, Selim; Gülten, Macit; Dolar, Enver; Irak, Kader; Eminler, Ahmet Tarık; Ayyıldız, Talat; Keskin, Murat; NAK, SELİM GİRAY; KIYICI, MURAT; GÜREL, SELİM; GÜLTEN, MACİT; DOLAR, MAHMUT ENVER; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 0000-0002-0019-3207; 0000-0003-4526-4352; 0000-0002-3208-6211; DVB-0510-2022; R-8751-2019; CCH-9450-2022; JZY-7001-2024; FQM-3662-2022; AAI-4213-2021; HLH-8209-2023; JGZ-0732-2023; AAG-9177-2021Objective: To investigate the relationship of liver histopathology with the levels of noninvasive markers, namely hyaluronic acid (HA) type 4 collagen and procollagen 3 amino-terminal peptide (P3NP) used for the assessment of hepatic fibrosis in patients with chronic viral hepatitis.Materials and Methods: The study included 80 patients, 56 with chronic hepatitis B (CHB) and 24 with chronic hepatitis C (CHC) who presented to the outpatient clinic at Uludag University Faculty of Medicine, Department of Gastroenterology, and underwent pretreatment liver biopsy between 2008 and 2010. The patients were divided into 2 groups according to the degree of fibrosis: group 1 included patients with grade <= 3 fibrosis (no fibrosis, mild or moderate), group 2 included patients with grade >= 4 fibrosis (severe fibrosis). The association of hepatic fibrosis grade with HA, type 4 collagen, and P3NP was examined.Results: Among the 65 patients in group 1 whose fibrosis grade was confirmed via liver biopsy, 47 (72.3%) had HBV and 18 (27.7%) had HCV, whereas 9 of 15 (60%) in group 2 had HBV and 6 of 15 (40%) had HCV. There was no significant difference in the non-invasive fibrosis markers between the groups (p>0.05). In addition, there was not a significant difference in HA and P3NP levels between the CHB patients in groups 1 and 2 (p>0.05), but the type 4 collagen level was significantly higher in the HBV patients in group 2 (p<0.05). On the other hand, there were no significant differences in HA, type 4 collagen, and P3NP levels, or fibrosis grade between the HC patients (p>0.05).Conclusion: The use of any marker or combination of markers examined in the present study is not a substitute for liver biopsy for assessing hepatic fibrosis. The fibrosis markers examined in the present study could be further examined in research on anti-fibrotic treatment. Future clinical investigations are needed for the evaluation of the value of these tests in diagnosis and monitoring. It should not be forgotten that the basic diagnostic approach is liver biopsy.Publication Soluble forms of extracellular cytokeratin 18 may differentiate simple steatosis from nonalcoholic steatohepatitis(Baishideng Publishing Group Inc, 2007-02-14) Yılmaz, Yusuf; Dolar, Enver; Ulukaya, Engin; Akgöz, Semra; Keskin, Murat; Kıyıcı, Murat; Aker, Sibel; Yılmaztepe, Arzu; Gürel, Selim; Gülten, Macit; Nak, Selim Giray; Yılmaz, Yusuf; DOLAR, MAHMUT ENVER; Ulukaya, Engin; GÜREL, SELİM; NAK, SELİM GİRAY; Akgöz, Semra; Keskin, Murat; KIYICI, MURAT; Aker, Sibel; YILMAZTEPE ORAL, ARZU; GÜLTEN, MACİT; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İstatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-4518-5283; 0000-0003-4875-5472; 0000-0003-4526-4352; 0000-0002-3208-6211; 0000-0002-8962-9758; K-6651-2012; AAG-9177-2021; K-5792-2018; EKV-4953-2022; JZY-7001-2024; AAI-4213-2021; EJH-8721-2022; A-5841-2017; HLH-8209-2023; EYR-7166-2022; FQM-3662-2022AIM: To investigate whether serum levels of two soluble forms of extracellular cytokeratin 18 (M30-antigen and M65-antigen) may differentiate nonalcoholic steatohepatitis (NASH) from simple steatosis in patients with nonalcoholic fatty liver disease (NAFLD).METHODS: A total of 83 patients with suspected NAFLD and 49 healthy volunteers were investigated. Patients with suspected NAFLD were classified according to their liver histology into four groups: definitive NASH (n = 45), borderline NASH (n = 24), simple fatty liver (n = 9), and normal tissue (n = 5). Serum levels of caspase-3 generated cytokeratin-18 fragments (M30-antigen) and total cytokeratin-18 (M65-antigen) were determined by ELISA.RESULTS: Levels of M30-antigen and M65-antigen were significantly higher in patients with definitive NASH compared to the other groups. An abnormal value (> 121.60 IU/L) of M30-antigen yielded a 60.0% sensitivity and a 97.4% specificity for the diagnosis of NASH. Sensitivity and specificity of an abnormal M65-antigen level (> 243.82 IU/L) for the diagnosis of NASH were 68.9% and 81.6%, respectively. Among patients with NAFLD, M30-antigen and M65-antigen levels distinguished between advanced fibrosis and early-stage fibrosis with a sensitivity of 64.7% and 70.6%, and a specificity of 77.3% and 71.2%, respectively.CONCLUSION: Serum levels of M30-antigen and M65-antigen may be of clinical usefulness to identify patients with NASH. Further studies are mandatory to better assess the role of these apoptonecrotic biomarkers in NAFLD pathophysiology. (C) 2007 The WJG Press. All rights reserved.