Hüsnü Kamil Limandal, Mehmet Ali Kayğın, Alev Lazoğlu Özkaya, Taha Özkara, Mevriye Serpil Diler, Hatice Işıl Çüçen, Ziya Yıldız, Servet Ergün, Özgür Dağ
{"title":"The role of alpha-1-antitrypsin in the etiopathogenesis of chronic venous disease: A prospective clinical trial.","authors":"Hüsnü Kamil Limandal, Mehmet Ali Kayğın, Alev Lazoğlu Özkaya, Taha Özkara, Mevriye Serpil Diler, Hatice Işıl Çüçen, Ziya Yıldız, Servet Ergün, Özgür Dağ","doi":"10.1177/02683555221141818","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to examine whether alpha-1-antitrypsin (AAT), an inhibitor of leukocyte esterase(LE), which damages the venous vessel wall, has a protective effect against chronic venous disease(CVD), and to examine the relationship between AAT levels and disease severity.</p><p><strong>Methods: </strong>Patients admitted with varicose vein disease and having reflux flow lasting longer than 0.5 s as determined by Doppler ultrasound were included. The informed consents were taken, and blood samples were obtained for complete blood count, C-reactive protein (CRP) level, and AAT level following anamnesis and physical examination. Clinical Etiologic Anatomic Pathologic (CEAP) classification was used to assess disease severity, and patients were divided into CEAP 1-5 groups accordingly.</p><p><strong>Results: </strong>A total of 87 patients were included in the study. There was no statistically significant difference between the groups in body weight, red blood cell counts, platelet counts, or neutrophil counts (<i>p</i> = 0.117, <i>p</i> = 0.932, <i>p</i> = 0.177, and <i>p</i> = 0.177, respectively).CRP and AAT levels were higher in patients with a CEAP clinical score of 5 compared to the other groups (<i>p</i> = 0.018, and <i>p</i> = 0.020, respectively). AAT levels were similar in the CEAP 1-3 group and decreased in the CEAP-4 group but increased again in the CEAP-5 group. The AAT level was 1.62 ± 0.3 g/L in the CEAP-1 group, 1.61 ± 0.21 g/L in the CEAP-2 group, 1.61 ± 0.27 g/L in the CEAP-3 group, 1.48 ± 0.28 g/L in the CEAP-4 group, and 1.94 ± 0.39 g/L in the CEAP-5 group. CRP levels and platelet counts were observed to affect AAT levels (<i>p</i> = 0.10, <i>p</i> = 0.017, respectively).</p><p><strong>Conclusion: </strong>We believe that our hypothesis that low AAT levels play a role in the etiopathogenesis of CVD has been partially validated, at least in the CEAP-4 group. However, we believe that increased AAT levels in the CEAP-5 group may be a reactive increase in increased LE levels due to higher CRP levels of this group.</p>","PeriodicalId":20139,"journal":{"name":"Phlebology","volume":"38 1","pages":"16-21"},"PeriodicalIF":1.6000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Phlebology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/02683555221141818","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 1
Abstract
Objective: The study aimed to examine whether alpha-1-antitrypsin (AAT), an inhibitor of leukocyte esterase(LE), which damages the venous vessel wall, has a protective effect against chronic venous disease(CVD), and to examine the relationship between AAT levels and disease severity.
Methods: Patients admitted with varicose vein disease and having reflux flow lasting longer than 0.5 s as determined by Doppler ultrasound were included. The informed consents were taken, and blood samples were obtained for complete blood count, C-reactive protein (CRP) level, and AAT level following anamnesis and physical examination. Clinical Etiologic Anatomic Pathologic (CEAP) classification was used to assess disease severity, and patients were divided into CEAP 1-5 groups accordingly.
Results: A total of 87 patients were included in the study. There was no statistically significant difference between the groups in body weight, red blood cell counts, platelet counts, or neutrophil counts (p = 0.117, p = 0.932, p = 0.177, and p = 0.177, respectively).CRP and AAT levels were higher in patients with a CEAP clinical score of 5 compared to the other groups (p = 0.018, and p = 0.020, respectively). AAT levels were similar in the CEAP 1-3 group and decreased in the CEAP-4 group but increased again in the CEAP-5 group. The AAT level was 1.62 ± 0.3 g/L in the CEAP-1 group, 1.61 ± 0.21 g/L in the CEAP-2 group, 1.61 ± 0.27 g/L in the CEAP-3 group, 1.48 ± 0.28 g/L in the CEAP-4 group, and 1.94 ± 0.39 g/L in the CEAP-5 group. CRP levels and platelet counts were observed to affect AAT levels (p = 0.10, p = 0.017, respectively).
Conclusion: We believe that our hypothesis that low AAT levels play a role in the etiopathogenesis of CVD has been partially validated, at least in the CEAP-4 group. However, we believe that increased AAT levels in the CEAP-5 group may be a reactive increase in increased LE levels due to higher CRP levels of this group.
期刊介绍:
The leading scientific journal devoted entirely to venous disease, Phlebology is the official journal of several international societies devoted to the subject. It publishes the results of high quality studies and reviews on any factor that may influence the outcome of patients with venous disease. This journal provides authoritative information about all aspects of diseases of the veins including up to the minute reviews, original articles, and short reports on the latest treatment procedures and patient outcomes to help medical practitioners, allied health professionals and scientists stay up-to-date on developments.
Print ISSN: 0268-3555