Revşa Evin Canpolat Erkan

Background: This study aimed to compare serum high mobility group box-1 (HMGB1) and high-sensitivity C-reactive protein (hs-CRP) levels in individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD) with those of a control group. Methods: The study included adolescents aged 12–18 years diagnosed with ADHD and healthy controls. Diagnostic assessment was performed using the K-SADS-PL interview; ADHD symptom severity was evaluated with the Turgay DSM-IV Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S), and autism-like symptoms were assessed with the ASSQ. Serum HMGB1 and hs-CRP levels were measured by ELISA. Results: Serum HMGB1 levels in the ADHD group (21.17 ± 12.17 ng/mL) were significantly lower compared to the control group (36.37 ± 21.88 ng/mL) (p < 0.001). In contrast, hs-CRP levels did not differ between the groups (p = 0.888). No significant association was found between HMGB1 and ADHD symptom severity; however, a significant positive correlation was identified with the ASSQ communication problems subscale (r = 0.401, p = 0.013). ROC analysis revealed moderate discriminative power (AUC = 0.738, cut-off value = 24.50 ng/mL; sensitivity 68.9%, specificity 74.3%). Conclusions: Serum HMGB1 levels were lower in adolescents with ADHD than in healthy controls, whereas hs-CRP levels did not differ between groups. The association between HMGB1 and communication problems suggests a possible relationship with specific neurodevelopmental dimensions; however, these findings are preliminary and hypothesis-generating and require replication in larger pediatric samples.

The present study aimed to evaluate the effects of pulsed electromagnetic field (PEMF) exposure on glucose metabolism‐related hormonal and oxidative stress markers. Twenty‐three male Wistar albino rats were randomly assigned to three groups: sham‐control ( n = 7), PEMF ( n = 8), and PEMF + vitamin C ( n = 8). The PEMF and PEMF + vitamin C groups were exposed to a pulsed magnetic field at 50 Hz and 1.5 mT for 4 h daily over 4 weeks. Vitamin C (250 mg/kg/day) was administered orally to the PEMF + vitamin C group. Serum and tissue levels of insulin, glucagon, glucagon‐like peptide‐1 (GLP‐1), sirtuin 1 (SIRT1), total antioxidant capacity (TAC), and total oxidant capacity (TOC) were measured. Histopathological evaluations of brain, liver, and pancreatic tissues were also performed. Serum glucose, insulin, glucagon, GLP‐1, SIRT1, TAC, and TOC levels did not differ significantly among the experimental groups. Gastric TAC levels were significantly higher in the PEMF + vitamin C group. In renal tissue, insulin levels were significantly elevated only in the PEMF + vitamin C group. PEMF exposure did not induce systemic biochemical changes in healthy rats but elicited tissue‐specific biochemical responses, particularly in gastric tissue. These findings suggest that PEMF may modulate glucose‐related endocrine and redox pathways at the gastrointestinal level without causing structural tissue damage. Bioelectromagnetics. 00:00–00, 2026. © 2026 Bioelectromagnetics Society.

Aim: Adipokines in gingival crevicular fluid (GCF) may reflect systemic metabolic and inflammatory conditions, including diabetes and periodontitis. Apelin, a multifunctional peptide expressed in adipose tissue and various organs, is involved in both metabolic regulation and inflammatory pathways and therefore represents a biologically relevant mediator for exploring the link between diabetes mellitus and periodontitis. This study aimed to investigate GCF apelin levels in periodontally healthy individuals, patients with periodontitis, and those with periodontitis and Diabetes Mellitus (DM). Methodology: Ninety participants were enrolled and equally distributed into three groups (n=30 each): Healthy, periodontitis, and periodontitis+DM. Clinical parameters were recorded, and GCF samples were collected for apelin measurement using ELISA. Data were analyzed using nonparametric and categorical statistical tests according to the distribution and type of variables. Results: GCF apelin levels were comparable among the periodontally healthy, periodontitis, and periodontitis+DM groups, showing no statistically significant differences (p = 0.991). An inverse correlation was observed between GCF volume and apelin concentration (rs = –0.39; p 0.05). Conclusion: GCF apelin levels did not differ significantly among the study groups. The inverse correlation between apelin concentration and GCF volume, an indirect indicator of local inflammation, may reflect a relationship with local inflammatory status. These findings suggest that GCF apelin alone has limited clinical value for distinguishing periodontitis with DM. Therefore, measuring GCF apelin as a single biomarker is not recommended for identifying periodontal disease status or diabetic individuals within a periodontal population. Nevertheless, these results contribute to understanding the relationship between metabolic conditions and periodontal inflammation. Further longitudinal and mechanistic studies are needed to clarify the origin and regulation of apelin in periodontal tissues and to determine its potential role as a biomarker or therapeutic target.

Background: Diabetic foot infection (DFI) is a serious complication of diabetes mellitus associated with chronic inflammation, impaired wound healing, endothelial dysfunction, and oxidative stress. Sirtuin (SIRT) signaling and the apelinergic system have been implicated in these processes. This study aimed to evaluate serum SIRT1, SIRT3, apelin, and elabela (ELA) levels in patients with DFI and to examine their cross-sectional associations with clinical indicators, inflammatory markers, osteomyelitis, and glycemic control. Methods: This cross-sectional study included 47 patients with DFI and 42 healthy controls. Serum biomarker levels were measured using enzyme-linked immunosorbent assay (ELISA). Clinical and laboratory data, including the infection component of the PEDIS classification, were recorded. Group comparisons, Spearman correlation analyses, receiver operating characteristic (ROC) curve analysis, and logistic regression were performed. Results: Patients with DFI exhibited higher inflammatory and glycemic markers and lower hemoglobin and lipid levels compared with controls (p < 0.05). Serum SIRT1, SIRT3, apelin, and ELA levels were significantly lower in the DFI group and showed inverse correlations with HbA1c, PEDIS stage, disease duration, osteomyelitis, and inflammatory markers. Among these biomarkers, SIRT1 showed the highest discriminative ability within this cohort (AUC = 0.820). In an exploratory multivariable model, age and SIRT1 were independently associated with the presence of DFI. Conclusions: Serum SIRT1, SIRT3, apelin, and ELA levels were lower in patients with DFI and were associated with clinical and biochemical indicators of disease burden. Among these biomarkers, SIRT1 demonstrated the strongest discriminative ability within this cohort. These findings suggest that sirtuin signaling and the apelinergic system may be relevant in the biological context of DFI; however, they should be interpreted cautiously. The observed differences may reflect not only DFI but also underlying diabetes, glycemic burden, age, and systemic inflammation. Further prospective studies including appropriate diabetic comparator groups are required to clarify the clinical relevance and potential utility of these biomarkers.

Background/Objectives: Periodontitis and diabetes mellitus (DM) are chronic inflammatory conditions that share common biological mechanisms, including systemic inflammation and insulin resistance. Adipokines are considered key mediators in this interrelationship; however, the roles of many adipokines remain unclear. Apelin and asprosin are relatively novel adipokines that have not yet been sufficiently investigated in dentistry. Therefore, this study aimed to evaluate salivary apelin and asprosin levels in periodontally healthy individuals, patients with periodontitis, and patients with periodontitis + DM and to investigate their associations with clinical periodontal parameters. Methods: A total of 90 individuals were included in the study, comprising 30 periodontally healthy subjects, 30 with periodontitis, and 30 with periodontitis and DM. Clinical periodontal indices and body mass index (BMI) were measured for each participant. Unstimulated saliva was collected from each participant, and apelin and asprosin concentrations were analyzed using an enzyme-linked immunosorbent assay (ELISA). The normality of continuous variables was examined with the Shapiro–Wilk test. For non-normally distributed data, non-parametric procedures such as the Mann–Whitney U and Kruskal–Wallis tests were applied. Comparisons of categorical variables between groups were performed using Pearson’s chi-square or the Fisher–Freeman–Halton test. Associations between continuous parameters were assessed through Spearman’s rank correlation analysis. A significance threshold of 5% (p < 0.05) was adopted for all statistical evaluations. Results: No significant intergroup differences were detected for age, gender, or BMI. The healthy group exhibited significantly lower plaque index (PI), gingival index (GI), and probing depth (PD) scores compared with both periodontitis groups, and these differences reached statistical significance (p < 0.001).The median salivary apelin level in the periodontitis + DM group was significantly reduced relative to the healthy group (p = 0.009). However, salivary asprosin concentrations did not differ significantly among the groups (p = 0.053). Spearman’s correlation analysis revealed positive correlations between asprosin and PD and clinical attachment loss (CAL), whereas apelin showed negative correlations with these parameters. Conclusions: Salivary apelin may serve as a potential biomarker for distinguishing healthy individuals from those with diabetic periodontitis. The opposing correlation patterns indicate that apelin and asprosin may be differentially related to periodontal tissue breakdown. However, further longitudinal and mechanistic studies are required to clarify the biological significance of these associations.

Background: Diabetic foot ulceration represents one of the most severe diabetic complications, with 50–60% progressing to diabetic foot infection (DFI). All diabetic wounds and diseases originate from peripheral vasculopathy and neuropathy, which are caused by oxidative stress and inflammatory processes. We investigated the utility of neutrophil-to-lymphocyte ratio (NLR) and CRP-to-albumin ratio (CAR) as cost-effective inflammatory biomarkers in DFI. Methods: The study included 58 DFI patients and 45 healthy controls. Disease severity was assessed using PEDIS staging. Routine laboratory parameters, NLR, derived NLR (d-NLR), and CAR were measured and compared. Results: In DFI patients, statistically significant increases (p < 0.001) were observed in NLR (3.12 vs. 1.99, p < 0.001), d-NLR (2.13 vs. 1.49, p = 0.003), CAR (0.91 vs. 0.03, p < 0.001), CRP (30.5 vs. 1.3 mg/L, p < 0.001) and PCT (0.1 vs. 0.02 μg/L, p < 0.001) values compared to the control group. Strong correlations existed between NLR, CAR and disease severity markers (CRP, PCT, HbA1c, osteomyelitis, PEDIS stage). ROC analysis revealed excellent discriminatory power for CAR (AUC = 0.915), PCT (AUC = 0.952), and CRP (AUC = 0.902), while NLR showed moderate performance (AUC = 0.702). Conclusions: NLR/CAR demonstrate excellent discrimination vs. healthy controls (AUC 0.915/0.702). The proposed workflow (NLR screening → CAR severity → PCT confirmation) requires prospective validation against with guidelines.

Background/Objectives: Rosacea increasingly appears to involve systemic immune and metabolic disturbances rather than isolated cutaneous inflammation. To evaluate inflammatory, platelet, and oxidative–metabolic biomarkers in rosacea and explore their interrelations. Methods: 90 patients with rosacea and 90 healthy controls were evaluated for hematologic inflammatory indices—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune–inflammation index (SII), pan-immune–inflammation value (PIV), mean platelet volume (MPV), and C-reactive protein (CRP)—along with oxidative–metabolic regulators including sirtuin 1 (SIRT1), sirtuin 3 (SIRT3), visfatin, and irisin. Logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of rosacea, while inter-marker associations were evaluated using Spearman’s rank correlation. Results: Rosacea patients showed higher NLR, PLR, SII, PIV, MPV, CRP, and LDL cholesterol (p < 0.05) and lower SIRT1, SIRT3, visfatin, and irisin (p < 0.01). MPV independently predicted rosacea (OR = 7.24; AUC = 0.827), whereas SIRT1 inversely correlated with disease risk. SIRT1, SIRT3, and visfatin showed inverse correlations with HbA1c and waist-to-height ratio, while fasting glucose and HOMA-IR remained within normal ranges. Conclusions: Rosacea exhibits dual systemic activation, an inflammatory–platelet and an oxidative–metabolic axis bridging immune dysregulation, mitochondrial stress, and vascular dysfunction. Recognition of these pathways highlights the potential of redox-targeted and metabolic interventions beyond symptomatic treatment.

Background and Objectives: Today, immunoassay methods are still widely used in the analysis of hormone tests. Due to the properties of the reagents used in immunoassay analyses and components other than the measured analyte, deviations in clinical results may occur. There are many factors that cause this condition called interference, and one of the most common of these is heterophile antibody (Ab). Puberty is a process that begins between the ages of 8 and 13 in girls and 9 and 14 in boys. Pulsatile luteinizing hormone (LH) release during sleep is the first hormonal change that indicates the approach of puberty. The reliability of the laboratory analysis result is important. In order to determine whether there is a risk of interference in the LH tests we analyzed in our laboratory, 48 serum samples of pediatric patients belonging to the pubertal age group were included in the study. Materials and Methods: In order to evaluate the suspicion of heterophile Ab interference, we measured the samples again by binding the antibodies and removing them from the matrix, as recommended in the Clinical and Laboratory Standards Institute (CLSI) I/LA30 guideline. For this, we used a heterophile blocking tube (HBT). We analyzed the samples with Beckman Coulter UniCel DxI 800 and Roche Cobas e601 immunoassay systems. We aliquoted the supernatants of the samples processed according to the HBT application protocol and measured them on both autoanalyzers. Results: We found a significant difference between the results of the samples measured before and after HBT pretreatment on the Beckman Coulter UniCel DxI 800 autoanalyzer (p = 0.01). LH values after HBT were higher than those before HBT: very high LH values were obtained in 4 patients, while the values showed increases ranging from 2 to 4.64-fold in 5 patients. There was no significant difference between the results evaluated before and after HBT pretreatment on the Roche Cobas e601 autoanalyzer (p = 0.27). Although there was a significant difference between the LH results of the HBT-untreated sera obtained in two different autoanalyzers (p < 0.001), we found that the LH measurements after HBT pretreatment did not create a statistically significant difference between the two devices (p = 0.76). Conclusions: We concluded that while HBTs were ineffective in detecting heterophile antibody interference in LH testing, the study underscores the complexity of interference in pediatric hormone assays and highlights the need for further investigation into alternative methods to ensure reliable test results in this age group.

Demir, dünyada en bol bulunan ama biyolojik olarak az miktarda olmasına rağmen birçok metabolik süreçte hayati bir rol oynar. Demir, birçok enzim için bir metal kofaktörü olarak, oksijen taşınması (hemoglobinler), kasların oksijenasyonu (myoglobin), oksijen metabolizması (oksidazlar, peroksidazlar, katalazlar, vb.), elektron transferi (sitokromlar), enerji metabolizması (mitokondriyal akonitaz ve elektron taşıma zincirinin proteinleri) ve DNA sentezi gibi çeşitli biyolojik işlevlerde görev yapmaktadır. Ayrıca kolajen, tirozin ve katekolaminlerin metabolizması için de demir içeren proteinler gereklidir. Demir ile şelat yapmış Hem transkripsiyon faktörlerine bağlanabilir ve sirkadiyen ritim, antioksidan stres tepkisi, apoptoz, hücre çoğalması, iyon kanalı aktivitesi ve mitokondriyal solunum dahil olmak üzere çeşitli yollardaki hedef genlerin transkripsiyonunu da düzenler. Ayrıca yağ asitleri, fosfolipitler, eikozanoidler, kolesterol ve türevlerinin (steroid hormonları, safra asitleri ve D vitamini) metabolizmasının gerçekleştirilmesinde birçok demir bağımlı oksidoredüktaz enzimini kullanılır. Fe'nin yüksek redoks potansiyeli, Fenton reaksiyonu yoluyla hidroksil radikali (OH•) gibi reaktif oksijen türlerinin oluşumunu katalize edebilir. Ayrıca demir Fenton reaksiyonları yoluyla hücresel hasara neden olmanın ötesinde, son zamanlarda ferroptozis olarak bilinen alternatif bir hücre ölüm yolunda da rol alır.