Diabetic patients have a markedly increased risk of cardiovascular disease compared with non-diabetics. Two drug groups today target insulin resistance; biguanides and thiazolidinediones. In addition, these may have other effects on cardiovascular risk factors. The aim of this study was to evaluate the effects of metformin and rosiglitazone on non-traditional cardiovascular risk factors. Forty type 2 diabetic patients were randomized into metformin and rosiglitazone groups. After receiving the optimal doses, the patients were monitored for 12 weeks. Biochemical parameters, lipid parameters, CRP, insulin, c-peptide, and HbA1c levels were analyzed. VWF, PAI-1, ICAM-1, TNF-α, IL-6, E-selectin, and fibrinogen levels were measured in order to assess coagulation status and endothelial dysfunction. In the metformin group, body mass index, PPG, HbA1c, IL-6, ICAM-1, and TNF-α levels were significantly decreased after 12 weeks compared with the basal levels. IL-6 levels decreased from 75 pg/ml ± 20 to 42 pg/ml ± 9 (P 0.023) and TNF- α levels from 61 pg/ml ± 31 to 39 pg/ml ± 10 (P 0.018). In the rosiglitazone group, FPG, PPG, HbA1c, insulin, HOMA-IR, IL-6, and TNF-α levels decreased significantly after 12 weeks compared with the basal levels. IL-6 levels decreased from 78 pg/ml ± 21 to 41 pg/ml ± 9 (P 0.028) and TNF-α levels from 62 pg/ml ± 19 to 37 pg/ml ± 10 (P 0.012). At the end of the study, no significant differences were determined between groups. Insulin resistance and type 2 diabetes are strongly associated with low grade inflammation. Both metformin and rosiglitazone were effective in controlling inflammatory markers in addition to metabolic parameters.

This study was intended to evaluate the prognostic and diagnostic significance of carbonic anhydrase IX (CA IX) and soluble urokinase plasminogen activator receptor (suPAR) levels in gastric cancer patients. CA IX and suPAR were analyzed from serum and plasma samples of gastric cancer patients. Fifty patients and 34 controls were enrolled. CA IX and suPAR levels were statistically significantly higher in the patient group (patient; 182.5 ± 212.4, control; 47.3 ± 32, P = 0.0001 and patient; 5.74 ± 5.3, control; 2.27 ± 0.77, P = 0.0001, respectively). CA IX and suPAR levels were higher in metastatic subjects (metastatic; 227.1 ± 273.5, non-metastatic; 147.4 ± 144.1, P > 0.05). Prognosis was worse in the patient group with elevated suPAR. CA IX and especially suPAR are correlated with the presence and stage of the disease. High suPAR levels indicate a poorer prognosis in gastric cancer patients.

Reactive oxygen species (ROS) are found in the development stages of carcinogenesis. Fifty two patients with gastric cancer and 35 controls were enrolled in this trial. IMA, MDA, Total Oxidant Status (TOS), Total Antioxidant Status (TAS) and Oxidative Stress Index (OSI) were evaluated.There was a significant increase in IMA and MDA levels in the patient group (0.405±0.111, 0.271±0.066; p= 0.0001 and 0.207±0.251, 0.077±0.103; p= 0.004 respectively). TOS was also higher in the patient group but it was not statistically different. TAS was statistically lower and there was significant difference in OSI (0.621±0.394, 0.996±0.37; p=0.0001 and 9.68±18.2, 2.9±3.85; p=0.001 respectively). The areas under receiver operating characteristics curves for the determination of gastric cancer were 0.842 for IMA and 0.708 for MDA.Increased levels of IMA, MDA and oxidative stress index were detected and this condition is associated with the impairment of oxidant-antioxidant balance.

The relation between cancer and coagulation is the subject of investigation since a relation between tumor and thrombosis has been determined. Antithrombin III is an important thrombin inhibitor, and increased thrombin-antithrombin (TAT) complex levels activate coagulation. Activated thrombin activatable fibrinolysis inhibitor (TAFI) inhibits the conversion of plasminogen to plasmin. In addition, it directly inactivates plasmin. Defective fibrinolysis increases the risk of thrombosis. In this study, we evaluated homeostatic parameters, TAFI, and TAT levels in patients with gastric cancer applying to the medical oncology outpatient clinic. Fifty-two patients and 35 healthy controls were included. ELISA was used to measure TAFI and TAT complex levels. These were statistically higher in the patient group (p < 0.05 and p = 0.001, respectively). D-dimer levels were higher in stage IV (p = 0.05). Correlations between lymph nodes and TAFI and TAT levels were examined. Weak but positive correlation between lymph nodes and TAFI was detected (R = 0.452, p = 0.027). TAFI and TAT levels were evaluated using relative operating characteristic analysis to differentiate the disease. TAT was more specific than TAFI according to this analysis (TAFI area under curve (AUC), 0.676; TAT AUC, 0.874). Thrombotic events and bleeding disorders need to be borne in mind in gastric cancer. This situation is due to the impairment of the balance between coagulation and fibrinolysis. Further studies are now needed to evaluate the effects of TAFI and TAT on survey and prognosis as well as the potential of these parameters as tumor markers for gastric cancer.

Background: Severe hyperlipidemia secondary to capecitabine, an oral fluoropyrimidine, is a very rare condition. There are no reported cases of hyperlipidemia associated with Uracil/tegafur (UFT). Objective: Report UFT-induced severe hyperlipidemia. Method: A 71-year-old male patient with metastatic colorectal cancer receiving capecitabine treatment was hospitalized at the end of the eighth cycle with the complaint of fatigue. Capecitabine treatment was discontinued in the patient in whom severe hyperlipidemia was detected together with disease progression. Gemphibrozile 1200 mg/day was initiated; patient’s triglyceride level and serum cholesterol decreased from 1768 to 149 mg/dL and from 497 to 99 mg/dL, respectively, five weeks later. The patient started to receive UFT chemotherapy and after the second cycle, he presented to our hospital again with the complaints of fatigue, headache, and yellow vision. The investigations revealed a serum triglyceride level of 4115 mg/dL and a cholesterol level of 734 mg/dL. Results: UFT chemotherapy was discontinued and lipopheresis was administered for three consecutive days, and gemphibrozile was initiated again at a dose of 1200 mg/day. The clinical presentation might be due to oral fluoropyrimidine. Three weeks later, serum cholesterol and triglyceride levels decreased to 106 and 403 mg/dL, respectively. Conclusion: This case is a unique case of hyperlipidemia secondary to UFT. Monitoring of lipid levels, when using Fluoropyrimidine, as well as hemograms, liver and renal functions would be appropriate.