Circulating endocan may represent a new marker that correlates with cardiovascular risk as well as the severity of disease in patients with psoriasis vulgaris. Endocan may be a surrogate endothelial dysfunction marker and may have a functional role in endothelium-dependent pathological disorders. Whether endocan levels could become a treatment target merits further investigation.

We read with great interest the article ''Correlation of Neutrophil to Lymphocyte Ratio With the Presence and Severity of Metabolic Syndrome'' by Buyukkaya et al. 1 They aimed to investigate the relationship between the criteria comprising metabolic syndrome (MS) and neutrophil-lymphocyte ratio (N/L ratio) as a novel, simple, and reliable indicator of inflammation. They showed that patients with MS had significantly higher N/L ratio compared to those without MS. Furthermore, N/L ratio increased as the severity of MS increased. A strong positive correlation was revealed between the severity of MS and N/L ratio and between the severity of MS and the highsensitivity C-reactive protein (hsCRP). In addition, the correlation analysis revealed a positive correlation between hsCRP and NLR in the patient population. The measurements of white blood cells (WBCs), neutrophils, and lymphocytes in the patients with MS were higher than those without MS. The study is successful in planning and presenting the results. We believe that these findings will enlighten further studies about the association between the severity of MS and the N/L ratio. Thanks to the authors for their contribution.The WBC count is one of the useful inflammatory biomarkers in clinical practice. Leukocyte subtype and N/L ratio are also indicators of systemic inflammation. Although WBCs are in normal range, subtypes of WBCs may predict cardiovascular mortality. The N/L ratio is also an inflammatory marker of major adverse cardiac events.2 Some comments may be of interest. Although the authors have showed patients with MS had significantly higher N/L ratio compared to those without MS, some of the factors affecting these markers such as smoking, alcohol, and malignancy were not mentioned in this study. In addition, the authors could add a MS subgroup analysis. A subgroup analysis of MS according to age, sex, CRP, WBCs, neutrophils, and lymphocytes might affect the results of the study. References

Background: Microalbuminuria (MA) is common in hypertensive population and is a marker for endothelial dysfunction and a predictor of increased cardiovascular risk. A great body of data shows the importance of MA as a strong predictor of renal and cardiovascular disease (CVD) risk in hypertensive population. Aim: In this study, we aimed to compare the antialbuminuric effects of an angiotensin II receptor antagonist, valsartan, with a calcium channel blocker, amlodipine, in newly diagnosed hypertensive patients. Material and methods: Totally, 20 patients were recruited into the study. Patients were randomized to one of the following intervention protocols: An (a) angiotensin II receptor blocker (valsartan, 80-320 mg/day) or (b) calcium channel blocker (amlodipine, 5-10 mg/day), for 12 weeks immediately after baseline measurements. Ten patients were randomized into valsartan group and 10 patients into the amlodipine group. Twenty-four-hour urinary albumin excretion (UAE) levels of the patient groups were measured before treatment and on the 12th week. Results: Patients of the two groups were matched for age and body mass index. In the amlodipine group, baseline urine microalbumin levels were higher compared to valsartan group, although the difference was not statistically significant (p ¼ 0.082). At the 12th week, there was a significant decrease in urine microalbumin levels in the amlodipine group, but no significant change was observed in the valsartan group. Conclusion: Amlodipine seems to be superior to valsartan in decreasing UAE. To reduce cardiovascular risks, endothelial dysfunction, and microinflammation, these factors are taken into consideration while prescribing antihypertensive drugs in hypertensive patients.

Pulse wave velocity (PWV), augmentation index (Aix), and central aortic pressure (CAP) are arterial stiffness markers of endothelial dysfunction (ED). We investigated the relationship between arterial stiffness parameters and asymmetric dimethylarginine (ADMA; a marker of ED), in newly diagnosed patients with hypertension (n = 101; 61 females). These patients were investigated in accordance with the recommendations of hypertension guidelines. Arterial stiffness was measured, and serum ADMA and C-reactive protein (CRP; a marker of inflammation) levels were determined. In both women and men, there was no difference in terms of age, body mass index, systolic and diastolic blood pressures, PWV, CAP and the levels of ADMA, while Aix and CRP levels were significantly higher in women (P = .004, P = .046, respectively). In the whole group, ADMA levels correlated with Aix (Pearson r = .237, P = .024). Our findings provide further evidence of a link between arterial stiffness and ED in newly diagnosed patients with hypertension.

Objective: There is a growing body of data supporting the association between diabetes and microcirculatory disfunction. We aimed to study e-selectin levels, and their associations with serum markers of inflammation and arterial stiffness in prediabetes and newly diagnosed diabetes patients in this study. Subjects and methods: Sixty patients (25 females) with a newly established elevated fasting serum glucose [20 impaired fasting glucose (IFG), 20 impaired glucose tolerance (IGT), 20 newly diagnosed diabetes (T2DM)] and 17 healthy controls (13 females) were included in the study. Serum e-selectin and hs-CRP levels, and arterial stiffness parameters of the patients were studied. Results: Fasting serum glucose was the most important predictor of serum e-selectin levels. Pulse wave velocity and central aortic pressures were significantly higher in IFG, IGT and T2DM groups, compared to controls (p = 0.001, < 0.001, 0.013 and 0.015, 0.002, 0.009, respectively). The mean arterial pressure did not show any significant association with serum e-selectin and hs-CRP levels (β coefficient: 0.092, p = 0.358; and β coefficient: 0.189, p = 0.362, respectively). Conclusion: Prediabetes patients have increasing e-selectin levels through the diagnosis of T2DM. E-selectin is associated with serum glucose levels. Prediabetic and newly diagnosed diabetics have higher arterial stiffness measurements. Serum e-selectin may be a good marker of endothelial inflammation and dysfunction increasing in parallel with serum glucose levels, predicting future cardiovascular events. Arch Endocrinol Metab. 2015;59(5):407-13