Background: Beta-thalassemia major (BTM) is an autosomal recessive disease characterized by hemolytic anemia. Increased iron load accumulated in the body as a result of frequent erythrocyte transfusions leads to endothelial dysfunction and cardiovascular complications. High asymmetric dimethylarginine (ADMA) levels disrupts endothelial function. Endocan is a soluble proteoglycan synthesized in vascular endothelial cells in many organs. High levels of endocan indicate endothelial dysfunction. We aimed to determine whether there is a correlation with cardiac evaluation instruments by evaluating circulating ADMA and endocan levels in BTM patient group and healthy control group and whether they can be a prognostic marker in terms of endothelial dysfunction and cardiovascular risk stratification. Methods: A total of 39 patients with BTM and 39 age and gender matched healthy children were enrolled in the study. Medical histories of all patients were recorded and physical examinations were performed. Complete blood count, reticulocytic count, serum ferritin and iron level, liver, renal function tests, plasma ADMA and endocan and proBNP. Cardiac examination results by a pediatric cardiologist were tested on all children in both patient and control groups. Results: Mean ADMA in the BTM group is higher than in the control group. Endocan levels in patients with BTM were not found to be statistical difference (337,5±344,0 pg/mL vs 218,14±171,1 pg/mL) (p=0,057). Serum endocan and ADMA levels were not associated with cardiovascular functions. Conclusions: Although serum levels of endocan were found to be significantly higher in BTM patients, high serum endocan and ADMA levels were not associated with cardiovascular functions.

Objectives: To investigate the cardiometabolic risk factors as endocan, dehydroepiandrosterone sulfate (DHEAS), ADAMTS-13, p-selectin as a predictor of atherosclerosis in patients with non-functional adrenocortical adenoma (NFAI). Methods: We included 44 patients with NFAI and 44 healthy individuals as the control group. The demographic, laboratory findings and anthropometric measurements were evaluated. The levels of serum endocan, p-selectin, ADAMTS-13 and carotid intima-media thickness (CIMT) measurement were evaluated. Results: There was no difference between the control group and the patients with NFAI in terms of BMI, WC, systolic and diastolic blood pressure, HDL-C, ACTH, morning cortisol, ADAMTS-13 and p-selectin levels. However, the levels of waist-hip ratio, total cholesterol, insulin, HOMA-IR, LDL-C, CIMT, endocan were significantly higher in the NFAI group in comparison with the control group (p< 0.05). The levels of DHEAS were found significantly lower in the patients with NFAI (p<0.05). There was a positive correlation between ADAMTS-13, and endocan and p-selectin (r=0.436; p=0.003, r=0.414; p=0.005). Conclusions: This is the first study investigating the relationship between endocan, p-selectin, ADAMTS-13 levels and NFAI. Increased endocan levels and decreased DHEAS levels might be used as the indicators of atherosclerosis in patients with NFAI. CIMT was also found as an independent predictor for NFAI. Evaluation of cardiac and metabolic parameters is important in conservative treatment of patients with NFAI. Key Worlds: Adrenal Incidentaloma, Endocan, P-Selectin, ADAMTS-13