Aim: Dentists may commonly meet fear and anxiety during dental procedures. Patients may be frightened due to the expectation of pain, and this may cause them to delay their dental treatment. Physicians should be able to plan treatment by noticing anxiety and fear situations. Numerous scales were developed for this purpose. The Dental Anxiety Scale (DAS) and Modified Dental Anxiety Scale (MDAS) are the most commonly used scales. The aim of the present study was to evaluate the dental anxiety of a group of adult individuals in the Nyala region of Sudan.

Material and Methods: The study was conducted on adults who have been referred to the Nyala Training and Research Hospital. The present study included 104 individuals, including 43 (41.35%) males and 61 (58.65%) females with ages ranging between 20 and 57 years. The participants were asked to fill in the prepared questionnaire. Dental anxiety level was determined through the Dental Anxiety Scale (DAS) and Modified Dental Anxiety Scale (MDAS).

Results: In this study, which examined levels of dental anxiety, it was concluded that there was no difference in anxiety level between the genders (p>0.05). It was observed that the use of aerators in dentistry practices increases anxiety (p<0.05). It was concluded that the heads of the dental scaler used during scaling also increased the level of anxiety (p<0.05). However, it was detected that they do not have a fear of local anesthesia (p>0.05).

Discussion: Considering the results of the study reveals that it has not been determined under what conditions the emerging anxiety can develop. However, it was observed that anxiety level differs among nations.

Keywords: Dental Anxiety, Dental Procedures, Dental Anesthesia

Introduction

Anxiety is the struggle of an individual under stress. It is not only a psychological but also a physiological process. The individual psychologically has delusions and fear, as well as a panic that he will experience bad things. This deteriorates the sleep pattern of the individual and initiates a process that progresses to distraction. Beyond psychological problems, headache, dizziness, arrhythmia, difficulty in breathing, paresthesia and even dry mouth may be experienced physiologically. Sweating, cold and moist skin appearance, chills, tachycardia, arrhythmia, facial flushing or pallor may be observed during clinical practice [1,2].
Dental anxiety is the strong negative emotions that an individual feels about dental practices. Sanikop et al. defined dental anxiety as an individual’s concern that something bad will happen related to their dental treatment. This anxiety may be affected by the individual’s personality traits, fear of pain or even the traumatic dental experience he may have had in childhood [3-5]. Even experiences that do not belong to him may affect an individual [6]. The most important reason noticed so far in the development of dental anxiety is considered the pain that the individual fears during the procedure. However, many other factors cause this condition. The most important difficulty in this situation for dentists is that patients will complicate their treatment because of this feeling [1,3,7].
Most of the physicians often encounter reactions due to fear and anxiety in their patients during dental applications. Apart from the negative dental experiences of the patients in the past, the approach of the physician to them affects these reactions. Since pediatric patients usually adopt the behaviors of the individuals around, comments of their families and friends about their experiences have a great effect. Furthermore, the instruments preferred in dental applications, the length of time spent in the waiting room can increase anxiety. When the patient sees the injector to be used, the injection and use of rotary tool (aerator) may increase this anxiety more. This increased anxiety may cause them to delay their treatment appointments, make irregular appointments, or even miss their appointments. When they realize this, their anxiety may have increased even more. Oral and dental diseases may increase and cause serious problems if they delay their dental treatments [1, 3, 8]. Oral health affects an individual’s quality of life and even self-esteem. The individual’s self-esteem may compromise due to dental problems because of the anxiety [9].
According to Saatchi et al., the most important reason for the development of dental anxiety is negative dental experiences in the past [10]. High dental anxiety affects physicians when creating a treatment plan. Dentists should allocate more time for these patients. Listening to the patient’s complaint before the treatment and giving detailed information about the treatment are also effective to diminish these negative effects because such concerns make the treatment difficult for both the patient and the physician [1].
However, studies show that dentists do not adequately perform screening for this anxiety. It was detected in a previous study conducted on dentists that only 20% of them regularly screen the anxiety level of their patients [10]. Numerous scales were developed for this purpose. The most frequently preferred anxiety scales, especially in adults may be listed as Dental Fear Questionnaire, Dental Anxiety Scale (DAS), Modified Dental Anxiety Scale (MDAS), Corah Dental Anxiety Scale and State-Trait Anxiety Inventory [6,9,12]. A study on 1392 individuals in England concluded that MDAS had a higher reliability in patients [13]. In previous studies conducted on the Turkish population, MDAS was found to be reliable if a value of ≥19 is accepted as the intersection point, as in our study [14, 15]. In this study, we aimed to measure the level of dental anxiety in adults in the Sudan Nyala region, DAS and MDAS were used in the light of these studies to determine the anxiety levels of the patients.

Material and Methods

Following approval from the ethics committee of Sudan Nyala Training and Research Hospital, 104 patients were informed about the study and their written consents were obtained from the Dental Clinic of Nyala Training and Research Hospital between June 2019 and January 2020. Adult volunteer patients without any psychological disorders were enrolled in the study. Patients with anxiety disorder, minors and patients over 65 years of age were excluded. Assistance was obtained from a translator who was fluent in the language of the region while preparing the questionnaire, and care was taken to ensure that the questions were in their own language. In the first part of the questionnaire, demographic data were included and questions related to gender, age, and reason for applying, which were thought to affect the level of dental anxiety were included. In the other part, DAS and MDAS which are commonly used in the evaluation of dental anxiety in adults today were used [12,16,17]. Dental procedures planned were performed on the patients after filling in the questionnaires.
The DAS was developed by Corah in 1969. This scale consisted of four questions with five options related to the patient reactions in different situations. The patients mark the answers that seem closest to them. Options are scored between 1 and 5, and the total score is calculated. A score between 5 and 20 is obtained. It is accepted that as the score increases, the level of dental anxiety increases. Scores at and over 15 indicated the highest level of anxiety. The application is easy and reliable; therefore, its use is widespread. A validity and reliability study of the scale was performed [18].
MDAS was created by adding a question to the DAS about the injection. The scoring method is the same as for DAS. Two studies conducted in Turkey demonstrated that the scale is valid and reliable [14,15].
After filling out the questionnaire forms, statistical analyzes were carried out with the help of the SPSS version 17.0 program. Consistency with normal distribution was evaluated with histogram graphics and the Kolmogorov-Smirnov test. Mean, standard deviation, and median values were used in descriptive analyses. Pearson’s Chi-Square test was used when evaluating categorical variables. While the non-normally distributed (nonparametric) variables were evaluated between the two groups, they were evaluated with the Mann-Whitney U test. Evaluation between multiple groups more than two was made with the Kruskal-Wallis test. Any p-value below 0.05 was accepted as statistically significant.

Results

The present study included 104 individuals, including 43 (41.35%) males and 61 (58.65%) females with ages ranging between 20 and 57 years. The number of people who find it fun to have a dentist appointment on the DAS scale and wait impatiently was 54; however, the number of people who stated that they would be afraid of this situation was only 1 person. On the other hand, there were 36 people who stated that waiting in the waiting room would not disturb them; only 9 people stated that they would be very worried. While there were 36 people who stated that the dentist would not be disturbed by the use of a rotatory head tool during dental procedures, there were 33 people who stated that they would be very worried. Forty-three people said that they would not be disturbed by the head used in dental cleaning; however, there were 10 people who said that it would make them feel very bad (Table 1).
Considering the effect of age variable on anxiety, the average age of those who are not worried because they have a dentist appointment is higher than those who are less worried. It was observed that the age variable did not cause a significant difference in the answers given to the other questions (Table 2).
When the effect of the gender variable on anxiety was examined, it was detected that the dentist appointment caused less anxiety in men when compared to women, and women had higher anxiety about a painful experience. On the other hand, the use of a rotating head device (aerator) by the dentist makes men more uncomfortable than women. Similarly, women feel less anxiety about the tool used during tooth cleaning compared to men. No significant results could be obtained when comparing the genders regarding the other questions (Table 3).

Discussion

It was concluded in many studies that the anxiety experienced during dental practices affects the oral health and quality of life of the person [19].
In our study, we aimed to evaluate the level of anxiety observed among residents of the region.
A higher dental anxiety value was reached in 7% of the individuals who participated in our study. It was reported that the dental anxiety value evaluated with MDAS in Turkey was 8.8% [14]. Dental anxiety was evaluated with MDAS in UK and was found to be 19 % [16]. A previous study conducted in Hong Kong reported the dental anxiety rate as 12.5% [20]. This situation shows us that dental anxiety situation varies according to geographical regions.
Many patients experience varying degrees of anxiety prior to dental practice. Oral surgery practices are particularly associated with a high level of anxiety (Olson S. A Examination of Dental Distress and Anxiety-Related Vulnerability Factors. University of Mississippi. 2018.). Sanikop et al. listed the factors most associated with increasing levels of dental anxiety as follows: the use of rotating head instruments and local anesthesia procedure. In our study, the use of a rotary tool is similar to this study in terms of leading to anxiety in individuals. However, individuals in our study stated that local anesthesia applications did not worry them [3].
Ozcelik et al. and Sanikop et al. stated that the long time spent in the waiting room before treatment may increase this anxiety, it was observed in our study that the time spent in the waiting room did not have an increasing effect on dental anxiety [1, 3].
In the present study, men were more courageous for going to their appointments than women. There are many studies addressing those women who have higher dental anxiety; however, in our study, women were more anxious about going to an appointment, they seemed to be more fearless about the procedures to be performed [21]. When male and female individuals were examined, it was seen that results such as tooth polishing, which is performed with rotary tools and more aesthetically, are less of a concern for women. We can attribute this to the courage of women in aesthetic practices. However, it was concluded in consideration of the general population that the patients were not worried about procedures such as filling or calculus removal and they were eager for these treatments (p>0.05). Considering the difficulty of accessing dental treatments in this region, we can say that their anxiety does not prevent them from having dental procedures.

Conclusion

As a result of the research, it was observed that approximately 7% of the patients who have been referred to the dental clinic had a higher level of dental anxiety. Gender, age, and the instruments chosen during dental treatment may cause a change in this anxiety. In the light of these results, dental anxiety continues to exist in the whole society to an undeniable extent; however, it was observed that it does not affect the desire for dental treatment in geographies where it is difficult to reach treatment. These studies should be conducted on large patient series in wider geographies. The responsibility of dentists is to determine the dental anxiety of individuals and make appropriate treatment plans.

Limitations

The main limitations of this study include a lack of questioning past dental experiences, conducting the study on a limited number of people, and getting help from an interpreter for communication.

Scientific Responsibility Statement

The authors declare that they are responsible for the article’s scientific content including study design, data collection, analysis and interpretation, writing, some of the main line, or all of the preparation and scientific review of the contents and approval of the final version of the article.

Animal and human rights statement

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No animal or human studies were carried out by the authors for this article.

Funding: None

Conflict of interest

None of the authors received any type of financial support that could be considered potential conflict of interest regarding the manuscript or its submission.

References

1. Appukuttan D. Strategies to manage patients with dental anxiety and dental phobia: literature review. Clin Cosmet Investig Dent. 2016; 8:35-50
2. Koroglu A, Durkan R. An evaluation of the etiology and the treatment procedures of dental anxiety syndrome encountered in aental applications. J Dent Fac Atatürk Univ. 2010; 20(3):205-12.
3. Sanikop S, Pallavi A, Suvarna P. Relationship between dental anxiety and pain perception during scaling. J Oral Sci. 2011; 53(3):341–8.
4. Doganer YÇ, Aydogan Ü, Yesil HÜ, Sarı O, Koc B. Dental anxiety and related factors in young individuals. Gülhane Med J. 2015; 57:160–4.
5. Ayaz E, Varol G. Examination of factors related to dental anxiety level in 1st grade students in health high school of Namık Kemal University Vocational School of Health Services. Nam Kem Med J. 2018; 6(3):96-103.
6. Keith D, Rinchuse D, Kennedy M, Zullo T. Effect of text message follow-up on patient’s self-reported level of pain and anxiety. Angle Orthod .2013; 83(4):605-10
7. Ayaz A, Bilgin N, Mollaoglu N. Use of state and trait anxiety scale in dental anxiety management. Journal of Clinical Science. 2017; 8(2):1553-60.
8. Crego A, Carrillo-Diaz M, Armfield JM, Romero M. From public mental health to community oral health: the impact of dental anxiety and fear on dental status. Front Public Health. 2013; 2(16):1-4.
9. Appukuttan D, Subramanian S, Tadepalli A, Damodaran LK. Dental anxiety among adults: An epidemiological study in South India. N Am J Med Sci. 2015; 7(1):13-8.
10. Saatchi M, Abtahi M, Mohammedi G, Mirdamadi M, Binandeh ES. The prevalence of dental anxiety and fear in patients referred to Isfahan Dental School, Iran. Dent Res J. 2015; 12(3):248-53.
11. Suhani RD, Suhani MF, Badea M. Dental anxiety and fear among a young population with hearing impairment. Clujul Med. 2016; 89(1):143–9.
12. Armfield JM. How do we measure dental fear and what are we measuring anyway. Oral Health Prev Dent. 2010; 8(2):107-15.
13. Humphris G, Crawford J, Hill K, Gilbert A, Freeman R. UK population norms for the modified dental anxiety scale with percentile calculator: adult dental health survey 2009 results. BMC Oral Health. 2013; 13(29):1-11.
14. Ilgüy D, Ilgüy M, Dincer S, Bayırlı G. Reliability and validity of the Modified Dental Anxiety Scale in Turkish patients. J Int Med Res. 2005; 33(2):252-9.
15. Tunc E, Firat D, Onur O, Sar V. Reliability and validity of the Modified Dental Anxiety Scale (MDAS) in a Turkish population. Community Dent Oral Epidemiol. 2005; 33(5):357-62.
16. White A, Giblin L, Boyd L. The prevalence of dental anxiety in dental practice settings. J Dent Hygiene. 2017; 91(1):30-4.
17. Menziletoglu D, Akbulut M, Büyükerkmen E, Isık BK. Evaluation of dental anxiety-fear levels of dentistry faculty students. Selcuk Dent J. 2018; 5(1):22–30.
18. Sevdaoğlu G, Doğan MC, Şükrü U, İnanc Y, Celik M. The reliability and validity of the Turkish adaptation of the Corah Dental Anxiety Scale and the incidence of dental anxiety. Ondokuz Mayıs Univ Dent J. 2006; 7(1):7-14.
20. Wong H, Mak C, To W. Development of a Dental Anxiety Provoking Scale: A pilot study in Hong Kong . J Dent Sci. 2015; 10:240-7.
21. Wali A, Siddiqui M, Gul A, Khan A. Analysis of level of anxiety and fear before and after endodontic treatment. J Dent Oral Health. 2016; 2(3):1-4
22. Valverde N, Fernandez J, Valverde A, Juan L, Ramirez J, Fraile J, et all. Use of virtual reality for the management of anxiety and pain in dental treatments: Systematic Review and Meta-Analysis. J Clin Med. 2020; 9:1-17.

Download attachments: 10.4328:ACAM.21198

Elif Esra Ozmen, Metin Ocak. Evaluation of dental anxiety: Nyala Region, Sudan. Ann Clin Anal Med 2022;13(9):1026-1030

Citations in Google Scholar: Google Scholar

Aim: Omentin-1 is an adipose tissue-derived cytokine with unknown biological function. The impact of omentin-1 on hypertension has been questioned due to its relation to obesity. This study is aimed to investigate omentin-1 levels in hypertensive patients.

Material and Methods: A prospective, case-control study evaluated patients admitted to outpatient cardiology clinics between January 2012 and December 2013. We designed two groups: the patient group comprised hypertensive patients with newly diagnosed stage-1 hypertension, and the control group comprised normotensive patients. The demographic and anthropometric characteristics and laboratory parameters of the patients in both groups were recorded. Plasma levels of omentin-1 were the primary outcome in this study.

Results: Patient group consisted of 52 hypertensive patients, whereas the control group consisted of 36 patients without hypertension. There was no significant difference between the groups in terms of demographic and clinical characteristics (p>0.05). The median omentin-1 level of the patient group was higher than that of the control group (756.2 ng/mL vs. 664.4 ng/mL); however, the difference was insignificant (p=0.161).

Discussion: The findings of this study did not suggest a significant relationship between the plasma omentin-1 levels and the newly diagnosed Stage I hypertension.

Keywords: Hypertension, Adipokines, Omentin

Introduction

Omentin-1 is the major circulating isoform of an adipose tissue-derived cytokine (adipokine) expressed in the visceral adipose tissue [1]. The biological function of omentin-1 is mainly unknown; however, it has been reported to play a role in promoting insulin-mediated glucose transport in human adipocytes, and vasodilatation of blood vessels occurs [2, 3]. The fact that overweight and obese people have low levels of omentin-1 led to the hypothesis that omentin-1 may be directly related to several metabolic, endocrine, and cardiovascular diseases associated with diabetes [2].
Hypertension, smoking, diabetes, and hyperlipidemia are the risk factors for the development of coronary artery disease [4]. Given its close association with diabetes and its anti-atherogenic properties, it has been speculated that omentin-1 may function as a biomarker in the context of the development of coronary artery disease, acute myocardial infarction, atrial fibrillation, and hypertension [4-8].
The findings regarding the omentin-1 levels in atherosclerotic and hypertensive patients in the literature are contradictory. There are studies that reported low levels of omentin-1 as well as studies that reported high levels of omentin-1 [9-11]. A negative correlation of omentin-1 concentrations with waist circumference, insulin resistance, and body mass index (BMI) has been shown [6]. To date, there is no study that comprehensively investigated any possible relation between omentin-1 and hypertension. In this context, the objective of this study is to investigate and compare the plasma levels of omentin-1 in hypertensive patients and healthy normotensive subjects in view of the hypothesis that low levels of omentin-1 are associated with hypertension.

Material and Methods

Study Design

This study was designed as a prospective, case-control analysis of the plasma omentin-1 levels in hypertensive patients and control subjects. The local ethics committee approved the study (Abant Izzet Baysal University, Ethics Committee for Clinical Studies, 20.12.2012/465). Written informed consent was obtained from the patients and the control subjects. The study was carried out in accordance with the Declaration of Helsinki.

Population and Sample

The study population comprised all patients admitted to the outpatient clinics of Abant Izzet Baysal University, Faculty of Medicine, Turkey, Department of Cardiology. The patient group comprised all consecutive patients above 18 years of age with a newly diagnosed stage I hypertension. The diagnostic criteria for stage I hypertension based on the 2017 American College of Cardiology (ACC) and American Heart Association (AHA) guidelines were as follows: systolic blood pressure of 130 to 139 mmHg or diastolic blood pressure of 80 to 89 mmHg [12]. Patients with significant cardiac pathologies such as coronary artery disease, valvular heart disease, atrial fibrillation, secondary hypertension, and congestive heart failure (ejection fraction <45%), as well as patients with chronic inflammatory and rheumatoid diseases, diabetes mellitus, cerebrovascular diseases, chronic renal failure, a body mass index (BMI) ≥ 30 kg/m2, who were actively smoking, and had anti-hypertensive treatment were not included in the study. The control group consisted of normotensive individuals randomly selected from the outpatient clinic admissions without any clinical cardiological diagnosis in the same period.

Measurements and Variables

Blood pressure measurements of the patient and control groups were performed twice in the outpatient room between 08.00 and 10.00 AM after they had rest for at least 10 minutes. The mean blood pressure value was regarded as the cut-off value for inclusion in the control group [6]. Peripheral blood samples to measure omentin-1 levels were taken after the patients fasted overnight. The samples were centrifuged for ten minutes at 4000 ppm and then stored in a deep freezer at – 22C˚. The plasma concentration of omentin-1 (ng/ml) was measured using a commercially available ELISA (enzyme-linked immunosorbent assay) kit (BioVendor serum/plasma omentin-1, Brno, Czech Republic).
Demographic and anthropometric characteristics of the patients (age, gender, BMI, and waist circumference) were recorded. Patients’ waist circumferences were measured at the mid-level between the lower rib margin and the iliac crest [13]. The laboratory tests included the measurement of the complete blood count, biochemical analysis (fasting blood glucose, urea, creatinine, sodium, potassium, aspartate aminotransferase, alanine aminotransferase levels), lipid profile (cholesterol, high-density lipoprotein, low-density lipoprotein, triglyceride levels), and the measurement of the serum thyroid-stimulating hormone (TSH) levels. Hypertensive patients were evaluated using conventional and M-mode echocardiography (GE Healthcare, Vivid S6 Echocardiography).

Statistical Analysis

The plasma levels of omentin-1 were the primary outcome in this study. In this context, omentin-1 levels of hypertensive patients and normotensive control subjects were compared.
Descriptive statistics were expressed as mean ± standard deviation and median with minimum-maximum values in the case of continuous variables and depending on whether they conform to normal distribution. Categorical variables were expressed as numbers and percentages. Shapiro-Wilk, Kolmogorov-Smirnov, and Anderson-Darling tests were used to determine whether the numerical variables conform to normal distribution or not.
The Independent Samples t-test was used to compare two independent groups in the case of numerical variables that conform to normal distribution; otherwise, the Mann-Whitney U test was used.
Pearson’s Chi-Squared test was used to compare differences between categorical variables in 2×2 tables.
For statistical analysis, “Jamovi project (2020), Jamovi (Version 2.0.0.0) [Computer Software] (Retrieved from https://www.jamovi.org) and JASP (Version 0.15) (Retrieved from https://jasp-stats.org) were used. In all statistical analyses, the significance level (p-value) was set at 0.05.

Results

The patient group consisted of 52 hypertensive patients, whereas the control group consisted of 36 patients without hypertension. The demographic and clinical characteristics of the patients are given in Table 1. The mean age of the patient group was higher than that of the control group; however, the difference was not statistically significant (p=0.241). There was also no statistical difference between the groups in terms of gender, BMI, and waist circumference (p>0.05).
The echocardiographic measurements of the hypertensive patients are summarized in Table 2. The mean ejection fraction was determined as 62.2 ± 3.5%.
The results of the laboratory tests are summarized in Table 3. There was no significant difference between the groups in laboratory parameters. The median omentin-1 levels were determined as 664.4 ng/mL and 756.2 ng/ml in the control and patient groups, respectively. The difference between the omentin-1 levels of the groups was insignificant (p=0.161).

Discussion

The findings of this study revealed no significant relationship between plasma omentin-1 levels and the newly diagnosed stage 1 hypertension. There was also no indication of a physiological impact of omentin-1 on the complex interactions that lead to the development of hypertension.
Previous studies have focused on the relationship of omentin-1 levels with several endocrine diseases, including diabetes, metabolic syndrome, obesity [4, 9, 14]. Lower omentin-1 levels were associated with diabetes and its complications. The impact of omentin-1 on the development and progression of cardiac diseases such as myocardial infarction, coronary artery disease, carotid atherosclerosis has also been studied [1, 7, 15, 16]. The omentin-1 levels were found to be significantly lower in patients with the said diseases [1, 4, 7, 9, 15]. Baig et al. [7] demonstrated that omentin-1 is an independent risk factor for the development of myocardial infarction. A negative correlation has been reported between the omentin-1 levels and the severity of coronary artery disease [17]. It is the belief of the authors of this study that clinically significant endocrine and coronary diseases, i.e., diabetes with diabetic complications, metabolic syndrome with atherosclerosis, and angiographically diagnosed coronary artery disease, are significantly associated with lower levels of omentin-1. Nevertheless, the nature and extent of this association are not clear. Thus, prospective studies are needed to clarify whether omentin-1 is involved in the pathogeneses of these studies or whether it is an end-product generated secondary to such diseases.
The results of the relevant animal studies revealed that omentin-1 has a vasodilating effect on the isolated blood vessels mediated via the endothelium-derived nitric oxide [2]. Lower levels of omentin-1 would be expected in hypertensive patients considering the action mechanism of omentin-1. Celik et al. [6] reported decreased omentin-1 levels in hypertensive patients. Nevertheless, contrary to this study, they included both the patients with stage 1 and stage II hypertension in their study and found the lowest levels of omentin-1 in Stage II patients. They attributed this finding to the endothelial dysfunction, which was determined to be positively correlated with the hypertension stage [18]. Sanlialp et al. [14] speculated that omentin-1 level might be a reliable predictive factor for the development of metabolic syndrome in hypertensive patients. They evaluated all hypertensive patients in respect of the coexistence of metabolic syndrome.
Contrary to the results of the above-mentioned studies, [6, 14] Cinemre et al. [11] found higher omentin-1levels in the patients with stage I to stage 3 hypertension than in the healthy control subjects. In comparison, there was no difference between the omentin-1 levels of hypertensive patients and the control subjects in this study. It is possible that the severity and duration of hypertension in patients included in this study were insufficient to obtain the desired outcomes. Thus, large-scale prospective studies are needed to clarify the impact of omentin-1 on the development of hypertension.
Several authors have suggested that gender is effective on omentin-1 levels. In parallel, Liu et al. [1] demonstrated higher omentin-1 levels in women with metabolic syndrome. The differences between the serum levels of patients of different genders reported in the literature are contradictory [19]. In one of these studies, a population-based study conducted with 864 unselected middle-aged, elderly adults, Onat et al. [13] found that the lower omentin-1 levels were associated with lower systolic blood pressure, HbA1c, and glucose levels. Additionally, they found that omentin-1 was an independent predictive factor for hypertension and diabetes, yet only in male patients. Systolic blood pressure values were 128.6 ± 17, 134±21, and 134±21 mmHg in adults with tertiles of omentin-1 from 1 to 3. There was no significant difference in diastolic blood pressure measurements. Therefore, these findings should be considered as a piece of pathophysiological evidence without hypertension’s clinical significance. Contrary to the findings reported in other studies, no correlation was found between gender and omentin-1 levels in the patient and control groups in this study [14]. It is possible that the differences between the characteristics of the study samples have led to such conflicting outcomes.

Study Limitation

The study’s small sample size and single-center study design were its primary limitations. Secondly, only the repeated office blood pressure measurements were used to diagnose hypertension. The 24-h ambulatory blood pressure monitoring could be of more help in terms of getting better results.

Conclusion

In conclusion, the findings of this study did not suggest a significant relationship between the plasma omentin-1 levels and the newly diagnosed Stage I hypertension. Further studies with extensive and diverse samples are needed to verify the findings of this study.

Scientific Responsibility Statement

The authors declare that they are responsible for the article’s scientific content including study design, data collection, analysis and interpretation, writing, some of the main line, or all of the preparation and scientific review of the contents and approval of the final version of the article.

Animal and human rights statement

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. No animal or human studies were carried out by the authors for this article.

Funding: None

Conflict of interest

None of the authors received any type of financial support that could be considered potential conflict of interest regarding the manuscript or its submission.

References

1. Liu R, Wang X, Bu P. Omentin-1 is associated with carotid atherosclerosis in patients with metabolic syndrome. Diabetes Res Clin Pract. 2011;93(1):21-5.
2. Yamawaki H, Tsubaki N, Mukohda M, Okada M, Hara Y. Omentin, a novel adipokine, induces vasodilation in rat isolated blood vessels. Biochem Biophys Res Commun. 2010;393(4):668-72.
3. Tan BK, Adya R, Randeva HS. Omentin: A Novel Link Between Inflammation, Diabesity, and Cardiovascular Disease. Trends Cardiovasc Med. 2010;20(5):143-8.
4. Eimal Latif AH, Anwar S, Gautham KS, Kadurei F, Ojo RO, Hafizyar F, et al. Association of Plasma Omentin-1 Levels With Diabetes and Its Complications. Cureus. 2021;13(9):e18203.
5. Lin S, Li X, Zhang J, Zhang Y. Omentin-1: Protective impact on ischemic stroke via ameliorating atherosclerosis. Clin Chim Acta. 2021;517:31-40.
6. Çelik M, Nar R, Nar G, Sökmen E, Günver G. Serum omentin-1 levels in hypertensive patients. J Hum Hypertens. 2021;35(3):290-5.
7. Baig M, Alghalayini KW, Gazzaz ZJ, Atta H. Association of Serum Omentin-1, Chemerin, and Leptin with Acute Myocardial Infarction and its Risk Factors. Pak J Med Sci. 2020;36(6):1183-8.
8. Chen Y, Liu F, Han F, Lv L, Tang CE, Xie Z, et al. Omentin-1 is associated with atrial fibrillation in patients with cardiac valve disease. BMC Cardiovasc Disord. 2020;20(1):214.
9. Biscetti F, Nardella E, Rando MM, Cecchini AL, Angelini F, Cina A, et al. Association between omentin-1 and major cardiovascular events after lower extremity endovascular revascularization in diabetic patients: A prospective cohort study. Cardiovasc Diabetol. 2020;19(1):170.
10. Askin L, Duman H, Ozyıldız A, Tanriverdi O, Turkmen S. Association between Omentin-1 and Coronary Artery Disease: Pathogenesis and Clinical Research. Curr Cardiol Rev. 2020;16(3):198-201.
11. Serinkan Cinemre FB, Cinemre H, Bahtiyar N, Kahyaoğlu B, Ağaç MT, Shundo H, et al. Apelin, Omentin-1, and Vaspin in patients with essential hypertension: association of adipokines with trace elements, inflammatory cytokines, and oxidative damage markers. Ir J Med Sci. 2021;190(1):97-106.
12. Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in Hypertension. 2018;71(6):e136-e139] [published correction appears in Hypertension. 2018;72(3):e33]. Hypertension. 2018;71(6):1269-324.
13. Onat A, Ademoglu E, Karadeniz Y, Can G, Uzun AO, Simsek B, et al. Population-based serum omentin-1 levels: Paradoxical association with cardiometabolic disorders primarily in men. Biomark Med. 2018;12(2):141-9.
14. Cetin Sanlialp S, Nar G, Nar R. Relationship between circulating serum omentin-1 levels and nascent metabolic syndrome in patients with hypertension. J Investig Med. 2022;70(3):780-5.
15. Bai P, Abdullah F, Lodi M, Sarhadi M, Dilip A, Shahab S, et al. Association Between Coronary Artery Disease and Plasma Omentin-1 Levels. Cureus. 2021;13(8):e17347.
16. Menzel J, di Giuseppe R, Biemann R, Wittenbecher C, Aleksandrova K, Eichelmann F, et al. Association between chemerin, omentin-1 and risk of heart failure in the population-based EPIC-Potsdam study. Sci Rep. 2017;7(1):14171.
17. Shang FJ, Wang JP, Liu XT, Zheng QS, Xue YS, Wang B, et al. Serum omentin-1 levels are inversely associated with the presence and severity of coronary artery disease in patients with metabolic syndrome. Biomarkers. 2011;16(8):657-62.
18. Moreno-Navarrete JM, Ortega F, Castro A, Sabater M, Ricart W, Fernández-Real JM. Circulating omentin as a novel biomarker of endothelial dysfunction. Obesity. 2011;19(8):1552-9.
19. de Souza Batista CM, Yang RZ, Lee MJ, Glynn NM, Yu DZ, Pray J, et al. Omentin plasma levels and gene expression are decreased in obesity. Diabetes. 2007;56(6):1655-61.

Download attachments: 10.4328:ACAM.21201

Mehmet Ozyasar, Alim Erdem. Relationship between plasma omentin-1 levels and newly diagnosed Stage I hypertension. Ann Clin Anal Med 2022;13(9):1036-1039

Citations in Google Scholar: Google Scholar