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    Association of HIF1α, BNIP3, and BNIP3L with Hypoxia-Related Metabolic Stress in Metabolic Syndrome
    (Mdpi, 2026) Kiran, Tugba Raika; Keskin, Lezan; Erdem, Mehmet; Guctekin, Zeynep; Inceoglu, Feyza
    Background and Objectives: Metabolic syndrome (MetS) is a complex condition marked by insulin resistance, central obesity, dyslipidemia, and chronic inflammation. Emerging evidence highlights the roles of hypoxia and mitochondrial stress in its pathophysiology. Hypoxia-inducible factor-1 alpha (HIF1 alpha) and the mitophagy-associated proteins BNIP3 and BNIP3L are key components of hypoxia-responsive mitochondrial stress signaling. This study aimed to evaluate the circulating levels of HIF1 alpha, BNIP3, and BNIP3L in MetS and to explore their associations with metabolic and inflammatory parameters. Materials and Methods: Serum concentrations of HIF1 alpha, BNIP3, and BNIP3L were measured by ELISA in 40 patients with MetS and 40 age and sex-matched controls. Biochemical, hematological, and anthropometric parameters were assessed, and receiver operating characteristic (ROC) analyses were performed to evaluate diagnostic performance. Results: Serum levels of HIF1 alpha, BNIP3, and BNIP3L levels were significantly higher in MetS patients compared with controls (p = 0.001). ROC analysis demonstrated strong diagnostic potential, particularly for BNIP3 (AUC = 0.928), followed by HIF1 alpha (AUC = 0.885) and BNIP3L (AUC = 0.770). These markers showed significant associations with metabolic indicators such as BMI, fasting glucose, triglycerides, and inflammatory markers. Conclusions: The coordinated upregulation of circulating HIF1 alpha, BNIP3, and BNIP3L in MetS is associated with metabolic dysregulation and systemic inflammation, reflecting alterations in hypoxia-responsive mitophagy-associated signaling rather than direct functional impairment of mitophagy. These findings support the potential relevance of these markers as indicators of metabolic stress in MetS. Further tissue-based and mechanistic studies are warranted to clarify their role in disease pathophysiology.
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    Evaluation of vascular tone in patients with menorrhagia: the role of apelin and norepinephrine
    (Walter de Gruyter Gmbh, 2026) Guctekin, Zeynep; Erdem, Mehmet; Dogan, Umran Karabulut; Yildirim, Engin; Kiran, Tugba Raika
    Objectives Menorrhagia, characterized by excessive menstrual bleeding, impacts 30 % of women of childbearing period and is frequently linked to anemia and discomfort in the pelvic region. Understanding the vascular and hormonal mechanisms underlying this condition could aid in developing non-surgical treatment options. This research focused on exploring the role of apelin and norepinephrine (NE), along with nitric oxide (NO) and prostacyclin (PGI2), in the pathophysiology of menorrhagia. Methods The study included 44 women diagnosed with menorrhagia and 44 healthy controls. Blood specimens were taken on the 2nd or 3rd day of menstruation, and serum specimens were prepared. The levels of apelin, NE, NO, and PGI2 were determined using commercially available ELISA kits. Furthermore, standard biochemical analyses were conducted on all specimens. Results Apelin and NE levels were significantly reduced in the menorrhagia group compared to control group (p<0.05). The comparison of NO and PGI2 levels showed no statistically significant difference between the menorrhagia and control groups (p>0.05). In the menorrhagia group, total cholesterol, iron-binding capacity, platelet count, and FSH concentrations were markedly higher than those in control individuals, conversely, albumin, iron, hemoglobin, MCV, hematocrit, and progesterone levels were notably reduced (p<0.05) .Conclusions The study identified apelin and NE as moderately discriminative markers in menorrhagia and suggested that these markers could potentially contribute to impaired vasoconstriction and excessive menstrual bleeding. Future research should focus on evaluating biomarkers across different menstrual phases and exploring new therapeutic strategies for uterine protection.