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Sahin M, Demirci İ, Haymana C, Taşçı İ, Sonmez A. Reply to Reply: The clinical outcome of COVID-19 infection in patients with a history of thyroid cancer: A nationwide study. Clin Endocrinol (Oxf) 2023; 99:533-534. [PMID: 34967024 DOI: 10.1111/cen.14670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Mustafa Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - İbrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - İlker Taşçı
- Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Batman A, Yazıcı D, Dikbaş O, Ağbaht K, Saygılı ES, Demirci İ, Bursa N, Ayas G, Anıl C, Cesur M, Korkmaz FN, Bahçecioglu AB, Çorapçıoğlu D, Erdoğan MF, Bostan H, Calapkulu M, Hepşen S, Uçan B, Çakal E, Güler BY, Haymana C, İpekçi SH, Aydın S, Sezer H, Özışık S, Deyneli O, Alagöl F, Tanakol R, Eroğlu M, Mutlu Ü, Hacışahinoğulları H, Üzüm AK, Demir C, Koç G, Fırat SN, Omma T, İnce N, Polat ŞB, Topaloğlu O, Aydın C, Çakır B, Bahadır ÇT, Güven M, Sözen M, Selek A, Cantürk Z, Çetinarslan B, Aydemir M, Taşkaldıran I, Bozkuş Y, İyidir ÖT, Haydardedeoğlu FE, Basmaz SE, Ünal MÇ, Demir T, Oğuz A, Çelik Ö, Yilmaz M, Cimsir A, Kayıhan S, Uc ZA, Tekin S, Topaloğlu Ö, Saydam BÖ, Ünsal YA, Özer Ö, Yorulmaz G, Uğur K, Çakır SD, Aşık M, Unubol M, Genc S, Andac B, Okur M, Dogan O, Karakiliç E, Kocabas GU, Kirac CO, Cansu GB, Uygur MM, Pekkolay Z, Öztürk S, Güngüneş A, Gürkan E, Keskin L, Çağlayan K, Günay YE, İmre E, Şener SY, Kalkan AT, Gök DE, Şahin M. Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study. J Clin Endocrinol Metab 2023; 108:e1013-e1026. [PMID: 37186260 DOI: 10.1210/clinem/dgad235] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
CONTEXT The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. METHODS This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19-related SAT (Cov-SAT), SARS-CoV-2 vaccine-related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. RESULTS Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. CONCLUSION Since there is no difference in terms of follow-up parameters and outcomes, COVID-19- and SARS-CoV-2 vaccine-related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism.
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Affiliation(s)
- Adnan Batman
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Dilek Yazıcı
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Oğuz Dikbaş
- Department of Endocrinology and Metabolism, Giresun University School of Medicine, 28200 Giresun, Turkey
| | - Kemal Ağbaht
- Department of Endocrinology and Metabolism, Defne Hospital, 31030 Hatay, Turkey
| | - Emre Sedar Saygılı
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, 17020 Canakkale, Turkey
| | - İbrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Nurbanu Bursa
- Department of Statistics Beytepe, Hacettepe University, 06230 Ankara, Turkey
| | - Görkem Ayas
- School of Medicine, Koc University, 34450 Istanbul, Turkey
| | - Cüneyd Anıl
- Department of Endocrinology and Metabolic Diseases, Güven Hospital, 06540 Ankara, Turkey
| | - Mustafa Cesur
- Department of Endocrinology and Metabolic Diseases, Güven Hospital, 06540 Ankara, Turkey
| | - Fatma Nur Korkmaz
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Adile Begüm Bahçecioglu
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Murat Faik Erdoğan
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Hayri Bostan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Murat Calapkulu
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Sema Hepşen
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Bekir Uçan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Erman Çakal
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Bağdagül Yüksel Güler
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Süleyman Hilmi İpekçi
- Department of Endocrinology, Hisar Intercontinental Hospital, 34768 Istanbul, Turkey
| | - Selami Aydın
- Department of Internal Medicine, Hisar Intercontinental Hospital, 34768 Istanbul, Turkey
| | - Havva Sezer
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Seçil Özışık
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Oğuzhan Deyneli
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Faruk Alagöl
- Department of Endocrinology and Metabolism, VKV Amerikan Hospital-Koç University School of Medicine, 34365 Istanbul, Turkey
| | - Refik Tanakol
- Department of Endocrinology and Metabolism, VKV Amerikan Hospital-Koç University School of Medicine, 34365 Istanbul, Turkey
| | - Mustafa Eroğlu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Balikesir University Faculty of Medicine, 10145 Balikesir, Turkey
| | - Ümmü Mutlu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Hülya Hacışahinoğulları
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Ayşe Kubat Üzüm
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Canan Demir
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Atilim University School of Medicine, 06830 Ankara, Turkey
| | - Gönül Koç
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Research Hospital, 06230 Ankara, Turkey
| | - Sevde Nur Fırat
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Research Hospital, 06230 Ankara, Turkey
| | - Tülay Omma
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Reasearch Hospital, 06230 Ankara, Turkey
| | - Nurcan İnce
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Şefika Burçak Polat
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Oya Topaloğlu
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Cevdet Aydın
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Bekir Çakır
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Çiğdem Tura Bahadır
- Department of Endocrinology and Metabolism, Amasya University, School of Medicine, 05100 Amasya, Turkey
| | - Mehmet Güven
- Department of Endocrinology and Metabolism, Sirnak State Hospital, 73000 Sirnak, Turkey
| | - Mehmet Sözen
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Alev Selek
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Zeynep Cantürk
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Berrin Çetinarslan
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Mustafa Aydemir
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Akdeniz University, School of Medicine, 07050 Antalya, Turkey
| | - Işılay Taşkaldıran
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Yusuf Bozkuş
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Özlem Turhan İyidir
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Filiz Ekşi Haydardedeoğlu
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 79097 Adana, Turkey
| | - Seda Erem Basmaz
- Department of Endocrinology and Metabolism, Kocaeli Derince Training and Research Hospital, 41900 Kocaeli, Turkey
| | - Mehmet Çağrı Ünal
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylul University, 35330 Izmir, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylul University, 35330 Izmir, Turkey
| | - Ayten Oğuz
- Department of Endocrinology and Metabolism, Faculty of Medicine, Biruni University, 34295 Istanbul, Turkey
| | - Özlem Çelik
- Department of Endocrinology and Metabolism, Faculty of Medicine, Acıbadem University, 34752 Istanbul, Turkey
| | - Merve Yilmaz
- Department of Endocrinology and Metabolism, Samsun State Hospital, 55060 Samsun, Turkey
| | - Aykut Cimsir
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Serdar Kayıhan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Ziynet Alphan Uc
- Department of Endocrinology and Metabolism, Usak University, Usak Training and Research Hospital, 64300 Usak, Turkey
| | - Sakin Tekin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Zonguldak Bulent Ecevit University, 67100 Zonguldak, Turkey
| | - Ömercan Topaloğlu
- Department of Endocrinology and Metabolism, Faculty of Medicine, Zonguldak Bulent Ecevit University Obesity and Diabetes Practice and Research Center, 67100 Zonguldak, Turkey
| | - Başak Özgen Saydam
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Yenimahalle Training and Research Hospital, 06370 Ankara, Turkey
| | - Yasemin Aydoğan Ünsal
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Yenimahalle Training and Research Hospital, 06370 Ankara, Turkey
| | - Özge Özer
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, 26040 Eskisehir, Turkey
| | - Göknur Yorulmaz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, 26040 Eskisehir, Turkey
| | - Kader Uğur
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Fırat University, 23119 Elazıg, Turkey
| | - Sezin Doğan Çakır
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Istanbul Taksim Training and Research Hospital, 34433 Istanbul, Turkey
| | - Mehmet Aşık
- Endocrinologist, Private Office, Bodrum, 48400 Mugla, Turkey
| | - Mustafa Unubol
- Department of Endocrinology and Metabolism, School of Medicine, Adnan Menderes University, 09100 Aydin, Turkey
| | - Selin Genc
- Department of Endocrinology and Metabolism, School of Medicine, Inonu University, 44280 Malatya, Turkey
| | - Burak Andac
- Department of Endocrinology and Metabolism, School of Medicine, Trakya University, 22130 Edirne, Turkey
| | - Mine Okur
- Department of Endocrinology and Metabolism, School of Medicine, Trakya University, 22130 Edirne, Turkey
| | - Ozlem Dogan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Haseki Training and Research Hospital, 34096 Istanbul, Turkey
| | - Ersen Karakiliç
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, 17020 Canakkale, Turkey
| | - Gokcen Unal Kocabas
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ege University, 35100 Izmir, Turkey
| | - Cem Onur Kirac
- Department of Endocrinology and Metabolism, Kahramanmaras Necip Fazil City Hospital, 46050 Kahramanmaras, Turkey
| | - Güven Barış Cansu
- Department of Endocrinology and Metabolism, School of Medicine, Kutahya University of Health Sciences, 43100 Kutahya, Turkey
| | - Meliha Melin Uygur
- Department of Endocrinology and Metabolism, School of Medicine, Marmara University, Pendik Training and Research Hospital, 34899 Istanbul, Turkey
| | - Zafer Pekkolay
- Department of Endocrinology and Metabolism, School of Medicine, Dicle University, 21100 Diyarbakir, Turkey
| | - Sadettin Öztürk
- Department of Endocrinology and Metabolism, School of Medicine, Gaziantep University, 27850 Gaziantep, Turkey
| | - Aşkın Güngüneş
- Department of Endocrinology and Metabolism, School of Medicine, Kırıkkale University, 71300 Kırıkkale, Turkey
| | - Eren Gürkan
- Department of Endocrinology and Metabolism, School of Medicine, Hatay Mustafa Kemal University, 31001 Hatay, Turkey
| | - Lezzan Keskin
- Department of Endocrinology and Metabolism, School of Medicine, Malatya Turgut Ozal University, Malatya Training and Research Hospital, 44000 Malatya, Turkey
| | - Kenan Çağlayan
- Department of Endocrinology and Metabolism, School of Medicine, Baskent University Istanbul Hospital, 34662 Istanbul, Turkey
| | - Yasemin Emur Günay
- Department of Endocrinology and Metabolism, School of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey
| | - Eren İmre
- Department of Endocrinology and Metabolism, Dr Ersin Arslan Education and Research Hospital, 27010 Gaziantep, Turkey
| | - Selcuk Yusuf Şener
- Department of Endocrinology and Metabolism, Pendik Medikalpark Hospital, 34899 Istanbul, Turkey
| | - Ahmet Toygar Kalkan
- Department of Endocrinology and Metabolism, Kastamonu Research and Training Hospital, 37150 Kastamonu, Turkey
| | - Deniz Engin Gök
- Department of Endocrinology and Metabolism, Lokman Hekim Hospital, 06700 Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
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Sonmez A, Demirci I, Haymana C, Tasci I, Ayvalı MO, Ata N, Ezgu FS, Bayram F, Barcin C, Caglayan M, Ülgü MM, Birinci S, Tokgozoglu L, Satman I, Kayikcioglu M. Clinical characteristics of adult and paediatric patients with familial hypercholesterolemia: A real-life cross-sectional study from the Turkish National Database. Atherosclerosis 2023; 375:9-20. [PMID: 37216728 DOI: 10.1016/j.atherosclerosis.2023.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) is the most common cause of premature atherosclerotic cardiovascular disease (ASCVD). Türkiye is among the countries with the highest rate of ASCVD. However, no population-based study has been published so far on the prevalence of FH, demographic and clinical characteristics, burden of ASCVD, treatment compliance, and attainment of low-density lipoprotein cholesterol (LDL-C) targets. METHODS We performed a study using the Turkish Ministry of Health's national electronic health records involving 83,063,515 citizens as of December 2021 dating back 2016. Adults fulfilling the diagnostic criteria of definite or probable FH according to the Dutch Lipid Network Criteria (DLNC), and children and adolescents fulfilling the criteria of probable FH according to the European Atherosclerosis Society (EAS) Consensus Panel report formed the study population (n = 157,790). The primary endpoint was the prevalence of FH. RESULTS Probable or definite FH was detected in 0.63% (1 in 158) of the adults and 0.61% (1 in 164) of the total population. The proportion of adults with LDL-C levels >4.9 mmol/L (190 mg/dL) was 4.56% (1 in 22). The prevalence of FH among children and adolescents was 0.37% (1 in 270). Less than one-third of the children and adolescents, and two-thirds of young adults (aged 18-29) with FH were already diagnosed with dyslipidaemia. The proportion of adults and children and adolescents on lipid-lowering treatment (LLT) was 32.1% and 1.5%, respectively. The overall discontinuation rate of LLT was 65.8% among adults and 77.9% among children and adolescents. Almost no subjects on LLT were found to attain the target LDL-C levels. CONCLUSIONS This nationwide study showed a very high prevalence of FH in Türkiye. Patients with FH are diagnosed late and treated sub-optimally. Whether these findings may explain the high rates of premature ASCVD in Türkiye needs further investigation. These results denote the urgent need for country-wide initiatives for early diagnosis and effective management of FH patients.
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Affiliation(s)
- Alper Sonmez
- Ankara Guven Hospital, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Cem Haymana
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Internal Medicine, Ankara, Turkiye
| | - Mustafa Okan Ayvalı
- General Directorate of the Health Information Systems, Ministry of Health, Ankara, Turkiye
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkiye
| | - Fatih Suheyl Ezgu
- Gazi University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkiye
| | - Fahri Bayram
- Erciyes University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kayseri, Turkiye
| | - Cem Barcin
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Cardiology, Ankara, Turkiye
| | - Murat Caglayan
- University of Health Sciences, Yildirim Beyazit Training and Research Hospital, Department of Biochemistry, Ankara, Turkiye
| | - Mustafa Mahir Ülgü
- General Directorate of the Health Information Systems, Ministry of Health, Ankara, Turkiye
| | - Suayip Birinci
- Deputy Health Minister, Ministry of Health, Ankara, Turkiye
| | - Lale Tokgozoglu
- Hacettepe University, Faculty of Medicine, Department of Cardiology, Ankara, Turkiye
| | - Ilhan Satman
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkiye
| | - Meral Kayikcioglu
- Ege University Faculty of Medicine, Department of Cardiology, Izmir, Turkiye.
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Aydogan U, Doganer YC, Haymana C, Kaplan U, Aydogdu A, Demirci I, Meric C, Sonmez YA. Evaluation of sexual functional status and consistency of scales in patients with hypogonadotropic hypogonadism before and after testosterone replacement therapy: a single-center experience. Arch Endocrinol Metab 2023; 67:179-188. [PMID: 36468923 PMCID: PMC10689042 DOI: 10.20945/2359-3997000000539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 07/20/2022] [Indexed: 12/12/2022]
Abstract
Objective This study aimed to investigate the frequency of sexual dysfunction and the effect of short-term testosterone replacement therapy on sexual functions in congenital hypogonadism patients. Furthermore, we sought to reveal the consistency of the self-report scales used for the diagnosis of sexual dysfunction and the relationship between biochemical parameters. Materials and methods The study was conducted on 47 young male patients aged above 18 years who were diagnosed with hypogonadotropic hypogonadism. Short (IIEF-5) and long (IIEF-15) forms of the International Index of Erectile Function and Arizona Sexual Experiences Scale (ASEX) were applied before treatment under the supervision of a physician. The patients' blood pressure, height, and weight were measured, and their luteinizing hormone (LH), FSH, and total testosterone levels were recorded. Patients who started their treatments were called for a follow-up checkup after 6 months. Their blood pressure, height, and weight were measured by reapplying the ASEX, IIEF-5, and IIEF-15. In addition, their LH, FSH, and total testosterone levels in the biochemical tests were rerecorded. Results In this study, the sexual dysfunction status of patients diagnosed with hypogonadotropic hypogonadism before and after treatment was evaluated using the ASEX, IIEF-15, and IIEF-5 scales. A decrease in sexual dysfunction was observed in all three scales after treatment compared with that before treatment. The IIEF-5 and IIEF-15 scales were found to be uncorrelated in terms of the pretreatment values but were correlated in terms of the post-treatment values. Although a correlation was observed between ASEX and IIEF- 5 before treatment, no correlation was detected between ASEX and IIEF-15. After the treatment, ASEX was found to be correlated with both IIEF-5 and IIEF-15. The results of the scales indicated the correlation in all categories, except the pretreatment results of the IIEF-15 scale. Conclusion The results of the current study demonstrated a significant improvement in the sexual function of hypogonadism patients undergoing short-term testosterone therapy. The ASEX, IIEF-5, and IIEF-15 scales used in the diagnosis and follow-up of sexual dysfunction were useful for evaluating sexual functions in hypogonadotropic hypogonadism patients.
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Affiliation(s)
- Umit Aydogan
- University of Health Sciences, Gulhane School of Medicine, Department of Family Medicine, Ankara, Turkey,
| | - Yusuf Cetin Doganer
- University of Health Sciences, Gulhane School of Medicine, Department of Family Medicine, Ankara, Turkey
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Umit Kaplan
- University of Health Sciences, Gulhane School of Medicine, Department of Family Medicine, Ankara, Turkey
| | - Aydogan Aydogdu
- International Medicana Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Coskun Meric
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Yusuf Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
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Demirci I, Haymana C, Candemir B, Yuksel B, Eser M, Meric C, Akin S, Gulcelik NE, Sonmez A. Triglyceride-glucose index levels in patients with Klinefelter syndrome and its relationship with endothelial dysfunction and insulin resistance: a cross-sectional observational study. Archives of Endocrinology and Metabolism 2023; 67:378-384. [PMID: 37011373 DOI: 10.20945/2359-3997000000594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Objective This study aimed to investigate the triglyceride-glucose (TyG) index, which is a simple surrogate marker of insulin resistance that is associated with various cardiometabolic diseases, in patients with Klinefelter syndrome (KS). Subjects and methods A total of 30 patients with KS (mean age: 21.53 ± 1.66 years) and 32 healthy controls (mean age: 22.07 ± 1.01 years) were included in the study. The clinical and laboratory parameters, TyG index, asymmetric dimethylarginine (ADMA) level, homeostatic model assessment of insulin resistance (HOMA-IR) score, and high-sensitivity C-reactive protein level were measured in patients with KS and healthy subjects. Results Patients with KS had higher HOMA-IR score (p = 0.043), ADMA levels (p < 0.001), and TyG index (p = 0.031) and lower high-density lipoprotein cholesterol levels (p < 0.001) than healthy subjects. TyG index was positively correlated with plasma ADMA (r = 0.48, p < 0.001) and HOMA-IR (r = 0.36, p = 0.011). Multivariate analyses showed that total testosterone level (β = -0.44, p = 0.001) and TyG index (β = 0.29, p = 0.045) were independent determinants of plasma ADMA levels. Conclusion Patients with KS had higher TyG indices than healthy subjects. Moreover, TyG index was independently associated with endothelial dysfunction in patients. TyG index may be a practical and useful measure to show the increased endothelial dysfunction in patients with KS.
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Sahin M, Demirci I, Haymana C, Tasci I, Emral R, Cakal E, Unluturk U, Satman I, Demir T, Ata N, Ertugrul D, Atmaca A, Salman S, Sahin I, Dagdelen S, Celik O, Caglayan M, Sonmez A. The Clinical Characteristics and Outcomes of COVID-19 Patients with Pre-Existing Thyroid Dysfunction: A Nationwide Study. Horm Metab Res 2023; 55:25-30. [PMID: 36328149 DOI: 10.1055/a-1971-8781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To which extent the pre-existing hypothyroidism or hyperthyroidism has an impact on coronavirus infection 2019 (COVID-19) outcomes remains unclear. The objective of this study was to evaluate COVID-19 morbidity and mortality in patients with pre-existing thyroid dysfunction. A retrospective cohort of patients with a polymerase chain reaction (PCR)-confirmed COVID-19 infection (n=14 966) from March 11 to May 30, 2020, was established using the database of the Turkish Ministry of Health. We compared the morbidity and mortality rates of COVID-19 patients with pre-existing hypothyroidism (n=8813) and hyperthyroidism (n=1822) to those patients with normal thyroid function (n=4331). Univariate and multivariate regression analyses were performed to identify the factors associated with mortality. Mortality rates were higher in patients with hyperthyroidism (7.7%) and hypothyroidism (4.4%) than those with normal thyroid function (3.4%) (p<0.001 and p=0.008, respectively). Pre-existing hyperthyroidism was significantly associated with an increased risk of mortality (OR 1.54; 95% CI, 1.02-2.33; p=0.042) along with advanced age, male gender, lymphopenia and chronic kidney disease (p<0.001 for all). Although a potential trend was noted, the association between pre-existing hypothyroidism and mortality was not significant (OR 1.36; 95% CI, 0.99-1.86; p=0.055). In conclusion, this study showed an association between pre-existing hyperthyroidism with higher COVID-19 mortality. A potential trend towards increased mortality was also observed for hypothyroidism. The risk was more pronounced in patients with hyperthyroidism.
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Affiliation(s)
- Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Cem Haymana
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Rıfat Emral
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Endocrinology and Metabolism, Samsun, Turkey
| | - Serpil Salman
- Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Endocrinology and Metabolism, Malatya, Turkey
| | - Selcuk Dagdelen
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | | | - Alper Sonmez
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
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Sonmez A, Haymana C, Demirci I, Cesur M, Rizzo M, Tasci I. Critical questions in diabetes management: What are the most compelling challenges and how can we handle them? Int J Cardiol Cardiovasc Risk Prev 2022; 15:200160. [PMID: 36573189 PMCID: PMC9789350 DOI: 10.1016/j.ijcrp.2022.200160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Abstract
Background The prevalence of diabetes mellitus is growing worldwide, showing almost a 10-fold increase in the last five decades. Despite advances in the understanding of the disease mechanisms, preventive measures, and treatment options, morbidity and mortality remain high. Moreover, the burden of uncontrolled glycemia and associated complications have a significant impact on healthcare costs. To be ready for the future and emerging issues in the management of diabetes and related disorders, a holistic approach is essential for the prevention of the next generations. So many challenges in the management of diabetes exist globally, which differ according to the health infrastructure, and cultural, economic, and sociodemographic status of the nations. Conclusions In this minireview and commentary on previously unaddressed needs relating to the management of diabetes, we discuss the ubiquitous and most compelling challenges and suggest potential solutions in the care of patients with diabetes.
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Affiliation(s)
- Alper Sonmez
- Ankara Guven Hospital, Department of Endocrinology and Metabolism, 06540, Kavaklidere, Ankara, Turkiye,Corresponding author. Ankara Guven Hospital, Department of Endocrinology and Metabolism, 06540, Kavaklidere, Ankara, Turkiye.
| | - Cem Haymana
- University of Health Sciences Türkiye, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Ibrahim Demirci
- University of Health Sciences Türkiye, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Mustafa Cesur
- Ankara Guven Hospital, Department of Endocrinology and Metabolism, 06540, Kavaklidere, Ankara, Turkiye,Yuksek Ihtisas University, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Manfredi Rizzo
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of South Carolina, Columbia, SC 29208, USA,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Ilker Tasci
- University of Health Sciences Türkiye, Gulhane Faculty of Medicine, Department of Internal Medicine, Ankara, Turkiye
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Demirci I, Haymana C, Tasci I, Satman I, Atmaca A, Sahin M, Ata N, Unluturk U, Cakal E, Dagdelen S, Sahin I, Celik O, Ertugrul D, Demir T, Emral R, Caglayan M, Salman S, Birinci S, Sonmez A. Higher rate of COVID-19 mortality in patients with type 1 than type 2 diabetes: a nationwide study. Endokrynol Pol 2022; 73:87-95. [PMID: 35119089 DOI: 10.5603/ep.a2022.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION COVID-19 disease has a worse prognosis in patients with diabetes, but comparative data about the course of COVID-19 in patients with type 1 (T1DM) and type 2 diabetes (T2DM) are lacking. The purpose of this study was to find out the relative clinical severity and mortality of COVID-19 patients with T1DM and T2DM. MATERIAL AND METHODS A nationwide retrospective cohort of patients with confirmed (PCR positive) COVID-19 infection (n = 149,671) was investigated. After exclusion of individuals with unspecified diabetes status, the adverse outcomes between patients with T1DM (n = 163), T2DM (n = 33,478) and those without diabetes (n = 115,108) were compared by using the propensity score matching method. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation, and mortality. RESULTS The patients with T1DM had higher mortality than the age- and gender-matched patients with T2DM (n = 489) and those without diabetes (n = 489) (p < 0.001). After further adjustment for the HbA1c, and microvascular and macrovascular complications, the odds of mortality (OR: 3.35, 95% CI: 1.41-7.96, p = 0.006) and ICU admission and/or mechanical ventilation (OR: 2.95, 95% CI: 1.28-6.77, p = 0.011) were significantly higher in patients with T1DM compared to those with T2DM. Older age (OR: 1.06, 95% CI: 1.01-1.12, p = 0.028) and lymphopaenia (OR: 5.13, 95% CI: 1.04-25.5, p = 0.045) were independently associated with mortality in patients with T1DM. CONCLUSIONS Patients with T1DM had worse prognosis of COVID-19 compared to T2DM patients or those without diabetes. These cases should be cared for diligently until more data become available about the causes of increased COVID-19 mortality in T1DM.
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Affiliation(s)
- Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Ankara, Turkey.
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Ankara, Turkey
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Ankara, Turkey
| | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey.,The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Turkey
| | - Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Naim Ata
- Ministry of Health, Department of Strategy Development, Ankara, Turkey
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Selcuk Dagdelen
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Ankara, Turkey
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Izmir, Turkey
| | - Rifat Emral
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | | | - Serpil Salman
- Medica Clinic, Endocrinology and Metabolism, Istanbul, Turkey
| | - Suayip Birinci
- Deputy Minister of Health, Ministry of Health, Ankara, Turkey
| | - Alper Sonmez
- University of Health Sciences, Gulhane Faculty of Medicine and Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
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Atmaca A, Demirci I, Haymana C, Tasci I, Sahin I, Cakal E, Ata N, Dagdelen S, Salman S, Emral R, Sahin M, Celik O, Demir T, Ertugrul D, Unluturk U, Caglayan M, Satman I, Sonmez A. No association of anti-osteoporosis drugs with COVID-19-related outcomes in women: a nationwide cohort study. Osteoporos Int 2022; 33:273-282. [PMID: 34402949 PMCID: PMC8369875 DOI: 10.1007/s00198-021-06067-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/10/2021] [Indexed: 01/08/2023]
Abstract
This study was performed to evaluate whether the use of drugs in the treatment of osteoporosis in women is associated with COVID-19 outcomes. The results showed that the risk of hospitalization, intensive care unit admission, and mortality was not altered in individuals taking anti-osteoporosis drugs, suggesting no safety issues during a COVID-19 infection. INTRODUCTION Whether patients with COVID-19 receiving anti-osteoporosis drugs have lower risk of worse outcomes has not been reported yet. The aim of this study was to evaluate the association of anti-osteoporosis drug use with COVID-19 outcomes in women. METHODS Data obtained from a nationwide, multicenter, retrospective cohort of patients diagnosed with COVID-19 from March 11th to May 30th, 2020 was retrieved from the Turkish Ministry of Health Database. Women 50 years or older with confirmed COVID-19 who were receiving anti-osteoporosis drugs were compared with a 1:1 propensity score-matched COVID-19 positive women who were not receiving these drugs. The primary outcomes were hospitalization, ICU (intensive care unit) admission, and mortality. RESULTS A total of 1997 women on anti-osteoporosis drugs and 1997 control patients were analyzed. In the treatment group, 1787 (89.5%) women were receiving bisphosphonates, 197 (9.9%) denosumab, and 17 (0.9%) teriparatide for the last 12 months. Hospitalization and mortality rates were similar between the treatment and control groups. ICU admission rate was lower in the treatment group (23.0% vs 27.0%, p = 0.013). However, multivariate analysis showed that anti-osteoporosis drug use was not an independent associate of any outcome. Hospitalization, ICU admission, and mortality rates were similar among bisphosphonate, denosumab, or teriparatide users. CONCLUSION Results of this nationwide study showed that preexisting use of anti-osteoporosis drugs in women did not alter the COVID-19-related risk of hospitalization, ICU admission, and mortality. These results do not suggest discontinuation of these drugs during a COVID-19 infection.
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Affiliation(s)
- A Atmaca
- Department of Endocrinology and Metabolism, School of Medicine, Samsun Ondokuz Mayis University, Samsun, Turkey.
| | - I Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - C Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - I Tasci
- Department of Internal Medicine Gulhane School of Medicine and Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - I Sahin
- Department of Endocrinology and Metabolism, School of Medicine, Malatya Inonu University, Malatya, Turkey
| | - E Cakal
- Department of Endocrinology and Metabolism, School of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - N Ata
- Department of Strategy Development, Ministry of Health, Republic of Turkey, Ankara, Turkey
| | - S Dagdelen
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | - S Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - R Emral
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
| | - M Sahin
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
| | - O Celik
- Public Hospitals General Directorate, Ministry of Health, Republic of Turkey, Ankara, Turkey
| | - T Demir
- Department of Endocrinology and Metabolism, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - D Ertugrul
- Department of Endocrinology and Metabolism, Kecioren Training and Research Hospital, School of Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - U Unluturk
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | - M Caglayan
- Ankara Provincial Health Directorate, Ankara, Turkey
| | - I Satman
- Department of Endocrinology and Metabolism, School of Medicine, Istanbul University, Istanbul, Turkey
- Turkish Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - A Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine and Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
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Demirci I, Demir T, Dagdelen S, Haymana C, Tasci I, Atmaca A, Ertugrul D, Ata N, Sahin M, Salman S, Sahin I, Emral R, Unluturk U, Cakal E, Celik O, Caglayan M, Satman I, Sonmez A. No association of Gaucher Disease with COVID-19-related outcomes: a nationwide cohort study. Intern Med J 2021; 52:379-385. [PMID: 34939733 DOI: 10.1111/imj.15673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/16/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is well documented that patients with chronic metabolic diseases such as diabetes and obesity are adversely affected by the Covid 19 pandemic. However, when the subject is rare metabolic diseases, there is not enough data in the literature. AIM To investigate course of COVID-19 among patients with Gaucher disease (GD), the most common lysosomal storage disease. METHODS Based on the National Health System data, a retrospective cohort of patients with confirmed (PCR positive) COVID-19 infection (n = 149 618) was investigated. The adverse outcomes between patients with GD (n = 39) and those without GD (n = 149 579) were compared in crude and propensity score matched (PSM) groups. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation and mortality. RESULTS The patients with GD were significantly older and had a higher frequency of hypertension, T2DM, dyslipidemia, asthma or COPD, chronic kidney disease, coronary artery disease, heart failure, and cancer. Although hospitalization rates in Gaucher patients were found to be higher in crude analyzes, the PSM models (model 1, age- and gender-matched; model 2, matched for age, gender, hypertension, T2DM, and cancer) revealed no difference for the outcomes between patients with GD and the general population. According to multivariate regression analyses, having a diagnosis of GD was not a significant predictor for hospitalization (p = 0.241), ICU admission/mechanical ventilation (p = 0.403) or mortality (p = 0.231). CONCLUSION According to our national data, SARS-CoV-2 infection in patients with GD does not have a more severe course than the normal population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Selcuk Dagdelen
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Turkey
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey
| | - Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Serpil Salman
- Medica Clinic, Endocrinology and Metabolism, Istanbul, Turkey
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Turkey
| | - Rifat Emral
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | | | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey
| | - Alper Sonmez
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
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Demirci I, Haymana C, Salman S, Tasci I, Corapcioglu D, Kirik A, Yetkin İ, Altay M, Sabuncu T, Bayram F, Satman I, Sonmez A. Rates and associates of influenza and pneumococcus vaccination in diabetes mellitus: A nationwide cross-sectional study (TEMD vaccination study). World J Diabetes 2021; 12:2107-2118. [PMID: 35047124 PMCID: PMC8696642 DOI: 10.4239/wjd.v12.i12.2107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/13/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.
AIM To investigate the prevalence of influenza and pneumococcal vaccinations and to search for the independent associates of vaccination in Turkish patients with diabetes.
METHODS In this cross-sectional, nationwide, multicenter study, adult patients with type 1 diabetes (T1DM) (n = 454) and type 2 diabetes (T2DM) (n = 4721), who were under follow-up for at least a year in the outpatient clinics, were consecutively enrolled. Sociodemographic, clinical, and laboratory parameters of patients were recorded. Vaccination histories were documented according to the self-statements of the patients.
RESULTS Patients with T1DM and T2DM had similar vaccination rates for influenza (23.6% vs 21.2%; P = 0.240) and pneumococcus (8% vs 7%; P = 0.451) vaccinations. Longer diabetes duration and older age were the common independent associates of having vaccination for both types of diabetes patients. Higher education level, using statin treatment, and having optimal hemoglobin A1c levels were the common independent associates of influenza and pneumococcal vaccination in patients with T2DM.
CONCLUSION TEMD Vaccination Study shows that patients with T1DM and T2DM had very low influenza and pneumococcal vaccination rates in Turkey. The lower rates of vaccination in certain populations urges the necessity of nationwide vaccination strategies targeting these populations.
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Affiliation(s)
- Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara 06190, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara 06190, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Liv Hospital, Istanbul 34000, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, University of Health Sciences, Gulhane Faculty of Medicine, Ankara 06018, Turkey
| | - Demet Corapcioglu
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara 06560, Turkey
| | - Ali Kirik
- Department of Internal Medicine, Balıkesir University, Faculty of Medicine, Balikesir 10145, Turkey
| | - İlhan Yetkin
- Department of Endocrinology and Metabolism, Gazi University, Faculty of Medicine, Ankara 06190, Turkey
| | - Mustafa Altay
- Department of Endocrinology and Metabolism, Kecioren Training and Research Hospital, Ankara 06190, Turkey
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, Harran University, Faculty of Medicine, Sanliurfa 63050, Turkey
| | - Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University, Faculty of Medicine, Kayseri 38000, Turkey
| | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, Faculty of Medicine, Istanbul 34000, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Faculty of Medicine, Ankara 06190, Turkey
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Emral R, Haymana C, Demirci I, Tasci I, Sahin M, Cakal E, Ata N, Unluturk U, Demir T, Ertugrul D, Sahin I, Atmaca A, Celik O, Caglayan M, Arga KY, Dagdelen S, Salman S, Satman I, Sonmez A. Lower COVID-19 Mortality in Patients with Type 2 Diabetes Mellitus Taking Dipeptidyl Peptidase-4 Inhibitors: Results from a Turkish Nationwide Study. Diabetes Ther 2021; 12:2857-2870. [PMID: 34398433 PMCID: PMC8365288 DOI: 10.1007/s13300-021-01133-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION To investigate the effect of preexisting treatment with dipeptidyl peptidase-4 inhibitors (DPP-4is) on COVID-19-related hospitalization and mortality in patients with type 2 diabetes mellitus (T2DM). METHODS A multicenter, retrospective cohort study was conducted using patient data extracted from the Turkish National Electronic Database. All patients who tested positive for COVID-19 (PCR test) between 11 March through to 30 May 2020 were screened for eligibility (n = 149,671). Following exclusion of patients based on pre-determined inclusion criteria, patients with T2DM using a DPP-4i or glucose-lowering medications other than a DPP-4i were compared for mortality and hospitalization. The propensity score method was used to match age, gender, micro- and macrovascular complications, and medications in the two groups. Independent associates of mortality were analyzed using multivariable analysis on the whole T2DM population. RESULTS A total of 33,478 patients with T2DM who tested postive for COVID-19 who met the inclusion criteria were included in the analysis. Median (interquartile range) age was 54 (22) years and 42.4% were male. Of these, 9100 patients using DPP-4is (n = 4550) or other glucose-lowering drugs (n = 4550) were matched in two groups. After matching, analysis revealed a lower mortality in the DPP-4i group (9.5 vs. 11.8%; p < 0.001). In the multivariable model, the use of DPP-4is (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.35-0.91; p = 0.02) was associated with lower mortality in the whole sample, while age, male gender, computed tomography finding of COVID-19, obesity, low glomerular filtration rate, and an insulin-based regimen also predicted increased risk of death. There was no association between the preexisting treatment with DPP-4is and COVID-19-related hospitalization in the matched analysis or multivariate model. The rate of admission to the intensive care unit and/or mechanical ventilation favored the DPP-4i group (21.7 vs. 25.2%; p = 0.001), although this association became saturated in the multivariate analysis (OR 0.65, 95% CI 0.39-1.08; p = 0.099). CONCLUSIONS The results of this study demonstrate an association between DDP-4i use and reduced mortality in people with T2DM who tested PCR positive for COVID-19.
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Affiliation(s)
- Rifat Emral
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey.
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health of the Republic of Turkey, Ankara, Turkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kecioren Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Aysegül Atmaca
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Ministry of Health of the Republic of Turkey, Ankara, Turkey
| | | | - Kazim Yalcin Arga
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - Ilhan Satman
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey
- Department of Endocrinology and Metabolism, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Emral R, Haymana C, Demirci I, Tasci I, Sahin M, Cakal E, Ata N, Unluturk U, Demir T, Ertugrul D, Sahin I, Atmaca A, Celik O, Caglayan M, Arga KY, Dagdelen S, Salman S, Satman I, Sonmez A. Correction to: Lower COVID-19 Mortality in Patients with Type 2 Diabetes Mellitus Taking Dipeptidyl Peptidase-4 Inhibitors: Results from a Turkish Nationwide Study. Diabetes Ther 2021; 12:2871-2872. [PMID: 34559403 PMCID: PMC8461138 DOI: 10.1007/s13300-021-01154-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rifat Emral
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey.
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health of the Republic of Turkey, Ankara, Turkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kecioren Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Aysegül Atmaca
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Ministry of Health of the Republic of Turkey, Ankara, Turkey
| | | | - Kazim Yalcin Arga
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - Ilhan Satman
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey
- Department of Endocrinology and Metabolism, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Sahin M, Haymana C, Demirci I, Tasci I, Rıfat E, Unluturk U, Satman I, Demir T, Cakal E, Ata N, Ertugrul D, Salman S, Sahin I, Dagdelen S, Celik O, Caglayan M, Atmaca A, Sonmez A. The clinical outcomes of COVID-19 infection in patients with a history of thyroid cancer: A nationwide study. Clin Endocrinol (Oxf) 2021; 95:628-637. [PMID: 33872399 PMCID: PMC8251412 DOI: 10.1111/cen.14486] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/03/2021] [Accepted: 04/15/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There are scarce published data in differentiated thyroid cancer patients about new coronavirus disease 2019 (COVID-19) disease outcomes and mortality. Here, we evaluated COVID-19 infection outcomes and mortality in thyroid cancer patients with COVID-19 infection. DESIGN AND METHODS We included a cohort of patients with thyroid cancer with PCR-confirmed COVID-19 disease from 11 March to 30 May 2020 from the Turkish Ministry of Health database in our nationwide, retrospective study. We compared the mortality and morbidity of COVID patients with or without thyroid cancer. Univariate and multivariate analyses were used to assess the independent factors for mortality, length of hospital stay and intensive care unit (ICU) admission and mechanical ventilation. We also analysed the effect of radioiodine treatment on severity and death rate of COVID-19 disease. RESULTS We evaluated 388 COVID-19 patients with thyroid cancer [median age: 54 years, interquartile range (IQR) 18 years, males: 23%] and age and gender-matched 388 COVID-19 patients without thyroid cancer. Patients with thyroid cancer had a similar mortality ratio compared with the non-cancer group. Among patients with thyroid cancer, age, presence of diabetes mellitus, asthma/COPD, heart failure, chronic kidney disease, prior coronary artery disease, RAS blocker usage and low lymphocyte count were associated with mortality. Radioactive iodine (RAI) treatment and cumulative radioactive iodine dosage did not negatively affect the severity and mortality of COVID-19 disease in our patient group. CONCLUSIONS Our study indicated that history of thyroid cancer did not have an increased risk of mortality or morbidity in COVID-19 disease. Besides, RAI therapy history and doses of radioactive iodine did not affect mortality or outcome.
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Affiliation(s)
- Mustafa Sahin
- Department of Endocrinology and MetabolismAnkara UniversityAnkaraTurkey
| | - Cem Haymana
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesGulhane Training and Research HospitalAnkaraTurkey
| | - Ibrahim Demirci
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesGulhane Training and Research HospitalAnkaraTurkey
| | - Ilker Tasci
- Department of Internal MedicineGulhane Faculty of Medicine and Gulhane Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
| | - Emral Rıfat
- Department of Endocrinology and MetabolismAnkara UniversityAnkaraTurkey
| | - Ugur Unluturk
- Department of Endocrinology and MetabolismFaculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Ilhan Satman
- Department of Endocrinology and MetabolismFaculty of MedicineIstanbul UniversityIstanbulTurkey
- Institute of Public Health and Chronic DiseasesThe Health Institutes of TurkeyIstanbulTurkey
| | - Tevfik Demir
- Department of Endocrinology and MetabolismFaculty of MedicineDokuz Eylul UniversityAnkaraTurkey
| | - Erman Cakal
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesDiskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey
| | - Naim Ata
- Department of Strategy DevelopmentMinistry of HealthAnkaraTurkey
| | - Derun Ertugrul
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesKecioren Training and Research HospitalAnkaraTurkey
| | - Serpil Salman
- Department of Endocrinology and MetabolismMedica ClinicIstanbulTurkey
| | - Ibrahim Sahin
- Department of Endocrinology and MetabolismFaculty of MedicineInonu UniversityMalatyaTurkey
| | - Selcuk Dagdelen
- Department of Endocrinology and MetabolismFaculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Osman Celik
- Ministry of HealthPublic Hospitals General DirectorateRepublic of TurkeyAnkaraTurkey
| | | | - Aysegul Atmaca
- Department of Endocrinology and MetabolismFaculty of MedicineOndokuz Mayis UniversitySamsunTurkey
| | - Alper Sonmez
- Department of Endocrinology and MetabolismGulhane Faculty of Medicine and Gulhane Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
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15
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Sahin I, Haymana C, Demir T, Demirci I, Tasci I, Atmaca A, Cakal E, Ata N, Emral R, Unluturk U, Ertugrul D, Salman S, Sahin M, Dagdelen S, Celik O, Caglayan M, Satman I, Sonmez A. Clinical Characteristics and Outcomes of COVID-19 Patients with Overweight and Obesity: Turkish Nationwide Cohort Study (TurCObesity). Exp Clin Endocrinol Diabetes 2021; 130:115-124. [PMID: 34384122 DOI: 10.1055/a-1552-4449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE While obesity is related to more severe outcomes of coronavirus disease 2019 (COVID-19), factors leading to poor prognosis still remain unclear. The present study evaluated the outcomes of COVID-19 patients who were overweight or obese and variables associated with severe disease in a large group of consecutive cases. METHODS A nationwide retrospective cohort study was performed using the Turkish National Healthcare Database. Demographic characteristics, laboratory tests, comorbidities, and medications of patients registered between March 11 and May 30, 2020, were recorded. RESULTS A total of 14, 625 patients (median age:42, IQR:26 years; female 57.4%) with normal weight (34.7%), overweight (35.6%), and obesity (29.7%) were included. Hospitalization, ICU admission, intubation/mechanical ventilation, pulmonary involvement, and mortality were significantly higher in patients who were overweight or obese. In adjusted analyses, both overweight (OR, 95% CI: 1.82, 1.04-3.21; p=0.037) and obesity (OR, 95% CI: 2.69, 1.02-1.05; p<0.001) were associated with a higher intubation/mechanical ventilation rate but only obesity was associated with increased mortality (OR, 95% CI: 2.56, 1.40-4.67; p=0.002). Old age, male gender, chronic kidney disease, and high C reactive protein levels were independently associated with COVID-19 mortality in overweight or obese patients. CONCLUSIONS COVID-19 patients who were overweight or obese were more likely to have adverse outcomes but only obesity was a predictor of mortality. Such patients should receive urgent medical attention and active management, especially the elderly, men, and people with chronic kidney disease.
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Affiliation(s)
- Ibrahim Sahin
- Faculty of Medicine, Department of Endocrinology and Metabolism, Inonu University, Malatya, Turkey
| | - Cem Haymana
- Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Tevfik Demir
- Faculty of Medicine, Department of Endocrinology and Metabolism, Dokuz Eylul University, Izmir, Turkey
| | - Ibrahim Demirci
- Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
| | - Aysegul Atmaca
- Faculty of Medicine, Department of Endocrinology and Metabolism, Ondokuz Mayis University, Samsun, Turkey
| | - Erman Cakal
- Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey
| | - Rifat Emral
- Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara University, Ankara, Turkey
| | - Ugur Unluturk
- Faculty of Medicine, Department of Endocrinology and Metabolism, Hacettepe University, Ankara, Turkey
| | - Derun Ertugrul
- Faculty of Medicine, Kecioren Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Serpil Salman
- Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Mustafa Sahin
- Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Selcuk Dagdelen
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | | | - Ilhan Satman
- Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey.,The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - Alper Sonmez
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
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16
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Haymana C, Demirci I, Tasci I, Cakal E, Salman S, Ertugrul D, Ata N, Unluturk U, Dagdelen S, Atmaca A, Sahin M, Celik O, Demir T, Emral R, Sahin I, Caglayan M, Satman I, Sonmez A. Clinical outcomes of non-diabetic COVID-19 patients with different blood glucose levels: a nationwide Turkish study (TurCoGlycemia). Endocrine 2021; 73:261-269. [PMID: 34156609 PMCID: PMC8218282 DOI: 10.1007/s12020-021-02789-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE New coronavirus disease 2019 (COVID-19) has a worse prognosis in patients with diabetes. However, there are insufficient data about the effect of hyperglycemia on COVID-19 prognosis in non-diabetic patients. This study aimed to investigate the relationship between random blood glucose levels measured at the time of diagnosis and prognosis of COVID-19 disease in non-diabetic patients. METHODS A nationwide retrospective cohort of non-diabetic patients with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. The patients were stratified into three groups according to blood glucose levels which were <100 mg/dL in group-1, in the range of 100-139 mg/dl in group-2, and the range of 140-199 mg/dl in group-3. Clinical characteristics and outcomes were compared among the groups. The primary outcome was mortality. RESULTS A total of 12,817 non-diabetic patients (median age [IQR]: 44 [25] years, females: 50.9%) were included. Patients in group-2 (5%) and group-3 (14%) had higher mortality rates than patients in group-1 (2.1%). The rates of hospitalization, hospital stays longer than 8 days, intensive care unit (ICU) admission, ICU stay more than 6 days, and mechanical ventilation were also significantly higher in group-3 patients. Likewise, glucose levels in the range of 140-199 mg/dL were an independent associate of mortality and composite of ICU admission and/or mechanical ventilation. CONCLUSION Hyperglycemia at the time of COVID-19 diagnosis is associated with poor prognosis in non-diabetic patients. Clinicians should be more careful in the treatment of non-diabetic COVID-19 patients with hyperglycemia.
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Affiliation(s)
- Cem Haymana
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Training and Research Hospital, Ankara, Turkey.
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, University of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Faculty of Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Aysegul Atmaca
- Department of Endocrinology and Metabolism, Samsun 19 Mayis University, Faculty of Medicine, Samsun, Turkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Ankara, Turkey
| | - Rifat Emral
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Malatya Inonu University, Faculty of Medicine, Malatya, Turkey
| | | | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, Faculty of Medicine, Istanbul, Turkey
- Turkish Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Ankara, Turkey
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17
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Sonmez A, Demirci I, Haymana C, Tasci I, Dagdelen S, Salman S, Ata N, Sahin I, Emral R, Cakal E, Atmaca A, Sahin M, Celik O, Demir T, Ertugrul D, Unluturk U, Caglayan M, Satman I. Clinical characteristics and outcomes of COVID-19 in patients with type 2 diabetes in Turkey: A nationwide study (TurCoviDia). J Diabetes 2021; 13:585-595. [PMID: 33655669 PMCID: PMC8013711 DOI: 10.1111/1753-0407.13171] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has been reported to be associated with a more severe course in patients with type 2 diabetes mellitus (T2DM). However, severe adverse outcomes are not recorded in all patients. In this study, we assessed disease outcomes in patients with and without T2DM hospitalized for COVID-19. METHODS A nationwide retrospective cohort of patients with T2DM hospitalized with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. Multivariate modeling was used to assess the independent predictors of demographic and clinical characteristics with mortality, length of hospital stay, and intensive care unit (ICU) admission and/or mechanical ventilation. RESULTS A total of 18 426 inpatients (median age [interquartile range, IQR]: 61 [17] years; males: 43.3%) were investigated. Patients with T2DM (n = 9213) were compared with a group without diabetes (n = 9213) that were matched using the propensity scores for age and gender. Compared with the group without T2DM, 30-day mortality following hospitalization was higher in patients with T2DM (13.6% vs 8.7%; hazard ratio 1.75; 95% CI, 1.58-1.93; P < .001). The independent associates of mortality were older age, male gender, obesity, insulin treatment, low lymphocyte count, and pulmonary involvement on admission. Older age, low lymphocyte values, and pulmonary involvement at baseline were independently associated with longer hospital stay and/or ICU admission. CONCLUSIONS The current study from the Turkish national health care database showed that patients with T2DM hospitalized for COVID-19 are at increased risk of mortality, longer hospital stay, and ICU admission.
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Affiliation(s)
- Alper Sonmez
- Department of Endocrinology and MetabolismUniversity of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research HospitalAnkaraTurkey
| | - Ibrahim Demirci
- Department of Endocrinology and MetabolismUniversity of Health Sciences Turkey, Gulhane Training and Research HospitalAnkaraTurkey
| | - Cem Haymana
- Department of Endocrinology and MetabolismUniversity of Health Sciences Turkey, Gulhane Training and Research HospitalAnkaraTurkey
| | - Ilker Tasci
- Department of Internal MedicineUniversity of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research HospitalAnkaraTurkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Serpil Salman
- Department of Endocrinology and MetabolismMedica ClinicIstanbulTurkey
| | - Naim Ata
- Department of Strategy DevelopmentRepublic of Turkey, Ministry of HealthAnkaraTurkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Faculty of MedicineMalatya İnönü UniversityMalatyaTurkey
| | - Rifat Emral
- Department of Endocrinology and Metabolism, Faculty of MedicineAnkara UniversityAnkaraTurkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Faculty of MedicineUniversity of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey
| | - Aysegul Atmaca
- Department of Endocrinology and Metabolism, Faculty of MedicineSamsun 19 Mayis UniversitySamsunTurkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Faculty of MedicineAnkara UniversityAnkaraTurkey
| | - Osman Celik
- Public Hospitals General DirectorateRepublic of Turkey, Ministry of HealthAnkaraTurkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Faculty of MedicineDokuz Eylul UniversityAnkaraTurkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, Faculty of MedicineUniversity of Health Sciences Turkey, Kecioren Training and Research HospitalAnkaraTurkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | | | - Ilhan Satman
- Department of Endocrinology and Metabolism, Faculty of MedicineIstanbul UniversityIstanbulTurkey
- Turkish Institute of Public Health and Chronic DiseasesIstanbulTurkey
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Affiliation(s)
- Bağdagül Yüksel Güler
- Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Cem Haymana
- Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
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Sabuncu T, Sonmez A, Eren MA, Sahin I, Çorapçioğlu D, Üçler R, Akin Ş, Haymana C, Demirci İ, Atmaca A, Ersöz HÖ, Satman I, Bayram F. Characteristics of patients with hypertension in a population with type 2 diabetes mellitus. Results from the Turkish Nationwide SurvEy of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Hypertension Study). Prim Care Diabetes 2021; 15:332-339. [PMID: 33277201 DOI: 10.1016/j.pcd.2020.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/05/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND The present survey aimed to find out the demographical and clinical characteristics of patients with hypertension in a population with type 2 diabetes mellitus (T2DM) in Turkey. METHODS Patients with T2DM who were followed-up in tertiary endocrine units for at least last one year were recruited. Demographic, clinical and biochemical data of the patients were collected. Hypertension was defined as taking anti-hypertensive medications or having office arterial blood pressure (ABP) ≥140/90 mmHg or home ABP ≥ 130/80 mmHg. RESULTS A total of 4756 (58.9% women) diabetic patients were evaluated. The percentage of patients with hypertension was 67.5% (n = 3212). Although 87.4% (n = 2808) of hypertensive patients were under treatment, blood pressure was on target in 52.7% (n = 1479) of patients. Hypertension proportions were higher in woman (p = 0.001), older, more obese, and those who had longer diabetes duration, lower education levels, higher frequency of hypoglycemic events (all p < 0.001) and higher triglyceride levels (p = 0.003). LDL cholesterol level and the percentage of smokers were lower in hypertensive group than in non-hypertensive group (both p < 0.001). The percentage of macro and microvascular complications was higher in the hypertensive group than in the normotensive one (both p < 0.001). In multivariate logistic regression analysis, being a woman (OR: 1.26, 95% CI: 1.04-1.51, p = 0.016), smoking (OR: 1.38, 95% CI: 1.05-1.80, p = 0.020), regular physical activity (OR: 1.24, 95% CI: 1.01-1.53, p = 0.039) and the presence of macrovascular complications (OR: 1.38 95% CI: 1.15-1.65, p = 0.001) were the significant predictors of good ABP regulation. The ratios of masked and white coat hypertension were 41.2% and 5.7%, respectively. CONCLUSION Our findings indicate that two-thirds (67.5%) of adult patients with T2DM have hypertension. Co-existence of hypertension increases the frequency of macro and microvascular diabetic complications in these patients. Despite the critical role of hypertension in morbidity and mortality, only half of the patients have favorable ABP levels. Masked hypertension seems to be another important issue in this population.
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Affiliation(s)
- Tevfik Sabuncu
- Harran University, Faculty of Medicine, Department of Endocrinology and Metabolism, Sanliurfa, Turkey
| | - Alper Sonmez
- Health Sciences University, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Mehmet Ali Eren
- Harran University, Faculty of Medicine, Department of Endocrinology and Metabolism, Sanliurfa, Turkey.
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Endocrinology and Metabolism, Malatya, Turkey
| | - Demet Çorapçioğlu
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Rıfkı Üçler
- Van Yüzüncü Yıl University, Faculty of Medicine, Department of Endocrinology and Metabolism, Van, Turkey
| | - Şafak Akin
- Ankara Memorial Hospital, Ankara, Turkey
| | - Cem Haymana
- Health Sciences University, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - İbrahim Demirci
- Health Sciences University, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ayşegül Atmaca
- On Dokuz Mayıs University, Faculty of Medicine, Department of Endocrinology and Metabolism, Samsun, Turkey
| | - Halil Önder Ersöz
- Karadeniz Teknik University, Faculty of Medicine, Department of Endocrinology and Metabolism, Trabzon, Turkey
| | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Fahri Bayram
- Erciyes University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kayseri, Turkey
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Satman I, Demirci I, Haymana C, Tasci I, Salman S, Ata N, Dagdelen S, Sahin I, Emral R, Cakal E, Atmaca A, Sahin M, Celik O, Demir T, Ertugrul D, Unluturk U, Arga KY, Caglayan M, Sonmez A. Unexpectedly lower mortality rates in COVID-19 patients with and without type 2 diabetes in Istanbul. Diabetes Res Clin Pract 2021; 174:108753. [PMID: 33741352 PMCID: PMC7963521 DOI: 10.1016/j.diabres.2021.108753] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/18/2021] [Accepted: 03/08/2021] [Indexed: 01/08/2023]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) is a risk factor for severe COVID-19. Our aim was to compare the clinical outcomes of patients with and without T2DM during the first hit of COVID-19 in Istanbul. METHODS A retrospective population-based study was conducted including all consecutive adult symptomatic COVID-19 cases. Patients were confirmed with rt-PCR; treated and monitored in accordance with standard protocols. The primary endpoints were hospitalization and 30-day mortality. RESULTS Of the 93,571 patients, 22.6% had T2DM, with older age and higher BMI. Propensity Score matched evaluation resulted in significantly higher rates of hospitalization (1.5-fold), 30-day mortality (1.6-fold), and pneumonia (1.4-fold). They revealed more severe laboratory deviations, comorbidities, and frequent drug usage than the Non-DM group. In T2DM age, pneumonia, hypertension, obesity, and insulin-based therapies were associated with an increased likelihood of hospitalization; whereas age, male gender, lymphopenia, obesity, and insulin treatment were considerably associated with higher odds of death. CONCLUSIONS COVID-19 patients with T2DM had worse clinical outcomes with higher hospitalization and 30-day mortality rates than those without diabetes. Compared to most territories of the world, COVID-19 mortality was much lower in Istanbul, which may be associated with accessible healthcare provision and the younger structure of the population.
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Affiliation(s)
- Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey; The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey.
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey.
| | - Serpil Salman
- Medica Clinic, Endocrinology and Metabolism, Istanbul, Turkey.
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey.
| | - Selcuk Dagdelen
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Turkey.
| | - Rifat Emral
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Turkey.
| | - Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey.
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Kazim Yalcin Arga
- The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey; Marmara University, Faculty of Engineering, Department of Bioengineering, Istanbul, Turkey.
| | | | - Alper Sonmez
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey; University of Health Sciences, Gulhane Faculty of Medicine and Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
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Candemir B, Haymana C, Candemir M. Letter to the Editor from Candemir et al: "Prevalence and Incidence of Atrial Fibrillation in a Large Cohort of Adrenal Incidentalomas: A Long- Term Study". J Clin Endocrinol Metab 2021; 106:e1919. [PMID: 33480991 DOI: 10.1210/clinem/dgab031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Burcu Candemir
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Keçiören, Ankara, Turkey
| | - Cem Haymana
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Keçiören, Ankara, Turkey
| | - Mustafa Candemir
- Gazi University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
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Demirci I, Haymana C, Candemir B, Meric C, Yuksel B, Eser M, Akın O, Akın S, Ersoz Gulcelik N, Sonmez A. Triglyceride-glucose index levels in patients with congenital hypogonadotropic hypogonadism and the relationship with endothelial dysfunction and insulin resistance. Endokrynol Pol 2021; 72:232-237. [PMID: 33749808 DOI: 10.5603/ep.a2021.0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 01/27/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The risk of cardiometabolic diseases is increased in patients with hypogonadism. The triglyceride-glucose (TyG) index is a novel surrogate marker of insulin resistance and is associated with cardiovascular diseases. We investigated the TyG index levels and the relationship with endothelial dysfunction and insulin resistance in patients with congenital hypogonadotropic hypogonadism (CHH). MATERIAL AND METHODS A total of 98 patients with CHH (mean age 21.66 ± 1.99 years) and 98 healthy control subjects (mean age 21.69 ± 1.21 years) were enrolled. The demographic parameters, TyG index, asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (hs-CRP), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured for all participants. RESULTS The patients had higher waist circumference (p < 0.001), triglycerides (p = 0.001), insulin (p = 0.003), HOMA-IR (p = 0.002), ADMA (p < 0.001), and TyG index (p < 0.001) levels and lower HDL-C (p = 0.044) and total testosterone (p < 0.001) levels compared to healthy control subjects. TyG index levels significantly correlated with the ADMA (r = 0.31, p = 0.003) and HOMA-IR (r = 0.32, p < 0.001) levels. TyG index was also determinant of HOMA-IR levels (ß = 0.20, p = 0.018). CONCLUSION The results of the present study show that patients with CHH had increased TyG index levels. Also, the TyG index is independently associated with insulin resistance in patients with CHH. Long-term follow-up studies are warranted to find out the role of the TyG index in determining cardiometabolic risk in patients with hypogonadism.
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Affiliation(s)
- Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gülhane Training and Research Hospital, Ankara, Turkey.
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Burcu Candemir
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine, Health Sciences University, Ankara, Turkey
| | - Coskun Meric
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine, Health Sciences University, Ankara, Turkey
| | - Bagdagul Yuksel
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine, Health Sciences University, Ankara, Turkey
| | - Mithat Eser
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine, Health Sciences University, Ankara, Turkey
| | - Onur Akın
- Department of Paediatric Endocrinology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Safak Akın
- Department of Endocrinology and Metabolism, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Nese Ersoz Gulcelik
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine, Health Sciences University, Ankara, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine, Health Sciences University, Ankara, Turkey
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Haymana C, Sonmez A, Demirci I, Fidan Yaylalı G, Nuhoglu I, Sancak S, Yilmaz M, Altuntas Y, Dinccag N, Sabuncu T, Bayram F, Satman I. Patterns and preferences of antidiabetic drug use in Turkish patients with type 2 diabetes - A nationwide cross-sectional study (TEMD treatment study). Diabetes Res Clin Pract 2021; 171:108556. [PMID: 33242516 DOI: 10.1016/j.diabres.2020.108556] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 10/07/2020] [Accepted: 11/11/2020] [Indexed: 11/22/2022]
Abstract
AIMS The treatment preferences in type 2 diabetes (T2DM) are affected by multiple factors. This survey aims to find out the profiles of the utilization of antidiabetics and their determinants. METHODS The nationwide, multicenter TEMD survey consecutively enrolled patients with T2DM (n = 4678). Medications including oral antidiabetics (OAD) and injectable regimens were recorded. Multiple injectable regimens with or without OADs were defined as complex treatments. RESULTS A total of 4678 patients with T2DM (mean age: 58.5 ± 10.4 years, 59% female) were enrolled. More than half of patients (n = 2372; 50.7%) were using injectable regimens with or without OADs, and others (n = 2306, 49.3%) were using only OADs. The most common OADs were metformin (93.5%), secretagogues (40.1%), and DPP-4 inhibitors (37.2%). The rates of the use of basal, basal-bolus and premix insulin were 26.5%, 39.5% and 22.4%, respectively. Patients using OADs achieved better glycemia, blood pressure and weight control (p < 0.001 for all) but poorer LDL-C control (p < 0.001). The independent associates of complex treatments were diabetes duration, obesity, eGFR, glycated haemoglobin, macro and microvascular complications, education level, and self-reported hypoglycemia. CONCLUSION This study is the first nationwide report to show that almost half of the patients with T2DM are using injectable regimens in Turkey.
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Affiliation(s)
- Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
| | - Alper Sonmez
- University of Health Sciences, Gulhane School of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Guzin Fidan Yaylalı
- Pamukkale University, School of Medicine, Department of Endocrinology and Metabolism, Denizli, Turkey
| | - Irfan Nuhoglu
- Karadeniz Technical University, School of Medicine, Department of Endocrinology and Metabolism, Trabzon, Turkey
| | - Seda Sancak
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Murat Yilmaz
- Çorlu REYAP Private Hospital, Department of Endocrinology and Metabolism, Tekirdag, Turkey
| | - Yuksel Altuntas
- University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Nevin Dinccag
- Istanbul University, School of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Tevfik Sabuncu
- Harran University, School of Medicine, Department of Endocrinology and Metabolism, Sanlıurfa, Turkey
| | - Fahri Bayram
- Erciyes University, School of Medicine, Department of Endocrinology and Metabolism, Kayseri, Turkey
| | - Ilhan Satman
- Istanbul University, School of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
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Bayram F, Sonmez A, Haymana C, Sabuncu T, Dizdar OS, Gurkan E, Carlioglu AK, Agbaht K, Ozdemir D, Demirci I, Barcin C, Salman S, Tetiker T, Balci MK, Kebapci N, Ersoy C, Yumuk V, Toth PP, Satman I. Utilization of statins and LDL-cholesterol target attainment in Turkish patients with type 2 diabetes - a nationwide cross-sectional study (TEMD dyslipidemia study). Lipids Health Dis 2020; 19:237. [PMID: 33176832 PMCID: PMC7659134 DOI: 10.1186/s12944-020-01408-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Attaining acceptable levels of LDL Cholesterol (LDL-C) significantly improves cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (T2DM). The LDL-C target attainment and the characteristics of patients attaining these targets were investigated in this study. Furthermore, the reasons for not choosing statins and the physicians' attitudes on the treatment of diabetic dyslipidemia were also examined. METHODS A nationwide, cross-sectional survey was conducted in tertiary centers for diabetes management. Adult patients with T2DM, who were under follow-up for at least a year in outpatient clinics, were consecutively enrolled for the study. LDL-C goals were defined as below 70 mg/dL for patients with macrovascular complications or diabetic nephropathy, and below 100 mg/dL for other patients. Data about lipid-lowering medications were self-reported. RESULTS A total of 4504 patients (female: 58.6%) were enrolled for the study. The mean HbA1c and diabetes duration was 7.73 ± 1.74% and 10.9 ± 7.5 years, respectively. The need for statin treatment was 94.9% (n = 4262); however, only 42.4% (n = 1807) of these patients were under treatment, and only 24.8% (n = 448) of these patients achieved LDL-C targets. The main reason for statin discontinuation was negative media coverage (87.5%), while only a minority of patients (12.5%) mentioned side effects. Physicians initiated lipid-lowering therapy in only 20.3% of patients with high LDL-C levels. It was observed that the female gender was a significant independent predictor of not attaining LDL-C goals (OR: 0.70, 95% CI: 0.59-0.83). CONCLUSIONS Less than 50 % of patients with T2DM who need statins were under treatment, and only a quarter of them attained their LDL-C targets. There exists a significant gap between the guideline recommendations and the real-world evidence in the treatment of dyslipidemia in T2DM.
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Affiliation(s)
- Fahri Bayram
- Department of Endocrinology and Metabolism, Erciyes University, School of Medicine, Kayseri, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, Harran University, School of Medicine, Sanliurfa, Turkey
| | - Oguzhan Sitki Dizdar
- Department of Endocrinology and Metabolism, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Eren Gurkan
- Department of Endocrinology and Metabolism, Mustafa Kemal University, School of Medicine, Hatay, Turkey
| | - Ayse Kargili Carlioglu
- Department of Endocrinology and Metabolism, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Kemal Agbaht
- Department of Endocrinology and Metabolism, Private Defne Hospital, Hatay, Turkey
| | - Didem Ozdemir
- Department of Endocrinology and Metabolism, Yildirim Beyazit University, School of Medicine, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Cem Barcin
- Department of Cardiology, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Private Liv Hospital, Istanbul, Turkey
| | - Tamer Tetiker
- Department of Endocrinology and Metabolism, Cukurova University, School of Medicine, Adana, Turkey
| | - Mustafa Kemal Balci
- Department of Endocrinology and Metabolism, Akdeniz University, School of Medicine, Antalya, Turkey
| | - Nur Kebapci
- Department of Endocrinology and Metabolism, Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Canan Ersoy
- Department of Endocrinology and Metabolism, Uludag University, School of Medicine, Bursa, Turkey
| | - Volkan Yumuk
- Department of Endocrinology and Metabolism, Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Peter P Toth
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
| | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, School of Medicine, Istanbul, Turkey
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Sonmez A, Tasci I, Demirci I, Haymana C, Barcin C, Aydin H, Cetinkalp S, Ozturk FY, Gul K, Sabuncu T, Satman I, Bayram F. A Cross-Sectional Study of Overtreatment and Deintensification of Antidiabetic and Antihypertensive Medications in Diabetes Mellitus: The TEMD Overtreatment Study. Diabetes Ther 2020; 11:1045-1059. [PMID: 32088879 PMCID: PMC7193034 DOI: 10.1007/s13300-020-00779-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Targeting better glycated hemoglobin (HbA1c) and blood pressure (BP) goals may endanger older adults with type 2 diabetes mellitus (T2DM). Overtreatment of T2DM and hypertension is a trending issue, although undertreatment is still common. We investigated the rates and predictors of overtreatment and undertreatment of glycemia and BP in older adults with T2DM and physicians' attitudes to deintensify or intensify treatment. METHODS Data from older adults (≥ 65 years) enrolled in a large nationwide T2DM survey in 2017 across Turkey were analyzed. Overtreatment of glycemia was defined as HbA1c < 6.5% plus the use of ≥ 2 oral antihyperglycemics or insulin, and BP overtreatment was defined as systolic BP (SBP) < 120 mmHg or diastolic BP (DBP) < 65 mmHg plus the use of ≥ 2 drugs. Undertreatment of glycemia was defined as HbA1c > 9%, and BP undertreatment was defined as SBP > 150 mmHg or DBP > 90 mmHg. Deintensification or intensification rates were calculated according to treatment modification initiated by the treating physician(s). RESULTS The rate of overtreatment in the glycemia group (n = 1264) was 9.8% (n = 124) and that in the BP group (n = 1052) was 7.3% (n = 77), whereas the rate of undertreatment was 14.2% (n = 180) and 15.2% (n = 160), respectively. In the adjusted model, use of oral secretagogues (sulfonylureas or glinides) (odds ratio [OR] 1.94, 95% confidence interval [CI] 1.2-3.1) and follow-up at a private clinic (OR 1.81, 95% CI 1.0-3.3) were predictors of glycemia overtreatment. BP overtreatment was independently associated with the use insulin-based diabetes therapies (OR 1.86, 95% CI 1.14-3.04). There was no independent association of BP undertreatment to the study confounders. The deintensification and intensification rates were 25 and 75.6%, respectively, for glycemia and 10.9 and 9.2%, respectively, for BP. CONCLUSIONS The results show that one in ten older adults with T2DM are overtreated while one in four require modification of their current antihyperglycemic and antihypertensive treatments. Physicians are eager to intensify medications while they largely ignore deintensification in diabetes management. These results warrant enforced measures to improve the care of older adults with T2DM. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT03455101.
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Affiliation(s)
- Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey.
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Cem Barcin
- Department of Cardiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Hasan Aydin
- Department of Endocrinology and Metabolism, School of Medicine, Yeditepe University, Istanbul, Turkey
| | - Sevki Cetinkalp
- Department of Endocrinology and Metabolism, School of Medicine, Ege University, Izmir, Turkey
| | - Feyza Yener Ozturk
- Department of Endocrinology and Metabolism, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kamile Gul
- Department of Endocrinology and Metabolism, School of Medicine, Sutcu Imam University, Kahramanmaras, Turkey
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, School of Medicine, Harran University, Sanliurfa, Turkey
| | - Ilhan Satman
- Department of Endocrinology and Metabolism, School of Medicine, Istanbul University, Istanbul, Turkey
| | - Fahri Bayram
- Department of Endocrinology and Metabolism, School of Medicine, Erciyes University, Kayseri, Turkey
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Sonmez A, Yumuk V, Haymana C, Demirci I, Barcin C, Kıyıcı S, Güldiken S, Örük G, Ozgen Saydam B, Baldane S, Kutlutürk F, Küçükler FK, Deyneli O, Çetinarslan B, Sabuncu T, Bayram F, Satman I. Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study). Obes Facts 2019; 12:167-178. [PMID: 30893706 PMCID: PMC6547285 DOI: 10.1159/000496624] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 01/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro- and microvascular complications of patients are not apparent. OBJECTIVES This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. METHODS We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. RESULTS Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. CONCLUSION The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity.
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Affiliation(s)
- Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey,
| | - Volkan Yumuk
- Department of Endocrinology and Metabolism, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Cem Barcin
- Department of Cardiology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey
| | - Sinem Kıyıcı
- Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Sibel Güldiken
- Department of Endocrinology and Metabolism, Medical Faculty, Trakya University, Edirne, Turkey
| | - Gonca Örük
- Department of Endocrinology and Metabolism, Atatürk Education and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey
| | - Basak Ozgen Saydam
- Department of Endocrinology and Metabolism, Medical Faculty, Dokuz Eylül University, Izmir, Turkey
| | - Süleyman Baldane
- Department of Endocrinology and Metabolism, Medical Faculty, Selçuk University, Konya, Turkey
| | - Faruk Kutlutürk
- Department of Endocrinology and Metabolism, Medical Faculty, Gaziosmanpaşa University, Tokat, Turkey
| | - Ferit Kerim Küçükler
- Department of Endocrinology and Metabolism, Medical Faculty, Hitit University, Corum, Turkey
| | - Oğuzhan Deyneli
- Department of Endocrinology and Metabolism, Medical Faculty, Marmara University, Istanbul, Turkey
| | - Berrin Çetinarslan
- Department of Endocrinology and Metabolism, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Tevfik Sabuncu
- Department of Endocrinology and Metabolism, Medical Faculty, Harran University, Urfa, Turkey
| | - Fahri Bayram
- Department of Endocrinology and Metabolism, Medical Faculty, Erciyes University, Kayseri, Turkey
| | - Ilhan Satman
- Department of Endocrinology and Metabolism, Medical Faculty, Istanbul University, Istanbul, Turkey
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Sonmez A, Haymana C, Bayram F, Salman S, Dizdar OS, Gurkan E, Kargili Carlıoglu A, Barcin C, Sabuncu T, Satman I. Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study). Diabetes Res Clin Pract 2018; 146:138-147. [PMID: 30244051 DOI: 10.1016/j.diabres.2018.09.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 09/04/2018] [Accepted: 09/13/2018] [Indexed: 12/12/2022]
Abstract
AIMS Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. METHODS A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c < 7%, home arterial blood pressure (ABP) < 135/85 mmHg, or LDL-C < 100 mg/dL. Achieving all parameters indicated triple metabolic control. RESULTS HbA1c levels of patients (n = 5211) were 8.6 ± 1.9% (71 ± 22 mmol/mol) and 7.7 ± 1.7% (61 ± 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, non-smoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. CONCLUSIONS Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease.
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Affiliation(s)
- Alper Sonmez
- Health Sciences University, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Cem Haymana
- Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
| | - Fahri Bayram
- Erciyes University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kayseri, Turkey
| | - Serpil Salman
- Istinye University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Oguzhan Sitki Dizdar
- Kayseri Training and Research Hospital, Department of Endocrinology and Metabolism, Kayseri, Turkey
| | - Eren Gurkan
- Mustafa Kemal University, Faculty of Medicine, Department of Endocrinology and Metabolism, Hatay, Turkey
| | - Ayse Kargili Carlıoglu
- Erzurum Training and Research Hospital, Department of Endocrinology and Metabolism, Erzurum, Turkey
| | - Cem Barcin
- Health Sciences University, Gulhane Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Tevfik Sabuncu
- Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Istanbul, Turkey
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Abstract
A 44-year-old male patient was admitted to the otolaryngology department with a history of progressive snoring, excessive daytime sleepiness, and reduced libido for the last 6 months. Polysomnography demonstrated the presence of moderate obstructive sleep apnea (OSA) with an apnea-hypopnea index (AHI) of 24.6 events/h, consisting of 77 obstructive and 59 central apneas. The marked number of central apneas in the sleep study and urologic complaints prompted the performance of brain magnetic resonance imaging (MRI), which indicated a pituitary macroadenoma (prolactinoma). Three months after treatment with cabergoline, a control MRI showed a significant reduction in the size of the macroadenoma. The AHI was also significantly decreased (to 11.6 events/h), as were the numbers of obstructive and central apneas. The patient's complaints regarding libido were also regressed. During this treatment period, CPAP therapy has not been tolerated by the patient. Cabergoline treatment reduced the severity of both obstructive and central sleep apneas in this patient.
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Affiliation(s)
- M Binar
- Department of Otolaryngology, Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey
| | - O Karakoc
- Department of Otolaryngology, Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey
| | - C Haymana
- Department of Endocrinology, Gulhane Medical School, Ankara, Turkey
| | - H Arslan
- Department of Otolaryngology, Head and Neck Surgery, Gulhane Medical School, Ankara, Turkey
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Bayram F, Sonmez A, Haymana C, Sabuncu T, Dizdar O, Gurkan E, Kargili carlioglu A, Agbaht K, Özdemir D, Kucuk bicer B, Barcin C, Salman S, Tetiker T, Balci M, Kebapci N, Ersoy C, Yumuk V, Satman I, Temd study group. Blood lipids, diabetic complications and the physician attitudes on dyslipidemia treatment; data from the Turkish nationwide survey of glycemic and other metabolic parameters of patients with diabetes. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Haymana C, Berlik H, Güneş Y, Tunçez OE, Aytekin C, Tapıkara Z, Güzel H, Öztürk Ö, Barçın C, Özgürtaş T, Azal Ö, Sönmez A. Identifying undiagnosed or undertreated patients with familial hypercholesterolemia from the laboratory records of a tertiary medical center. Turk Kardiyol Dern Ars 2018; 45:731-738. [PMID: 29226894 DOI: 10.5543/tkda.2017.63846] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Familial hypercholesterolemia (FH) is a life-threatening genetic disease associated with elevated low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease that is undiagnosed and undertreated around the world. This study aimed to examine the demographic characteristics, awareness, and treatment adherence of undiagnosed or undertreated FH patients based on laboratory records. METHODS In a 16-month retrospective survey using laboratory records, patients with elevated LDL-C (>250 mg/dL) were identified (n=395). Patients younger than 18 years of age or with secondary causes of dyslipidemia were excluded (n=98). In all, 297 patients were called and asked to participate in a phone interview regarding their demographic characteristics, awareness of dyslipidemia, and treatment adherence. RESULTS A total of 147 patients (mean age: 51.7±16.6 years; 59.2% female) completed the interview. The mean LDL-C level of the patients was 292.8±49.9 mg/dL. According to the Dutch Lipid Clinic Network criteria, 18.4% of the patients had definite FH, 66.0% had probable FH, and 15.6% had possible FH. Although the majority of the patients (93.9%) were aware of their high LDL-C level, only about half of them (n=75; 51.0%) were in treatment. Of all the patients who were interviewed, 21% (n=31) had never taken medication to lower their LDL-C, and 28% (n=41) had stopped taking a lipid-lowering drug. CONCLUSION This pilot study revealed that a significant number of FH patients were not taking statins despite having a very high LDL-C level. Nationwide detection of likely FH patients using hospital records and interviewing them via a phone survey may help to better understand and manage these high-risk patients.
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Affiliation(s)
- Cem Haymana
- Department of Endocrinology and Metabolism, Gülhane Training and Research Hospital, Ankara, Turkey.
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Ince S, Emer O, Deveci S, Okuyucu K, Alagoz E, San H, Ayan A, Karacalioglu O, Haymana C, Gunalp B, Arslan N. Complementary role of parathormone washout test to 99m Tc-MIBI parathyroid scintigraphy and histopathologic analysis of cell types in parathyroid adenomas. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2018.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ince S, Emer O, Deveci S, Okuyucu K, Alagoz E, San H, Ayan A, Karacalioglu O, Haymana C, Gunalp B, Arslan N. Complementary role of parathormone washout test to 99mTc-MIBI parathyroid scintigraphy and histopathologic analysis of cell types in parathyroid adenomas. Rev Esp Med Nucl Imagen Mol 2018; 37:205-210. [PMID: 29730179 DOI: 10.1016/j.remn.2017.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 12/13/2017] [Accepted: 12/25/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Parathyroid scintigraphy (PS) can be negative or equivocal (N/E) in a considerable number of cases with highly suspicious clinical findings and biochemical results for parathyroid adenoma (PA). The aims of this study were to investigate the complementary role of parathormone washout test (PWT) to PS in patients with primary hyperparathyroidism (PHPT) and evaluate histopathologic aspects of PAs in comparison with PS results. MATERIAL AND METHODS Thirty-eight patients with PHPT referred for PS were included in the study. Seventeen patients had both scintigraphic and ultrasonographic findings concordant with PA (Group A). Twenty-one patients having N/E PS, but suspected lesions for PA on ultrasonography (US) formed Group B. PWT was performed for all patients and they underwent the surgical intervention. An adenoma was removed in all patients and the histopathologic cell characteristics were established. RESULTS The tumor size on US was larger in those patients whose adenomas were seen on the PS (P<.001). The percentages of chief (or principal), oxyphilic and clear cells in PAs were not statistically different between the groups. Serum parathormone level and PWT were not statistically significant between Group A and Group B (P=.095 and P=.04, respectively). CONCLUSION Although there is not a definitive threshold value, the sensitivity of PS increases with lesion size. While chief cell and oxyphilic cell content of PAs tend to deplete in N/E PS, clear cell rate increases substantially. Combining PS with both US and PWT increases the sensitivity of detection and localization of PAs.
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Affiliation(s)
- Semra Ince
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía.
| | - Ozdes Emer
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
| | - Salih Deveci
- Department of Pathology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
| | - Kursat Okuyucu
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
| | - Engin Alagoz
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
| | - Huseyin San
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
| | - Aslı Ayan
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
| | - Ozgur Karacalioglu
- Department of Pathology, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Bengul Gunalp
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
| | - Nuri Arslan
- Department of Nuclear Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turquía
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Haymana C, Aydogdu A, Demirci I, Dinc M, Demir O, Torun D, Yesildal F, Meric C, Basaran Y, Sonmez A, Azal O. Increased Endothelial Dysfunction and Insulin Resistance in Patients with Klinefelter Syndrome. Endocr Metab Immune Disord Drug Targets 2018; 18:401-406. [PMID: 29468986 DOI: 10.2174/1871530318666180220114322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 12/16/2017] [Accepted: 01/25/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Patients with Klinefelter Syndrome (KS) have increased cardiometabolic risk however the pathogenesis is not clear. We investigated the presence of endothelial dysfunction, insulin resistance and inflammation in an unconfounded population of KS. METHODS A total of 32 patients with KS (mean age 21.59 ± 1.66 years) and 33 healthy control subjects (mean age: 22.15 ± 1.03 years) were enrolled. The demographic parameters, Asymmetric dimethylarginine (ADMA), homeostatic model assessment of insulin resistance (HOMA-IR) index and highsensitivity C-reactive protein (hs-CRP) levels were measured. RESULTS The patients had higher Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), insulin, HOMA-IR and ADMA levels (p < 0.001 for all) and lower High Density Lipoprotein Cholesterol (HDL-C) and total testosterone levels (p=0.002 and p<0.001, respectively), compared to the healthy controls. Total testosterone levels were significantly negatively correlated to ADMA (r = - 0.479, p < 0,001), hs-CRP (r = -0.291, p = 0.034) and positively correlated to HDL-C (r = 0.429, p = 0.001) levels. The multivariate analysis has shown that total testosterone (β = -0.412, p = 0.001) and TG (β = 0.332, p = 0.009) levels were the significant independent determinants of the plasma ADMA levels. CONCLUSION The results of the present study show that endothelial dysfunction and insulin resistance are prevalent even in the very young subjects with KS, who have no metabolic or cardiac problems at present. Also, hypogonadism seems to play an important role for increased cardiometabolic risk in patients with KS.
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Affiliation(s)
- Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
| | - Aydogan Aydogdu
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
| | - Mustafa Dinc
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
| | - Orhan Demir
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
| | - Deniz Torun
- Department of Medical Genetics, Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fatih Yesildal
- Department of Biochemistry, Selahattin Eyyubi Public Hospital, Diyarbakır, Turkey
| | - Coskun Meric
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
| | - Yalcin Basaran
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
| | - Omer Azal
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital - 06010, Etlik, Ankara, Turkey
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Akın O, Arslan M, Haymana C, Karabulut E, Hacihamdioglu B, Yavuz ST. Association of neck circumference and pulmonary function in children. Ann Allergy Asthma Immunol 2017; 119:27-30. [PMID: 28527867 DOI: 10.1016/j.anai.2017.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/06/2017] [Accepted: 04/24/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Childhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity. OBJECTIVE To investigate the correlation between anthropometric indices and pulmonary function test results in children without asthma. METHODS Children without any respiratory disorders were enrolled in this study. Anthropometric measurements, such as height, weight, neck circumference (NC), and waist circumference, were obtained from the enrollees and body mass index was calculated. Afterward, pulmonary function tests were performed using spirometry. RESULTS A total of 178 children (106 boys, 59.5%) with a mean age of 9.7 years were included the study. NC was above the 90th percentile in 65 children. Importantly, pulmonary parameters, such as forced expiratory volume during the first second (FEV1) and the ratio of FEV1 to forced vital capacity (FVC), were lower in subjects with a large NC. Similarly, waist circumference was above the 90th percentile in 67 children, and FEV1/FVC was significantly lower in children with a large waist circumference. Moreover, there was a statistically significant negative correlation among FEV1, FEV1/FVC, and body mass index SD score. Also, multivariable linear regression analysis showed that an NC above the 90th percentile was associated with lower FEV1 and FEV1/FVC values. CONCLUSION We identified NC as a novel anthropometric index that is strongly correlated with respiratory functions in children. Therefore, close monitoring of respiratory symptoms, particularly in children with obesity and a large NC, could help with early and prompt determination of respiratory complications of obesity.
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Affiliation(s)
- Onur Akın
- Department of Pediatric Endocrinology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Mutluay Arslan
- Department of Pediatrics, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology, Gülhane Education and Research Hospital, Ankara, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Bulent Hacihamdioglu
- Department of Pediatric Endocrinology, GATA Military School of Medicine, Ankara, Turkey
| | - Suleyman Tolga Yavuz
- Department of Pediatric Allergy, GATA Military School of Medicine, Ankara, Turkey; Department of Pediatric Allergy, Children's Hospital, University of Bonn, Bonn, Germany.
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Haymana C, Aydoğdu A, Soykut B, Erdem O, Ibrahimov T, Dinc M, Meric C, Basaran Y, Sonmez A, Azal O. Oxidative stress status in congenital hypogonadism: an appraisal. Toxicol Mech Methods 2017; 27:451-457. [DOI: 10.1080/15376516.2017.1320693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- C. Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
| | - A. Aydoğdu
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
| | - B. Soykut
- Department of Pharmaceutical Toxicology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - O. Erdem
- Department of Pharmaceutical Toxicology, Gulhane Training and Research Hospital, Ankara, Turkey
| | - T. Ibrahimov
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
| | - M. Dinc
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
| | - C. Meric
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Y. Basaran
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
| | - A. Sonmez
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
| | - O. Azal
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
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Haymana C, Sonmez A, Aydogdu A, Tapan S, Basaran Y, Meric C, Baskoy K, Taslipinar A, Yilmaz MI, Azal O. Effect of testosterone replacement therapy on vitamin D and FGF-23 levels in congenital hypogonadism. Endokrynol Pol 2017; 68:311-616. [PMID: 28230890 DOI: 10.5603/ep.a2017.0009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 05/06/2016] [Accepted: 06/04/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Patients with hypogonadism are at increased risk of cardiac and metabolic diseases and osteoporosis. Vitamin D and Fibroblast growth factor-23 (FGF-23) play role in the regulation of bone mineral metabolism and endothelial functions. Low vitamin D levels are reported in hypogonadism, while there is no data about the effect of testosterone replacement therapy (TRT). We investigated the effect of TRT on vitamin D and FGF-23 levels along with endothelial functions and insulin resistance in hypogonadal patients. MATERIAL AND METHODS Patients with congenital hypogonadotrophic hypogonadism (CHH) (n=32, age 20.6 ±1.58 years) were enrolled. TRT was implemented in transdermal form. The demographic parameters, FGF-23, 25(OH)D3, Asymmetric dimethylarginine (ADMA) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured both before and after TRT. RESULTS After a follow-up period of 3.63±1.33 months, ADMA and FGF-23 levels were significantly increased (p=0.03 and p=0.005 respectively), while the 25(OH)D3 and HOMA-IR index were not significantly changed. The body mass index and waist circumference levels of the patients were also increased (p<0.001 and p=0.02) along with a significant decrease in the HDL cholesterol levels (p=0.006). CONCLUSIONS The results show that a short term TRT increases plasma FGF-23 and ADMA levels, in young, treatment naive patients with CHH. Whether this is an early implication of TRT related adverse effects in this very young and treatment naïve population of CHH is not clear. Future prospective studies are required to find out the long-term effects of TRT on cardio-metabolic morbidity and mortality in this specific population.
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Affiliation(s)
- Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018 Etlik Ankara, Turkey.
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Sönmez A, Dinç M, Taşlıpınar A, Aydoğdu A, Meriç C, Başaran Y, Haymana C, Demir O, Yılmaz İ, Azal Ö. Add on Exenatide Treatment is Beneficial in Poorly Controlled Obese Type 2 Diabetics under Intensive Insulin Regimens. Exp Clin Endocrinol Diabetes 2017; 125:256-261. [DOI: 10.1055/s-0042-120708] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alper Sönmez
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
| | - Mustafa Dinç
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
| | - Abdullah Taşlıpınar
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
| | - Aydogan Aydoğdu
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
| | - Coskun Meriç
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
| | - Yalcin Başaran
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
| | - Cem Haymana
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
| | - Orhan Demir
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
| | - İlker Yılmaz
- Gulhane Military Medical Academy, Department of Nephrology, School of Medicine, Ankara/TURKEY
| | - Ömer Azal
- Gulhane Military Medical Academy, Department of Endocrinology and Metabolism, School of Medicine, Ankara/TURKEY
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Haymana C, Sonmez A, Aydogdu A, Tapan S, Basaran Y, Meric C, Baskoy K, Dinc M, Yazici M, Taslipinar A, Barcin C, Yilmaz MI, Bolu E, Azal O. Visceral adiposity index and triglyceride/high-density lipoprotein cholesterol ratio in hypogonadism. Arch Endocrinol Metab 2017; 61:282-287. [PMID: 28225990 PMCID: PMC10118811 DOI: 10.1590/2359-3997000000236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 10/10/2016] [Indexed: 11/21/2022]
Abstract
Background Cardiometabolic risk is high in patients with hypogonadism. Visceral adiposity index (VAI) and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio are the practical markers of atherosclerosis and insulin resistance and independent predictors of cardiaovascular risk. To date, no study has evaluated VAI levels and TG/HDL-C ratio in hypogonadism. Subjects and methods A total of 112 patients with congenital hypogonadotrophic hypogonadism (CHH) (mean age, 21.7 ± 2.06 years) and 124 healthy subjects (mean age, 21.5 ± 1.27 years) were enrolled. The demographic parameters, VAI, TG/HDL-C ratio, asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (hs-CRP), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured for all participants. Results The patients had higher total cholesterol (p = 0.04), waist circumference, triglycerides, insulin, and HOMA-IR levels (p = 0.001 for all) than the healthy subjects. VAI and ADMA and TG/HDL-C levels were also higher in patients than in healthy subjects (p < 0.001 for all). VAI was weakly correlated with ADMA (r = 0.27, p = 0.015), HOMA-IR (r = 0.22, p = 0.006), hs-CRP (r = 0.19, p = 0.04), and total testosterone (r = -0.21, p = 0.009) levels, whereas TG/HDL-C ratio was weakly correlated weakly with ADMA (r = 0.30, p = 0.003), HOMA-IR (r = 0.22, p = 0.006), and total testosterone (r = -0.16, p = 0.03) levels. Neither VAI nor TG/HDL-C ratio determined ADMA, HOMA-IR, and hs-CRP levels. Conclusions The results of this study demonstrate that patients with hypogonadism have elevated VAI and TG/HDL-C ratio. These values are significantly correlated with the surrogate markers of endothelial dysfunction, inflammation, and insulin resistance. However, the predictive roles of VAI and TG/HDL-C ratio are not significant. Prospective follow-up studies are warranted to clarify the role of VAI and TG/HDL-C ratio in predicting cardiometabolic risk in patients with hypogonadism.
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Affiliation(s)
- Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Aydogan Aydogdu
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Serkan Tapan
- Department of Biochemistry, Gulhane School of Medicine, Ankara, Turkey
| | - Yalcin Basaran
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Coskun Meric
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Kamil Baskoy
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Mustafa Dinc
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Mahmut Yazici
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Abdullah Taslipinar
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Cem Barcin
- Department of Cardiology, Gulhane School of Medicine, Ankara, Turkey
| | | | - Erol Bolu
- Department of Endocrinology and Metabolism, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Omer Azal
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
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Safer U, Haymana C, Safer VB. Comment on: Preoperative Sarcopenia Strongly Influences the Risk of Postoperative Pancreatic Fistula Formation After Pancreaticoduodenectomy. J Gastrointest Surg 2017; 21:422-423. [PMID: 27738879 DOI: 10.1007/s11605-016-3293-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 09/27/2016] [Indexed: 01/31/2023]
Affiliation(s)
- Umut Safer
- Department of Internal Medicine, Gulhane School of Medicine Haydarpasa Training Hospital, 34688, Istanbul, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Vildan Binay Safer
- Department of Physical Medicine and Rehabilitation, Haydarpasa Numune Training and Research Hospital, 34688, Istanbul, Turkey
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Okuyucu K, Ince S, Alagoz E, Emer O, San H, Balkan E, Ayan A, Meric C, Haymana C, Acıkel C, Gunalp B, Karacalioglu AO, Arslan N. Risk factors and stratification for recurrence of patients with differentiated thyroid cancer, elevated thyroglobulin and negative I-131 whole-body scan, by restaging 18F-FDG PET/CT. Hell J Nucl Med 2016; 19:208-217. [PMID: 27824959 DOI: 10.1967/s002449910402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 09/06/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE In nearly 20%-30% of patients with differentiated thyroid carcinoma (DTC) relapse and 7% of them die during the next 10 years after initial diagnosis. In 10%-30% of patients with DTC after ablation therapy during the follow-up show a negative iodine-131 (131I) whole-body screening test (131I WBS) and increased serum thyroglobulin (Tg) level. Loss of ability of DTC metastatic lesions to trap 131I is associated with pure survival and often aggressive disease. Several studies have shown that in DTC cases non trapping 131I, fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) can detect recurrence or metastases with high sensitivity (80%-90%). The purpose of this study was to investigate the clinicopathologic features and other related risk factors of patients with DTC having elevated Tg levels and negative 131I WBS in which recurrence was detected by 18F-FDG PET/CT. We tried to study and stratify patients in this grey zone who could benefit from 18F-FDG PET/CT for the detection of metastases/recurrence according to predefined risk factors not investigated by other researchers. SUBJECTS AND METHODS We studied retrospectively 165 DTC patients with elevated Tg levels and a negative 131I WBS during their follow-up between 2004-2015. Metastases/recurrence was found in 49% of the patients on restaging with 18F-FDG PET/CT and were compared with nonmetastatic group according to predefined risk factors. These factors were also evaluated in true positive and false negative cases. RESULTS The sensitivity and specificity of 18F-FDG PET/CT for detecting recurrent/metastatic disease were 90% and 98.5%, respectively. No apparent predefined risk factor impacting a false negative 18F-FDG PET/CT was found. Findings in follicular carcinoma, Hürtle cell carcinoma and papillary carcinoma were not different from positive PET findings. The variants of papillary carcinoma also had no statistically difference with regard to 18F-FDG results. CONCLUSION The most important factors affecting a true positive 18F-FDG PET/CT study were: ETE, high total 131I dose and the SUVmax values over 4.5.
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Affiliation(s)
- Kursat Okuyucu
- Department of Nuclear Medicine, Gulhane Military Medical Academy and Medical Faculty, 06018, Ankara, Turkey.
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Aydogdu A, Haymana C, Soykut B, Erdem O, Basaran Y, Baskoy K, Dinc M, Taslipinar A, Sonmez A, Bolu E, Azal O. Erratum to: Trace Element Levels in Congenital Hypogonadotrophic Hypogonadism. Biol Trace Elem Res 2016; 171:33. [PMID: 26494238 DOI: 10.1007/s12011-015-0539-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A Aydogdu
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - C Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - B Soykut
- Department of Pharmaceutical Toxicology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - O Erdem
- Department of Pharmaceutical Toxicology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - Y Basaran
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - K Baskoy
- Department of Endocrinology and Metabolism, Haydarpasa Training Hospital, 34668, Istanbul, Turkey
| | - M Dinc
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - A Taslipinar
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - A Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - E Bolu
- Department of Endocrinology and Metabolism, Memorial Atasehir Hospital, 34750, Atasehir, Istanbul, Turkey
| | - O Azal
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
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Aydogdu A, Haymana C, Soykut B, Erdem O, Basaran Y, Baskoy K, Dinc M, Taslipinar A, Sonmez A, Bolu E, Azal O. Trace Element Levels in Congenital Hypogonadotrophic Hypogonadism. Biol Trace Elem Res 2016; 171:26-32. [PMID: 26343359 DOI: 10.1007/s12011-015-0496-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/27/2015] [Indexed: 11/26/2022]
Abstract
Cardiometabolic diseases are prevalent in hypogonadism. The pathophysiologic mechanism of increased cardiometabolic risk in hypogonadal patients is not clear. Recently, trace elements have been linked to the development of chronic disease especially cardiovascular disease. We investigated the trace element levels in an unconfounded population of congenital hypogonadotrophic hypogonadism (CHH) and also searched for the relationship with metabolic risk factors. A total of 89 patients with CHH (mean age 21.8 ± 2.0 years) and 80 healthy control subjects (mean age 21.3 ± 1.1 years) were enrolled. The demographic parameters, homeostatic model assessment of insulin resistance (HOMA-IR) levels and plasma zinc, copper, and selenium levels, were measured in patients and healthy controls. The patients had higher waist circumferences (p = 0.014), triglyceride (p = 0.04), insulin (p = 0.004), HOMA-IR levels (p = 0.001), and lower selenium (p = 0.049), zinc (p = 0.004), and copper (p = 0.012) levels when compared to the healthy controls. There was a significant relationship between zinc levels and HOMA-IR levels (p = 0.015). In the regression analysis, zinc levels were independently associated with the calculated HOMA-IR levels (p = 0.015). The results of the present study show that plasma selenium, zinc, and copper levels are decreased in patients with CHH. Also, plasma zinc levels are independently associated with insulin resistance in patients with hypogonadism. Long-term follow-up studies are warranted to investigate the effect of trace elements on the increased cardiometabolic risk in hypogonadism.
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Affiliation(s)
- A Aydogdu
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - C Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - B Soykut
- Department of Pharmaceutical Toxicology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - O Erdem
- Department of Pharmaceutical Toxicology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - Y Basaran
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - K Baskoy
- Department of Endocrinology and Metabolism, Haydarpasa Training Hospital, 34668, Istanbul, Turkey
| | - M Dinc
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - A Taslipinar
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - A Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
| | - E Bolu
- Department of Endocrinology and Metabolism, Memorial Atasehir Hospital, 34750, Atasehir, Istanbul, Turkey
| | - O Azal
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey
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Sonmez A, Yilmaz MI, Saglam M, Unal HU, Gok M, Cetinkaya H, Karaman M, Haymana C, Eyileten T, Oguz Y, Vural A, Rizzo M, Toth PP. The role of plasma triglyceride/high-density lipoprotein cholesterol ratio to predict cardiovascular outcomes in chronic kidney disease. Lipids Health Dis 2015; 14:29. [PMID: 25885289 PMCID: PMC4407467 DOI: 10.1186/s12944-015-0031-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 04/01/2015] [Indexed: 01/22/2023] Open
Abstract
Background Cardiovascular disease (CVD) risk is substantially increased in subjects with chronic kidney disease (CKD). The Triglycerides (TG) to High-Density Lipoprotein Cholesterol (HDL-C) ratio is an indirect measure of insulin resistance and an independent predictor of cardiovascular risk. No study to date has been performed to evaluate whether the TG/HDL-C ratio predicts CVD risk in patients with CKD. Methods A total of 197 patients (age 53 ± 12 years) with CKD Stages 1 to 5, were enrolled in this longitudinal, observational, retrospective study. TG/HDL-C ratio, HOMA-IR indexes, serum asymmetric dimethyl arginine (ADMA), high sensitivity C-reactive protein (CRP), parathyroid hormone (PTH), calcium, phosphorous, estimated glomerular filtration rate (eGFR), and albumin levels were measured. Flow mediated vasodilatation (FMD) of the brachial artery was assessed by using high-resolution ultrasonography. Results A total of 11 cardiovascular (CV) deaths and 43 nonfatal CV events were registered in a mean follow-up period of 30 (range 9 to 35) months. Subjects with TG/HDL-C ratios above the median values (>3.29) had significantly higher plasma ADMA, PTH, and phosphorous levels (p = 0.04, p = 0.02, p = 0.01 respectively) and lower eGFR and FMD values (p = 0.03, p < 0.001 respectively). The TG/HDL-C ratio was an independent determinant of FMD (β = −0.25 p = 0.02) along with TG, HDL-C, hsCRP, serum albumin, phosphate levels, systolic blood pressure, PTH, eGFR and the presence of diabetes mellitus. The TG/HDL-C ratio was also a significant independent determinant of cardiovascular outcomes [HR: 1.36 (1.11-1.67) (p = 0.003)] along with plasma ADMA levels [HR: 1.31 (1.13-1.52) (p < 0.001)] and a history of diabetes mellitus [HR: 4.82 (2.80-8.37) (p < 0.001)]. Conclusion This study demonstrates that the elevated TG/HDL-C ratio predicts poor CVD outcome in subjects with CKD. Being a simple, inexpensive, and reproducible marker of CVD risk, the TG/HDL-C ratio may emerge as a novel and reliable indicator among the many well-established markers of CVD risk in CKD. Systematic review registration Clinical trial registration number and date: NCT02113462 / 10-04-2014.
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Affiliation(s)
- Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Mahmut Ilker Yilmaz
- Department of Nephrology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Mutlu Saglam
- Department of Radiology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Hilmi Umut Unal
- Department of Nephrology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Mahmut Gok
- Department of Nephrology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Hakki Cetinkaya
- Department of Nephrology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Murat Karaman
- Department of Nephrology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Tayfun Eyileten
- Department of Nephrology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Yusuf Oguz
- Department of Nephrology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Abdulgaffar Vural
- Department of Nephrology, Gulhane School of Medicine, 06018, Etlik, Ankara, Turkey.
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
| | - Peter P Toth
- University of Illinois School of Medicine, Peoria, Il, USA.
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Affiliation(s)
- C Haymana
- Department of Endocrinology, Gulhane School of Medicine, 06018, Ankara, Turkey
| | - U Safer
- Department of Geriatrics, Gulhane School of Medicine, 06018, Ankara, Turkey.
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Sonmez A, Haymana C, Aydogdu A, Tapan S, Basaran Y, Meric C, Baskoy K, Dinc M, Yazici M, Taslipinar A, Barcin C, Yilmaz MI, Bolu E, Azal O. Endothelial dysfunction, insulin resistance and inflammation in congenital hypogonadism, and the effect of testosterone replacement. Endocr J 2015; 62:605-13. [PMID: 25924666 DOI: 10.1507/endocrj.ej15-0125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Patients with hypogonadism have poor cardiovascular and metabolic outcomes, and the effect of testosterone replacement therapy (TRT) is not clear. We investigated the presence of inflammation, insulin resistance and endothelial dysfunction in an unconfounded population of congenital hypogonadotrophic hypogonadism (CHH) and the effect of TRT on these subjects. A total of 60 patients with CHH (mean age 21.82±2.22 years) and 70 healthy control subjects (mean age 21.32±1.13 years) were enrolled. The demographic parameters, Asymmetric dimethylarginine (ADMA), TNF-like weak inducer of apoptosis (TWEAK), high sensitive C reactive protein (hs-CRP) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured before and after TRT. The patients had higher Waist Circumferences (WC) (p=0.009), Diastolic Blood Pressures (p=0.02), Triglycerides (p=0.03), ADMA, insulin and HOMA-IR levels (p<0.001 for all) and lower TWEAK levels (p<0.001), compared to the healthy controls. After 5.56 ± 2.04 months of TRT, the patients had significantly elevated systolic blood pressures (p=0.01), body mass indexes and WC (p<0.001 and p=0.001 respectively) and decreased total and HDL cholesterol levels (p=0.032 and p<0.001 respectively). ADMA levels significantly increased (p=0.003), while the alterations in TWEAK, hsCRP and HOMA-IR were not significant. The results of the present study show that endothelial dysfunction, inflammation and insulin resistance are prevalent even in the very young subjects with CHH, who have no metabolic or cardiac problems at present. This increased cardiometabolic risk however, do not improve but even get worse after six months of TRT. Long term follow-up studies are warranted to investigate the unfavorable cardiometabolic effects of TRT.
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Affiliation(s)
- Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018 Etlik Ankara, TURKEY
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Meric C, Sonmez A, Aydogdu A, Tapan S, Haymana C, Basaran Y, Baskoy K, Sertoglu E, Taslipinar A, Bolu E, Azal O. Osteoprotegerin, fibroblast growth factor 23, and vitamin D3 levels in male patients with hypogonadism. Horm Metab Res 2014; 46:955-8. [PMID: 25181418 DOI: 10.1055/s-0034-1387789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cardiometabolic disorders and osteoporosis are prevalent in patients with hypogonadism. Osteoprotegerin (OPG) and fibroblast growth factor-23 (FGF-23), are co-secreted from bones and vascular endothelium, regulating bone mineral metabolism and vascular functions. Vitamin D is another hormone with dual effects on bone and vascular metabolism. The aim of this study was to search for any difference between the serum levels of OPG, FGF-23, and vitamin D in patients with hypogonadism and the healthy controls. We also aimed to search for any relationship between these parameters and endothelial dysfunction or insulin resistance. Forty-nine male patients with congenital hypogonadotropic hypogonadism (CHH) (mean age 20.71 ± 1.75 years) and 43 BMI matched healthy male subjects (mean age 21.37 ± 1.04 years) were enrolled. OPG, FGF-23, vitamin D, and asymmetric dimethylarginine (ADMA) levels were measured from the fasting serum samples. The insulin sensitivity was estimated by homeostatic model assessment-insulin resistance (HOMA-IR) formula. Triglycerides, insulin, HOMA-IR, and ADMA levels in the patient group were significantly higher than the values of the control group (p = 0.014, p = 0.002, p = 0.003, p < 0.001, respectively). The OPG, FGF-23, and vitamin D levels of the patients were not significantly different from the healthy controls. In addition, these markers were not correlated to ADMA or HOMA-IR levels. The results show that young and treatment naive subjects with CHH have endothelial dysfunction and insulin resistance when compared to their healthy counterparts. However, the OPG, FGF-23, and vitamin D levels were similar in the 2 groups. In addition, these parameters are not significantly related to the endothelial functions or insulin resistance in these subjects.
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Affiliation(s)
- C Meric
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - A Sonmez
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - A Aydogdu
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - S Tapan
- Department of Biochemistry, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - C Haymana
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - Y Basaran
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - K Baskoy
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - E Sertoglu
- Department of Biochemistry, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - A Taslipinar
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - E Bolu
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
| | - O Azal
- Department of Endocrinology, Gulhane School of Medicine, Etlik, Ankara, Turkey
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Affiliation(s)
- Umit Cintosun
- Department of Geriatrics, Gülhane Military Medical Academy, Ankara, Turkey.
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Aydogdu A, Haymana C, Tapan S, Sonmez A, Azal O. Increased visceral adiposity index in patients with polycystic ovary syndrome; relationship between inflammation, insulin resistance and hyperandrogenity. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sonmez A, Haymana C, Aydogdu A, Tapan S, Basaran Y, Meric C, Baskoy K, Taslipinar A, Azal O. Effect of testosteron replacement treatment on the adma, fgf-23 and vitamin d levels in hypogonadism. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Aydogdu A, Haymana C, Baskoy K, Durukan AH, Ozgur G, Azal O. Combined choroidal neovascularization and hypopituitarism in a patient with homozygous mutation in methylenetetrahydrofolate reductase gene. J Res Med Sci 2014; 19:75-9. [PMID: 24672570 PMCID: PMC3963328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 12/17/2012] [Accepted: 01/01/2013] [Indexed: 10/31/2022]
Abstract
We report a case of choroidal neovascularization (CNV) secondary to methylenetetrahydrofolate reductase (MTHFR) gene mutation in a 20-year-old male patient with hypopituitarism. Treatment with three consecutive injections of intravitreal ranibizumab (anti-vascular endothelial growth factor) resulted in significant improvement of the patient's vision and the appearance of the macula. A search of the literature produced no previously reported case of MTHFR gene mutation associated both CNV and possibly hypopituitarism. With hormone replacement therapy of hypopituitarism, acetyl salicylic acid 100 mg/day also was started. The patient was clinically stable both for CNV and other thromboembolic disorders over a 6-month follow-up and also 1-year follow-up period.
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Affiliation(s)
- Aydogan Aydogdu
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey,Address for correspondence: Dr. Aydogan Aydogdu, Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey. E-mail:
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Kamil Baskoy
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Ali H. Durukan
- Department of Ophthalmology, Gulhane School of Medicine, Ankara, Turkey
| | - Gokhan Ozgur
- Department of Hematology, Gulhane School of Medicine, Ankara, Turkey
| | - Omer Azal
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
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