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Yarar Z, Can M, Caliskan Burgucu H, Karadeniz Y, Ozturk Y, Karakose M, Kulaksizoglu M, Karakurt F. Marine–Lenhart Syndrome with Unilateral Orbitopathy and Metastatic Thyroid Papillary Carcinoma to Lymph Node. Turk J Endocrinol Metab 2022. [DOI: 10.5152/tjem.2022.22040] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Can M, Kocabas M, Karakose M, Yerlikaya FH, Alsancak Y, Turkmen K, Kulaksizoglu M, Karakurt F. Arterial stiffness, carotid intima-media thickness, endocan and A disintegrin-like and metalloprotease with thrombospondin type I motif 9 levels and their relationship with disease activity in acromegaly patients with and without cardiovascular risk factors. Endocr Pract 2021; 28:298-303. [PMID: 34843972 DOI: 10.1016/j.eprac.2021.11.084] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/20/2021] [Accepted: 11/20/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Cardiovascular complications such as cardiomyopathy and endothelial dysfunction, which are frequently seen in patients with acromegaly, are among the most important causes of morbidity and mortality. In this study, we aimed to investigate arterial stiffness, carotid intima-media thickness, endocan and A disintegrin-like and metalloprotease with thrombospondin type I motif 9 (ADAMTS9) levels and their relationship with disease activity in acromegaly patients with and without cardiovascular risk factors. DESIGN A total of 60 patients with acromegaly, 25 with active disease, 26 with well-controlled disease, and 9 newly diagnosed, and 60 age-, sex- and body mass index (BMI)-matched healthy control subjects were enrolled in this study. All subjects' height, weight, BMI, systolic blood pressure (SBP), distolic blood pressure (DBP), fasting plasma glucose (FPG), insulin, hemoglobin A1c (HbA1c), C-reactive protein (CRP), lipid, endocan, ADAMTS9, pulse wave velocity (PWV) and carotid intima-media thickness (CIMT) measurements were performed. RESULTS SBP, DBP, FPG, HbA1c and PWV levels of the acromegaly group were higher than the control group. In acromegaly patients with cardiovascular disease (CVD) risk factors, PWV was higher than the control group, and in acromegaly patients without CVD risk factor, PWV was similar to the control group. In the correlation analysis, a positive correlation was found between PWV and age, BMI, SBP, DBP, FPG and HbA1c levels in the acromegaly group. CONCLUSIONS In our study, we found that arterial stiffness increased in acromegaly patients with CVD risk factors, and that increased arterial stiffness was associated with hemodynamic (SBP, DBP) and metabolic (BMI, FPG, HBA1C) parameters.
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Affiliation(s)
- Mustafa Can
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
| | - Muhammet Kocabas
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Melia Karakose
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | | | - Yakup Alsancak
- Department of Cardiology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Kultigin Turkmen
- Department of Nephrology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Kulaksizoglu
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Feridun Karakurt
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
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Can M, Kocabaş M, Karakose M, Burgucu HC, Yarar Z, Kulaksizoglu M, Karakurt F. Thyroid Nodules in Patients with Acromegaly: Frequency According to the ACR TI-RADS Classification and its Relationship with Disease Activity. Exp Clin Endocrinol Diabetes 2021; 129:931-936. [PMID: 34425596 DOI: 10.1055/a-1500-4591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/20/2022]
Abstract
PURPOSE In our study, we aimed to determine the frequency of thyroid nodules in patients with acromegaly according to the American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) classification and its relationship with acromegaly disease activity. METHODS A total of 56 patients with acromegaly and age, sex, and body mass index matched with 56 healthy control subjects were included in our study. Thyroid-stimulating hormone, free thyroxine, and anti-thyroperoxidase antibody levels of patients and control subjects were measured. In addition, patients and healthy controls were evaluated by ultrasonography to determine thyroid structure, thyroid volume, and thyroid nodules and to make ACR TI-RADS classification. RESULTS Thyroid nodules were present in 31 (55.4%) of 56 patients in the acromegaly group and 20 (35.7%) of 56 subjects in the control group, and the frequency of thyroid nodules was significantly higher in the acromegaly group (p=0.038). The mean number of nodules in the acromegaly group and control group was 1.27±1.43 and 0.48±0.73, respectively, and the mean number of nodules was significantly higher in the acromegaly group (p=0.003). The number of patients with TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules in the acromegaly group was higher than the control group (p=0.026, p=0.049, p=0.007, respectively). No difference was found in terms of cytological findings between those who have undergone FNAB in the acromegaly group and control group. CONCLUSION In our study, we found that the frequency of thyroid nodules, the number of thyroid nodules, and the number of TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules increased in patients with acromegaly. There was no significant difference between acromegaly disease activity and thyroid nodule frequency, number of thyroid nodules, and TI-RADS classifications.
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Affiliation(s)
- Mustafa Can
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Muhammet Kocabaş
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Melia Karakose
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Hatice Caliskan Burgucu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Zeliha Yarar
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Mustafa Kulaksizoglu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Feridun Karakurt
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
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Ozgen Saydam B, Sonmez M, Simsir IY, Erturk MS, Kulaksizoglu M, Arkan T, Hekimsoy Z, Cavdar U, Akinci G, Demir T, Altay CT, Mihci E, Secil M, Akinci B. A subset of patients with acquired partial lipodystrophy developing severe metabolic abnormalities. Endocr Res 2019; 44:46-54. [PMID: 30182761 DOI: 10.1080/07435800.2018.1513029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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] [Indexed: 01/21/2023]
Abstract
UNLABELLED Purpose/Aim of the study: Acquired partial lipodystrophy (APL) is a rare disease characterized by selective loss of adipose tissue. In this study, we aimed to present a subset of patients with APL, who developed severe metabolic abnormalities, from our national lipodystrophy registry. MATERIALS AND METHODS Severe metabolic abnormalities were defined as: poorly controlled diabetes (HbA1c above 7% despite treatment with insulin more than 1 unit/kg/day combined with oral antidiabetics), severe hypertriglyceridemia (triglycerides above 500 mg/dL despite treatment with lipid-lowering drugs), episodes of acute pancreatitis, or severe hepatic involvement (biopsy-proven non-alcoholic steatohepatitis (NASH)). RESULTS Among 140 patients with all forms of lipodystrophy (28 with APL), we identified 6 APL patients with severe metabolic abnormalities. The geometric mean for age was 37 years (range: 27-50 years; 4 females and 2 males). Five patients had poorly controlled diabetes despite treatment with high-dose insulin combined with oral antidiabetics. Severe hypertriglyceridemia developed in five patients, of those three experienced episodes of acute pancreatitis. Although all six patients had hepatic steatosis at various levels on imaging studies, NASH was proven in two patients on liver biopsy. Our data suggested that APL patients with severe metabolic abnormalities had a more advanced fat loss and longer disease duration. CONCLUSIONS We suggest that these patients represent a potential subgroup of APL who may benefit from metreleptin or investigational therapies as standard treatment strategies fail to achieve a good metabolic control.
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Affiliation(s)
- Basak Ozgen Saydam
- a Division of Endocrinology and Metabolism , Dokuz Eylul University, Izmir
| | - Melda Sonmez
- b Department of Internal Medicine, Koc University, School of Medicine, Istanbul
| | | | | | - Mustafa Kulaksizoglu
- e Division of Endocrinology and Metabolism , Necmettin Erbakan University, Konya
| | - Tugba Arkan
- f Division of Endocrinology and Metabolism , Kocaeli Training Hospital, Kocaeli
| | - Zeliha Hekimsoy
- g Division of Endocrinology and Metabolism , Celal Bayar University, Manisa
| | - Umit Cavdar
- a Division of Endocrinology and Metabolism , Dokuz Eylul University, Izmir
| | - Gulcin Akinci
- h Division of Pediatric Neurology , Behcet Uz Pediatric Children's Hospital, Izmir
| | - Tevfik Demir
- a Division of Endocrinology and Metabolism , Dokuz Eylul University, Izmir
| | | | - Ercan Mihci
- j Division of Pediatric Genetics , Akdeniz University, Antalya
| | - Mustafa Secil
- i Department of Radiology , Dokuz Eylul University, Izmir
| | - Baris Akinci
- a Division of Endocrinology and Metabolism , Dokuz Eylul University, Izmir
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Erdogan M, Kulaksizoglu M, Tetik A, Solmaz S, Kucukaslan AS, Eroglu Z. The relationship of the endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF) gene polymorphism in Turkish type 2 diabetic patients with and without diabetic foot ulcers. Foot (Edinb) 2018; 37:5-10. [PMID: 30321858 DOI: 10.1016/j.foot.2018.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 03/12/2017] [Revised: 05/27/2018] [Accepted: 06/25/2018] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This study aims to evaluate the influence of eNOS G894T and VEGF C936T gene polymorphism in diabetic foot ulcers. METHOD We studied 50 patients with diabetic foot ulcers and 57 diabetic patients without diabetic foot ulcer and a control group of 75 healthy individuals. RESULTS The genotype eNOS distribution did not differ between Type 2 Diabetic Patients group and Diabetic Foot Ulcer group (P>0.05). The frequency of the polymorphic T allele in Type 2 Diabetic Patients were significantly higher than the control group (42.3% and 24.5%, respectively)(p<0.01). The frequency of the polymorphic T allele between the Type 2 Diabetic Patients and Diabetic Foot Ulcer group was similar (p>0.05). The genotype VEGF distribution did not differ between Type 2 Diabetic Patients group and Diabetic Foot Ulcer group (P>0.05). The frequency of the polymorphic T allele between the Type 2 Diabetic Patients and Diabetic Foot Ulcer group was similar for both groups (p>0.05). CONCLUSION Polymorphism of eNOS G894T is not a risk factor for diabetic foot ulcer formation. T allele is a risk factor for diabetes, but T allele is not a risk factor for diabetic foot ulcer formation. Polymorphism of VEGF C936T and T allele are not risk factors for diabetes occurence and diabetic foot formation.
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Affiliation(s)
- Mehmet Erdogan
- Ege University Medical School, Department of Endocrinology and Metabolic Diseases, Bornova, 35100 Izmir, Turkey.
| | - Mustafa Kulaksizoglu
- Necmettin Erbakan University Medical School, Department of Endocrinology and Metabolic Diseases, Konya, Turkey
| | - Asli Tetik
- Ege University Medical School, Department of Medical Biology, Bornova, Izmir, Turkey
| | - Soner Solmaz
- Numune Education and Research Hospital, Internal Medicine, Adana, Turkey
| | - Ali Sahin Kucukaslan
- Ege University Medical School, Department of Medical Biology, Bornova, Izmir, Turkey
| | - Zuhal Eroglu
- Ege University Medical School, Department of Medical Biology, Bornova, Izmir, Turkey
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Dagdelen S, Deyneli O, Olgun N, Siva ZO, Sargin M, Hatun S, Kulaksizoglu M, Kaya A, Gürlek CA, Hirsch LJ, Strauss KW. Turkish Insulin Injection Technique Study: Population Characteristics of Turkish Patients with Diabetes Who Inject Insulin and Details of Their Injection Practices as Assessed by Survey Questionnaire. Diabetes Ther 2018; 9:1629-1645. [PMID: 29961245 PMCID: PMC6064578 DOI: 10.1007/s13300-018-0464-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Over 7 million people in Turkey have diabetes. Of the 1 million who inject insulin little is known of their habits and injection techniques. METHODS We conducted an Injection Technique Questionnaire (ITQ) survey throughout Turkey that involved 1376 patients from 56 centers. Turkish values were compared with those from 41 other countries participating in the ITQ, known here as Rest of World (ROW). RESULTS The majority (50.4%) of Turkish insulin users give four injections/ day as opposed to ROW, where only 30.9% do. The abdomen is the most common injection site used by Turkish patients, but they also inject insulin in multiple body sites more often than do patients in ROW. Body mass index values in Turkey were 0.75 units higher than those in ROW as was the mean total daily dose (average daily dose [ADD]) of insulin (54.0 IU in Turkey vs. 47.4 IU in ROW). Mean glycated hemoglobin (HbA1c) in Turkey was 9.1%, which is higher than in ROW and possibly related to the higher BMI and ADD. Turkish patients use insulin analogs (short and long-acting) more frequently than do patients in ROW. The shortest pen needles (4 mm) are used by about one-third of patients in Turkey, but the longer ones (8 mm) are equally common. Needles are reused in Turkey at a rate of 3.4 injections/single needle. However, needle reuse, whether with pens or syringes, is lower in Turkey than ROW, as is the number of times a reused needle is used. More than 75% of used sharps in Turkey go into the rubbish, with nearly 6% having no protection of the tip. CONCLUSION The continued use of 8-mm needles raises the risk of intramuscular injections in Turkish patients. Despite full reimbursement, needle reuse still remains an important issue. More focus needs to be given to dwell times under the skin, reconstitution of cloudy insulant, correct use of skin folds and safe disposal of sharps. FUNDING BD Diabetes Care.
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Affiliation(s)
- Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Hacettepe Mah., Sıhhıye, 06230, Ankara, Turkey
| | - Oguzhan Deyneli
- Department of Endocrinology and Metabolism, School of Medicine, Koc University, Davutpasa Cad. No:4, Topkapı, 34010, Istanbul, Turkey
| | - Nermin Olgun
- Nursing Department, Faculty of Health Sciences, Hasan Kalyoncu University, Havaalanı Yolu Üzeri 8. km. Sahinbey, Gaziantep, Turkey
| | - Zeynep Osar Siva
- Department of Endocrinology, Diabetes and Metabolism, Istanbul University Cerrahpasa School of Medicine, Cerrahpasa Mah. Kocamustafapasa Cad. No:53, Fatih, 34098, Istanbul, Turkey
| | - Mehmet Sargin
- Faculty of Medicine, Istanbul Medeniyet University, Egitim Mah. Dr. Erkin Cad, Kadıköy, 34722, Istanbul, Turkey
| | - Sükrü Hatun
- Department of Pediatric Endocrinology and Diabetes, Koc University School of Medicine, Davutpasa Cad. No: 4, Topkapı, 34010, Istanbul, Turkey
| | - Mustafa Kulaksizoglu
- Faculty of Medicine Department of Endocrinology and Metabolism, Necmettin Erbakan University Meram, Yunus Emre Mah. Beysehir Cad. No:281, Meram, 42080, Konya, Turkey
| | - Ahmet Kaya
- Faculty of Medicine Department of Endocrinology and Metabolism, Necmettin Erbakan University Meram, Yunus Emre Mah. Beysehir Cad. No:281, Meram, 42080, Konya, Turkey
| | - Cansu Aslan Gürlek
- BD Diabetes Care, Ruzgarlibahce Mah. S.Sinan Eroglu Cad. No:6, Akel Is Merkezi A Blok -3. Kat 34805 Kavacik Beykoz, Istanbul, Turkey
| | | | - Kenneth W Strauss
- BD Diabetes Care, POB 13, Erembodegem-Dorp 86, 9320, Erembodegem, Belgium.
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Dagdelen S, Deyneli O, Olgun N, Siva ZO, Sargin M, Hatun S, Kulaksizoglu M, Kaya A, Gürlek CA, Hirsch LJ, Strauss KW. Turkish Insulin Injection Techniques Study: Complications of Injecting Insulin Among Turkish Patients with Diabetes, Education They Received, and the Role of Health Care Professional as Assessed by Survey Questionnaire. Diabetes Ther 2018; 9:1615-1628. [PMID: 29961244 PMCID: PMC6064601 DOI: 10.1007/s13300-018-0463-8] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Using the Turkish and rest of world (ROW) Injection Technique Questionnaire (ITQ) data we address key insulin injection complications. METHODS Summarized in first ITQ paper. RESULTS Nearly one-third of Turkish insulin users described lesions consistent with lipohypertrophy (LH) at their injection sites and 27.4% were found to have LH by the examining nurse (using visual inspection and palpation). LH lesions in the abdomen and thigh of Turkish patients are slightly smaller than those measured in ROW but more than half of Turkish patients who have LH continue to inject into them at least daily. More than a quarter of Turkish patients have frequent unexplained hypoglycemia and nearly 2 out of 5 have glycemic variability, both of which have been linked to the presence of LH and the habit of injecting into it. Nearly half of Turkish injectors report having pain on injection. Of these, just over half report having painful injections only several times a month or year (i.e., not with every injection). In Turkey the diabetes nurse has by far the major role in teaching patients how to inject. Nearly 40% of Turkish injectors get their sites checked at least annually, and a larger proportion than ROW had received recent (within the last 12 months) instruction on how to inject properly. CONCLUSION Turkish patients and professionals have clearly made progress in injection technique, but there are still considerable challenges ahead which the new Turkish guidelines will help address. FUNDING BD Diabetes Care.
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Affiliation(s)
- Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Hacettepe Mah., 06230, Sıhhıye, Ankara, Turkey
| | - Oguzhan Deyneli
- Department of Endocrinology and Metabolism, Koc University School of Medicine, Davutpasa Cad. No: 4, 34010, Topkapı, Istanbul, Turkey
| | - Nermin Olgun
- Nursing Department, Faculty of Health Sciences, Hasan Kalyoncu University, Havaalanı Yolu Üzeri 8. km, Sahinbey, Gaziantep, Turkey
| | - Zeynep Osar Siva
- Department of Endocrinology, Diabetes and Metabolism, Cerrahpasa School of Medicine, Istanbul University, Cerrahpasa Mah. Kocamustafapasa Cad. No: 53, 34098, Fatih, Istanbul, Turkey
| | - Mehmet Sargin
- Faculty of Medicine, Istanbul Medeniyet University, Egitim Mah. Dr. Erkin Cad., 34722, Kadıköy, Istanbul, Turkey
| | - Sükrü Hatun
- Department of Pediatric Endocrinology and Diabetes, Koc University School of Medicine, Davutpasa Cad. No: 4, 34010, Topkapı, Istanbul, Turkey
| | - Mustafa Kulaksizoglu
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Yunus Emre Mah. Beysehir Cad. No: 281, 42080, Meram, Konya, Turkey
| | - Ahmet Kaya
- Department of Endocrinology and Metabolism, Meram Faculty of Medicine, Necmettin Erbakan University, Yunus Emre Mah. Beysehir Cad. No: 281, 42080, Meram, Konya, Turkey
| | - Cansu Aslan Gürlek
- BD Diabetes Care, Ruzgarlibahce Mah. S.Sinan Eroglu Cad. No: 6, Akel Is Merkezi A Blok -3. Kat, Kavacik, 34805, Beykoz, Istanbul, Turkey
| | | | - Kenneth W Strauss
- BD Diabetes Care, POB 13, Erembodegem-Dorp 86, 9320, Erembodegem, Belgium.
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Erdogan M, Kulaksizoglu M, Ganidagli S, Berdeli A. Genetic variations in interleukin 6 rs1800795 polymorphism and the association with susceptibility to Hashimoto's thyroiditis. Meta Gene 2017. [DOI: 10.1016/j.mgene.2016.12.010] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Erdogan M, Kulaksizoglu M, Ganidagli S, Berdeli A. Fas/FasL gene polymorphism in patients with Hashimoto's thyroiditis in Turkish population. J Endocrinol Invest 2017; 40:77-82. [PMID: 27572459 DOI: 10.1007/s40618-016-0534-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 08/10/2015] [Accepted: 08/16/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Hashimoto's disease is a polygenic disorder with complex etiopathogenesis. Apoptosis is proposed as one of its mechanisms. The Fas/Fas ligand cascade represents a major pathway initiating apoptosis. This study aims to evaluate the influence of Fas and FasL gene polymorphism in Hashimoto's thyroiditis in Turkish population. MATERIALS AND METHODS A total of 112 patients with Hashimoto's thyroiditis and 112 cases of healthy control people were included in this study. The evaluation of genotype for Fas -670 A/G and FasL 843 C/T gene polymorphism was performed by using PCR-RFLP method. RESULTS The FAS genotype and gene allele frequency distribution did differ between the control group (AA 36.6 %, AG 50.0 %, GG 13.4 %, A 61.6 %, G 38.4 %) and the Hashimoto's thyroiditis patients (AA 21.4 %, AG 50.9 %, GG 27.7 %, A 46.9 %, G 53.1 %) (p < 0.01). The evaluation of FasL genotype and gene allele frequency did not show statistically significant difference between the patient group (CC 27.7 %, CT 45.5 %, TT 26.8 %, C 50.4 %, T 49.6 %) and control group (CC 33.9 %, CT 44.6 %, TT 21,4 %, C 56.3 %, T 43.8 %) (p > 0.05). CONCLUSIONS Gene polymorphism of Fas and G allele frequency may play a role in the regulation of apoptosis in thyroid autoimmune disorders. There is a need for further studies to clarify the genetic role of apoptosis in HT.
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Affiliation(s)
- M Erdogan
- Department of Endocrinology and Metabolic Diseases, Ege University Medical School, 35100, Bornova, Izmir, Turkey.
| | - M Kulaksizoglu
- Department of Endocrinology and Metabolic Diseases, Necmettin Erbakan University Medical School, Konya, Turkey
| | - S Ganidagli
- Department of Internal Medicine, Numune Training and Research Hospital, Adana, Turkey
| | - A Berdeli
- Laboratory of Molecular Medicine, Department of Pediatrics, Ege University Medical School, Bornova, Izmir, Turkey
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Abstract
The thyroid gland is susceptible to nodulation. The mechanism responsible for the growth of only some follicular cells, which results in nodule formation, is not yet clear. Selenium deficiency may be a risk factor in the development of thyroid nodules. The aim of this study was to investigate the relationship between selenium levels in patients with euthyroid nodular thyroid disease. Seventy patients with a solitary euthyroid thyroid nodule, 70 patients with more than one euthyroid nodule, and 60 healthy patients without thyroid nodules were included in the study. Venous serum samples were stored at -80°C and analyzed the same day using spectrometry. The selenium levels of patients with multiple thyroid nodules, solitary nodules, and patients without nodules were 57.3 ± 14.8 μg/L; 58.8 ± 15.1 μg/L; and 57.6 ± 13.3 μg/L, respectively. The mean serum selenium level of all patients included in the study was 57.9 ± 14.4 μg/L. Although serum selenium levels were slightly higher in men, a statistically significant difference was not observed. In our study, a significant relationship between serum selenium levels and nodular thyroid disease was not seen. Our study was undertaken in an iodine sufficient region. Mean serum selenium levels were lower compared with many other studies, which may be associated with the low selenium content of the soil. Nodular thyroid disease shows multifactorial features. When our study is considered together with previous studies, serum selenium levels may considered to be effective on structural thyroid diseases if combined with additional factors such as severe iodine deficiency. Further studies are required to assess the role of selenium in thyroid nodule formation.
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Affiliation(s)
- Davut Sakız
- Department of Endocrinology and Metabolism, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Ahmet Kaya
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Kulaksizoglu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
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Kebapcilar L, Kebapcilar AG, Ilhan TT, Ipekci SH, Baldane S, Pekin A, Kulaksizoglu M, Celik C. Is the Mean Platelet Volume a Predictive Marker of a Low Apgar Score and Insulin Resistance in Gestational Diabetes Mellitus? A Retrospective Case-Control Study. J Clin Diagn Res 2016; 10:OC06-OC10. [PMID: 27891368 DOI: 10.7860/jcdr/2016/20874.8611] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 04/21/2016] [Accepted: 06/23/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Gestational diabetes is defined as various degrees of glucose intolerance diagnosed or detected for the first time during pregnancy and is the most common metabolic complication of pregnancy. Early diagnosis and adequate treatment are important to prevent complications. Pre-eclampsia, polyhydramnios, fetalmacrosomia, and operative delivery are some of the complications seen in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM). AIM The present study was designed to determine whether there was an association between Mean Platelet Volume (MPV) in predicting poor fetal outcome, insulin resistance, neonatal Apgar scores and gestational age for women with GDM. MATERIALS AND METHODS In this retrospective study, we enrolled 101 pregnant women with GDM together with a group of 138 healthy controls. MPV, insulin and homeostatic model assessment (HOMA-IR) values were measured at 24-28 weeks of the pregnancy. An independent samples t-test was used to compare MPV values. Multivariate linear regression models were used to establish relations between MPV values, HOMA-IR, insulin levels and Apgar score. RESULTS There was a significant positive correlation between MPV values, HOMA-IR and Insulin levels and a negative correlation with Apgar score at 1 min and 5 min in the GDM group (r=0.227, p=0.02; r=0.206, p=0.03; r=-0.485, p<0.001; and r=-0.399, p<0.001, respectively). In the multivariate logistic regression analysis, a high MPV value was most consistently associated with a low Apgar 1 min score (β=-0.387, p=0.003) in the GDM group. An MPV of >8.0 fL had a sensitivity of 82% and a specificity of 75% for the prediction of GDM. CONCLUSION We investigated the potential of MPV values in predicting low Apgar scores and insulin resistance in women with GDM.
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Affiliation(s)
- Levent Kebapcilar
- Associate Professor, Department of Internal Medicine, Division of Endocrinology and Metabolism, Selcuk University , Konya, Turkey
| | - Ayse Gul Kebapcilar
- Associate Professor, Department of Gynecology and Obstetrics, Selcuk University , Konya, Turkey
| | - Tolgay Tuyan Ilhan
- Assistant Professor, Department of Gynecology and Obstetrics, Selcuk University , Konya, Turkey
| | - Suleyman Hilmi Ipekci
- Associate Professor, Department of Internal Medicine, Division of Endocrinology and Metabolism, Selcuk University , Konya, Turkey
| | - Suleyman Baldane
- Assistant Professor, Department of Internal Medicine, Division of Endocrinology and Metabolism, Selcuk University , Konya, Turkey
| | - Aybike Pekin
- Associate Professor, Department of Gynecology and Obstetrics, Selcuk University , Konya, Turkey
| | - Mustafa Kulaksizoglu
- Associate Professor, Department of Internal Medicine, Division of Endocrinology and Metabolism, Necmettin Erbakan University , Konya, Turkey
| | - Cetin Celik
- Professor, Department of Gynecology and Obstetrics, Selcuk University , Konya, Turkey
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Kucuk A, Gulyer H, Savut B, Sahin M, Gungor T, Kulaksizoglu M, Kaya A. Miscible Two Diseases in Old Age: Hypopituitarism and Pseudogout. Electron J Gen Med 2016. [DOI: 10.15197/ejgm.01368] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Caliskan M, Turan Y, Caliskan Z, Gullu H, Ciftci FC, Avci E, Duran C, Kostek O, Telci Caklili O, Koca H, Kulaksizoglu M. Previous gestational diabetes history is associated with impaired coronary flow reserve. Ann Med 2015; 47:615-23. [PMID: 26555575 DOI: 10.3109/07853890.2015.1099719] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a prediabetic state that is known to increase the risk of cardiovascular diseases. We have investigated coronary flow velocity reserve (CFVR) and epicardial fat thickness (EFT), and left ventricular diastolic function in patients with a history of previous GDM (p-GDM). METHODS Ninety-three women with GDM history and 95 healthy women without GDM history were recruited. We used transthoracic Doppler echocardiography to assess CFVR, EFT, and left ventricular diastolic function. Insulin resistance of each subject was assessed with homeostasis model assessment insulin resistance (HOMA-IR). Hemoglobin A1c and high-sensitivity C-reactive protein (hsCRP) were also measured in all patients. RESULTS CFVR values were significantly lower (2.34 ± 0.39 versus 2.80 ± 0.24, p < 0.001) and EFT values were significantly higher in patients with p-GDM than the control group (5.5 ± 1.3 versus 4.3 ± 1.1, p < 0.001). E/E' ratio (7.21 ± 1.77 versus 6.53 ± 1.38, p = 0.003), hemoglobin A1c (5.2 ± 0.4 and 5.0 ± 0.3, p = 0.001), HOMA-IR (2.8 ± 1.4 versus 1.7 ± 0.9, p = 0.04), and hsCRP levels were significantly higher in the p-GDM group than the control group. Multivariate analysis revealed that gestational diabetes history is independently associated with CFVR. CONCLUSION Women with a GDM history may be at more risk regarding coronary microvascular dysfunction compared to the healthy ones.
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Affiliation(s)
- Mustafa Caliskan
- a Istanbul Medeniyet University , Cardiology and Internal Medicine Department , Istanbul , Turkey
| | - Yasar Turan
- b Konya Education and Research Hospital , Cardiology and Endocrinology Department , Konya , Turkey
| | - Zuhal Caliskan
- c Baskent University, Ankara Teaching and Medical Research Center , Internal Medicine, Obstetric and Gynecology and Cardiology Department , Konya , Turkey
| | - Hakan Gullu
- c Baskent University, Ankara Teaching and Medical Research Center , Internal Medicine, Obstetric and Gynecology and Cardiology Department , Konya , Turkey
| | - Faika Ceylan Ciftci
- c Baskent University, Ankara Teaching and Medical Research Center , Internal Medicine, Obstetric and Gynecology and Cardiology Department , Konya , Turkey
| | - Enver Avci
- c Baskent University, Ankara Teaching and Medical Research Center , Internal Medicine, Obstetric and Gynecology and Cardiology Department , Konya , Turkey
| | - Cevdet Duran
- b Konya Education and Research Hospital , Cardiology and Endocrinology Department , Konya , Turkey
| | - Osman Kostek
- a Istanbul Medeniyet University , Cardiology and Internal Medicine Department , Istanbul , Turkey
| | - Ozge Telci Caklili
- a Istanbul Medeniyet University , Cardiology and Internal Medicine Department , Istanbul , Turkey
| | - Harun Koca
- b Konya Education and Research Hospital , Cardiology and Endocrinology Department , Konya , Turkey
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Caliskan M, Caklili OT, Caliskan Z, Duran C, Çiftçi FC, Avci E, Güllü H, Kulaksizoglu M, Koca H, Muderrisoglu H. Does gestational diabetes history increase epicardial fat and carotid intima media thickness? Echocardiography 2014; 31:1182-7. [PMID: 24666015 DOI: 10.1111/echo.12597] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is defined as glucose intolerance that has begun during pregnancy. Recent studies have proven that development of atherosclerosis may be established in this population even without presence of type 2 diabetes. For assessment of atherosclerosis, epicardial fat thickness (EFT) is recently being used as a surrogate marker. In this study, we aimed to prove that women with GDM history are more inclined to have higher EFT levels than women without GDM history. METHODS Sixty-two patients with previous GDM and 33 age- and sex-matched controls were allocated. Epicardial fat thicknesses of the subjects were measured with transthorasic echocardiography and carotid intima media thickness (c-IMT) was measured with ultrasound. Insulin resistance (IR) of each subject was assessed with Homeostasis model of assessment-insulin resistance (HOMA-IR). RESULTS Carotid IMT and EFT were significantly higher in previous GDM group than controls. Serum gamma-glutamyl transferase (GGT), uric acid, and high-sensitivity C-reactive protein (hs-CRP) levels were also found significantly higher in the patients with previous GDM as compared to the controls. We observed that carotid IMT (β = 310, P = 0.003), total cholesterol (β = 315, P = 0.002), BMI (β = 308, P = 0.002), HbA1c (β = 227, P = 0.018), and HOMA-IR (β = 184, P = 0.049) were independently correlated with EFT. CONCLUSIONS Although the number of patients included in this study is limited, high EFT results may indicate presence of atherosclerosis in women with previous GDM.
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Affiliation(s)
- Mustafa Caliskan
- Cardiology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
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15
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Kulaksizoglu M, Ipekci SH, Kebapcilar L, Kebapcilar AG, Korkmaz H, Akyurek F, Baldane S, Gonen MS. Risk factors for diabetes mellitus in women with primary ovarian insufficiency. Biol Trace Elem Res 2013; 154:313-20. [PMID: 23812652 DOI: 10.1007/s12011-013-9738-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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] [Received: 05/11/2013] [Accepted: 06/19/2013] [Indexed: 02/07/2023]
Abstract
Primary ovarian insufficiency (POI) is not only a gynecological problem but also has serious effects on women's health such as changes in hormone levels that can trigger fluctuations in blood sugar level and inflammation status. The present study was designed to determine vitamin D, copper, zinc, metabolic parameters [insulin, homeostasis model of assessment-insulin resistance (HOMA-IR)], inflammation parameters such as procalcitonin and high sensitivity C reactive protein (hs-CRP), and lipid profile in POI patients and control subjects with normal menstrual cycles. A total of 43 patients with nondiabetic POI were studied in order to evaluate and compare the findings with those of the control group, which comprised 33 women with normal menstrual cycles. The women with POI had higher levels of serum copper, serum insulin, glucose, LDL-cholesterol, total cholesterol, HOMA-IR, hs-CRP, and procalcitonin, whereas serum vitamin D and zinc levels were lower compared with the healthy control group. Follicle-stimulating hormone (FSH) levels were positively correlated with insulin, glucose, HOMA-IR, hs-CRP, procalcitonin, and copper and negatively correlated with vitamin D and zinc levels. In multivariate statistic analyses with body mass index and FSH as dependent variables, FSH was positively associated with copper and HOMA-IR negatively with vitamin D levels. The present study demonstrated that women with POI have traditional risk factors for diabetes mellitus, including lower levels of vitamin D, whereas higher levels of copper and HOMA-IR.
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Affiliation(s)
- Mustafa Kulaksizoglu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Meram School of Medicine, Konya University, Konya, Turkey
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16
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Kebapcilar AG, Kulaksizoglu M, Ipekci SH, Korkmaz H, Kebapcilar L, Akyurek F, Taner CE, Gonen MS. Relationship between mean platelet volume and low-grade systemic coagulation with vitamin D deficiency in primary ovarian insufficiency. Arch Gynecol Obstet 2013; 288:207-12. [PMID: 23377179 DOI: 10.1007/s00404-013-2735-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Premature menopause in young women is associated with an increased incidence of cardiovascular disease. The present study was designed to determine vitamin D (vit D) and the coagulation parameters such as activated partial thromboplastin time (APTT), PT, D-dimer, white blood cell (WBC), and mean platelet volume (MPV) levels, in primary ovarian insufficiency (POI) patients and control women with a normal menstrual cycle. MATERIALS AND METHODS A total of 43 patients with non-diabetic POI were studied in order to evaluate and compare with the control group comprising 33 women with a normal menstrual cycle. RESULTS There was no significant difference between the groups for age and body mass index (BMI). D-dimer, WBC, MPV, PT, total cholesterol, and LDL cholesterol were higher in women with POI. APTT levels were also increased but missed the significance in POI group. Women with POI had significantly lower serum vit D levels compared with healthy control group. FSH level was positively correlated with D-dimer, WBC, MPV, and negatively correlated to vit D and serum D vit level was inversely correlated with MPV, APTT, D-dimer, FSH levels in individual women. CONCLUSIONS The obtained results seem to indicate that POI patients had low-grade systemic coagulation and fibrinolytic activation as evidenced by elevated D-dimer, WBC, MPV, PT values potentially be used as indicators of risk factor for thrombosis and atherosclerosis in POI women. All of our patients with POI were deficient in vit D. These results also suggest that vit D deficiency plays important roles of POI women and associated with coagulation, independently from age and BMI.
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Kulaksizoglu S, Kulaksizoglu M, Kebapcilar AG, Torun AN, Ozcimen E, Turkoglu S. Can first-trimester screening program detect women at high risk for gestational diabetes mellitus? Gynecol Endocrinol 2013; 29:137-40. [PMID: 22954283 DOI: 10.3109/09513590.2012.708800] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [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: 11/13/2022] Open
Abstract
This study was designed to compare first-trimester maternal serum biochemical markers of aneuploidy and fetal nuchal translucency in pregnancies complicated by gestational diabetes mellitus and those of a control group. The study included 60 gestational diabetic and 60 control women who attended the first-trimester combined screening program for Down syndrome between 11 and 14 gestational weeks with complete follow-up data and delivered in our institution. Maternal serum free β-human chorionic gonadotropin, pregnancy-associated plasma protein-A and fetal nuchal translucency were investigated. The combined risks, double test risks and age risks were calculated by PRISCA software version 4.0. Comparison of the results between the two groups yielded no significant differences in serum levels of free β-human chorionic gonadotropin and fetal nuchal translucency. However, women who developed gestational diabetes mellitus had significantly lower pregnancy-associated plasma protein-A. And also, the combined risks and double test risks calculated by PRISCA software were statistically higher in gestational diabetic women than normal pregnant women. These results suggest that differences can be seen between diabetic and healthy pregnant women in first-trimester maternal serum biochemical markers of aneuploidy.
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Affiliation(s)
- Sevsen Kulaksizoglu
- Department of Biochemistry, Baskent University School of Medicine, Ankara, Turkey.
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18
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Abstract
Thyroid hormones stimulate directly or indirectly growth of erythroid colonies through erythropoietin. Anemia is often the first sign of hypothyroidism. Hypothyroidism can cause a wide variety of anemic disorders. Numerous mechanisms are involved in the pathogenesis of these anemias that can be microcytic, macrocytic and normocytic. We designed this study to investigate the anemia frequency and if present, etiology of anemia in hypothyroid patients. 100 patients with overt hypothyroid, 100 patients with subclinical hypothyroid, and 200 healthy controls were enrolled in this study. Overt hypothyroidism diagnosis is done when elevated TSH and low levels of free T4 and/or free T3 have been observed. Subclinical hypothyroidism is defined as elevated serum TSH with normal free T(4) and free T(3) levels. Peripheral smears of the anemic patients were examined. Anemia prevalence was 43% in the overt hypothyroid group, 39% in the subclinical hypothyroid group, and 26% in the control group (p=0.0003 and p=0.021 respectively related to controls). Thus, the frequency of anemia in subclinical hypothyroidism is as high as that in overt hypothyroidism. There was no difference between the hypothyroid groups in terms of anemia. Vitamin B12, Fe, and folic acid were similar between these groups. According to our findings, anemia of chronic disease is the most common type of anemia in hypothyroid patients. Suspicion of hypothyroidism should be considered in anemias with uncertain etiology.
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Affiliation(s)
- Mehmet Erdogan
- Department of Endocrinology and Metabolism, School of Medicine, Ege University, Bornova, Izmir, Turkey.
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19
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Ermis N, Gullu H, Caliskan M, Unsal A, Kulaksizoglu M, Muderrisoglu H. Gabapentin therapy improves heart rate variability in diabetic patients with peripheral neuropathy. J Diabetes Complications 2010; 24:229-33. [PMID: 19195912 DOI: 10.1016/j.jdiacomp.2008.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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] [Received: 07/15/2008] [Revised: 09/26/2008] [Accepted: 12/03/2008] [Indexed: 11/19/2022]
Abstract
PURPOSE Diabetic cardiac neuropathy, which is characterized by reduced heart rate variability (HRV), frequently coexists with peripheral neuropathy. Gabapentin has been used for the treatment of diabetic neuropathy. We aimed to evaluate the possible effect of gabapentin treatment on autonomic function in patients with type 2 diabetes via HRV. METHODS Thirty patients with type 2 diabetes mellitus and peripheral neuropathy and 28 age- and sex-matched healthy controls were consecutively registered. Each patient underwent HRV measurements, and diabetic patients were administered gabapentin. After 3 months of gabapentin therapy, HRV parameters were measured again. RESULTS Baseline HRV parameters were blunted in patients with diabetes mellitus according to the controls [standard deviation of all NN intervals (SDNN, ms): 106.3+/-29.9 vs. 148.8+/-36.5, P=.001; power spectrum of the high-frequency band (HF, ms(2)): 133.6+/-98.3 to 231.4+/-197.6, P=.02; power spectrum of the low-frequency band (LF, ms(2)): 341.8+/-247.8 to 511.5+/-409.4, P=.048; LF/HF ratio: 3.3+/-2.4 to 2.6+/-1.5, P=.33]. After 3 months of treatment with gabapentin, some HRV parameters showed some improvement. SDNN (106.2+/-29.8 to 119.4 +/- 25, P=.016) and HF (133.6+/-98.3 to 167.6+/-118.3, P=.021) increased significantly. LF/HF ratio decreased (from 3.3+/-2.4 to 2.3+/-1.9, P=.039) and LF remained unchanged (341.8+/-247.8 to 352.3+/-228.9, P=.88). CONCLUSIONS Therapeutic doses of gabapentin not only alleviate neuropathic symptoms but also improve cardiac autonomic function in diabetic patients with peripheral neuropathy.
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Affiliation(s)
- Necip Ermis
- Cardiology Department, Baskent University Medical School, Ankara, Turkey.
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20
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Torun AN, Kulaksizoglu S, Kulaksizoglu M, Pamuk BO, Isbilen E, Tutuncu NB. Serum total antioxidant status and lipid peroxidation marker malondialdehyde levels in overt and subclinical hypothyroidism. Clin Endocrinol (Oxf) 2009; 70:469-74. [PMID: 18727709 DOI: 10.1111/j.1365-2265.2008.03348.x] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.3] [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: 12/21/2022]
Abstract
BACKGROUND Mitochondria are the main production site of free oxygen radicals, which can cause organ dysfunction by oxidation of cellular macromolecules such as carbohydrates, lipids and proteins. Oxidative stress may result from either overproduction of these species or from failure of the antioxidant defence systems. Thyroid hormones have well-known effects on mitochondrial oxygen consumption, but data about how hypothyroidism affects oxidative stress are controversial, and little is known about oxidative stress in subclinical hypothyroidism. Total antioxidant status (TAS) gives information about all of the antioxidants in the organism, while malondialdehyde (MDA) is a lipid peroxidation marker used to assess lipid peroxidation due to increased oxidative stress. We aimed to determine how hypothyroidism and subclinical hypothyroidism affect serum MDA and TAS. SUBJECTS AND METHODS Serum TAS, MDA, C-reactive protein levels and lipid compositions were studied in 20 hypothyroid, 40 subclinical hypothyroid and 40 healthy subjects. RESULTS MDA was elevated in both hypothyroid and subclinical hypothyroid patients compared with controls, while TAS levels show no significant differences between groups. Low-density lipoprotein (LDL) cholesterol levels were significantly high in both hypothyroid and subclinical hypothyroid patients. Triglyceride levels were high only in hypothyroid patients when compared with the controls. MDA showed a correlation with LDL cholesterol, total cholesterol and triglyceride. CONCLUSIONS These results suggest an increased oxidative stress in both hypothyroid and subclinical hypothyroidism states, which can be explained by both the insufficient increase in the antioxidant status and the altered lipid metabolism in these cases.
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Affiliation(s)
- Ayse Nur Torun
- Department of Endocrinology, Baskent University Faculty of Medicine, Ankara, Turkey.
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21
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Pamuk BO, Torun AN, Kulaksizoglu M, Algan C, Ertugrul DT, Yilmaz Z, Tutuncu NB, Demirag NG. 49,XXXXY syndrome with autoimmune diabetes and ocular manifestations. Med Princ Pract 2009; 18:482-5. [PMID: 19797926 DOI: 10.1159/000235899] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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] [Received: 08/25/2008] [Accepted: 02/05/2009] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We report a rare case of 49,XXXXY syndrome with autoimmune diabetes (requiring insulin therapy), bilateral cataracts and unilateral glaucoma. CLINICAL PRESENTATION AND INTERVENTION A 25-year-old man with mental retardation presented with multiple skeletal abnormalities, polyuria and polydipsia. He had high glucose concentrations, without ketonuria, and hypergonadotropic hypogonadism. Ophthalmic examination revealed a polar cataract in both eyes and increased intraocular pressure in the left eye. The anti-islet cell antibody test was positive, and anti-glutamic acid decarboxylase autoantibody levels were elevated. Karyotype analysis revealed 49,XXXXY. Intensive insulin therapy and testosterone replacements were started. CONCLUSION The autoimmune nature of diabetes that we observed in our patient seems to be predisposed by hypogonadism. Cataract and glaucoma in this case seem to be the result of diabetes, and an association of these ocular manifestations with the syndrome 49,XXXXY seems unlikely.
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Affiliation(s)
- Baris Onder Pamuk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, TR-06490 Ankara, Turkey.
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Affiliation(s)
- Ayse Nur Torun
- Department of Endocrinology, Baskent University, Ankara, Turkey
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Demir M, Gokturk HS, Ozturk NA, Kulaksizoglu M, Serin E, Yilmaz U. Helicobacter pylori prevalence in diabetes mellitus patients with dyspeptic symptoms and its relationship to glycemic control and late complications. Dig Dis Sci 2008; 53:2646-9. [PMID: 18320319 DOI: 10.1007/s10620-007-0185-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [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] [Received: 11/24/2007] [Accepted: 12/20/2007] [Indexed: 12/11/2022]
Abstract
BACKGROUND There are contradictory reports on Helicobacter pylori prevalence and its relationship to late complications of diabetes mellitus (DM). The aim of this study was to determine the prevalence of H. pylori infection in type 2 DM patients and to evaluate the relationship between H. pylori infection and the glycemic control, late complications. MATERIAL AND METHOD A total of 141 type 2 DM patients and 142 nondiabetic subjects with upper gastrointestinal symptoms were enrolled in the study. All patients underwent upper gastrointestinal endoscopy with biopsy specimens obtained from gastric antrum and corpus. H. pylori status was evaluated in each patient by both the rapid urease test and histopathological examination. Plasma glucose, HbA1c, microalbuminuria in 24 h collected urine, electroneuromyography, and fundoscopic examinations were performed in all subjects. RESULTS The prevalence of H. pylori infection was 61.7% and 58.5%, respectively, among type 2 diabetic patients and nondiabetic controls and was not statistically significant (P = 0.577). The duration of diabetes, fasting blood glucose and haemoglobin A1c levels, nephropathy and retinopathy prevalence did not differ significantly between the two groups (diabetics versus nondiabetics). There was no late complication in 60.3% of the type 2 diabetic patients as compared to at least one late complication in the remainders. A statistically significant correlation was found between H. pylori infection and the presence of neuropathy (P = 0.021). CONCLUSIONS The prevalence of H. pylori infection did not differ significantly between the diabetic patients and nondiabetic controls. Interestingly, diabetics with H. pylori infection had a higher incidence of neuropathy, although there was no association between the duration and regulation of diabetes, retinopathy, nephropathy and H. pylori status.
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Affiliation(s)
- Mehmet Demir
- Department of Gastroenterology, Baskent University Faculty of Medicine, Konya, Turkey
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Turan H, Serefhanoglu K, Torun AN, Kulaksizoglu S, Kulaksizoglu M, Pamuk B, Arslan H. Frequency, Risk Factors, and Responsible Pathogenic Microorganisms of Asymptomatic Bacteriuria in Patients with Type 2 Diabetes Mellitus. Jpn J Infect Dis 2008. [DOI: 10.7883/yoken.jjid.2008.236] [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] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Hale Turan
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Baskent University, Turkey
| | - Kivanc Serefhanoglu
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Baskent University, Turkey
| | - Ayse Nur Torun
- Internal Medicine Department, Faculty of Medicine, Baskent University, Turkey
| | | | | | - Baris Pamuk
- Internal Medicine Department, Faculty of Medicine, Baskent University, Turkey
| | - Hande Arslan
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Baskent University, Turkey
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Turan H, Serefhanoglu K, Torun AN, Kulaksizoglu S, Kulaksizoglu M, Pamuk B, Arslan H. Frequency, risk factors, and responsible pathogenic microorganisms of asymptomatic bacteriuria in patients with type 2 diabetes mellitus. Jpn J Infect Dis 2008; 61:236-238. [PMID: 18503181] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Urinary tract infection is a serious problem in diabetic patients, and asymptomatic bacteriuria (ASB) in these patients is a risk factor for pyelonephritis and renal dysfunction. In the present study, we investigated the relationships between age, body mass index, duration of diabetes, HbA1c level, glucosuria, glomerular filtration rate and microalbuminuria in type 2 diabetic patients with ASB. One hundred and twenty-three patients with type 2 diabetes mellitus were included in the study. The patients were divided into two groups according to ASB; Group I consisted of 22 patients with ASB, and Group II of 101 patients without ASB. There were no significant differences between the groups in regard to age, body mass index, creatinine clearance or microalbuminuria, while there were significant differences in HbA1c, duration of diabetes mellitus, glucosuria and pyuria (P < 0.05). The most commonly isolated microorganism was Escherichia coli. The present study identified the duration of diabetes, high HbA1c, glucosuria and pyuria as risk factors for ASB in type 2 diabetic patients.
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Affiliation(s)
- Hale Turan
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Baskent University, Ankara, Turkey.
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Abstract
Gastrin and pentagastrin stimulate thyroid C cells and elevate serum calcitonin levels. Gastrin levels may be elevated when histamine-2 receptor blockers (H2RB) and/or proton pump inhibitors (PPI) are used, or in patients with pernicious anemia (PA). This study was designed to investigate the long-term effects of elevated gastrin levels on serum calcitonin levels. We conducted a pentagastrin stimulation test to evaluate C cell reserves in patients who had been using PPI and/or H2RB for an extended period, as well as in patients with PA. We compared the results with a healthy control group of similar age and sex. A total of 40 controls (26 women, 24 men) and 25 patients (15 women, 10 men) using H2RB and/or PPI, and 37 patients (24 women, 13 men) with PA were enrolled. The groups were similar in terms of mean age and sex distribution. Mean fasting gastrin levels, and mean baseline and pentagastrin-stimulated calcitonin levels were significantly higher in the H2RB+PPI and PA groups than in controls. No significant differences were observed between the H2RB+PPI and PA groups. There was no correlation between gastrin and calcitonin levels. However, mean calcitonin levels were significantly higher in subjects with high baseline gastrin levels than in controls. The prevalence of autoimmune thyroid disease was 32% in the PA group. Patients with PA and thyroiditis had significantly higher baseline gastrin levels than patients with PA only (p<0.01). PA with autoimmune thyroid disease had also significantly higher baseline and pentagastrin-stimulated calcitonin levels than did PA patients without autoimmune thyroid disease. In conclusion, chronic elevated gastrin levels led to elevated calcitonin levels. Further histopathological studies showing C cell hyperplasia are needed to confirm the mechanism of this relationship.
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Affiliation(s)
- M F Erdogan
- Department of Endocrinology and Metabolic Diseases, Ankara University School of Medicine, Ankara, Turkey
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Gürsoy A, Kulaksizoglu M, Sahin M, Ertugrul DT, Ozer F, Tutuncu NB, Demirag NG. Severe hypertriglyceridemia-induced pancreatitis during pregnancy. J Natl Med Assoc 2006; 98:655-7. [PMID: 16623082 PMCID: PMC2569241] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Chylomicronemia syndrome is a rare disorder characterized by the presence of chylomicrons in the fasting state. An acute and potentially life-threatening complication of chyiomicronemia syndrome is severe acute pancreatitis. We report a case of a 24-year-old primigravida with severe hypertriglyceridemia-induced pancreatitis. We reviewed the clinical course and treatment of hypertriglyceridemia-induced pancreatitis. She was admitted in the 37th week of gestation with severe abdominal pain, which was radiating to the back, and having uterine contractions. Cesarean delivery was performed under spinal anesthesia, and a healthy male infant was born. Intraoperative findings included milky peritoneal fluid collection. Elevated pancreatic enzymes with significant hypertriglyceridemia (10,092 mg/dL) suggesting acute pancreatitis were also found on chemical analysis. The diagnosis of acute pancreatitis was confirmed by computed tomography scan. Treatment with continuous intravenous insulin--glucose, cessation of oral intake, and nasogastric decompression--dramatically decreased the triglyceride levels to 608 mg/dL within five days. She was discharged as symptom free with strict dietary intervention after 10 days. Intravenous insulin is a low-cost and effective alternative treatment in hypertriglyceridemia-induced pancreatitis during pregnancy. To our knowledge, such a high triglyceride level has not previously been reported in pregnancy.
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Affiliation(s)
- Alptekin Gürsoy
- Faculty of Medicine, Department of Endocrinology and Metabolism, Baskent University, Ankara, Turkey.
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