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Pray C, Narula N, Wong EC, Marshall JK, Rangarajan S, Islam S, Bahonar A, Alhabib KF, Kontsevaya A, Ariffin F, Co HU, Al Sharief W, Szuba A, Wielgosz A, Diaz ML, Yusuf R, Kruger L, Soman B, Li Y, Wang C, Yin L, Erkin M, Lanas F, Davletov K, Rosengren A, Lopez-Jaramillo P, Khatib R, Oguz A, Iqbal R, Yeates K, Avezum Á, Reinisch W, Moayyedi P, Yusuf S. A176 ASSOCIATIONS OF ANTIBIOTICS, HORMONAL THERAPIES, ORAL CONTRACEPTIVES, AND LONG-TERM NSAIDS WITH INFLAMMATORY BOWEL DISEASE: RESULTS FROM THE PROSPECTIVE URBAN RURAL EPIDEMIOLOGY (PURE) STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991214 DOI: 10.1093/jcag/gwac036.176] [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: 03/09/2023] Open
Abstract
Background The pathogenesis of inflammatory bowel disease (IBD) which includes Crohn’s disease (CD) and ulcerative colitis (UC), is believed to involve activation of the intestinal immune system in response to the gut microbiome among genetically susceptible hosts. IBD has been historically regarded as a disease of developed nations, though in the past two decades there has been a reported shift in the epidemiological pattern of disease. High-income nations with known high prevalence of disease are seeing a stabilization of incident cases, while a rapid rise of incident IBD is being observed in developing nations. This suggests that environmental exposures may play a role in mediating the risk of developing IBD. The potential environmental determinants of IBD across various regions is vast, though medications have been increasingly recognized as one broad category of risk factors. Purpose Several medications have been considered to contribute to the etiology of IBD. This study assessed the association between medication use and risk of developing IBD using the Prospective Urban Rural Epidemiology (PURE) cohort. Method This was a prospective cohort study of 133,137 individuals between the ages of 20-80 from 24 countries. Country-specific validated questionnaires documented baseline and follow-up medication use. Participants were followed prospectively at least every 3 years. The main outcome was development of IBD, including CD and UC. Short-term (baseline but not follow-up use) and long-term use (baseline and subsequent follow-up use) was evaluated. Results are presented as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Result(s) During the median follow-up of 11.0 years [interquartile range (IQR) 9.2-12.2], we recorded 571 incident cases of IBD (143 CD and 428 UC). Higher risk of incident IBD was associated with baseline antibiotic use [aOR: 2.81 (95% CI: 1.67-4.73), p=0.0001] and hormonal medication use [aOR: 4.43 (95% CI: 1.78-11.01), p=0.001]. Among females, previous or current oral contraceptive use was also associated with IBD development [aOR: 2.17 (95% CI: 1.70-2.77), p=5.02E-10]. NSAID users were also observed to have increased risk of IBD [aOR: 1.80 (95% CI: 1.23-2.64), p=0.002], which was driven by long-term users [aOR: 5.58 (95% CI: 2.26-13.80), p<0.001]. All significant results were consistent in direction for CD and UC with low heterogeneity. Conclusion(s) Antibiotics, hormonal medications, oral contraceptives, and long-term NSAID use were associated with increased odds of incident IBD after adjustment for covariates. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding below: Salim Yusuf is supported by the Heart & Stroke Foundation/Marion W. Burke Chair in Cardiovascular Disease. The PURE Study is an investigator-initiated study funded by the Population Health Research Institute, the Canadian Institutes of Health Research (CIHR), Heart and Stroke Foundation of Ontario, support from CIHR’s Strategy for Patient Oriented Research (SPOR) through the Ontario SPOR Support Unit, as well as the Ontario Ministry of Health and Long-Term Care and through unrestricted grants from several pharmaceutical companies, with major contributions from AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, and GlaxoSmithkline, and additional contributions from Novartis and King Pharma and from various national or local organisations in participating countries; these include: Argentina: Fundacion ECLA; Bangladesh: Independent University, Bangladesh and Mitra and Associates; Brazil: Unilever Health Institute, Brazil; Canada: Public Health Agency of Canada and Champlain Cardiovascular Disease Prevention Network; Chile: Universidad de la Frontera; China: National Center for Cardiovascular Diseases; Colombia: Colciencias, grant number 6566-04-18062; India: Indian Council of Medical Research; Malaysia: Ministry of Science, Technology and Innovation of Malaysia, grant numbers 100 -IRDC/BIOTEK 16/6/21 (13/2007) and 07-05-IFN-BPH 010, Ministry of Higher Education of Malaysia grant number 600 -RMI/LRGS/5/3 (2/2011), Universiti Teknologi MARA, Universiti Kebangsaan Malaysia (UKM-Hejim-Komuniti-15-2010); occupied Palestinian territory: the UN Relief and Works Agency for Palestine Refugees in the Near East, occupied Palestinian territory; International Development Research Centre, Canada; Philippines: Philippine Council for Health Research & Development; Poland: Polish Ministry of Science and Higher Education grant number 290/W-PURE/2008/0, Wroclaw Medical University; Saudi Arabia: the Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia (research group number RG -1436-013); South Africa: the North-West University, SANPAD (SA and Netherlands Programme for Alternative Development), National Research Foundation, Medical Research Council of SA, The SA Sugar Association (SASA), Faculty of Community and Health Sciences (UWC); Sweden: grants from the Swedish state under the Agreement concerning research and education of doctors; the Swedish Heart and Lung Foundation; the Swedish Research Council; the Swedish Council for Health, Working Life and Welfare, King Gustaf V’s and Queen Victoria Freemasons Foundation, AFA Insurance, Swedish Council for Working Life and Social Research, Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning, grant from the Swedish State under the Läkar Utbildnings Avtalet agreement, and grant from the Västra Götaland Region; Turkey: Metabolic Syndrome Society, AstraZeneca, Turkey, Sanofi Aventis, Turkey; United Arab Emirates (UAE): Sheikh Hamdan Bin Rashid Al Maktoum Award For Medical Sciences and Dubai Health Authority, Dubai UAE. Disclosure of Interest C. Pray: None Declared, N. Narula Grant / Research support from: Neeraj Narula holds a McMaster University Department of Medicine Internal Career Award. Neeraj Narula has received honoraria from Janssen, Abbvie, Takeda, Pfizer, Merck, and Ferring, E. C. Wong: None Declared, J. K. Marshall Grant / Research support from: John K. Marshall has received honoraria from Janssen, AbbVie, Allergan, Bristol-Meyer-Squibb, Ferring, Janssen, Lilly, Lupin, Merck, Pfizer, Pharmascience, Roche, Shire, Takeda and Teva., S. Rangarajan: None Declared, S. Islam: None Declared, A. Bahonar: None Declared, K. F. Alhabib: None Declared, A. Kontsevaya: None Declared, F. Ariffin: None Declared, H. U. Co: None Declared, W. Al Sharief: None Declared, A. Szuba: None Declared, A. Wielgosz: None Declared, M. L. Diaz: None Declared, R. Yusuf: None Declared, L. Kruger: None Declared, B. Soman: None Declared, Y. Li: None Declared, C. Wang: None Declared, L. Yin: None Declared, M. Erkin: None Declared, F. Lanas: None Declared, K. Davletov: None Declared, A. Rosengren: None Declared, P. Lopez-Jaramillo: None Declared, R. Khatib: None Declared, A. Oguz: None Declared, R. Iqbal: None Declared, K. Yeates: None Declared, Á. Avezum: None Declared, W. Reinisch Consultant of: Speaker for Abbott Laboratories, Abbvie, Aesca, Aptalis, Astellas, Centocor, Celltrion, Danone Austria, Elan, Falk Pharma GmbH, Ferring, Immundiagnostik, Mitsubishi Tanabe Pharma Corporation, MSD, Otsuka, PDL, Pharmacosmos, PLS Education, Schering-Plough, Shire, Takeda, Therakos, Vifor, Yakult, Consultant for Abbott Laboratories, Abbvie, Aesca, Algernon, Amgen, AM Pharma, AMT, AOP Orphan, Arena Pharmaceuticals, Astellas, Astra Zeneca, Avaxia, Roland Berger GmBH, Bioclinica, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Covance, Danone Austria, DSM, Elan, Eli Lilly, Ernest & Young, Falk Pharma GmbH, Ferring, Galapagos, Genentech, Gilead, Grünenthal, ICON, Index Pharma, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, LivaNova, Mallinckrodt, Medahead, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nash Pharmaceuticals, Nestle, Nippon Kayaku, Novartis, Ocera, Omass, Otsuka, Parexel, PDL, Periconsulting, Pharmacosmos, Philip Morris Institute, Pfizer, Procter & Gamble, Prometheus, Protagonist, Provention, Robarts Clinical Trial, Sandoz, Schering-Plough, Second Genome, Seres Therapeutics, Setpointmedical, Sigmoid, Sublimity, Takeda, Therakos, Theravance, Tigenix, UCB, Vifor, Zealand, Zyngenia, and 4SC, Advisory board member for Abbott Laboratories, Abbvie, Aesca, Amgen, AM Pharma, Astellas, Astra Zeneca, Avaxia, Biogen IDEC, Boehringer-Ingelheim, Bristol-Myers Squibb, Cellerix, Chemocentryx, Celgene, Centocor, Celltrion, Danone Austria, DSM, Elan, Ferring, Galapagos, Genentech, Grünenthal, Inova, Janssen, Johnson & Johnson, Kyowa Hakko Kirin Pharma, Lipid Therapeutics, MedImmune, Millenium, Mitsubishi Tanabe Pharma Corporation, MSD, Nestle, Novartis, Ocera, Otsuka, PDL, Pharmacosmos, Pfizer, Procter & Gamble, Prometheus, Sandoz, Schering-Plough, Second Genome, Setpointmedical, Takeda, Therakos, Tigenix, UCB, Zealand, Zyngenia, and 4SC, P. Moayyedi: None Declared, S. Yusuf: None Declared
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Affiliation(s)
- C Pray
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University
| | - N Narula
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University,Population Health Research Institute, McMaster University and Hamilton Health Sciences
| | - E C Wong
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University
| | - J K Marshall
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University
| | - S Rangarajan
- McMaster University and Hamilton Health Sciences, Population Health Research Institute, Hamilton, Canada
| | - S Islam
- McMaster University and Hamilton Health Sciences, Population Health Research Institute, Hamilton, Canada
| | - A Bahonar
- Isfahan Cardiovascular Research Center, Isfahan, Iran, Islamic Republic Of
| | - K F Alhabib
- King Fahad Cardiac Center, King Saud Medical City, Saudi Arabia
| | - A Kontsevaya
- National research center for therapy and preventive medicine, Moscow, Russian Federation
| | - F Ariffin
- Faculty of Medicine UiTM, Selangor, Malaysia
| | - H U Co
- University of the Philippines College of Medicine, Ermita, Philippines
| | - W Al Sharief
- Family Medicine Department, Medical Education & Research Department in Dubai Health Authority (DHA), Oud Metha-Dubai, United Arab Emirates
| | - A Szuba
- Wroclaw Medical University, Wroclaw, Poland
| | - A Wielgosz
- University of Ottawa Heart Institute, Ottawa, Canada
| | - M L Diaz
- Estudios Clínicos Latino América, Rosario, Argentina
| | - R Yusuf
- Independent University, Bangladesh, Bashundhara , Bangladesh
| | - L Kruger
- Africa Unit for Transdisciplinary Health Research , North West University, Potchefstroom, South Africa
| | - B Soman
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Y Li
- Medical Research & Biometrics Center, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - C Wang
- Medical Research & Biometrics Center, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - L Yin
- Medical Research & Biometrics Center, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - M Erkin
- Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
| | - F Lanas
- Universidad de La Frontera, Temuco, Chile
| | - K Davletov
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - A Rosengren
- Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
| | - P Lopez-Jaramillo
- Masira Research Institute, Universidad de Santander , Bucaramanga, Colombia
| | - R Khatib
- Institute of Community and Public Health, Birzeit University,, Birzeit, Palestinian, State of
| | - A Oguz
- Internal Medicine, Istanbul Medeniyet University,, Istanbul, -
| | - R Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi City, Pakistan
| | - K Yeates
- Department of Medicine, Queen's University, Kingston, Canada
| | - Á Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - W Reinisch
- Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
| | - P Moayyedi
- Department of Medicine (Division of Gastroenterology) and Farncombe Family Digestive Health Research Institute, McMaster University,Population Health Research Institute, McMaster University and Hamilton Health Sciences
| | - S Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences
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Ulgen C, Ozturk I, Sahin M, Guzel FB, Oguz A, Altunoren O, Gungor O. The amount of skeletal muscle mass is associated with arterial stiffness in hemodialysis patients. Ther Apher Dial 2023; 27:24-30. [PMID: 35426237 DOI: 10.1111/1744-9987.13853] [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: 02/10/2022] [Revised: 03/11/2022] [Accepted: 04/11/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Sarcopenia was determined to be associated with increased arterial stiffness in the nondialysis patient population, but there is no available data on this subject in dialysis patients. METHODS A total of 79 patients were included in the study. Sarcopenia was diagnosed according to the EWSGOP-2 criteria. Arterial stiffness was measured noninvasively with a mobile-O-Graph device. RESULTS Skeletal muscle mass was observed to be positively correlated with weight, body mass index, creatinine, and uric acid, while negatively correlated with augmentation index. There was a correlation between augmentation index and sodium, phosphorus, systolic blood pressure, diastolic blood pressure, cardiac index, muscle percentage, fat percentage, and skeletal muscle mass. When the determinants of augmentation index in the linear regression analysis were viewed, just the systolic blood pressure and skeletal muscle mass were observed to be the determinant. CONCLUSION Decreased skeletal muscle mass contributes to increased arterial stiffness in hemodialysis patients.
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Affiliation(s)
- Cansu Ulgen
- Internal Medicine Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ilyas Ozturk
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Murat Sahin
- Endocrinology and Metabolism Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Fatma Betul Guzel
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ayten Oguz
- Endocrinology and Metabolism Department, Biruni University Faculty of Medicine, Istanbul, Turkey
| | - Orcun Altunoren
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
| | - Ozkan Gungor
- Nephrology Department, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey
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Sahin M, Oguz A, Tüzün D, Işiktaş O, Işiktaş S, Ülgen C, Şahin H, Gul K. A new marker predicting gestational diabetes mellitus: First trimester neutrophil/lymphocyte ratio. Medicine (Baltimore) 2022; 101:e30514. [PMID: 36086702 PMCID: PMC10980480 DOI: 10.1097/md.0000000000030511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/22/2022] [Accepted: 08/05/2022] [Indexed: 01/22/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a condition that is very common during pregnancy and has negative consequences for both mother and fetus. Insulin resistance has been shown as an important cause in the pathogenesis of GDM and low-level inflammation is suggested to be one of the underlying causes of insulin resistance. We aimed to investigate whether the neutrophil-lymphocyte ratio (NLR), which is an indicator of systemic inflammation, is a predictor for GDM. A total of 228 pregnant women, including 128 GDM (patient group) and 100 healthy pregnant were included in the study. GDM was diagnosed with a 1-step approach between 24 and 28 weeks of pregnancy. We found a significant increase in NLR in the 1st and 3rd trimesters in the GDM group compared to healthy pregnant women, which supports that systemic inflammation starts in the early stages of pregnancy and continues throughout pregnancy. We also reported a positive correlation between NLR and fasting plasma glucose and body mass index in both trimesters. We showed that first trimester NLR independently predicted the development of GDM.
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Affiliation(s)
- Murat Sahin
- Faculty of Medicine, Department of Endocrinology and Metabolism, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ayten Oguz
- Endocrinology and Metabolism Division, Biruni University Faculty of Medicine, İstanbul, Turkey
| | - Dilek Tüzün
- Faculty of Medicine, Department of Endocrinology and Metabolism, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Okay Işiktaş
- Faculty of Medicine, Department of Internal Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turkey
| | - Songül Işiktaş
- Faculty of Medicine, Department of Internal Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turkey
| | - Cansu Ülgen
- Faculty of Medicine, Department of Internal Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turkey
| | - Hatice Şahin
- Department of Pulmonology, Kahramanmras Necip Fazil State Hospital, Kahramanmaras, Turkey
| | - Kamile Gul
- Department of Endocrinology and Metabolism Liv Hospital, Gaziantep, Turkey
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Şahin M, Oguz A, Tuzun D, Akkus G, Törün GI, Bahar AY, Şahin H, Gül K. Effectiveness of TI-RADS and ATA classifications for predicting malignancy of thyroid nodules. ADV CLIN EXP MED 2021; 30:1133-1139. [PMID: 34510845 DOI: 10.17219/acem/139591] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Thyroid cancer is one of the most common cancers and is especially common in young patients. Therefore, effective recognition and treatment of thyroid cancer are essential for patient survival. OBJECTIVES To compare the effectiveness of standard guidelines for predicting thyroid malignancy. To do so, thyroid nodules were classified according to the categories of the American Thyroid Association (ATA) and Thyroid Imaging Reporting and Data System (TI-RADS) guidelines, and compared with fine-needle aspiration biopsy (FNAB) results. MATERIAL AND METHODS The study included 1741 thyroid nodules with a final diagnosis in 1121 consecutive patients. The FNAB was recommended for all patients according to ATA guidelines and subsequently performed. The nodules were reclassified according to TI-RADS guidelines. RESULTS Comparing nodules classified according to ATA and TI-RADS in terms of ultrasonography (US) features with the Bethesda cytological diagnosis classification System for Reporting Thyroid Cytopathology, 37.6% of the nodules classified in the high-risk category according to the ATA classification were found to be malignant cytology, 10.4% suspicious for malignancy, 4% non-diagnostic, 9.6% indeterminant cytology, and 38.4% benign. According to the TI-RADS risk category, 50% of those with high suspicion were malignant, 13.3% suspicious for malignancy cytology and 36.7% were benign. For the TI-RADS guidelines, the best cutoff value for differentiating benign and malignant nodules was found to be 4.5 (area under the curve (AUC) = 0.962, 95% CI = 0.943-0.981, p < 0.001). For the ATA guidelines, the best cutoff value for separating benign and malignant nodules was 4.5 (AUC = 0.917, 95% CI = 0.875-0.959, p < 0.001). The diagnostic performances of the TI-RADS and ATA score systems were evaluated using highly suspicious nodules. The sensitivity and specificity of highly suspicious nodules, according to both TI-RADS and ATA guidelines, were both high. Sensitivity and specificity of ATA classification were 80% and 96.3%, respectively. Sensitivity and specificity of TI-RADS classification were 76% and 97.5%, respectively, but positive predictive value was low (63.3% compared to 55.5%). CONCLUSIONS Both, the ATA and TI-RADS classifications can effectively predict malignancy risk of thyroid nodules and may thus decrease unnecessary FNAB.
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Affiliation(s)
- Murat Şahin
- Department of Endocrinology and Metabolism, Kahramanmaraş Sütçü İmam University, Turkey
| | - Ayten Oguz
- Department of Endocrinology and Metabolism, Gaziantep Liv Hospital, Turkey
| | - Dilek Tuzun
- Department of Endocrinology and Metabolism, Kahramanmaraş Sütçü İmam University, Turkey
| | - Gülsüm Akkus
- Department of Internal Medicine, Etimesgut Şehit Sait Ertürk State Hospital, Ankara, Turkey
| | - Gul Inci Törün
- Department of Internal Medicine, Afsin State Hospital, Kahramanmaraş, Turkey
| | - Abdulkadir Yasir Bahar
- Department of Pathology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Turkey
| | - Hatice Şahin
- Department of Pulmonology, Kahramanmraş Necip Fazıl State Hospital, Turkey
| | - Kamile Gül
- Department of Endocrinology and Metabolism, Gaziantep Liv Hospital, Turkey
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Oguz A, Sahin M, Ulgen C, Uyan M, Gul K. Overt hypogonadism is a cardiovascular risk factor in type 2 diabetic males: An observational study. Andrologia 2021; 54:e14271. [PMID: 34632609 DOI: 10.1111/and.14271] [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: 08/31/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022] Open
Abstract
We aimed to evaluate the effects of hypogonadism on metabolic and chronic complications in type 2 diabetic males. 261 nonobese males with type 2 diabetes aged 18-70 were involved in the study. Hypononadal males were divided into 2 groups as overt hypogonadism (total testosterone≤230 ng/dl) and borderline hypogonadism (230-345 ng/dl). The control group involved eugonadal diabetic males. Micro-macrovascular complications were recorded. 101 patients had hypogonadism (38.7%), and 160 patients were eugonadal (61.3%). Microvascular complication rate was not different, but macrovascular complication rate was significantly higher in hypogonadal males (42.6%/31.3%, p = 0.042). Optimal glycosylated haemoglobin (HbA1c) achievement(<7%) was significantly lower in hypogonadal patients (20.8%/31.3%, p = 0.043). Poor glycaemic control (HbA1c≥7%), presence of microvascular complication and increased triglyceride levels were independent risk factors for hypogonadism (OR: 1.5, p = 0.044;OR:3.89,p = 0.025 and OR: 1.0, p = 0.016 respectively). Overt hypogonadism, hypertension, hypercholesterolaemia and severe hypoglycaemia were independent risk factors for macrovascular complications (OR: 1.0, p = 0.027; OR:2.6, p = 0.002; OR: 1.8, p = 0.047 and OR: 1.0, p = 0.007 respectively), diabetes duration (≥5 years) and poor glycaemic control for microvascular complication (OR: 1.0, p = 0.031 and OR:2.0, p = 0.028). As a result, hypogonadism is frequent among diabetic males and poor glycaemic control may be an important contributing factor. Furthermore overt hypogonadism is an important cardiovascular risk marker. Therefore, ensuring eugonadism in diabetic patients may positively affect both glycaemic control and complications.
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Affiliation(s)
- Ayten Oguz
- Department of Endocrinology and Metabolism, Faculty of Medicine, Istinye University, İstanbul, Turkey
| | - Murat Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Cansu Ulgen
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Merve Uyan
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Kamile Gul
- Gaziantep Liv Hospital, Endocrinology and Metabolism, Gaziantep, Turkey
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Oguz A, Sahin M, Tuzun D, Kurutas EB, Ulgen C, Bozkus O, Gul K. Irisin is a predictor of sarcopenic obesity in type 2 diabetes mellitus: A cross-sectional study. Medicine (Baltimore) 2021; 100:e26529. [PMID: 34190188 PMCID: PMC8257893 DOI: 10.1097/md.0000000000026529] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 03/24/2021] [Accepted: 06/15/2021] [Indexed: 12/25/2022] Open
Abstract
We aimed to evaluate sarcopenia and sarcopenic obesity (SO) in patients with type 2 diabetes mellitus (T2DM), possible relationships with serum irisin and myostatin levels, and the effect of glycemic control on SO.Ninety T2DM patients were included in this a cross-sectional study. Sarcopenia was determined by evaluating muscle mass (bioelectrical impedance analysis), muscle strength (HGS), and gait speed (GS). Patients with muscle mass loss with functionally reduced muscle strength and/or performance were considered sarcopenic. In addition, participants were divided into 3 groups according to the FM (fat mass)/FFM (fat-free mass) ratio [group 1:5th-50th percentiles; group 2:50th-95th percentiles and group 3: ≥95 percentiles (sarcopenic obese)]. Irisin, myostatin levels and metabolic parameters were measured in all patients.The prevalence of sarcopenia and SO was 25.6% and 35.6%, respectively. Irisin levels were lower in sarcopenic patients, while glycosylated hemoglobin (A1c), body mass index (BMI), FM, and FM index were higher (P < .05). From group 1 to group 3, BMI, FM, FM index, GS, myostatin, and A1c increased, and muscle mass percentage, HGS, and irisin decreased (P < .05). A positive correlation was found between FM/FFM and myostatin and a negative correlation between FM/FFM and irisin (r = 0.303, P = .004 vs. r = -0.491, P < .001). Irisin remained an important predictor of SO, even after adjusting for confounding variables (OR:1.105; 95% CI:0.965-1.338, P = .002). The optimal cut-off value for irisin to predict SO was 9.49 ng/mL (specificity = 78.1%, sensitivity = 75.8%). In addition, A1c was an independent risk factor for SO development (OR:1.358, P = .055).This study showed that low irisin levels (<9.49ng/mL) and poor glycemic control in T2DM patients were an independent risk factor, especially for SO.
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Affiliation(s)
- Ayten Oguz
- Faculty of Medicine, Istinye University, Istanbul
| | | | | | | | - Cansu Ulgen
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | | | - Kamile Gul
- Faculty of Medicine, Istinye University, Istanbul
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Tuzun D, Oguz A, Aydin MN, Kurutas EB, Ercan O, Sahin M, Ünsal V, Ceren I, Akçay A, Gul K. Is FGF-23 an early indicator of atherosclerosis and cardiac dysfunction in patients with gestational diabetes? Arch Endocrinol Metab 2018; 62:506-513. [PMID: 30462803 PMCID: PMC10118658 DOI: 10.20945/2359-3997000000070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 06/10/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Fibroblast growth factor 23 (FGF-23) is a phosphorus-regulating hormone and plays a role in the pathogenesis of myocardial hypertrophy. The aim of this study was to evaluate the association of FGF-23 levels with echocardiographic parameters and insulin resistance (IR) in patients with gestational diabetes. SUBJECTS AND METHODS Fifty-four pregnant patients with gestational diabetes mellitus (GDM) (age, 31.12 ± 5.72 years) and 33 healthy pregnant women (age, 29.51 ± 4.92 years) were involved in the study. Fasting insulin, fasting plasma glucose (FPG), lipid profile, oral glucose tolerance test (OGTT), FGF23, echocardiographic parameters, and carotid artery intima-media thickness (CIMT) were evaluated in the two groups. RESULTS The two groups were not significantly different in age, sex, body mass index, lipid profile, or blood pressure. Insulin, homeostatic model assessment-insulin resistance (HOMA-IR), FGF-23 levels, CIMT, left ventricular (LV) mass, LV mass index and myocardial performance index (MPI) were significantly higher in the GDM group. HOMA-IR was positively correlated with FGF-23, and insulin was positively correlated with FGF-23. Additionally, FGF-23 was positively correlated with CIMT, LV mass index, and MPI. CONCLUSION Our findings suggest that monitoring serum FGF-23 may be useful as a non-invasive indicator of subclinical atherosclerosis in patients with GDM.
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Affiliation(s)
- Dilek Tuzun
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kahramanmaras, Turkey
| | - Ayten Oguz
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kahramanmaras, Turkey
| | - Muhammet Naci Aydin
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaras, Turkey
| | - Ergul Belge Kurutas
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Biochemistry, Kahramanmaras, Turkey
| | - Onder Ercan
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Obstetric and Gynecology, Kahramanmaras, Turkey
| | - Murat Sahin
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kahramanmaras, Turkey
| | - Velid Ünsal
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Biochemistry, Kahramanmaras, Turkey
| | - Imran Ceren
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaras, Turkey
| | - Ahmet Akçay
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaras, Turkey
| | - Kamile Gul
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kahramanmaras, Turkey
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8
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Sokmen G, Sahin M, Tuzun D, Sokmen A, Bolat H, Oguz A, Doganer A, Nacar H, Gul K. Assessment of Subclinical Cardiac Alterations and Atrial Electromechanical Delay by Tissue Doppler Echocardiography in Patients with Nonfunctioning Adrenal Incidentaloma. Arq Bras Cardiol 2018; 111:656-663. [PMID: 30328944 PMCID: PMC6248257 DOI: 10.5935/abc.20180188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/10/2018] [Indexed: 01/08/2023] Open
Abstract
Background Majority of the incidentally discovered adrenal masses, called adrenal
incidentaloma (AI), are nonfunctioning adrenal adenomas. The appropriate
management of AI is still a matter debate, so it is necessary to investigate
their associated morbidity. However, data regarding morphological and
functional cardiac alterations are limited in this group. Objective In this study, we aimed to assess cardiac structural and functional
characteristics and atrial conduction properties in patients with
nonfunctioning AI. Methods Thirty patients with nonfunctioning AI and 46 properly matched control
subjects were included in the study. After hormonal and biochemical
analysis, all participants underwent transthoracic echocardiography to
obtain systolic and diastolic parameters of both ventricles, in addition to
atrial conduction times by tissue Doppler echocardiography. Data were
analyzed with Statistical Package for the Social Sciences (SPSS, Chicago,
IL, United States) statistics, version 17.0 for Windows. P < 0.05 was
considered statistically significant. Results Left ventricular (LV) mass index and LV myocardial performance index were
significantly increased in AI group. Among atrial conduction times, both
intra- and interatrial electromechanical delays were significantly prolonged
in patients with nonfunctioning AI. Other laboratory and echocardiographic
findings were similar between groups. Conclusion Our study revealed that intra- and inter-atrial conduction times were
prolonged, and LV mass index was increased in patients with nonfunctioning
AI. These findings may be markers of subclinical cardiac involvement and
tendency to cardiovascular complications. Close follow-up is necessary for
individuals with nonfunctioning AI for their increased cardiovascular risk.
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Affiliation(s)
- Gulizar Sokmen
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaraş - Turquia
| | - Murat Sahin
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaraş - Turquia
| | - Dilek Tuzun
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaraş - Turquia
| | - Abdullah Sokmen
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaraş - Turquia
| | - Hanife Bolat
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Internal Medicine, Kahramanmaraş - Turquia
| | - Ayten Oguz
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Endocrinology, Kahramanmaraş - Turquia
| | - Adem Doganer
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Kahramanmaraş - Turquia
| | - Huseyin Nacar
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaraş - Turquia
| | - Kamile Gul
- Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Endocrinology, Kahramanmaraş - Turquia
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Gonen O, Erbakan A, Mesci B, Caklili OT, Oguz A. Anxiety rate of caregivers and its association with nutritional status. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1840] [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: 10/28/2022]
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10
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Abstract
Prolactinomas are the most common pituitary tumors but rarely seen in adolescent males. There is no indication for surgery both in micro- and macro-adenomas unless an urgent treatment is necessary. First line treatment is always medical with dopamine agonists. In this report, we presented a patient with pubertal arrest and giant prolactinoma that disappeared in a short time with cabergoline treatment.
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Affiliation(s)
- A Oguz
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - D Tuzun
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - M Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - K Gul
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Sahin M, Demircioglu D, Oguz A, Tuzun D, Sarica MA, Inanc E, Gul K. Does insulin resistance increase thyroid volume in patients with polycystic ovary syndrome? Arch Endocrinol Metab 2017; 61:145-151. [PMID: 27901182 PMCID: PMC10118860 DOI: 10.1590/2359-3997000000225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 06/29/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the effect of gonadotropin, sex hormone levels and insulin resistance (IR) on thyroid functions and thyroid volume (TV) in polycystic ovary syndrome (PCOS). SUBJECTS AND METHODS 69 new diagnosed PCOS patients (age 24.82 ± 6.17) and 56 healthy control female (age 26.69 ± 5.25) were involved to the study. Fasting plasma glucose, lipid profile, insulin, thyroid stimulating hormone (TSH), free thyroxine (fT4), estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone levels and urine iodine were measured in all participants. Thyroid and pelvic ultrasound were performed in all participants. RESULTS Insulin, HOMA-IR, LH, E2 and TV were higher in PCOS group (p < 0.05). TV was significantly higher in PCOS patients with IR compared to non-IR PCOS patients (p < 0.001), while TSH, fT4, and urine iodine levels were similar between these groups (p > 0.05). There was a negative correlation between E2 and TSH (p < 0.05) and a positive correlation between TSH and TV (p < 0.05). There was a significant positive correlation between TV and LH, insulin, HOMA-IR (p < 0.05). CONCLUSION This study showed that TV was increased in patients with insulin resistance but differences in TSH and LH levels may affect TV changes as well.
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Affiliation(s)
| | | | - Ayten Oguz
- Kahramanmaras Sutcu Imam University, Turkey
| | | | | | - Elif Inanc
- Kahramanmaras Sutcu Imam University, Turkey
| | - Kamile Gul
- Kahramanmaras Sutcu Imam University, Turkey
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Taskesen F, Arikanoglu Z, Bostanci S, Oguz A, Uslukaya O, Turkoglu A, Veli Ulger B, Bac B. Rectovaginal fistulas: five year's experience. Clin Ter 2016; 165:129-32. [PMID: 24999564 DOI: 10.7417/ct.2014.1709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Rectovaginal fistula is an epithelial connection between the anterior wall of the rectum and posterior wall of the vagina. The etiology of the rectovaginal fistula can be trauma orginated from violent acts or foreign bodies as well as trauma during obstetric, gynecologic, or colorectal surgeries. The purpose of this study was to share our clinic experience and surgical management for rectovaginal fistulas. PATIENTS AND METHODS This study was conducted at the Department of General Surgery, University of Dicle. All patients who were treated for rectovaginal fistulas between January 2005 and December 2011 were included to this study. RESULTS There were fifteen patients in a mean age of 32 ± 9.6. The most common complains of patients were arrival of gas and stool from the vagina. The etilogy of rectovaginal fistula was most commonly obstetric trauma in our patients and three of them had anal incontinance. The mean time of hospital stay was 5 days ± 1.7. Postoperative wound infection was seen in two patients and reccurence disease occurred in two patients during the postoperative period. CONCLUSIONS Rectovaginal fistula treatment is a challenging condition for the surgeon since anatomical relationships and different surgical conditions changes according to the paitents. Various surgical techniques are available for the management of rectovaginal fistulas according to their etiology, size, location. For the treatment of low fistulas, best results were achieved using conservative fistulectomy, layer closure, and both-sided covering of the tissue defect with advancement vaginal and rectal flaps.
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Affiliation(s)
- F Taskesen
- Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey
| | - Z Arikanoglu
- Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey
| | - S Bostanci
- Department of Obstetrics and Gynaecology, Sakarya Education and Research Hospital, Korucuk, 54100, Sakarya, Turkey
| | - A Oguz
- Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey
| | - O Uslukaya
- Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey
| | - A Turkoglu
- Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey
| | - B Veli Ulger
- Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey
| | - B Bac
- Department of Surgery, Dicle University Hospital, Faculty of Medicine, 21280, Diyarbakir, Turkey
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Affiliation(s)
- A Oguz
- Department of Medical Oncology, Baskent University, Ankara, Turkey
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14
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Gonen O, Bozkurt I, Dizman N, Oguz A. SUN-P130: Awareness of Healthcare Professionals and the Status of their Patients in Nutritional Care. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30473-3] [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: 12/01/2022]
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15
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Unal D, Oguz A, Tasdemir A, Koc A. Invasion of lung cancer into breast: The first case report. Indian J Cancer 2016; 52:197-8. [PMID: 26853402 DOI: 10.4103/0019-509x.175815] [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: 11/04/2022]
Affiliation(s)
- D Unal
- Department of Radiation Oncology, Kayseri Education and Research Hospital, Kayseri, Turkey
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16
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Beyca HH, Mesci B, Telci Caklili O, Mutlu HH, Oguz A. NEUROPATHY ASSOCIATED WITH HYPERTRIGLYCERIDEMIA IN PATIENTS WITH METABOLIC SYNDROME. Acta Endocrinol (Buchar) 2016; 12:26-29. [PMID: 31258796 DOI: 10.4183/aeb.2016.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Context With more studies investigating effects of high serum lipid levels, new findings are emerging regarding the damage these biomolecules may cause. Aim In this study we aimed to find a relation between neuropathy and hypertriglyceridemia in patients with metabolic syndrome (MS). Material and methods One hundred and twenty subjects (Ninety subjects with metabolic syndrome and 30 healthy controls) were included in the study. Subjects with MS were divided into three groups. HbA1C levels of the subjects were < 5.7% in group A, ≥ 5.7% - < 6.5% in group B, and ≥ 6.5% - < 8.0% in group C. Pin-Prick test and Semmes- Weinstein Monofilament were used for neurological examination. Electromyography was performed to patients with neuropathy to support the diagnosis. Results Neuropathy prevalence was found to be higher in the subjects with metabolic syndrome compared to control group. (9.9 %; 16.65 %; 23.31 % vs. 3.3%; in group A, group B, group C vs. healthy control group respectively) (p=0.003 for group A, p=0.0002 for group B, p=0.0002 for group C). There was an association between triglyceride levels and neuropathy in group C. Conclusion Patients with MS may have more neuropathy risk than we estimate.
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Affiliation(s)
| | | | - O Telci Caklili
- Medeniyet University Goztepe Training and Research Hospital, Dept. of Internal Medicine, Turkey
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17
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Oguz A, Tuzun D, Sahin M, Bulbul N, Celik A, Guvenc N, Inanc E, Gul K. Should human chorionic gonadotropine treatment increase thyroid volume? Arch Endocrinol Metab 2015; 59:482-486. [PMID: 26331230 DOI: 10.1590/2359-3997000000096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 07/01/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Our aim was to investigate the thyroid function tests and thyroid volume differences among males with isolated hypogonadotropic hypogonadism (IHH) who take androgen replacement treatment (ART). MATERIALS AND METHODS Forty-four male with IHH with a mean age 33.2 (18-54), diagnosed in Endocrinology and Metabolism Department between September 2013 and September 2014 and 40 healthy male control with a mean age 27.77 (18-55) were involved to study. Patient group was divided to testosterone-treated patients (n = 19) and human chorionic gonadotropine (hCG)-treated patients (n = 25). Patient group was compared in terms of total testosterone, thyroid function tests [thyroid stimulating hormone (TSH), free thyroxine (fT4)] and thyroid volume, before and 6 months after treatment. Patient group was compared with control group as well. RESULTS When we compared the patient group with the control group, there was no significant difference for age, Body mass index, TSH, fT4 and thyroid volume between two groups before treatment. There was no difference in terms of TSH, but fT4, testosterone levels and thyroid volume were significantly higher after treatment, when the patient group was compared before and after treatment (p < 0.05). When we compared testosterone-treated patients and hCG-treated patients; thyroid volume was higher among hCG-treated patients (p = 0.001) but there was no difference for thyroid volume before and after testosterone treatment (p > 0.05). There was no statistically significant correlation between testosterone levels with TSH, fT4 and thyroid volume (r = 0.09, p = 0.32; r = 0.14, p = 0.11; r = 0.15, p = 0.09, respectively). CONCLUSION Our study showed that ART increases the thyroid volume especially in hCG-treated patients. Therefore, we suggest that thyroid volume changes should be followed up in hCG-treated patients.
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Affiliation(s)
- Ayten Oguz
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Dilek Tuzun
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Murat Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Nese Bulbul
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ahmet Celik
- Department of Biochemistry, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Numan Guvenc
- Department of Family Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Elif Inanc
- Department of Internal Medicine, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Kamile Gul
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Oguz A, Tuzun D, Sahin M, Usluogullari AC, Usluogullari B, Celik A, Gul K. Frequency of isolated maternal hypothyroxinemia in women with gestational diabetes mellitus in a moderately iodine-deficient area. Gynecol Endocrinol 2015; 31:792-5. [PMID: 26190538 DOI: 10.3109/09513590.2015.1054801] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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] [Indexed: 11/13/2022] Open
Abstract
AIM To investigate frequency of isolated maternal hypothyroxinemia (IMH) in women with gestational diabetes mellitus (GDM) using both the method specific trimester range (MSTR) and the standard reference range (SRR). METHODS Our study included 50 GDM patients (case group) and 60 non-GDM pregnant (control group). Glucose, insulin, HOMA-IR, fT4 and TSH values were measured when pregnancy was confirmed in all participants. Thyroid function tests were measured in each trimester using the SRR and the MSTR. RESULTS In the second and third trimesters, mean fT4 levels were significantly lower in the case group compared to the control group, based on the SRR (p < 0.001). Mean fT4 levels were within the normal reference range in both groups, based on the MSTR; however, the levels were significantly lower in the case group (p < 0.001). Using the SRR, IMH frequencies in the second and third trimesters, in the case group were 56 and 86%, respectively, and were 13.3 and 46.7%, respectively, in the control group (p < 0.001). Using the MSTR, the IMH frequencies in the second and third trimesters were 8 and 14%, respectively; there were no instances of IMH in the control group. CONCLUSION This study shows that changes in glucose metabolism may affect the thyroid hormone levels (fT4). Additionally, evaluating thyroid function tests in GDM patients using the MSTR can give more accurate results.
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Affiliation(s)
- Ayten Oguz
- a Department of Endocrinology and Metabolism, Faculty of Medicine , Kahramanmaras Sutcu Imam University , Kahramanmaras , Turkey
| | - Dilek Tuzun
- a Department of Endocrinology and Metabolism, Faculty of Medicine , Kahramanmaras Sutcu Imam University , Kahramanmaras , Turkey
| | - Murat Sahin
- a Department of Endocrinology and Metabolism, Faculty of Medicine , Kahramanmaras Sutcu Imam University , Kahramanmaras , Turkey
| | - Alper Celil Usluogullari
- b Clinic of Endocrinology and Metabolic Diseases, Dr. Ersin Arslan State Hospital , Gaziantep , Turkey
| | - Betül Usluogullari
- c Clinic of Obstetrics and Gynecology, Cengiz Gokcek Obstetrics and Children's Hospital , Gaziantep , Turkey , and
| | - Ahmet Celik
- d Department of Biochemistry, Faculty of Medicine , Kahramanmaras Sutcu Imam University , Kahramanmaras , Turkey
| | - Kamile Gul
- a Department of Endocrinology and Metabolism, Faculty of Medicine , Kahramanmaras Sutcu Imam University , Kahramanmaras , Turkey
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Oguz A, Tuzun D, Ozdemir E, Ersoy R, Yazgan AK, Cakir B. Importance of ectopic thyroid tissue detected in the midline of the neck: single center experience. Arch Endocrinol Metab 2015; 60:231-5. [PMID: 26331224 PMCID: PMC10522296 DOI: 10.1590/2359-3997000000073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 05/07/2015] [Accepted: 05/27/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Ectopic thyroid tissue (ETT) is a rare abnormality of the thyroid gland and the true prevalence and importance is not known. The aim of this study was to evaluate ultrasonography (US) guided fine needle aspiration biposy (FNAB) results, sonographic features, and frequency of ETT detected in the midline of the neck. SUBJECTS AND METHODS Five thousand five hundred and twenty outpatients who were referred to our thyroid clinic between September 2010 and April 2012 and underwent thyroid US, were retrospectively analyzed. Patients with ETT, detected in the midline of the neck in US were included in the study. Thyroid functions, sonographic features, and US guided FNAB results were evaluated. RESULTS There were 81 (81.8%) female and 18 (18.2%) male patients with a mean age of 50.9 ± 11.7. The ETT in the midline was present in 1.79% (99/5,520) of the patients. In the majority of the patients, benign sonographic features (isoechoic, regular margin, type 1 vascularization) were detected. There were 92 (92.9%) patients with a previous history of thyroidectomy and all were histopathologically benign. In 7 (7.1%) patients, there was no history of thyroid operation. FNAB results of ETT were benign. CONCLUSION This study evaluated the importance of ETT detected incidentally in the midline of the neck. Especially in patients with a history of thyroidectomy, the thyroid masses in the midline of the neck can be found as incidental with imaging methods. Our results suggests that the incidence of malignancy in this group is much lower than orthotopic thyroid nodules and they are often benign.
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Affiliation(s)
- Ayten Oguz
- Ankara Atatürk Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyAnkara Atatürk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Dilek Tuzun
- Ankara Atatürk Education and Research HospitalDepartment of Endocrinology and MetabolismAnkaraTurkeyAnkara Atatürk Education and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Elif Ozdemir
- Yıldırım Beyazıt UniversityFaculty of MedicineDepartment of Nuclear MedicineAnkaraTurkeyYıldırım Beyazıt University, Faculty of Medicine, Department of Nuclear Medicine, Ankara, Turkey
| | - Reyhan Ersoy
- Yildirim Beyazit UniversityFaculty of MedicineDepartment of Endocrinology and MetabolismAnkaraTurkeyYildirim Beyazit University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Aylin Kilic Yazgan
- Yıldırım Beyazıt UniversityAnkara Atatürk Education and Research HospitalDepartment of PathologyAnkaraTurkeyYıldırım Beyazıt University, Ankara Atatürk Education and Research Hospital, Department of Pathology, Ankara, Turkey
| | - Bekir Cakir
- Yildirim Beyazit UniversityFaculty of MedicineDepartment of Endocrinology and MetabolismAnkaraTurkeyYildirim Beyazit University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
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Oguz A, Cevizci E, Ertekin A, Abdulnabi R. Clinical outcomes and resource use after 24 months of insulin therapy in Turkish patients with type 2 diabetes: subgroup analysis of the TREAT study. Int J Clin Pract 2015; 69:588-96. [PMID: 25472768 DOI: 10.1111/ijcp.12584] [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] [Received: 01/09/2014] [Accepted: 10/10/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study evaluated levels of metabolic control, resource use and quality of life in Turkish patients with type 2 diabetes initiated on insulin in routine care. PATIENTS AND METHODS The prospective, observational TREAT study evaluated patients from five different countries who were initiated on insulin and followed for 24 months. In this paper, we present the results of a cohort analysis specific to Turkish patients from the study. RESULTS A total of 211 patients in the Turkish multicenter cohort [male patients 50.2%, age 56.5 year±8.9 SD, body mass index (BMI) 30.6 kg/m2±5.4 SD, diabetes duration 9.7 year±5.9 SD] initiated insulin at baseline. Oral antidiabetic drugs had been used by 93.4% of patients prior to insulin initiation, and 65.9% had used more than one regimen. Pre-existing metformin therapy was continued by 68.7% of patients after insulin initiation. In the three most common insulin regimens, glycosylated haemoglobin (HbA1C) declined over 24 months from 10.27% to 7.82% (long/intermediate acting), from 10.82% to 7.52% (premixed) and from 10.42% to 7.67% (basal-bolus). Less than 25% achieved a glycaemic goal of HbA1C≤7.0% and changes in insulin dose or regimen rarely occurred. Premixed insulin regimens were associated with greatest weight gain. Hypoglycaemic episodes were reported by more patients at 3, 6 and 12 months than at baseline or at 18 or 24 months. Healthcare use increased over baseline levels in the first 6 months, but was closer to baseline levels at subsequent assessments. Patient recorded health profiles improved after initiating insulin, particularly quality of life scores related to psychological distress and pain/discomfort. Morisky scores predictive of medication adherence and treatment persistence also improved. CONCLUSIONS In Turkish patients with type 2 diabetes, metabolic control remained suboptimal after initiating insulin as part of routine care even after 24 months of insulin treatment. Apparent shortcomings in routine care in most patients included a high baseline HbA1C because of delayed insulin initiation and an unwillingness to individualise insulin regimens.
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Affiliation(s)
- A Oguz
- Department of Internal Medicine, Istanbul Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey
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Muratli S, Uzunlulu M, Gonenli G, Oguz A, Isbilen B. Fetuin A as a new marker of inflammation in Hashimoto thyroiditis. MINERVA ENDOCRINOL 2015; 40:9-14. [PMID: 24732714] [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: 06/03/2023]
Abstract
AIM Fetuin-A levels are reported to be low as a negative acute phase reactant in systemical inflammatory situations. Hashimoto thyroiditis is characterized with inflammation. In this study, we hypothesised that the serum fetuin A levels could be found to be low due to inflammation in patients with Hashimoto thyroiditis. For this purpose, serum fetuin A levels in patients with Hashimoto thyroiditis were compared with those in healthy subjects. METHODS A total of 85 participants (11 male, 74 female, mean age: 38.60±10.14 years) were included. The patient group consisted of 44 Hashimoto thyroiditis patients with subclinical hypothyroidism (7 male, 37 female) and the control group consisted of 41 healthy subjects (4 male, 37 female). Groups were compared according to their demographic, anthropometric and biochemical data and serum fetuin-A levels. Correlation analysis was used for determining the relation between fetuin A levels and clinical parameters. RESULTS Fetuin-A levels of the patient group were found lower than those of the control group (0.58±0.50 g/L versus 1.53±1.60 g/L, P=0.001). Fetuin-A levels were not correlated with clinical parameters such as TSH, C-reactive protein, body mass index, waist circumference, blood pressure, glucose, and lipids. CONCLUSION These findings supported the hypothesis that serum fetuin A levels could be found to be low as a negative acute phase reactant in patients with Hashimoto thyroiditis. Fetuin A can be considered as an indicator of inflammation in Hashimoto thyroiditis.
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Affiliation(s)
- S Muratli
- Medeniyet University Goztepe Training and Research Hospital Department of Internal Medicine Istanbul, Turkey -
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Sayar H, Sahin M, Dogan PO, Karabulut S, Seringec N, Oguz A. Immunohistochemical expression of Insulin-like growth factor-1, Transforming growth factor-beta1, and Vascular endothelial growth factor in parathyroid adenoma and hyperplasia. INDIAN J PATHOL MICR 2014; 57:549-52. [PMID: 25308005 DOI: 10.4103/0377-4929.142658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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
BACKGROUND Insulin-like growth factor (IGF), transforming growth factor-beta1 (TGF-β1), and vascular endothelial growth factor (VEGF) are commonly studied growth factors, but little data are available on the immunohistochemical expression of these factors in parathyroid lesions. MATERIALS AND METHODS Tissue specimens from 36 patients with primary hyperparathyroidism (P-HPT) (26 adenomas and 10 primary hyperplasias) were examined. Normal parathyroid tissue adjacent to the adenoma or area of hyperplasia was used as control tissue. Preoperative laboratory testing [serum Ca and P, creatinine and parathormone levels (PTH)] which led to the diagnosis of P-HPT had been performed, the size and weight of the parathyroid glands measured, and postoperative serum PTH levels determined. Paraffin-embedded parathyroid tissue specimens were stained with antibodies to IGF-1, VEGF, and TGF-β1 using standard immunohistochemical procedures. RESULTS IGF-1 immunoreactivity was seen in 50% of hyperplasia and in 46% of adenoma samples, but in 87% of normal parathyroid tissue in the vicinity of the adenomas (P = 0.005). TGF-β1 immunoreactivity was observed in 90% of hyperplasia, in 92% of adenoma samples, and in 95% of normal tissues around adenomas. VEGF immunoreactivity was observed in 70% of hyperplastic and 65% of adenomatous tissues, as well as in 54% of normal tissues in the vicinity of the adenoma. No significant differences in the expression of IGF-1, TGF-β1, and VEGF were observed between primary adenomas compared to hyperplasia samples (P > 0.05). CONCLUSIONS Parathyroid tissue is clearly a site for production of IGF-1, TGF-β1, and VEGF. IGF-1 receptor activity was higher in normal parathyroid tissue compared to hyperplastic and adenomatous tissue.
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Affiliation(s)
- Hamide Sayar
- Department of Pathology, Kahramanmaras Sutcu İmam University Faculty of Medicine, Kahramanmaras, Turkey
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Sendur M, Aksoy S, Uncu D, Demir H, Yuksel S, Ekinci A, Kaplan M, Ustaalioglu B, Tufan G, İnanc M, Ozdemir N, Artac M, Taştekin D, Kacan T, Oguz A, Arpaci E, Yazılıtas D, Gumus M, Zengin N, Altundag M. Efficacy of Adjuvant 9-Weeks Trastuzumab in Node-Negative T1A/B Her2-Positive Breast Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.44] [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: 11/14/2022] Open
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Oguz A, Karadeniz C, Tekkesin F, Pinarli FG, Okur A, Kapucu O, Akdemir OU, Işık M. Evaluation of FDG-PET/CT and Conventional Imaging Techniques in Pediatric Hodgkin Lymphoma Patients in a Single Center. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Oguz A, Benroubi M, Brismar K, Melo P, Morar C, Cleall SP, Giaconia J, Schmitt H. Clinical outcomes after 24 months of insulin therapy in patients with type 2 diabetes in five countries: results from the TREAT study. Curr Med Res Opin 2013; 29:911-20. [PMID: 23659564 DOI: 10.1185/03007995.2013.803053] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [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]
Abstract
OBJECTIVE To assess factors associated with insulin regimens at initiation, changes in treatment and metabolic control over 2 years of insulin therapy in patients with type 2 diabetes in five countries. RESEARCH DESIGN AND METHODS TREAT was a prospective, 24 month, observational study in patients with type 2 diabetes initiating insulin in clinical practice. Patient characteristics were collected at baseline and metabolic outcomes at 3, 6, 12, 18 and 24 months after initiation. RESULTS A total of 985 patients were enrolled, 886 assessed at baseline and 734 (82.8%) at 24 months. Baseline characteristics varied between countries: 52.8% of patients were men; mean age was 60.4 years; body mass index, 29.7 kg/m²; time since diagnosis, 10.1 years; HbA1c, 9.6%. Less than 25% of patients met ADA/IDF targets for blood pressure/LDL cholesterol. Overall, 50.1% of patients were initiated on long/intermediate insulin, 39.3% on mixture and 7.8% on basal-bolus; distribution varied between countries. Patients on long/intermediate were more likely to have lower baseline HbA1c and be intensified to other regimens (19.4%). No oral antidiabetic medication was used for 16.4% initiating on long/intermediate, 47.4% on mixture and 62.3% with basal-bolus. Overall, mean HbA1c decreased from 9.6% to 7.6%, with little difference between regimens at endpoint. The percentage of patients with hypoglycaemia was highest at 6 months and with basal-bolus. LIMITATIONS Sites were not selected at random. Drop-out of patients prior to 24 months may have introduced a bias that favoured responders. CONCLUSIONS Mean baseline HbA1c was high, indicating delayed initiation of insulin treatment. Blood pressure and lipids were suboptimally controlled. Insulin regimens varied between countries, changed little and resulted in similar HbA1c levels after 24 months.
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Affiliation(s)
- A Oguz
- Department of Internal Medicine, Istanbul Medeniyet University, Göztepe Education and Research Hospital, Istanbul, Turkey
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Kapan M, Onder A, Oguz A, Taskesen F, Aliosmanoglu I, Gul M, Tacyildiz I. The effective risk factors on mortality in patients undergoing damage control surgery. Eur Rev Med Pharmacol Sci 2013; 17:1681-1687. [PMID: 23832738] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Damage control surgery is a life-saving procedure used in fatal injuries. Morbidity and mortality rate are high in these patients due to massive trauma. The aim of this study was to analyze the risk factors associated with mortality in abdominal traumas that underwent damage control surgery. PATIENTS AND METHODS The retrospective study included 24 patients that underwent damage control surgery between January 2004 and September 2010. Age, gender, type of injury, period of time before admission, hemodynamic parameters, associated organ injury, injury severity score, surgical procedures performed, length of hospital stay, and complication and mortality rates were recorded. RESULTS The study included 16 (66.7%) men and 8 (33.3%) women, with a mean age of 32.3 years. Median period of time before admission was 30.83 minutes. All the patients were present with hypothermia and acidosis at admission, while only 5 of them were hemodynamically stable. Mean 6.75 units of blood were transfused in all of them. Common etiological factors included gunshot (50%) and motor vehicle accident (25%). Hepatic injury (83.3%) was the most common organ injury. Mean injury severity score (ISS) was 28.88. Damage control surgery was performed in all the patients. Skin-only closure was applied in 17 (70.8%), while 7 (29.2%) patients received Bogota bag application. Definitive surgery was achieved through de-packing over 36-48 hours in average. Total mortality occurred in 11 (45.8%) patients. Period of time before admission, core temperature at admission, pH levels and amount of blood transfusion were statistically different in the mortality group. A total of 16 complications occurred in 10 patients. Among these, intraabdominal abscess (46.2%) was the most common. CONCLUSION Hypothermia (< 35°C), acidosis (pH < 7.2), instability related to systolic blood pressure, massive blood transfusion, and delayed admission are predictive factors for mortality.
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Affiliation(s)
- M Kapan
- Department of General Surgery, School of Medicine, Dicle University, Diyarbakir, Turkey.
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Oguz A, Tuzun D, Ozdemir D, Baci Y, Ersoy R, Avsar AF, Cakir B. Prevalance of gestational diabetes mellitus in patients with gestational transient thyrotoxicosis. Gynecol Endocrinol 2013; 29:336-9. [PMID: 23327556 DOI: 10.3109/09513590.2012.752451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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
OBJECTIVE To investigate prevalence of gestational diabetes mellitus (GDM) in patients with gestational transient thyroxicosis (GTT). METHODS Fifty two patients with GTT and 100 age matched healthy pregnant women were included. Fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), LDL-cholesterol, HDL-cholesterol, triglyceride, thyrotrophin (TSH) and thyroid hormones were measured at thyrotoxic state in GTT patients and at 6-12th weeks of pregnancy in control group. Oral glucose tolerance test (OGTT) with 100 g glucose was performed and laboratory parameters were re-evaluated at 24-28th weeks of pregnancy in all subjects. RESULTS Mean age of patients with GTT was 28.46 ± 5.45 and control group was 27.78 ± 3.75(p = 0.085). Patients with GTT had significantly higher HbA1c, LDL-cholesterol and HDL-cholesterol at 6-12th weeks of pregnancy (p < 0.01, p < 0.01 and p = 0.034, respectively). TSH was negatively correlated with HbA1c and LDL-cholesterol in thyrotoxic state in GTT patients (r = -0.393, p < 0.001 and r = -0.293, p < 0.001, respectively). OGTT showed GDM in 7 (13.5%) GTT patients and 4 (4%) healthy pregnants (p = 0.047). HbA1c, LDL-cholesterol and HDL-cholesterol were higher in GTT patients compared to healthy pregnants also at 24-28th weeks of pregnancy (p < 0.001, p < 0.001 and p = 0.024). CONCLUSION Although GTT is known to be a transient state that can resolve spontaneously, it might have negative effect on carbohydrate metabolism like other causes of hyperthyroidism.
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Affiliation(s)
- Ayten Oguz
- Department of Endocrinology and Metabolism, Ataturk Education and Research Hospital, Yıldırım Beyazit University, Ankara, Turkey
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Oguz A, Caklılı Ö. PP-252 ISN'T IT THE TIME TO CHANGE THE NAME OF TYPE 2 DIABETES? WHICH IS THE RISK EQUIVALENT OF CARDIOVASCULAR DISEASE? HYPERGLYCEMIA, DIABETES MELLITUS OR IS IT THE TIME FOR A NEW NAME? Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70456-x] [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: 10/26/2022]
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Oguz A, Gumus M, Ipek A, Tuzun D, Ersoy R, Cakir B. Effects of menstrual cycle showing infradian rhythm on thyroid blood flow and thyroid volume in healthy women. BIOL RHYTHM RES 2013. [DOI: 10.1080/09291016.2011.652863] [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: 10/28/2022]
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Oguz A, Kapan M, Onder A, Kilic E, Gumus M, Basarali MK, Firat U, Boyuk A, Buyukbas S. The effects of curcumin on the liver and remote organs after hepatic ischemia reperfusion injury formed with Pringle manoeuvre in rats. Eur Rev Med Pharmacol Sci 2013; 17:457-466. [PMID: 23467943] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND We aimed to investigate the effects of curcumin on ischemia/ reperfusion (IR) injury of the liver and distant organs resulting from liver blood flow arrest. MATERIALS AND METHODS Totally 40 rats, divided into four groups, each included 10 rats were used. Group I as only laparatomy, Group II laparatomy and curcumin application, Group III hepatic IR; and Group IV as hepatic IR and curcumin application group. Ischemia was generated by hepatoduedonal ligament clamping for 30 minutes and then reperfusion is started. Curcumin capsules were opened and appropriate dose had been created within weighing scales. After calculations, the powder was diluted with saline. Fifteen minutes before the ischemia, curcumin was applied via oral gavage. Blood samples were taken from the animals for biochemical analysis at 60th minutes of the experiment in the first and second groups; 30 minutes after beginning reperfusion in the third and forth groups. Simultaneously, liver, lung and kidney tissues were sampled for biochemical and histopathological examinations. RESULTS Plasma malondialdehyde levels were found to be higher (p < 0.001), but total antioxidant activity values were not different in IR group compared with IR + curcumin group (p > 0.05). Biochemical and histopathological evaluation of tissue samples revealed that there were no differences in total antioxidant activity, total oxidant activity and histopathologic scores in IR + curcumin group compared with values of IR group (p > 0.05). CONCLUSIONS Curcumin did not reduce the effects of hepatic ischemia reperfusion injury on the liver and distant organs including kidneys and lungs significantly.
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Affiliation(s)
- A Oguz
- Department of General Surgery, Ceylanpinar State Hospital, Sanliurfa, Turkey
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Taskesen F, Arikanoglu Z, Uslukaya O, Aliosma-Noglu I, Oguz A, Guzel A, Tas I. Laparoscopic salvage for malfunctioning of peritoneal dialysis catheters. MINERVA CHIR 2012; 67:505-509. [PMID: 23334114] [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: 06/01/2023]
Abstract
AIM The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed for elimination of catheter-induced mechanical complications developing in CAPD patients. METHODS Medical records of 31 patients who had undergone CAPD catheter implantation at the Dicle University Medical Faculty Hemodialysis Unit between January 2001 and June 2012 were examined retrospectively. Double-felted spiral Tenckhoff catheters were used in all patients for peritoneal access. RESULTS We performed a retrospective review of 31 patients who, over an 11-year period, underwent revision of a peritoneal dialysis catheter using laparoscopy. Chronic renal failure requiring dialysis occurred in 31 patients (12 males and 19 female). Ages ranged from 13 to 77 years (mean age 35.8 years). CONCLUSION As a conclusion, CAPD is currently a choice to be frequently used in patients with ESRD. In the treatment of CAPD-associated mechanical catheter complications laparoscopic method may be preferred because of patient comfort, short hospital stay, and lesser postoperative complications.
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Affiliation(s)
- F Taskesen
- Department of Surgery, Dicle University Hospital, Faculty of Medicine, Diyarbakir, Turkey.
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Oguz A, Atay AE, Tas A, Seven G, Koruk M. Predictive role of acute phase reactants in the response to therapy in patients with chronic hepatitis C virus infection. Gut Liver 2012; 7:82-8. [PMID: 23424009 PMCID: PMC3572325 DOI: 10.5009/gnl.2013.7.1.82] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 05/23/2012] [Accepted: 06/20/2012] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/AIMS Biochemical parameters and acute-phase proteins (APPs) may provide complementary data in patients with chronic hepatitis C (CHC). We aimed to evaluate the predictive role of APPs in the response to antiviral therapy. METHODS Forty-five patients underwent antiviral therapy. Serum ferritin, C-reactive protein (CRP), transferrin, albumin, alpha-1 acid glycoprotein (A1AG), and alpha-2 macroglobulin (A2MG) levels were examined at the initial evaluation and at the 4th, 12th, and 48th weeks. HCV RNA levels were examined at the initial evaluation and at the 12th and 48th weeks. RESULTS Ferritin, transferrin, A1AG, and A2MG levels were significantly higher in the patient group (p<0.05). CRP, ferritin, A1AG, and A2MG levels were significantly increased from baseline to the 4th week (p<0.05). The responders and nonresponders to antiviral therapy had insignificantly but remarkably different levels of CRP, ferritin, transferrin, A1AG, A2MG, and alanine aminotransferase (ALT) both at the initial evaluation and at the 12th week. CONCLUSIONS Variations in ferritin, A1AG, A2MG, albumin, CRP, and transferrin levels are not alternatives to virological and biochemical parameters for predicting an early response to therapy in patients with CHC. However, the investigation of ALT levels and hepatitis C virus RNA in combination with acute-phase reactants may provide supplementary data for evaluating responses to antiviral therapy.
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Affiliation(s)
- Ayten Oguz
- Department of Internal Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
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Sagun G, Ozata M, Mesci B, Ozcoban F, Oguz A. Symptomatic hypokalaemia and rhabdomyolysis due to excessive and long-term soft drink consumption: a case report. Acta Clin Belg 2012; 67:217-218. [PMID: 22897072 DOI: 10.2143/acb.67.3.2062659] [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: 06/01/2023]
Abstract
A 35-year-old man was admitted to the emergency room with the complaint of weakness of the extremities, which abruptly began in the morning. Only mild generalized muscle weakness was present on physical examination. Laboratory data showed hypokalaemia, elevation of creatinine phosphokinase and serum transaminases. He had been consuming 2.5 litres of soft drink per day for 20 years. There could not be found any metabolic, organic, traumatic and/or pharmacological reason to cause hypokalaemia and rhabdomyolysis other than the long-term and excess consumption of soft drinks. The patient was cured by the replacement of electrolytes and the avoidance of drinking soft drinks.
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Affiliation(s)
- G Sagun
- Internal Medicine Clinic, Instanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
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Abstract
AIM It has been reported that people with asthma may have an increased risk of cardiovascular disease and metabolic disorders due to direct involvement of common inflammatory mediators. Metabolic syndrome (MetS) is also characterized by inflammation, In this study, we hypothesised that the prevalence of MetS would increase in patients with asthma. Based on this, we evaluated the prevalence of MetS in patients with asthma and the relationship between asthma and cardiometabolic risk factors. MATERIALS AND METHODS The study included a total of 188 non-diabetic patients. The asthma group (70 female, 20 male, mean age: 43.83 +/- 10.98) included the patients who were diagnosed with asthma by a pulmonologist, while the control group (81 female, 17 male, mean age: 42.01 +/- 9.21) included non-asthmatic patients who presented for routine health control. The primary endpoint of the study was to compare the prevalence of MetS between the groups, while the secondary endpoint was to evaluate the relationship between asthma and cardiometabolic risk factors such as body mass index, waist circumference, blood pressure, lipid parameters, C-reactive protein, fasting plasma glucose, uric acid and homeostasis model assessment of insulin resistance. The International Diabetes Federation criteria were used for the diagnosis of MetS. RESULTS Although the prevalence of MetS was slightly higher in the asthma group than in the control group (36.7% vs. 33.7%, respectively), the difference was not statistically significant (p > 0.05). In multivariate logistic regression analysis, C-reactive protein (OR 2.204; 95% CI; 1, 129-4, 303) was associated with asthma. CONCLUSION Although there are numerous rational theories proposing that asthma can be associated with MetS, the results of the present study, which was conducted with a limited number of patients, find no arguments for higher prevalence of MetS in asthma patients compared to the overall population.
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Affiliation(s)
- M Uzunlulu
- Goztepe Egitim ve Arastirma Hastanesi, Ic Hastaliklari Klinigi, Istanbul, Turkiye.
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Cakir B, Aydin C, Korukluoğlu B, Ozdemir D, Sisman IC, Tüzün D, Oguz A, Güler G, Güney G, Kuşdemir A, Sanisoglu SY, Ersoy R. Diagnostic value of elastosonographically determined strain index in the differential diagnosis of benign and malignant thyroid nodules. Endocrine 2011; 39:89-98. [PMID: 21077000 DOI: 10.1007/s12020-010-9416-3] [Citation(s) in RCA: 44] [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: 06/07/2010] [Accepted: 10/24/2010] [Indexed: 12/21/2022]
Abstract
Elastosonography (ES) is a newly developed method that is used for the differential diagnosis of benign and malignant thyroid nodules. In different studies, ES scoring has been compared with histopathological findings, and sensitivity and specificity of the scoring were calculated. In this study, it determines the strain index (SI) as well as the ES to score thyroid nodules, and establishes the role for these parameters in the differential diagnosis of thyroid nodules using histopathological analysis as a reference standard. Real-time ES in transverse axis (TA) and longitudinal axis (LA) was performed in 391 nodules of 292 patients. ES scoring was made for all the nodules. SI in TA and LA was calculated for four times in each nodule and mean values were determined. The results were compared with final histopathological diagnoses. In histopathological examinations, 125 (31.97%) of 391 nodules were malignant and 266 (68.03%) were benign. Of these histopathologically benign nodules, 189 (%71.05) were also probably benign according to elastosonographic scoring (scores of 1, 2, or 3), while 77 (28.95%) were probably malignant (scores of 4 or 5). Among 125 histopathologically malignant nodules, 52 (41.60%) were probably benign and 73 (58.40%) were probably malignant according to elastosonographic scoring. There was a significant relation between scoring and histopathological findings (χ(2) = 36.513; P < 0.001). Accordingly, sensitivity and specificity of ES scoring were 58.4 and 71.0%, respectively. ROC analysis value obtained for strain ratios in LA (AUC: 75.5%; P < 0.001) had a higher significance compared to ROC analysis value obtained for strain ratios in TA (AUC: 66.0%). Thus, ROC analysis evaluation was applied only for SI in LA. The optimal SI cut-off value in LA for all the nodules was found to be 16.709 (sensitivity: 73.4%, specificity: 70.0%) (AUC: 75.4 ± 0.03%; 70.2-80.5%). SI cut-off value corresponding to 90% sensitivity in this axis was 4.516 (specificity: 35.7%). Sensitivity and specificity of SI values that were determined according to morphological features of nodules in gray-scale ultrasonography were higher. For hypoechoic nodules with microcalcifications and without a halo, SI cut-off value, sensitivity, and specificity were 17.020, 84.3, and 81.1%, respectively. Our study is the first clinical-wide series study that measured, used, and compared the ES scoring and SI cut-off values for the differential diagnosis of benign and malignant thyroid nodules. This study indicates that measurement of SI with ES as a noninvasive procedure may be used as an adjunctive method to the conventional methods for the differential diagnosis of thyroid nodules.
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Affiliation(s)
- Bekir Cakir
- Department of Endocrinology and Metabolism, Ankara Atatürk Education and Research Hospital, Bilkent, Ankara, Turkey
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Yildirim A, Sedef Tunaoglu F, Guclu Pinarli F, Ilhan M, Oguz A, Karadeniz C, Olgunturk R, Oguz D, Kula S. Early diagnosis of anthracycline toxicity in asymptomatic long-term survivors: dobutamine stress echocardiography and tissue Doppler velocities in normal and abnormal myocardial wall motion. European Journal of Echocardiography 2010; 11:814-22. [DOI: 10.1093/ejechocard/jeq071] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Gul K, Ozdemir D, Dirikoc A, Oguz A, Tuzun D, Baser H, Ersoy R, Cakir B. Are endogenously lower serum thyroid hormones new predictors for thyroid malignancy in addition to higher serum thyrotropin? Endocrine 2010; 37:253-60. [PMID: 20960260 DOI: 10.1007/s12020-010-9316-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [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: 09/17/2009] [Accepted: 12/21/2009] [Indexed: 10/19/2022]
Abstract
It is well known that TSH plays a major role in the secretion of thyroid hormones, maintenance of thyroid specific gene expression, and gland growth. In this study, we aimed to evaluate association between tests of thyroid functions (fT3, fT4, TSH) and differentiated thyroid carcinoma. 441 patients operated for nodular goiter between 2005 and 2008 were analyzed. Thyroid functions were studied in the period of 1-30 days prior to surgery. In postoperative histopathological examination, differentiated thyroid carcinoma and benign thyroid disease were detected in 166 (37.6%) and 275 (62.4%) patients, respectively. Patients with thyroid malignancy had significantly lower serum fT3 (P = 0.001), lower fT4 (P = 0.022), and higher TSH levels (P < 0.001) compared to patients with benign disease, although all analytes were within the normal range. We subdivided by quartile serum fT3, fT4, and TSH in normal limits into three groups. The odds ratio (ORs) for the risk of thyroid cancer with a serum TSH between 0.63 and 1.67 μIU/ml and 1.68-4.00 μIU/ml, compared with a serum TSH between 0.40 and 0.62 μIU/ml were calculated as 2.60 (95% CIs 1.49-4.54) and 6.50 (95% CIs 3.51-12.03), respectively. There was also a greater risk of thyroid cancer in patients with fT3 levels of 1.57-3.00 pg/ml, compared with patients with fT3 levels of 3.89-4.71 pg/ml (OR 2.95, 95% CIs 1.68-5.20). For fT4, OR for the risk of thyroid cancer between 0.85 and 1.17 ng/dl compared with 1.48-1.78 ng/dl was 2.14 (95% CIs 1.22-3.74). In conclusion, lower fT3, fT4, and higher TSH concentrations within normal limits were related with increased thyroid cancer independent from sex and nodule type. Particularly, the association between lower fT3, fT4 levels and a diagnosis of thyroid cancer is a novel finding.
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Affiliation(s)
- Kamile Gul
- Department of Endocrinology and Metabolism, Ankara Ataturk Education and Research Hospital, Bilkent, Ankara, Turkey.
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Kanat M, Serin E, Tunckale A, Yildiz O, Sahin S, Bolayirli M, Arinc H, Dirican A, Karagoz Y, Altuntas Y, Celebi H, Oguz A. A multi-center, open label, crossover designed prospective study evaluating the effects of lipid lowering treatment on steroid synthesis in patients with Type 2 diabetes (MODEST Study). J Endocrinol Invest 2009; 32:852-6. [PMID: 19783896 DOI: 10.1007/bf03345757] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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: 01/02/2023]
Abstract
OBJECTIVE It has been suggested that lipid-lowering treatment with the use of statins adversely affects the steroid hormones. However, the safety of lipid lowering treatment targeting very low levels of LDL with respect to the steroid hormones has not been established. RESEARCH DESIGN AND METHODS A prospective, randomized, multicenter trial was conducted involving 98 patients. The patients were randomized into 2 groups: group-I received 10 mg of atorvastatin plus 10 mg of ezetimibe and group-II 80 mg of atorvastatin for the first 3 months. After crossover, the first group received 80 mg of atorvastatin and the second group 10 mg of atorvastatin plus 10 mg of ezetimibe for the following 3 months. Cortisol, DHEAS, testosterone, and estradiol levels were measured at the enrollment and at the end of the 1st, 2nd, 3rd, and 6th months. RESULTS Along with a decrease in LDL level, the levels of DHEAS, testosterone, and estradiol decreased in both groups (p<0.001). While cortisol levels were maintained in the group given 10 mg of atorvastatin plus 10 mg of ezetimibe, it decreased significantly after the crossover to 80 mg of atorvastatin (p<0.001). The group initially given 80 mg of atorvastatin measured a lower level of cortisol for the first 3 months and it returned to normal levels after switching to 10 mg of atorvastatin plus 10 mg of ezetimibe. CONCLUSION Eighty milligrams of atorvastatin decreased all adrenal and gonadal steroids, whereas 10 mg of ezetimibe combined with 10 mg of atorvastatin had at least no impact on cortisol levels.
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Affiliation(s)
- M Kanat
- Department of Internal Medicine, Izzet Baysal Medical School, Abant Izzet Baysal University, TR14280-Golkoy, Bolu, Turkey.
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Uzunlulu M, Oguz A. Waist circumference is associated with asymmetric dimethylarginine levels in patients with metabolic syndrome. Acta Clin Belg 2008; 63:352-3. [PMID: 19186572 DOI: 10.1179/acb.2008.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Oguz A, Temizhan A, Abaci A, Kozan O, Erol C, Ongen Z, Celik S. THE PREVALANCE OF METABOLIC SYNDROME IN TURKISH ADULTS ACCORDING TO IDF DEFINITION. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70518-x] [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: 10/22/2022]
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Mesci B, Oguz A, Sagun H, Uzunlulu M, Biberci Keskin E, Coksert D. DIETARY BREADS: MYTH OR REALITY? ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70559-2] [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: 10/22/2022]
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Oguz A, Uzunlulu M. SHORT TERM FLUVASTATIN TREATMENT LOWERS SERUM ASYMMETRIC DIMETHYLARGININE LEVELS IN PATIENTS WITH METABOLIC SYNDROME. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70848-1] [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: 11/26/2022]
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Oguz A, Sagun G, Uzunlulu M, Alpaslan B, Yorulmaz E, Tekiner E, Sariisik A. PREVALENCE AND AWARENESS OF ABDOMINAL OBESITY IN TURKISH HEALTHCARE WORKERS. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70523-3] [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: 11/16/2022]
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Sariiisik A, Oguz A, Uzunlulu M. THE INADEQUATE IMPROVEMENT IN THE CONTROL RATE OF HYPERTENSION IN KOCAELI, TURKEY. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70372-6] [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: 11/27/2022]
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Oguz A, Citak C, Karadeniz C, Okur V, Okur A. 1414 POSTER The relationship between nutritional status and IGF-I and IGFBP-3 in patients with childhood solid tumours. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70753-x] [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: 11/30/2022] Open
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Oguz A, Dogan EG, Uzunlulu M, Oguz FM. Insulin resistance and adiponectin levels in Behçet's syndrome. Clin Exp Rheumatol 2007; 25:S118-S119. [PMID: 17949565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Abstract
AIM It is well known that increased insulin resistance is associated with the development of cardiovascular disease in patients with rheumatoid arthritis and that tumour necrosis factor-alpha plays an important role in this process. Infliximab is a chimeric monoclonal anti-tumour necrosis factor-alpha antibody. This study investigates the effects of long term infliximab treatment on insulin resistance in patients with rheumatoid arthritis. MATERIALS AND METHODS Seven rheumatoid arthritis patients (6 female and 1 male; mean age: 44.6 +/- 12.3, mean duration of disease: 6.8 y) for whom infliximab treatment had been planned at the rheumatology and internal medicine clinics were included. Patients were evaluated during and at the end of the study with a mean follow-up duration of 9.6 months. Fasting plasma glucose, fasting plasma insulin levels and serum lipid profile were assessed at baseline and throughout the treatment period (prior to every infusion). Homeostasis Model Assessment of Insulin Resistance model was used for the assessment of insulin sensitivity. RESULTS Fasting insulin and Homeostasis Mode Assessment of Insulin Resistance levels decreased after treatment (from 19.4 +/- 7.7 microU/ml to 8.9 +/- 4.1 microU/ml and from 2.4 +/- 1 to 1.1 +/- 0.5, respectively; p < 0.05 for both). No significant change was observed in other parameters. CONCLUSION An improvement in insulin sensitivity was observed in patients receiving long term infliximab treatment for rheumatoid arthritis.
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Affiliation(s)
- F M Oguz
- Ic Hastaliklari Klinigi, Istanbul-Turkey
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Abstract
OBJECTIVE To determine prevalence of the metabolic syndrome (MS) in a sample representing Turkish population using United States Adult Treatment Panel-3 guidelines. DESIGN The study included random samples from both urban and rural populations in the seven geographical regions of Turkey. The population for this analysis were 2108 men (1372 in urban and 736 in rural areas) and 2151 women (1423 in urban and 728 in rural areas) with a mean age of 40.9+/-14.9 years (range 20-90). RESULTS The prevalence of the MS diagnosed using the Adult Treatment Panel III criteria was 33.9% (1442 of 4259) and differed significantly in men (28%) and women (39.6%). The prevalence of syndrome increased with age in men, from 10.7% in subjects aged 20-29 years to 49% in those aged over 70 years. The prevalence increased with age in women, from 9.6% in subjects aged 20-29 years to 74.6% in those aged 60-69 years, and decreased to 68.6% in those over 70 years of age. The prevalence of the syndrome was similar in urban (33.8%) and rural (33.9%) population. We found 26.8, 26.4, 19.3, 10.9 and 3.6% of the population had at least 1, 2, 3, 4 or 5 components, respectively. We found 57.2, 32.3 and 10.6% of the subjects with MS had 3, 4 and 5 components, respectively. CONCLUSIONS The prevalence of the MS in the adult Turkish population is very high, especially in women. Our findings have important implications for public health in Turkey.
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Affiliation(s)
- O Kozan
- Department of Cardiology, School of Medicine, Dokuz Eylül University, Izmir, Turkey
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Abaci A, Oguz A, Kozan O, Toprak N, Senocak H, Deger N, Sahin M, Sur H, Fici F, Erol C. Treatment and control of hypertension in Turkish population: a survey on high blood pressure in primary care (the TURKSAHA study). J Hum Hypertens 2006; 20:355-61. [PMID: 16511506 DOI: 10.1038/sj.jhh.1001995] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although the management and the control rates of hypertension are generally low throughout the world, there are substantial differences between the countries. The aim of this study was to determine the control rate of blood pressure and the characteristics of the patients who have been admitted to primary care units in Turkey. Our study included 16,270 patients aged above 18 years who were diagnosed as hypertensive in representative nationwide sample of 1,000 primary care units in Turkey. The mean age of the patients was 60+/-11 years (60.1% women). Of 16,270 patients, 15 187 (93.3%) were on an antihypertensive treatment, whereas 1,083 (6.7%) were receiving no treatment. The patients who were women, diabetic, smoker, obese, and those who had a concomitant cardiovascular disease (CVD) had a higher rate of antihypertensive treatment. Of 15,187 treated patients, 4,912 (30.2%) had a controlled systolic blood pressure, 7,063 (43.4%) a controlled diastolic blood pressure, and in 3,931 (24.2%), both were under control. A logistic regression analysis demonstrated that age (OR 1.33), diabetes (OR 4.96), body mass index (OR 1.41) and the presence of a CVD (OR 1.19) were predictors for blood pressure being under control. The blood pressure control rates ranged between 16.6 and 30.5% among seven geographical regions. In the primary care units in Turkey, the blood pressure control rate is consistently low in treated hypertensive patients. In addition, there are differences between the geographical regions in both the proportion of those receiving medications and the blood pressure control rates.
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Affiliation(s)
- A Abaci
- Department of Cardiology, School of Medicine, Gazi University, Ankara, Turkey.
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