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Guclu M, Aslan BB, Setayeshi T, Kiyici S. Could the presence of adrenal incidentaloma negatively affect COVID 19 outcomes? Endocrine 2023; 82:406-413. [PMID: 37488407 DOI: 10.1007/s12020-023-03454-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND AND OBJECTIVE Adrenal incidentalomas (AIs) are lesions larger than 1 cm that are incidentally detected in the adrenal glands. Chest computed tomography (CCT) is widely used in the first evaluation of patients with suspected coronavirus disease (COVID-19) that resulted in many incidental findings in the thorax and upper abdomen. In this study, we aimed to investigate the frequency of AI and their effects on the course and outcome of COVID-19 regardless of functional status. MATERIAL AND METHODS We included 2493 patients aged between 18 and 99 years and whose adrenal glands were clearly visible in CCT images. They were divided into two groups: those with AI (AI group) and without AI (Control group). RESULTS AI was detected in 148 (5.93%) patients and 80 (54.1%) of them were male. There was no difference in sex distribution between the groups, but the median age of patients with AI was significantly higher than those without AI [54.5 (20-94 years) vs. 42 (18-99 years); p < 0.001)]. In addition, in the AI group, both hospitalizations due to COVID-19-related conditions (30.4 vs. 21.2%, p = 0.008) and the mortality rate experienced during this time was significantly higher (14.7 vs. 7%, p < 0.001) diseases. The AI group had a significantly higher comorbidity rate than the control group (61.5 vs. 41.9%, p < 0.001). The most common comorbid diseases were hypertension, cardiovascular diseases, diabetes mellitus, respiratory system diseases, and hyperlipidaemia. Advanced age and male gender in terms of mortality, advanced age and covid 19 positivity in terms of hospitalization were determined as significant risk factors. CONCLUSIONS The presence of AI may increase the morbidity and mortality rates associated with COVID-19, regardless of their functional status. Therefore, patients subjected to CCT imaging for COVID-19-related lung diseases should also be evaluated for AI. Careful follow-up of patients with COVID-19 and AI is necessary to monitor the progression of COVID-19.
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Affiliation(s)
- Metin Guclu
- Bursa Faculty of Medicine, Yuksek Ihtisas Research Training and Hospital, Endocrinology and Metabolism Department, University of Health Sciences, Bursa, Turkey.
| | - Bilal Burcak Aslan
- Bursa Faculty of Medicine, Yuksek Ihtisas Research and Training Hospital, Department of Internal Medicine, University of Health Sciences, Bursa, Turkey
| | - Tirdad Setayeshi
- Bursa Faculty of Medicine, Yuksek Ihtisas Research and Training Hospital, Department of Radiology, University of Health Sciences, Bursa, Turkey
| | - Sinem Kiyici
- Bursa Faculty of Medicine, Yuksek Ihtisas Research Training and Hospital, Endocrinology and Metabolism Department, University of Health Sciences, Bursa, Turkey
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Ulutas HG, Guclu M, Aslanci ME, Karatas G. The relationship between carotid intima-media thickness and microvascular changes in retinal zones and optic disc in patients with type 1 diabetes mellitus. Eur J Ophthalmol 2021; 32:2328-2337. [PMID: 34851200 DOI: 10.1177/11206721211064024] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of this study was to detect early retinal vascular changes with optical coherence tomography angiography (OCTA) in type 1 diabetes mellitus (T1DM) patients without diabetic retinopathy and to evaluate the correlation of the results with carotid intima-media thickness (IMT). DESIGN This is a case-control and cross-sectional study. METHODS This study included 38 adult patients with T1DM, and 38 age and gender-matched healthy controls. Retinal and optic disc (OD) measurements were taken using OCTA. The carotid artery IMT of each patient was measured using Doppler ultrasonography. Superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density, foveal avascular zone (FAZ), non-flow area (NFA) and foveal density (FD) were analysed in the fovea centred 6 × 6 mm macular area. The superficial capillary plexus and DCP were also scanned centred on the peripapillary region. The correlations between OCTA measurements and carotid IMT, duration of DM and haemoglobin A1c levels in patients with T1DM were evaluated. RESULTS The mean values for carotid IMT were significantly higher in diabetic patients than in controls (p < 0.001). The mean values for vessel density SCP, DCP and OD were significantly lower in the diabetic group (p < 0.05). There were correlations between the carotid IMT and duration of T1DM and the evaluated parameters of OCTA. CONCLUSION Microvascular changes in the SCP and DCP in patients with T1DM without DR offer important data. OCTA can be used to detect early microvascular changes in patients with T1DM without DR. In addition, a relationship was found between SCP vascular dropout and carotid IMT.
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Affiliation(s)
- Hafize Gokben Ulutas
- Department of Ophthalmology, University of Health Sciences, 147003Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Metin Guclu
- Department of Endocrinology, University of Health Sciences, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Mehmet Emin Aslanci
- Department of Ophthalmology, University of Health Sciences, 147003Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Gokhan Karatas
- Department of Radiology, University of Health Sciences, Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Ertugrul DT, Kan E, Tura CB, Tugtekin HB, Ayakta H, Celebioglu M, Yılmaz C, Utebay O, Yetkin I, Gurkan E, Sezer K, Gen R, Ozcaylak S, Okuturlar Y, Coskun M, Giynas NG, Aysal H, Erdem AS, Aydemir M, Bakiner O, Cicekli E, Gezer D, Kaya R, Kebapcilar L, Cinkir U, Ulu MS, Ersoy C, Kagan MT, Ekiz BD, Kilinc F, Onbasi K, Cengiz M, Celik M, Guclu M, Sarıkaya M, Ozbag O, Sari R, Ucler R, Sezikli S, Araz M, Gundogan E, Bozkurt E, Akbas M, Bozkus R, Akinci B, Karakilic E, Medeni M, Keskek O, Goncuoglu ES, Zuhur SS, Sahin AZ, Dal K, Eren MA, Arkan T, Taskiran B, Kilinc G, Bozkirli E, Kafesciler SO, Kafesciler N, Sen EC, Doganay S, Koseoglu C, Tetiker T, Bayraktaroglu T, Oguz A, Ataoglu E, Demirpence MM, Tursun S, Anaforoglu I, Tabak O, Emral R, Karsidag K, Dizdar OS, Tuzcu AK, Caliskan M, Sirmatel P, Kocaoz Y, Dogan H, Fenkci SM, Sahin I, Karaca Z. Add-on therapy with dapagliflozin in routine outpatient care of type 2 diabetes patients from Turkey: a retrospective cohort study on HbA1c, body weight, and blood pressure outcomes. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-00954-4] [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: 11/24/2022] Open
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Abstract
BACKGROUND There are many factors that affect weight loss after bariatric surgery. The present study evaluated the impact of health literacy on weight loss after bariatric surgery in morbidly obese patients. METHODS The data of 118 patients who underwent laparoscopic sleeve gastrectomy for morbid obesity (body mass index-BMI ≥ 40 kg/m2) and completed a 1-year follow-up period were recorded and evaluated, prospectively. The Turkish version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to evaluate the health literacy of these patients. Their demographic characteristics, preoperative and postoperative weight (at 6 and 12 months), BMI, the percentage of excess weight loss (% EWL), excess BMI loss (% EBL) and total weight loss (%TWL), comorbidities, socioeconomic characteristics (marital status, income level, educational status, and duration), and HLS-EU-Q47 results were recorded and compared. RESULTS A significant inverse relationship was identified between preoperative BMI and scores for health promotion health literacy and general health literacy indexes (p = 0.024 and p = 0.032, respectively). A significant positive relationship was noted between % EWL and % EBL at 6 and 12 months, and health promotion health literacy index scores (6 months: p = 0.004, p = 0.006; 12 months: p < 0.001 and p < 0.001, respectively). A similar significant positive relationship was recorded between the % EWL and % EBL at 12 months and the health care health literacy index scores (p = 0.042 and p = 0.036, respectively). There was also a significant positive relationship between general health literacy index scores and % EWL and % EBL at 12 months (p = 0.022 and p = 0.021, respectively). % EWL at 12 months increased by 0.39, with a 1-point increase in health promotion and health literacy index scores. CONCLUSIONS A high health literacy index score in morbidly obese patients is associated with successful weight loss after bariatric surgery.
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Affiliation(s)
- Umut Eren Erdogdu
- Bursa Yuksek Ihtisas Teaching and Research Hospital, Department of General Surgery, University of Health Sciences, Bursa, Turkey.
| | - Haci Murat Cayci
- Bursa Yuksek Ihtisas Teaching and Research Hospital, Department of General Surgery, University of Health Sciences, Bursa, Turkey
| | - Ali Tardu
- Bursa Yuksek Ihtisas Teaching and Research Hospital, Department of General Surgery, University of Health Sciences, Bursa, Turkey
| | - Hakan Demirci
- Bursa Yuksek Ihtisas Teaching and Research Hospital, Department of Family Medicine Section, University of Health Sciences, Bursa, Turkey
| | - Gurcan Kisakol
- Bursa Yuksek Ihtisas Teaching and Research Hospital, Department of Endocrinology, University of Health Sciences, Bursa, Turkey
| | - Metin Guclu
- Bursa Yuksek Ihtisas Teaching and Research Hospital, Department of Endocrinology, University of Health Sciences, Bursa, Turkey
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Kiyici S, Koca N, Sigirli D, Aslan BB, Guclu M, Kisakol G. Food Addiction Correlates with Psychosocial Functioning More Than Metabolic Parameters in Patients with Obesity. Metab Syndr Relat Disord 2020; 18:161-167. [PMID: 32027557 DOI: 10.1089/met.2019.0108] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Aim: To investigate the association of food addiction (FA) with the psychosocial functioning and metabolic parameters in obese patients seeking weight-loss treatment. Methods: Two hundred twenty-four obese patients (male/female: 28/196) with a mean age of 44.5 ± 13.4 years and body mass index (BMI) of 41.6 ± 7.2 were included in the study. After receiving sociodemographic data and medical history, detailed physical examination, including anthropometric measurements, was performed by an experienced physician. Blood samples were taken after 8-12 hr of fasting. The presence of FA was evaluated by using Yale Food Addiction Scale (YFAS). Psychological evaluation was performed by using a self-reported Patient Health Questionnaire-9 (PHQ-9) and health-related quality of life using the 36-item short-form health survey (SF-36). Results: Seventy-two of 224 (32.1%) patients met the criteria for FA, according to YFAS. The mean age of patients with FA was younger compared with patients without FA (P < 0.001). There was no statistically significant difference between the patients with and without FA in terms of BMI, fat percentage, and waist circumference (P = 0.440, P = 0.644, and P = 0.144, respectively). The depression frequency was significantly higher (61.1%, P < 0.001), while the SF-36 score of mental health was lower (P = 0.027) in patients with FA than in the patients without FA. Age- and sex-adjusted mean fasting plasma glucose level was lower in patients with FA (P = 0.021), but serum insulin levels, HOMA-IR (homeostasis model assessment of insulin resistance), HbA1c (hemoglobin A1c), lipid parameters, and vascular adiposity index were comparable. Conclusions: We found that FA frequency was very high in obese patients seeking treatment for weight loss, and it correlates with psychosocial functioning more than metabolic parameters.
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Affiliation(s)
- Sinem Kiyici
- Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Nizameddin Koca
- Department of Internal Medicine, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Deniz Sigirli
- Department of Bio-Statistics, Uludag University Medical Faculty, Bursa, Turkey
| | - Bilal Burçak Aslan
- Department of Internal Medicine, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Metin Guclu
- Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
| | - Gurcan Kisakol
- Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Training Hospital, University of Health Sciences, Bursa, Turkey
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Kiyici S, Guclu M, Budak F, Sigirli D, Tuncel E. Even Short-Term Telmisartan Treatment Ameliorated Insulin Resistance But Had No Influence on Serum Adiponectin and Tumor Necrosis Factor-Alpha Levels in Hypertensive Patients with Metabolic Syndrome. Metab Syndr Relat Disord 2019; 17:167-172. [PMID: 30688550 DOI: 10.1089/met.2018.0129] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND We investigated the effect of short-term telmisartan usage in addition to lifestyle changes such as diet and exercise on insulin resistance, lipid metabolism, and serum adiponectin and tumor necrosis factor-alpha (TNF-α) levels in hypertensive patients with metabolic syndrome (MetS). METHODS A total of 36 hypertensive patients with MetS were randomized to telmisartan and control groups in an open-labeled prospective study. RESULTS There were significant decreases in anthropometric variables of patients according to baseline measurements in both groups at the end of the study. Serum insulin level and insulin resistance assessed by homeostasis model assessment-insulin resistance were decreased significantly in the telmisartan group (P = 0.040 and P = 0.034, respectively) compared with the controls, while there was no statistically significant change in the lipid profiles of the two groups. Serum adiponectin level was increased by 19.1% ± 41.7% in the telmisartan group, but intergroup analysis revealed no significant change. There was also no significant change in serum TNF-α level in either group. CONCLUSION It has been observed that even short-term telmisartan treatment had favorable effects on insulin resistance and glucose metabolism compared with lifestyle changes alone. The fundamental effect of telmisartan treatment on insulin resistance renders it a good therapeutic option for hypertensive patients with MetS.
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Affiliation(s)
- Sinem Kiyici
- 1 Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Metin Guclu
- 1 Department of Endocrinology and Metabolism, Bursa Yuksek Ihtisas Education and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Ferah Budak
- 2 Department of Immunology, Medical Faculty, Uludag University, Bursa, Turkey
| | - Deniz Sigirli
- 3 Department of Bio-Statistics, and Medical Faculty, Uludag University, Bursa, Turkey
| | - Ercan Tuncel
- 4 Department of Endocrinology and Metabolism, Medical Faculty, Uludag University, Bursa, Turkey
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Abstract
Metastases to the thyroid gland are rarely encountered in clinical practice. They may originate from various primary sites, mainly kidney, lung, breast, esophagus and uterus. Prostate cancer is one of the most frequent malignancies in men. It generally has a favorable course, and autopsy series have shown occult prostate cancer in many subjects, especially in aged males. However, prostate cancer sometimes exhibits an aggressive behavior and cases with a poor prognosis have been reported. Occasional reports of metastasis from prostate cancer to the thyroid gland have been documented. We describe the case of a 73-year-old patient presenting with thyroid metastasis from long-standing prostate cancer.
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Affiliation(s)
- Hadi Selimoglu
- Department of Endocrinology and Metabolism Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Cevdet Duran
- Department of Endocrinology and Metabolism Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Ozlem Saraydaroglu
- Department of Pathology, Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Metin Guclu
- Department of Endocrinology and Metabolism Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Sinem Kiyici
- Department of Endocrinology and Metabolism Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Canan Ersoy
- Department of Endocrinology and Metabolism Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Mehmet Ali Eren
- Department of Internal Medicine, Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Ercan Tuncel
- Department of Endocrinology and Metabolism Uludag University, Faculty of Medicine, Bursa, Turkey
| | - Sazi Imamoglu
- Department of Endocrinology and Metabolism Uludag University, Faculty of Medicine, Bursa, Turkey
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Guclu M, Kiyici S, Gul Z, Cavun S. Exenatide treatment causes suppression of serum fasting ghrelin levels in patients with type 2 diabetes mellitus. Endocr Connect 2018; 7:193-198. [PMID: 29217653 PMCID: PMC5776666 DOI: 10.1530/ec-17-0242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/23/2017] [Accepted: 12/07/2017] [Indexed: 11/08/2022]
Abstract
AIM In the present study, we investigated the long-term effects of exenatide treatment on serum fasting ghrelin levels in patients with type 2 diabetes mellitus. METHODS Type 2 diabetic patients, who were using metformin with and without the other antihyperglycemic drugs on a stable dose for at least 3 months, were enrolled in the study. BMI>35 kg/m2 and HbA1c>7.0% were the additional inclusion criteria. Oral antihyperglycemic drugs, other than metformin, were stopped, and metformin treatment was continued at 2000 mg per day. Exenatide treatment was initiated at 5 µg per dose subcutaneously (sc) twice daily, and after one month, the dose of exenatide was increased to 10 µg twice daily. Changes in anthropometric variables, glycemic control, lipid parameters and total ghrelin levels were evaluated at baseline and following 12 weeks of treatment. RESULTS Thirty-eight patients (male/female = 7/31) entered the study. The mean age of patients was 50.5 ± 8.8 years with a mean diabetes duration of 8.5 ± 4.9 years. The mean BMI was 41.6 ± 6.3 kg/m2 and the mean HbA1c of patients was 8.9 ± 1.4%. The mean change in the weight of patients was -5.6 kg and the percentage change in weight was -5.2 ± 3.7% following 12 weeks of treatment. BMI, fasting plasma glucose and HbA1c levels of patients were decreased significantly (P < 0.001 and P < 0.001; respectively), while there was no change in lipid parameters. Serum fasting ghrelin levels were significantly suppressed following 12 weeks of exenatide treatment compared with baseline values (328.4 ± 166.8 vs 245.3 ± 164.8 pg/mL) (P = 0.024). CONCLUSION These results suggest that the effects of exenatide on weight loss may be related with the suppression of serum fasting ghrelin levels, which is an orexigenic peptide.
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Affiliation(s)
- Metin Guclu
- Health Sciences UniversityBursa Yuksek Ihtisas Education and Training Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Sinem Kiyici
- Health Sciences UniversityBursa Yuksek Ihtisas Education and Training Hospital, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Zulfiye Gul
- Department of PharmacologyUludag University Medical Faculty, Bursa, Turkey
| | - Sinan Cavun
- Department of PharmacologyUludag University Medical Faculty, Bursa, Turkey
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Tigen K, Paudel A, Ozben Sadic B, Guclu M, Yoldemir T, Yildiz I, Sayar N, Sari I, Basaran Y. P5237The evaluation of ventricular functions by speckle tracking echocardiography in preeclamptic patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5237] [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: 11/13/2022] Open
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Yoldemir AT, Cimsit C, Guclu M, Akpinar IN. Evaluation of Vaginal Vault Position With Dynamic MRI in Women Who Had Laparoscopic Sacrocolpopexy for Uterine Prolapse. J Minim Invasive Gynecol 2016; 22:S249-S250. [PMID: 27679181 DOI: 10.1016/j.jmig.2015.08.870] [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: 10/22/2022]
Affiliation(s)
- A T Yoldemir
- Obstetrics and Gynecology, Marmara University, School of Medicine, Research and Training Hospital, Istanbul, Marmara, Turkey
| | - C Cimsit
- Radiology, Marmara University, School of Medicine, Research and Training Hospital, Istanbul, Marmara, Turkey
| | - M Guclu
- Obstetrics and Gynecology, Marmara University, School of Medicine, Research and Training Hospital, Istanbul, Marmara, Turkey
| | - I N Akpinar
- Radiology, Marmara University, School of Medicine, Research and Training Hospital, Istanbul, Marmara, Turkey
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Guclu M, Ali A, Eroglu DU, Büyükuysal SO, Cander S, Ocak N. Serum Levels of sRAGE Are Associated with Body Measurements, but Not Glycemic Parameters in Patients with Prediabetes. Metab Syndr Relat Disord 2016; 14:33-9. [DOI: 10.1089/met.2015.0078] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Metin Guclu
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Training Hospital-Bursa, Bursa, Turkey
| | - Asuman Ali
- Department of Neurology, Sevket Yilmaz Research and Training Hospital-Bursa, Bursa, Turkey
| | - Derya Ustun Eroglu
- Department of Internal Medicine, Sevket Yilmaz Research and Training Hospital-Bursa, Bursa, Turkey
| | - Sema Oral Büyükuysal
- Department of Biochemistry, Sevket Yilmaz Research and Training Hospital-Bursa, Bursa, Turkey
| | - Soner Cander
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Training Hospital-Bursa, Bursa, Turkey
| | - Nihal Ocak
- Department of Biochemistry, Sevket Yilmaz Research and Training Hospital-Bursa, Bursa, Turkey
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Topyildiz F, Kiyici S, Gul Z, Sigirli D, Guclu M, Kisakol G, Cavun S. Exenatide Treatment Causes Suppression of Serum Ghrelin Levels following Mixed Meal Test in Obese Diabetic Women. J Diabetes Res 2016; 2016:1309502. [PMID: 26998491 PMCID: PMC4779845 DOI: 10.1155/2016/1309502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 01/07/2016] [Accepted: 01/21/2016] [Indexed: 12/02/2022] Open
Abstract
AIM To investigate the effect of exenatide treatment on serum ghrelin levels in obese female patients with type 2 diabetes mellitus. METHODS Fourteen female patients with type 2 diabetes mellitus being treated with metformin and exenatide were enrolled. A mixed meal test was applied to the patients while continuing with their daily medications. Blood samples were taken before and at 60, 120, and 180 minutes following mixed meal test to measure serum total ghrelin, glucose, and insulin levels. The following week, exenatide treatment of the patients was paused for 24 hours and the same experimental procedures were repeated. RESULTS Serum ghrelin levels were suppressed significantly at 180 minutes with exenatide treatment compared with baseline (294.4 ± 57.5 versus 234.5 ± 59.4 pg/mL) (p < 0.001). Serum ghrelin levels at 180 minutes were statistically different when percentage change in serum ghrelin levels after mixed meal tests with and without exenatide usage were compared (p = 0.001). Estimated total area under the curve values for serum ghrelin concentrations was also significantly lower with exenatide compared with omitted treatment (p = 0.035). CONCLUSION These results suggest that the effect of exenatide on weight loss may be related with the suppression of serum ghrelin levels, which is an orexigenic peptide.
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Affiliation(s)
- Figen Topyildiz
- Bursa Yuksek Ihtisas Education and Research Hospital, Department of Internal Medicine, 16330 Bursa, Turkey
| | - Sinem Kiyici
- Bursa Yuksek Ihtisas Education and Research Hospital, Department of Internal Medicine, 16330 Bursa, Turkey
- *Sinem Kiyici:
| | - Zulfiye Gul
- Uludag University Medical Faculty, Department of Pharmacology, 16059 Bursa, Turkey
| | - Deniz Sigirli
- Uludag University Medical Faculty, Department of Bio-Statistics, 16059 Bursa, Turkey
| | - Metin Guclu
- Bursa Yuksek Ihtisas Education and Research Hospital, Department of Endocrinology and Metabolism, 16330 Bursa, Turkey
| | - Gurcan Kisakol
- Bursa Yuksek Ihtisas Education and Research Hospital, Department of Endocrinology and Metabolism, 16330 Bursa, Turkey
| | - Sinan Cavun
- Uludag University Medical Faculty, Department of Pharmacology, 16059 Bursa, Turkey
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Kahvecioglu S, Guclu M, Ustundag Y, Gul CB, Dogan I, Dagel T, Esen B, Akturk Esen S, Celik H, Esen I. Evaluation of serum Spondin 2 levels in the different stages of Type 2 diabetic nephropathy. Nephrology (Carlton) 2015; 20:721-726. [DOI: 10.1111/nep.12507] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Serdar Kahvecioglu
- Department of Nephrology; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
| | - Metin Guclu
- Department of Endocrinology; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
| | - Yasemin Ustundag
- Department of Biochemistry; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
| | - Cuma Bulent Gul
- Department of Nephrology; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
| | - Ibrahim Dogan
- Department of Nephrology; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
| | - Tuncay Dagel
- Department of Nephrology; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
| | - Bennur Esen
- Department of Nephrology; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
| | - Selin Akturk Esen
- Department of Internal Medicine; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
| | - Huseyin Celik
- Department of Nephrology; Acibadem Hospital; Bursa Turkey
| | - Irfan Esen
- Department of Internal Medicine; Bursa Sevket Yilmaz Training and Research Hospital; Bursa Turkey
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Guclu M, Cander S, Kiyici S, Vatansever E, Hacihasanoğlu AB, Kisakol G. Serum macroprolactin levels in pregnancy and association with thyroid autoimmunity. BMC Endocr Disord 2015; 15:31. [PMID: 26091810 PMCID: PMC4475296 DOI: 10.1186/s12902-015-0025-2] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 06/01/2015] [Indexed: 12/16/2022] Open
Abstract
BACGROUND To assess the contribution of macroprolactin to high serum prolactin levels and their association with thyroid status and thyroid autoimmunity during pregnancy. METHODS 138 pregnant women who suspected of having thyroid dysfunction were studied and divided into three groups according to the thyroid status; group 1; euthyroidism (n 40), group 2; hypothyroidism (n 54), and group 3; hyperthyroid (n 44). Polyethylene glycol (PEG) precipitation method was used for detection of macroprolactin. A percentage recovery of 40 % or less is considered as macroprolactinemia. If macroprolactin was negative, the percentage of monomeric prolactin recovery (monoPRL %) after PEG precipitation was used for comparison between the groups. RESULTS Macroprolactinemia was found in two patients (1.4 %) one from hypothyroid and other from euthyroid group. Basal prolactin levels in these patients were 400 and 403 ng/mL respectively. Referring to all patients, there was no correlation between PRL, macroPRL or monoPRL % with thyroid hormone status and also with the serum levels of thyroid antibodies (p > 0.05). A positive correlation was observed between the serum levels of PRL with TSH (p = 0.014 and r = 0.219), while a negative correlation was found with FT4 (p = 0.011 and r = -0.227). CONCLUSIONS Despite the fact that serum prolactin levels were found to be high during pregnancy, the contribution of macroprolactin was found to be insignificant in our study. Unlike other auto immune diseases, we could not find any relationship between thyroid autoimmunity and PRL, macroPRL or monoPRL %. These results confirmed that measured prolactin was quite homogeneous during pregnancy.
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Affiliation(s)
- Metin Guclu
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey.
| | - Soner Cander
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
| | - Sinem Kiyici
- Department of Internal Medicine, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
| | - Ebru Vatansever
- Department of Biochemistry, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
| | - Arif Bayram Hacihasanoğlu
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
| | - Gurcan Kisakol
- Department of Endocrinology and Metabolism, Sevket Yilmaz Research and Education Hospital, Bursa, Turkey
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Kahvecioglu S, Ersoy A, Ayar Y, Guclu M, Gul CB, Ustundag Y, Dogan I, Yildiz A. SP136EVALUATION OF SERUM SPONDIN 2 LEVELS IN THE DIFFERENT ETIOLOGIES OF GLOMERULAR DISEASES. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv189.09] [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: 11/13/2022] Open
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Guclu M, Oz Gul O, Cander S, Unal O, Ozkaya G, Sarandol E, Ersoy C. Effect of Rosiglitazone and Insulin Combination Therapy on Inflammation Parameters and Adipocytokine Levels in Patients with Type 1 DM. J Diabetes Res 2015; 2015:807891. [PMID: 26273677 PMCID: PMC4530282 DOI: 10.1155/2015/807891] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 03/10/2015] [Accepted: 03/17/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the efficacy of combined therapy of insulin and rosiglitazone on metabolic and inflammatory parameters, insulin sensitivity, and adipocytokine levels in patients with type 1 diabetes mellitus (type 1 DM). MATERIAL AND METHODS A total of 61 adults with type 1 DM were randomly and prospectively assigned in open-label fashion to take insulin and rosiglitazone 4 mg/day (n = 30) or insulin alone (n = 31) for a period of 18 weeks while undergoing insulin therapy without acute metabolic complications. RESULTS Combination therapy did not significantly improve metabolic and inflammatory parameters, insulin sensitivity, and adiponectin levels. While leptin and resistin levels decreased in both groups (group 1: resistin 6.96 ± 3.06 to 4.99 ± 2.64, P = 0.006; leptin 25.8 ± 17.6 to 20.1 ± 12.55, P = 0.006; group 2: resistin 7.16 ± 2.30 to 5.57 ± 2.48, P = 0.031; leptin 16.72 ± 16.1 to 14.0 ± 13.4, P = 0.007) Hgb and fibrinogen levels decreased only in group 1 (Hgb 13.72 ± 1.98 to 13.16 ± 1.98, P = 0.015, and fibrinogen 4.00 ± 1.08 to 3.46 ± 0.90, P = 0.002). Patients in both groups showed weight gain and the incidence of hypoglycemia was not lower. DISCUSSION The diverse favorable effects of TZDs were not fully experienced in patients with type 1 DM. These results are suggesting that insulin sensitizing and anti-inflammatory characteristics of TZDs were likely to be more pronounced in patients who were not totally devoid of endogenous insulin secretion.
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Affiliation(s)
- Metin Guclu
- Division of Endocrinology, Sevket Yılmaz Research and Education Hospital, 16310 Bursa, Turkey
- Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey
- *Metin Guclu:
| | - Ozen Oz Gul
- Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey
| | - Soner Cander
- Division of Endocrinology, Sevket Yılmaz Research and Education Hospital, 16310 Bursa, Turkey
- Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey
| | - Oguzkaan Unal
- Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey
- Acibadem Private Hospital, 16210 Bursa, Turkey
| | - Guven Ozkaya
- Department of Biostatistics, School of Medicine, Uludağ University, 16210 Bursa, Turkey
| | - Emre Sarandol
- Department of Biochemistry, School of Medicine, Uludağ University, 16210 Bursa, Turkey
| | - Canan Ersoy
- Department of Endocrinology and Metabolism, School of Medicine, Uludağ University, 16210 Bursa, Turkey
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Cander S, Dizdar OS, Oz Gul O, Guclu M, Unal OK, Tuncel E, Erturk E, Imamoglu S, Ersoy C. Comparison of efficacy and safety of once- versus twice-daily insulin detemir added on to oral antidiabetics in insulin-naive type 2 diabetes patients: 24-week, crossover, treat to target trial in a single center. Prim Care Diabetes 2014; 8:256-264. [PMID: 24522170 DOI: 10.1016/j.pcd.2014.01.010] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/17/2014] [Accepted: 01/18/2014] [Indexed: 11/22/2022]
Abstract
AIM To compare once- versus twice-daily insulin detemir added on OADS therapy in insulin-naive type 2 diabetes patients in terms of efficacy and safety. METHODS An open-label study performed at a single center, comprised a randomized, crossover 24 week with insulin-naive type 2 diabetes patients. Insulin detemir was initiated with mean 0.12 U/kg in all patients (Group I once-daily, Group II twice-daily) and titrated for 24 week. RESULTS A total of 50 patients completed the study (Group I n:25, Group II n:25). With use of once- and twice-daily insulin, HbA1c values were decreased by 1.8% (±2.0) and 1.5% (±1.4) within the first 12 weeks (p<0.01), whereas increased by 0.21% (±0.7) and 0.14% (±0.8) in the second 12 weeks (p>0.05). The increases in the insulin doses were found as 0.22 U/kg and 0.35 U/kg with once- and twice-daily insulin use, respectively (p:0.04). Although minor hypoglycemic events were similar in both groups in the first 12 weeks, 2-fold increase was found in the patients shifting from once- to twice-daily dose. Within the first and second periods, the body weight of the patients was observed an increase of 0.4 and 1.6 kg with once-daily dose, whereas a decrease of 0.1 and 2.1 kg in the twice-daily dose, in the same period. CONCLUSION Once-daily use of insulin detemir up to 0.4 U/kg was found to have similar efficacy and safety as twice-daily use. Twice dose use of insulin did not provide a prominent glycemic control advantage on 1.5-fold higher use of insulin.
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Affiliation(s)
- Soner Cander
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey.
| | - Oguzhan Sitki Dizdar
- Uludag University Medical School, Department of Internal Medicine, Bursa, Turkey
| | - Ozen Oz Gul
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey
| | - Metin Guclu
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey; Bursa Sevket Yilmaz Education and Research Hospital, Division of Endocrinology and Metabolism, Bursa, Turkey
| | - Oguz Kaan Unal
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Ercan Tuncel
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Erdinc Erturk
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Sazi Imamoglu
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
| | - Canan Ersoy
- Uludag University Medical School, Department of Endocrinology and Metabolism, Bursa, Turkey
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Topaloglu AK, Lomniczi A, Kretzschmar D, Dissen GA, Kotan LD, McArdle CA, Koc AF, Hamel BC, Guclu M, Papatya ED, Eren E, Mengen E, Gurbuz F, Cook M, Castellano JM, Kekil MB, Mungan NO, Yuksel B, Ojeda SR. Loss-of-function mutations in PNPLA6 encoding neuropathy target esterase underlie pubertal failure and neurological deficits in Gordon Holmes syndrome. J Clin Endocrinol Metab 2014; 99:E2067-75. [PMID: 25033069 PMCID: PMC5393493 DOI: 10.1210/jc.2014-1836] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Gordon Holmes syndrome (GHS) is characterized by cerebellar ataxia/atrophy and normosmic hypogonadotropic hypogonadism (nHH). The underlying pathophysiology of this combined neurodegeneration and nHH remains unknown. OBJECTIVE We aimed to provide insight into the disease mechanism in GHS. METHODS We studied a cohort of 6 multiplex families with GHS through autozygosity mapping and whole-exome sequencing. RESULTS We identified 6 patients from 3 independent families carrying loss-of-function mutations in PNPLA6, which encodes neuropathy target esterase (NTE), a lysophospholipase that maintains intracellular phospholipid homeostasis by converting lysophosphatidylcholine to glycerophosphocholine. Wild-type PNPLA6, but not PNPLA6 bearing these mutations, rescued a well-established Drosophila neurodegenerative phenotype caused by the absence of sws, the fly ortholog of mammalian PNPLA6. Inhibition of NTE activity in the LβT2 gonadotrope cell line diminished LH response to GnRH by reducing GnRH-stimulated LH exocytosis, without affecting GnRH receptor signaling or LHβ synthesis. CONCLUSION These results suggest that NTE-dependent alteration of phospholipid homeostasis in GHS causes both neurodegeneration and impaired LH release from pituitary gonadotropes, leading to nHH.
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Affiliation(s)
- A Kemal Topaloglu
- Division of Pediatric Endocrinology (A.K.T., E.M., F.G., N.O.M., B.Y.) and Department of Neurology (A.F.K.), Faculty of Medicine, and Department of Biotechnology (A.K.T., L.D.K., M.B.K.), Institute of Sciences, Cukurova University, 01330 Adana, Turkey; Division of Neuroscience (A.L., G.A.D., S.R.O.), Oregon National Primate Research Centre, Beaverton, Oregon 97006; Oregon Institute of Occupational Health Sciences (D.K., M.C.), Oregon Health and Science University, Portland, Oregon 97239; Laboratories for Integrative Neuroscience and Endocrinology (C.A.M.), School of Clinical Sciences, University of Bristol, Bristol, United Kingdom BS1 3NY; Department of Human Genetics (B.C.H.), Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands 6525 GA; Departments of Endocrinology and Metabolism (M.G.) and Pediatric Endocrinology and Metabolism (E.D.P., E.E.), School of Medicine, Uludag University, Bursa, Turkey 16110; and Department of Cell Biology, Physiology, and Immunology (J.M.C.), University of Cordoba, Cordoba, Spain 14071
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19
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Affiliation(s)
- Metin Guclu
- Department of Endocrinology and Metabolism, School of Medicine, Uludag University, Bursa, Turkey
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Selimoglu H, Duran C, Kiyici S, Ersoy C, Guclu M, Ozkaya G, Tuncel E, Erturk E, Imamoglu S. The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome. J Endocrinol Invest 2010; 33:234-8. [PMID: 19820295 DOI: 10.1007/bf03345785] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [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] [Indexed: 11/24/2022]
Abstract
Insulin resistance (IR) is one of the common features of the polycystic ovary syndrome (PCOS), and recent studies indicate the possible role of vitamin D in the pathogenesis of IR and glucose metabolism. Aim of this study was aimed to determine the effect of vitamin D replacement therapy on glucose metabolism, insulin, and androgen levels in obese, insulin-resistant women with PCOS. Eleven women with PCOS were included in the study. Mean age of the patients was 23.6+/-5.7 yr, body mass index 33.9+/-5.1 kg/m(2). Six patients (54.5%) had acantosis nigricans and 10 (90.9%) oligoamenorrhea. The mean Ferriman Gallwey score was 14.1+/-4.6. Only 2 women were within the normal limits of vitamin D levels as >20 ng/ml. Three weeks after the administration of the single dose of 300,000 units of vitamin D3 orally, 25-hydroxyvitamin D3 significantly increased from 16.9+/-16 ng/ml to 37.1+/-14.6 ng/ml (p: 0.027) and only 2 women were detected to have vitamin D3 levels <20 ng/ml. Although glucose and insulin levels were decreased non-significantly, homeostasis model assessment (HOMA)-IR significantly decreased from 4.41+/-1.38 to 3.67+/-1.48 (p: 0.043). No significant alterations were witnessed at the levels of DHEAS, total and free testosterone, androstenedione. No correlation was found between vitamin D with HOMA and other hormonal parameters. In conclusion, women with PCOS have mostly insufficient vitamin D levels, and vitamin D replacement therapy may have a beneficial effect on IR in obese women with PCOS.
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Affiliation(s)
- H Selimoglu
- Division of Endocrinology, Malatya State Hospital, Malatya, Turkey
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21
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Oz Gul O, Tuncel E, Yilmaz Y, Ulukaya E, Gul CB, Kiyici S, Oral AY, Guclu M, Ersoy C, Imamoglu S. Comparative effects of pioglitazone and rosiglitazone on plasma levels of soluble receptor for advanced glycation end products in type 2 diabetes mellitus patients. Metabolism 2010; 59:64-9. [PMID: 19709689 DOI: 10.1016/j.metabol.2009.07.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 06/29/2009] [Accepted: 07/08/2009] [Indexed: 11/24/2022]
Abstract
Low levels of soluble receptor for advanced glycation end products (sRAGE) have been associated with the occurrence of vascular complications in patients with type 2 diabetes mellitus. Preliminary evidence has suggested that thiazolidinediones have the ability to modulate circulating levels of this molecule in the hyperglycemic milieu. The aim of this pilot study was to assess the differential effect of 2 different thiazolidinediones-pioglitazone and rosiglitazone-on plasma levels of sRAGE in type 2 diabetes mellitus patients. Sixty type 2 diabetes mellitus subjects were randomly assigned to receive pioglitazone (30 mg/d, n = 19), rosiglitazone (4 mg/d, n = 20), or placebo (medical nutrition therapy, n = 21) for 12 weeks. Changes in plasma glucose, glycosylated hemoglobin, insulin resistance (homeostasis model assessment), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and sRAGE were evaluated at baseline and after 12 weeks. At 12 weeks, the pioglitazone (P < .001) group had a significant increase from baseline in sRAGE values that was not seen in the medical nutrition therapy and rosiglitazone groups. We conclude that, in type 2 diabetes mellitus patients, pioglitazone-but not rosiglitazone-significantly raised sRAGE, which may contribute to its antiatherogenic effects.
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Affiliation(s)
- Ozen Oz Gul
- Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa 16059, Turkey
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Ersoy C, Sadikoglu G, Orhan H, Guclu M, Sarandol E, Akgun MD, Ozcakir A, Imamoglu S. Body fat distribution has no effect on serum visfatin levels in healthy female subjects. Cytokine 2009; 49:275-8. [PMID: 20045351 DOI: 10.1016/j.cyto.2009.11.011] [Citation(s) in RCA: 4] [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] [Received: 05/21/2009] [Revised: 10/23/2009] [Accepted: 11/06/2009] [Indexed: 01/12/2023]
Abstract
Obesity is the presence of either abnormal absolute amount or relative proportion of body fat. Contrary to gluteal obesity, visceral obesity is associated with different metabolic alterations including insulin resistance (IR). A relatively new adipocytokine visfatin is shown to be expressed predominantly in visceral fat and exhibit insulin-mimicking effects in rodents. It is still unclear whether serum visfatin levels are associated with increased total or visceral fat mass in humans. The aim of our study was to investigate the relation between visfatin and obesity parameters namely body mass index (BMI) and waist circumference (WaC) and IR in healthy female subjects. Eighty one female subjects 20 years of age, having no diagnosis of glucose intolerance or diabetes, hypertension and dyslipidemia were chosen. The patients were divided into four groups according to their BMI and WaC values. Serum visfatin and HOMA-IR levels did not differ among groups. No correlation was detected between serum visfatin levels and obesity and metabolic parameters. In conclusion, we demonstrated that body fat distribution did not affect serum visfatin levels in healthy female subjects. Further studies are needed to clarify the exact factors influencing and determining serum visfatin levels and its clinical reflections.
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Affiliation(s)
- Canan Ersoy
- Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey.
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Selimoglu H, Duran C, Kiyici S, Guclu M, Ersoy C, Ozkaya G, Erturk E, Tuncel E, Imamoglu S. Comparison of composite whole body insulin sensitivity index derived from mixed meal test and oral glucose tolerance test in insulin resistant obese subjects. Endocrine 2009; 36:299-304. [PMID: 19598007 DOI: 10.1007/s12020-009-9213-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Revised: 06/01/2009] [Accepted: 06/18/2009] [Indexed: 01/23/2023]
Abstract
Apart from fasting blood glucose (FBG) and insulin (FBI), oral glucose tolerance test (OGTT) is also used in calculating insulin sensitivity. During OGTT, insulin secretion may not reflect normal physiological insulin secretion. Based on this idea, hepatic and whole body insulin sensitivity rates were tested during OGTT and mixed meal test (MMT) in obese subjects. Thirty-one women with Quantitative Insulin Sensitivity Check Index (QUICKI) values below 0.350 and body mass index (BMI) >or=30 were included into the study. OGTT with 75-g glucose and MMT 300 kcal were applied to all cases. Data obtained from OGTT and MMT were used in the assessment of insulin sensitivity with Hemostasis of Model Assessment-Insulin Resistance (HOMA-IR) and Matsuda's Composite Whole Body Insulin Sensitivity Index (Matsuda's ISI). Mean BMI, FBG, and FBI were 36.8 +/- 3.9 kg/m(2), 100.5 +/- 0.10 mg/dl, 16.2 +/- 5.3 microg/ml, respectively. QUICKI was 0.31 +/- 0.01 and HOMA-IR was 3.71 +/- 0.88. Matsuda's ISI derived from OGTT was 6.96 +/- 3.35 and from MMT was 11.32 +/- 6.61. In analysis, it was demonstrated that there was a correlation between HOMA-IR, QUICKI, and Matsuda's ISIs derived from OGTT and MMT. Comparing the time periods separately, it was detected that despite similar increment in insulin levels, glucose levels were higher in OGTT than MMT at 15 and 30 min. Consequently, Matsuda's ISI was demonstrated to be effectively used with the data of MMT, as used with OGTT. Moreover, MMT was shown to be in parallel to physiologic insulin secretion and reflect pancreatic functions better compared to OGTT.
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Affiliation(s)
- Hadi Selimoglu
- Division of Endocrinology, Malatya State Hospital, Malatya, Turkey
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24
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Topaloglu AK, Reimann F, Guclu M, Yalin AS, Kotan LD, Porter KM, Serin A, Mungan NO, Cook JR, Imamoglu S, Akalin NS, Yuksel B, O'Rahilly S, Semple RK. TAC3 and TACR3 mutations in familial hypogonadotropic hypogonadism reveal a key role for Neurokinin B in the central control of reproduction. Nat Genet 2009; 41:354-358. [PMID: 19079066 PMCID: PMC4312696 DOI: 10.1038/ng.306] [Citation(s) in RCA: 604] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Accepted: 12/03/2008] [Indexed: 11/09/2022]
Abstract
The timely secretion of gonadal sex steroids is essential for the initiation of puberty, the postpubertal maintenance of secondary sexual characteristics and the normal perinatal development of male external genitalia. Normal gonadal steroid production requires the actions of the pituitary-derived gonadotropins, luteinizing hormone and follicle-stimulating hormone. We report four human pedigrees with severe congenital gonadotropin deficiency and pubertal failure in which all affected individuals are homozygous for loss-of-function mutations in TAC3 (encoding Neurokinin B) or its receptor TACR3 (encoding NK3R). Neurokinin B, a member of the substance P-related tachykinin family, is known to be highly expressed in hypothalamic neurons that also express kisspeptin, a recently identified regulator of gonadotropin-releasing hormone secretion. These findings implicate Neurokinin B as a critical central regulator of human gonadal function and suggest new approaches to the pharmacological control of human reproduction and sex hormone-related diseases.
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Affiliation(s)
- A Kemal Topaloglu
- Cukurova University, Faculty of Medicine, Department of Pediatric Endocrinology and Metabolism, Balcali, Adana, TURKEY
| | - Frank Reimann
- Cambridge Institute for Medical Research and Department of Clinical Biochemistry, University of Cambridge, Wellcome Trust/MRC Building, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0XY, UK
| | - Metin Guclu
- Uludag University, Faculty of Medicine, Department of Endocrinology and Metabolism, Bursa, TURKEY
| | - Ayse Serap Yalin
- Marmara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, TURKEY
| | - L Damla Kotan
- Cukurova University, Faculty of Medicine, Department of Forensic Medicine, Balcali, Adana, TURKEY
| | - Keith M Porter
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Ayse Serin
- Cukurova University, Faculty of Medicine, Department of Forensic Medicine, Balcali, Adana, TURKEY
| | - Neslihan O Mungan
- Cukurova University, Faculty of Medicine, Department of Pediatric Endocrinology and Metabolism, Balcali, Adana, TURKEY
| | - Joshua R Cook
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Sazi Imamoglu
- Uludag University, Faculty of Medicine, Department of Endocrinology and Metabolism, Bursa, TURKEY
| | - N Sema Akalin
- Marmara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, TURKEY
| | - Bilgin Yuksel
- Cukurova University, Faculty of Medicine, Department of Pediatric Endocrinology and Metabolism, Balcali, Adana, TURKEY
| | - Stephen O'Rahilly
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Robert K Semple
- University of Cambridge Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
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Duran C, Tuncel E, Ersoy C, Ercan I, Selimoglu H, Kiyici S, Guclu M, Erturk E, Imamoglu S. The investigation of the efficacy of insulin glargine on glycemic control when combined with either repaglinide or acarbose in obese Type 2 diabetic patients. J Endocrinol Invest 2009; 32:69-73. [PMID: 19337019 DOI: 10.1007/bf03345682] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Combinations of insulin and oral antidiabetic drugs (OAD) are often prescribed instead of insulin alone. In this study, the effects of insulin glargine (IG) in combination with repaglinide or acarbose on glycemic parameters were investigated. Obese Type 2 diabetic patients with fasting blood glucose (FBG) levels >or= 7.7 mmol/l [corrected] and hemoglobin glycated (A1C) >or=9% under maximal OAD combination therapy were enrolled. Previous therapies were discontinued, and patients were randomized into 2 groups. The combinations of IG and repaglinide were administered to group 1, and of IG and acarbose to group 2 for 13 weeks. Twenty patients in group 1 and 18 patients in group 2 completed the study. A1C levels were significantly decreased from 10.9+/-1.4% to 7.7+/-1.1% in group 1 and 11.0+/-1.4% to 8.1+/-1.4% in group 2. FBG levels were significantly decreased from 11.9+/-2.7 to 7.1+/-2.3 mmol/l in group 1 and 11.1+/-2.5 to 6.8+/-1.4 mmol/l in group 2. Post-prandial glucose levels were significantly decreased from 15.3+/-3.8 to 10.3+/-3.0 mmol/l in group 1 and 14.0+/-3.1 to 8.9+/-2.2 mmol/l in group 2. Intergroup comparisons indicated no significant differences. More weight gain was detected in group 1, compared to the baseline. Symptomatic hypoglycemia incidence was similar in both groups. Severe hypoglycemic attacks were seen in two patients in group 1. Flatulence incidence was higher in acarbose group. Conclusively, repaglinide and acarbose were equally effective when combined with IG for obese Type 2 diabetic patients controlled inadequately with OAD alone. Furthermore, acarbose seems to have advantages over repaglinide concerning weight gain and severe hypoglycemic attacks.
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Affiliation(s)
- C Duran
- Division of Endocrinology, Konya Education and Research Hospital, Meram Konya 42000, Turkey.
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Erer S, Yilmazlar S, Zarifoglu M, Guclu M. A case report on pituitary macroadenoma presented as hemichorea hemiballism syndrome. Neurol Sci 2008; 29:289-90. [PMID: 18810608 DOI: 10.1007/s10072-008-0984-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ersoy C, Kiyici S, Budak F, Oral B, Guclu M, Duran C, Selimoglu H, Erturk E, Tuncel E, Imamoglu S. The effect of metformin treatment on VEGF and PAI-1 levels in obese type 2 diabetic patients. Diabetes Res Clin Pract 2008; 81:56-60. [PMID: 18358555 DOI: 10.1016/j.diabres.2008.02.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [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: 01/16/2008] [Accepted: 02/07/2008] [Indexed: 10/22/2022]
Abstract
The aim of the study was to evaluate the effect of metformin on markers of endothelial function, vascular inflammation and factors of thrombosis in obese type 2 diabetic patients. Twenty-four type 2 diabetic patients (15 female, 9 male) previously under medical nutrition treatment (MNT)+regular exercise programme (REP) without chronic micro or macrovascular complications with the mean age of 50.5+/-1.5 years, diabetes duration of 17.9+/-6.3 months and body mass index (BMI) of 31.7+/-0.8 kg/m(2) were enrolled in the study. In the first 4 weeks, all the patients continued MNT+REP. In the following 12 weeks, metformin (mean daily dosage of 1381+/-85 mg) was added. After the first period with MNT+REP, BMI, waist circumference, fat percentage, blood pressure and HDL cholesterol decreased significantly. After metformin addition, there was a significant decrement in BMI, waist circumference, fat percentage, fasting and postprandial plasma glucose, hemoglobin A1C, plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF) and increment in beta cell reserve values of the patients. Our results indicated that, metformin addition had beneficial effect on VEGF and PAI-1 levels in obese type 2 diabetic patients under MNT+REP, independent from its' favourable effects on BMI and glycemic control.
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Affiliation(s)
- Canan Ersoy
- Department of Endocrinology and Metabolism, Uludag University Medical School, 16059 Görükle-Bursa, Turkey.
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Duran C, Ediger D, Ersoy C, Coskun NF, Selimoglu H, Ercan I, Kiyici S, Guclu M, Saglam DA, Erturk E, Tuncel E, Imamoglu S. Frequency of atopy and allergic disorders among adults with Type 1 diabetes mellitus in the southern Marmara region of Turkey. J Endocrinol Invest 2008; 31:211-5. [PMID: 18401202 DOI: 10.1007/bf03345592] [Citation(s) in RCA: 3] [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: 10/25/2022]
Abstract
AIM Autoimmune disorders are considered to be associated with a Th1 immune response whereas allergic diseases with a Th2 response. Studies mainly performed on children revealed conflicting results regarding the association of atopy/allergic disease and autoimmune disorders. Therefore, we aimed to investigate the prevalence of allergic diseases in adult Type 1 diabetic patients. METHODS Eighty-nine Type 1 diabetic patients and 64 controls were enrolled into the study. Skin-prick test and European Community Respiratory Health Survey questionnaire were performed on all cases. Patients who gave at least one positive answer to questions about asthma in the questionnaire underwent pulmonary function test and methacholine challenge test. RESULTS Patients' mean age were similar in diabetic patients and controls (28.2+/-8.9 and 28.1+/-5.2 yr; respectively). In skin-prick test, the rate of positive response to at least one allergen was not significantly different in diabetes (29.2%) and in the control group (31.3%). In European Community Respiratory Health Survey questionnaire, diabetic patients waked up by an attack of cough more than controls did. The rate of physician-diagnosed asthma was similar in both groups. There was no difference between the 2 groups based on the answers of other questions about asthma and other allergic diseases such as allergic rhinitis, eczema, and drug allergy. CONCLUSION We found that atopy frequencies were similar in an adult population of Type 1 diabetic patients and controls. Although asthmatic symptom prevalence is increased in diabetic patients, the incidence of current asthma was similar in both groups.
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Affiliation(s)
- C Duran
- Division of Endocrinology and Metabolism, Konya Education and Research Hospital, Konya, Turkey.
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Unal O, Erturk E, Ozkan H, Kiyici S, Guclu M, Ersoy C, Yener F, Imamoglu S. Effect of levothyroxine treatment on QT dispersion in patients with subclinical hypothyroidism. Endocr Pract 2008; 13:711-5. [PMID: 18194926 DOI: 10.4158/ep.13.7.711] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the effect of levothyroxine treatment in patients with subclinical hypothyroidism on electrocardiographic variables, especially on ventricular repolarization-related factors. METHODS Sixteen women (mean age, 48.2 years) with subclinical hypothyroidism were treated with levothyroxine for 16 weeks. All standard 12-lead electrocardiographic recordings were scanned and transferred to a computer, and the QT intervals were measured on 300 times magnified recordings. QT dispersion, which reflects the heterogeneity of the ventricular repolarization, was calculated by the difference between the QT maximum and the QT minimum. RESULTS We found that, after 16 weeks of levothyroxine treatment, the QT interval decreased from 387.2 +/- 10.8 ms to 345.6 +/- 13.0 ms (P<0.0001). The study patients exhibited a significant reduction of QT dispersion from 46.5 +/- 5.3 ms to 30.7 +/- 5.8 ms (P<0.0001). On linear regression analysis, a positive relationship was found between QT dispersion and logarithmic serum TSH levels (r = 0.492; P<0.0001). CONCLUSION We conclude that serum TSH concentration has a role in ventricular inhomogeneity and, therefore, that subclinical hypothyroidism may predispose to ventricular arrhythmias. A large-scale, multicenter, randomized trial should be undertaken to address the benefit-to-risk ratio of levothyroxine treatment on cardiac inhomogeneity in patients with subclinical hypothyroidism.
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Affiliation(s)
- Oguzkaan Unal
- Department of Endocrinology, Uludag University School of Medicine, Bursa, Turkey
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Selimoglu H, Duran C, Saraydaroglu O, Guclu M, Kiyici S, Ersoy C, Eren MA, Tuncel E, Imamoglu S. Prostate cancer metastasis to thyroid gland. Tumori 2007; 93:292-5. [PMID: 17679467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Metastases to the thyroid gland are rarely encountered in clinical practice. They may originate from various primary sites, mainly kidney, lung, breast, esophagus and uterus. Prostate cancer is one of the most frequent malignancies in men. It generally has a favorable course, and autopsy series have shown occult prostate cancer in many subjects, especially in aged males. However, prostate cancer sometimes exhibits an aggressive behavior and cases with a poor prognosis have been reported. Occasional reports of metastasis from prostate cancer to the thyroid gland have been documented. We describe the case of a 73-year-old patient presenting with thyroid metastasis from long-standing prostate cancer.
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Affiliation(s)
- Hadi Selimoglu
- Department of Endocrinology and Metabolism, Uludag University, Faculty of Medicine, Bursa, Turkey.
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