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Introduction:Acromegaly is a rare disease caused by overproduction of growth hormone (GH) secreted from a benign pituitary adenoma. It has been shown in many studies that the incidence of cancer is increased in patients with acromegaly with increased GH and insulin-like growth factor-1 (IGF-1). Especially, colon cancer is more common. Thrombospondin-1 (TSP-1) is a glycoprotein that is thought to play an important role in cancer formation. This study aimed to evaluate circulating TSP-1 levels in patients with acromegaly.Methods:This study was a case-control study. Fifty-two patients with active acromegaly with GH more...

Objective The aim of this study is to investigate the diagnostic accuracy of complete blood count (CBC), C-reactive protein (CRP), and procalcitonin (PCT) levels, which can be used as a cultural alternative for the diagnosis of infection faster. Methods The patients were divided into two groups as bacteremia (n = 220) and nonbacteremia group (n = 812). The bacteremia group was divided into two subgroups as Gram-positive bacteria (n = 167) and Gram-negative bacteria (n = 53). Results PCT, CRP, red blood cell distribution width (RDW), platelet distribution width (PDW), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV) levels were significantly higher in patients with positive blood culture than non-patients. The serum PCT levels were 3.80 (0.83–37.68) and 0.43 (0.16–2.61) ng/mL, respectively (p Conclusions It is important that RDW, PDW, NLR, PLR, MPV values can be measured quickly, easily and cheaply by automatic hematological analysis. However, among the markers tested, PCT has the best diagnostic performance for Gram-negative bacteremia. more...

INTRODUCTION[|]Diabetic nephropathy (DN) is the major cause of chronic renal failure, and proteinuria is an independent risk factor for the end stage renal disease. The random urine protein: creatinine ratio (P: C ratio) can accurately predict the amount of 24-hour urinary protein excretion. Apelin is thought to be associated with endothelial dysfunction, angiogenesis, and inflammation. This study investigated the apelin concentration and its association with the urine P: C ratio, and metabolic parameters in subjects with and without type 2 diabetes mellitus (T2D).[¤]METHODS[|]This study involved 86 subjects: 56 with newly diagnosed and untreated T2D and 30 non-diabetic controls. All subjects underwent a complete clinical examination that included anthropometric and laboratory measurements.[¤]RESULTS[|]Twenty-four males and sixty-two females participated in this study, and their mean age was 52.27+-11.34 years. There were no differences in age, thyrotropin-stimulating hormone (TSH), creatinine clearance, and apelin levels between groups. As expected, fasting plasma glucose, weight, body mass index, and HbA1C were higher in T2D subjects (p=0.001, p=0.02, p=0.03, and p=0.001, respectively). Although apelin levels were higher in the control group, the differences were not statistically significant (p=0.93). The P: C ratio levels were lower in the control group, and the differences were statistically significant (p=0.006). A Spearman correlation analysis revealed that serum apelin levels were not correlated with the urine P: C ratio.[¤]DISCUSSION AND CONCLUSION[|]Our study demonstrates that T2D is associated with decreased serum apelin levels and increased urine P: C ratios compared to those in non-diabetic subjects. This association may depend on impaired glucose homeostasis. Our results show that the serum apelin levels were not correlated with the urine protein: creatinine ratio and provide further evidence regarding the relationship between apelin and DN.[¤] more...

Objectives: We aimed to investigate serum neudesin levels that has neural, metabolic functions in patients with polycystic ovary syndrome (PCOS). Material and methods: The study included 180 women (age range, 18–44 years) with a diagnosis of PCOS and a control group that included 100 healthy females (age range, 18–46 years). Body mass index (BMI), waist circumference, Ferriman-Gallwey score, was evaluated and plasma glucose, lipid profile, estradiol, progesterone, total testosterone, prolactin, insulin, dehydroepiandrosterone sulfate (DHEA-S), FSH, LH, free T3, free T4, thyroid stymulating hormone (TSH), anti-thyroperoxidase (anti-TPO) antibody and neudesin levels were evaluated in all participants. Results: BMI and waist circumference were similar between two groups. Ferriman-Gallwey score was significantly higher in the patient group. Fasting blood glucose, HbA1C, lipid parameters except triglyceride levels, free T3, free T4, TSH, anti-TPO were similar between the two groups. Triglyceride, insulin and HOMA values were significantly higher in PCOS patients. While follicle-stimulating hormone (FSH), estradiol, progesterone, prolactin and DHEAS levels were similar, LH was significantly higher in patients with PCOS. Serum neudesin level was significantly lower in PCOS patients with respect to controls (p = 0.015). Neudesin was positively correlated with insulin (r = 0.224, p = 0.037), and progesterone (r = 0.716, p = 0.001). Multiple regression analysis revealed that neudesin correlated with only progesterone (beta = 0.308, p = 0.001). Conclusions: Due to the association of decreased levels of neudesin with PCOS and correlation of neudesin with progesterone, neudesin may be related with one of patophysiologic pathways of PCOS. Still, it is not certain that decreased neudesin is involved in the pathogenesis of PCOS or is the result of the disorder. more...

BACKGROUND: We aimed to evaluate the value of ischemia modified albumin (IMA) as a prognostic marker in acute pancreatitis (AP) patients, determine whether it is efficient in assessing the disease severity or not, and to estimate the correlation between IMA and the inflammatory markers, prognostic markers and scoring systems routinely used in clinical practice. METHODS: 100 adult patients (18 years and older) who have been hospitalized and evaluated with AP diagnosis in Tepecik Training and Research Hospital,, Department of Gastroenterology, between April 1, 2017 and April 1, 2018 have been enrolled in the study. Patients have been stratified disease etiology (biliary or non-biliary). The non-biliary group has been divided into subgroups as alcoholic, lipemic, or idiopathic. Disease severity has been categorized as mild, moderate, or severe pancreatitis according to the Atlanta classification. Ranson, Harmless Acute Pancreatitis Score (HAPS), Bedside Severity Index for Acute Pancreatitis (BISAP) scores have been determined for each patient. Patients have been grouped as necrotizing or edematous according to the Atlanta classification. RESULTS: According to our findings, IMA has been found to be correlated with disease severity, Ranson and BISAP scores, and procalcitonin levels. We have observed that some laboratory parameters including blood urea nitrogen and hematocrit levels and HAPS scoring system are not correlated to IMA. CONCLUSION: Our study is the first study to compare multiple prognostic factors with IMA in AP patients. In our study, the association between IMA and AP has been evaluated in the context of prognostic scoring and disease severity. more...

Centrifugation separates particles within the specimen according to their shape, dimensions, and density and basically can be defined as a separation method. The centrifuge is an essential device in medical laboratories to prepare the serum, plasma, and urine samples for analysis. It is basically an electric device composed of the stationary (motor) and the motile (rotor) part. The centrifugation depends on two main variables: relative centrifugal force (RCF) and centrifugation time. The physical impact separating the specimen into its components in the centrifuge known as RCF is expressed as the multiples of gravitational acceleration (×g). RPM, defined as the number of rotations of the centrifuge per minute, shows the speed of the centrifuge. RCF value can be calculated by using RPM, and the centrifuge radius. Because models and sizes of centrifuges vary considerably, the use of gravity (g) forces instead of RPM is suggested. The centrifuges can be classified according to their usage, speed, technical specifications, and rotor type. An accurate and precise centrifugation process is essential to prevent errors in the preanalytical phase. The purpose of this document is to ensure the standardization of a good, precise protocol for the centrifugation process among the medical laboratories. more...

Amaç: Bu çalışmada, otoimmün karaciğer hastalığında (AILD) belirteç olarak total antioksidan durum (TAS), oksidatif stres indeksi (OSI), total oksidan durum (TOS), iskemi modifiye albumin (IMA) ve iskemi modifiye albumin oranının (IMAR) yararı değerlendirildi.Gereç ve Yöntem: Çalışma, 22'si otoimmün hepatit (AIH), 32'si primer biliyer kolanjit (PBC) ve 12'si AIH/PBC örtüşme sendromu olan toplam 66 AILD hastası ve 49 sağlıklı kontrol içermekteydi. Serum TAS, TOS, IMA, albumin (Alb), laktat dehidrojenaz (LDH), alkalen fosfataz (ALP), aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), total bilirubin (TBil), direkt bilirubin (DBil) ve 25-hidroksivitamin D (25 [OH] D) analiz edildi. OSI, TOS/TAS olarak hesaplandı ve IMAR, IMA ve Alb'den türetildi.Bulgular: Serum TAS, TOS, OSI, IMA ve IMAR değerleri AILD grubunda kontrollere göre anlamlı olarak daha yüksekti (sırasıyla p=0.004, Objective: Current study evaluated the utility of total antioxidant status (TAS), oxidative stress index (OSI), total oxidant status (TOS), ischemia-modified albumin (IMA), and ischemia-modified albumin ratio (IMAR) as markers in autoimmune liver disease (AILD).Material and Methods: The study included a total of 66 AILD patients, 22 with autoimmune hepatitis (AIH), 32 with primary biliary cholangitis (PBC), and 12 with AIH/PBC overlap syndrome, and 49 healthy controls. Serum TAS, TOS, IMA, albumin (Alb), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBil), direct bilirubin (DBil), and 25-hydroxyvitamin D (25[OH]D) were analyzed. OSI was calculated as TOS/TAS and IMAR was derived from IMA and Alb.Results: Serum TAS, OSI, TOS, IMA, and IMAR values were found to be significantly higher in the AILD group compared to controls (p=0.004 more...

Objective: The aim of this study was to investigate the levels of ischemia-modified albumin (IMA) in people with essential thrombocytosis (ET).Methods: A total of 30 patients with ET patient group and 30 volunteers with no known disease control group (C group) were included in this study after the approval of ethics committee and written informed consent was obtained. Patients with a history of major thrombosis were excluded. IMA levels and independent variables were investigated and effects on thrombosis susceptibility were also studied. In addition to that; comorbid disease state, drug use and used drugs group were questioned in patient group and effects of them on IMA levels were studied.Results: In our study, when ET patient group and C group were compared, the mean serum IMA levels in ET patient group and C group was detected as 0,6726 (0,527-0,776) Absorbans Unite (ABSU) and 0,4342 (0,346-0,612) ABSU respectively and in ET patient group was significantly higher than C group (p more...

Background In this study it was aimed to evaluate the effect of pegylated interferon alfa-2a/2b and ribavirin, which are used for treatment of chronic hepatitis C (CHC), on insulin resistance and metabolic factors. Materials and methods A total of 104 CHC patients aged 20–75 years with available serum insulin data at 0 and 48 weeks, and hepatitis C virus (HCV)-RNA data at 0, 12, 24, 48 and 72 weeks were included in the study. All clinical para-meters were assessed according to the therapy response. Results Among 104 patients, sustained virologic response (SVR) was achieved in 55 cases. A statistically significant difference was noted between SVR and non-SVR groups regarding γ-glutamyltranspeptidase (GGT), insulin level plus homeostasis model assessment (HOMA) score and insulin resistance at week 48, log HCV-RNA and stage of fibrosis. Conclusion Insulin resistance is accepted to have a negative effect on SVR. Insulin resistance may improve once SVR is achieved. Presence of IR at week 48 has been found associated with SVR. In this context, it can be advocated that insulin resistance at week 48 may be a predictive factor for prediction of SVR at week 72. more...

Background and aim: Vitamin D deficiency and oxidative stress were suggested to be related to prostate cancer risk. We aimed to investigate the association of serum PSA concentration with vitamin D... more...

Serum procalcitonin (PCT) and C-reactive protein (CRP) are markers of systemic inflammation and bacterial infection. We aimed to compare the usefulness of procalcitonin and CRP in patients with community-acquired pneumonia and exacerbations of chronic obstructive pulmonary disease (COPD).A total of 116 consecutive patients were included in the study: 76 with chronic obstructive pulmonary disease in group 1, and 40 with pneumonia in group 2.Median serum CRP level was 44 mg/L in the COPD group and 132 mg/L in the pneumonia group. Median value of serum PCT was found to be 0.07 in the COPD group and 0.14 ng/mL in the pneumonia group. Serum PCT and CRP levels were significantly higher in the pneumonia group compared to the COPD group (p0.001). The area under the ROC curve was 0.788 (CI: 0.704-0.872) for CRP and 0.699 (CI: 0.599-0.800) for procalcitonin to identify pneumonia.Procalcitonin and CRP levels were significantly higher in patients with community-acquired pneumonia presenting to the emergency department with indications for hospitalization than in patients with exacerbations of chronic obstructive pulmonary disease. Serum CRP and procalcitonin concentrations were strongly correlated. CRP might be a more valuable marker in these patients with lower respiratory tract infections.Serumski prokalcitonin (PCT) i C-reaktivni protein (CRP) markeri su sistemske inflamacije i bakterijske infekcije. Naš cilj bio je da se uporedi korisnost prokalcitonina i CRP-a kod pacijenata sa vanbolničkom pneumonijom i pogoršanjima hronične opstruktivne bolesti pluća (HOBP).Ukupno 116 uzastopnih pacijenata je uključeno u ovu studiju: 76 sa hroničnom opstruktivnom bolešću pluća u grupi 1 i 40 sa pneumonijom u grupi 2.Srednji nivo CRP-a u serumu bio je 44 mg/L u grupi sa HOBP i 132 mg/L u grupi sa pneumonijom. Srednja vrednost PCT-a u serumu bila je 0,07 u grupi HOBP i 0,14 ng/mL u grupi sa pneumonijom. Nivo PCT-a i CRP-a u serumu bio je značajno viši u grupi sa pneumonijom u poređenju s grupom sa HOBP (p0,001). Oblast ispod ROC krive bila je 0,788 (CI: 0,704–0,872) za CRP i 0,699 (CI: 0,599–0,800) za prokalcitonin za identifikovanje pneumonije.Nivoi prokalcitonina i CRP-a bili su značajno povišeni kod pacijenata sa vanbolničkom pneumonijom koji su se javili odeljenju hitne sluzbe i imali indikacije za hospitalizaciju nego kod pacijenata sa pogoršanjem hronične opstruktivne bolesti pluća. Koncentracije CRP-a i prokalcitonina u serumu bile su u jakoj korelaciji. CRP bi mogao imati veću vrednost kao marker kod ovih pacijenata sa infekcijama nižeg respiratornog trakta. more...

INTRODUCTION: Measurement of blood zinc levels is frequently used in the diagnosis of a few conditions such as growth retardation, immunodeficiency, infertility, neurological disorder, and acrodermatitis enteropathica. The serum matrix is the most preferred one to determine zinc levels due to the ease of analysis with other tests and cost-effectiveness of blood collection tubes used to obtain serum samples. In our study, we aimed to compare serum and plasma zinc test results for accurate and reliable zinc measurement in plain tubes with clot activator and gel and in heparin-free tubes, which specifically produced for trace element analysis. METHODS: Twenty-seven randomly selected patients were included in the study. Blood samples drawn simultaneously from patients were pipetted into tubes with clot activator and gel (SST) (SST II Advance, Vacutainer, Becton Dickinson and Company, USA) as well as into trace element tubes with sodium heparin (NH) (NH Trace Elements Sodium Heparin, Vacuette, Greiner Bio-One GmbH, Austria). After the centrifugation process, zinc levels in serum and plasma samples were analyzed by colorimetric method using an autoanalyzer. Bias between serum and plasma zinc levels was evaluated according to the allowable bias criterion based on biological variation and regression analysis performed. RESULTS: The mean and standard deviation of serum and plasma zinc levels were 49.0±11.5 μg/dL and 46.4±12.0 μg/dL, respectively, and a statistically significant difference was determined (p=0.012) in between. Besides, the bias between serum and plasma was 6.8%, which was above the allowable bias (3.3%) and considered as clinically significant. No systematic or random errors detected. DISCUSSION AND CONCLUSION: When selecting a blood collection tube for trace element analysis, the structural differences between tubes and the matrix effect should be considered carefully. more...

Background Cardiovascular events such as myocardial infarction and stroke are frequent comorbidities in rheumatic diseases [1]. In relation, components of the metabolic syndrome (MS) including insulin resistance (IR), central obesity, high blood pressure, high triglycerides, and low high-density lipoprotein (HDL) are related to a high rate of endothelial dysfunction and atherosclerosis in patients with RA [2]. Objectives We aimed to investigate the relationship between disease activity and insulin resistance (IR) and the levels of adipocytokines in non-diabetic patients with newly diagnosed rheumatoid arthritis (RA) who are naive to disease modifying anti-rheumatic drugs (DMARDs). Methods Forty-seven DMARD-naive patients with RA and 25 age-, gender-, and BMI-matched controls were included. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), 28-joint-count disease activity score (DAS28), serum lipids, glucose, HbA1c, insulin, leptin, resistin, visfatin, and RBP4 levels were measured. Homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. Patients were studied before and 3 months after treatment with DMARDs. Results Levels of adipokines were similar in patients with RA and controls (p > 0.05 for all). However, RA patients with active disease (DAS28 > 3.2) had numerically higher levels of leptin (9.3 (3.7-17.4) vs. 7.6 (3.7-11.0), p = 0.289), insulin (8.0 (5.2-12.7) vs. 5.9 (4.2-8.7), p = 0.285), and HOMA-IR (1.9 (1.1-3.0) vs. 1.3 (1.0-1.9), p = 0.209). DAS28 was correlated with HOMA-IR (r = 0.356, p = 0.016), insulin (r = 0.323, p = 0.02), and leptin (r = 0.399, p = 0.005) in the study group (Figure-1). Regardless of the type of treatment modality, leptin levels (7.4 (4.4-13.4) vs. 6.4 (3.3-11.6, p = 0.047) decreased significantly after treatment, as did insulin levels (6.9 (4.9-12.5) vs. 5.9 (4.1- 8.8), p =0.01) and HOMA-IR score (1.7 (1.1-2.7) vs. 1.3 (1.0-2.0), p= 0.012). The reduction in leptin was more prominent in patients with active disease (9.3 (3.7-17.4) vs. 6.9 (3.1-11.4), p = 0.028). The reduction in ESR was correlated with ΔHOMA-IR (r = 0.308, p = 0.039), and CRP reduction was correlated with Δresistin (r = 0.288, p = 0.049) and ΔRBP4 (r = 0.456, p = 0.001). Conclusion Disease activity is associated with IR and correlates with circulating levels of adipokines in patients with RA. Treatment with DMARDs reduces leptin and improves IR. References [1] Maradit-Kremers H, Crowson CS, Nicola PJ, Ballman KV, Roger VL, Jacobsen SJ et al. Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: a population-based cohort study. Arthritis Rheum.2005; 52:402–11. [2] Burggraaf B, van Breukelen-van der Stoep DF, de Vries MA, Klop B, van Zeben J, van de Geijn GM et al. Progression of subclinical atherosclerosis in subjects with rheumatoid arthritis and the metabolic syndrome Atherosclerosis. 2018; 271:84-91. Disclosure of Interests None declared more...

Introduction: Irisin, a recently identified myokine, is associated with increased energy expenditure and has a potential role in obesity. Therefore, we investigated circulating irisin levels in morbidly obese patients undergoing sleeve gastrectomy (SG). Material and methods: Thirty morbidly obese patients undergoing SG and 30 healthy subjects were included. All participants were evaluated at baseline and again at three months post-SG. Body weight and height, the lipid profile, and plasma glucose, HbA1c, insulin, and irisin levels were measured at each visit. Results: The two groups had similar mean age and sex distribution. Serum irisin was significantly lower in the morbidly obese subjects compared with the controls (p = 0.003) and negatively correlated with BMI, body weight, insulin levels, and HOMA-IR (p = 0.006, p = 0.011, p = 0.046, p = 0.048, respectively). When the morbidly obese patients were re-evaluated three months post-SG, their weight and BMI had significantly decreased (both p = 0.001). Similarly, the insulin, HbA1c, HDL-cholesterol, and HOMA-IR values significantly decreased (p = 0.001, p = 0.028, p = 0.006, and p = 0.001, respectively). However, irisin levels remained unchanged (p = 0,267). Conclusion: Although the irisin levels were significantly lower in the morbidly obese subjects, they did not change after SG-induced weight loss. (Endokrynol Pol 2016; 67 (5): 481–486) more...

Highlights • COVID-19 is more severe in older patients. • Hypertension is the most frequent comorbidity in severe and non-severe COVID-19 cases. • Cough is the prominent clinical symptom in severe and non-severe COVID-19 cases. • Detection of severe and critical COVID-19 cases at an earlier stage is crucial. • CAR is a useful marker in early differentiation of severity in COVID-19 patients., C-reactive protein-to-albumin ratio (CAR) has been used as an indicator of prognosis in various diseases. Here, we intended to assess the CAR’s diagnostic power in early differentiation of hospitalized severe COVID-19 cases. In this retrospectively designed study, we evaluated 197 patients in total. They were divided into two groups based on their severity of COVID-19 as non-severe (n = 113) and severe (n = 84). The comparison of groups’ demographic data, comorbidities, clinical symptoms, and laboratory test results were done. Laboratory data of the patients within the first 24 h after admission to the hospital were evaluated. The calculation of receiver operating characteristic (ROC) curve was used to determine the diagnostic power of CAR in differentiating severity of COVID-19. Independent risk factors predictive of COVID-19 severity were determined by using logistic regression analysis. Although lymphocyte count levels were lower, severe COVID-19 patients had higher mean age, higher levels of neutrophil count, CRP, aspartate aminotransferase (AST), ferritin, and prothrombin time (P more...

Objective Mean platelet volume (MPV) and platelet function analysis have been studied before in acromegaly, but the effect of treatment on both parameters has not been evaluated. We aimed to investigate MPV and platelet function analysis in acromegalic patients after six-months of treatment. Methods Forty patients with active acromegaly and 36 healthy subjects were included in the study. Plasma glucose and lipids, fibrinogen, GH, IGF-1 levels, MPV and platelet function analysis were measured. All patients with acromegaly were re-evaluated six months after treatment. Results Fasting blood glucose (FBG), GH, IGF-1, fibrinogen levels and MPV values were significantly higher in acromegalic group compared with the control. Platelet function was enhanced significantly (pcol-ADP: 0.002, pcolepinephrine: 0.002). After 6 months of treatment FBG, serum GH, IGF-1, fibrinogen and MPV decreased and collagen/ADP- and collagen/epinephrine-closure times (CT) were increased. Acromegalic patients that were in remission with long-acting SSA after surgery had significantly higher fibrinogen levels and MPV and decreased collagen/epinephrine-CT with respect to the controls (pfibrinogen: 0.001, pMPV: 0.026, pcol-epinephrine: 0.037). Conclusion Acromegaly was associated with increased MPV and enhanced platelet activity. Although growth hormone hypersecretion was controlled by surgery and medical treatment, these parameters did not improve - indicating a still increased risk for cardiovascular events. more...

Background As plasma is the recommended sample type for Roche adrenocorticotropic hormone (ACTH) assay, we evaluated the effect of EDTA concentration on Cobas ACTH assay. Methods Samples containing twofold and fourfold higher concentrations of EDTA were prepared by adding plasma to empty K2EDTA tubes and by making under-filled EDTA tubes. All measurements were performed with four replicates. Results Increased EDTA concentration resulted in a significant decrease in ACTH concentration. Fifty-per cent-filled EDTA tube showed 19% decrease in ACTH concentration and 25% filled EDTA tube showed 50% decrease in ACTH concentration. Conclusion We recommend that inadequately filled EDTA specimens should be rejected when using Cobas ACTH assay. more...

Objective: In this study, we aimed to evaluate serum irisin and apelin levels in patients with subclinical hypothyroidism (SCH) when they were subclinical hypothyroid and become euthyroid after levothyroxine therapy and association of these adipokines with markers of atherosclerosis such as serum homocysteine levels and carotid intima-media thickness (IMT). Subjects and methods: The study included 160 patients with newly diagnosed subclinical hypothyroidism due to Hashimoto's thyroiditis and 86 euthyroid healty subjects. Serum glucose and lipid profile, insulin, HOMA, TSH, free T3, free T4, anti-thyroperoxidase and anti-thyroglobulin antibodies, homocysteine, apelin and irisin levels were measured in all study subjects. Thyroid and carotid ultrasound examinations were performed. The subclinical hypothyroid group was reevaluated after 12-weeks of levothyroxine therapy when they became euthyroid. Results: Clinical characteristics of the patient and control group were similar. Glucose, insulin and HOMA levels, lipid parameters and free T3 were similar between the two groups.. Serum homocystein was higher and apelin was lower in patients with SCH, but irisin levels were similar between the two groups. While thyroid volume was lower, carotid IMT was significantly greater in patients with SCH (pCarotidIMT:0,01). After 12-weeks of levothyroxine therapy, all the studied parameters remained unchanged except, serum freeT4, TSH, homocystein and apelin. While homocystein decreased (p: 0,001), apelin increased significantly (p = 0,049). In multivariate analysis, low apelin levels significantly contributed to carotid IMT (p = 0,041). Conclusions: Apelin-APJ system may play a role in vascular and cardiac dysfunction in patients with SCH and treatment of this condition may improve the risk of cardiovascular disease. more...

Objective: Non-alcoholic fatty liver disease (NAFLD) is affecting people worldwide with increasing prevalence. Non-invasive tests are required for both diagnosis and staging of the disease. We aimed to evaluate diagnostic accuracy of routine liver enzymes and cytokines in NAFLD. Methods: A total of 88 cases, aged between 20 and 62 years, were included in the study. Serum ALT, AST, GGT, triglyceride, TNF-alpha, IL-6 and IL-8 were measured in 40 patients with NAFLD and in 48 healthy control patients with similar BMI and demographic characteristics. Diagnostic performances of serum biomarkers for diagnosis of NAFLD were evaluated with ROC analysis. Results: ALT and AST showed good diagnostic performance in predicting patients with NAFLD in the overall group (AUC=0.817; 95% CI[0.721-0.913], AUC=0.815; 95% CI[0.718-0.911] respectively) but in obese subjects ALT and AST showed poor performance (AUC=0.659; 95% CI[0.478-0.841], AUC=0.680; 95% CI[0.498-0.861] respectively). Among cytokines TNF-alpha showed best performance in the diagnosis of NAFLD in both overall group and obese subjects (AUC=0.892; 95% CI[0.824- 0.959], AUC=0.858; 95% CI[0.739-0.977] respectively). The optimal cut off value for TNF-alpha was 10.65pg/ml with a sensitivity of 75% and a specificity of 93% in the overall group. IL-6 and IL-8 showed poor performance. Conclusion: TNF-alpha may be a good parameter for predicting patients with NAFLD. J Clin Exp Invest 2015; 6 (1): 16-20 Key words: TNF-alpha, IL-8, IL 6, non-alcoholic fatty liver disease more...

Objective: In our study we aimed to examine serum homocysteinelevels of patients without thyroid dysfunctionswho have high serum anti thyroid peroxidase (anti-TPO)levels and patients with subclinical hypothyroidism whohave high serum thyroid stimulating hormone (TSH) andanti-TPO levels.Methods: One hundred and seven premenopause femaleoutpatients who referred to endocrine clinic of our hospitalwere included in our study. We generated 3 groups. Firstgroup (Control) consists of 53 (50%) patients between theages of 30-40 years. Second group (Euthyroid) consistsof 31 (29%) patients between the ages of 26-49. Thirdgroup (Subclinical Hypothyroidism) consists of 23 (21%)patients between the ages of 33-53 years. Serum totalcholesterol, triglycerides, high density lipoprotein (HDL)levels were measured by Olympus 2700 autoanalyzer.Serum TSH, free T4, anti-TPO and homocysteine levelswere measured by Siemens Immulite 2000 autoanalyzer.Results: In our study, total cholesterol, triglycerides, lowdensity lipoprotein (LDL) and very low density lipoprotein(VLDL) levels were not statistically significantly differentamong the groups. Although serum homocysteine levelsof the third group were higher than the other groups it wasnot statistically significantly different among the groups.Conclusion: Serum homocysteine and lipid levels of patientswith euthyroidism and subclinical hypothyroidismwho have positive anti-TPO levels may be inadequate inassessing the risk of cardiovascular diseases. J Clin ExpInvest 2013; 4 (3): 293-297Key words: Hypothyroidsm, homocysteine, premenopause more...

Introduction:Determining the factors affecting hemoglobin AMethods:We retrospectively analyzed serum fasting glucose, fasting insulin, 2 h glucose and HbAResults:Insulin resistant subjects with normal glucose tolerance had significantly higher HbAConclusion:Our data showed that HOMA-IR is associated with glycated hemoglobin values independent of glycemic status and the effect of age on HbA more...

Objective: To investigate the effect of temperature and protease inhibitor on adrenocorticotrophin (ACTH) stability. Methods: We collected blood specimens from 10 donors into K3 EDTA (ethylenediaminetetraacetic acid) and K3 EDTA + aprotinin tubes. Plasma specimens were held at room temperature and at 2 °C to 8 ° C for 0, 2, 4, 8, 24, and 72 hours. ACTH concentrations in 4 storage conditions were compared with repeated-measures analysis of variance (ANOVA) at each time point. Results : ACTH concentrations substantially decreased after a 72-hour time period. At the 72nd hour, standard EDTA tubes and EDTA + aprotinin tubes stored at 4 ° C showed the optimal stability. EDTA + aprotinin tubes stored at room temperature performed more strongly than standard EDTA tubes stored at room temperature. Conclusion: Our results show that refrigerated storage is more effective than protease inhibitor addition to maintain ACTH stability. We recommend using aprotinin tubes, especially for specimens standing at room temperature. * Abbreviations : ACTH : adrenocorticotrophin EDTA : ethylenediaminetetraacetic acid CV : coefficient of variance ANOVA : analysis of variance more...

Objective: In our study, we intended to examine the effects of vitamin D levels of pregnant women on the baby during winter months. Materials and Methods: Study population consisted of 250 healthy pregnant women who have completed 37 weeks of gestation. Venous blood samples were drawn from pregnant women prenatally in the labor room and from babies on the umbilical cord during the delivery. 25(OH)D levels of samples were measured by chemiluminescent immunoassay on Diasorin Liaison autoanalyzer. Results: While the mean of vitamin D levels in mothers was 11.5±5.9 ng/mL, this value was found as 10.9±5.9 in cord blood. Vitamin D levels of mothers and umbilical cords were found to be correlated (r=0.548, p more...

Irisin, a recently identified myokine, is associated with increased energy expenditure and has a potential role in obesity. Therefore, we investigated circulating irisin levels in morbidly obese patients undergoing sleeve gastrectomy (SG).Thirty morbidly obese patients undergoing SG and 30 healthy subjects were included. All participants were evaluated at baseline and again at three months post-SG. Body weight and height, the lipid profile, and plasma glucose, HbA1c, insulin, and irisin levels were measured at each visit.The two groups had similar mean age and sex distribution. Serum irisin was significantly lower in the morbidly obese subjects compared with the controls (p = 0.003) and negatively correlated with BMI, body weight, insulin levels, and HOMA-IR (p = 0.006, p = 0.011, p = 0.046, p = 0.048, respectively). When the morbidly obese patients were re-evaluated three months post-SG, their weight and BMI had significantly decreased (both p = 0.001). Similarly, the insulin, HbA1c, HDL-cholesterol, and HOMA-IR values significantly decreased (p = 0.001, p = 0.028, p = 0.006, and p = 0.001, respectively). However, irisin levels remained unchanged (p = 0,267).Although the irisin levels were significantly lower in the morbidly obese subjects, they did not change after SG-induced weight loss. (Endokrynol Pol 2016; 67 (5): 481-486). more...

Familial Mediterranean fever (FMF) is an auto-inflammatory disease characterised by periodic inflammatory attacks. We investigated changes in monocyte-granulocyte derived S10012A and chitotriosidase in both the attack and silent period of FMF for better estimation of inflammation. Endogenous resolvin was determined for utility to restrict inflammation. This study included 29 FMF patients (15 M/14 F) and 30 healthy controls (15 M/15 F). Serum levels of highly sensitive C-reactive protein, serum amiloid A (SAA), S100A12, chitotriosidase, and resolvin D1 were measured. Age, sex, body mass indexes, and lipids were similar between patients and controls. Biomarkers including hs-CRP, SAA, S100A12, chitotriosidase, and resolvin D1 were higher in the attack period of FMF patients compared to controls (P < 0.001). When FMF patients in the silent period were compared with their attack period, hs-CRP, SAA, and chitotriosidase were found elevated in the attack period (P < 0.001, P < 0.001, and P = 0.02 respectively). Serum levels of SAA, S100A12, chitotriosidase, and resolvin D1 in the silent period of FMF patients were still found elevated compared to healthy controls, indicating subclinical inflammation (P < 0.001, P < 0.001, P = 0.009, and P < 0.001 respectively ). In subgroup analysis, patients with M694V homozygote and heterozygote mutations had higher S10012A and hs-CRP compared to other mutation carriers. Our findings indicate that chitotriosidase and S10012A are useful in diagnosis and detection of subclinical inflammation and/or assessment of disease activity in FMF patients. They could be more informative for inflammation in various disease states compared to hsCRP and SAA. Resolvin D1 is elevated in both the attack and silent periods of FMF. It may be helpful to restrict inflammation. Graphical Abstract more...

Aim: The cardiovascular system is susceptible to thyroid hormones. Many studies show that hypothyroidism is associated with increased cardiovascular risk, functional abnormalities, atherosclerosis, and increased arterial stiffness. Pulse wave velocity (PWV) and augmentation index (AI) are regarded as indexes of arterial stiffness. Oxidative free radicals that occur during ischemic events cause certain chemical changes in the albumin molecules. The ischemia-modified albumin (IMA) has been suggested as an indicator of oxidative stress. Evaluation of oxidative stress markers and parameters of arterial stiffness can shed light on the mechanism of increased cardiovascular risk in patients with hypothyroidism. Material and Methods: For this study, PWV, AI measurements, and IMA levels of 20 untreated patients with overt hypothyroidism (OH), 21 untreated patients with subclinical hypothyroidism (SH), and 30 healthy controls (control-CNT) were evaluated. Patients and the healthy controls’ gender, age, weight, height, body mass index, waist circumference, smoking habit and blood biochemical results were recorded. Results: PWV was found to be increased in patients with overt hypothyroidism; however, there was no difference in between subclinical hypothyroidism and control group(p=0,881). Also, PWV had a significant positive correlation with; age, BMI, waist circumference, blood glucose, uric acid, pulse pressure and systolic and diastolic blood pressures. IMA levels were not different in between the groups. Conclusion: Hence the increased CV risk in patients withhypothyroidism is a multifactorial state; the interplay of many factors determines it.Future studies with larger sample sizes are needed to evaluate the possible relationship among IMA levels, arterial stiffness parameters and cardiovascular risk factors in patients with hypothyroidism. more...

Introduction: Studies about vitamin D [25(OH)D] stability in plasma are limited and preanalytical variables such as tube type may affect results. We aimed to evaluate effect of storage conditions, sample type and some preanalytical variables on vitamin D concentration. Materials and methods: Blood samples from 15 healthy subjects were centrifuged at different temperatures and stored under different conditions. Serum and plasma 25(OH)D difference, effect of centrifugation temperature and common storage conditions were investigated. Results: There was no difference between serum and plasma vitamin D concentration. Centrifugation temperature had no impact on vitamin D concentration. 25(OH)D is stable under common storage conditions: 4 hours at room temperature, 24 hours at 2-8 °C, 7 days at -20 °C, 3 months at -80 °C. Conclusion: Vitamin D does not require any special storage conditions and refrigeration. Both serum and plasma can be used for measurement. more...

Prediabetes (PD) is a dysmetabolic state of glucose level between diabetes mellitus and normal glucose tolerance (NGT) which includes basically impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). All these conditions are becoming a considerable public health problem worldwide [1]. Measurement of glucose in plasma of fasting subjects is widely accepted as a diagnostic criterion for diabetes. Oral glucose tolerance test (OGTT) evaluates the efficiency of the body to metabolize glucose. For many years, fasting plasma glucose (FPG) test and OGTT have been used as “gold standards” for diagnosis of glucose metabolism disorders [2]. In addition hemoglobin A1C (HbA1C) measurement has also become the focus of considerable attention for diagnosis of diabetes. HbA1C is formed by the nonenzymatic attachment of glucose to the N-terminal valin of the beta chain of hemoglobin and its normal range is between 4% and 6% [2-4]. Because of the long life span of erythrocytes, HbA1C reflects long-term glycemic exposure, representing the average glucose concentration over the preceding 8-12 weeks [2]. more...

Background Ankylosing spondylitis (AS) is a chronic inflammatory disease of spine and sacroiliac joints; it is characterized by new bone formation, and the disease processes can be accompanied by osteoporosis. In the present study, we investigated changes in bone mineral density (BMD) and in the levels of various bone turnover-related biomarkers and cytokines in a cohort of AS patients, with regard to clinical parameters, disease activity, and treatment regimen. Methods 55 AS patients and 33 healthy controls included in the study. Spinal mobility was assessed by the Bath Ankylosing Spondylitis Metrology Index (BASMI), and radiologic changes were scored by the Bath Ankylosing Spondylitis Radiologic Index (BASRI). Patients were also evaluated with the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Bone mineral density (BMD) assessed by dual energy X-ray absorptiometry. Various biomarkers and cytokines of bone turnover including osteoprotegerin (OPG), serum band 5 tartrate-resistant acid phosphatase (TRAP-5), soluble receptor activator of nuclear factor kappa-B ligand (sRANKL), secreted frizzled-related protein 1 (sFRP-1), Dickkopf-related protein 1 (DKK-1), and sclerostin were studied. Results The levels of TRAP-5, NTX, sRANKL, sclerostin, sFRP-1, DKK-1, and IFNγ, were similar between the patients and controls (p > 0.05), while BMD of femoral neck, and OPG levels were significantly lower in AS patients (p Conclusions In this cross-sectional study we showed that OPG levels were significantly lower in AS patients compared to healthy subjects. On the other hand, the levels of wingless (Wnt) signal pathway inhibitors seem not altered. Ectopic bone formation in AS may be related to dysfunction of these molecules at the cellular level. more...

The aim of this study was to assess whether the quantities of factor VIII and factor IX in fresh-frozen plasma produced from whole blood stored at 4 °C for 24 hours are adequate for their intended purpose.Fresh-frozen plasma separated from whole blood after storage at 4 °C overnight (24 hours from donation) was compared with plasma prepared 8 hours after donation using a standard method. The amounts of factor VIII and factor IX obtained with the two methods were compared.Compared to the levels of factor VIII and factor IX in plasma prepared within 8 hours of blood collection, the levels in plasma prepared after 24 hours of storage at 4 °C were 25% and 9% lower, respectively. Ninety percent of the factor VIII and 100% of the factor IX levels were above 0.5 IU/mL (standard haematology reference range) after 24 hours of storage.These data suggest that there is good retention of coagulation factor activity in plasma produced from whole blood stored at 4 ºC for 24 hours and that such plasma would be an acceptable product for most patients requiring fresh-frozen plasma. more...

SUMMARYObjective: Although vitamin D deficiency have been suggested in children is widespread recently, the data about vitamin D status of Turkish children is limited. The objective of the present study was to determine prevalence of vitamin D deficiency in children in Aegean region and to show effect of age, gender and seasons on vitamin D levels. The data from hospital information system was examined retrospectively. Method: Between January 2011 and February 2013, children admitted to department of paediatrics our hospital for health examination was taken blood for vitamin D measurement. Serum vitamin D levels were determined by electrochemiluminescent method and categorized as, Amaç: Tüm dünyada D vitamin eksikliği çocuk, genç yetişkin ve yaşlılarda çok fazla araştırılmasına rağmen ülkemizdeki çocuk ve adolesan grup ile ilgili veriler sınırlıdır. Hastanemizde D vitamini ölçümü yapılan çocuklarda D vitamini eksikliği prevelansını belirlemeyi; yaş, cinsiyet ve mevsimlerin etkisini görmeyi amaçladık. Yöntem: Hastanemize sağlık kontrolü için Ocak 2011-Şubat 2013 tarihleri arasında başvuran ve vitamin D (25-OH) ölçümleri yapılan 2909 çocuğun vitamin D düzeyleri hastane bilgi sisteminden retrospektif olarak incelendi. D vitamini durumları, vitamin D düzeyleri 20 ng/mL’den düşük ise eksiklik; 30 ng/mL ise yetersizlik olarak sınıflandırıldı. Ayrıca yaşlarına göre çocuklar 0-3 yaş, 4-6 yaş, 7-12 yaş ve 13-17 yaş olarak dört alt gruba bölündü. Bulgular: Tüm çocukların (1653 erkek, 1256 kız) vitamin D sonuçları ortalaması 28,00 ± 15,55 ng/mL bulundu.En yüksek serum D vitamini 0-3 yaş grubunda ve en düşük düzey 13-17 yaş grubunda bulundu. Kız ve erkek çocuklarda mevsimler arasında D vitamini ölçümlerinde anlamlı fark saptandı. Tüm yaş gruplarında D vitamini eksikliği yüksek oranda bulundu. Sonuç: İncelediğimiz tüm çocukların yaklaşık %61’inin D vitamini yetersizliği ve eksikliğinin bulunması, yaşamın ilk yılında sağlık politikasında da yer alan D vitamini desteğinin daha sonraki yaşlarda ve özellikle adolesan dönemde devam ettirilmesinin uygun olacağı düşünüldü more...