149 results on '"Yavuz, Dilek Gogas"'
Search Results
102. Diurnal Blood Pressure Abnormalities Are Related to Endothelial Dysfunction in Patients with Non-Complicated Type 1 Diabetes
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Deyneli, Oguzhan, primary, Yazici, Dilek, additional, Toprak, Ahmet, additional, Yuksel, Meral, additional, Aydin, Hasan, additional, Tezcan, Hakan, additional, Yavuz, Dilek Gogas, additional, and Akalin, Sema, additional
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- 2008
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103. Exogenous Subclinical Hyperthyroidism Impairs Endothelial Function in Nodular Goiter Patients
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Yavuz, Dilek Gogas, primary, Yazιcι, Dilek, additional, Toprak, Ahmet, additional, Deyneli, Oguzhan, additional, Aydιn, Hasan, additional, Yüksel, Meral, additional, and Akalιn, Sema, additional
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- 2008
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104. Adherence to insulin treatment in insulin-naïve type 2 diabetic patients initiated on different insulin regimens.
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Yavuz, Dilek Gogas, Ozcan, Sevim, and Deyneli, Oguzhan
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TYPE 2 diabetes treatment , *INSULIN therapy , *PEOPLE with diabetes , *BLOOD sugar - Abstract
Objective: We aimed to evaluate adherence to insulin treatment in terms of treatment persistence and daily adherence to insulin injections among insulin-naïve type 2 diabetic patients initiating insulin therapy with basal (long acting), basal-bolus, and premixed insulin regimens in a tertiary endocrinology outpatient clinic. Methods: A total of 433 (mean age of 55.5±13.0 years; 52.4% females) insulin-naïve type 2 diabetic patients initiated on insulin therapy were included in this questionnaire-based phone interview survey at the sixth month of therapy. Via the telephone interview questions, patients were required to provide information about persistence to insulin treatment, self-reported blood glucose values, and side effects; data on demographics and diabetes characteristics were obtained from medical records. Results: Self-reported treatment withdrawal occurred in 20.1% patients, while 20.3% patients were nonadherent to daily insulin. Negative beliefs about insulin therapy (24.1%) and forgetting injections (40.9%) were the most common reasons for treatment withdrawal and dose skipping, respectively. Younger age (49.5±15.0 vs 56.4±12.0 years) (P=0.001) and shorter duration of diabetes (4.8±4.3 vs 8.8±6.3 years) (P=0.0008) and treatment duration (5.2±2.4 vs 10.7±2.4 months) (P=0.0001) were noted, respectively, in discontinuers vs continuers. Basal bolus was the most commonly prescribed insulin regimen (51.0%), while associated with higher likelihood of skipping a dose than regular use (61.3% vs. 46.0%, P=0.04). Conclusions: Persistence to insulin therapy was poorer than anticipated but appeared to be higher in patients with the basal bolus regimen. Negative perceptions about insulin therapy seemed to be the main cause for poor adherence in our cohort. [ABSTRACT FROM AUTHOR]
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- 2015
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105. Erythrocyte Membrane Anionic Content and Urinary Glycosaminoglycan Excretion in Type 1 Diabetes: Association with Retinopathy
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Yenice, Özlem, primary, Kazokoğlu, Haluk, additional, Özcan, Eda, additional, Yüksel, Meral, additional, Adigüzel, Göksenin, additional, Haklar, Goncagül, additional, and Yavuz, Dilek Gogas, additional
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- 2006
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106. Effects of Aminoguanidine on Lipid and Protein Oxidation in Diabetic Rat Kidneys
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Yavuz, Dilek Gogas, primary, Küçükkaya, Belgin, additional, Ersöz, H. önder, additional, Yalçin, A. Süha, additional, Emerk, Kaya, additional, and Akalin, Sema, additional
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- 2002
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107. Effects of Aminoguanidine on Glomerular Basement Membrane Thickness and Anionic Charge in a Diabetic Rat Model
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Yavuz, Dilek Gogas, primary, Ersöz, Halil Önder, additional, Tuncel, Mürvet, additional, Sargon, Mustafa F., additional, Küçükkaya, Belgin, additional, Ahiskali, Rengin, additional, and Akalin, Sema, additional
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- 2001
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108. Streptozotosin ile diyabet oluşturulmuş sıçanlarda aminoguanidinin serum paraoksonaz aktivitesi üzerine etkisi.
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Parmaksız, İlker, Atak, Palmet Gün, Yavuz, Dilek Gogas, and Şirikçi, Önder
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DIABETES ,ENDOCRINE diseases ,HIGH density lipoproteins ,STREPTOZOTOCIN ,GLUCOSE - Abstract
Copyright of Turkish Journal of Biochemistry / Turk Biyokimya Dergisi is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2011
109. Paraoxonase 1 Activity in Endocrine Diseases.
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Tarçın, Özlem and Yavuz, Dilek Gogas
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DIAGNOSIS of endocrine diseases , *ACROMEGALY , *POLYCYSTIC ovary syndrome , *HYPERLIPIDEMIA , *DIABETES , *ENDOCRINOLOGY , *LIPIDS , *LIPOPROTEINS , *METABOLISM , *OBESITY , *OSTEOPOROSIS , *THYROID diseases , *DIAGNOSIS - Abstract
Paraoxonase is an esterase bound to high-density lipoproteins which by metabolizing lipid peroxides, prevents their accumulation on low-density lipoproteins. It also hydrolyzes various organophosphorus compounds. Considering the role of PON1 in hydrolyzing phospholipid and cholesteryl-ester hydroperoxides and thus protecting lipoproteins against oxidative modification, it can be concluded that PON1 may be an indicator of the risk of atherosclerosis/coronary artery disease development. Recent studies have also shown that PON activity was related to several disorders, including endocrine disorders as well. In this paper, we review the relation of PON1 activity with endocrine diseases like diabetes, thyroid dysfunction, osteoporosis, polycystic ovary syndrome (PCOS), obesity and dyslipidemia. [ABSTRACT FROM AUTHOR]
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- 2011
110. A 27 year follow-up of education and scientific research in a medical faculty: Marmara University School of Medicine.
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Yavuz, Dilek Gogas, Çavdar, Safiye, and Erenus, Mithat
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- 2011
111. Bir Tıp Fakültesinde Eğitimin ve Bilimsel Araştırmaların 27 Yıllık İzlemi: Marmara Üniversitesi Tıp Fakültesi.
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Yavuz, Dilek Gogas, Çavdar, Safiye, and Erenus, Mithat
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MEDICAL education , *UNIVERSITIES & colleges , *PROFESSIONAL education , *POSTSECONDARY education ,STUDY & teaching of medicine - Abstract
ABSTRACT Aim: Medical education and an important part of clinical research is carried out by medical faculties in Turkey. By 2010, 75 medical faculties are available in Turkey. Marmara University School of Medicine (MUTF) established as the twentieth medical faculty of Turkey represents a different model from conventional medical faculties because it was one of the first Turkish medical faculties providing education in English. The aim of this study is to shed light on the future of medical education by investigating the contribution of MUTF to the medical education and science of our country, evaluating the data on specialty education and scientific research during the 27 years from the establishment of the MUTF until today. Method: In this study, data on pre and postgraduate education, lecturers and scientific publications were obtained by screening the archieve of the faculty, national publication index, international publication indexes, citation indexes and thesis archieves of higher education institutions and compared them to the other data from our country. Results: For each lecturer, the number of students was calculated as "3.5" and the number of the publications was calculated as "0.85". The publications from the MUTF constitute 64.7% of the total publications of Marmara University and specialty theses constitute 10.7% of MUTF originated publications. 51% of the publications were in the journals with impact factor < 1.9. Conclusion: Education and scientific research parameters of MUTF are parallel to the data of the country. Although there is an increase in the number of original articles, the number of original articles published in journals with high impact factor, is not increasing accordingly. Local and national measures and encouragements seem necessary for increasing the number of original publications and publications in journals with high impact factors. [ABSTRACT FROM AUTHOR]
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- 2011
112. C-Reactive Protein 1059G/C Gene Polymorphism in Type 2 Diabetic Patients.
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Yazıcı, Dilek, Yavuz, Dilek Gogas, Yüksel, Meral, Özben, Beste, Sancak, Seda, Deyneli, Oğuzhan, and Akalın, Sema
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HEART disease risk factors , *ANALYSIS of variance , *BIOMARKERS , *C-reactive protein , *CAROTID artery diseases , *PEOPLE with diabetes , *ENDOCRINOLOGY , *GENETIC polymorphisms , *METABOLISM , *TYPE 2 diabetes - Abstract
Objective: C-reactive protein (CRP) is considered to be a cardiovascular risk marker and changes in its level have been attributed to genetic factors. The aim of the study was to determine CRP 1059G/C gene polymorphism frequency and its relationship with CRP levels and carotid artery intima-media thickness (CIMT) in type 2 diabetic patients (DM). Materials and Methods: One hundred and sixty-four type 2 diabetic patients (mean age: 57±7 years; F/M: 80/84) and 151 controls (mean age: 53±7 years; F/M: 81/70) were recruited. CIMT was assessed by carotid ultrasonography. CRP 1059G/C polymorphism was determined by polymerase chain reaction and restriction fragment length polymorphism analyses. Results: The CRP 1059G/C polymorphism distribution in diabetic group and controls were similar (1059GG in 92% vs. 88%, 1059GC in 2% vs. 5%; 1059CC in 6% vs. 7%). CRP levels (4.3±6.6 mg/L vs. 2.5±2.3 mg/L; p=0.02) and CIMT (0.67±0.18mm vs. 0.56±0.19mm; p<0.0001) were increased in diabetics compared to controls. No association of CRP and CIMT with CRP 1059G/C polymorphism was found. Conclusions: Increased CRP levels and CIMT seem to be independent of CRP 1059G/C gene polymorphism in our group of type 2 diabetic patients. [ABSTRACT FROM AUTHOR]
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- 2010
113. Effects of Aminoguanidine on Lipid and Protein Oxidation in Diabetic Rat Kidneys.
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YAVUZ, DILEK GOGAS, KÜÇÜKKAYA, BELGIN, ERSÖZ, H. ÖNDER, YALÇIN, A. SÜHA, EMERK, KAYA, and AKALIN, SEMA
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- 2002
114. Effects of Aminoguanidine on Glomerular Basement Membrane Thickness and Anionic Charge in a Diabetic Rat Model.
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YAVUZ, DILEK GOGAS, ERSÖZ, HALIL ÖNDER, TUNCEL, MÜRVET, SARGON, MUSTAFA F., KÜÇÜKKAYA, BELGIN, AHISKALI, RENGIN, and AKALIN, SEMA
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- 2001
115. Aminoguanidine prevents bone structure changes in Streptozocin-induced diabetic rats
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Yavuz, Dilek Gogas, Parmaksiz, Ilker, Cetinel, Sule, Ahiskali, Rengin, Yasemin Ersoy, Tugtepe, Halil, Yazici, Dilek, Sirikci, Cinder, and Akalin, Sema
116. Prevalence of vertebral fractures and serum sclerostin levels in acromegaly
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Dilek Yazici, Dilek Gogas Yavuz, Meliha Melin Uygur, Onur Bugdayci, Uygur, Meliha Melin, Yazici, Dilek Dereli, Bugdayci, Onur, and Yavuz, Dilek Gogas
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Adult ,medicine.medical_specialty ,Sclerostin ,Endocrinology, Diabetes and Metabolism ,Radiography ,030209 endocrinology & metabolism ,Radiosurgery ,Gastroenterology ,Bone remodeling ,03 medical and health sciences ,chemistry.chemical_compound ,Absorptiometry, Photon ,0302 clinical medicine ,Endocrinology ,Bone Density ,Internal medicine ,Diabetes mellitus ,Acromegaly ,Prevalence ,medicine ,Humans ,Bone mineral ,Lumbar Vertebrae ,business.industry ,Hypogonadism ,Middle Aged ,medicine.disease ,chemistry ,Case-Control Studies ,030220 oncology & carcinogenesis ,Spinal Fractures ,Vertebral fracture ,Secondary osteoporosis ,BONE-MINERAL DENSITY ,Bone turnover markers ,business ,Body mass index - Abstract
ObjectiveAn increased prevalence of vertebral fractures (VFs) has been reported in previous studies. The aim of this study was to evaluate the association between bone mineral density (BMD), bone turnover markers, serum sclerostin levels, and vertebral fractures (VFs) in acromegaly patients. We also evaluated the effects of gonadal status, disease activity, treatment modality, age, sex, and body mass index (BMI) on skeletal endpoints.DesignCase-control study.Patients and measurementsSeventy acromegaly patients (M/F:36/34, mean age 45,5±11,9 years) and 70 controls (M/F:31/39; mean age 45.66±11.9 years) were included. VFs, BMD, calcium metabolism, markers of bone turnover, and sclerostin levels were evaluated. BMD was measured by dual-energy X-ray absorptiometry (Hologic QDR 4500). Conventional lateral radiography of the spine was performed and the Genant method was used for the assessment of fractures of T4–L5 vertebrae.ResultsThe prevalence of vertebral fractures was higher in acromegalic patients as compared with the control group (72.9% vs. 20%; p
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- 2021
117. Pulmonary Function and Serum Carboxymethyl- Lysine Level Evaluation in Acromegaly Patients
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Meliha Melin Uygur, Mehmet Yasar, Ayse Serap Yalin, Dilek Gogas Yavuz, Sait Karakurt, Yalin, A. Serap, Yasar, Mehmet, Uygur, Meliha Melin, Karakurt, Sait, and Yavuz, Dilek Gogas
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medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Lysine ,medicine.disease ,pulmonary function tests ,Gastroenterology ,Pulmonary function testing ,insulin-like growth factor-1 ,carboxymethyl-lysine ,Internal medicine ,Acromegaly ,growth hormone ,Internal Medicine ,medicine ,GROWTH-HORMONE ,business - Abstract
Objective: We aimed to evaluate the pulmonary function tests (PFTs) and serum carboxymethyl-lysine (CML) level and their association with the disease activity in patients with acromegaly. Material and Methods: This cross-sectional study included 65 acromegalic patients (F/M:28/37) and 52 controls ( F/M:23/29). PFTs such as spirometry and diffusing capacity of the lungs for carbon monoxide (DLCO) were performed to determine the lungs' ability to exchange gases. Serum CML levels were measured with the enzyme-linked immunosorbent assay. Basal and nadir growth hormone (GH), hemoglobin A1c (HbA1c), and insulin-like growth factor-1 (IGF-1) were also assessed. Results: Serum CML levels were significantly higher in acromegalic patients (208.1 +/- 80 ng/mL) than in controls (174.2 +/- 11 ng/mL), (p=0.02). The evaluated PFTs were expressed as predicted values [forced expiratory volume in the 1st second % (p=0.01), forced vital capacity % (p=0.007), functional residual capacity % (p=0.03), residual volume % (p=0.03), vital capacity % (p=0.007), total lung capacity % (p=0.01), and DLCO% (p=0.02)) that were found to be elevated in acromegalic patients than in controls. CML levels positively correlated with HbA1c (r=0.53, p=0.02) but did not con-elate with basal GH levels (r=0.35, p=0.06). GH and IGF-1 levels positively correlated with lung volume in acromegalic patients. Conclusion: Serum CML levels increased in acromegaly patients but had no association with the PFTs results. Increased lung volume was the most prominent lung function alteration in acromegalic patients; relevantly, we found elevated GH and IGF-1 levels to be associated with the increased lung volumes. Future studies need to evaluate the association between the advanced glycation end-products and complications of acromegaly.
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- 2021
118. Clinical and demographic aspects of Paget disease of bone: A multicentric study from Turkey
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Mustafa Kulaksizoglu, Ferhat Deniz, Zeliha Hekimsoy, Oğuzhan Deyneli, Alev Selek, Nilüfer Özdemir, Şevki Çetinkalp, Zeynep Cantürk, Alper Gürlek, Suleyman Hilmi Ipekci, Dilek Gogas Yavuz, Semra Ayturk, Ersin Akarsu, Cevdet Duran, Aysegul Atmaca, Fulden Sarac, Meral Mert, Firat Bayraktar, Hasan Aydin, Seda Sancak, Melin Uygur, Eda Ertorer, Yavuz, Dilek Gogas, Ayturk, Semra, Cetinkalp, Sevki, Bayraktar, Firat, Kulaksizoglu, Mustafa, Hekimsoy, Zeliha, Aydin, Hasan, Uygur, Melin, Deniz, Ferhat, Ipekci, Suleyman, Atmaca, Aysegul, Sarac, Fulden, Ozdemir, Nilufer, Canturk, Zeynep, Mert, Meral, Sancak, Seda, Ertorer, Eda, Duran, Cevdet, Akarsu, Ersin, Deyneli, Oguzhan, Selek, Alev, Gurlek, Alper, OMÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Atmaca, Ayşegül, Deyneli, Oğuzhan (ORCID 0000-0001-6582-7031 & YÖK ID 171914), Aytürk, Semra, Çetinkalp, Şevki, Bayraktar, Fırat, Kulaksızoğlu, Mustafa, Aydın, Hasan, İpekçi, Süleyman, Saraç, Fulden, Özdemir, Nilüfer, Cantürk, Zeynep, Ertörer, Eda, Gürlek, Alper, and School of Medicine
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medicine.medical_specialty ,Hearing loss ,Medicine ,Endocrinology metabolism ,Disease ,serum alkaline phosphatase ,DIAGNOSIS ,Metabolic bone disease ,bisphosphonate therapy ,Rheumatology ,Internal medicine ,medicine ,MANAGEMENT ,polyostotic disease ,Femur ,Bone pain ,Pelvis ,business.industry ,RC581-607 ,medicine.disease ,PREVALENCE ,Zoledronic acid ,medicine.anatomical_structure ,Paget disease of bone ,Polyostotic disease ,Serum alkaline phosphatase ,Bisphosphonate therapy ,paget disease of bone ,Cohort ,Original Article ,Immunologic diseases. Allergy ,medicine.symptom ,business ,medicine.drug - Abstract
Objective: Paget disease of bone (PDB) is a metabolic bone disease that has been rarely reported in the Eastern countries. This study aimed to evaluate the clinical and demographic characteristics of patients with PDB followed up at endocrinology clinics in Turkey. Methods: an invitation was sent to tertiary endocrinology clinics to complete a survey on the demographic, clinical, radiological, and laboratory parameters, as well as treatment modalities of patients with PDB. This study enrolled clinically and radiologically proven 185 patients with PDB from 18 endocrinology centers based in 10 cities of Turkey. Results: this cohort of PDB had female preponderance (women/men: 105/80) with a mean age, during diagnosis, of 57±10 years. Most of the patients (59.6%) were symptomatic at diagnosis. Bone pain and headache were the predominant clinical symptoms. Polyostotic disease was observed in 67.5% (n=125) of patients. Frequently affected bones were skull (41.6%), pelvis (53.5%), spine (41%), and femur (25.4%). Moreover, 17 patients with skull involvement had hearing loss. Mean serum alkaline phosphatase (ALP) level (552±652 IU/L; range: 280-5762 IU/L) was over the normal reference cutoff with normal serum calcium levels. Intravenous bisphosphonates (zoledronic acid, 5 mg; pamidronate, 60-90 mg) were the most used drugs (75%) for the treatment of PDB. Most of the patients (87.1%) treated with intravenous bisphosphonates responded well, with a decrease in serum ALP level (117±114 IU/L) in the 12th month of therapy. Furthermore, 16 patients relapsed after the second year of therapy; 3 patients did not respond to the initial intravenous bisphosphonate treatment. Conclusion: the patients with PDB followed up by endocrinology clinics of Turkey exhibited polyostotic disease with classical clinical, radiological, and biochemical features and women's predominance with good response to intravenous bisphosphonate therapy., NA
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- 2021
119. Vitamin D level is associated with mortality predictors in ventilator-associated pneumonia caused by Acinetobacter baumannii.
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Haliloglu, Murat, Bilgili, Beliz, Haliloglu, Ozlem, Yavuz, Dilek Gogas, and Cinel, Ismail
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VITAMIN D deficiency , *PNEUMONIA , *ACINETOBACTER baumannii , *LUNG infections , *MORTALITY , *ARTIFICIAL respiration complications , *NUTRITION - Abstract
Introduction: Vitamin D plays a role in host defense and is known to be associated with mortality in patients in the intensive care unit (ICU). We aimed to evaluate the relationships between vitamin D levels and predictors of mortality in patients with ventilator-associated pneumonia (VAP) caused by extensively drug-resistant Acinetobacter baumanii (XDR A. baumanii). Methodology: A retrospective single-center study was conducted in an 18-bed adult ICU of a teaching hospital, including all patients with VAP due to XDR A. baumanii. Levels of 25(OH)D, procalcitonin (PCT), C-reactive protein (CRP), n-terminal pro-BNP (NT-proBNP), as well as clinical scores (Sequential Organ Failure Assessment [SOFA], Acute Physiology And Chronic Health Evaluation [APACHE II], Clinical Pulmonary Infection Score [CPIS) were recorded. Results: Forty-for patients were studied over six months. All patients had vitamin D deficiency. The 28-day mortality in patients with 25(OH)D levels ≤ 10 ng/mL was higher than in patients with 25(OH)D > 10ng/mL (p = 0.001). The fourth- and seventh-day SOFA scores (p= 0.04 and p= 0.001) and first- and fourth-day procalcitonin levels (p = 0.03 and p = 0.004) were higher in patients with 25(OH)D levels ≤ 10 ng/mL. The clinical scores (SOFA, CPIS, and CEPPIS) and biomarkers (NT-proBNP, PCT) were negatively correlated with 25(OH)D levels in all study groups. Conclusions: Severe vitamin D deficiency was associated with adverse outcome in VAP due to XDR A. baumanii. Vitamin D levels may be a prognostic predictor of VAP. It is also important to evaluate the effect of rapid vitamin D replacement on mortality. [ABSTRACT FROM AUTHOR]
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- 2016
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120. Effects of concomitant obesity and diabetes on the aggressiveness and outcomes of differentiated thyroid cancer patients
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Onur Elbasan, Rakesh Choorikkadu, Dilek Gogas Yavuz, Elbasan, Onur, and Yavuz, Dilek Gogas
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medicine.medical_specialty ,obesity ,Endocrinology, Diabetes and Metabolism ,T2DM ,prediabetes ,Overweight ,Diseases of the endocrine glands. Clinical endocrinology ,Iodine Radioisotopes ,BMI ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,metastasis ,Prediabetes ,Obesity ,Thyroid Neoplasms ,Thyroid cancer ,Retrospective Studies ,RISK ,business.industry ,Type 2 Diabetes Mellitus ,AARP DIET ,Retrospective cohort study ,medicine.disease ,RC648-665 ,Diabetes Mellitus, Type 2 ,Concomitant ,Thyroidectomy ,Medicine ,Differantiated thyroid cancer ,medicine.symptom ,Neoplasm Recurrence, Local ,business - Abstract
Objective: Obesity and diabetes are the risk factors for cancer development including differentiated thyroid cancer (DTC). Contradictory accumulated data indicates the possible negative effects of obesity and hyperglyceamia as a factor for aggressiveness of DTC. The aim of the present study is to investigate the association of high body mass index (BMI) and presence of type 2 diabetes mellitus (T2DM) on the histological aggressiveness and clinical outcomes in DTC patients followed for over 4 years in a single center. Materials and methods: Consequative 526 DTC patients who had undergone total thyroidectomy and/or radioactive iodine (RAI) ablation were reviewed retrospectively. Patients were divided into groups based on their BMI: normal weight, overweight, obese and also were evalauted in 3 groups presence of diabetes, prediabetes and nomoglyceamia. Histological aggressiveness of DTC at the time of diagnosis and clinical response at the time of last clinical visit were reassessed according to the criteria suggested by ATA 2015 guideline. Results: No differences in histopathologic features, risk of recurrence, cumulative dose of RAI ablation and prevalence of 131I avid metastatic disease were demonstrated among the groups both classified according to BMI and hyperglycemia. Mean of 3.4 year follow-up also showed no differences in the clinial repsonse to therapy and percentage of nonthyroid primary cancer in DTC patients. Conclusion: In this retrospective study we demonstrated that obesity and T2DM have no additive effect on DTC aggressiveness and response to therapy. DTC patients with obesity and diabetes can be treated according to present guidelines without requirement for spesific attention. Arch Endocrinol Metab. 2021;65(4):455-61
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- 2021
121. Use of Insulin Degludec/Insulin Aspart in the Management of Diabetes Mellitus: Expert Panel Recommendations on Appropriate Practice Patterns
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YAVUZ, DİLEK, DEMİRCİOĞLU, SERAP, Demir, Tevfik, Turan, Serap, Unluhizarci, Kursad, Topaloglu, Oya, Tukek, Tufan, and Yavuz, Dilek Gogas
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hypoglycemia ,Turkey ,type 1 diabetes ,glycemic control ,IDegAsp ,type 2 diabetes ,expert panel ,treatment switching - Abstract
Insulin degludec/insulin aspart (IDegAsp) is a fixed-ratio co-formulation of insulin degludec (IDeg), which provides long-lasting basal insulin coverage, and insulin aspart (IAsp), which targets post-prandial glucose. This expert panel aimed to provide a practical and implementable guidance document to assist clinicians in prescribing IDegAsp in the diabetes management with respect to different patient populations including children and adults with type 1 diabetes (T1D) or type 2 diabetes (T2D) as well as pregnant, elderly and hospitalized patients and varying practice patterns (insulin-naive, insulin-treated, switching from basal, basal bolus and premix regimens). The experts recommended that IDegAsp can be used in insulin-naive T2D patients with poor glycemic control (HbA1c >8.5%) despite optimal oral antidiabetic drugs (OADs) as well as in insulin-treated T2D patients by switching from basal insulin, basal-bolus therapy or premixed insulins in relation to lower risk of nocturnal hypoglycemia, fewer injections and lower intraday glycemic variability, respectively. The experts considered the use of IDegAsp in children with T2D as a basal bolus alternative rather than as an alternative to basal insulin after metformin failure, use of IDegAsp in adult T1D patients as a simplified basal bolus regimen with lesser nocturnal hypoglycemia, fewer injections and better fasting plasma glucose control and in children with T1D as an alternative insulin regimen with fewer injection to increase treatment adherence. The proposed expert opinion provides practical information on use of IDegAsp in different patient populations and practice patterns to assist clinicians, which seems to compensate the need for easily implementable guidance on this novel insulin regimen.
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- 2021
122. Serum Paraoxonase-1 Activity and Paraoxonase Q192 Gene Polymorphism in a Young, Healthy Population
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Tuğçe Apaydin, Ahu Telli, Dilek Gogas Yavuz, Onder Sirikci, Palmet Atak, Özlem Üstay, Yavuz, Dilek Gogas, Ustay, Ozlem, Atak, Palmet Gun, Telli, Ahu, Apaydin, Tugce, and Sirikci, Onder
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medicine.medical_specialty ,PREDICTOR ,paraoxonase Q192R gene ,Endocrinology, Diabetes and Metabolism ,PHENOTYPE ,INTIMA-MEDIA THICKNESS ,VARIABLES ,LIPOPROTEINS ,Internal medicine ,Internal Medicine ,medicine ,gender ,OXIDATIVE STRESS ,Serum paraoxonase ,Paraoxonase-1 ,PON1 ,RISK ,biology ,business.industry ,arylesterase ,Healthy population ,Paraoxonase ,ASSOCIATION ,Endocrinology ,biology.protein ,CORONARY-ARTERY-DISEASE ,Gene polymorphism ,high-HDL cholesterol ,business - Abstract
Objective: Paraoxonase-1 (PON1) enzyme and PON Q192R gene polymorphism are associated with atherosclerosis in many middle-aged individuals and high populations at risk of cardiovascular disease. This study aimed to determine serum PON-1 and arylesterase (ARE) activities, PON Q192R polymorphism, and their association with gender, lipoprotein levels, and carotid intima-media thickness (CIMT) among young healthy individuals. Material and Methods: Four hundred fifteen healthy volunteers (F/M: 213/202, 19-25 years) were included in the study. Serum lipoprotein levels and PON1, ARE activities were measured using spectrophotometric methods. PON 192Q polymorphism was evaluated by polymerase chain reaction, and CIMT was measured using Doppler ultrasonography. Results: Serum PON1 activity and PON Q192R polymorphism frequencies were similar between men and women, while ARE activity was significantly higher in women. PON1 activity was considerably higher in RR carriers than in QQ and QR carriers among both men and women. Serum high-density lipoprotein level was lower, and CIMT was higher in men compared to women. Conclusion: PON1 enzyme activities did not differ according to gender, and ARE activity was higher in women. High PON1 activity is associated with PONQ192 RR polymorphism carriers. PON Q192 gene polymorphism could be a determinant of PON activity.
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- 2021
123. Practical use of insulin degludec/insulin aspart in a multinational setting: beyond the guidelines
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YAVUZ, DİLEK, Mehta, Roopa, Chen, Roger, Hirose, Takahisa, John, Mathew, Kok, Adri, Lehmann, Roger, Unnikrishnan, Ambika Gopalakrishnan, Yavuz, Dilek Gogas, and Fulcher, Gregory
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antidiabetic drug ,NPH INSULIN ,STEADY-STATE ,HYPOGLYCEMIA ,insulin analogues ,GLYCEMIC CONTROL ,GLUCOSE CLAMP ,GLARGINE ,TYPE-2 DIABETES-MELLITUS ,PHARMACODYNAMIC PROPERTIES ,BASAL ,type 2 diabetes ,CO-FORMULATION - Abstract
Insulin degludec/insulin aspart (IDegAsp) is a fixed-ratio co-formulation of insulin degludec, which provides long-lasting basal insulin coverage, and insulin aspart, which targets postprandial glycaemia. This review provides expert opinion on the practical clinical use of IDegAsp, including: dose timings relative to meals, when and how to intensify treatment from once-daily (OD) to twice-daily (BID) dose adjustments, and use in special populations (including hospitalized patients). IDegAsp could be considered as one among the choices for initiating insulin treatment, preferential to starting on basal insulin alone, particularly for people with severe hyperglycaemia and/or when postprandial hyperglycaemia is a major concern. The recommended starting dose of IDegAsp is 10 units with the most carbohydrate-rich meal(s), followed by individualized dose adjustments. Insulin doses should be titrated once weekly in two-unit steps, guided by individualized fasting plasma glucose targets and based on patient goals, preferences and hypoglycaemia risk. Options for intensification from IDegAsp OD are discussed, which should be guided by HbA1c, prandial glucose levels, meal patterns and patient preferences. Recommendations for switching to IDegAsp from basal insulin, premixed insulins OD/BID, and basal-plus/basal-bolus regimens are discussed. IDegAsp can be co-administered with other antihyperglycaemic drugs however, sulphonylureas frequently need to be discontinued or the dose reduced, and the IDegAsp dose may need to be decreased when sodium-glucose co-transporter-2 inhibitors or glucagon-like peptide-1 receptor agonists are added. Considerations around the initiation or continuation of IDegAsp in hospitalized individuals are discussed, as well as in those undergoing medical procedures.
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- 2020
124. Updated approach for the management of osteoporosis in Turkey: a consensus report
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Funda Atamaz Çalış, Hatice Bodur, Özlen Peker, Ülkü Akarırmak, Vedat Hamuryudan, Umit Inceboz, Özlem El, Dilşad Sindel, Şansın Tüzün, Dilek Gogas Yavuz, Yesim Kirazli, Sema Öncel, Yeşim Gökçe Kutsal, Berrin Durmaz, İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kirazli, Yesim, Calis, Funda Atamaz, El, Ozlem, Kutsal, Yesim Gokce, Peker, Ozlen, Sindel, Dilsad, Tuzun, Sansin, Yavuz, Dilek Gogas, Durmaz, Berrin, Akarirmak, Ulku, Bodur, Hatice, Hamuryudan, Vedat, Inceboz, Umit, Oncel, Sema, and Ege Üniversitesi
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Male ,FRAX ,Turkey ,Turkish ,Osteoporosis ,Diagnosis of osteoporosis ,Disease ,Fractures, Bone ,Bone Density ,Multidisciplinary approach ,Prevalence ,Medicine ,Orthopedics and Sports Medicine ,Vitamin D ,VITAMIN-D ,Societies, Medical ,DXA ,education.field_of_study ,High prevalence ,Bone Density Conservation Agents ,Treatment Outcome ,POSTMENOPAUSAL WOMEN ,Practice Guidelines as Topic ,language ,BONE ,medicine.medical_specialty ,CALCIUM SUPPLEMENTATION ,Consensus ,Population ,CONTROLLED-TRIAL ,Risk Assessment ,Treatment of osteoporosis ,Intervention (counseling) ,Humans ,education ,business.industry ,Consensus Statement ,HIP FRACTURE ,Fracture risk assessment ,PERFORMANCE ,medicine.disease ,PREVENTION ,language.human_language ,Family medicine ,Dietary Supplements ,RISK-FACTORS ,Calcium ,business ,Osteoporotic Fractures - Abstract
As a result of the current demographics, increased projections of osteoporosis (OP) and prevalence of the disease in Turkey, a panel of multidisciplinary experts developed a thorough review to assist clinicians in identifying OP and associated fracture risk patients, diagnosing the disease with the appropriate available diagnostic methods, classifying the disease, and initiating appropriate treatment. the panel expects to increase the awareness of this prevalent disease, decrease consequences of OP with corresponding cost savings and, ultimately, decrease the overall burden of OP and related fractures in Turkey. Background OP is not officially accepted as a chronic disease in Turkey despite the high prevalence and predicted increase in the following years. However, there are areas where the country is performing well, such as having a country-specific fracture risk assessment model, DXA access, and the uptake of FRAX. Additional efforts are required to decrease the existing treatment gap estimating 75-90% of patients do not receive pharmacological intervention for secondary prevention, and the diagnosis rate is around 25%. Methods A selected panel of Turkish experts in fields related to osteoporosis was provided with a series of relevant questions to address prior to the multi-day conference. Within this conference, each narrative was discussed and edited by the entire group, through numerous drafts and rounds of discussion until a consensus was achieved. Represented in the panel were a number of societies including the Turkish Osteoporosis Society, the Society of Endocrinology and Metabolism of Turkey (SEMT), and the Turkish Society of Physical Medicine and Rehabilitation. Results Standardized general guidelines to identify OP and related fractures and at-risk population in Turkey, which will enable clinicians to accurately and effectively diagnose the disease, treat the appropriate patients with available pharmacological and non-pharmacological treatments and decrease the burden of the disease. Conclusions This manuscript provides a review of the current state of OP and related fractures in Turkey. Moreover, this manuscript reviews current international guidelines and national studies and proposes a number of helpful country-specific classifications that can be used by healthcare providers caring for the at-risk population. Additionally, the panel proposes practical recommendations that should be implemented nationally in order to decrease the burden of OP and related fractures and effectively preventing the burden in future generations., Americas Health Foundation (AHF), a 501(c)3 nonprofit organization; AmgenAmgen, The manuscript was supported by a grant from the Americas Health Foundation (AHF), a 501(c)3 nonprofit organization dedicated to improving healthcare, and by unrestricted grants from Amgen.
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- 2020
125. Serum ICAM-1 level and ICAM-1 gene 1462A>G (K469E) polimorphism on microalbuminuria in nondiabetic, nonhypertensive and normolipidemic obese patients: Genetical background of microalbuminuria in obesity
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Halit Akbas, Dilek Gogas Yavuz, Bennur Esen, Hale Guler, Emel Saglam Gokmen, Ahmet Engin Atay, Saadet Pilten, Atay, Ahmet Engin, Esen, Bennur, Akbas, Halit, Gokmen, Emel Saglam, Pilten, Saadet, Guler, Hale, Yavuz, Dilek Gogas, and Acibadem University Dspace
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medicine.medical_specialty ,Adhesion molecule ,030209 endocrinology & metabolism ,RETINOPATHY ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,lcsh:RC870-923 ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,SOLUBLE ADHESION MOLECULES ,Internal medicine ,Diabetes mellitus ,Genotype ,medicine ,Obesity ,Polymorphism ,RISK ,Creatinine ,Proteinuria ,business.industry ,ASSOCIATION ,ICAM-1 gene ,medicine.disease ,lcsh:Diseases of the genitourinary system. Urology ,Comorbidity ,Endocrinology ,chemistry ,Nephrology ,Albuminuria ,SELECTIN ,Microalbuminuria ,medicine.symptom ,business - Abstract
Background: A growing body of evidence suggest that obese individuals are under risk of renal parenchymal disorders when compared to nonobese counterparts. Microalbuminuria is the early marker of renal involvement. Although most of obese patients carries multiple risk factors for microalbuminuria, some obese individuals without risk factor may progress to microalbuminuria. The present study was performed to examine the role of ICAM-1 gene 1462A>G (K469E) polymorphism on microalbuminuria in obese subjects without diabetes mellitus, hypertension, hiperlipidemia and older age. Methods: Ninety eight obese and 96 nonobese individuals without a comorbidity enrolled into the study. Senim ICAM-1 level was measured by enzyme linked immunoabsorbent assay (ELISA) method. ICAM-1 gene 1462A>G (K469E) polymorphism was examined by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Nepholometric method was used to examine urinary albumin loss, and microalbuminuria was measured by albumin to creatinine ratio. Results: Obese individuals had significantly higher microalbuminuria and proteinuria level compared to nonobese subjects (p: 0.043 and p: 0.011; respectively). GG genotype of ICAM-1 carriers have significantly higher microalbuminuria compared to individuals with AA or AG genotype carriers (p: 0.042). Senim ICAM-1 level was significantly correlated with creatinine and microalbuminuria (p: 0.002 and p: 0.03; respectively). Logistic regression analysis indicated a 7.39 fold increased risk of microalbuminuria in individuals with GG genotype of ICAM-1 gene 1462A>G (K469E) polymorphism. Conclusions: GG genotype of ICAM-1 gene K469E polymorphism is associated with increased microalbuminuria in obese individuals without another metabolic risk factor. (C) 2017 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
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- 2017
126. Vitamin D level is associated with mortality predictors in ventilator-associated pneumonia caused by Acinetobacter baumannii
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Dilek Gogas Yavuz, Murat Haliloglu, Beliz Bilgili, Ismail Cinel, Ozlem Haliloglu, Haliloglu, Murat, Bilgili, Beliz, Haliloglu, Ozlem, Yavuz, Dilek Gogas, and Cinel, Ismail
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Acinetobacter baumannii ,Male ,INTENSIVE-CARE-UNIT ,PROGNOSIS ,Gastroenterology ,Severity of Illness Index ,Procalcitonin ,law.invention ,SOFA SCORE ,0302 clinical medicine ,law ,030212 general & internal medicine ,Aged, 80 and over ,APACHE II ,Ventilator-associated pneumonia ,Pneumonia, Ventilator-Associated ,General Medicine ,Middle Aged ,Intensive care unit ,Intensive Care Units ,ACQUIRED PNEUMONIA ,Infectious Diseases ,nutrition ,BRAIN NATRIURETIC PEPTIDE ,INFECTIONS ,PROCALCITONIN KINETICS ,Female ,Acinetobacter Infections ,Adult ,medicine.medical_specialty ,vitamin D deficiency ,Microbiology ,03 medical and health sciences ,ventilator-associated pneumonia ,D DEFICIENCY ,Virology ,Internal medicine ,Severity of illness ,Acinetobacter baumanii ,medicine ,Vitamin D and neurology ,Humans ,Hospitals, Teaching ,Aged ,Retrospective Studies ,SEPSIS ,business.industry ,030208 emergency & critical care medicine ,medicine.disease ,Survival Analysis ,mortality ,infection ,Surgery ,Pneumonia ,Parasitology ,SERUM 25-HYDROXYVITAMIN D ,business - Abstract
Introduction: Vitamin D plays a role in host defense and is known to be associated with mortality in patients in the intensive care unit (ICU). We aimed to evaluate the relationships between vitamin D levels and predictors of mortality in patients with ventilator-associated pneumonia (VAP) caused by extensively drug-resistant Acinetobacter baumanii (XDR A. baumanii). Methodology: A retrospective single-center study was conducted in an 18-bed adult ICU of a teaching hospital, including all patients with VAP due to XDR A. baumanii. Levels of 25(OH)D, procalcitonin (PCT), C-reactive protein (CRP), n-terminal pro-BNP (NT-proBNP), as well as clinical scores (Sequential Organ Failure Assessment [SOFA], Acute Physiology And Chronic Health Evaluation [APACHE II], Clinical Pulmonary Infection Score [CPIS) were recorded. Results: Forty-for patients were studied over six months. All patients had vitamin D deficiency. The 28-day mortality in patients with 25(OH)D levels ≤ 10 ng/mL was higher than in patients with 25(OH)D > 10ng/mL (p = 0.001). The fourth- and seventh-day SOFA scores (p= 0.04 and p= 0.001) and first- and fourth-day procalcitonin levels (p = 0.03 and p = 0.004) were higher in patients with 25(OH)D levels ≤ 10 ng/mL. The clinical scores (SOFA, CPIS, and CEPPIS) and biomarkers (NT-proBNP, PCT) were negatively correlated with 25(OH)D levels in all study groups. Conclusions: Severe vitamin D deficiency was associated with adverse outcome in VAP due to XDR A. baumanii. Vitamin D levels may be a prognostic predictor of VAP. It is also important to evaluate the effect of rapid vitamin D replacement on mortality.
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- 2016
127. Diurnal Blood Pressure Abnormalities Are Related to Endothelial Dysfunction in Patients with Non-Complicated Type 1 Diabetes
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Ahmet Toprak, Hakan Tezcan, Oguzhan Deyneli, Hasan Aydin, Meral Yüksel, Sema Akalin, Dilek Gogas Yavuz, Dilek Yazici, Deyneli, Oguzhan, Yazici, Dilek, Toprak, Ahmet, Yuksel, Meral, Aydin, Hasan, Tezcan, Hakan, Yavuz, Dilek Gogas, and Akalin, Sema
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Adult ,Male ,medicine.medical_specialty ,Ambulatory blood pressure ,AUTONOMIC NEUROPATHY ,Endothelium ,Physiology ,Blood Pressure ,Nitric Oxide ,Thiobarbituric Acid Reactive Substances ,DISEASE ,MELLITUS ,endothelial function ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,TBARS ,Humans ,oxidative stress ,ESSENTIAL-HYPERTENSION ,Endothelial dysfunction ,nondipper ,IDDM PATIENTS ,Glycated Hemoglobin ,Type 1 diabetes ,diabetes ,biology ,Dipper ,business.industry ,MORTALITY ,Cholesterol, LDL ,medicine.disease ,biology.organism_classification ,Circadian Rhythm ,Vasodilation ,ambulatory blood pressure monitoring ,Diabetes Mellitus, Type 1 ,Endocrinology ,Blood pressure ,medicine.anatomical_structure ,6-YEAR FOLLOW-UP ,DEPENDENT VASODILATION ,Cardiology ,Female ,Endothelium, Vascular ,BLUNTED NOCTURNAL FALL ,Cardiology and Cardiovascular Medicine ,business - Abstract
Patients with diabetes have an increased cardiovascular morbidity and mortality despite interventions to prevent these outcomes. Abnormalities in diurnal blood pressure patterns are also associated with excess cardiovascular mortality. The aim of this study was to determine the effects of diurnal blood pressure patterns on endothelial function and oxidative stress in patients with uncomplicated type 1 diabetes mellitus. Thirty-two normotensive and normoalbuminuric type 1 diabetic patients (21 dipper and 11 nondipper) and 37 healthy (27 dipper and 10 nondipper) volunteers underwent 24-h ambulatory blood pressure monitoring. Their endothelial functions were evaluated using flow mediated dilatation (FMD) and by measuring nitric oxide and thiobarbituric acid reactive substances (TBARS). Dippers were defined as subjects who exhibited an average reduction in both systolic and diastolic blood pressure of greater than 10% between day and night periods. Nondipper type 1 diabetic patients and controls had nighttime systolic and diastolic blood pressure values that were significantly higher than those of dipper diabetic patients (p
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- 2008
128. Sağlık çalışanlarında d vitamini düzeyi: d vitamini ile endotel fonksiyonu arasındaki ilişki
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Haliloğlu, Özlem (Asmaz), Yavuz, Dilek Gogas, and İç Hastalıkları Anabilim Dalı
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İç Hastalıkları ,Tıp - Published
- 2012
129. Akromegalik hastalarda akciğer yapı ve fonksiyonlarının değerlendirilmesi
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Yalın, Ayşe Serap, Yavuz, Dilek Gogas, and İç Hastalıkları Anabilim Dalı Endokrinoloji ve Metabolizma Bilim Dalı
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Endokrinoloji - Abstract
İÇİNDEKİLERÖnsöz……………………………………………………………………………..iKısaltmalar …………………………………………………………………....ii-iii1. Giriş ve Amaç……………………………………………………………….1-22. Genel Bilgiler………………………………………………………………3-262.1. Epidemiyoloji……………………………………………………......32.2. Etiyoloji…………………………………………………………...3-42.3. Klinik Seyir………………………………………………………. 4-62.4. Klinik Belirti ve Bulgular………………………………………...6-102.5. Tanı……………………………………………………………...10-112.6. GH………………………………………………………………11-122.7. IGF-1……………………………………………………………13-152.8. Akromegalik Hastalarda Solunum Sisteminde MeydanaGelen Değişiklikler……………………………………………....15-172.9. Tanı……………………………………………………………...17-212.10. Solunum Fonksiyon Testleri…………………………………....21-263. Gereç ve Yöntemler…………………………………………………………27-304. Bulgular……………………………………………………………………..31-445. Tartışma ve Sonuçlar………………………………………………………..45-546. Türkçe Özet……………….……………………………………………………557. İngilizce Özet (Abstract)…………………………………………...…………..568. Kaynaklar…………………………………………………………………....
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- 2011
130. Tip 2 diyabetlerde D vitamini düzeylerinin endote fonksiyonu ve osteoprotegerin düzeyleri ile iliişkisi
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Güneş, Mutlu, Yavuz, Dilek Gogas, and İç Hastalıkları Anabilim Dalı Endokrinoloji ve Metabolizma Bilim Dalı
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Endokrinoloji - Published
- 2011
131. Tip I diabetes mellitusu olan hastalarda periferik kanda dolaşan endotel hücrelerinin endotel fonksiyonu ile olan ilişkisi
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Aşıcıoğlu, Ebru, Yavuz, Dilek Gogas, and İç Hastalıkları Anabilim Dalı
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Diyabetli Hastalar ,İç Hastalıkları - Published
- 2008
132. Tip I diabetes mellitusu olan hastalarda periferik kanda dolaşan endotel hücrelerin endotel fonksiyonu ile olan ilişkisi
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Aşicioğlu, Ebru, Yavuz, Dilek Gogas, and İç Hastalıkları Anabilim Dalı
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Endocrinology and Metabolic Diseases ,Endokrinoloji ve Metabolizma Hastalıkları - Abstract
109
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- 2008
133. Vitamin D eksikliği olan bireylerde Vitamin D replasmanının endotel fonksiyonu, oksidatif stres ve inflamasyon belirteçleri üzerine etkileri
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Tarçın, Özlem (Üstay), Yavuz, Dilek Gogas, and Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı
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Oksidatif Stres ,Vitamin D Eksikliği ,Vitamin D ,Endokrinoloji - Published
- 2007
134. Morbid obesity leads to increased skin autofluorescence independent of metabolic syndrome components.
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Apaydın T and Yavuz DG
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- Humans, Glycation End Products, Advanced metabolism, Optical Imaging, Skin metabolism, Glucose metabolism, Obesity, Morbid complications, Obesity, Morbid epidemiology, Obesity, Morbid metabolism, Metabolic Syndrome epidemiology, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 metabolism
- Abstract
Background: Obesity, diabetes mellitus, and metabolic syndrome (MetS) are associated with increased accumulated skin advanced glycation end products. We aimed to evaluate the association of MetS components with skin autofluorescence (SAF) in patients with morbid obesity., Methods: Eight hundred and one patients with morbid obesity and 94 age-matched controls with normal body mass index (BMI) and normal glucose metabolism were included. Advanced glycation end products (AGEs) were measured using SAF in the forearm, with an AGE reader., Results: The prevalence of MetS in patients with morbid obesity was 65.5% (n = 525). Type 2 diabetes mellitus (type 2 DM) and hypertension were present in 40.9% (n = 328) and 43.7% (n = 357). Patients with morbid obesity and those with MetS had higher SAF measurements compared with the control group, 1.85 ± 0.44 arbitrary unit (AU) and 1.86 ± 0.43 AU vs. 1.72 ± 0.30 AU, respectively (p = 0.016). There was no difference in SAF levels between patients with and without MetS. SAF measurements of patients without MetS were not statistically different from the control group (p = 0.076). Patients with five MetS criteria had higher SAF measurements compared with patients with fewer MetS components (p = 0.019). There was no difference in SAF levels between patients with type 2 DM, impaired glucose metabolism, and patients with normal glucose metabolism (p = 0.513)., Discussion: Although MetS and type 2 DM are known as factors related to increased SAF levels, obesity can cause elevated SAF measurements in different ways independent of concomitant comorbid diseases. Larger studies with longer follow-ups are needed to enlighten the underlying mechanism.
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- 2022
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135. When do we need to suspect maturity onset diabetes of the young in patients with type 2 diabetes mellitus?
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Üstay Ö, Apaydın T, Elbasan O, Polat H, Günhan G, Dinçer C, Şeker L, Ateş EA, Yabacı A, Güney Aİ, and Yavuz DG
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- Adult, C-Peptide, Hepatocyte Nuclear Factor 1-alpha genetics, Humans, Mutation genetics, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 genetics
- Abstract
Objective: Maturity onset diabetes of the young (MODY) patients have clinical heterogeneity as shown by many studies. Thus, often it is misdiagnosed to type 1 or type 2 diabetes(T2DM). The aim of this study is to evaluate MODY mutations in adult T2DM patients suspicious in terms of MODY, and to show clinical and laboratory differences between these two situations., Methods: In this study, we analyzed 72 type 2 diabetic patients and their relatives (35F/37M) who had been suspected for MODY and referred to genetic department for mutation analysis. The gene mutations for MODY have been assessed in the laboratory of Marmara University genetics. Totally 67 (32F/35M; median age 36.1) diabetic patients were analyzed for 7 MODY mutations. Twelve patients who have uncertain mutation (VUS) were excluded from study for further evaluation. MODY(+) (n:30) patients and T2DM patients (n:25) were compared for clinical and laboratory parameters., Results: In MODY(+) subjects, mutations in GCK (MODY 2) (n:12; 40%) were the most common followed by HNF4A (MODY 1) (n:4; 13.3%). Diabetes diagnosis age was younger in MODY(+) group but not statistically significant. Sixty-six percent of MODY(+) subjects had diabetes history at 3-consecutive generations in their family compared with 28% of T2DM patients statistically significant (p:0.006). Gender, BMI, C-peptide, HbA1c, lipid parameters, creatinine, GFR, microalbuminuria, vitamin D and calcium were not statistically different between the groups., Conclusion: According to present study results, MODY mutation positivity is most probable in young autoantibody (-) diabetic patients diagnosed before 30 years of age, who have first degree family history of diabetes.
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- 2022
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136. The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations.
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Bahat G, Catikkas NM, Yavuz DG, Borman P, Guzel R, and Reginster JY
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- Absorptiometry, Photon, Aged, Bone Density, Humans, Male, Risk Assessment, Turkey epidemiology, Osteoporosis diagnostic imaging, Osteoporosis epidemiology, Osteoporotic Fractures epidemiology
- Abstract
Purpose: The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. In this article, we outlined the current situation of OP in older adults in Turkey and investigated the differences between Turkey and a representative developed European country (Belgium), in terms of the screening, diagnosis, and treatment of OP. Our intention in this regard was to identify areas in need of improvement and subsequently to make a clear call for action to address these issues., Methods: Herein, considering the steps related to the OP approach, we made a complete review of the studies conducted in Turkey and compared with the literature recommendations., Results: There is a need for a national osteoporotic fracture registry; measures should be taken to improve the screening and treatment of OP in older males, such as educational activities; technicians involved in dual-energy X-ray absorptiometry (DXA) scanning should undergo routine periodic training; all DXA centers should identify center-specific least significant change values; all older adults should be considered for routine lateral dorsolumbar X-ray imaging for the screening of vertebral fractures while ordering DXA scans; the inclusion of vertebral fracture assessment (VFA) software in DXA assessments should be considered; screening using a fracture risk assessment tool (FRAX) algorithm that is specific to Turkey should be integrated; the fortification of foods with vitamin D is required; the high fracture risk by country-specific FRAX algorithm and the presence of falls/high fall risk should be integrated in reimbursement terms; and finally, more "fracture liaison services" should be established., Conclusion: We suggest that the practical consideration of our suggestions will provide considerable support to the efforts for combating with the adverse consequences of OP in society. This approach can be subsequently modeled for other populations to improve the management of OP globally., (© 2021. International Osteoporosis Foundation and National Osteoporosis Foundation.)
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- 2021
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137. Biochemical characteristics and calcium and PTH levels of patients with high normal and elevated serum 25(OH)D levels in Turkey: DeVIT-TOX survey.
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Pekkolay Z, Yavuz DG, Saygılı ES, Değertekin CK, Topaloğlu Ö, Önder ÇE, Soylu H, Taskaldıran I, Pazır AE, Uğur K, Tanrıkulu S, Fırat SN, Atak BM, Batman A, Omma T, Cağıltay E, Özdemir N, Altuntaş SÇ, İmga NN, Karakılıç E, Hekimsoy Z, Kılınç F, Yay A, Eroğlu M, and Tuzcu AK
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- Adult, Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, Turkey, Calcium, Vitamin D analogs & derivatives
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Vitamin D intake over the recommended dose is usually associated with high serum 25(OH)D levels and generally not associated with symptoms of hypercalcemia. High doses of cholecalciferol need to be avoided to protect against vitamin D toxicity and related complications. Strict adherence to the clinical guidelines for treating vitamin D deficiency can ensure safe and effective treatment., Purpose: We observed a tendency to use high doses of cholecalciferol for vitamin D deficiency treatment or vitamin D supplementation. We aimed to determine the biochemical characteristics of patients with high normal and elevated serum 25(OH)D levels., Methods: An online invitation was sent to all tertiary endocrinology clinics in Turkey to complete an online retrospective survey (DeVIT-TOX Survey) for patients diagnosed with high serum 25(OH)D levels (> 88 ng/mL) between January 2019 and December 2019. The patients were evaluated according to the presence of signs and symptoms of hypercalcemia and doses of vitamin D intake, evaluated into the following three groups according to their 25(OH)D levels: group 1, > 150 ng/mL; group 2, 149-100 ng/mL; and group 3, 99-88 ng/mL., Results: A total of 253 patients were included in the final analysis (female/male: 215/38; mean age, 51.5 ± 15.6 years). The average serum 25(OH)D level was 119.9 ± 33 (range, 88-455) ng/mL, and the average serum calcium level was 9.8 ± 0.7 (range, 8.1-13.1) mg/dL. Most (n = 201; 75.4%) patients were asymptomatic despite having high serum 25(OH)D and calcium levels. The serum 25(OH)D level was significantly higher in the symptomatic groups than in the asymptomatic groups (138.6 ± 64 ng/mL vs. 117.7 ± 31 ng/mL, p < 0.05). The most common cause (73.5%) associated with high serum 25(OH)D levels was the inappropriate prescription of a high dose of oral vitamin D (600.000-1.500.000 IU) for treating vitamin D deficiency/insufficiency in a short time (1-3 months). The cut-off value of 25 (OH) D level in patients with hypercalcemia was found to be 89 ng/mL [median 116.5 (89-216)]., Conclusions: High dose of vitamin D intake is associated with a high serum 25 OH D level, without symptoms of hypercalcemia. Inappropriate prescription of vitamin D is the primary cause for elevated 25(OH) D levels and related hypercalcemia. Hypercalcemia may not be observed in every patient at very high 25(OH) D levels. Adherence to the recommendation of guidelines is essential to ensure safe and effective treatment of vitamin D deficiency., (© 2021. International Osteoporosis Foundation and National Osteoporosis Foundation.)
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- 2021
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138. Prevalence of vertebral fractures and serum sclerostin levels in acromegaly.
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Uygur MM, Yazıcı DD, Buğdaycı O, and Yavuz DG
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- Absorptiometry, Photon, Adult, Bone Density, Case-Control Studies, Humans, Lumbar Vertebrae, Middle Aged, Prevalence, Acromegaly complications, Acromegaly epidemiology, Spinal Fractures diagnostic imaging, Spinal Fractures epidemiology, Spinal Fractures etiology
- Abstract
Objective: An increased prevalence of vertebral fractures (VFs) has been reported in previous studies. The aim of this study was to evaluate the association between bone mineral density (BMD), bone turnover markers, serum sclerostin levels, and vertebral fractures (VFs) in acromegaly patients. We also evaluated the effects of gonadal status, disease activity, treatment modality, age, sex, and body mass index (BMI) on skeletal endpoints., Design: Case-control study., Patients and Measurements: Seventy acromegaly patients (M/F:36/34, mean age 45.5 ± 11.9 years) and 70 controls (M/F:31/39; mean age 45.66 ± 11.9 years) were included. VFs, BMD, calcium metabolism, markers of bone turnover, and sclerostin levels were evaluated. BMD was measured by dual-energy X-ray absorptiometry (Hologic QDR 4500). Conventional lateral radiography of the spine was performed and the Genant method was used for the assessment of fractures of T4-L5 vertebrae., Results: The prevalence of vertebral fractures was higher in acromegalic patients as compared with the control group (72.9 vs. 20%; p < 0.001). Serum phosphate (P) levels (3.46 ± 0.59 mg/dl vs. 3.11 ± 0.44 mg/dl; p < 0.001) and b-cross laps (CTx) levels (0.47 µg/l, range 0.04-2.38 vs. 0.28 µg/l, range 0.11-0.80; p < 0.001) were significantly higher in acromegaly patients than control subjects. Serum sclerostin levels were similar between either acromegaly patients and control subjects or acromegaly patients with VF and without VF. In the means of treatment modality, VFs were more frequent in patients treated with adjuvant gamma knife radiosurgery (GKS) (p = 0.07). In the binary logistic regression analysis, the age of the acromegaly patients, the presence of hypogonadism, and GKS treatment were the factors significantly correlated with the occurrence of spinal fractures., Conclusions: The prevalence of VFs in patients with acromegaly is higher than in control subjects. Since advanced age, the presence of hypogonadism and GKS treatment were the factors predicting VFs in acromegaly; radiological evaluations should be considered as an emerging tool especially in those patients. Although markers of bone turnover elevated in acromegaly, they were not useful for the prediction of fractures. Serum sclerostin levels showed no discrepancy between the two groups and further studies are required for assessment of sclerostin role in this form of secondary osteoporosis., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2021
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139. Determinants of High-Dose Insulin Usage and Upper Extremity Muscle Strength in Adult Patients With Type 2 Diabetes.
- Author
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Imre E, Apaydin T, Gunhan HG, and Yavuz DG
- Subjects
- Adult, Aged, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Diabetes Mellitus, Type 2 drug therapy, Insulin administration & dosage, Muscle Strength drug effects, Upper Extremity physiology
- Abstract
Objectives: In this study, we aimed to determine the association between upper extremity muscle strength and insulin dose in patients with type 2 diabetes., Methods: A total of 236 patients with type 2 diabetes under insulin treatment for at least 1 year were included in this cross-sectional study. Patients were divided into 3 groups based on their total daily insulin dose (TDID): group 1, TDID >2 U/kg/day or >200 units/day; group 2, TDID 1 to 2 U/kg/day or 51 to 199 U/day; and group 3, TDID <0.5 U/kg/day or 50 U/day. High-dose insulin use was defined as total daily insulin dose >2 U/kg or >200 U/day. Muscle strength was measured using a handgrip dynamometer., Results: High-dose insulin users were younger and had higher measures of generalized and central obesity and glycated hemoglobin. There was no significant difference in muscle strength between the groups. Low muscle strength was seen in 26.7% of all patients. Patients with low muscle strength were older, had lower insulin dose treatment and had better glycemic control than patients with normal muscle strength. Handgrip strength was inversely correlated with age, body mass index and duration of diabetes, but not with TDID., Conclusions: Patients with type 2 diabetes with high-dose insulin use had similar upper extremity muscle strength measurements with standard-dose insulin users. Studies with more patients are needed to determine the relationship between muscle mass, muscle strength and high-dose insulin use., (Copyright © 2020 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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140. Early detection of neuropathy in patients with type 2 diabetes with or without microalbuminuria in the absence of peripheral neuropathy and retinopathy.
- Author
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Celiker H, Erekul G, Turhan SA, Kokar S, Yavuz DG, Gunduz OH, Tavakoli M, and Toker E
- Subjects
- Cornea, Humans, Microscopy, Confocal, Nerve Fibers, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 diagnosis, Diabetic Neuropathies diagnosis, Diabetic Neuropathies etiology, Diabetic Retinopathy complications, Diabetic Retinopathy diagnosis, Diabetic Retinopathy epidemiology
- Abstract
Purpose: Our goal is early detection of neuropathy in patients with type 2 diabetes with or without microalbuminuria in the absence of diabetic retinopathy and peripheral neuropathy by using in vivo corneal confocal microscopy (IVCCM)., Methods: A total of 60 type-2 diabetic patients, assigned to either a diabetes mellitus (DM) with microalbuminuria group (DM/MA+, n=30) or a DM without microalbuminuria group (DM/MA-, n=30), and 30 age-matched control subjects were enrolled in this study. All cases underwent evaluation of blood glucose level, HbA
1c , lipid fractions, body mass index (BMI), and corneal sensitivity (CS). Corneal nerve fiber length (NFL), nerve fiber density (NFD), nerve branch density (NBD), and tortuosity coefficient (TC) were quantified by IVCCM. None of the patients had peripheral neuropathy or retinopathy., Results: Compared with the healthy subjects, NFL and NFD were reduced in both diabetic groups (P<0.0001), while NBD was significantly reduced in the DM/MA+ group. Between the diabetic groups, NFL, NFD, and NBD were significantly higher in the DM/MA- group (all P's<0.001). CS was significantly lower in DM/MA+ compared with DM/MA- and controls (both P's<0.0001). NFD and NFL were inversely correlated with age, triglyceride level, and BMI., Conclusion: These results indicate that significant damage to small nerves, quantified using IVCCM, can be detected in the absence of retinopathy, peripheral neuropathy or microalbuminuria in type 2 diabetic patients. The severity of corneal nerve involvement may further increase in the presence of nephropathy. This feature may also be valuable for early detection of microvascular complications of DM, allowing for the prevention of progression of life threatening microvascular complications., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)- Published
- 2021
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141. Seven cases of parathyroid carcinoma and review of the literature.
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Apaydın T and Yavuz DG
- Subjects
- Adult, Bone Density Conservation Agents therapeutic use, Calcium blood, Female, Humans, Hypoparathyroidism drug therapy, Male, Middle Aged, Parathyroid Hormone blood, Carcinoma diagnosis, Carcinoma pathology, Parathyroid Neoplasms diagnosis, Parathyroid Neoplasms pathology
- Abstract
Parathyroid cancer is a rare malignancy and an uncommon cause of hyperparathyroidism. In the present study, we present seven cases of parathyroid carcinoma. The female ratio was 5/7 (71.4%). Median age at diagnosis was 47 years, and median follow-up duration was 60 months (IQR 29-75). Mean calcium level at diagnosis was 12.7 mg/dL (range, 11.3-13.9), and mean parathormone level was 1115 ng/L (IQR 287-1470). Two patients (28.5%) had a palpable neck mass. Coexisting brown tumor was present in three patients (42.8%), and nephrolithiasis was found in one patient (14.2). Average tumor size was 29 mm (IQR 28-40). Capsular and vascular invasion were detected in six patients (85.7%), intrathyroidal spread was observed in two patients (28.5%), and soft tissue invasion was seen in three patients (42.8%). Parathyroid adenoma was present in one patient and parathyroid gland hyperplasia in another patient. Adjuvant radiotherapy was given to four patients (57.1%). There was no metastatic disease or death. At the last visit, two patients had increased parathormone levels and no additional focus could be detected in either. Patients with markedly elevated parathormone and calcium levels and a palpable larger mass on the neck should be evaluated for parathyroid cancer. En bloc resection is the mainstay treatment. Despite contradictory results, adjuvant radiotherapy to the neck may help to reduce the risk of local recurrence in patients with microscopic residual parathyroid carcinoma.
- Published
- 2021
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142. Corrigendum to "Long-term endocrinological outcomes of gamma knife radiosurgery in acromegaly patients", [Growth Hormone & IGF Research, Volume 55, December 2020, 101335].
- Author
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Uygur MM, Deyneli O, and Yavuz DG
- Published
- 2021
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143. Assessment of 1 mg Dexamethasone Suppression Test in Patients with Obesity Before Bariatric Surgery.
- Author
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Yavuz DG, Apaydin T, Gunhan HG, and Uygur MM
- Subjects
- Adult, Dexamethasone, Female, Humans, Hydrocortisone, Middle Aged, Obesity complications, Obesity surgery, Retrospective Studies, Bariatric Surgery, Obesity, Morbid surgery
- Abstract
Purpose: This study aims to examine the prevalence of Cushing's syndrome (CS) in class 3 obese patients before bariatric surgery., Materials and Methods: The data of 1037 class 3 obese patients admitted to the endocrinology outpatient clinic for endocrinological evaluation before bariatric surgery between 2012 and 2019were reviewed retrospectively. One milligram dexamethasone suppression test (DST) was used for the evaluation of hypercortisolism in all cases and cutoff accepted as 1.8 μg/dL., Results: The mean body mass index (BMI) was 48 ± 8.9 kg/m
2 and age was 42 ± 10 years with female preponderance (F/M: 799/238] being observed in this cohort. Insufficient cortisol suppression was found in 40 patients; confirmed hypercortisolemia was detected in 8 patients. The prevalence of pathologic DST was 3.85% and 0.77% in confirmed hypercortisolism. The specificity for 1-mg DST with the cutoff 1.8 μg/dL was calculated as 96.8%., Conclusion: Hypercortisolism prevalence was found to be low, and 1 mg DST is a sufficient test for the screening of CS in class 3 obese patients evaluated before bariatric surgery.- Published
- 2020
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144. Long-term endocrinological outcomes of gamma knife radiosurgery in acromegaly patients.
- Author
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Uygur MM, Deyneli O, and Yavuz DG
- Subjects
- Acromegaly blood, Acromegaly pathology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Radiosurgery, Retrospective Studies, Acromegaly surgery, Biomarkers blood, Human Growth Hormone blood, Insulin-Like Growth Factor I analysis
- Abstract
Gamma knife radiosurgery (GKS) is a treatment option for recurrent or persistent disease in patients with acromegaly., Objective: We aimed to retrospectively evaluate acromegaly patients who had undergone GKS in terms of pituitary hormone status, efficacy of GKS, and prognostic factors., Method: One-hundred and ten acromegaly patients who underwent GKS, and who were referred to our outpatient endocrinology clinic between 2007 and 2017, were included in the study. Anterior pituitary hormones and radiology imaging during follow-up were recorded. Remission for acromegaly was defined as a normal insulin-like growth factor 1 (IGF-1) level adjusted for age and gender, and a random growth hormone (GH) level < 1 ng/ml. Endocrine control was defined as normal GH and IGF-1 levels under medication., Results: After a mean follow-up of 6.5 ± 4.7 years; remission, endocrine control, and uncontrolled status was observed in 16.4%, 60%, and 23.6% of patients; respectively. Adenoma volume was decreased after GKS (P < .0001). Remnant adenoma diameter was higher in the uncontrolled group compared to the remission and endocrine control group. The presence of tumor extension was associated with disease status (P = .03) and higher initial GH and IGF-1 levels. The mean time after GKS to remission was 26.5 months. Six (5.4%) patients had new-onset pituitary deficiency after GKS. In the multivariate analysis, pre-GKS IGF-1 levels and patient's age were associated with disease status., Conclusion: GKS is an effective adjuvant treatment with minimal side effects to control GH and IGF-1 levels, increase remission rates, endocrine control, and reduce tumor diameter in persistent acromegaly patients after surgery., (Copyright © 2020. Published by Elsevier Ltd.)
- Published
- 2020
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145. Single Center Experience in the Surgical Management of Primary Hyperparathyroidism.
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Demir B, Binnetoglu A, Sahin A, and Yavuz DG
- Abstract
Objectives: As calcium included as a part of routine laboratory screening early diagnosis of primary hyperparathyroidism (PHPT) has been increased. Surgical resection of parathyroid adenoma or hyperplasia still is the mainstay of the treatment for most PHPT patients. The aim of this study was to evaluate of the surgical outcomes of patients with PHPT that referred to our ENT department of our University Hospital for the last 6 years., Methods: One hundred thirty-seven patients with PHPT who underwent parathyroid surgery in our clinic between October 2011 and January 2018 included in this retrospective study. Data on demographics, clinical findings, past medical history, preoperative laboratory values in 3 months, preoperative localizing imaging studies including ultrasonography (USG) and 99mTc-sestamibi (methoxyisobutyl isonitrile, [MIBI]) scan, operative findings, postoperative laboratory values, and pathology reports were recorded. MIBI scan and USG are used as the first-line modalities in our center. Single-photon emission computed tomography was used for challenging situations of re-exploration and ectopic parathyroid pathology. Four-dimensional computed tomography scanning is was preferred as the last imaging modality. Focused unilateral neck exploration (FUNE) was performed with intraoperative frozen section analysis as a routine procedure. Bilateral neck exploration (BNE) was used only in re-exploration, ectopic parathyroid, and with high suspicion of multigland disease., Results: Totally 137 patients (female:male, 3:3; mean age, 54.6±13.2 years) included in the study. Single parathyroid adenoma was found in 108 patients (78.8%). Most common adenoma localization was left inferior parathyroid gland (46.7%). FUNE was performed in 89.8% of the patients and BNE for 10.2% of the patients. Postoperative normocalcemia was reached in 132 patients and permanent hypocalcemia was observed in two patients. Persistence hypercalcemia observed in three patients. Postoperative pathology reports revealed three patients have parathyroid carcinoma., Conclusion: Preoperative imaging modalities is very important in parathyroidectomy surgery. Routine use of preoperative imaging modalities reduced the risk of complications in our clinic.
- Published
- 2020
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146. Effects of vitamin D supplementation on insulin sensitivity and androgen levels in vitamin-D-deficient polycystic ovary syndrome patients.
- Author
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Karadağ C, Yoldemir T, and Yavuz DG
- Subjects
- Adolescent, Adult, Androstenedione blood, Blood Glucose, Body Mass Index, Dietary Supplements, Female, Humans, Polycystic Ovary Syndrome complications, Prospective Studies, Testosterone blood, Vitamin D analogs & derivatives, Vitamin D Deficiency complications, Vitamin D Deficiency drug therapy, Young Adult, Cholecalciferol therapeutic use, Insulin Resistance physiology, Polycystic Ovary Syndrome blood, Vitamin D Deficiency blood
- Abstract
Aim: The aim of this study was to identify the effects of vitamin D supplementation on insulin sensitivity and androgen levels in vitamin-D-deficient polycystic ovary syndrome (PCOS) patients., Methods: Sixty-seven vitamin-D-deficient (25-hydroxyvitamin D [25(OH)D] levels below 20 ng/mL) PCOS patients and 54 vitamin-D-deficient non-PCOS volunteer subjects matched for age and body mass index were enrolled to this prospective study. All participants were given 50 000 IU/week cholecalciferol orally for 8 weeks and 1500 IU/day for 4 weeks. Insulin sensitivity was calculated with the Matsuda insulin sensitivity index (ISI) based on an oral glucose tolerance test. Matsuda ISI, gonadal hormones (estrogen, testosterone, androstenedione), and 25(OH)D levels were studied before and at the end of the 12th week of vitamin D load., Results: After vitamin D supplementation, serum androstenedione levels had decreased significantly (P = 0.007) and Matsuda ISI values had increased significantly (P = 0.001) in the PCOS group but no significant changes were seen in those parameters in controls. We observed positive correlations between 25(OH)D levels and Matsuda ISI (r = 0.307; P < 0.01), and negative correlations between 25(OH)D levels and total testosterone (r = -0.306; P < 0.01) and androstenedione (r = -0.275; P < 0.01) levels in the PCOS group., Conclusion: Vitamin D supplementation increased insulin sensitivity and decreased androgen levels in vitamin-D-deficient women with PCOS but did not have any effect in vitamin-D-deficient non-PCOS women. These results may indicate the possible role of vitamin D in the complex pathogenesis of PCOS., (© 2017 Japan Society of Obstetrics and Gynecology.)
- Published
- 2018
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147. Does cardiovascular risk vary according to the criteria for a diagnosis of polycystic ovary syndrome?
- Author
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Ramoglu S, Yoldemir T, Atasayan K, and Yavuz DG
- Subjects
- Adolescent, Adult, Blood Glucose analysis, Body Mass Index, Carotid Intima-Media Thickness, Fasting, Female, Humans, Hyperandrogenism, Insulin blood, Ovary pathology, Polycystic Ovary Syndrome pathology, Risk Factors, Cardiovascular Diseases diagnosis, Cardiovascular Diseases etiology, Polycystic Ovary Syndrome complications, Polycystic Ovary Syndrome diagnosis
- Abstract
Aim: The risk of cardiovascular disease is higher in women with polycystic ovary syndrome (PCOS) compared to healthy individuals. Chronic inflammation, insulin resistance, hyperandrogenemia, hyperlipidemia and increased oxidative stress are known to have a role in the formation of atherosclerosis and cardiovascular disease. The aim of our study was to evaluate if cardiovascular risk varied according to different PCOS criteria, using carotid intima-media thickness (CIMT), which is an important marker of major cardiovascular events in the later stages of life., Methods: The study group included 52 women aged 18-35 diagnosed with PCOS, and the control group comprised 45 age-matched healthy women. Body mass index, CIMT, fasting serum glucose and insulin levels and hormonal and lipid profiles were compared between the groups., Results: There was no significant difference in CIMT levels between the groups. The CIMT levels in the PCOS group did not differ whether hyperandrogenism, polycystic ovary-like appearance on ultrasound or oligo/anovulation status were present or not. Furthermore, when all cases were divided into subgroups according to BMI values, the CIMT values were similar between the groups., Conclusion: Because PCOS and atherosclerosis both have a complex nature, it is likely that the evaluation of CIMT alone may not be sufficient to determine endothelial dysfunction in a reproductive age group., (© 2017 Japan Society of Obstetrics and Gynecology.)
- Published
- 2017
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148. Serum ICAM-1 level and ICAM-1 gene 1462A>G (K469E) polimorphism on microalbuminuria in nondiabetic, nonhypertensive and normolipidemic obese patients: Genetical background of microalbuminuria in obesity.
- Author
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Atay AE, Esen B, Akbas H, Gokmen ES, Pilten S, Guler H, and Yavuz DG
- Abstract
Background: A growing body of evidence suggest that obese individuals are under risk of renal parenchymal disorders when compared to nonobese counterparts. Microalbuminuria is the early marker of renal involvement. Although most of obese patients carries multiple risk factors for microalbuminuria, some obese individuals without risk factor may progress to microalbuminuria. The present study was performed to examine the role of ICAM-1 gene 1462A>G (K469E) polymorphism on microalbuminuria in obese subjects without diabetes mellitus, hypertension, hiperlipidemia and older age., Methods: Ninety eight obese and 96 nonobese individuals without a comorbidity enrolled into the study. Serum ICAM-1 level was measured by enzyme linked immunoabsorbent assay (ELISA) method. ICAM-1 gene 1462A>G (K469E) polymorphism was examined by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Nepholometric method was used to examine urinary albumin loss, and microalbuminuria was measured by albumin to creatinine ratio., Results: Obese individuals had significantly higher microalbuminuria and proteinuria level compared to nonobese subjects (p: 0.043 and p: 0.011; respectively). GG genotype of ICAM-1 carriers have significantly higher microalbuminuria compared to individuals with AA or AG genotype carriers (p: 0.042). Serum ICAM-1 level was significantly correlated with creatinine and microalbuminuria (p: 0.002 and p: 0.03; respectively). Logistic regression analysis indicated a 7.39 fold increased risk of microalbuminuria in individuals with GG genotype of ICAM-1 gene 1462A>G (K469E) polymorphism., Conclusions: GG genotype of ICAM-1 gene K469E polymorphism is associated with increased microalbuminuria in obese individuals without another metabolic risk factor., (Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
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149. The evaluation of endothelial function and structure in hirsute patients in reproductive age.
- Author
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Atasayan K, Yoldemir T, Ramoglu S, and Yavuz DG
- Subjects
- Adolescent, Adult, Androgens blood, Body Mass Index, Carotid Intima-Media Thickness, Case-Control Studies, Endothelium, Vascular diagnostic imaging, Female, Hirsutism blood, Hirsutism diagnostic imaging, Humans, Ovary diagnostic imaging, Prospective Studies, Ultrasonography, Waist-Hip Ratio, Young Adult, Endothelium, Vascular physiopathology, Hirsutism physiopathology, Ovary physiopathology
- Abstract
Objective: To evaluate the endothelial function and structure in patients with hirsutism in reproductive age., Study Design: The study was conducted on 69 consecutive women admitted with complaints of hirsutism and 63 voluntary healthy women, as controls. A total of 132 subjects who applied to the Gynecology and Infertility Outpatient Clinics were included. Participants with modified Ferriman Gallway (mFG) score over 8 were considered to be hirsute. The demographic, metabolic, hormonal characteristics, risk factors of cardiovascular disease, CIMT (carotis intima media thickness) and FMD (flow-mediated dilatation) were compared between hirsute women and those in the control group. A prospective case-control study was performed., Results: There was no statistically significant difference in CIMT (0,50±0,08 vs 0,52±0,08, p=0.38) and FMD (10,80±6,83 vs 9,57±6,52, p=0.34) values between the study and control groups, respectively. There was no statistically significant correleation between CIMT and FMD values with age, body mass index (BMI), waist circumference, hip circumference, waist/hip ratio, CRP (C-reactive protein), total cholesterol, LDL (low density lipoprotein), HDL (high density lipoprotein), total testosteron, FAI (free androjen index), androstenedion, SHBG (sex hormone binding globuline), DHEA-S, hirsutism score, sistolic blood pressure, diastolic blood pressure, HOMA-IR (homeostatic model of assesment insuline resistance) value., Conclusion: The effect of the presence of hirsutism on either CIMT and FMD values, among young patients was not significant. Since endothelial dysfunction might became evident after a long period of physio-pathological process, our findings obtained from younger patients may not really show the impact of hirsutism on endothelial function in short term., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2016
- Full Text
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