Browsing by Author "Anil, Cuneyd"

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Biomolecular Markers for Improving Management of Follicular and Medullary Thyroid Cancer
(2014) Mousa, Umut; Anil, Cuneyd; Isildak, Serife Mehlika; Gursoy, Alptekin; Carpi, Angelo; https://orcid.org/0000-0002-8078-9376; https://orcid.org/0000-0003-3802-9733; https://orcid.org/0000-0002-2602-1657; I-1735-2018; AAA-4216-2021
Thyroid cancer usually presents as a thyroid nodule. According to different reports, more than 95% of thyroid nodules are benign. The gold standard for preoperative diagnosis of thyroid cancer is fine-needle aspiration cytology (FNAC). Especially in diagnosing medullary thyroid carcinoma (MTC) and some cases of well-differentiated thyroid carcinomas, biomolecular markers are proposed to increase the diagnostic value of FNAC. In this chapter, we mainly focused on classification, genetics, use of biomolecular and invasive markers, as well as treatment of follicular thyroid cancer (FTC) and MTC. In the case of FTC, some molecular and immunohistochemical markers are proposed and are currently under investigation principally for improving preoperative diagnosis. Unlike MTC, there is no powerful biomarker such as calcitonin (Ct) for FTC diagnosis. In the follow-up, serum thyroglobulin (Tg) and whole-body iodine-131 scintigraphy are effective. MTC has relatively poor prognosis. Postsurgical therapy is scarcely effective. Blood Ct is the best studied and preferred marker in the diagnosis and follow-up of MTC. It can be measured in the basal state or after provocative stimuli such as pentagastrin and high-dose calcium. Carcinoembryonic antigen (CEA) and chromogranin A (CgA) are the other markers currently used for selected cases. Ct and CEA doubling times are gaining importance for the prognosis of MTC. The importance of rearranged during transfection (RET) proto-oncogene screening in MTC is also discussed in this chapter. RET has also become a therapeutic target. In conclusion, the management of FTC and MTC includes diagnostic and therapeutic problems. However, thanks to the development of translational medicine, the biomolecular marker studies are improving FTC and MTC diagnosis, prognosis, and therapy.
Comment on "Metformin Decreases Thyroid Volume and Nodule Size in Subjects with Insulin Resistance: A Preliminary Study"
(2017) Nar, Asli; Anil, Cuneyd; Kut, Altug; Atesagaoglu, Berna; Tutuncu, Neslihan Bascil; Gursoy, Alptekin; 0000-0002-1816-3903; 0000-0003-0998-8388; 0000-0003-3534-2628; 0000-0003-2730-7144; 0000-0003-3802-9733; 27802445; ABG-5027-2020; AAA-2743-2021; W-2366-2017
Do Statins Affect Thyroid Volume and Nodule Size in Patients with Hyperlipidemia in a Region with Mild-to-Moderate Iodine Deficiency? A Prospective Study
(2018) Bozkus, Yusuf; Demir, Canan; Anil, Cuneyd; Mousa, Umut; Kut, Altug; Nar, Asli; Tutuncu, Neslihan B.; 0000-0002-6976-6659; 0000-0003-0998-8388; 0000-0002-8078-9376; 0000-0002-1816-3903; 0000-0003-3802-9733; 0000-0003-0776-8349; 29402848; AAA-5419-2021; AAA-2743-2021; I-1735-2018; AAK-4857-2021; ABG-5027-2020; A-2550-2015
Objective: The objective of this study was to assess the anti-proliferative pleiotropic effects of statins on thyroid function, volume, and nodularity. Subjects and Methods: One hundred and six hyperlipidemic patients were included in this prospective study. The 69 patients in the statin groups received atorvastatin (16 received 10 mg and 18 received 20 mg) or rosuvastatin (20 received 10 mg and 15 received 20 mg). The 37 patients in the control group, assessed as not requiring drugs, made only lifestyle changes. Upon admission and after 6 months, all patients were evaluated by ultrasonography as well as for lipid variables (total cholesterol, high-and low-density lipoprotein cholesterol, and triglycerides) and thyroid function and structure. Results: After 6 months, no differences in thyroid function, thyroid volume, the number of thyroid nodules, or nodule size were observed in the statin and control groups. In a subgroup analysis, total thyroid volume had decreased more in patients receiving 20 mg of rosuvastatin than that in the control group (p < 0.05). Maximum nodule size had decreased more in those receiving 10 mg of rosuvastatin (p < 0.05). Conclusions: Our results suggest an association between rosuvastatin treatment and smaller thyroid volume and maximum nodule diameter; this could be attributable to the antiproliferative effects of statin therapy on the thyroid. (C) 2018 The Author(s) Published by S. Karger AG, Basel
The effect of iatrogenic subclinical hyperthyroidism on anxiety, depression and quality of life in differentiated thyroid carcinoma
(2020) Gulsoy Kirnap, Nazli; Turhan Iyidir, Ozlem; Bozkus, Yusuf; Isildak, Serife Mehlika; Anil, Cuneyd; Firat, Sevde Nur; Demir, Canan; Nar, Asli; Bascil, Tutuncu Neslihan; 0000-0003-0998-8388; 0000-0001-5305-6807; 0000-0003-3802-9733; 0000-0002-1816-3903; 32490648; K-7904-2019
Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subclinical hyperthyroidism (SCH) are limited. Subclinical hyperthyroidism induction by administering L-Thyroxine (LT4) is the standard treatment method in differentiated thyroid carcinoma (DTC) follow-up. Our aim was to investigate whether anxiety, depression and quality of life are affected in DTC patients followed-up with exogenous SCH. Materials and methods: The patients were divided into exogenous SCH by LT4-DTC (n = 127), euthyroid-DTC (n = 66) and exogenous euthyroid-benign thyroid nodutile (BTN) who underwent thyroidectomy for benign thyroid pathology (n = 85) groups. Results: The rate of moderate/severe anxiety was significantly higher in SCH-DTC than euthyroid-BTN group (27.5%, n = 35 vs. 9.4%, n = 8) (P = 0.001). TSH levels and Beck anxiety inventory (BAI) scores were significantly negatively correlated(P = 0.009 r = -0.16). Free T4 and BAI were significantly positively correlated (P = 0.04 r = 0.4). The groups were similar in terms of depression severity (P = 0.15). Subclinical hyperthyroid-DTC group scored significantly lowerthan euthyroid-BTN group in all scales of SF-36 quality of life survey. Conclusion: LT4-induced SCH, which is a part of traditional DTC treatment, can exacerbate the anxiety symptoms in patients and disrupt their quality of life, depending on the level of fT4.
Effect of weight loss diets on biochemical parameters and anthropometric measurements in prolactinoma patients
(2019) Yesil, Esen; Kiziltan, Gul; Anil, Cuneyd; Ok, Mehtap Akcil; Bayraktar, Nilufer; AAZ-8170-2020
Background: The aims of this study were to determine the effect of weight loss on biochemical parameters and anthropometric measurements in prolactinoma patients and to evaluate the effectiveness of weight loss diet along with medical treatment. Methods: Twenty-two patients with prolactinoma were divided into two groups and one of the groups was applied weight loss diet (diet group) while the other group was diet free (control group). Each participant was interviewed using a structured questionnaire. The biochemical parameters (fasting plasma glucose, fasting plasma insulin, prolactin, leptin, TSH, T4, cortisol, HbA1c, AST, ALT and blood lipids) of participants were analyzed and anthropometric measurements were taken. Results: There was a significant change in mean BMI after treatment in diet group (p=0.000). The mean level of serum prolactin decreased from 45.1 +/- 31.63 ng/dL at baseline to 12.6 +/- 8.19 ng/dL after three months in diet group (p=0.006). Despite there being no statistically significant difference between diet and control group in terms of baseline level of prolactin measurement (p=0.800), statistically significant difference between the two groups in terms of final level of prolactin measurement (p=0.027) was observed. There was a significant change in mean level of leptin after treatment in diet group (p=0.001). Conclusions: In addition to medical treatment, weight loss diets sped up the healing process for hyperprolactinemia and the reduction in body weight had positive effects on the metabolic profiles of prolactinoma patients.
The effects of hyperinsulinemia on cochlear functions
(2020) Koca, Arzu Or; Koca, Huseyin Samet; Anil, Cuneyd; 33402607
Context: Hyperinsulinemia is the most common metabolic change associated with cochleovestibular diseases. Aim: We aimed to investigate the auditory functions in hyperinsulinemic individuals. Settings and Design: A total of 164 patients were included in this case-control study. While 76 patients with insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR] of >= 2.5) constituted the case group, 88 patients with HOMA-IR values of <2.5 constituted the control group of the study. Material and Methods: The 75 g oral glucose tolerance test, blood biochemistry tests, hormonal analysis, audiological assessment, electrocochleography (EcochG), and transient evoked otoacoustic emissions (TEOAE) testing were performed. Statistical Analysis: One-way analysis of variance and Kruskal-Wallis analysis of variance were used for the comparison of the metabolic and ear parameters in the normal glucose tolerance (NGT), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) groups. The chi-square test was used to compare nominal variables. Spearman and Pearson correlation coefficients were used for the correlation analyses of continuous variables. Results: The pure tone audiometry at 0.5, 1, 2, and 4 kHz was better in the case group than in the control group. A positive correlation was found between HbA1c and right ear 0.5, 1, 4, and 8 kHz threshold values and left ear 2, 4, 6, and 8 kHz threshold values. A negative correlation was found between HbA1c and speech discrimination scores. The right ear 1.00 and 2.83 kHz TEOAE measurements in the individuals with NGT were found higher than those in patients with IGT, and the 1.42 kHz TEOAE measurements and reproducibility were found higher than those in patients with IFG. The left ear 1.00 and 1.42 kHz TEOAE measurements of the IGT patients were found lower than those of IFG and NGT patients. Conclusion: We showed that hearing was worsening in hyperinsulinemic patients and prediabetic conditions were related to hearing function impairment.
Metformin Decreases Thyroid Volume and Nodule Size in Subjects with Insulin Resistance: A Preliminary Study
(2016) Anil, Cuneyd; Kut, Altug; Atesagaoglu, Berna; Nar, Asli; Tutuncu, Neslihan Bascil; Gursoy, Alptekin; 26618447
Objective: The aim of this study was to investigate the effects of metformin on thyroid volume and nodule size. Subjects and Methods: Prospective data were gathered on 100 newly diagnosed subjects with insulin resistance (68 female, 32 male) between August 2008 and May 2010. Each subject followed a standard diet and exercise program, and received 1,700 mg/day of metformin therapy for 6 months. The height, weight, waist circumference (WC) and thyroid hormone levels of each subject were measured. Additionally, the dimensions of the thyroid lobes and maximum diameter of each thyroid nodule were determined by ultrasonography. BMI and thyroid volumes were also calculated. Insulin resistance was estimated by homeostasis model assessment. All these parameters were measured at the beginning and at the end of the treatment period. Results: BMI and WC decreased significantly after metformin therapy (34.5 +/- 5.1 vs. 32.7 +/- 4.8, p < 0.0001, and 106.3 +/- 11.8 vs. 101.8 +/- 19.0 cm, p = 0.008, respectively). Insulin resistance also decreased after metformin therapy (4.5 +/- 1.9 vs. 2.9 +/- 1.7, p < 0.0001). The mean thyroid volume (22.5 +/- 11.2 vs. 20.3 +/- 10.4 ml, p < 0.0001) and mean thyroid nodule size (12.9 +/- 7.6 vs. 11.7 +/- 7.2 mm, p < 0.0001) also decreased after treatment. Conclusion: In subjects with insulin resistance, metformin therapy significantly decreased thyroid volume and nodule size. (C) 2015 S. Karger AG, Basel
The Relationship Between Thyroid Volume and Malignant Thyroid Disease
(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Altundag, Ozden; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; https://orcid.org/0000-0003-3802-9733; https://orcid.org/0000-0003-0998-8388; https://orcid.org/0000-0003-0197-6622; https://orcid.org/0000-0002-1816-3903; 24338169; AAA-2743-2021; W-9219-2019; ABG-5027-2020
The present retrospective study aimed to investigate the relationship between thyroid volume and prevalence of thyroid cancer. We investigated the data of 3,850 patients who underwent fine-needle aspiration biopsy (FNAB). Biopsy results were evaluated as diagnostic or nondiagnostic, and diagnostic results were classified as benign, malignant, and indeterminate. We included 2,672 patients who underwent FNAB firstly in our hospital and evaluated as diagnostic biopsy except subgroup of indeterminate. We obtained cytologic data, levels of serum thyroid-stimulating hormone (TSH), and thyroid volumes of those patients retrospectively. Among 2,672 patients with thyroid nodule, 2,562 (95.9 %) patients had benign cytology and 110 (%4,1) patients had malignant cytology. There was no correlation between the malignancy and gender (p = 0.935), and patients with malignant cytology were younger (52 vs 59, p < 0.001). Also, TSH levels were higher in patients with malignant than benign cytology (p = 0.017). Median volume of right part, left part, and total thyroid for patients who had malignant cytology was significantly lower than patients who had benign cytology (8.3, 7.1, 15.9 vs 10.8 ml, 9.0 mml, 20.6 ml, respectively, p <= 0.001 for all parameters). The results demonstrated that thyroid cancer prevalence was higher in patients with low thyroid volume. According to our results, thyroid volume should be considered as a risk factor for malignancy in the evaluation of thyroid nodules.
Sympathetic skin responses and electromyographic reaction times in chronic autoimmune thyroiditis: An overlooked electrodiagnostic study
(2022) Yemisci, Oya Umit; Ozen, Selin; Sisman, Tubanur Ozturk; Anil, Cuneyd; Cosar, Sacide Nur Saracgil; 0000-0002-0501-5127; 0000-0001-8306-463X; 35949958; AAJ-8820-2021; AAF-1085-2021
Objectives: This study aims to evaluate peripheral nerve functions, sympathetic skin responses (SSRs), and electromyographic (EMG) reaction times in hypothyroid patients and to compare them to healthy individuals. Patients and methods: Between January 2007 and September 2007, a total of 54 patients with Hashimoto's thyroiditis including 35 euthyroid (3 males, 32 females; mean age: 45.2 +/- 10.2 years; range, 35 to 60 years) and 19 with subclinical hypothyroidism (2 males, 17 females; mean age: 43.2 +/- 12.6 years; range, 40 to 65 years) were included in the study. The control group consisted of 35 healthy individuals (5 males, 30 females; mean age: 39.1 +/- 9.3 years; range, 29 to 52 years). Nerve conduction studies (NCSs), SSRs of the hand and foot obtained by stimulation of the contralateral median nerve, and EMG reaction times of the extensor indicis proprius muscle were performed in all subjects. Results: There was no significant difference in peripheral NCSs and SSRs between patients and the control group. However, reaction times were longer in the AIT patients compared to the healthy individuals suggesting alterations in cognitive function related to the primary disease process in AIT. Conclusion: Electrodiagnosis of autonomic nervous system involvement and cognitive impairment can be challenging in AIT. However, EMG reaction times and SSRs are practical and useful tools that are often overlooked. On the other hand, SSRs may be combined with more quantitative tests, such as sudomotor axon reflex testing, to allow us to better determine the extent of involvement of the autonomic nervous system in AIT.
Thyroid Nodules Are More Prevalent in Subjects with Colon Polyps, Independent of Insulin Resistance
(2019) Mousa, Umut; Anil, Cuneyd; Demir, Canan Cicek; Bozkus, Yusuf; Ozturk, Kubra; Tutuncu, Neslihan Bascil; Gursoy, Alptekin; 30861528
Objective: Colorectal polyps and thyroid nodules are common disorders linked to hyperinsulinemia and metabolic syndrome (Mets). The direct association between these two diseases is not clear. We aimed to analyze the prevalence of thyroid nodules in subjects with and without colorectal polyps. The secondary aim was to establish the prevalence of Mets and its parameters in both disorders and to determine if insulin resistance and hyperinsulinemia are common underlying pathophysiological mechanisms. Subjects and Methods: One hundred and five subjects with colorectal polyps (71 males, 34 females) and 68 controls (28 males, 40 females) were enrolled. The parameters of Mets together with TSH, insulin, low-density lipoprotein cholesterol, and homeostasis model for assessment of insulin resistance levels were calculated. We performed thyroid ultrasonography in all participants. Results: The prevalence of Mets was similar in the colorectal polyp and control groups (37.1 vs. 37.3%, p = 0.982). The prevalence of Mets was nonsignificantly higher in subjects with a documented thyroid nodule compared to subjects without a thyroid nodule (43.0 vs. 32.6%, p = 0.205). The prevalence of thyroid nodules in subjects with colorectal polyps was significantly higher than in subjects without polyps (52.9 vs. 35.3%, p = 0.017). Compared to subjects with no colorectal polyps, we established a significant increase in the odds of having thyroid nodules (OR 2.05; 95% CI: 1.097-3.860, p = 0.017). The presence of colorectal polyps and age in the adjusted model were established to be independent risk factors for having thyroid nodules (p = 0.025 and p = 0.007, respectively). Conclusion: These results may support the presence of other common mechanisms in the development of these two pathologies other than insulin resistance and hyperinsulinemia. (C) 2019 The Author(s) Published by S. Karger AG, Basel
Thyroid volume in patients with glucose metabolism disorders
(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; 25465604
Objective: Thyroid volume and the prevalence of thyroid nodules are higher in patients with insulin resistance. A relationship between thyroid volume and glucose metabolism disorders (GMD) has not as yet been clarified. The present retrospective study aimed to investigate the association between GMD and thyroid volume. Subjects and methods: We investigated the data of 2,630 patients who were evaluated for thyroid biopsy in our hospital. The study population included 602 patients with GMD, 554 patients with diabetes mellitus (DM) and 1,474 patients with normal glucose metabolism as a control group. We obtained the levels of serum thyroid stimulating hormone (TSH) and the thyroid volumes of those patients retrospectively. Results: The median ages for the control group, GMD group and DM group were 55 (15-91) years, 60 (27-97) years, and 65 (27-91) years respectively and there was a statistically significant difference between the groups with regard to age and gender (p < 0.001). Levels of TSH were similar in all groups. The median total thyroid volumes for patients with DM and GMD were significantly higher than that of the control group [22.5 (3-202) mL, 20.2 (4-190) mL, and 19.2 (3-168) mL respectively, p <= 0.001 for all parameters]. Also the median total thyroid volume for patients with DM was significantly higher than that of the GMD group (p < 0.001). According to the correlation analysis, thyroid volume was significantly correlated with age (r = 0.92, p < 0.001) and TSH (r = 0.435, p < 0.001). Age, gender, TSH levels, GMD and DM diagnosis were independently correlated with thyroid volume. Conclusion: The thyroid gland is one of the target tissues of metabolic disorders. We reported a positive correlation between GMD/type 2 DM and thyroid volume. Further controlled, prospective, randomized studies on this subject are required to gain more information.