Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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2016 - 20183

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Author: search.filters.author.Bascil Tutuncu, Neslihansearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccess

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    Effects of Short Term Mild L-Thyroxine Suppression Therapy on Myocardial Functions, and Its Assessment with Tissue Doppler Imaging
    (2016) Bozkus, Yusuf; Sunger, Ahmet; Yildirir, Aylin; Bascil Tutuncu, Neslihan; 0000-0001-8750-5287; 0000-0002-6976-6659; 0000-0002-1816-3903; 25389951; A-4947-2018; AAA-5419-2021; ABG-5027-2020
    BACKGROUND: While adverse effects of overt hyperthyroidism on the cardiovascular system are well-known, the effects of subclinical hyperthyroidism are not clear. The aim of the study was to investigate the effects of short term mild L-thyroxine (LT4) suppression therapy on myocardial functions in a group of premenopausal women with goiter, by using echocardiographic methods and tissue Doppler imaging (TDI). METHODS: Sixteen participants with goiter received LT4 suppression therapy to keep TSH levels between 0.1-0.4 mu IU/mL. After baseline and 1st month assessment, 6-weeks follow-up were scheduled until 6th month assessment to adjust the medication dose during study period. All TSH levels decreased below 0.4 mu IU/mL by the end of first month and stayed below this level throughout study period. At the beginning of the study and at month 6, the thyroid ultrasonography, Holter monitorization test, stress test, electrocardiograms and echocardiograms of participants were assessed. This was followed by a comparison of baseline and 6th month data. RESULTS: Baseline and 6th month 2-D echocardiography measurements of participants revealed that mean left ventricle diameter in diastole (4.1 +/- 0.3 vs 3.8c0.2 mm) and posterior wall thickness in diastole (0.9 +/- 0.1 vs. 0.8 +/- 0.1 mm) decreased (P<0.05); while stroke volume (41.9 +/- 9.9 vs. 48 +/- 8.2), stroke volume index (25.6 +/- 5.4 vs. 29.4 +/- 4.7), cardiac output (3.5 +/- 1.4 vs. 3.9 +/- 0.9) and cardiac index (2.2 +/- 0.8 vs. 2.4 +/- 0.5) increased (P<0.05). Other 2D echocardiography parameters did not change significantly. The pulse wave Doppler examination, stress test and Holier monitorization of participants did not reveal any difference between baseline and 6th month measurements. No statistically significant difference was observed in measurements of TDI except decreased septum S velocity. CONCLUSIONS: Short term mild LT4 suppression treatment did not cause systolic or diastolic dysfunction, or conduction defect in the heart; therefore may be safe in premenopausal females with not known cardiac disease.
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    Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Study)
    (2018) Bascil Tutuncu, Neslihan; Bozkirli, Emre; 0000-0002-1816-3903; 0000-0002-1644-6790; 30244051; ABG-5027-2020; E-9887-2014
    Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. (C) 2018 Elsevier B.V. All rights reserved.
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    Turkish Nationwide Survey Of Glycemic And Other Metabolic Parameters Of Patients With Diabetes Mellitus (Temd Study)
    (2018) Bascil Tutuncu, Neslihan; Bozkirli, Emre; https://orcid.org/0000-0002-1644-6790; 30244051; E-9887-2014
    Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. (C) 2018 Elsevier B.V. All rights reserved.