Tıp Fakültesi / Faculty of Medicine

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

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2014 - 20194

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Subject: search.filters.subject.Insulin resistance

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    Effects of Infliximab Treatment in Terms of Cardiovascular Risk and Insulin Resistance in Ankylosing Spondylitis Patients
    (2014) Bozkirli, Emine Duygu Ersozlu; Bozkirli, Emre; Yucel, Ahmet Eftal; https://orcid.org/0000-0002-4860-9072; 24252046; E-9887-2014
    Objective. To assess the effects of infliximab treatment on insulin sensitivity and cardiovascular risk factors in patients with ankylosing spondylitis (AS). Methods. In this prospective study, 30 consecutive AS patients (23 men and 7 women) fulfilling the modified 1984 New York criteria for AS were investigated. All patients were treated with intravenous infliximab. A complete biochemical profile and assesments were obtained before and after 12 weeks of infliximab therapy. The Homoeostasis Model Assessment of Insulin Resistance Index (HOMA-IR) was used to measure insulin resistance (IR). Framingham equation was used to assess cardiovascular risk factors. Results. After 12 weeks of infliximab treatment, there was no statistically significant difference in fasting insulin, HOMA-IR, lipid parameters, body-mass index, waist circumference and waist hip ratio, whereas fasting glucose levels (p = 0.001), triglycerides/high-density lipoprotein (HDL) ratio (p = 0.043) and total cholesterol/HDL (p = 0.041) ratio increased significantly from baseline. A significant decrease was observed for both systolic blood pressures (p < 0.001) and diastolic blood pressures (p = 0.003) in the 12th-week visit. A significant decrease was also found in terms of Framingham risk scores (p = 0.028) after treatment. Conclusions. Study results suggest that infliximab treatment may reduce cardiovascular risk and blood pressures without changing IR.
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    ABDOMINAL BIOELECTRIC IMPEDANCE FOR FOLLOW-UP OF DIETERS: A PROSPECTIVE STUDY
    (2019) Bozkus, Y.; Mousa, U.; Demir, C. C.; Anil, C.; Kut, A.; Iyidir, O. Turhan; Kirnap, N. Gulsoy; Firat, S.; Nar, A.; Tutuncu, N. B.; 0000-0002-1816-3903; 31508169; ABG-5027-2020; K-7904-2019
    Context. Visceral adipose tissue (VAT) is a strong predictor of carbohydrate metabolism disorders. Abdominal bioelectrical impedance analysis (A-BIA) is a simple method for the measurement of VAT and is a promising tool in screening and follow-up of abdominal obesity. However the role of A-BIA in dieting individuals has not been evaluated adequately in longitudinal follow-up studies. Objective. The aim of this study is to determine the role of A-BIA in identifying the changes in metabolic predictors after diet and/or exercise therapy. Design. All patients who sought weight loss treatment underwent baseline assessment and were prescribed a program of diet. After a mean follow-up of 3.2 months, data were analyzed. Subjects and Methods. Ultimately, 103 participants who reported adhering to the diet, enrolled to the study. We tested associations between changes in body composition measures and changes in laboratory measures using correlations and multivariate linear regression analysis. Results. Mean loss of body weight was 3.4 +/- 2.8 kg. All but waist-to-hip ratio, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels changed significantly (p<0.001). Decreases in body weight, body mass index (BMI), and VAT level significantly correlated with decreases in fasting blood glucose, fasting insulin level, and HOMA-IR score (r=0.230-0.371). In multiple linear regression analysis changes in BMI and VAT significantly correlated with change in HOMA-IR score (F(7.93)=2.283, p=0.034, R2=0.147). Conclusion. Decreases in BMI and VAT, as determined by A-BIA, were predictors of changes in metabolic laboratory measures. A-BIA is useful for follow-up of patients receiving diet therapy for weight loss.
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    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
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    Insulin, Glucagon and Growth Hormone and CIMT in Glucose Intolerance
    (2017) İyidir, Ozlem Turhan; Demir, Ozgur; Emral, Rifat; 0000-0001-5305-6807; K-7904-2019
    Objective: There is an increasing evidence that glucagon and growth hormone (GH)-insulin-like growth factor (IGF) axis may play an important role in glucose metabolism since early stages of glucose intolerance. Carotid intima media thickness is a marker for subclinical atherosclerosis. We aimed to evaluate glucagon, GH and IGF-1 in prediabetic states and their relationship with carotid intima media thickness. Methods: One hundred subjects underwent a 75 gr oral glucose tolerance test and were divided into 4 groups according to their state of glucose tolerance: (i) normal glucose tolerance (NGT)/Controls (n=21), (ii) impaired glucose tolerance (IGT) (n=35), (iii) impaired fasting glucose (IFG) (n=22), (iv) type 2 diabetes mellitus (n=22). Insulin, glucagon and GH were measured at 0, 60 and 120. minutes of OGTT and their area under the curve (AUC) were calculated. Fasting IGF-1 levels and carotid intima media thickness were determined in all participants. Results: AUC for Glucagon was significantly higher in subjects with IGT, IFG and type 2 diabetes mellitus compared to NGT subjects. AUC for GH was significantly higher in subjects with IFG compared to subjects with IGT, type 2 diabetes mellitus and NGT. Plasma IGF-1 levels were significantly lower in subjects with abnormal glucose tolerance. CIMT was significantly higher in IFG group and CIMT was found to be negatively correlated with IGF-1 levels in subjects with IFG. Conclusion: There are pathological alterations of glucagon, GH-IGF-1 and insulin in prediabetic stages. Among these alterations insulin resistance and IGF-1 are associated with CIMT. Further studies needed to investigate the role of treatments targeting insulin sensitivity will have an impact on the association between insulin and early atherogenesis