Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Plasma fetuin-A levels are reduced in patients with hypothyroidism(2014) Bakiner, Okan; Bozkirli, Emre; Ertugrul, Derun; Sezgin, Nurzen; Ertorer, EdaObjective: To determine plasma fetuin-A levels in hypothyroid patients before and after treatment with L-thyroxine (T-4) and to determine the relation between plasma fetuin-A levels with cardiovascular risk factors. Design: A prospective, controlled, single-blind study. Methods: Forty-four treatment-naive female patients diagnosed with hypothyroidism and 39 age-and sex-matched control subjects were enrolled. Anthropometric measurements, blood pressure, plasma TSH, fetuin-A, free T-4, LDL-cholesterol, triglyceride, C-reactive protein, fibrinogen levels, and brachial artery flow-mediated dilatation were measured. All measurements were repeated after 3 months in the control group and 3 months after the attainment of euthyroidism with (L)-T4 replacement in the hypothyroid group. Baseline data were compared between the two groups. Posttreatment plasma fetuin-A levels of hypothyroid patients were compared with baseline levels of both groups. The relationship between plasma fetuin-A, TSH levels, and other cardiovascular risk factors was evaluated. Results: Plasma fetuin-A levels were similar to 20% lower in hypothyroid female patients compared with the controls (P=0.0001). Fetuin-A levels increased by similar to 20% in hypothyroid patients after achievement of euthyroidism (P=0.0001) and were no longer different compared with controls (P=0.38). There was a negative correlation between plasma TSH and fetuin-A levels (r=-0.79; P=0.001). There was no significant correlation between plasma fetuin-A levels and cardiovascular risk factors within or between groups. The fetuin-A levels were normalized with thyroid hormone treatment. Conclusion: Plasma fetuin-A levels are reduced in female patients with hypothyroidism, which are restored to normal during restoration of euthyroidism. There was no relation with cardiovascular risk factors.Item Plasma fetuin-A levels are reduced in patients with hypothyroidism (vol 170, pg 411, 2014)(2014) Bakiner, Okan; Bozkirli, Emre; Ertugrul, Derun; Sezgin, Nurzen; Ertorer, EdaItem Insulin Resistance in Non-Obese Polycystic Ovary Syndrome Subjects and Relation with Family History of Diabetes Mellitus(2015) Bozkirli, Emre; Bakiner, Okan; Ertorer, Eda; Anaforoglu, Inan; Tutuncu, Neslihan Basil; Demirag, Nilgun GuvenerPurpose: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women in reproductive age. Conflicting results are reported in the studies examining insulin resistance in lean PCOS subjects. We aimed to observe the controversial presence of insulin resistance in lean PCOS subjects with the gold standard method and assess the impacts of family history of type 2 diabetes mellitus (T2DM) on insulin resistance in these patients. Material and Method: Nineteen patients with PCOS and nine age-BMI matched control subjects were recruited into the study. Patients with PCOS were divided into two groups according to their FH of T2DM among their first degree relatives (FHneg vs FHpos). Insulin resistance was evaluated with homeostasis model assessment of insulin resistance (HOMA-IR) and hyperinsulinemic euglycemic clamp technique for all participants. Results: Mean M values were significantly higher in the control group when compared with PCOS patients (p=0.003). There was no statistically significant difference for HOMA-IR and M values when FHneg and FHpos patients were compared. Although HOMA-IR values were similar between all groups, M values were lower in FHneg and FHpos groups compared to the controls (p=0.02 and 0.004 respectively). Discussion: Lean PCOS patients have evident insulin resistance when compared to healthy subjects, and FH of T2DM seems to not affect insulin resistance. Even non-obese PCOS patients should be encouraged for healthy eating style and exercise to prevent the potential risks associated with insulin resistance. Furthermore these patients can see benefits from medical therapies which improve insulin sensitivity.Item Low Prevalence of Periodontitis in Acromegaly: Growth Hormone May Exert a Protective Effect(2015) Serinoz, Hulya; Ertorer, Melek Eda; Bascil, Sibel; Bakiner, Okan; Bozkirli, Emre; Tutuncu, Neslihan B.Purpose: To evaluate bone mineral density (BMD) measurements and the presence of periodontitis in patients with acromegaly, as well as to inquire the impact of interfering factors. Material and Method: Forty-seven acromegalic patients with any accompanying condition known to affect calcium-bone metabolism and 60 age-matched healthy controls were included. Age, gender, duration and activity of acromegaly, past-present therapy options, pituitary hormone profiles, replacement therapies, and the results of periodontal analysis were recorded. Results: Eighteen patients were male (38.3%), 29 were female (61.7%). The mean age of the patients was 46.6 +/- 11.5 years, twenty-five (53.1%) had active, 22 (46.8%) had inactive acromegaly. The latter were older and had longer disease duration (p=0.04, p=0.003, respectively). Serum calcium and phosphorus levels, 24-hour urinary calcium excretion and BMD at the lumbar spine and femur neck insignificantly associated with disease activity (p>0.05). Osteoporosis was detected in 6 patients (12.76%). Periodontitis and advanced periodontitis were more common in control group (66.7% vs. 44.7%), (43.3% vs. 12.8%) (p=0.022, p=0.0001, respectively). There was no difference in chronic periodontitis and severity between active and inactive groups (48% vs. 40.9%; p=0.279). No difference was noted in other study parameters, as well. Repeated measures analysis of variance demonstrated statistically insignificant distribution between GH change in time and periodontitis subgroups. Discussion: We demonstrated that acromegaly exerted no clear negative impact on vertebral BMD in the absence of overt hypogonadism. Regardless of disease activity, acromegaly cases exhibited lower rates of periodontitis with less severity which remained unchanged in the presence of accompanying metabolic disorders known to have negative impact on periodontal tissue. Chronic exposure to excess GH may have a protective role against periodontitis.Item Postprandial Hypoglycemia: An Unusual Presentation for Insulinoma(2016) Haydardedeoglu, Filiz Eksi; Torun, Ayse Nur Izol; Andic, Cagatay; Bakiner, Okan; Bozkirli, Emre; kayaselcuk, Fazilet; Ertorer, Melek EdaInsulinoma is the most common type of islet cell tumor of the pancreas and its incidence is estimated at four per one million persons per year. Although fasting hypoglycemia is the typical presentation, cases with postprandial hypoglycemia have rarely been reported. A 48-year-old woman was admitted to our department for evaluation of hypoglycemia. Laboratory data suggested a state of postprandial endogenous hyperinsulinemic hypoglycemia. Abdominal computed tomography revealed a mass lesion measuring 20 mm at the distal pancreas. A decision was made to perform an arterial calcium-stimulated venous sampling for excluding nesidioblastosis coexisting with a pancreatic incidental mass. After that the patient was referred to surgery. Pathological examination revealed a low-grade well-differentiated neuroendocrine tumor with regional lymph node metastasis. Herein, we report a case of malignant insulinoma presenting with postprandial hypoglycemia and discuss the differential diagnosis and possible mechanisms of postprandial hypoglycemia in insulinoma cases.