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Öğe Arterial Stiffness, Carotid Intima-Media Thickness, Endocan, and A Disintegrin and Metalloproteinase With Thrombospondin Type I Motif 9 Levels and Their Relationship With Disease Activity in Patients With Acromegaly With and Without Cardiovascular Risk Factors(Elsevier Inc, 2022) Can, Mustafa; Kocabas, Muhammet; Karakose, Melia; Yerlikaya, Fatma Humeyra; Alsancak, Yakup; Turkmen, Kultigin; Kulaksizoglu, MustafaObjective: Cardiovascular complications such as cardiomyopathy and endothelial dysfunction, which are frequently seen in patients with acromegaly, are among the most important causes of morbidity and mortality. In this study, we aimed to investigate arterial stiffness, carotid intima-media thickness, endocan level, and A disintegrin and metalloproteinase with thrombospondin type I motif 9 level and their relationship with disease activity in patients with acromegaly with and without cardiovascular risk factors. Methods: A total of 60 patients with acromegaly-25 with active disease, 26 with well-controlled disease, and 9 with newly diagnosed disease-and 60 age-, sex-, and body mass index (BMI)-matched healthy control subjects were enrolled in this study. All the subjects' height, weight, BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG) level, insulin, hemoglobin A1C (HbA1C), C-reactive protein, lipid, endocan, A disintegrin and metalloproteinase with thrombospondin type I motif 9 levels, pulse wave velocity (PWV), and carotid intima-media thickness were measured. Results: The SBP, DBP, FPG level, HbA1C level, and PWV of the acromegaly group were higher than those of the control group. In patients with acromegaly with cardiovascular disease (CVD) risk factors, the PWV was higher than that in the control group, and in patients with acromegaly without CVD risk factors, the PWV was similar to that in the control group. In a correlation analysis, a positive correlation was found between PWV and age, BMI, SBP, DBP, FPG level, and HbA1C level in the acromegaly group. Conclusion: In our study, we found that arterial stiffness increased in patients with acromegaly with CVD risk factors and that increased arterial stiffness was associated with hemodynamic (SBP and DBP) and metabolic (BMI, FPG level, and HbA1C level) parameters. (c) 2021 AACE. Published by Elsevier Inc. All rights reserved.Öğe Evaluation of subclinical cardiovascular disease by carotid intima media thickness, epicardial adipose tissue thickness, serum endocan, and nesfatin-1 levels in patients with primary hyperparathyroidism(Tubitak Scientific & Technological Research Council Turkey, 2022) Kocabas, Muhammet; Alsancak, Yakup; Can, Mustafa; Cordan, Ilker; Burgucu, Hatice Caliskan; Karakose, Melia; Yerlikaya, Fatma HumeyraBackground/aim: Data on the presence and extent of cardiovascular disease (CVD) risk in primary hyperparathyroidism (PHPT) are conflicting. In our study, we aimed to investigate the increased CVD risk in patients with PHPT by carotid intima-media thickness (CIMT), epicardial adipose tissue (EAT) thickness, and serum levels of endocan and nesfatin-1. Materials and methods: Patients with PHPT (n = 44) and age- and sex-matched healthy control subjects (n = 40) were enrolled in this study. Demographic data of the participants were questioned. Serum endocan and nesfatin-1 concentrations were assessed using commercially available ELISA kits. Noninvasive measurements of CIMT and EAT thickness were made with high-resolution ultrasonography and B-mode echocardiography. Results: There was no statistically significant difference in serum endocan and nesfatin-1 levels and EAT thickness in the PHPT group compared to controls. CIMT was statistically significantly higher in the PHPT group compared to controls (p = 0.001). A negative correlation was found between PTH and low-density lipoprotein cholesterol level (p = 0.001) but no significant relationship was found between other parameters. Conclusion: We found that CIMT is increased in patients with PHPT and consequently, CVD risk is high in these patients. More comprehensive studies are needed to identify other markers that predict increased CVD risk in patients with PHPT.Öğe Expression of endocan and vascular endothelial growth factor and their correlation with histopathological prognostic parameters in pheochromocytoma(Springer, 2023) Kocabas, Muhammet; Can, Mustafa; Karakose, Melia; Esen, Haci Hasan; Kulaksizoglu, Mustafa; Karakurt, FeridunObjectiveEndocan and vascular endothelial growth factor (VEGF) are markers expressed in various cancer types that are highly vascular, and they have prognostic significance for these cancers. In this study, we aimed to show the expression of endocan and VEGF in pheochromocytoma tumor tissues and to evaluate their correlations with histopathological parameters.Material and methodsThirty-eight patients who had been operated for pheochromocytoma were included in the study. As the control group, 28 subjects whose specimens contained normal adrenal medulla tissue were included. The formalin-fixed paraffin-embedded specimens of pheochromocytoma patients were evaluated for Pheochromocytoma of the Adrenal gland Scaled Score (PASS). Sections were then stained for immunohistochemical analysis. The degree of endocan and VEGF positivity was determined by the proportion of stained cells on a negative to strong scale.ResultsEndocan (p < 0.001) and VEGF (p = 0.004) expressions were found to be significantly higher in the pheochromocytoma group than in the control group. In the pheochromocytoma group, total PASS score (r = 0.714; p < 0.001) and most of the PASS score components were positively correlated with the level of endocan expression. Median Ki-67 index (p = 0.010), total PASS score (p < 0.001), tumor cell spindling (p = 0.048), and nuclear pleomorphism (p = 0.030) were higher in pheochromocytoma with VEGF expression than in those without.ConclusionIf our findings are supported by studies with a larger sample size, we think that endocan has the potential to be used both as a tumor marker and in predicting malignancy potential in patients with pheochromocytoma, and that the detection of VEGF expression in these tumors is also associated with an increase in malignancy potential.Öğe Expression of the angiogenesis markers endocan in Cushing's syndrome due to cortisol producing adenoma(Springer, 2023) Can, Mustafa; Kocabas, Muhammet; Karakose, Melia; Esen, Haci Hasan; Kulaksizoglu, Mustafa; Karakurt, FeridunPurpose In this study, we aimed to investigate the endocan expression in tissue samples of patients diagnosed with Cushing's syndrome (CS) due to Cortisol-Producing-Adenoma (CPA) and compare it with normal adrenal cortex tissue, and also to evaluate the correlations of endocan expression with clinical and histopathological features. Methods 11 patients who were operated for CS due to CPA between 2009-2021 and 14 control subjects with normal adrenal cortex were included in the study. Demographic, laboratory and clinicopathological data of the patients were recorded. Sections of 4-5 mu m thickness were taken from paraffin blocks of patients diagnosed with CS due to CPA and control subjects with normal adrenal cortex tissue. The sections were then stained in a closed system automatic immunohistochemical staining device to perform immunohistochemical analysis. The endocan positive grade were determined based on the proportion of stained cells on a scale of negative to strong. Results The number of subjects with positive endocan expression and the mean endocan expression level in the CS group were significantly higher than the control group (p = 0.005, p < 0.001, respectively). No correlation was found between endocan expression and clinical and histopathological features. Conclusion According to the results of our study, endocan overexpression in CPA tissues may be related to the hormonal functionality of CPA.Öğe HDR Syndrome Accompanying Type 1 Diabetes Mellitus and Hypopituitarism(Hindawi Ltd, 2019) Can, Mustafa; Karakurt, Feridun; Kocabas, Muhammed; Cordan, Ilker; Karakose, Melia; Kulaksizoglu, MustafaHDR (Hypoparathyroidism, Deafness, and Renal Dysplasia) syndrome is an autosomal dominant disorder characterized by the triad of hypoparathyroidism, sensorineural deafness, and renal disease. Approximately 65% of patients with HDR syndrome have all three of these features, while others have different combinations of these features. We aimed to present a case with primary hypoparathyroidism, hearing loss, and nondiabetic chronic kidney disease and diagnosed as HDR syndrome while being followed up for type 1 diabetes mellitus and hypopituitarism.Öğe Incidence of second primary malignancies in patients with thyroid cancer in the Turkish population(Tubitak Scientific & Technological Research Council Turkey, 2019) Karakose, Melia; Cordan, Ilker; Can, Mustafa; Kocabas, Muhammet; Kulaksizoglu, Mustafa; Karakurt, FeridunBackground/aim: Thyroid cancer is the most common endocrine malignancy. Recently the incidence has been increasing faster compared to other malignancies. Different studies have shown that the incidence of breast cancer in patients followed due to thyroid cancer has increased, and vice versa. The aim of this study was to evaluate the frequency of second primary cancers in the follow-up of patients with thyroid cancer. Materials and methods: In this study, 1196 patients with thyroid cancer were evaluated in the Necmettin Erbakan University Meram Medical School's Department of Endocrinology between 2004 and 2018. Demographic characteristics and radiological and pathological results of the patients were recorded. The presence of accompanying second malignancies in patients with thyroid cancer was investigated. Results: In our study, 985 (82.4%) women (mean age: 46.1 +/- 13.3 years) and 211 (17.6%) men (mean age: 49.9 +/- 14.2 years) were evaluated. The median follow-up was 63 months (2-164 months). Of the 1196 patients, 1126 (94.1%) had no additional cancer and 70 (5.9%) patients had a second malignancy. The accompanying second malignancies were breast cancer in 24 (2%) patients, skin cancer in 8 (0.7%) patients, renal cell cancer in 5 (0.4%) patients, lung cancer in 5 (0.4%) patients, colon cancer in 5 (0.4%) patients, lymphoma in 5 (0.4%) patients, endometrial cancer in 4 (0.3%) patients, and 14 cases of other rare types of cancer. Conclusion: In our study, it was found that the most common second primary malignancy in patients with thyroid cancer was breast cancer. However, other cancers (skin cancer, renal cell cancer, lymphoma, and colon, lung, or endometrial cancer) may occur in patients with thyroid cancer.Öğe Increased incidence of malignancy in patients with primary hyperparathyroidism(Tubitak Scientific & Technological Research Council Turkey, 2021) Karakose, Melia; Kocabas, Muhammet; Can, Mustafa; Caliskan Burgucu, Hatice; Cordan, Ilker; Kulaksizoglu, Mustafa; Karakurt, FeridunBackground/aim: Primary hyperparathyroidism (PHPT) is a disease that is diagnosed more frequently and generally in the asymptomatic period, with widely available biochemical tests. Evidence suggesting an association between PHPT and malignancy risk is increasing. Clarification of this association will be useful in PHPT for malignancy screening and management of patients with PHPT. In this study, we aimed to investigate the frequency of cancer in PHPT patients. Materials and methods: A total of 775 PHPT patients were included in the retrospective study. Demographic, clinical and laboratory data of the patients were evaluated retrospectively. Results: Malignancy was detected in 128 (16.50%) of 775 PHPT patients (female/male: 625/150). The mean age at diagnosis of PHPT was 57.99 +/- 10.86 years, and the mean age at diagnosis of malignancy was 57.46 +/- 11.17 years. Of the 128 patients with malignancy, 53 (41.40%) were diagnosed in the same year as PHPT. In terms of malignancy types, 51 (6.50%) of 775 PHPT patients had thyroid cancer. Thyroid cancer was followed by breast cancer (2.30%) and stomach cancer (1%) in order of frequency. Conclusion: We think that PHPT patients should be examined more carefully in terms of cancer risk, especially thyroid cancer. More comprehensive studies are needed to clarify the relationship between PHPT and cancer.Öğe Palosuran in Gentamicin-Induced Acute Kidney Injury in an Experimental Rat Model(Aves, 2022) Burgucu, Hatice Caliskan; Olukman, Murat; Coskunsever, Deniz; Sen, Sait; Sozmen, Eser Yildirim; Can, Mustafa; Duman, SonerObjective: Urotensin-II is a potent vasoconstrictor peptide and has fibrotic effects in the heart and kidneys and palosuran is a selective urotensin-II receptor antagonist. This study aimed to investigate the effects of palosuran, which has antifibrotic effects, in an acute kidney injury model formed with gentamicin and to reveal new treatment options for acute kidney injury cases. Methods: A total of 24 Wistar albino rats were randomly divided into 3 groups of 8 animals as the control group, the gentamicin group, and the gentamicin+palosuran group. The rats in the control group received a 1 x 1 mL intramuscular injection of saline for 8 days. To create acute kidney injury in the rats in the gentamicin group, an intramuscular injection of 100 mg/kg/day gentamycine was applied for 8 days. In the gentamicin + palosuran group, an intramuscular injection of 100 mg/kg/day gentamycine was applied for 8 days, together with 300 mg/kg palosuran dissolved in distilled water and administered by oral gavage twice a day for the same period. Serum urea, creatinine, calcium, albumin, total protein levels, and urine gamma-glutamyl transferase and protein levels were evaluated for all the groups. In addition, tubular degeneration, tubular necrosis, tubular regeneration, tubulointerstitial nephritis, microcalcification, and total histological scores of these groups were also examined histopathologically. Results: The urine gamma-glutamyl transferase levels of the gentamicin and gentamicin + palosuran groups were significantly higher than those of the control group (311 +/- 60.5 and 140 +/- 39.5 vs. 0.33 +/- 0.22, P <.05). On the eighth day, the gamma-glutamyl transferase levels of the gentamicin + palosuran group were significantly lower than the gentamicin group (311 +/- 60.5 vs. 140 +/- 39.5, P <.05). A significant decrease was obtained in tubular necrosis in the gentamicin + palosuran group compared to the gentamicin group (2.5 +/- 0.3 vs. 1.3 +/- 0.4, P <.05). A statistically significant decrease was determined in the total histological score in the gentamicin + palosuran group compared to the gentamicin group (6.4 +/- 0.7 vs. 4.7 +/- 0.7, P <.05). Our results showed that the urotensin-II receptor antagonist, palosuran, had positive effects on tubular necrosis, tubular degeneration, tubular regeneration, and the total histological score in an experimental acute kidney injury model formed with gentamicin. Conclusion: The study results suggest that urotensin-II may play a role in the physiopathology of acute renal failure associated with gentamicin. These results are promising for the use of palosuran in the treatment of acute kidney injury.Öğe Prevalence of comorbidities and associated factors in acromegaly patients in the Turkish population(Tubitak Scientific & Technological Research Council Turkey, 2021) Can, Mustafa; Kocabas, Muhammet; Cordan, Ilker; Caliskan Burgucu, Hatice; Karakose, Melia; Kulaksizoglu, Mustafa; Karakurt, FeridunBackground/aim: The presence of comorbidities in patients with acromegaly causes an increase in morbidity and/or mortality and a decrease in quality of life. In this study, we aimed to investigate the demographic, clinical and laboratory features, prevalence of acromegaly-related comorbidities, and factors associated with these comorbidities in patients with acromegaly. Materials and methods: In the study, 96 patients who were followed up with the diagnosis of acromegaly were included. Clinical, laboratory and imaging features, and accompanying comorbidities of the patients were recorded from the patient files. Results: Of the patients included in the study, 63 (65.6%) were female and 33 (34.4%) were male. The mean age of diagnosis was 42.61 +/- 12.08, and the mean follow-up period was 9.97 +/- 7.26 years. Median insulin-like growth factor 1 level was 238.16 ng/mL (30.5-820), median growth hormone level was 2.05 ug/L (0.1-29.4). A total of 60 (62.5%) of the patients were in the well-controlled group, and 36 (37.5%) had active disease at the time of inclusion. Diabetes mellitus (DM) was detected in 30 (31.3%) patients, prediabetes in 19 (28.8%) patients, hypertriglyceridemia in 38 (42.2%) patients, hypertension (HT) in 41 (42.7%) patients, cardiovascular disease in 5 (5.2%) patients, malignancy in 9 (9.4%) patients, obstructive sleep apnea syndrome in 8 (8.3%) patients, carpal tunnel syndrome in 11 (11.5%) patients, arthropathy in 5 (5.2%) patients, hearing loss in 7 (7.3%) patients, thyroid nodule in 56 (67.5%) patients, thyroid cancer in 4 (4.2%) patients, colonic polyp in 19 (38.8%) patients. Conclusion: In this study, we revealed that the most common comorbidities in acromegaly patients in the Turkish population are thyroid nodules, low high-density lipoprotein (HDL cholesterol (HDL-C) level, hypertriglyceridemia, HT, colonic polyps, DM, and prediabetes, and female sex and age at diagnosis are the most important factors associated with comorbidities.Öğe The Relationship between Bone Mineral Densitometry and Visceral Adiposity Index in Postmenopausal Women(Georg Thieme Verlag Kg, 2023) Elmas, Halis; Duran, Cevdet; Can, Mustafa; Tolu, Ismet; Guney, IbrahimObjective It was aimed to compare visceral adiposity index (VAI) levels in patients with normal bone mineral density (BMD), osteopenia, and osteoporosis.Methods One hundred twenty postmenopausal women (40 with normal BMD, 40 with osteopenia, and 40 with osteoporosis) between the ages of 50 to 70 years were included in the study. For females, the VAI was calculated using the formula (waist circumference [WC]/[36.58 + (1.89 x body mass index (BMI))]) x (1.52/High-density lipoprotein [HDL]-cholesterol [mmol/L]) x (triglyceride [TG]/0.81 [mmol/L]).Results The time of menopause from the beginning was similar in all groups. Waist circumference was found to be higher in those with normal BMD than in the osteopenic and osteoporotic groups ( p = 0.018 and p < 0.001, respectively), and it was also higher in the osteopenic group than in the osteoporotic group ( p = 0.003). Height and body weight, BMI, blood pressure, insulin, glucose, HDL-cholesterol, and homeostasis model assessment-insulin resistance (HOMA-IR) levels were similar in all groups. Triglyceride levels were found to be higher in the normal BMD group, compared with the osteoporotic group ( p = 0.005). The level of VAI was detected as higher in those with normal BMD, compared with the women with osteoporosis ( p = 0.002). Additionally, the correlation analysis showed a positive correlation between dual-energy X-ray absorptiometry (DXA) spine T -scores, WC, VAI, and a negative correlation between DXA spine T -scores and age.Conclusion In our study, we found higher VAI levels in those with normal BMD, compared with women with osteoporosis. We consider that further studies with a larger sample size will be beneficial in elucidating the entity.Öğe The relationship between glomerular filtration rate, and metabolic and inflammatory parameters in obese and non-obese patients with polycystic ovary syndrome(Elsevier, 2020) Can, Mustafa; Duran, Cevdet; Guney, Ibrahim; Elmas, Halis; Ayhan, Mehmet; Erdem, Said SamiAim: To investigate the relationship between glomerular filtration rates (GFR), and homeostasis model assesment of insulin resistance (HOMA-IR), C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in patients with polycystic ovary syndrome (PCOS). Material and methods: Thirty-one overweight and obese PCOS patients with body mass index (BMI) >= 25 kg/m(2) and 25 non-obese PCOS patients with BMI < 25 kg/m(2) were included into patients' group, while 23 overweight and obese, and 25 non-obese age-and BMI-matched healthy individuals (aged between 18 and 40 years), were enrolled as controls. Levels of serum creatinine, glucose, insulin, CRP, and complete blood count were measured. eGFR, HOMA-IR and NLR were also calculated. Results: In PCOS group, HOMA-IR (p=0.001), CRP (p=0.025) and waist hip ratio (WHR) (p=0.011) were higher than controls. In obese PCOS sub-group, HOMA-IR (p=0.004) and WHR (p=0.002) were higher than obese controls. In non-obese PCOS sub-group, HOMA-IR (p=0.001) were higher than non-obese controls. In obese PCOS sub-group; HOMA-IR (p = 0.001) and CRP (p=0.001) levels were significantly higher than non-obese PCOS sub-group. In terms of other parameters, no significant difference was found between the groups. The analysis showed a negative correlation between GFR, and BMI and HOMA-IR in PCOS group, between GFR, WHR and insulin levels in obese PCOS sub-group, and between BMI, and HOMA-IR and NLR in non-obese PCOS sub-group. Conclusion: Although HOMA-IR and CRP were higher in PCOS group, there was no difference in NLR and GFR levels between those with PCOS and controls. (C) 2020 Sociedad Espanola de Arteriosclerosis. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe The Relationship between Pre-operative Anti-thyroglobulin Antibody Level and Lymph Node Metastasis and Recurrence in Differentiated Thyroid Cancer(Kare Publ, 2023) Kaynak, Hulya; Kocabas, Muhammet; Can, Mustafa; Cordan, Ilker; Karakose, Melia; Karakurt, Feridun; Kulaksizoglu, MustafaOBJECTIVE We aimed to investigate the relationship between positivity and level of pre-operative anti-thyroglobulin antibody (TgAb) and stage, recurrence, and metastasis in differentiated thyroid cancer (DTC). METHODS Three hundred and thirty-one patients who underwent total thyroidectomy and whose TgAb was measured in the pre-operative and post-operative period were included in the study. The laboratory and clinicopathological data of the patients were recorded from patient files. RESULTS Of the 331 patients enrolled, 253 (76.4%) were female and 78 (23.6) were male, and the mean age was 46.7 +/- 15.4. The final histopathology results were DTC in 126 (38.1%) patients and benign in 205 (61.9%) patients. TgAb was positive in 26 (20.6%) of 126 patients in the DTC group, while it was positive in 29 (14.1%) of 205 patients in the benign group. In patients with DTC, having lymph node metastasis, recurrence, and receiving radioactive iodine (RAI) ablation were found to be associated with higher pre-operative TgAb levels (p=0.023, p=0.032 and p=0.022, respectively). The TSH level at the time of diagnosis was significantly higher in the DTC group compared to the benign group (p<0.001). CONCLUSION In our study, pre-operative TgAb levels were found to be significantly higher in DTC patients with lymph node metastasis or recurrence. We found that pre-operative TgAb level significantly correlated with recurrence and lymph node metastasis.Öğe Thyroid Nodules in Patients with Acromegaly: Frequency According to the ACR TI-RADS Classification and its Relationship with Disease Activity(Georg Thieme Verlag Kg, 2021) Can, Mustafa; Kocabas, Muhammet; Karakose, Melia; Burgucu, Hatice Caliskan; Yarar, Zeliha; Kulaksizoglu, Mustafa; Karakurt, FeridunPurpose: In our study, we aimed to determine the frequency of thyroid nodules in patients with acromegaly according to the American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) classification and its relationship with acromegaly disease activity. Methods: A total of 56 patients with acromegaly and age, sex, and body mass index matched with 56 healthy control subjects were included in our study. Thyroid-stimulating hormone, free thyroxine, and anti-thyroperoxidase antibody levels of patients and control subjects were measured. In addition, patients and healthy controls were evaluated by ultrasonography to determine thyroid structure, thyroid volume, and thyroid nodules and to make ACR TI-RADS classification. Results: Thyroid nodules were present in 31 (55.4%) of 56 patients in the acromegaly group and 20 (35.7%) of 56 subjects in the control group, and the frequency of thyroid nodules was significantly higher in the acromegaly group (p=0.038). The mean number of nodules in the acromegaly group and control group was 1.271.43 and 0.48 +/- 0.73, respectively, and the mean number of nodules was significantly higher in the acromegaly group (p=0.003). The number of patients with TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules in the acromegaly group was higher than the control group (p=0.026, p=0.049, p=0.007, respectively). No difference was found in terms of cytological findings between those who have undergone FNAB in the acromegaly group and control group. Conclusion: In our study, we found that the frequency of thyroid nodules, the number of thyroid nodules, and the number of TI-RADS 1, TI-RADS 2, and TI-RADS 4 nodules increased in patients with acromegaly. There was no significant difference between acromegaly disease activity and thyroid nodule frequency, number of thyroid nodules, and TI-RADS classifications.
