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Öğe The association of decreased testosterone with atherosclerosis and inflammation in male predialysis patients with chronic kidney disease(Elsevier, 2020) Aydemir, Harun; Guney, Ibrahim; Duran, Cevdet; Gencer, Vedat; Akbayrak, Sahabettin; Kurku, Huseyin; Akgul, Yavuz Sultan SelimPurpose: To investigate the frequency of hypogonadism and its relationship to inflammation and carotid intima-media thickness (CIMT) in male patients with predialysis chronic kidney disease (CKD). Methods: A total of 105 patients with CKD, 55 (52.4%) as stage 3, 33 (31.4%) as stage 4 and 17 (16.2%) as stage 5, were enrolled into the study. Total testosterone (TT) and free testosterone (FT), interleukin 6 (IL-6), C-reactive protein (CRP) levels, and CIMT were measured. Results: According to TT and FT, hypogonadism was detected in 18 (17.1%) and 22 (20.9%) patients, respectively. There was no difference in terms of TT and FT, CIMT, CRP and IL-6 between the stages of CKD. According to TT, the patients with hypogonadism had significantly higher CRP and high-density lipoprotein cholesterol (HDL-cholesterol) levels (p=0.004 and p=0.005, respectively). There was no significant difference in other parameters. According to FT, the patients with hypogonadism had significantly higher CRP (p=0.017), and TT were negatively correlated with body mass index (BMI), waist circumference (WC), hip circumference, and CRP levels. FT was negatively correlated with age, waist circumference, systolic blood pressure, diastolic blood pressure (DBP) and CRP. Conclusions: The frequency of hypogonadism was found around 17-21% among the patients with CKD. Despite similar IL-6 and CIMT levels, CRP was found to be higher in the patients with hypogonadism. We consider that further studies with larger populations are needed to elucidate the entity. (C) 2020 Sociedad Espanola de Arteriosclerosis. Published by Elsevier Espana, S.L.U. All rights reserved.Öğe Comparison of Salivary Cortisol, Serum Cortisol, Plasma ACTH and Urinary Free Cortisol Levels in Thyrotoxic and Hypothyroid Patients(Ortadogu Ad Pres & Publ Co, 2012) Gonen, Mustafa Sait; Ozkaya, Emin; Kurban, Sevil; Ipekci, Suleyman Hilmi; Duran, Cevdet; Kulaksizoglu, SevsenObjective: Hypothalamo-pituitary-adrenal (HPA) axis is affected by thyroid hormones. The present study was designed to compare the level of salivary cortisol, serum cortisol, plasma adrenocorticotropic hormone (ACTH) and urinary free cortisol (UFC) levels in patients with subclinical and overt thyrotoxicosis and hypothyroidism. Material and Methods: We analyzed the salivary cortisol, serum cortisol, plasma ACTH and UFC levels in 123 patients with thyroid dysfunction. The patients were classified into four groups; overt thyrotoxicosis (n=32), subclinical thyrotoxicosis (n=29), overt hypothyroidism (n=28) and subclinical hypothyroidism (n=34). Results: There were no significant differences in terms of salivary cortisol, serum cortisol, plasma ACTH and UFC levels in patients with subclinical and overt thyrotcodcosis (p>0.05). Similarly, no significant differences could be detected in terms of salivary cortisol, serum cortisol, plasma ACTH and UFC levels in patients with subclinical and overt hypothyroidism (p>0.05). The comparison of patients with hypothyroidism and thyrotoxicosis also did not yield any significant difference in terms of salivary cortisol, serum conisol, plasma ACTH and UFC levels (p>0.05). Conclusion: Similar salivary cortisol, serum cortisol, plasma ACTH and UFC levels were detected in patients with hypothyroidism and thyrotoxicosis. Thus, we may suggest that thyroid hormone status does not play a role in the HPA axis. The major limitation of this study was the absence of a healthy control group. Further studies with large numbers of patients are required to clarify the association between thyroid hormone dysfunction and glucocorticoid levels.Öğe Distribution of RET Mutations and Evaluation of Treatment Approaches in Hereditary Medullary Thyroid Carcinoma in Turkey(2016) Aydoğan, Berna İmge; Yüksel, Bağdagül; Tuna, Mazhar Müslüm; Başaran, Mehtap Navdar; Kocaeli Akkurt, Ayşen; Ertörer, Melek Eda; Aydın Tezcan, Kadriye; Güldiken, Sibel; Şimşek, Yasin; Özdamar Karaca, Züleyha Cihan; Yılmaz, Merve; Aktürk, Müjde Yaşım; Anaforoğlu, İnan; Kebapçı, Medine Nur; Duran, Cevdet; Taşlıpınar, Abdullah; Kulaksızoğlu, Mustafa; Gürsoy, Alptekin; Dağdelen, Selçuk; Erdoğan, Murat FaikObjective: This retrospective multicenter study, centrally conducted and supported by the Society of Endocrinology and Metabolism of Turkey, aimed to evaluate the impact of free RET proto-oncogene testing in medullary thyroid carcinoma (MTC) patients. Surgical timing, adequacy of the treatment, and frequency of prophylactic thyroidectomy (PTx) in mutation carriers were also assessed. Methods: Genetic testing for MTC and pheochromocytoma was conducted between July 2008 and January 2012 in 512 patients. Application forms and RET mutation analyses of these patients whose blood samples were sent from various centers around Turkey were assessed retrospectively. An evaluation form was sent to the physicians of the eligible 319 patients who had confirmed sporadic MTC, familial MTC (FMTC), multiple endocrine neoplasia type 2 (MEN2), or who were mutation carriers. Physicians were asked to give information about the surgical history, latest calcitonin levels, morbidity, mortality, genetic screening, and PTx among family members. Twenty-five centers responded by filling in the forms of 192 patients. Results: Among the 319 patients, RET mutation was detected in 71 (22.3%). Cys634Arg mutation was the most prevalent mutation (43.7%), followed by Val804Met in 18 patients (25.4%), and Cys634Tyr in 6 patients (8.5%). Among 192 MTC patients, the diagnosis was sporadic MTC in 146 (76.4%), FMTC in 14 (7.3%), MEN2A in 15 patients (7.9%), and MEN2B in one patient. The number of mutation carriers among 154 apparently sporadic MTC patients was 8 (5.2%). Ten patients were submitted to PTx out of twenty-four mutation carriers at a mean age of 35±19 years. Conclusion: Turkish people have a similar RET proto-oncogene mutation distribution when compared to other Mediterranean countries. Despite free RET gene testing, the number of the PTx in Turkey is limited and relatively late in the life span of the carriers. This is mainly due to patient and family incompliance and incomplete family counselling.Öğe Does Gestational Diabetes History Increase Epicardial Fat and Carotid Intima Media Thickness?(Wiley, 2014) Caliskan, Mustafa; Caklili, Ozge Telci; Caliskan, Zuhal; Duran, Cevdet; Ciftci, Faika C.; Avci, Enver; Gullu, HakanBackgroundGestational diabetes mellitus (GDM) is defined as glucose intolerance that has begun during pregnancy. Recent studies have proven that development of atherosclerosis may be established in this population even without presence of type 2 diabetes. For assessment of atherosclerosis, epicardial fat thickness (EFT) is recently being used as a surrogate marker. In this study, we aimed to prove that women with GDM history are more inclined to have higher EFT levels than women without GDM history. MethodsSixty-two patients with previous GDM and 33 age- and sex-matched controls were allocated. Epicardial fat thicknesses of the subjects were measured with transthorasic echocardiography and carotid intima media thickness (c-IMT) was measured with ultrasound. Insulin resistance (IR) of each subject was assessed with Homeostasis model of assessmentinsulin resistance (HOMA-IR). ResultsCarotid IMT and EFT were significantly higher in previous GDM group than controls. Serum gamma-glutamyl transferase (GGT), uric acid, and high-sensitivity C-reactive protein (hs-CRP) levels were also found significantly higher in the patients with previous GDM as compared to the controls. We observed that carotid IMT (=310, P=0.003), total cholesterol (=315, P=0.002), BMI (=308, P=0.002), HbA1c (=227, P=0.018), and HOMA-IR (=184, P=0.049) were independently correlated with EFT. ConclusionsAlthough the number of patients included in this study is limited, high EFT results may indicate presence of atherosclerosis in women with previous GDM.Öğe Papillary thyroid carcinoma after radioactive iodine treatment for toxic thyroid nodule: Case report(Marmara Univ, Fac Medicine, 2018) Sevinc, Baris; Karahan, Omer; Duran, Cevdet; Cayci, Mustafa; Ay, SerdenRadioactive iodine (RAI) treatment is recommended as the first choice for toxic thyroid nodules by American Thyroid Association (ATA). Here, we present our second case of papillary thyroid carcinoma after RAI therapy. A fifty five-year-old woman received RAI therapy for toxic thyroid nodule in the right lobe in 2005. Pre-treatment fine needle aspiration biopsy (FNAB) revealed benign cytology. She was euthyroid after the therapy. However, 8 years after the treatment she had 15 mm thyroid nodule in the same location. This time, FNAB result was suspected for papillary thyroid carcinoma. The patient underwent bilateral total thyroidectomy and the histopathological evaluation revealed papillary thyroid carcinoma in the nodule. This is the second case with papillary carcinoma after RAI therapy. Papillary carcinoma developed after the RAI therapy. In conclusion, all cases should be closely followed up after RAI therapy for carcinoma development.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 Visceral Adiposity Index Levels in Patients with Hypothyroidism(Natl Med Assoc, 2018) Pekgor, Selma; Duran, Cevdet; Kutlu, Ruhusen; Solak, Ibrahim; Pekgor, Ahmet; Eryilmaz, Mehmet AliObjective: To assess visceral adiposity index (VAI) as a sign of cardio-vascular diseases (CVD) in hypothyroidism patients and to compare CVD risks in overt or subclinical hypothyroidism patients. Materials and methods: Sixty-eight hypothyroidism patients (29 with overt and 39 with subclinical hypothyroidism) and 33 age- and gender-matched control patients were included. VAI levels were calculated with the following formula: (waist circumference (WC)/[36.58+(1.89xbody mass index (BMI))])x[(triglyceride (TG) (mmol/L)/0.81)x(1.52xhigh-density lipoprotein cholesterol (HDL-cholesterol) (mmol/L))] and (WC/[39.68+(1.88xBMI)])x[(TG (mmol/L)/1.03)x(1.31xHDL-cholesterol (mmol/L))], respectively. Results: While body weight (p < 0.01), BMI (p < 0.01), TG and VAI levels (p < 0.01) were higher in hypothyroidism patients than controls, HDL-cholesterol levels were lower (p = 0.02). When patients were divided to groups as subclinical (n = 39) and overt hypothyroidism (n = 29) and compared with each other and controls (n = 33), body weight (p = 0.02 and p = 0.02, respectively), BMI (p = 0.01 and p < 0.01, respectively) and TG (p < 0.01 and p = 0.03, respectively) were higher in overt and subclinical hypothyroidism groups than controls. HDL-cholesterol was lower only in the group with overt hypothyroidism than controls (p = 0.01). Although found similar to each other in overt and subclinical hypothyroidism groups, VAI levels were observed to be higher in both groups than controls (p < 0.01 and p = 0.02, respectively). In correlation analysis, a positive correlation was determined between thyroid stimulating hormone (TSH), BMI and VAI levels (p = 0.03 and p < 0.01, respectively). Conclusions: Due to the association between increased VAI levels, and metabolic syndrome and CVDs, we consider that several measures should be promptly taken to decrease these risk factors, and further studies with a larger sample size should be performed.
