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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 Clinical and demographic aspects of Paget disease of bone: A multicentric study from Turkey(Aves, 2021) Yavuz, Dilek Gogas; Ayturk, Semra; Cetinkalp, Sevki; Bayraktar, Firat; Kulaksizoglu, Mustafa; Hekimsoy, Zeliha; Aydin, HasanObjective: Paget disease of bone (PDB) is a metabolic bone disease that has been rarely reported in the Eastern countries. This study aimed to evaluate the clinical and demographic characteristics of patients with PDB followed up at endocrinology clinics in Turkey. Methods: An invitation was sent to tertiary endocrinology clinics to complete a survey on the dernc:graphic, clinical, radiological, and laboratory parameters, as well as treatment modalities of patients with PDB. This study enrolled clinically and radiologically proven 185 patients with PDB from 18 endocrinology centers based in 10 cities of Turkey. Results: This cohort of PDB had female preponderance (women/men: 105/80) with a mean age, during diagnosis, of 57 +/- 10 years. Most of the patients (59.6%) were symptomatic at diagnosis. Bone pain and headache were the predominant clinical symptoms. Polyostotic disease was observed in 67.5% (n=125) of patients. Frequently affected bones were skull (41.6%), pelvis (53.5%), spine (41%), and femur (25.4%). Moreover, 17 patients with skull involvement had hearing loss. Mean serum alkaline phosphatase (ALP) level (552 +/- 652 IU/L; range: 280-5762 IU/L) was over the normal reference cutoff with normal serum calcium levels. Intravenous bisphosphonates (zoledronic acid, 5 mg; pamidronate, 60-90 mg) were the most used drugs (75%) for the treatment of PDB. Most of the patients (87.1%) treated with intravenous bisphosphonates responded well, with a decrease in serum ALP level (117 +/- 114 IU/L) in the 12th month of therapy. Furthermore, 16 patients relapsed after the second year of therapy; 3 patients did not respond to the initial intravenous bisphosphonate treatment. Conclusion: The patients with PDB followed up by endocrinology clinics of Turkey exhibited polyostotic disease with classical clinical, radiological, and biochemical features and women's predominance with good response to intravenous bisphosphonate therapy.Öğe Do We Need to Replace GH to Correct Anemia in Hypopituitarism?(Endocrine Soc, 2014) Kulaksizoglu, Mustafa; Ipekci, Suleyman Hilmi; Gonulalan, Gulsum; Ozturk, Mine; Kaya, Ahmet; Gonen, Mustafa Sait; Cakir, Mehtap[Abstract Not Availabe]Öğe Effects of diabetic education on metabolic parameters in type 2 diabetic patients using insulin(Elsevier Ireland Ltd, 2016) Kaya, Ahmet; Kulaksizoglu, Mustafa; Ozdamar, Fatma; Caglayan, Melek[Abstract Not Availabe]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 Hyperosmolar Nonketotic State Associated with Quetiapine(Galenos Yayincilik, 2014) Kaya, Ahmet; Turan, Elif; Ozlurk, Mine; Savut, Bulent; Kulaksizoglu, Mustafa; Gonulalan, GulsumA 67-year-old man was admitted to our hospital because of decreased oral intake and confusion. He had a 2-year history of diabetes mellitus and he had a good glycaemic control with oral antidiabetic drugs (latest HbA1C: 7.2%). Quetiapine was initiated 15 days ago in a psychiatric clinic because of depression. The patient was taken to the intensive care unit with the diagnosis of hyperosmolar nonketotic state and acute renal failure. All the medications were discontinued; intravenous hydration and insulin infusion were started. The relationship between secondgeneration antipsychotics (SGAs) and hyperglycemia is a topic of interest and insulin resistance is commonly accepted as the mechanism for hyperglycemia. Patients receiving SGAs should be followed more closely for metabolic disorders.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 Is there a link between premature ovarian failure and serum concentrations of vitamin D, zinc, and copper?(Lippincott Williams & Wilkins, 2013) Kebapcilar, Ayse Gul; Kulaksizoglu, Mustafa; Kebapcilar, Levent; Gonen, Mustafa Sait; Unlu, Ali; Topcu, Ali; Demirci, FatihObjective: The risk of primary ovarian insufficiency (POI) increases in association with autoimmune conditions. Adequate intake of vitamin D (vit D) and trace elements is required for the immune system to function efficiently. The aim of this study was to evaluate vit D, zinc, and copper blood levels in women with POI who had given birth to at least one child and in women with normal menstrual cycles. Methods: This was a cross-sectional, case-control study involving 63 participants divided into two groups: the study group, which is composed of 35 women with POI, and the control group, which is composed of 28 women with normal menstrual cycles. Serum concentrations of zinc, vit D, and copper were determined for each participant. Results: Women with POI had significantly higher serum copper levels and copper-to-zinc ratio but significantly lower serum vit D and zinc levels when compared with the healthy control group. Serum follicle-stimulating hormone levels were inversely correlated with zinc and vit D levels and positively correlated with the copper-to-zinc ratio and copper levels. Vit D levels were inversely correlated with follicle-stimulating hormone levels, copper-to-zinc ratio, and copper levels and positively correlated with zinc levels. Conclusions: Most women with POI are deficient in vit D. Zinc, copper, and vit D seem to correlate with hormonal status in the participants. The present study may generate hypotheses for future studies that will investigate the possible mechanisms behind alterations in trace elements and vit D deficiency in women with POI and whether these changes could be used to screen for the risk of developing POI.Öğe Miscible Two Diseases in Old Age: Hypopituitarism and Pseudogout(Modestum Ltd, 2016) Gulyer, Huseyin; Savut, Bulent; Sahin, Muhammed; Gungor, Tayfun; Kucuk, Adem; Kulaksizoglu, Mustafa; Kaya, AhmetCalcium pyrophosphate dihydrate deposition disease is a disease characterized by collecting of crystals in hyaline cartilage, fibrocartilage and soft tissues, related to many endocrine and metabolic conditions, and seen more commonly in old age. Hypopituitarism may occur in old age with fatigue, decrease in libido, weight loss and musculoskeletal symptoms as a major cause of the overall condition impairment. As one gets older, the signs of these two diseases may progress even without any significant disease. The natural process which comes with old age, and pseudogout and hypopituitarism can mask one to another clinically and the symptoms of three situation may be overlapping. This can lead to difficulty and delay in diagnosis. Our case was an elderly female patient diagnosed with hypopituitarism and pseudogout.Öğe Miscible Two Diseases in Old Age: Hypopituitarism and Pseudogout(Modestum Ltd, 2016) Gulyer, Huseyin; Savut, Bulent; Sahin, Muhammed; Gungor, Tayfun; Kucuk, Adem; Kulaksizoglu, Mustafa; Kaya, AhmetCalcium pyrophosphate dihydrate deposition disease is a disease characterized by collecting of crystals in hyaline cartilage, fibrocartilage and soft tissues, related to many endocrine and metabolic conditions, and seen more commonly in old age. Hypopituitarism may occur in old age with fatigue, decrease in libido, weight loss and musculoskeletal symptoms as a major cause of the overall condition impairment. As one gets older, the signs of these two diseases may progress even without any significant disease. The natural process which comes with old age, and pseudogout and hypopituitarism can mask one to another clinically and the symptoms of three situation may be overlapping. This can lead to difficulty and delay in diagnosis. Our case was an elderly female patient diagnosed with hypopituitarism and pseudogout.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 Ratio of insulin cessation in patients with new onset insulin usage(Elsevier Ireland Ltd, 2016) Kulaksizoglu, Mustafa; Kaya, Ahmet; Ozdamar, Fatma[Abstract Not Availabe]Öğe Relationship between mean platelet volume and low-grade systemic coagulation with vitamin D deficiency in primary ovarian insufficiency(Springer Heidelberg, 2013) Kebapcilar, Ayse Gul; Kulaksizoglu, Mustafa; Ipekci, Suleyman Hilmi; Korkmaz, Huseyin; Kebapcilar, Levent; Akyurek, Fikret; Taner, Cuneyt EftalPremature menopause in young women is associated with an increased incidence of cardiovascular disease. The present study was designed to determine vitamin D (vit D) and the coagulation parameters such as activated partial thromboplastin time (APTT), PT, D-dimer, white blood cell (WBC), and mean platelet volume (MPV) levels, in primary ovarian insufficiency (POI) patients and control women with a normal menstrual cycle. A total of 43 patients with non-diabetic POI were studied in order to evaluate and compare with the control group comprising 33 women with a normal menstrual cycle. There was no significant difference between the groups for age and body mass index (BMI). D-dimer, WBC, MPV, PT, total cholesterol, and LDL cholesterol were higher in women with POI. APTT levels were also increased but missed the significance in POI group. Women with POI had significantly lower serum vit D levels compared with healthy control group. FSH level was positively correlated with D-dimer, WBC, MPV, and negatively correlated to vit D and serum D vit level was inversely correlated with MPV, APTT, D-dimer, FSH levels in individual women. The obtained results seem to indicate that POI patients had low-grade systemic coagulation and fibrinolytic activation as evidenced by elevated D-dimer, WBC, MPV, PT values potentially be used as indicators of risk factor for thrombosis and atherosclerosis in POI women. All of our patients with POI were deficient in vit D. These results also suggest that vit D deficiency plays important roles of POI women and associated with coagulation, independently from age and BMI.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 Risk Factors for Diabetes Mellitus in Women with Primary Ovarian Insufficiency(Humana Press Inc, 2013) Kulaksizoglu, Mustafa; Ipekci, Suleyman Hilmi; Kebapcilar, Levent; Kebapcilar, Ayse Gul; Korkmaz, Huseyin; Akyurek, Fikret; Baldane, SuleymanPrimary ovarian insufficiency (POI) is not only a gynecological problem but also has serious effects on women's health such as changes in hormone levels that can trigger fluctuations in blood sugar level and inflammation status. The present study was designed to determine vitamin D, copper, zinc, metabolic parameters [insulin, homeostasis model of assessment-insulin resistance (HOMA-IR)], inflammation parameters such as procalcitonin and high sensitivity C reactive protein (hs-CRP), and lipid profile in POI patients and control subjects with normal menstrual cycles. A total of 43 patients with nondiabetic POI were studied in order to evaluate and compare the findings with those of the control group, which comprised 33 women with normal menstrual cycles. The women with POI had higher levels of serum copper, serum insulin, glucose, LDL-cholesterol, total cholesterol, HOMA-IR, hs-CRP, and procalcitonin, whereas serum vitamin D and zinc levels were lower compared with the healthy control group. Follicle-stimulating hormone (FSH) levels were positively correlated with insulin, glucose, HOMA-IR, hs-CRP, procalcitonin, and copper and negatively correlated with vitamin D and zinc levels. In multivariate statistic analyses with body mass index and FSH as dependent variables, FSH was positively associated with copper and HOMA-IR negatively with vitamin D levels. The present study demonstrated that women with POI have traditional risk factors for diabetes mellitus, including lower levels of vitamin D, whereas higher levels of copper and HOMA-IR.Öğe Serum Selenium Levels in Euthyroid Nodular Thyroid Diseases(Humana Press Inc, 2016) Sakiz, Davut; Kaya, Ahmet; Kulaksizoglu, MustafaThe thyroid gland is susceptible to nodulation. The mechanism responsible for the growth of only some follicular cells, which results in nodule formation, is not yet clear. Selenium deficiency may be a risk factor in the development of thyroid nodules. The aim of this study was to investigate the relationship between selenium levels in patients with euthyroid nodular thyroid disease. Seventy patients with a solitary euthyroid thyroid nodule, 70 patients with more than one euthyroid nodule, and 60 healthy patients without thyroid nodules were included in the study. Venous serum samples were stored at -80A degrees C and analyzed the same day using spectrometry. The selenium levels of patients with multiple thyroid nodules, solitary nodules, and patients without nodules were 57.3 +/- 14.8 mu g/L; 58.8 +/- 15.1 mu g/L; and 57.6 +/- 13.3 mu g/L, respectively. The mean serum selenium level of all patients included in the study was 57.9 +/- 14.4 mu g/L. Although serum selenium levels were slightly higher in men, a statistically significant difference was not observed. In our study, a significant relationship between serum selenium levels and nodular thyroid disease was not seen. Our study was undertaken in an iodine sufficient region. Mean serum selenium levels were lower compared with many other studies, which may be associated with the low selenium content of the soil. Nodular thyroid disease shows multifactorial features. When our study is considered together with previous studies, serum selenium levels may considered to be effective on structural thyroid diseases if combined with additional factors such as severe iodine deficiency. Further studies are required to assess the role of selenium in thyroid nodule formation.Öğe A subset of patients with acquired partial lipodystrophy developing severe metabolic abnormalities(Taylor & Francis Inc, 2019) Saydam, Basak Ozgen; Sonmez, Melda; Simsir, Ilgin Yildirim; Erturk, Mehmet Sercan; Kulaksizoglu, Mustafa; Arkan, Tugba; Hekimsoy, ZelihaPurpose/Aim of the study: Acquired partial lipodystrophy (APL) is a rare disease characterized by selective loss of adipose tissue. In this study, we aimed to present a subset of patients with APL, who developed severe metabolic abnormalities, from our national lipodystrophy registry. Materials and Methods: Severe metabolic abnormalities were defined as: poorly controlled diabetes (HbA1c above 7% despite treatment with insulin more than 1 unit/kg/day combined with oral antidiabetics), severe hypertriglyceridemia (triglycerides above 500 mg/dL despite treatment with lipid-lowering drugs), episodes of acute pancreatitis, or severe hepatic involvement (biopsy-proven non-alcoholic steatohepatitis (NASH)). Results: Among 140 patients with all forms of lipodystrophy (28 with APL), we identified 6 APL patients with severe metabolic abnormalities. The geometric mean for age was 37 years (range: 27-50 years; 4 females and 2 males). Five patients had poorly controlled diabetes despite treatment with high-dose insulin combined with oral antidiabetics. Severe hypertriglyceridemia developed in five patients, of those three experienced episodes of acute pancreatitis. Although all six patients had hepatic steatosis at various levels on imaging studies, NASH was proven in two patients on liver biopsy. Our data suggested that APL patients with severe metabolic abnormalities had a more advanced fat loss and longer disease duration. Conclusions: We suggest that these patients represent a potential subgroup of APL who may benefit from metreleptin or investigational therapies as standard treatment strategies fail to achieve a good metabolic control.
