Publications (20)35.8 Total impact
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Article: Insulin Versus GLP-1 Analogues in Poorly Controlled Type 2 Diabetic Subjects on Oral Therapy A Meta Analysis.
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ABSTRACT: Aim: To compare insulin and GLP-1 analogues therapy on glycemic control in poorly controlled T2DM subjects failing on oral therapy. Methods: The electronic database PubMed was systematically searched for randomized controlled trial (RCTs) with duration >16 weeks comparing the addition of insulin therapy versus GLP-1 analogues in poorly controlled T2DM subjects on oral therapy. Results: We identified 7 RCTs with 2199 patients of whom 1119 were assigned to insulin therapy and 1080 received a GLP-1 analogue. Both insulin and GLP-1 analogues were effective in lowering HbA1c with no statistically significant difference between the mean decreases in HbA1c. However, insulin was more effective than GLP-1 analogues in lowering the fasting plasma glucose (FPG) concentration, while GLP-1 agonists were more effective in lowering the post prandial glucose (PPG) concentration. Insulin therapy was associated with weight gain while GLP-1 analogues consistently caused weight loss and the difference between the mean change in body weight between the two therapies was highly statistically significant. Despite a similar decrease in HbA1c, the risk of hypoglycemia was 35% lower (p=0.001) with GLP-1 therapy compared to insulin. Compared to insulin, GLP-1 analogues caused a significant decrease in systolic blood pressure and were associated with greater rate of gastrointestinal adverse events. Conclusion/interpretation: In poorly controlled T2DM subjects on oral therapy, GLP-1 analogues and insulin are equally effective in lowering the HbA1c. However, GLP-1 analogues have additional nonglycemic benefits and lower risk of hypoglycemia. Thus, GLP-1 analogues should be considered as a treatment option in this group of diabetic individuals.Journal of endocrinological investigation 04/2012; · 1.57 Impact Factor -
Article: Evaluation of various insulin sensitivity indices in lean idiopathic hirsutism patients.
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ABSTRACT: Hirsutism is characterized by excessive growth of terminal hair in a male pattern. Idiopathic hirsutism (IH) is a common cause of hirsutism. Since there are few data demonstrating IH is associated with insulin resistance, we tried to assess various insulin sensitivity indices in lean IH and compare with healthy subjects. A cross-sectional study was performed in 71 lean (BMI between 20-25 kg/m(2)) women (17-39 years old), 31 with IH and 40 healthy individuals. Blood glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), hepatic insulin sensitivity (ISI (HOMA)), Quicky index, reciprocal fasting insulin resistance index, fasting Belfiore index, and fasting glucose/insulin ration (GIR) were estimated using a single fasting sample of glucose and insulin levels. Raynaud indices calculated using the mathematical estimation in a single fasting sample of insulin levels were determined and compared in two groups. Fasting insulin, Raynaud index, HOMA-IR and Fasting insulin resistance index (FIRI) results were higher in IH group than in controls (p<0.01, for all). Fasting Belfiore index, QUICKI index, ISI(HOMA) and FIRI(-1) results were lower in IH group than in controls (p<0.01, for all). Our study showed that lean IH patients were more insulin resistant than healthy subjects. We propose that insulin sensitivity indices are useful methods for measuring insulin resistance in IH.Endocrine Journal 02/2012; 59(4):291-6. · 2.03 Impact Factor -
Article: Hyperthyroidism: a risk factor for female sexual dysfunction.
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ABSTRACT: Hyperthyroidism is a common hormonal disorder in women that may cause female sexual dysfunction (FSD). To assess sexual function in women with hyperthyroidism. A total of 40 women with clinical hyperthyroidism and 40 age-matched voluntary healthy women controls were included in the study. All the subjects were evaluated with a detailed medical and sexual history, including a Female Sexual Function Index (FSFI) questionnaire for sexual status and the Beck Depression Inventory (BDI) for psychiatric assessment. The levels of serum thyroid-stimulating hormone (TSH), thyroid hormones, sex hormone binding globulin (SHBG), total testosterone (tT), free testosterone (fT), prolactin, estradiol, follicle-stimulating hormone, and luteinizing hormone were measured. The mean total FSFI scores were 24.2 ± 9.96 in the hyperthyroidic group and 29 ± 10.4 in the control group (P < 0.0001). Desire (P < 0.040), arousal (P < 0.0001), lubrication (P < 0.0001), orgasm (P < 0.0001), satisfaction (P < 0.0001), and pain (P < 0.007) domain scores were also significantly lower in women with hyperthyroidism. The mean BDI score for hyperthyroidic patients was significantly greater than the score for the control group (P < 0.0001). The mean SHBG level in the hyperthyroidic group was found to be significantly higher than the level in the controls (P < 0.0001), whereas the mean fT level in the hyperthyroidic group was lower than in the control group (P < 0.0001). The FSFI score showed a significant negative correlation with the serum SHBG (r = -0.309, P = 0.005), free triiodothyronine (r = -0.353, P = 0.006) and free tetraiodothyronine (r = -0.305, P = 0.018) levels, BDI scores (r = -0.802, P = 0.0001) and positive correlation with tT (r = 0.284, P = 0.011), fT (r = 0.407, P = 0.001), and TSH (r = 0.615, P = 0.0001) levels. A significant percentage of women with clinical hyperthyroidism had sexual dysfunction. Increased depressive symptoms, increased SHBG level, and decreased fT levels were all found to be associated with FSD in clinical hyperthyroidism.Journal of Sexual Medicine 06/2011; 8(8):2327-33. · 3.55 Impact Factor -
Article: Do eating disorders accompany metabolic syndrome in psoriasis patients? Results of a preliminary study.
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ABSTRACT: Metabolic syndrome (MBS) has been reported as a frequent comorbidity in psoriatic patients. The main pathogenesis is considered to be inflammation in this association. MBS has been investigated in eating disorders as well. While psoriasis has some psychiatric comorbidities, the link between psoriasis, MBS, and eating disorders (EDs) is unknown. The study was designed as a cross-sectional, randomized, and controlled trial. A total of 100 patients with psoriasis were included in the study. Sociodemographic data, clinical subtype of psoriasis, Psoriasis Area and Severity Index (PASI) scores, and associated diseases were registered for each patient. The criteria for diagnosis of MBS developed by the International Diabetes Foundation (IDF) was used. These are central obesity (waist circumference ≥94 cm in men or ≥80 cm in women), plus two of the following: elevated triglycerides (≥150 mg/dL), reduced high-desity lipoprotein cholesterol (>40 mg/dL for men; >50 mg/dL for women), elevated blood pressure (≥130 mmHg systolic or ≥85 mmHg diastolic), and elevated fasting blood glucose (≥100 mg/dL). Additionally, the Eating Attitude Test (EAT), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI), and psychiatric interview were performed for all patients. There were 45 female and 55 male patients, aged between 18 and 85 years old (median 41.12 ± 16.01). MBS was present in 31% of the patients with psoriasis. There was no correlation between the severity of psoriasis and MBS. EAT scores were ≥30 in 7/100 patients. Four out of 31 patients with MBS (12.9%) had ED and 3/69 patients were without MBS (4.3%). Mean ED scores were compared statistically and the difference was significant (EAT = 17.9 ± 9.558 and 11.5 ± 7.204, P < 0.001). Defining risk factors leading to comorbidities is important in psoriasis. EDs seem to have an impact on the development of MBS in psoriasis. Establishment and treatment of EDs in patients with psoriasis may prevent the onset of MBS and other comorbidities due to MBS.Clinical, Cosmetic and Investigational Dermatology 01/2011; 4:139-43. -
Article: Use of knee height for the estimation of stature in elderly Turkish people and their relationship with cardiometabolic risk factors.
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ABSTRACT: The determination of the approximately truest value in height measurement is important in many fields, but it is difficult to perform true measurements, especially in the elderly individuals. We planned to investigate the following items in geriatric Turkish population: to calculate the decrease in height with advancing age by using the standing height measurement and estimated height derived from the knee height; to evaluate the significance of difference between the two measurement methods in the calculation of body mass index (BMI) and waist/height ratio (WHtR); to determine the cut-off value of WHtR according to estimated height in elderly individuals. We studied 551 cases aged between 19 and 97 years. Knee height was measured using a sliding caliper in a sitting position. Linear regression analysis was carried out to derive predictive equations for the estimation of stature with adults (≤ 50 years of age) according to the gender. This equation was then used to estimate height among elderly subjects. Of the cases, 60.3% were <60 years (mean: 48.75 ± 7.50); 39.7% of the cases were >60 years (mean: 69.51 ± 7.12). Estimated BMI (EBMI) measurements in the females and males >60 years were in average 1.23 kg/m(2) and 0.92 kg/m(2) higher than their real BMIs, respectively. EBMI measurements in the females <60 years were 0.32 kg/m(2) higher than their real BMIs (p<0.01). There is a statistically significant difference between WHtR in the females of both age groups, and in the males >60 years, as compared to our estimated WHtR (EWHtR) measurements (p<0.01). The cut-off point of WHtR was 0.61 and 0.58 in the female and male cases of >60 years in our study, respectively. WHtR seemed to be a better anthropometric index that could predict most cardiometabolic risk factors in our study. EWHtR emerged to be a better cardiometabolic risk index especially in the elderly group.Archives of gerontology and geriatrics 12/2010; 54(1):82-9. · 1.36 Impact Factor -
Article: Sexual dysfunction in women with clinical hypothyroidism and subclinical hypothyroidism.
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ABSTRACT: Hypothyroidism is a common hormonal disorder in women that may affect the phases of female sexual function. To investigate female sexual function in patients with clinic hypothyroidism and subclinic hypothyroidism. A total of 25 women with clinic hypothyroidism (group 4), 25 women with subclinic hypothyroidism [thyroid stimulating hormone (TSH) value <or=10 mU/L (group 2), TSH value >10 mU/L (group 3)], and 20 age matched voluntary healthy women controls (group 1) were included in the study. All the subjects were evaluated with a detailed medical and sexual history, including a female sexual function index (FSFI) questionnaire for sexual status and the Beck Depression Inventory for psychiatric assessment. The levels of serum TSH, thyroid hormones, prolactin (PRL), free testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, lipid profile, and blood glucose were measured. Female sexual dysfunction (FSD) was diagnosed in 14 of 25 patients (56%) in group 4, in 6 of 11 patients (54.6%) in group 3, in 2 of 14 patients (14.6%) in group 2, and while only 3 of 20 the control group of women (15%) had FSD (P = 0.006). The mean total FSFI scores were 23.9 in the group 4, 26.03 in the group 3, 29.2 in the group 2, and 32.30 in the control group (P < 0.0001). The mean BDI score for clinic hypothyroidic patients was significantly greater than the scores for the control group and for the group 2 (P = 0.017 and P = 0.043, respectively). The mean PRL levels for patients in group 4 and group 3 were found to be significantly higher than the level for controls (P < 0.0001), whereas other serum hormone levels were not different among groups. A significant percent of women with clinic hypothyroidism and subclinic hypothyroidism with TSH values >10 mU/L had sexual dysfunction. Hyperprolactinemia, hyperlipidemia, and depression were associated with FSD in clinic hypothyroidism. Different than clinic hypothyroidism depression was not associated with FSD in subclinic hypothyroidism with TSH values >10 mU/L.Journal of Sexual Medicine 07/2010; 7(7):2583-90. · 3.55 Impact Factor -
Article: A geriatric patient with diffuse idiopathic skeletal hyperostosis.
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ABSTRACT: The most frequent health problems seen in senility are chronic and degenerative diseases. A 75-year-old male patient with the complaints of weight loss and difficulty in swallowing was admitted to our hospital from a nursing home. Upper system fiber-optic gastrointestinal endoscopy was performed and a mass at the junction of the hypopharynx and esophagus just below recessus piriformis obstructing almost the whole of the lumen and blocking the distal passage was detected. Computed tomography revealed marked narrowing secondary to osseous hypertrophy in the air column of the hypopharynx and proximal esophagus. Diffuse idiopathic skeletal hyperostosis or Forestier's disease is an idiopathic disease characterized by the ossification of the anterior longitudinal ligament of vertebra and some of the extraspinal ligaments. In the present case we aim to discuss an elderly patient who suffered from dysphagia and weight loss and the diagnostic stages.World Journal of Gastroenterology 04/2010; 16(13):1673-5. · 2.47 Impact Factor -
Article: Autoimmune Polyendocrine Syndrome Presenting As Diabetic Ketoacidosis in a 20-Year-Old Woman With Crohn Disease: A Case Report
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ABSTRACT: Autoimmune polyendocrine syndrome (APS) is defined as a multiple endocrine gland insufficiency associated with an autoimmune disease. The first clinical manifestation of APS-1 usually occurs in childhood and new components may successively appear throughout life, with the majority of patients (63%) have 3 to 5 organ involvement. The most frequent manifestations of APS include chronic mucocutaneous candidiasis, hypoparathyroidism, adrenocortical failure, and gonadal failure in females. We present a case of APS that cannot be classified in any group of APS presenting with Crohn disease.The Endocrinologist 10/2009; 19(6):251-252. · 0.09 Impact Factor -
Article: Diffusing Lung Capacity of Carbon Monoxide/Alveolar Volume as an Index for Evaluating Diffusing Capacity of the Acromegalic Lung
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ABSTRACT: Background and Objectives: Acromegaly alters the structure, elasticity, and function of the entire respiratory apparatus. The purpose of the present study was to compare the diffusing capacity in patients with acromegaly and healthy subjects to elucidate the usefulness of diffusing lung capacity of carbon monoxide/alveolar volume (DLCO/VA) in the evaluation of respiratory functions of patients with acromegaly. Patients and Methods: A total of 75 subjects attending Endocrinology and Metabolism Clinics at Sisli Etfal Training and Research Hospital between May 2007 and May 2008 were enrolled in the study. Results: Acromegaly group included 44 patients (19 males, 25 females; mean age: 46.25 ± 2.1 years). Control group included 31 healthy subjects (9 males, 22 females; mean age: 40.92 ± 1.88). There was no statistical difference in gender distribution between patients and control groups (P > 0.05). Body mass indices were also similar between control and patient groups (P > 0.05). DLCO was similar in patients with acromegaly and healthy subjects (P > 0.05). However, the DLCO/VA was reduced significantly in patients with acromegaly when compared with control values (P < 0.01). Conclusions: DLCO is similar in acromegalic and healthy subjects; DLCO/VA, however, may be a useful index for evaluating the respiratory dysfunction in acromegaly.The Endocrinologist 10/2009; 19(6):288-290. · 0.09 Impact Factor -
Article: The effects of polyphenol-containing antioxidants on oxidative stress and lipid peroxidation in Type 2 diabetes mellitus without complications.
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ABSTRACT: The hyperglycemia-induced oxidative stress in diabetes mellitus (DM) is the major factor in the pathogenesis of cardiovascular complications. The phenolic compounds are potent antioxidants that can reverse the factors leading to cardiovascular complications in DM. The aim of this study was to determine the antagonizing effects of a polyphenol-rich antioxidant supplement containing pomegranate extract, green tea extract, and ascorbic acid, on oxidative stress in Type 2 diabetic patients. A total of 114 male and female non-smokers (56 study, 58 placebo) with Type 2 DM and without any complications were recruited. The blood levels of fasting blood glucose, glycated hemoglobin, LDL, HDL, triglycerides, plasma malondialdehyde (MDA), total glutathione (GSH), hydrogen peroxide, and antioxidant capacity (AOC) were determined at the beginning and at the end of the 3-month trial. The differences of the data changes between the groups were statistically analyzed by Mann-Whitney U test. The study group showed a decrease in LDL and an increase in HDL and the comparison with the difference in placebo group was statistically significant (p<0.001 for LDL and p<0.001 for HDL). Accordingly, as a by-product of lipid peroxidation, plasma MDA was decreased in the study group compared to the placebo group (p<0.001). As an indicator of increased antioxidant defense, total plasma GSH and AOC increased more in the study group compared to control group (p<0.001). These observations indicated that the polyphenol-rich antioxidant supplement containing pomegranate extract, green tea extract, and ascorbic acid has important antagonizing effects on oxidative stress and lipid peroxidation in patients with Type 2 DM and might be beneficial in preventing cardiovascular complications.Journal of endocrinological investigation 10/2009; 33(2):118-24. · 1.57 Impact Factor -
Article: A multi-center, open label, crossover designed prospective study evaluating the effects of lipid lowering treatment on steroid synthesis in patients with Type 2 diabetes (MODEST Study).
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ABSTRACT: It has been suggested that lipid-lowering treatment with the use of statins adversely affects the steroid hormones. However, the safety of lipid lowering treatment targeting very low levels of LDL with respect to the steroid hormones has not been established. A prospective, randomized, multicenter trial was conducted involving 98 patients. The patients were randomized into 2 groups: group-I received 10 mg of atorvastatin plus 10 mg of ezetimibe and group-II 80 mg of atorvastatin for the first 3 months. After crossover, the first group received 80 mg of atorvastatin and the second group 10 mg of atorvastatin plus 10 mg of ezetimibe for the following 3 months. Cortisol, DHEAS, testosterone, and estradiol levels were measured at the enrollment and at the end of the 1st, 2nd, 3rd, and 6th months. Along with a decrease in LDL level, the levels of DHEAS, testosterone, and estradiol decreased in both groups (p<0.001). While cortisol levels were maintained in the group given 10 mg of atorvastatin plus 10 mg of ezetimibe, it decreased significantly after the crossover to 80 mg of atorvastatin (p<0.001). The group initially given 80 mg of atorvastatin measured a lower level of cortisol for the first 3 months and it returned to normal levels after switching to 10 mg of atorvastatin plus 10 mg of ezetimibe. Eighty milligrams of atorvastatin decreased all adrenal and gonadal steroids, whereas 10 mg of ezetimibe combined with 10 mg of atorvastatin had at least no impact on cortisol levels.Journal of endocrinological investigation 09/2009; 32(10):852-6. · 1.57 Impact Factor -
Article: Investigation of the Presence of Acropachy in Patients With Autoimmune Thyroid Diseases
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ABSTRACT: Thyroid acropachy is an extremely rare but well-recognized manifestation of autoimmune thyroid disease. Although many isolated cases of acropachy have appeared in the medical literature, the prevalance of acropachy is unknown in autoimmune thyroid diseases. Likewise, histopathologic features of acropachy have not been previously reported. We investigated the presence of acropachy and early stage changes in patients with autoimmune thyroid disease. Clinical, radiologic, and histopathologic slides were done. The study was performed in 52 adults (32 to 58-years-old), 40 patients with autoimmune thyroid disease (35 Hashimoto thyroiditis, 5 Basedow Graves), and 12 healthy individuals. After subjects underwent detailed dermatologic examinations, anteroposterior radiography of their hands and feet was performed and punch biopsies were done from volar aspects of the distal ends of the fourth digits of their left hands. On dermatologic examination, only 1 patient had fusiform of soft tissue swellings of hand fingers. Radiography of the hands and feet was normal in all patients. Mucin accumulation was seen in 5 patients and these patients were accepted as having acropachy histopathologically. All these patients had Hashimoto thyroiditis and none had opthalmopathy and dermopathy. There were no significant correlations of histopathologic findings with opthalmopathy, the duration of the disease, titers of antibodies, and thyroid status. We consider that these changes seen pathologically are early stage changes of acropachy.The Endocrinologist 12/2006; 17(1):23-25. · 0.09 Impact Factor -
Article: After myocardial infarction carvedilol improves insulin resistance compared to metoprolol.
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ABSTRACT: Both carvedilol and metoprolol have cardioprotective effects and decrease infarct size in myocardium. We compared effects of carvedilol and metoprolol on insulin resistance and serum lipid levels after myocardial infarction. Fifty-nine patients aged between 30 and 70 and BMI = 25-30 kg/m2, who were diagnosed with myocardial infarction with ST segment elevation, were considered to be eligible for the study. Patients were randomly allocated to two different therapy protocols. Metoprolol 100 mg bid or carvedilol 25 mg bid was added to their standardized therapy regimen. Baseline to week 4 and 12, fasting blood glucose, serum lipid profile, BMI, C-peptide, insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were measured. After 12 weeks of metoprolol therapy HOMA-IR, insulin and C-peptide levels were significantly higher (p < 0.05 for all) and total cholesterol and triglyceride levels decreased significantly (p < 0.05 for all) compared to baseline. After 12 weeks of carvedilol therapy HOMA-IR, insulin and C-peptide (p < 0.05 for all), total cholesterol and triglyceride (p = 0.001 for all) decreased significantly compared to baseline. Carvedilol provided more decrease in total cholesterol and LDL levels than metoprolol (p = 0.043 and p = 0.021, respectively). In patients after myocardial infarction, carvedilol added to background therapy improved insulin resistance and lipid profile.Clinical Research in Cardiology 02/2006; 95(2):99-104. · 2.95 Impact Factor -
Article: The effect of dual PPAR alpha/gamma stimulation with combination of rosiglitazone and fenofibrate on metabolic parameters in type 2 diabetic patients.
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ABSTRACT: We assessed the additive effect of dual peroxisome proliferators activated receptors (PPAR) alpha/gamma induction, achieved by the addition of fenofibrate to rosiglitazone, on metabolic control and diabetic dyslipidemia. Fourty type 2 diabetic patients with poor metabolic control who were taking oral antidiabetic agents and/or insulin were included in the study. Patients received 4 mg of rosiglitazone per day for 12 weeks. Later, 200mg of fenofibrate per day was added to the therapy regimen for another 12 weeks. HbA1c, uric acid, serum lipid profile and body mass index (BMI) were assessed at the start and at the 12th and the 24th weeks of the study. BMI values at the 12th and the 24th weeks of the study increased significantly (p<0.01) while for HbA1c levels there was a reduction at the 12th and the 24th weeks of 11% (p<0.001) and 13% (p<0.002), respectively. The change in HbA1c levels after the addition of fenofibrate to the rosiglitazone therapy was not statistically significant. The change in LDL levels with rosiglitazone at the 12th week was not statistically significant while the addition of fenofibrate to rosiglitazone decreased mean LDL levels from 126.8+/-29.6 mg/dL to 106.7+/-26.7 mg/dL (p<0.001). The mean percent reduction in triglyceride levels at the 12th and the 24th weeks were 19% and 33%, respectively (p<0.001). HDL levels increased from 44.59 mg/dL to 50.14 mg/dL (p<0.001) at week 12. A further increase of 16% (p<0.001) was observed after the addition of fenofibrate to rosiglitazone. In type 2 diabetic patients dual PPAR alpha/gamma stimulation by means of concomitant administration of rosiglitazone and fenofibrate improves the atherogenic dyslipidemic profile of these patients with good tolerability.Diabetes Research and Clinical Practice 02/2006; 71(1):52-8. · 2.75 Impact Factor -
Article: Reactive hypoglycemia in lean young women with PCOS and correlations with insulin sensitivity and with beta cell function.
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ABSTRACT: Reactive hypoglycemia (RH), which is a postprandial hypoglycemic state, occurs within 2-5 h after food intake. It is classified as idiopathic, alimentary, or diabetic reactive hypoglycemia. We studied the incidence of reactive hypoglycemia and looked for any correlations between it and the presence of insulin sensitivity and/or beta cell function in young lean polycystic ovary syndrome (PCOS) patients. This study was designed as a cross-sectional study in 64 lean young women with PCOS (BMI < or = 25 kg/m2). Various indices of insulin sensitivity and beta cell function derived from the oral glucose tolerance test (OGTT) results were used. We found the rate of RH to be 50% in lean young women with PCOS. DHEA-S and PRL levels were found to be lower in subjects with RH (P < 0.05 and P > 0.05, respectively). Beta cell function indices such as the insulinogenic index (at 120 min), CIR (at 120 min) and HOMA beta cell index were found to be insignificantly higher in the RH group than the nonreactive hypoglycemia (NRH) group. The 4 h glucose level, but not the 3 h glucose level, was significantly correlated with insulin resistance indices, such as fasting insulin level, HOMA-IR, Quicky index, and FIRI in the RH group. Significantly decreased DHEA-S levels were an interesting finding. In conclusion, there is an urgent need to investigate RH in lean young women with PCOS. Our results indicate that more definite insulin resistance occurs in subjects with RH in the fourth hour of the OGTT than those with RH in the third hour. In addition, RH in the fourth hour together with a low DHEA-S level may be predictive of future diabetes in young women with PCOS even when they are not obese.European Journal of Obstetrics & Gynecology and Reproductive Biology 04/2005; 119(2):198-205. · 1.97 Impact Factor -
Article: Comparison of various simple insulin sensitivity and beta-cell function indices in lean hyperandrogenemic and normoandrogenemic young hirsute women.
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ABSTRACT: To assess and compare various simple insulin sensitivity and beta-cell function indices in lean, hirsute, young women. Prospective study. Departments of endocrinology and metabolism at a university and a state hospital. Seventy-one hirsute young women were classified as hyperandrogenemic or normoandrogenemic. Insulin sensitivity and beta-cell function indices derived from a single sample and an oral glucose tolerance test (OGTT). Lean hyperandrogenemic hirsute women have insulin resistance and increased beta-cell function. The most sensitive indices of insulin resistance were total and 1-hour and 2-hour post-challenge insulin levels during OGTT. When a cut-off value of 3.2 or greater for homeostasis model assessment of insulin resistance (HOMA-IR) was accepted, 46% of hyperandrogenemic women and 30% of normoandrogenemic women were insulin resistant. Fasting insulin level was best correlated with the fasting insulin resistance index, HOMA-IR, and Quicky index. The HOMA-IR was best correlated with fasting insulin level and the hepatic insulin sensitivity index (ISI(HOMA)). Insulin levels based on OGTT are the most useful index of insulin resistance and beta-cell function index in hirsute women. The HOMA-IR may be a proposed global test for insulin resistance; it correlated well with both OGTT-derived insulin resistance and beta-cell function indices and with global insulin resistance indices derived from a single sample (such as ISI (HOMA), Quicky index, FIRI(-1), fasting Belfiore index, and glucose/insulin ratio).Fertility and Sterility 08/2003; 80(1):133-42. · 3.56 Impact Factor -
Article: Rhabdomyolysis and severe haemolytic anaemia, hepatic dysfunction and intestinal osteopathy due to hypophosphataemia in a patient after Billroth II gastrectomy.
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ABSTRACT: Hypophosphataemic syndromes lead to appreciable morbidity and mortality. A deficiency or lack of phosphate leads to tissue hypoxia and disruption of cellular function, which may cause severe clinical complications. We present various manifestations of hypophosphataemia; in all cases, diagnosis was delayed due to lack of follow-up. We present the case of a patient with rhabdomyolysis, severe haemolytic anaemia, hepatic dysfunction and intestinal osteopathy due to hypophosphataemia complicated by gastric Billroth II anastomosis surgery. We also review the literature concerning hypophosphataemic conditions. In conclusion, the determination of serum calcium and phosphate levels should be included in the routine follow-up of Billroth II anastomosed patients.European Journal of Gastroenterology & Hepatology 06/2002; 14(5):555-7. · 1.76 Impact Factor -
Article: The presence of insulin resistance and comparison of various insulin sensivity indices in women with androgenetic alopecia.
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ABSTRACT: We aimed to identify the association of female androgenetic alopecia with insulin resistance and to evaluate various simple insulin sensitivity indices and beta cell function in women with androgenetic alopecia (AGA). A cross-sectional study was performed in 66 non-obese women (24-44 years old), 41 with AGA alone and 25 healthy individuals. Blood glucose, insulin, c-peptide levels, oral glucose tolerance test (OGTT); insulin sensitivity and beta cell function indices derived from a single blood sample and OGTT were determined and compared in the two groups. Women with AGA had impaired glucose tolerance (IGT) rates of 12.5%. In the control group IGT was 0%. Fasting glucose, c-peptide, insulin were higher in AGA group. When the indices were evaluated, Raynaud index, FIRI and HOMA-IR results found to be higher in the AGA group than in controls (p < 0.05, for all). Fasting insulin(-1), GIR, FIRI(-1), QUICKY index, ISI HOMA, HOMA-IS results were lower in AGAs than in controls (p < 0.05, for all). Our study showed that women with AGA alone were more insulin resistant than healthy subjects. We suggest that beta cell function and insulin sensitivity indices are useful methods for measuring insulin resistance in AGAs, and HOMA-IR is a good predictor of insulin resistance. We propose that OGTT should be applied in women with AGA.European journal of dermatology: EJD 17(1):21-5. · 2.53 Impact Factor -
Article: Prevalence of metabolic syndrome in patients with psoriasis.
Indian journal of dermatology, venereology and leprology 77(2):193-4. · 0.98 Impact Factor -
Article: Comparison of epicardial adipose tissue (EAT) thickness and anthropometric measurements in metabolic syndrome (MS) cases above and under the age of 65.
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ABSTRACT: EAT is a new index of cardiac and visceral obesity. Waist circumference (WC) measurement is not fully reliable in the determination of visceral adipose tissue (VAT), especially in elderly individuals. Studies on the reflection of the intra-abdominal fat mass by the EAT mass surrounding the heart were performed. Our purpose in this study was to determine the relation between the MS criteria and EAT in MS cases and especially to compare anthropometric measures between non-geriatric patients under the age of 65, and geriatric ones over the age of 65 years. The study was performed during the years 2008 and 2009 on 120 cases; 66.7% of them were under the age of 65 and 33.3% of the cases were 65-year old or older. All of the patients were diagnosed as MS by the International Diabetes Federation (IDF) criteria. They were randomized as per the application order and included to the study. Each subject underwent transthoracic two-dimensional (2D) guided M-mode echocardiogram. We measured epicardial fat thickness on the 1/3 section close to the ventricle basis adjacent to the free wall of right ventricle from both the parasternal long axis (LA) and parasternal short axis (SA) views. Multiple regression analysis showed that WC, systolic blood pressure (SBP) and age were the strongest independent variables correlated with EAT (p<0.001). We also determined a significant correlation between low-density lipoprotein-cholesterol (LDL-C) and EAT (p<0.05). Our data show that EAT-measurement by echocardiography is an efficient method in determination of visceral adiposity and shall be taken into consideration especially when advanced age groups are in question.Archives of gerontology and geriatrics 52(2):e79-84. · 1.36 Impact Factor
Top co-authors
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Institutions
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2002–2012
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Sisli Etfal Training and Research Hospital
İstanbul, Istanbul, Turkey
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2009
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Yeditepe Üniversitesi Hastanesi
İstanbul, Istanbul, Turkey
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