Publications (31)59.78 Total impact
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Article: Effect of cycline D1 (CCND1) gene polymorphism on tumor formation and behavior in patients with prolactinoma.
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ABSTRACT: The objective of this study was to investigate the effect of G870A gene polymorphism of CCND1 on the formation and behavioral features of prolactinomas. One hundred and thirteen patients with prolactinoma and 108 age and gender matched control were included in the study. The patients were divided into two groups as noninvasive and invasive tumors. CCND1 G870A gene polymorphism was compared in patients/control and invasive/noninvasive groups. A and G allele frequencies were found as 41.7% and 58.3% in the controls, and 61.1% and 38.9% in the patients (p<0.01). Rates of G/G, G/A and A/A genotypes were found as 11.8%, 55.9% and 32.4% in the noninvasive group, and 15.6%, 44.4% and 40.0% in the invasive group, respectively. Differences between patient and control groups were significant but were not between invasive and noninvasive groups in terms of the allele frequencies and genotype distribution. Mean tumor size and serum levels of prolactin at the time of diagnosis and change in these values after the treatment were not found statistically significant in genotype subgroups. CCND1 G870A gene polymorphism may be an important factor in the early stages of the tumor formation. However, it did not affect the features of the tumor.Gene 08/2012; 509(1):158-63. · 2.34 Impact Factor -
Article: Effect of sitagliptin monotherapy on serum total ghrelin levels in people with type 2 diabetes.
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ABSTRACT: Sitagliptin is not associated with weight gain and has neutral effects on body weight. It is unclear whether sitagliptin treatment alters serum ghrelin levels in people with type 2 diabetes. Forty-four subjects with type 2 diabetes were randomly assigned to receive sitagliptin or medical nutrition therapy (MNT) for 12 weeks. Changes in anthropometric variables, glycemic control, insulin resistance, lipid parameters, and total ghrelin levels were evaluated at baseline and following 12 weeks of treatment. Significant decreases in body weight and body mass index were observed over the entire study period in both treatment groups. Glycosylated hemoglobin and postprandial plasma glucose levels were statistically significant decreased in the groups receiving sitagliptin compared with baseline values (p=0.021 and p=0.021, respectively), while they were unchanged in the groups receiving MNT. There was a significant decrease in total ghrelin in the groups receiving sitagliptin (p=0.04) compared with baseline values but not in the groups receiving MNT (p=0.46) at the end of the 12 weeks. In this study of patients with type 2 diabetes, treatment with sitagliptin was associated with a significant decrease in serum ghrelin levels. These results suggest that the neutral effect of sitagliptin on weight might be associated with the suppression of fasting serum ghrelin levels.Diabetes research and clinical practice 08/2011; 94(2):212-6. · 2.16 Impact Factor -
Article: The Relationship Between Minor Alterations in Thyroid Function in Euthyroid Patients and Obesity
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ABSTRACT: Although the effects of hypothyroidism or hyperthyroidism on weight have clearly been demonstrated, data regarding the effects of relatively minor defects in thyroid function are limited. In the present study, the relationship between body mass index (BMI) and alterations in thyroid function within the normal range was investigated in obese patients. Three hundred fifty-seven euthyroid, obese patients (309 female and 48 male; mean age, 42 years) were included in the study. The patients were divided into 2 groups based on a BMI threshold value of 40 kg/m2. Thyroid function, BMI, and the epidemiologic characteristics of the patients were retrospectively evaluated. No statistically significant difference was detected between the groups with respect to gender, place of birth, place of residence, smoking habits, and family history. Severely obese patients with a BMI ≥40 kg/m2 were older and had a lower serum-free thyroxine level (fT4) than obese patients with a BMI <40 kg/m2 (P < 0.01). In patients with normal thyroid function, a negative correlation between fT4 and BMI existed. No statistically significant association was detected between BMI and epidemiologic characteristics in euthyroid, obese patients.The Endocrinologist 10/2010; 20(6):304-307. · 0.09 Impact Factor -
Article: Body fat distribution has no effect on serum visfatin levels in healthy female subjects.
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ABSTRACT: Obesity is the presence of either abnormal absolute amount or relative proportion of body fat. Contrary to gluteal obesity, visceral obesity is associated with different metabolic alterations including insulin resistance (IR). A relatively new adipocytokine visfatin is shown to be expressed predominantly in visceral fat and exhibit insulin-mimicking effects in rodents. It is still unclear whether serum visfatin levels are associated with increased total or visceral fat mass in humans. The aim of our study was to investigate the relation between visfatin and obesity parameters namely body mass index (BMI) and waist circumference (WaC) and IR in healthy female subjects. Eighty one female subjects 20 years of age, having no diagnosis of glucose intolerance or diabetes, hypertension and dyslipidemia were chosen. The patients were divided into four groups according to their BMI and WaC values. Serum visfatin and HOMA-IR levels did not differ among groups. No correlation was detected between serum visfatin levels and obesity and metabolic parameters. In conclusion, we demonstrated that body fat distribution did not affect serum visfatin levels in healthy female subjects. Further studies are needed to clarify the exact factors influencing and determining serum visfatin levels and its clinical reflections.Cytokine 03/2010; 49(3):275-8. · 3.02 Impact Factor -
Article: The effect of vitamin D replacement therapy on insulin resistance and androgen levels in women with polycystic ovary syndrome.
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ABSTRACT: Insulin resistance (IR) is one of the common features of the polycystic ovary syndrome (PCOS), and recent studies indicate the possible role of vitamin D in the pathogenesis of IR and glucose metabolism. Aim of this study was aimed to determine the effect of vitamin D replacement therapy on glucose metabolism, insulin, and androgen levels in obese, insulin-resistant women with PCOS. Eleven women with PCOS were included in the study. Mean age of the patients was 23.6+/-5.7 yr, body mass index 33.9+/-5.1 kg/m(2). Six patients (54.5%) had acantosis nigricans and 10 (90.9%) oligoamenorrhea. The mean Ferriman Gallwey score was 14.1+/-4.6. Only 2 women were within the normal limits of vitamin D levels as >20 ng/ml. Three weeks after the administration of the single dose of 300,000 units of vitamin D3 orally, 25-hydroxyvitamin D3 significantly increased from 16.9+/-16 ng/ml to 37.1+/-14.6 ng/ml (p: 0.027) and only 2 women were detected to have vitamin D3 levels <20 ng/ml. Although glucose and insulin levels were decreased non-significantly, homeostasis model assessment (HOMA)-IR significantly decreased from 4.41+/-1.38 to 3.67+/-1.48 (p: 0.043). No significant alterations were witnessed at the levels of DHEAS, total and free testosterone, androstenedione. No correlation was found between vitamin D with HOMA and other hormonal parameters. In conclusion, women with PCOS have mostly insufficient vitamin D levels, and vitamin D replacement therapy may have a beneficial effect on IR in obese women with PCOS.Journal of endocrinological investigation 10/2009; 33(4):234-8. · 1.57 Impact Factor -
Article: Effect of rosiglitazone, metformin and medical nutrition treatment on arterial stiffness, serum MMP-9 and MCP-1 levels in drug naive type 2 diabetic patients.
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ABSTRACT: The aim of the study was to evaluate the long-term effect of rosiglitazone and metformin monotherapy with medical nutrition treatment (MNT) and of MNT alone on arterial stiffness, serum monocyte chemoattractant protein (MCP)-1 and matrix metalloproteinase (MMP)-9 in drug naive patients with type 2 diabetes mellitus. Fifty type 2 diabetic patients were randomized to receive rosiglitazone 4 mg/day (n=19) or metformin 850 mg/day (n=16) with MNT or MNT alone (n=15), for 52 weeks. Arterial stiffness was assessed by using large and small artery elasticity index (SAEI and LAEI, respectively). SAEI, LAEI, serum MCP-1 and MMP-9 levels were measured at baseline and following 52 weeks of treatment. SAEI was improved only in the rosiglitazone group, and the difference was still statistically significant when the three groups were compared (p=0.024). There were no differences in LAEI in inter- and intragroup comparisons at the end of the study. Serum MMP-9 levels were decreased in the metformin (-13.5+/-34.8%, p=0.02) and rosiglitazone (-27.2+/-51.0%, p=0.023) groups compared with baseline values, whereas no significant change was seen in serum MCP-1 levels. These results suggest that rosiglitazone monotherapy has favorable effects on arterial stiffness compared with metformin monotherapy independent of glycemic control.Diabetes research and clinical practice 09/2009; 86(1):44-50. · 2.16 Impact Factor -
Article: Comparative effects of pioglitazone and rosiglitazone on plasma levels of soluble receptor for advanced glycation end products in type 2 diabetes mellitus patients.
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ABSTRACT: Low levels of soluble receptor for advanced glycation end products (sRAGE) have been associated with the occurrence of vascular complications in patients with type 2 diabetes mellitus. Preliminary evidence has suggested that thiazolidinediones have the ability to modulate circulating levels of this molecule in the hyperglycemic milieu. The aim of this pilot study was to assess the differential effect of 2 different thiazolidinediones-pioglitazone and rosiglitazone-on plasma levels of sRAGE in type 2 diabetes mellitus patients. Sixty type 2 diabetes mellitus subjects were randomly assigned to receive pioglitazone (30 mg/d, n = 19), rosiglitazone (4 mg/d, n = 20), or placebo (medical nutrition therapy, n = 21) for 12 weeks. Changes in plasma glucose, glycosylated hemoglobin, insulin resistance (homeostasis model assessment), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and sRAGE were evaluated at baseline and after 12 weeks. At 12 weeks, the pioglitazone (P < .001) group had a significant increase from baseline in sRAGE values that was not seen in the medical nutrition therapy and rosiglitazone groups. We conclude that, in type 2 diabetes mellitus patients, pioglitazone-but not rosiglitazone-significantly raised sRAGE, which may contribute to its antiatherogenic effects.Metabolism: clinical and experimental 09/2009; 59(1):64-9. · 2.59 Impact Factor -
Article: Comparison of composite whole body insulin sensitivity index derived from mixed meal test and oral glucose tolerance test in insulin resistant obese subjects.
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ABSTRACT: Apart from fasting blood glucose (FBG) and insulin (FBI), oral glucose tolerance test (OGTT) is also used in calculating insulin sensitivity. During OGTT, insulin secretion may not reflect normal physiological insulin secretion. Based on this idea, hepatic and whole body insulin sensitivity rates were tested during OGTT and mixed meal test (MMT) in obese subjects. Thirty-one women with Quantitative Insulin Sensitivity Check Index (QUICKI) values below 0.350 and body mass index (BMI) >or=30 were included into the study. OGTT with 75-g glucose and MMT 300 kcal were applied to all cases. Data obtained from OGTT and MMT were used in the assessment of insulin sensitivity with Hemostasis of Model Assessment-Insulin Resistance (HOMA-IR) and Matsuda's Composite Whole Body Insulin Sensitivity Index (Matsuda's ISI). Mean BMI, FBG, and FBI were 36.8 +/- 3.9 kg/m(2), 100.5 +/- 0.10 mg/dl, 16.2 +/- 5.3 microg/ml, respectively. QUICKI was 0.31 +/- 0.01 and HOMA-IR was 3.71 +/- 0.88. Matsuda's ISI derived from OGTT was 6.96 +/- 3.35 and from MMT was 11.32 +/- 6.61. In analysis, it was demonstrated that there was a correlation between HOMA-IR, QUICKI, and Matsuda's ISIs derived from OGTT and MMT. Comparing the time periods separately, it was detected that despite similar increment in insulin levels, glucose levels were higher in OGTT than MMT at 15 and 30 min. Consequently, Matsuda's ISI was demonstrated to be effectively used with the data of MMT, as used with OGTT. Moreover, MMT was shown to be in parallel to physiologic insulin secretion and reflect pancreatic functions better compared to OGTT.Endocrine 07/2009; 36(2):299-304. · 1.42 Impact Factor -
Article: AN UNUSUAL PRESENTATION OF HYPOTHYROIDISM WITH ISOLATED PERICARDIAL EFFUSION IN AN ABLATIVELY TREATED PAPILLARY THYROID CARCINOMA PATIENT
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ABSTRACT: Papillary thyroid carcinoma is one of the differentiated cancers of the thyroid. Hypothyroidism occuring after total thyroidectomy and ablative dose of radioactive iodine should be treated with L-thyroxine to prevent clinical symptoms and signs of hypothyroidism and occasional tumor growth. A 50-year-old female patient with a history of total thyroidectomy 15 years ago due to papillary thyroid carcinoma with capsule invasion followed by ablative dose of radioactive iodine and received no hormone replacement treatment from then-on since she was lost to follow-up was admitted with dyspnea on excursion and chest pain. Although she had laboratory findings of hypothyroidism, there was no remarkable clinical sign or symptom related to hypothyroidism other than isolated pericardial effusion. Her thyroglobulin (Tg) level was low but a halo image was observed in the pericardiac region with no other activity in the rest of the body in I131 scan. Differential diagnosis indicated that isolated pericardial effusion was due to hypothyroidism rather than recurrence of the papillary thyroid carcinoma. The importance of thyroid status evaluation in suspected individuals for the differential diagnosis of complications due to the recurrence of the underlying thyroid cancer or hypothyroidism and the reliability of Tg to rule out metastasis in cases with a false positive I131 scan are discussed on behalf of our case in the view of the literature.The Anatolian Journal of Clinical Investigation. 01/2009; -
Article: The effect of metformin treatment on VEGF and PAI-1 levels in obese type 2 diabetic patients.
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ABSTRACT: The aim of the study was to evaluate the effect of metformin on markers of endothelial function, vascular inflammation and factors of thrombosis in obese type 2 diabetic patients. Twenty-four type 2 diabetic patients (15 female, 9 male) previously under medical nutrition treatment (MNT)+regular exercise programme (REP) without chronic micro or macrovascular complications with the mean age of 50.5+/-1.5 years, diabetes duration of 17.9+/-6.3 months and body mass index (BMI) of 31.7+/-0.8 kg/m(2) were enrolled in the study. In the first 4 weeks, all the patients continued MNT+REP. In the following 12 weeks, metformin (mean daily dosage of 1381+/-85 mg) was added. After the first period with MNT+REP, BMI, waist circumference, fat percentage, blood pressure and HDL cholesterol decreased significantly. After metformin addition, there was a significant decrement in BMI, waist circumference, fat percentage, fasting and postprandial plasma glucose, hemoglobin A1C, plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF) and increment in beta cell reserve values of the patients. Our results indicated that, metformin addition had beneficial effect on VEGF and PAI-1 levels in obese type 2 diabetic patients under MNT+REP, independent from its' favourable effects on BMI and glycemic control.Diabetes research and clinical practice 08/2008; 81(1):56-60. · 2.16 Impact Factor -
Article: Calcineurin inhibitors and post-transplant weight gain.
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ABSTRACT: Excessive weight gain that leads to obesity is quite common after kidney transplantation. This is often attributed to immunosuppression. The aim of this retrospective study was to assess the effect of calcineurin inhibitors on post-transplant weight gain. A total of 99 patients were studied. The patients were divided into cyclosporine A (CyA) and tacrolimus (Tac) groups and were evaluated for weight changes and risk factors related to weight gain. The weights of patients in both groups significantly increased after the sixth month. The median weight gain at 12 months was 3.5 and 8.0 kg compared with pretransplant dry weight in the Tac and CyA groups, respectively. The increases in the CyA group were significant compared with those of the Tac group. The prevalences of obese and overweight patients in both groups did not differ during a 12-month follow-up. The frequencies of diabetes mellitus, hypertension and dyslipidemia were comparable in both groups. The decrease in systolic blood pressure (BP) of the Tac group was significant compared with the decrease in the CyA group at the 12th month. In the 12-month follow-up period, the increases in triglyceride, total- and low-density lipoprotein-cholesterol values of the CyA group were significantly higher than those of the Tac group. The weight change between 0 and 12 months was negatively correlated with pretransplant body mass index (BMI) and positively with cumulative corticosteroid doses, total-cholesterol and BP changes. Only pretransplant BMI, creatinine clearance, CyA usage, being hypertensive and dyslipidemic were independent predictors of weight gain at the 12th month. Our results suggested that the type of immunosuppression may affect post-transplant weight gain.Nephrology 04/2008; 13(5):433-9. · 1.31 Impact Factor -
Article: Arterial elasticity and plasma levels of adiponectin and leptin in type 2 diabetic patients treated with thiazolidinediones.
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ABSTRACT: Thiazolidinediones (TZDs) improve peripheral insulin sensitivity, but the effect on arterial stiffness is less clear. The aim of the present study was to assess the differential effect of pioglitazone or rosiglitazone on arterial stiffness and plasma levels of adiponectin and leptin in patients with type 2 diabetes mellitus. Thirty-five type 2 diabetic subjects were randomly assigned to receive pioglitazone (30 mg/day; n = 14), rosiglitazone (4 mg/day; n = 11), or placebo (medical nutrition therapy; n = 10) for 12 weeks. Changes in plasma glucose, glycosylated hemoglobin, insulin resistance (HOMA-IR), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, adiponectin, and leptin were evaluated at baseline and after 12 weeks. In parallel, large arterial compliance (C1) and small arterial compliance (C2) were measured at baseline and at the end of treatment period. At 12 weeks, the rosiglitazone (P = 0.026) and pioglitazone (P = 0.004) groups had a significant increase from baseline in adiponectin that was not seen in the medical nutrition therapy group. No significant changes in plasma leptin and in C1 and C2 elasticity indexes were observed over the entire study period in any of the treatment groups. In this study of patients with type 2 diabetes, treatment with TZDs was associated with a significant improvement in adiponectin levels, although no significant effects were seen on leptin levels and arterial elasticity.Endocrine 03/2008; 33(1):101-5. · 1.42 Impact Factor -
Article: Why does post-transplant osteonecrosis develop?
Nephrology Dialysis Transplantation 09/2007; 22(8):2412. · 3.40 Impact Factor -
Article: Determination and comparison of the factors leading to overweight and obesity in an urban population
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ABSTRACT: BACKGROUNDTo evaluate and compare the demographic and socioeconomic features and life styles of normal weight, overweight and obese subjects living in the city center of Bursa and investigate these features in the obese group by subgrouping according to body mass index (BMI). METHODSThe study included randomly assigned 2011 subjects older than 18 years of age. A questionnaire was filled in for each participant about age, gender, occupation, educational and marital status, family history of obesity and personal history of co-morbidities, smoking, alcohol, exercise and dietary habits. RESULTSOverweight ratio in men (53.5% vs 40.5%) and obese ratio in women (22.7% vs 39.3%) were higher. Female gender, educational level, family history for obesity, diastolic blood pressure and smoking were the main predictors of high BMI. In subgroup analysis, there was no difference between dietary and physical habits and co-morbid disease prevalences.CONCLUSIONSSince being overweight is a pre-obese, pre-diabetic and pre-hypertensive stage, every attempt should be made to increase public awareness for the prevention of gaining weight to prevent obesity and related co-morbid illnesses.The Anatolian Journal of Clinical Investigation. 01/2007; -
Article: Serum monocyte chemoattractant protein-1 and monocyte adhesion molecules in type 1 diabetic patients with nephropathy.
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ABSTRACT: Monocyte chemoattractant protein (MCP)-1 is suggested to be implicated in the pathogenesis of diabetic nephropathy by activating and recruiting monocytes to the glomerulus via regulation of adhesion molecule expressions. The aim of this study was to test potential associations between serum concentrations of MCP-1, monocyte expression of Mac-1 and LFA-1 and nephropathy in type 1 diabetes mellitus. Serum MCP-1 levels and expression of monocyte adhesion molecules in 51 type 1 diabetic patients with and without diabetic nephropathy were compared with matched 15 healthy control subjects. Concentrations of serum MCP-1 were determined by enzyme-linked immunosorbent assays whereas monocyte expression of adhesion molecules Mac-1 and LFA-1 was measured by flow cytometry. Serum MCP-1 levels and expression of Mac-1, but not LFA-1, were significantly higher in diabetic patients compared with controls. The mean serum MCP-1 level was 137.2 +/- 71.4 pg/mL in control patients, whereas it was 246.2 +/- 114.9 pg/ml in diabetic patients (p = 0.002). Serum MCP-1 levels were positively correlated with HbA1c and plasma fasting glucose levels. There was no difference in serum levels of MCP-1 and expression of monocyte adhesion molecules between type 1 diabetic patients with and without diabetic nephropathy. In type 1 diabetic patients, the levels of circulating MCP-1 concentration and expression of Mac-1 is mostly influenced by glycemic control rather than the existence of diabetic nephropathy.Archives of Medical Research 12/2006; 37(8):998-1003. · 1.88 Impact Factor -
Article: Tumor Size Predictive for Malignancy in Indeterminate Follicular Thyroid Lesions
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ABSTRACT: Fine needle aspiration biopsy is of little value in distinguishing benign and malignant thyroid follicular neoplasms. In this study, we investigated clinical and histopathologic characteristics of cytologically indeterminate thyroid follicular lesions (ITFL) in attempt to predict malignancy as determined by histopathologic examination. Fifty-seven patients diagnosed with ITFL underwent thyroidectomy. The mean patient age was 50.4 ± 13.4 years. Based on the histopathologic findings, cases were classified into 3 categories: nonfollicular lesion (NF), follicular adenoma (FA), and follicular carcinoma (FC). The NF group contained 19 subjects with nodular colloidal goiter (NCG), 3 with Hashimoto thyroiditis. and one with granulomatous thyroiditis. The FA group contained 7 classic follicular and 8 Hürtle cell adenomas. The FC group contained 6 classic follicular, 8 Hürtle cell, and one insular carcinoma. The mean nodule size was significantly larger in the FC group than in the FA and NF groups (4.2 ± 2.4 cm vs 2.2 ± 0.9 cm and 2.5 ± 1.3 cm, respectively, P < 0.05). Using a value of nodule size of 3 cm, the sensitivity and specificity for solvent malignant histology are 66.7% and 83.3%, respectively. These data show that nodule size of ITFL is predictive of malignancy. A nodule size greater than 3 cm is associated with a higher probability of malignancy and suggests total thyroidectomy as an initial therapeutic intervention.The Endocrinologist 10/2006; 16(6):313-316. · 0.09 Impact Factor -
Article: Is glucocorticoid-induced osteonecrosis after kidney transplantation related to osteoporosis?
Nephrology Dialysis Transplantation 06/2006; 21(5):1452-3. · 3.40 Impact Factor -
Article: Synchronous carcinomas of stomach and bladder together with AA amyloidosis.
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ABSTRACT: Although the association and causality between chronic inflammatory states and systemic AA amyloidosis have been well established, the evidence linking solid malignancies to reactive AA amyloidosis is scarce. Here, a case of diagnosed AA amyloidosis associated with synchronous carcinomas of stomach and bladder complicated with nephrotic syndrome and renal failure is reported.Nephrology 05/2006; 11(2):120-3. · 1.31 Impact Factor -
Article: Comparison of the obesity risk and related factors in employed and unemployed (housewife) premenopausal urban women.
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ABSTRACT: The aim of the study was to assess the interaction between occupational and leisure time physical activities (LTPA) as well as socioeconomical status (SES), lifestyles and dietary habits on the prevalences of overweight and obesity in employed and unemployed (housewife) urban premenopausal Turkish women. Among 1209 women surveyed 508 premenopausal ones between 20 and 45 years of age were included in the study. Overweight prevalence in the employed (47.3% versus 36.2%) and obesity prevalence in the unemployed women (housewives) were higher (42.2% versus 11.6%). The ratio of family history for obesity, co-morbid diseases, habit of <30 min of walking/day, consuming meals twice/day, preference of vegetables were higher in the housewives. Employed women had a higher SES scoring, education level, percentage of no habit of walking, consuming meals thrice per day, preference for protein, smoking and alcohol consumption. Housewife group had a higher glucose level measured while employed group higher total cholesterol. Age, waist circumference (WaC), having one or two meals/day versus three or four meals/day, having lunch at home versus outdoor lunch, having one parity versus none were the main predictors of obesity. Our results indicated that lifestyle interventions should be afforded for increasing LTPA for both employed and unemployed women since overweight and obesity prevalences are high in both.Diabetes Research and Clinical Practice 05/2006; 72(2):190-6. · 2.75 Impact Factor -
Article: Insulin analogue usage in a haemodialysis patient with type 2 diabetes mellitus.
Nephrology Dialysis Transplantation 03/2006; 21(2):553-4. · 3.40 Impact Factor
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2004–2010
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Uludag University
- Department of Internal Medicine (Faculty of Medicine)
USA
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