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Findikoglu G, Altinkapak A, Yaylali GF. Is isoenergetic high-intensity interval exercise superior to moderate-intensity continuous exercise for cardiometabolic risk factors in individuals with type 2 diabetes mellitus? A single-blinded randomized controlled study. Eur J Sport Sci 2023; 23:2086-2097. [PMID: 36622777 DOI: 10.1080/17461391.2023.2167238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The aim of this study was to compare the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) with equal energy expenditure on glycaemic and cardiometabolic risk factors in people with Type 2 Diabetes Mellitus (T2DM) when compared to the control. Sixty-three people with T2DM were randomly assigned to HIIT, MICT, or non-exercising controls. Individuals were trained with HIIT at 90 and 30% of their VO2peak (1:2 min ratio) starting from 8 up to 16 intervals and MICT at 50% of VO2peak, on a cycle ergometer, 3 times/week for 12 weeks under supervision. The primary outcome measure was the change in HbA1c. Aerobic capacity, cardiovascular responses, anthropometric measures, body composition, glycaemic, and cardiometabolic risk factors were measured at the beginning and the end of the 12-week training period. There was no significant difference between HIIT and MICT or when compared to the control for HbA1c, glucose, insulin resistance, blood lipids, cardiovascular responses, anthropometric measures, body composition, and abdominal and visceral fat (padj > 0.05). HIIT and MICT increased VO2peak significantly compared to controls (p < 0.05) but not to each other (p > 0.05). Both HIIT and MICT improved VO2peak and HbA1c after 12 weeks of training compared to their baseline, furthermore, only MICT caused additional improvements in cardiovascular responses, anthropometric measures, and abdominal fat compared to baseline (p < 0.05). As a conclusion, isoenergetic HIIT or MICT did not improve HbA1c. The two protocols were equally efficient for improvement in aerobic capacity but had little effect on other cardiometabolic factors.Trial registration: ClinicalTrials.gov identifier: NCT03682445.HighlightsHIIT and MICT with equal energy expenditure were equally efficient for aerobic capacity compared to controls.Isoenergetic HIIT or MICT were not superior for improving HbA1c.Isoenergetic HIIT and MICT were not superior to each other for anthropometric measures, body composition, and cardiometabolic risk factors.
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Affiliation(s)
- Gulin Findikoglu
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Pamukkale, Denizli, Turkey
| | - Abdurrahim Altinkapak
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Pamukkale, Denizli, Turkey
| | - Guzin Fidan Yaylali
- Faculty of Medicine, Department of Endocrinology and Metabolism Diseases, University of Pamukkale, Denizli, Turkey
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Anaforoglu I, Sancak S, Akbas EM, Oruk GG, Canat M, Tezcan KA, Uc ZA, Gorar S, Duman GC, Yaylali GF, Yılmaz M, Bilir BE, Bozoglan H, Akbaba G, Tuna MM, Akcay S, Tuzun D, Bagir GS, Haydardedeoglu FE, Elbuken G, Yorulmaz G, Celik O, Topbas M. Effects of Treatment Adherence on Quality of Life in Hypoparathyroid Patients. Exp Clin Endocrinol Diabetes 2021; 129:918-925. [PMID: 33694151 DOI: 10.1055/a-1400-2668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study aimed to evaluate the current situation of hypoparathyroid patients and to investigate the relationship between treatment adherence and quality of life. STUDY DESIGN Prospective, multicentre study. METHODS Adult patients presenting with the diagnosis of hypoparathyroidism to 20 different endocrinology clinics were included. They were receiving conventional therapies for hypoparathyroidism, using calcium, active vitamin D, and magnesium. We collected data on demographic features, disease- and treatment-related information, and results of routine laboratory tests, treatment adherence, and presence of complications. Beck Depression Inventory, Beck Anxiety Inventory, and Short Form-36 quality of life assessments were administered. RESULTS Among the 300 patients studied, 60.7% were adherent to their treatment, and 34.1% had complications. Anxiety and depression scores were significantly higher in non-adherent versus treatment-adherent patients (p<0.001 and p=0.001, respectively). Most of the domains of quality-of-life scores were also significantly lower in non-adherent patients. Both anxiety and depression scores showed significant, negative correlations with serum calcium and magnesium concentrations (r=-0.336, p<0.001 and r=-0.258, p<0.001, respectively). CONCLUSIONS Nearly 40% of the patients were non-adherent to conventional treatment for hypoparathyroidism, and such patients had higher anxiety and depression scores and poorer quality of life scores. Conventional treatment might not be sufficient to meet the needs of patients with hypoparathyroidism. In addition to seeking new therapeutic options, factors influencing quality of life should also be investigated and strategies to improve treatment adherence should be developed.
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Affiliation(s)
- Inan Anaforoglu
- Bahcesehir University, Faculty of Medicine, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
| | - Seda Sancak
- University of Health Sciences, Fatih Sultan Mehmet Education and Research Hospital, Endocrinology and Metabolism Disorders, Department of Internal Medicine, İstanbul, Turkey
| | - Emin Murat Akbas
- Erzincan Binali Yıldırım University, Mengücek Gazi Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Erzincan, Turkey
| | - Guzide Gonca Oruk
- Izmir Katip Celebi University, Ataturk Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Izmir, Turkey
| | - Masum Canat
- Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
| | - Kadriye Aydın Tezcan
- Kartal Dr. Lütfi Kirdar City Hospital, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
| | - Ziynet Alphan Uc
- Usak Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Usak, Turkey
| | - Suheyla Gorar
- Health Sciences University, Antalya Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Antalya, Turkey
| | - Gulhan Cavlak Duman
- Sivas Cumhuriyet University Health Services Practice and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Adana, Turkey
| | - Guzin Fidan Yaylali
- Pamukkale University Hospitals, Department of Internal Diseases, Endocrinology Clinic, Denizli, Turkey
| | - Merve Yılmaz
- Samsun Gazi State Hospital, Department of Internal Diseases, Endocrinology Clinic, Samsun, Turkey
| | - Betul Ekiz Bilir
- Tekirdag State Hospital, Department of Internal Diseases, Endocrinology Clinic, Tekirdag, Turkey
| | - Humeyra Bozoglan
- Giresun University Prof. Dr. A. Ilhan Ozdemir Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Giresun, Turkey
| | - Gulhan Akbaba
- Mugla Sitki Kocman University Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Mugla, Turkey
| | - Mazhar Muslum Tuna
- Umraniye Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
| | - Seckin Akcay
- Umraniye Training and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Istanbul, Turkey
| | - Dilek Tuzun
- Kahramanmaras Sutcu Imam University Health Practice and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Kahramanmaras, Turkey
| | - Gulay Simsek Bagir
- Baskent University Adana Dr. Turgut Noyan Practice and Research Center, Department of Internal Diseases, Endocrinology Clinic, Adana, Turkey
| | - Filiz Eksi Haydardedeoglu
- Baskent University Adana Dr. Turgut Noyan Practice and Research Center, Department of Internal Diseases, Endocrinology Clinic, Adana, Turkey
| | - Gulsah Elbuken
- Namık Kemal University, Faculty of Medicine, Department of Internal Medicine, Endocrinology Clinic
| | - Goknur Yorulmaz
- Eskisehir Osmangazi University Health, Practice and Research Hospital, Department of Internal Diseases, Endocrinology Clinic, Eskisehir, Turkey
| | - Ozlem Celik
- Mehmet Ali Aydınlar Acıbadem University, Faculty of Medicine, Department of Internal Diseases, Endocrinology Clinic, İstanbul, Turkey
| | - Murat Topbas
- Karadeniz Technical University, Faculty of Medicine, Department of Public Health, Trabzon, Turkey
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Toprak I, Fenkci SM, Fidan Yaylali G, Martin C, Yaylali V. Early retinal neurodegeneration in preclinical diabetic retinopathy: a multifactorial investigation. Eye (Lond) 2019; 34:1100-1107. [PMID: 31654034 DOI: 10.1038/s41433-019-0646-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/03/2019] [Accepted: 09/09/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/OBJECTIVES To investigate effects of microalbuminuria (MA), diabetes duration, glycosylated haemoglobin (HbA1c) level, hypertension (HT) and/or hyperlipidaemia (HL) coexistence on retinal layers in diabetic patients without diabetic retinopathy (DR) using spectral-domain optical coherence tomography (SD-OCT). SUBJECTS/METHODS This cross-sectional study involved 95 (45 had MA and 50 had no MA) patients with type 2 diabetes mellitus (DM) without DR and 91 age- and gender-matched non-diabetic controls. Macular and peripapillary SD-OCT measurements (Heidelberg Engineering GmbH, Heidelberg, Germany), DM duration, HbA1c levels and presence of HT and/or HL were used for statistical analyses. RESULTS The MA (+), MA (-) and control groups had similar age and gender distribution (p > 0.05). The differences in SD-OCT measurements among the MA (+), MA (-) and control groups were insignificant (p > 0.05). However, diabetic patients (n = 95) had significantly thinner inferior-temporal peripapillary retinal nerve fibre layer (RNFL) (p = 0.042) than in the controls (n = 91). Superior peripapillary RNFL was significantly thinner in patients with an HbA1c level > 7% (p = 0.049). However, 3 mm-nasal, temporal and superior perifoveal thicknesses were significantly lower in patients with DM duration over 10 years (p < 0.05). HT and/or HL coexistence did not lead a significant difference in SD-OCT parameters among the groups. CONCLUSIONS In diabetic patients without DR, peripapillary inferior-temporal RNFL thinning might be an early sign of neuroretinal degeneration and it seems to be independent from vascular endothelial damage (MA). Poor metabolic control appears to lead superior peripapillary RNFL thinning, while perifoveal thicknesses tend to decrease with longer DM duration.
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Affiliation(s)
- Ibrahim Toprak
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey.
| | - Semin Melahat Fenkci
- Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Guzin Fidan Yaylali
- Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Cigdem Martin
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Volkan Yaylali
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Toprak I, Fenkci SM, Fidan Yaylali G, Martin C, Yaylali V. Effect of microalbuminuria on corneal endothelium in patients with diabetes without retinopathy. Clin Exp Optom 2019; 103:625-629. [PMID: 31625203 DOI: 10.1111/cxo.12969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/30/2019] [Accepted: 08/20/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effect of microalbuminuria on corneal endothelium in patients with diabetes without retinopathy. METHODS This cross-sectional study comprised 100 patients with type 2 diabetes mellitus (DM) without diabetic retinopathy and 92 control subjects without diabetes. Forty-five patients had microalbuminuria and 55 subjects were microalbuminuria negative. Endothelial measurements were obtained using specular microscopy. Endothelial cell density, average area, co-efficient of variation, maximum area, minimum area, hexagonality and corneal thickness were compared between the groups on the basis of microalbuminuria, DM duration and medication, HbA1c , body mass index, serum lipid and protein profiles, hypertension and hyperlipidaemia diagnosis. RESULTS There were no significant differences in age, gender, endothelial cell density, average area, co-efficients of variation, maximum area, minimum area, hexagonality or corneal thickness among the microalbuminuria positive, microalbuminuria negative and control groups (p > 0.05). However, microalbuminuria positive patients had lower high-density lipoprotein levels than the microalbuminuria negative patients (p = 0.042). DM and control groups showed similar endothelial measurements (p > 0.05). Patients with a HbA1c > 7 per cent (53 mmol/mol) had lower hexagonality value (p = 0.039) than in the subjects with a HbA1c ≤ 7 per cent. No significant differences were found in endothelial parameters when groups were compared based on DM duration, medication and co-morbidities. CONCLUSIONS Microalbuminuria positive and negative patients with DM without retinopathy seem to have similar corneal endothelial measurements with controls. However, patients with a HbA1c > 7 per cent should be monitored for deterioration in corneal endothelial cell morphology even without diabetic retinopathy, which might be critical prior to anterior segment surgery.
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Affiliation(s)
- Ibrahim Toprak
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Semin Melahat Fenkci
- Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Guzin Fidan Yaylali
- Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Cigdem Martin
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Volkan Yaylali
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Akinci B, Onay H, Demir T, Savas-Erdeve Ş, Gen R, Simsir IY, Keskin FE, Erturk MS, Uzum AK, Yaylali GF, Ozdemir NK, Atik T, Ozen S, Yurekli BS, Apaydin T, Altay C, Akinci G, Demir L, Comlekci A, Secil M, Oral EA. Clinical presentations, metabolic abnormalities and end-organ complications in patients with familial partial lipodystrophy. Metabolism 2017; 72:109-119. [PMID: 28641778 DOI: 10.1016/j.metabol.2017.04.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/18/2017] [Accepted: 04/23/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Familial partial lipodystrophy (FPLD) is a rare genetic disorder characterized by partial lack of subcutaneous fat. METHODS This multicenter prospective observational study included data from 56 subjects with FPLD (18 independent Turkish families). Thirty healthy controls were enrolled for comparison. RESULTS Pathogenic variants of the LMNA gene were determined in nine families. Of those, typical exon 8 codon 482 pathogenic variants were identified in four families. Analysis of the LMNA gene also revealed exon 1 codon 47, exon 5 codon 306, exon 6 codon 349, exon 9 codon 528, and exon 11 codon 582 pathogenic variants. Analysis of the PPARG gene revealed exon 3 p.Y151C pathogenic variant in two families and exon 7 p.H477L pathogenic variant in one family. A non-pathogenic exon 5 p.R215Q variant of the LMNB2 gene was detected in another family. Five other families harbored no mutation in any of the genes sequenced. MRI studies showed slightly different fat distribution patterns among subjects with different point mutations, though it was strikingly different in subjects with LMNA p.R349W pathogenic variant. Subjects with pathogenic variants of the PPARG gene were associated with less prominent fat loss and relatively higher levels of leptin compared to those with pathogenic variants in the LMNA gene. Various metabolic abnormalities associated with insulin resistance were detected in all subjects. End-organ complications were observed. CONCLUSION We have identified various pathogenic variants scattered throughout the LMNA and PPARG genes in Turkish patients with FPLD. Phenotypic heterogeneity is remarkable in patients with LMNA pathogenic variants related to the site of missense mutations. FPLD, caused by pathogenic variants either in LMNA or PPARG is associated with metabolic abnormalities associated with insulin resistance that lead to increased morbidity.
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Affiliation(s)
- Baris Akinci
- Division of Endocrinology, Dokuz Eylul University, Izmir, Turkey.
| | - Huseyin Onay
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Tevfik Demir
- Division of Endocrinology, Dokuz Eylul University, Izmir, Turkey
| | - Şenay Savas-Erdeve
- Division of Pediatric Endocrinology, Dr. Sami Ulus Obstetrics and Gynecology, Children's Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Ramazan Gen
- Division of Endocrinology, Mersin University, Mersin, Turkey
| | | | - Fatma Ela Keskin
- Division of Endocrinology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Ayse Kubat Uzum
- Division of Endocrinology, Capa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | | | - Tahir Atik
- Division of Pediatric Genetics, Ege University, Izmir, Turkey
| | - Samim Ozen
- Division of Pediatric Endocrinology, Ege University, Izmir, Turkey
| | | | - Tugce Apaydin
- Division of Endocrinology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Canan Altay
- Department of Radiology, Dokuz Eylul University, Izmir, Turkey
| | - Gulcin Akinci
- Division of Pediatric Neurology, Dr.Behcet Uz Children's Hospital, Izmir, Turkey
| | - Leyla Demir
- Department of Biochemistry, Ataturk Training Hospital, Izmir, Turkey
| | | | - Mustafa Secil
- Department of Radiology, Dokuz Eylul University, Izmir, Turkey
| | - Elif Arioglu Oral
- Division of Endocrinology and Metabolism, Brehm Center for Diabetes Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Akinci G, Topaloglu H, Demir T, Danyeli AE, Talim B, Keskin FE, Kadioglu P, Talip E, Altay C, Yaylali GF, Bilen H, Nur B, Demir L, Onay H, Akinci B. Clinical spectra of neuromuscular manifestations in patients with lipodystrophy: A multicenter study. Neuromuscul Disord 2017; 27:923-930. [PMID: 28754454 DOI: 10.1016/j.nmd.2017.05.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 01/14/2023]
Abstract
Lipodystrophy is a heterogeneous group of disorders characterized by loss of adipose tissue. Here, we report on clinical spectra of neuromuscular manifestations of Turkish patients with lipodystrophy. Seventy-four patients with lipodystrophy and 20 healthy controls were included. Peripheral sensorimotor neuropathy was a common finding (67.4%) in lipodystrophic patients with diabetes. Neuropathic foot ulcers were observed in 4 patients. Drop foot developed in 1 patient with congenital generalized lipodystrophy type 1. Muscle symptoms and hypertrophy were consistent findings in congenital generalized lipodystrophy (21/21) and familial partial lipodystrophy (25/34); on the other hand, overt myopathy with elevated creatine kinase activity was a distinctive characteristic of congenital generalized lipodystrophy type 4. Muscle biopsies revealed myopathic changes at different levels. Accumulation of triglycerides was observed which contributes to insulin resistance. All patients with congenital generalized lipodystrophy suffered from tight Achilles tendons at various levels. Scoliosis was observed in congenital generalized lipodystrophy type 4 (2/2) and familial partial lipodystrophy type 2 (2/17). Atlantoaxial instability was unique to congenital generalized lipodystrophy type 4 (2/2). Bone cysts were detected in congenital generalized lipodystrophy type 1 (7/10) and congenital generalized lipodystrophy type 2 (2/8). Our study suggests that lipodystrophies are associated with a wide spectrum of neuromuscular abnormalities.
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Affiliation(s)
- Gulcin Akinci
- Department of Pediatric Neurology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
| | - Haluk Topaloglu
- Department of Pediatric Neurology, Hacettepe University Children's Hospital, Ankara, Turkey
| | - Tevfik Demir
- Department of Internal Medicine, Division of Endocrinology, Dokuz Eylul University, Izmir, Turkey
| | | | - Beril Talim
- Pediatric Pathology Unit, Hacettepe University Children's Hospital, Ankara, Turkey
| | - Fatma Ela Keskin
- Department of Internal Medicine, Division of Endocrinology, Gaziosmanpasa Taksim Training Hospital, Istanbul, Turkey
| | - Pinar Kadioglu
- Department of Internal Medicine, Division of Endocrinology, Istanbul University, Istanbul, Turkey
| | - Enez Talip
- Department of Internal Medicine, Division of Endocrinology, Dokuz Eylul University, Izmir, Turkey
| | - Canan Altay
- Department of Radiology, Dokuz Eylul University, Izmir, Turkey
| | - Guzin Fidan Yaylali
- Department of Internal Medicine, Division of Endocrinology, Pamukkale University, Denizli, Turkey
| | - Habib Bilen
- Department of Internal Medicine, Division of Endocrinology, Ataturk University, Erzurum, Turkey
| | - Banu Nur
- Department of Pediatrics, Division of Pediatric Genetics, Akdeniz University, Antalya, Turkey
| | - Leyla Demir
- Department of Biochemistry, Ataturk Training Hospital, Izmir, Turkey
| | - Huseyin Onay
- Department of Medical Genetics, Ege University, Izmir, Turkey
| | - Baris Akinci
- Department of Internal Medicine, Division of Endocrinology, Dokuz Eylul University, Izmir, Turkey
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Fidan Yaylali G, Turgut S, Akin F, Ozkan S, Tural M, Tunc Ata M, Ozlu C, İsler K. Visfatin Levels in Subclinical Hypothyroidism. Int J Pept Res Ther 2015. [DOI: 10.1007/s10989-015-9479-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Topsakal S, Akin F, Turgut S, Yaylali GF, Herek D, Ayada C. Relationship of apelin, procalcitonin, and fetuin-A concentrations with carotid intima-media thickness in acromegaly. Ann Clin Biochem 2014; 52:456-61. [DOI: 10.1177/0004563214562431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2014] [Indexed: 12/31/2022]
Abstract
Background Acromegaly is characterized by excess growth hormone and insulin-like growth factor-1 concentrations. There is conflicting evidence as to whether acromegaly is associated with an increased risk of atherosclerosis. Apelin is an adipose tissue-derived peptide that may be associated with hyperinsulinemia. Fetuin-A is a hepatocyte produced plasma glycoprotein that has an important role as a calcification inhibitor. The aim of this study was to examine apelin, fetuin-A, and procalcitonin concentrations and to assess their relationship with carotid intima medial thickness (cIMT) in subjects with acromegaly. Methods Apelin, fetuin-A, and procalcitonin serum concentrations were measured in 37 (20 inactive and 17 active) subjects with acromegaly and 30 control subjects, along with carotid intima medial thickness. Results The concentrations of apelin, fetuin-A, and procalcitonin were increased in subjects with acromegaly. There were significant correlations between apelin, fetuin-A, and procalcitonin in subjects with acromegaly. Carotid intima medial thickness values were similar between control subjects and subjects with acromegaly. Conclusions Carotid intima medial thickness was not increased in subjects with acromegaly. It is possible that the increased apelin and fetuin-A concentrations observed play a protective role against the development of atherosclerosis in subjects with acromegaly.
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Affiliation(s)
- S Topsakal
- Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - F Akin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - S Turgut
- Department of Physiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - GF Yaylali
- Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - D Herek
- Department of Radiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - C Ayada
- Department of Physiology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Yaylali YT, Yaylali GF, Akin F, Susam I, Bastemir M. OP-044 EFFECTS OF TESTOSTERONE THERAPY ON RIGHT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION IN PATIENTS WITH IDIOPATHIC HYPOGONADOTROPIC HYPOGONADISM. Int J Cardiol 2010. [DOI: 10.1016/s0167-5273(10)70046-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fidan Yaylali G, Akin F, Turgut S, Kursunluoglu R. IGF-1 gene polymorphism in obese patients with insulin resistance. Mol Biol Rep 2009; 37:529-33. [DOI: 10.1007/s11033-009-9729-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Accepted: 08/04/2009] [Indexed: 10/20/2022]
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Colakoglu M, Fidan Yaylali G, Yalcin Colakoglu N, Yilmaz M. Successful treatment of visceral leishmaniasis with fluconazole and allopurinol in a patient with renal failure. ACTA ACUST UNITED AC 2009; 38:208-10. [PMID: 16500783 DOI: 10.1080/00365540500321405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Standard treatments for visceral leishmaniasis (antimonials, amphotericin B and pentamidine) pose several problems. Failure of antimonials or severe toxicity is particularly troublesome in patients with renal insufficiency. We report a case of visceral leishmaniaisis and renal insufficiency successfully treated with fluconazole and allopurinol for 4 months.
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Affiliation(s)
- Murat Colakoglu
- Department of Nephrology, School of Medicine, Pamukkale University, Denizli, Turkey.
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Akin F, Yaylali GF, Turgut S, Kaptanoglu B. Growth hormone/insulin-like growth factor axis in patients with subclinical thyroid dysfunction. Growth Horm IGF Res 2009; 19:252-255. [PMID: 19111490 DOI: 10.1016/j.ghir.2008.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 11/18/2008] [Accepted: 11/19/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Our aim was to evaluate serum concentrations of GH, IGF-I, and insulin-like growth factor-binding protein-3 (IGFBP-3) in patients with subclinical thyroid dysfunction before and after normalization of thyroid function. DESIGN AND METHODS The study included 51 patients (mean age 42.2+/-1.8 years) with subclinical hypothyroidism and 30 patients (mean age 44.3+/-2.4 years) with subclinical hyperthyroidism. A group of 37 euthyroid healthy subjects were studied as controls. Serum concentrations of TSH, FT4, FT3, GH, insulin, IGF-I, and IGFBP-3 were measured in all patients before starting therapy and after normalization of thyroid function. The dosage of levothyroxine (LT4) and antithyroid drugs was adjusted in attempt to keep the serum-free thyroxine (FT4) and thyrotropin (TSH) concentrations within the normal range. MAIN OUTCOME Baseline growth hormone levels were similar with hypothyroid group and hyperthyroid group in relation to euthyroid control subjects. Fasting serum IGF-I levels were significantly lower in the subclinical hypothyroid group compared with the control group. On the other hand, IGF-I levels of subclinical hyperthyroid patients and control group were similar. After normalization of thyroid function tests, IGF-I concentrations were increased in subclinical hypothyroid subjects, but unchanged in subclinical hyperthyroid subjects. Patients with subclinical hyperthyroidism showed slightly lower mean serum IGFBP-3 concentrations than those found in control group, but the difference was not statistically significant. Serum GH and IGFBP-3 levels were unaltered by treatment. CONCLUSIONS In this study, it was shown that GH-IGF axis was not affected in patients with subclinical hyperthyroidism, while it was affected in patients with subclinical hypothyroidism. That is, investigation of the axis in subclinical hyperthyroidism would not bring any extra advantages, but LT4 replacement therapy could prevent abnormalities related to GH-IGF axis in patients with subclinical hypothyroidism.
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Affiliation(s)
- Fulya Akin
- University of Pamukkale, Faculty of Medicine, Department of Endocrinology and Metabolism, Denizli, Turkey.
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Yaylali GF, Akin F, Bastemir M, Yaylali YT, Ozden A. Phaeochromocytoma comb?ned with subclinical Cushing's syndrome and pituitary microadenoma. ACTA ACUST UNITED AC 2008; 31:E176-81. [DOI: 10.25011/cim.v31i3.3475] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objectives: Phaeochromocytoma (PHEO) occasionally associates with pathological lesions of the adrenal cortex. The coexistence of PHEO and pre-clinical Cushing's syndrome (PCS) of the same adrenal gland has rarely been reported. We report a case of PHEO and PCS originating from the same adrenal gland and discuss the peculiar diagnostic aspects of this entity.
Clinical Presentation: A 64 yr old man was hospitalized to evaluate the right adrenal mass which was discovered incidentally by ultrasonography. He had a history of type 2 diabetes mellitus and hyperlipidemia. Blood pressure measurements were all normal during his hospital stay. Laboratory examination showed: urinary catecholamines were markedly increased. HbA1C of 14.3 %, midnight cortisol of 11(?g/dL), cortisol was not suppressed after the overnight 1 mg oral dexamethasone suppression test (DST): 3.42(?g/dL), 24 hr free cortisol in the urine : 213 µg/day (10-100), cortisol levels were suppressed more than 50% with 8 mg of dexamethasone. CT scan of the adrenal glands showed a 6 cm well encapsulated right adrenal mass together with a clearly normal left adrenal gland. MRI investigation of the sella turcica revealed a pituitary microadenoma on the right side of the adenohypophysis He was treated with ? and subsequent ? blockers after the diagnosis of PHEO and PCS was made. Right adrenalectomy was performed. The pathology showed typical PHEO with adrenocortical hyperplasia. VMA, metanefrin and free cortisol levels were normalized one month after surgery.
Conclusion: The present report is a rare case of PHEO combined with PCS in the same adrenal gland.
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Akin F, Yaylali GF, Bastemir M. The use of lithium carbonate in the preparation for definitive therapy in hyperthyroid patients. Med Princ Pract 2008; 17:167-70. [PMID: 18287805 DOI: 10.1159/000112975] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Accepted: 05/08/2007] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to elucidate the effectiveness of lithium carbonate prior to thyroidectomy or radioiodide therapy in patients with thyrotoxicosis. SUBJECTS AND METHODS Lithium carbonate was used as preoperative preparation or radioiodide therapy in 5 patients with Graves' disease and in 1 patient with toxic multinodular goiter because of side effects of thionamide in 5 patients and ineffectiveness of antithyroid medication in the remaining patient. RESULTS All 6 patients had a benign course following treatment without thyroid storm. No adverse effects or complications of lithium carbonate were observed. CONCLUSION This report shows that lithium carbonate can be safely used preoperatively or prior to radioiodide therapy in circumstances where antithyroid medications are contraindicated and are ineffective in obtaining an euthyroid status.
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Affiliation(s)
- Fulya Akin
- Department of Endocrinology and Metabolic Diseases, School of Medicine, Pamukkale University, Denizli, Turkey.
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Bastemir M, Akin F, Yaylali GF. The PPAR-gamma activator rosiglitazone fails to lower plasma growth hormone and insulin-like growth factor-1 levels in patients with acromegaly. Neuroendocrinology 2007; 86:119-23. [PMID: 17671378 DOI: 10.1159/000106830] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2007] [Accepted: 06/26/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIM Despite combined therapy consisting of surgery, external X-ray, and medical therapy, a significant number of acromegaly patients continue to have uncontrolled growth hormone (GH) secretion and active disease. These patients, particularly those with large or invasive tumors, require additional therapy to decrease their GH levels. Our aim was to investigate whether patients with documented GH-secreting pituitary adenomas leading to acromegaly would respond with attenuation of GH and insulin-like growth factor-1 (IGF-1) levels after treatment with a peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist. METHODS We conducted prospective analyses in the Endocrinology Clinic of the Pamukkale University. Acromegaly patients who had active disease participated in two admissions: before and after 6 weeks of daily treatment with 8 mg of oral rosiglitazone. Four male and 3 female patients have completed the study. Basal and nadir GH levels during an oral glucose tolerance test were determined, and the IGF-1 and IGF-binding protein-3 levels were also measured both before and 6 weeks after the rosiglitazone treatment. RESULTS Treatment with rosigitazone did not reduce basal and nadir GH levels during the oral glucose tolerance test and the IGF-1 levels in the patient population as a whole (p > 0.05). CONCLUSIONS The PPAR-gamma activator rosiglitazone, used at maximum approved dosage, did not reduce plasma GH and IGF-1 levels in patients with acromegaly. Further studies with higher doses and longer duration of PPAR-gamma agonist administration would be required to determine its usefulness in the treatment in this group of patients.
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Affiliation(s)
- Mehmet Bastemir
- Department of Endocrinology and Metabolic Diseases, Pamukkale University School of Medicine, Denizli, Turkey.
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Colakoglu M, Yaylali GF, Colakoglu NY, Yilmaz M. Successful treatment of visceral leishmaniasis with fluconazole and allopurinol in a patient with renal failure. Scand J Infect Dis 2006; 38:152-4. [PMID: 16449014 DOI: 10.1080/00365540500277201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Standard treatments for visceral leishmaniasis (antimonials, amphotericin B and pentamidine) pose several problems. Failure of antimonials or severe toxicity is particularly troublesome in patients with renal insufficiency. We report a case of visceral leishmaniasis and renal insufficiency successfully treated with fluconazole and allopurinol for 4 months.
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Affiliation(s)
- Murat Colakoglu
- Departments of Nephrology, School of Medicine, Pamukkale University, Denizli, Turkey.
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