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Erdogan B, Ata N, Caglayan M, Gözükara MG, Gemcioglu E, Sokmen FC, Yilmaz N, Celik O, Ayvali MO, Ulgu MM, Birinci S. Association between hyponatremia, inflammation, and mortality in patients undergoing peritoneal dialysis: A nationwide observations. Ther Apher Dial 2024; 28:265-271. [PMID: 38093682 DOI: 10.1111/1744-9987.14092] [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] [Received: 06/27/2023] [Revised: 10/26/2023] [Accepted: 11/17/2023] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Hyponatremia is the most common electrolyte disorder often present in peritoneal dialysis (PD) patients. The aim of this retrospective study was to investigate the effect of hyponatremia on mortality in patients undergoing PD. METHODS The health records of adult individuals with an inserted PD catheter identified via the centralized national e-health database were used. RESULTS The mean age of the 846 patients included in the study was 52.48 years (±14.6). The mean sodium level was 136.51 mEq/L. Sodium levels <137 mEq/L were associated with higher death risk independent of comorbidities. There was a 0.821 times less reduction in mortality for each mEq /L increase in serum sodium. CONCLUSION Our study provides evidence that monitoring and adjusting serum sodium levels is crucial in managing PD patients with hyponatremia, as low serum sodium level was found to be a significant and independent predictor of mortality.
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Affiliation(s)
- Bulent Erdogan
- Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Republic of Turkey Ministry of Health, Ankara, Turkey
| | - Murat Caglayan
- Department of Medical Biochemistry, Etlik City Hospital, Ankara, Turkey
| | - Melih Gaffar Gözükara
- Department of Public Health, Ankara Yıldırım Beyazıt University-Faculty of Medicine, Ankara, Turkey
| | - Emin Gemcioglu
- Department of Internal Medicine, Ankara Etlik City Hospital, Ankara, Turkey
| | - Fevzi Coskun Sokmen
- Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nuray Yilmaz
- Department of Internal Medicine, Ankara City Hospital, Cankaya, Turkey
| | - Osman Celik
- Republic of Turkey Ministry of Health, Ankara, Turkey
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Ulgu MM, Caglayan M, Ata N, Sonmez C, Senes M, Gulbahar O, Gonel A, Birinci S. Cost analysis of 25-hydroxy vitamin D tests in Turkiye with big data: A cross-sectional study. North Clin Istanb 2023; 10:618-625. [PMID: 37829737 PMCID: PMC10565744 DOI: 10.14744/nci.2023.42899] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/02/2023] [Accepted: 07/07/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE The high prevalence of vitamin D deficiency in the population causes physicians to request more vitamin D tests and increases laboratory costs. It is aimed at investigating the demanded numbers and cost analyzes of 25-hydroxyvitamin D (25(OH)D) tests with the big data obtained from the national information health system of the Turkish Ministry of Health. METHODS Between 2017 and 2018, all inpatient and outpatient tests and 25(OH)D tests in all medical biochemistry laboratories in Turkiye were determined based on department and institution type. The cost amount, distribution among health institutions, and test request rates were calculated. In both years, the top ten most expensive tests, according to health institutions, were evaluated. RESULTS The total number of medical biochemistry tests performed in 2017 and 2018 was 1.424.948.155 and 1.713.134.326, respectively. The number of 25 (OH)D tests analyzed in the same years was 8.698.393 and 13.919.127, respectively. When the data of the 2 years are compared, the consumption of 25 (OH)D tests increased by 37% in General hospital laboratories, whereas it increased by 115.09% in primary health laboratories. When all health institutions were evaluated, the increase rate in 25 (OH)D test demand was 60%, while the cost increase rate was 23%. CONCLUSION This report showed that the demands for 25(OH)D testing are increasing steeply, especially in primary health-care facilities. In this direction, laboratory information system test demand restrictions in accordance with national and international guidelines are important issues for policymakers.
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Affiliation(s)
| | - Murat Caglayan
- Department of Medical Biochemistry, Etlik City Hospital, Ankara, Turkiye
| | - Naim Ata
- Ministry of Health, Ankara, Turkiye
| | - Cigdem Sonmez
- Department of Medical Biochemistry, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkiye
| | - Mehmet Senes
- Department of Medical Biochemistry, Ankara Training and Research Hospital, Ankara, Turkiye
| | - Ozlem Gulbahar
- Department of Medical Biochemistry, Gazi University Training and Research Hospital, Ankara, Turkiye
| | - Ataman Gonel
- Department of Nutrition and Dietetics, Hasan Kalyoncu University Faculty of Health Science, Gaziantep, Turkiye
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Birinci S, Ulgu MM, Caglayan M, Ata N. Hypertriglyceridemia and its impact on hematological indicators: A study based on Turkish national health database. North Clin Istanb 2023; 10:626-630. [PMID: 37829738 PMCID: PMC10565748 DOI: 10.14744/nci.2023.71235] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 07/23/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE The hematocrit (Hct) to hemoglobin (Hb) ratio, generally at 3.0 in healthy individuals, can vary in certain disease states. An emerging area of interest is the potential influence of triglyceride concentrations on this ratio and hemoglobin A1C (HbA1c) levels. This study aimed to identify the changes in HbA1c and the Hct/Hb ratio as triglyceride concentration increases. METHODS This research involved an extensive analysis of 35,656,613 laboratory samples taken between January 2015 and December 2022 in Türkiye, including the respective triglyceride, Hb, Hct, and HbA1c results. The laboratory test results were obtained from the national health database of the Turkish Ministry of Health. The triglyceride levels were divided into 24 groups, each incremented by 100 mg/dL from a range of 0-3099 mg/dL. Mean and standard deviation values of Hb and Hct were calculated for each group, and the Hct/Hb ratio was graphically represented. RESULTS The average HbA1c values ranged between 4.37±0.85 and 7.76±3.19 across the groups, Hb averages ranged from 9.75±1.7 to 14.03±2.21, Hct averages from 27.35±4.97 to 38.86±5.66, and Hct/Hb ratios varied between 2.77 and 3.03. The overall average for all samples was identified as 5.15±0.13 for HbA1c, 38.48±5.13 for Hct, 12.73±1.65 for Hb, and 3.02 for the Hct/Hb ratio. CONCLUSION It was observed that the Hct/Hb ratio gradually decreased as triglyceride levels increased. Evaluating anemia based on Hb concentration in individuals with hypertriglyceridemia might be misleading. It is recommended to use a correction factor based on triglyceride level.
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Affiliation(s)
| | | | - Murat Caglayan
- Department of Medical Biochemistry, Ankara Etlik City Hospital, Ankara, Turkiye
| | - Naim Ata
- Ministry of Health, Ankara, Turkiye
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Caglayan M, Gonel A, Tayman C, Cakir U, Koyuncu I, Temiz E, Sert Y. Investigation of the effect of vitamin K1 prophylaxis on newborn screenings tests in newborns. J Med Biochem 2023; 42:376-382. [PMID: 37814616 PMCID: PMC10560507 DOI: 10.5937/jomb0-40162] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 11/22/2022] [Indexed: 10/11/2023] Open
Abstract
Background Routine screening for hereditary disorders in newborns includes screening for treatable metabolic and endocrine disorders, such as biotidinase deficiency, galactosemia, maple syrup urine disease, hypothyroidism, and cystic fibrosis. Incorrect test results may be encountered due to the use of vitamin K1. To investigate the interference effect of vitamin K1 on neonatal screening tests and to raise awareness of erroneous measurements. Methods Heel blood samples were taken from 25 newborns born in a neonatal intensive care unit. Dry blood C0, C2, C3, C4, C4DC, C5:1, C5OH, C5DC, C6, C6DC, C8, C8:1, C8DC, C10, C10:1, C10DC, C12, C14, C14:1, C14:2, C16, C16:1, C18, C18:1, C18:2, C18:OH, methylglutaryl, valine, leucine/isoleucine, methionine, phenylalanine, argininosuccinic acid, aspartate, alanine, arginine, citrulline, glycine, ornithine, and glutamate tests were studied using the tandem mass spectrometry (MS) method. The results of the heel blood samples obtained before and after the application of vitamin K1 (Phyto menadione) were compared. Results In two studies conducted with in vitro and in vivo tests, C0, C2, C3, C4, C4DC, C5, C5OH, C6, C8, C10, C10:1, C14, C16, C16:1, C18, C18:1, methylglutaryl, phenylalanine, argininosuccinic acid, tyrosine, aspartate, arginine, citrulline, glycine, and glutamine were all significantly elevated (p < 0.05). Conclusions Heel blood samples may yield false results due to vitamin K1 administration. In the case of doubtful results, a new sample should be taken and the measurement should be repeated.
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Affiliation(s)
- Murat Caglayan
- Health Science University, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Medical Biochemistry, Ankara, Turkey
| | - Ataman Gonel
- Hasan Kalyoncu University, Faculty of Health Science, Medical Park Gaziantep Hastanesi, Department of Nutrition and Dietetics, Gaziantep, Turkey
| | - Cuneyt Tayman
- University of Health Sciences, Ankara City Hospital, Department of Neonatology, Cankaya, Ankara, Turkey
| | - Ufuk Cakir
- University of Health Sciences, Ankara City Hospital, Department of Neonatology, Cankaya, Ankara, Turkey
| | - Ismail Koyuncu
- Harran University, Medicine Faculty, Department of Medical Biochemistry, Sanliurfa, Turkey
| | - Ebru Temiz
- Harran University, Health Services Vocational School, Program of Medical Promotion and Marketing, Sanliurfa, Turkey
| | - Yasemin Sert
- Ankara City Hospital, Department of Gynecology Obstetrics, Ankara, Turkey
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Sonmez A, Demirci I, Haymana C, Tasci I, Ayvalı MO, Ata N, Ezgu FS, Bayram F, Barcin C, Caglayan M, Ülgü MM, Birinci S, Tokgozoglu L, Satman I, Kayikcioglu M. Clinical characteristics of adult and paediatric patients with familial hypercholesterolemia: A real-life cross-sectional study from the Turkish National Database. Atherosclerosis 2023; 375:9-20. [PMID: 37216728 DOI: 10.1016/j.atherosclerosis.2023.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND AIMS Familial hypercholesterolemia (FH) is the most common cause of premature atherosclerotic cardiovascular disease (ASCVD). Türkiye is among the countries with the highest rate of ASCVD. However, no population-based study has been published so far on the prevalence of FH, demographic and clinical characteristics, burden of ASCVD, treatment compliance, and attainment of low-density lipoprotein cholesterol (LDL-C) targets. METHODS We performed a study using the Turkish Ministry of Health's national electronic health records involving 83,063,515 citizens as of December 2021 dating back 2016. Adults fulfilling the diagnostic criteria of definite or probable FH according to the Dutch Lipid Network Criteria (DLNC), and children and adolescents fulfilling the criteria of probable FH according to the European Atherosclerosis Society (EAS) Consensus Panel report formed the study population (n = 157,790). The primary endpoint was the prevalence of FH. RESULTS Probable or definite FH was detected in 0.63% (1 in 158) of the adults and 0.61% (1 in 164) of the total population. The proportion of adults with LDL-C levels >4.9 mmol/L (190 mg/dL) was 4.56% (1 in 22). The prevalence of FH among children and adolescents was 0.37% (1 in 270). Less than one-third of the children and adolescents, and two-thirds of young adults (aged 18-29) with FH were already diagnosed with dyslipidaemia. The proportion of adults and children and adolescents on lipid-lowering treatment (LLT) was 32.1% and 1.5%, respectively. The overall discontinuation rate of LLT was 65.8% among adults and 77.9% among children and adolescents. Almost no subjects on LLT were found to attain the target LDL-C levels. CONCLUSIONS This nationwide study showed a very high prevalence of FH in Türkiye. Patients with FH are diagnosed late and treated sub-optimally. Whether these findings may explain the high rates of premature ASCVD in Türkiye needs further investigation. These results denote the urgent need for country-wide initiatives for early diagnosis and effective management of FH patients.
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Affiliation(s)
- Alper Sonmez
- Ankara Guven Hospital, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Cem Haymana
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkiye
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Internal Medicine, Ankara, Turkiye
| | - Mustafa Okan Ayvalı
- General Directorate of the Health Information Systems, Ministry of Health, Ankara, Turkiye
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkiye
| | - Fatih Suheyl Ezgu
- Gazi University, Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkiye
| | - Fahri Bayram
- Erciyes University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kayseri, Turkiye
| | - Cem Barcin
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Cardiology, Ankara, Turkiye
| | - Murat Caglayan
- University of Health Sciences, Yildirim Beyazit Training and Research Hospital, Department of Biochemistry, Ankara, Turkiye
| | - Mustafa Mahir Ülgü
- General Directorate of the Health Information Systems, Ministry of Health, Ankara, Turkiye
| | - Suayip Birinci
- Deputy Health Minister, Ministry of Health, Ankara, Turkiye
| | - Lale Tokgozoglu
- Hacettepe University, Faculty of Medicine, Department of Cardiology, Ankara, Turkiye
| | - Ilhan Satman
- Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkiye
| | - Meral Kayikcioglu
- Ege University Faculty of Medicine, Department of Cardiology, Izmir, Turkiye.
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Dal K, Uzman M, Ata N, Ertugrul DT, Bursa N, Caglayan M, Baser S, Akkan T, Imrat E, Celik O, Ulgu MM, Sahin M, Birinci S. The effect of vitamin D status on non-alcoholic fatty liver disease: a population-based observational study. Endokrynol Pol 2023; 74:63-66. [PMID: 36704977 DOI: 10.5603/ep.a2023.0002] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The effect of vitamin D status on steatosis has not been fully elucidated. In this study, we planned to investigate this interaction using a large-scale population-based cohort. MATERIAL AND METHODS Patients diagnosed with simple steatosis (K76.0) and non-alcoholic steatohepatitis (NASH) (K75.8) by using the International Classification of Diseases 10th Revision (ICD-10) coding system, and who had 25-hydroxyvitamin D (25OHD) measurements at the diagnosis, were included in the study. Control group comprised subjects without liver diseases. Age, gender, alanine aminotransferase (ALT) and 25OHD levels, and the date of the measurements were recorded. RESULTS We compared ALT and 25OHD measurements between the patient and control groups, and between the simple steatosis and NASH subgroups. 25OHD levels were lower and ALT levels were higher in the patient group (p < 0.001, effect size = 0.028, and p < 0.001, effect size = 0.442, respectively). Logistic regression analysis showed that when 25OHD levels decrease by 1 ng/dL, it increases the risk of being in the patient group by 3.7%. CONCLUSION Our results suggest that vitamin D status may be related to the development of non-alcoholic fatty liver disease (NAFLD). Although this relationship is weak, it may be important in the pathogenesis of steatosis.
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Affiliation(s)
- Kursat Dal
- Department of Internal Medicine, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.
| | - Metin Uzman
- Department of Gastroenterology, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, Türkiye
| | - Naim Ata
- Strategy Development Department, Ministry of Health, Ankara, Türkiye
| | - Derun Taner Ertugrul
- Department of Endocrinology and Metabolism, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, Türkiye
| | - Nurbanu Bursa
- Department of Statistics, Hacettepe University, Ankara, Türkiye
| | - Murat Caglayan
- Department of Medical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Türkiye
| | - Salih Baser
- Department of Internal Medicine, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Türkiye
| | - Tolga Akkan
- Department of Endocrinology and Metabolism, Ankara Ataturk Sanatoryum Training and Research Hospital, University of Health Sciences, Ankara, Türkiye
| | - Ersan Imrat
- General Directorate of Information Systems, Ministry of Health, Ankara, Türkiye
| | - Osman Celik
- Public Hospitals Department, Ministry of Health, Ankara, Türkiye
| | - Mustafa Mahir Ulgu
- General Directorate of Information Systems, Ministry of Health, Ankara, Türkiye
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Suayip Birinci
- Deputy Minister of Health, Ministry of Health, Ankara, Türkiye
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Sahin M, Demirci I, Haymana C, Tasci I, Emral R, Cakal E, Unluturk U, Satman I, Demir T, Ata N, Ertugrul D, Atmaca A, Salman S, Sahin I, Dagdelen S, Celik O, Caglayan M, Sonmez A. The Clinical Characteristics and Outcomes of COVID-19 Patients with Pre-Existing Thyroid Dysfunction: A Nationwide Study. Horm Metab Res 2023; 55:25-30. [PMID: 36328149 DOI: 10.1055/a-1971-8781] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To which extent the pre-existing hypothyroidism or hyperthyroidism has an impact on coronavirus infection 2019 (COVID-19) outcomes remains unclear. The objective of this study was to evaluate COVID-19 morbidity and mortality in patients with pre-existing thyroid dysfunction. A retrospective cohort of patients with a polymerase chain reaction (PCR)-confirmed COVID-19 infection (n=14 966) from March 11 to May 30, 2020, was established using the database of the Turkish Ministry of Health. We compared the morbidity and mortality rates of COVID-19 patients with pre-existing hypothyroidism (n=8813) and hyperthyroidism (n=1822) to those patients with normal thyroid function (n=4331). Univariate and multivariate regression analyses were performed to identify the factors associated with mortality. Mortality rates were higher in patients with hyperthyroidism (7.7%) and hypothyroidism (4.4%) than those with normal thyroid function (3.4%) (p<0.001 and p=0.008, respectively). Pre-existing hyperthyroidism was significantly associated with an increased risk of mortality (OR 1.54; 95% CI, 1.02-2.33; p=0.042) along with advanced age, male gender, lymphopenia and chronic kidney disease (p<0.001 for all). Although a potential trend was noted, the association between pre-existing hypothyroidism and mortality was not significant (OR 1.36; 95% CI, 0.99-1.86; p=0.055). In conclusion, this study showed an association between pre-existing hyperthyroidism with higher COVID-19 mortality. A potential trend towards increased mortality was also observed for hypothyroidism. The risk was more pronounced in patients with hyperthyroidism.
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Affiliation(s)
- Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Cem Haymana
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
| | - Rıfat Emral
- Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Endocrinology and Metabolism, Samsun, Turkey
| | - Serpil Salman
- Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Endocrinology and Metabolism, Malatya, Turkey
| | - Selcuk Dagdelen
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | | | - Alper Sonmez
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
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Caglayan M, Gonel A, Celik O, Sozuer A, Ulgu MM, Ata N, Birinci S. Investigation of Therapeutic Drug Monitoring of Tacrolimus in Different Age Groups: Results from a Turkish Nationwide Study. LETT DRUG DES DISCOV 2022. [DOI: 10.2174/1570180819666220825122534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The blood level of tacrolimus (TAC) used for post-transplant immunosuppression should be within the therapeutic index. Geriatric individuals may be at risk of organ rejection because in this age group, routine drug use is usually disrupted and the bioavailability of aging-related drugs is decreased.
Objective:
The aim of this study was to analyze the age-related variability of blood TAC levels in patients in Turkey.
Methods:
In this study, 697,616 patients who underwent TAC measurement in the laboratories of public, private, and university hospitals between 2018 and 2020 were identified from the Health-net database of the Ministry of Health. The results of patients aged ≥65 years were compared with those of patients aged <65 years. The differences between the sexes in the same age group were also examined. Data from the Turkish Ministry of Health National Electronic Database were used to design a multicenter retrospective cohort study.
Results:
The study included 697,616 patients. The mean TAC concentration was 7.2 ± 6.25 ng/mL for all the patients, 7.13 ± 6.7 ng/mL for the female patients, and 7.24 ± 5.96 ng/mL for the male patients. A statistically significant difference in TAC concentration was found between the men and women in the general population. Groups aged ≥65 years were compared among themselves. A statistically significant decrease in TAC concentration was found only in the age group of 75–79 years (5.63 ± 4.09 ng/mL) of women compared with the men. In all other age groups, the TAC levels of the men were lower.
Conclusions:
The proportion of patients with TAC concentrations lower than the therapeutic index was higher in the groups aged ≥65 years. Thus, patients aged ≥65 years may be at risk of organ rejection, as optimum immunosuppression cannot be achieved. In these patients, more frequent drug monitoring and providing training to ensure the compliance of the patient and the patient's relatives in the use of TAC may be recommended.
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Affiliation(s)
- Murat Caglayan
- Department of Medical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Health Science University, Ankara, Turkey
| | - Ataman Gonel
- Department of Nutrition and Dietetics, Faculty of Health Science, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Osman Celik
- Republic of Turkey Ministry of Health, Ankara, Turkey
| | | | | | - Naim Ata
- Republic of Turkey Ministry of Health, Ankara, Turkey
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Caglayan M, Gonel A. Experimental Investigation of Immunoglobulin and Complement Concentrations in Exposure to IVIG, HBIG, Rituximab, Tocilizumab, and Bevacizumab. LETT DRUG DES DISCOV 2022. [DOI: 10.2174/1570180819666220804105533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Immunoglobulins (Igs) are produced in plasma cells in response to glycoprotein-like immunogens, and they are also used as therapeutics in the pharmaceutical industry. It may be important to know the effects of therapeutic Igs on Ig levels during therapy to eliminate any misconceptions about the immunity of patients.
Objective:
This study aimed to investigate the effects of monoclonal antibody (mAb) derivative drugs and therapeutic antibody (intravenous Ig [IVIG] and hepatitis B immune globulin [HBIG]) treatments on blood IgG, IgA, IgM, IgE, complement component 3 (C3), and complement component 4 (C4) levels
Methods:
N Protein Control SL / Low (Siemens, Marburg, Germany, Lot: 084654) was used as the control solution. Aliquots of IVIG, HBIG, rituximab, tocilizumab, and bevacizumab (20 µL) were added to 180 µL of the control solution, and the solutions were vortexed (5 s). The samples were studied using a Dade Behring BN II (Siemens, Marburg, Germany) nephelometer. All measurements were repeated three times by performing the same process in which distilled water (20 µL) was added to the control solution to determine the target value, and the average values were taken. The bias formula was used to calculate the amount by which the results deviated from the target value.
Results:
IVIG caused the greatest deviation (45.97%) to IgG levels. HBIG, rituximab, tocilizumab, and bevacizumab caused the IgG level to deviate by 0.81%, 9.68%, 27.42%, and 30.65%, respectively. In the IgA test, tocilizumab increased the reading by 8.66%, while the other therapeutics caused reductions in the reading, with the smallest and largest changes caused by HBIG (-0.93%) and bevacizumab (-4.98%). Tocilizumab increased the IgE level by 0.48%, and rituximab and bevacizumab reduced the IgE level by -0.21% with -8.47%, respectively. Tocilizumab, IVIG, and HBIG caused 1.41%, 2.70%, and 4.32% deviations, respectively, in the C3 levels. Whereas bevacizumab (-1.08%) and rituximab (-5.41%) caused reductions in the C3 levels. Tocilizumab, HBIG, rituximab, IVIG, and bevacizumab caused deviations of 0.87%, -2.31%, -3.76%, -6.36%, -8.38%, respectively, in the C4 levels.
Conclusion:
Deviations in measured IgG levels after therapeutic Ig and mAb infusions may cause errors in clinical decisions. It is recommended that Ig levels be measured before infusion or when the therapeutic drug has been eliminated from the blood.
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Affiliation(s)
- Murat Caglayan
- Department of Medical Biochemistry, Health Science University, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ataman Gonel
- Department of Nutrition and Dietetics, Faculty of Health Science, Hasan Kalyoncu University, Gaziantep, Turkey
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10
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Guney M, Hosbul T, Cuce F, Artuk C, Taskin G, Caglayan M, Alacam S, Kurkcu MF, Yildiz F, Erdal H, Erdem G, Bakir A. Evaluation of the relationship between progression and SARS-CoV-2 viral load in COVID-19 cases in Ankara, Turkey. J Infect Dev Ctries 2022; 16:462-468. [DOI: 10.3855/jidc.14940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 09/03/2021] [Indexed: 10/31/2022] Open
Abstract
Introduction: Patients infected with SARS-CoV-2 may present with varying clinical pictures. This study aimed to examine the relationship between viral load cycle threshold value, clinical prognosis and other laboratory parameters in initial swab samples on the day of hospitalization.
Methodology: This retrospective and cross-sectional study included 112 patients, who were diagnosed with SARS-CoV-2 via the Bio-Rad CFX96 TouchTM system. Cycle threshold values for the RdRp gene obtained from reverse transcriptase polymerase chain reaction positive patients were recorded.
Results: The mean age of the 112 patients was 47.57 ± 17 years. No relationship was found in symptoms, pneumonia, oxygen need, follow-up in intensive care unit, and mortality between patient groups with cycle threshold values of < 30 and ≥ 30. Frequencies of thrombocytopenia (50%) and elevated LDH levels were higher in patients with cycle threshold values of ≥ 30 (p = 0.02 and p = 0.04, respectively). There was a weak but significant correlation between cycle threshold values and CRP levels (Pearson’s r = 0.207, p = 0.029).
Conclusions: Symptoms or clinical prognosis were not significantly related to the SARS-CoV-2 viral load levels tested at admission or for the first time within the scope of this study. Thrombocytopenia and elevated LDH rates were higher in patients with cycle threshold values of ≥ 30. A weak but significant correlation was found between the viral load and CRP levels. Large-scale studies are needed to further elucidate this subject matter.
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11
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Demirci I, Haymana C, Tasci I, Satman I, Atmaca A, Sahin M, Ata N, Unluturk U, Cakal E, Dagdelen S, Sahin I, Celik O, Ertugrul D, Demir T, Emral R, Caglayan M, Salman S, Birinci S, Sonmez A. Higher rate of COVID-19 mortality in patients with type 1 than type 2 diabetes: a nationwide study. Endokrynol Pol 2022; 73:87-95. [PMID: 35119089 DOI: 10.5603/ep.a2022.0008] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION COVID-19 disease has a worse prognosis in patients with diabetes, but comparative data about the course of COVID-19 in patients with type 1 (T1DM) and type 2 diabetes (T2DM) are lacking. The purpose of this study was to find out the relative clinical severity and mortality of COVID-19 patients with T1DM and T2DM. MATERIAL AND METHODS A nationwide retrospective cohort of patients with confirmed (PCR positive) COVID-19 infection (n = 149,671) was investigated. After exclusion of individuals with unspecified diabetes status, the adverse outcomes between patients with T1DM (n = 163), T2DM (n = 33,478) and those without diabetes (n = 115,108) were compared by using the propensity score matching method. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation, and mortality. RESULTS The patients with T1DM had higher mortality than the age- and gender-matched patients with T2DM (n = 489) and those without diabetes (n = 489) (p < 0.001). After further adjustment for the HbA1c, and microvascular and macrovascular complications, the odds of mortality (OR: 3.35, 95% CI: 1.41-7.96, p = 0.006) and ICU admission and/or mechanical ventilation (OR: 2.95, 95% CI: 1.28-6.77, p = 0.011) were significantly higher in patients with T1DM compared to those with T2DM. Older age (OR: 1.06, 95% CI: 1.01-1.12, p = 0.028) and lymphopaenia (OR: 5.13, 95% CI: 1.04-25.5, p = 0.045) were independently associated with mortality in patients with T1DM. CONCLUSIONS Patients with T1DM had worse prognosis of COVID-19 compared to T2DM patients or those without diabetes. These cases should be cared for diligently until more data become available about the causes of increased COVID-19 mortality in T1DM.
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Affiliation(s)
- Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Ankara, Turkey.
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Ankara, Turkey
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Ankara, Turkey
| | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey.,The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Turkey
| | - Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Naim Ata
- Ministry of Health, Department of Strategy Development, Ankara, Turkey
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Selcuk Dagdelen
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Ankara, Turkey
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Izmir, Turkey
| | - Rifat Emral
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | | | - Serpil Salman
- Medica Clinic, Endocrinology and Metabolism, Istanbul, Turkey
| | - Suayip Birinci
- Deputy Minister of Health, Ministry of Health, Ankara, Turkey
| | - Alper Sonmez
- University of Health Sciences, Gulhane Faculty of Medicine and Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
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12
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Atmaca A, Demirci I, Haymana C, Tasci I, Sahin I, Cakal E, Ata N, Dagdelen S, Salman S, Emral R, Sahin M, Celik O, Demir T, Ertugrul D, Unluturk U, Caglayan M, Satman I, Sonmez A. No association of anti-osteoporosis drugs with COVID-19-related outcomes in women: a nationwide cohort study. Osteoporos Int 2022; 33:273-282. [PMID: 34402949 PMCID: PMC8369875 DOI: 10.1007/s00198-021-06067-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/10/2021] [Indexed: 01/08/2023]
Abstract
This study was performed to evaluate whether the use of drugs in the treatment of osteoporosis in women is associated with COVID-19 outcomes. The results showed that the risk of hospitalization, intensive care unit admission, and mortality was not altered in individuals taking anti-osteoporosis drugs, suggesting no safety issues during a COVID-19 infection. INTRODUCTION Whether patients with COVID-19 receiving anti-osteoporosis drugs have lower risk of worse outcomes has not been reported yet. The aim of this study was to evaluate the association of anti-osteoporosis drug use with COVID-19 outcomes in women. METHODS Data obtained from a nationwide, multicenter, retrospective cohort of patients diagnosed with COVID-19 from March 11th to May 30th, 2020 was retrieved from the Turkish Ministry of Health Database. Women 50 years or older with confirmed COVID-19 who were receiving anti-osteoporosis drugs were compared with a 1:1 propensity score-matched COVID-19 positive women who were not receiving these drugs. The primary outcomes were hospitalization, ICU (intensive care unit) admission, and mortality. RESULTS A total of 1997 women on anti-osteoporosis drugs and 1997 control patients were analyzed. In the treatment group, 1787 (89.5%) women were receiving bisphosphonates, 197 (9.9%) denosumab, and 17 (0.9%) teriparatide for the last 12 months. Hospitalization and mortality rates were similar between the treatment and control groups. ICU admission rate was lower in the treatment group (23.0% vs 27.0%, p = 0.013). However, multivariate analysis showed that anti-osteoporosis drug use was not an independent associate of any outcome. Hospitalization, ICU admission, and mortality rates were similar among bisphosphonate, denosumab, or teriparatide users. CONCLUSION Results of this nationwide study showed that preexisting use of anti-osteoporosis drugs in women did not alter the COVID-19-related risk of hospitalization, ICU admission, and mortality. These results do not suggest discontinuation of these drugs during a COVID-19 infection.
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Affiliation(s)
- A Atmaca
- Department of Endocrinology and Metabolism, School of Medicine, Samsun Ondokuz Mayis University, Samsun, Turkey.
| | - I Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - C Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - I Tasci
- Department of Internal Medicine Gulhane School of Medicine and Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - I Sahin
- Department of Endocrinology and Metabolism, School of Medicine, Malatya Inonu University, Malatya, Turkey
| | - E Cakal
- Department of Endocrinology and Metabolism, School of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
| | - N Ata
- Department of Strategy Development, Ministry of Health, Republic of Turkey, Ankara, Turkey
| | - S Dagdelen
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | - S Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - R Emral
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
| | - M Sahin
- Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Ankara, Turkey
| | - O Celik
- Public Hospitals General Directorate, Ministry of Health, Republic of Turkey, Ankara, Turkey
| | - T Demir
- Department of Endocrinology and Metabolism, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - D Ertugrul
- Department of Endocrinology and Metabolism, Kecioren Training and Research Hospital, School of Medicine, University of Health Sciences Turkey, Ankara, Turkey
| | - U Unluturk
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | - M Caglayan
- Ankara Provincial Health Directorate, Ankara, Turkey
| | - I Satman
- Department of Endocrinology and Metabolism, School of Medicine, Istanbul University, Istanbul, Turkey
- Turkish Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - A Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine and Gulhane Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey
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13
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Demirci I, Demir T, Dagdelen S, Haymana C, Tasci I, Atmaca A, Ertugrul D, Ata N, Sahin M, Salman S, Sahin I, Emral R, Unluturk U, Cakal E, Celik O, Caglayan M, Satman I, Sonmez A. No association of Gaucher Disease with COVID-19-related outcomes: a nationwide cohort study. Intern Med J 2021; 52:379-385. [PMID: 34939733 DOI: 10.1111/imj.15673] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/16/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND It is well documented that patients with chronic metabolic diseases such as diabetes and obesity are adversely affected by the Covid 19 pandemic. However, when the subject is rare metabolic diseases, there is not enough data in the literature. AIM To investigate course of COVID-19 among patients with Gaucher disease (GD), the most common lysosomal storage disease. METHODS Based on the National Health System data, a retrospective cohort of patients with confirmed (PCR positive) COVID-19 infection (n = 149 618) was investigated. The adverse outcomes between patients with GD (n = 39) and those without GD (n = 149 579) were compared in crude and propensity score matched (PSM) groups. The outcomes were hospitalization, the composite of intensive care unit (ICU) admission and/or mechanical ventilation and mortality. RESULTS The patients with GD were significantly older and had a higher frequency of hypertension, T2DM, dyslipidemia, asthma or COPD, chronic kidney disease, coronary artery disease, heart failure, and cancer. Although hospitalization rates in Gaucher patients were found to be higher in crude analyzes, the PSM models (model 1, age- and gender-matched; model 2, matched for age, gender, hypertension, T2DM, and cancer) revealed no difference for the outcomes between patients with GD and the general population. According to multivariate regression analyses, having a diagnosis of GD was not a significant predictor for hospitalization (p = 0.241), ICU admission/mechanical ventilation (p = 0.403) or mortality (p = 0.231). CONCLUSION According to our national data, SARS-CoV-2 infection in patients with GD does not have a more severe course than the normal population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Selcuk Dagdelen
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Turkey
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey
| | - Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Serpil Salman
- Medica Clinic, Endocrinology and Metabolism, Istanbul, Turkey
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Turkey
| | - Rifat Emral
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | | | - Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey
| | - Alper Sonmez
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey
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14
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Emral R, Haymana C, Demirci I, Tasci I, Sahin M, Cakal E, Ata N, Unluturk U, Demir T, Ertugrul D, Sahin I, Atmaca A, Celik O, Caglayan M, Arga KY, Dagdelen S, Salman S, Satman I, Sonmez A. Lower COVID-19 Mortality in Patients with Type 2 Diabetes Mellitus Taking Dipeptidyl Peptidase-4 Inhibitors: Results from a Turkish Nationwide Study. Diabetes Ther 2021; 12:2857-2870. [PMID: 34398433 PMCID: PMC8365288 DOI: 10.1007/s13300-021-01133-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION To investigate the effect of preexisting treatment with dipeptidyl peptidase-4 inhibitors (DPP-4is) on COVID-19-related hospitalization and mortality in patients with type 2 diabetes mellitus (T2DM). METHODS A multicenter, retrospective cohort study was conducted using patient data extracted from the Turkish National Electronic Database. All patients who tested positive for COVID-19 (PCR test) between 11 March through to 30 May 2020 were screened for eligibility (n = 149,671). Following exclusion of patients based on pre-determined inclusion criteria, patients with T2DM using a DPP-4i or glucose-lowering medications other than a DPP-4i were compared for mortality and hospitalization. The propensity score method was used to match age, gender, micro- and macrovascular complications, and medications in the two groups. Independent associates of mortality were analyzed using multivariable analysis on the whole T2DM population. RESULTS A total of 33,478 patients with T2DM who tested postive for COVID-19 who met the inclusion criteria were included in the analysis. Median (interquartile range) age was 54 (22) years and 42.4% were male. Of these, 9100 patients using DPP-4is (n = 4550) or other glucose-lowering drugs (n = 4550) were matched in two groups. After matching, analysis revealed a lower mortality in the DPP-4i group (9.5 vs. 11.8%; p < 0.001). In the multivariable model, the use of DPP-4is (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.35-0.91; p = 0.02) was associated with lower mortality in the whole sample, while age, male gender, computed tomography finding of COVID-19, obesity, low glomerular filtration rate, and an insulin-based regimen also predicted increased risk of death. There was no association between the preexisting treatment with DPP-4is and COVID-19-related hospitalization in the matched analysis or multivariate model. The rate of admission to the intensive care unit and/or mechanical ventilation favored the DPP-4i group (21.7 vs. 25.2%; p = 0.001), although this association became saturated in the multivariate analysis (OR 0.65, 95% CI 0.39-1.08; p = 0.099). CONCLUSIONS The results of this study demonstrate an association between DDP-4i use and reduced mortality in people with T2DM who tested PCR positive for COVID-19.
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Affiliation(s)
- Rifat Emral
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey.
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health of the Republic of Turkey, Ankara, Turkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kecioren Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Aysegül Atmaca
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Ministry of Health of the Republic of Turkey, Ankara, Turkey
| | | | - Kazim Yalcin Arga
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - Ilhan Satman
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey
- Department of Endocrinology and Metabolism, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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15
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Emral R, Haymana C, Demirci I, Tasci I, Sahin M, Cakal E, Ata N, Unluturk U, Demir T, Ertugrul D, Sahin I, Atmaca A, Celik O, Caglayan M, Arga KY, Dagdelen S, Salman S, Satman I, Sonmez A. Correction to: Lower COVID-19 Mortality in Patients with Type 2 Diabetes Mellitus Taking Dipeptidyl Peptidase-4 Inhibitors: Results from a Turkish Nationwide Study. Diabetes Ther 2021; 12:2871-2872. [PMID: 34559403 PMCID: PMC8461138 DOI: 10.1007/s13300-021-01154-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Rifat Emral
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey.
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health of the Republic of Turkey, Ankara, Turkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kecioren Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Aysegül Atmaca
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Ministry of Health of the Republic of Turkey, Ankara, Turkey
| | | | - Kazim Yalcin Arga
- Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - Ilhan Satman
- Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey
- Department of Endocrinology and Metabolism, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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16
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Bakir A, Hosbul T, Cuce F, Artuk C, Taskin G, Caglayan M, Guney M, Kurkcu MF, Yildiz F, Erdal H, Erdem G. Investigation of Viral Load Cycle Threshold Values in Patients with SARS-CoV-2 Associated Pneumonia with Real-Time PCR Method. J Infect Dev Ctries 2021; 15:1408-1414. [PMID: 34780363 DOI: 10.3855/jidc.14281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/31/2020] [Accepted: 06/25/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION In this study, we aimed investigate the relationship of SARS-CoV-2 viral load cycle threshold (Ct) values with pneumonia. METHODOLOGY A total of 158 patients in whom SARS-CoV-2 was confirmed in upper respiratory tract (URT) samples with molecular method and who had computed tomography (CT) of the chest, between April 2020 and June 2020 were included in this retrospective cross-sectional study. RESULTS Mean age of 158 PCR positive patients was 45.22 ± 17.89 and 60.8% of them were male. Pneumonia was detected in 40.5% of the patients on their chest CT. A weak but significant correlation was found between SARS-CoV-2 Ct value detected with PCR in analysis of oropharyngeal/ nasopharyngeal (OP/NP) samples and chest CT score (Pearson's r: 0.197, p = 0.01). No correlation was found between the first detected viral load Ct value and age, gender and mortality. There was no significant correlation between chest CT score and mortality. While the areas remaining under ROC curve for Ct value in analysis of OP/NP samples in prediction of chest CT score ≥ 1, ≥ 5 and ≥ 10 were 0.564, 0.640 and 0.703 respectively. CONCLUSIONS We found that the amount of SARS-CoV-2 viral load (inverse relationship with Ct) detected in OP/NP samples of patients with COVID-19 pneumonia did not reflect the increasing severity of pulmonary lesions on chest CT. Although primary target of SARS-CoV-2 is all epithelial cells of the respiratory tract we believe studies comparing viral loads in lower respiratory tract samples are needed to determine the severity of pulmonary disease.
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Affiliation(s)
- Ayfer Bakir
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Medical Microbiology, Ankara, Turkey.
| | - Tugrul Hosbul
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Ferhat Cuce
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Radiology, Ankara, Turkey
| | - Cumhur Artuk
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Turkey
| | - Gurhan Taskin
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Critical Care, Ankara, Turkey
| | - Murat Caglayan
- Ankara Provincial Health Directorate, Ministry of Health, Republic of Turkey, Ankara, Turkey
| | - Mustafa Guney
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Muhammed Furkan Kurkcu
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Fatime Yildiz
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Medical Microbiology, Ankara, Turkey
| | - Harun Erdal
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Gastroenterology, Ankara, Turkey
| | - Gul Erdem
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Medical Microbiology, Ankara, Turkey
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17
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Sahin M, Haymana C, Demirci I, Tasci I, Rıfat E, Unluturk U, Satman I, Demir T, Cakal E, Ata N, Ertugrul D, Salman S, Sahin I, Dagdelen S, Celik O, Caglayan M, Atmaca A, Sonmez A. The clinical outcomes of COVID-19 infection in patients with a history of thyroid cancer: A nationwide study. Clin Endocrinol (Oxf) 2021; 95:628-637. [PMID: 33872399 PMCID: PMC8251412 DOI: 10.1111/cen.14486] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/03/2021] [Accepted: 04/15/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There are scarce published data in differentiated thyroid cancer patients about new coronavirus disease 2019 (COVID-19) disease outcomes and mortality. Here, we evaluated COVID-19 infection outcomes and mortality in thyroid cancer patients with COVID-19 infection. DESIGN AND METHODS We included a cohort of patients with thyroid cancer with PCR-confirmed COVID-19 disease from 11 March to 30 May 2020 from the Turkish Ministry of Health database in our nationwide, retrospective study. We compared the mortality and morbidity of COVID patients with or without thyroid cancer. Univariate and multivariate analyses were used to assess the independent factors for mortality, length of hospital stay and intensive care unit (ICU) admission and mechanical ventilation. We also analysed the effect of radioiodine treatment on severity and death rate of COVID-19 disease. RESULTS We evaluated 388 COVID-19 patients with thyroid cancer [median age: 54 years, interquartile range (IQR) 18 years, males: 23%] and age and gender-matched 388 COVID-19 patients without thyroid cancer. Patients with thyroid cancer had a similar mortality ratio compared with the non-cancer group. Among patients with thyroid cancer, age, presence of diabetes mellitus, asthma/COPD, heart failure, chronic kidney disease, prior coronary artery disease, RAS blocker usage and low lymphocyte count were associated with mortality. Radioactive iodine (RAI) treatment and cumulative radioactive iodine dosage did not negatively affect the severity and mortality of COVID-19 disease in our patient group. CONCLUSIONS Our study indicated that history of thyroid cancer did not have an increased risk of mortality or morbidity in COVID-19 disease. Besides, RAI therapy history and doses of radioactive iodine did not affect mortality or outcome.
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Affiliation(s)
- Mustafa Sahin
- Department of Endocrinology and MetabolismAnkara UniversityAnkaraTurkey
| | - Cem Haymana
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesGulhane Training and Research HospitalAnkaraTurkey
| | - Ibrahim Demirci
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesGulhane Training and Research HospitalAnkaraTurkey
| | - Ilker Tasci
- Department of Internal MedicineGulhane Faculty of Medicine and Gulhane Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
| | - Emral Rıfat
- Department of Endocrinology and MetabolismAnkara UniversityAnkaraTurkey
| | - Ugur Unluturk
- Department of Endocrinology and MetabolismFaculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Ilhan Satman
- Department of Endocrinology and MetabolismFaculty of MedicineIstanbul UniversityIstanbulTurkey
- Institute of Public Health and Chronic DiseasesThe Health Institutes of TurkeyIstanbulTurkey
| | - Tevfik Demir
- Department of Endocrinology and MetabolismFaculty of MedicineDokuz Eylul UniversityAnkaraTurkey
| | - Erman Cakal
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesDiskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey
| | - Naim Ata
- Department of Strategy DevelopmentMinistry of HealthAnkaraTurkey
| | - Derun Ertugrul
- Department of Endocrinology and MetabolismFaculty of MedicineUniversity of Health SciencesKecioren Training and Research HospitalAnkaraTurkey
| | - Serpil Salman
- Department of Endocrinology and MetabolismMedica ClinicIstanbulTurkey
| | - Ibrahim Sahin
- Department of Endocrinology and MetabolismFaculty of MedicineInonu UniversityMalatyaTurkey
| | - Selcuk Dagdelen
- Department of Endocrinology and MetabolismFaculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Osman Celik
- Ministry of HealthPublic Hospitals General DirectorateRepublic of TurkeyAnkaraTurkey
| | | | - Aysegul Atmaca
- Department of Endocrinology and MetabolismFaculty of MedicineOndokuz Mayis UniversitySamsunTurkey
| | - Alper Sonmez
- Department of Endocrinology and MetabolismGulhane Faculty of Medicine and Gulhane Training and Research HospitalUniversity of Health SciencesAnkaraTurkey
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18
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Dinc B, Kirca F, Aydogan S, Toyran A, Basyigit T, Omay I, Gun P, Caglayan M, Surel AA. Evaluation of SARS-CoV-2 RT-PCR test results from a pandemic hospital according to demographic data. Public Health 2021; 198:208-210. [PMID: 34481276 PMCID: PMC8332732 DOI: 10.1016/j.puhe.2021.07.041] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/25/2021] [Accepted: 07/27/2021] [Indexed: 11/28/2022]
Abstract
Objectives The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to coronavirus disease 2019 (COVID-19) in China at the end of 2019 has resulted in a global pandemic. On 11 March 2020, the first case of COVID-19 was reported in Turkey. The aim of this study was to evaluate SARS-CoV-2 Real-Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test results from the Medical Microbiology Laboratory of a pandemic hospital according to demographic data. Study design Retrospective cohort study. Methods SARS-CoV-2 RT-PCR test results of 413,013 samples from 194,062 patients were retrospectively analysed. Tests were carried out between 27 March and 31 December 2020 using two commercial kits. The patient's age and gender were recorded, in addition to the percentage of positive test results per month (i.e. monthly positivity). Pearson’s Chi-squared test was used to analyse statistical significance. Results Overall SARS-CoV-2 positivity in the pandemic hospital was 19.9%. Female gender and younger age (0–18 years) had a statistically significant higher positivity (P < 0.05). There was a statistically significant higher positivity in August and September. Conclusions Higher positivity among the younger population and females may be the leading cause of low COVID-19 mortality rates in Turkey as these population groups are less likely to die from the disease. Governments should disaggregate COVID-19 data by age and gender, and vaccine studies focussing on younger populations should be accelerated because this population group represents an important source of infection.
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Affiliation(s)
- B Dinc
- Department of Medical Microbiology, Ministry of Health, Ankara City Hospital, Ankara Turkey; Department of Medical Microbiology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey.
| | - F Kirca
- Department of Medical Microbiology, Ministry of Health, Ankara City Hospital, Ankara Turkey
| | - S Aydogan
- Department of Medical Microbiology, Ministry of Health, Ankara City Hospital, Ankara Turkey
| | - A Toyran
- Department of Medical Microbiology, Ministry of Health, Ankara City Hospital, Ankara Turkey
| | - T Basyigit
- Department of Medical Microbiology, Ministry of Health, Ankara City Hospital, Ankara Turkey
| | - I Omay
- Department of Medical Microbiology, Ministry of Health, Ankara City Hospital, Ankara Turkey
| | - P Gun
- Department of Medical Microbiology, Ministry of Health, Ankara City Hospital, Ankara Turkey
| | - M Caglayan
- Department of Healthcare, Ministry of Health, Ankara, Turkey
| | - A A Surel
- Ministry of Health, Ankara City Hospital, Ankara, Turkey
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19
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Sahin I, Haymana C, Demir T, Demirci I, Tasci I, Atmaca A, Cakal E, Ata N, Emral R, Unluturk U, Ertugrul D, Salman S, Sahin M, Dagdelen S, Celik O, Caglayan M, Satman I, Sonmez A. Clinical Characteristics and Outcomes of COVID-19 Patients with Overweight and Obesity: Turkish Nationwide Cohort Study (TurCObesity). Exp Clin Endocrinol Diabetes 2021; 130:115-124. [PMID: 34384122 DOI: 10.1055/a-1552-4449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 12/15/2022]
Abstract
PURPOSE While obesity is related to more severe outcomes of coronavirus disease 2019 (COVID-19), factors leading to poor prognosis still remain unclear. The present study evaluated the outcomes of COVID-19 patients who were overweight or obese and variables associated with severe disease in a large group of consecutive cases. METHODS A nationwide retrospective cohort study was performed using the Turkish National Healthcare Database. Demographic characteristics, laboratory tests, comorbidities, and medications of patients registered between March 11 and May 30, 2020, were recorded. RESULTS A total of 14, 625 patients (median age:42, IQR:26 years; female 57.4%) with normal weight (34.7%), overweight (35.6%), and obesity (29.7%) were included. Hospitalization, ICU admission, intubation/mechanical ventilation, pulmonary involvement, and mortality were significantly higher in patients who were overweight or obese. In adjusted analyses, both overweight (OR, 95% CI: 1.82, 1.04-3.21; p=0.037) and obesity (OR, 95% CI: 2.69, 1.02-1.05; p<0.001) were associated with a higher intubation/mechanical ventilation rate but only obesity was associated with increased mortality (OR, 95% CI: 2.56, 1.40-4.67; p=0.002). Old age, male gender, chronic kidney disease, and high C reactive protein levels were independently associated with COVID-19 mortality in overweight or obese patients. CONCLUSIONS COVID-19 patients who were overweight or obese were more likely to have adverse outcomes but only obesity was a predictor of mortality. Such patients should receive urgent medical attention and active management, especially the elderly, men, and people with chronic kidney disease.
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Affiliation(s)
- Ibrahim Sahin
- Faculty of Medicine, Department of Endocrinology and Metabolism, Inonu University, Malatya, Turkey
| | - Cem Haymana
- Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Tevfik Demir
- Faculty of Medicine, Department of Endocrinology and Metabolism, Dokuz Eylul University, Izmir, Turkey
| | - Ibrahim Demirci
- Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
| | - Aysegul Atmaca
- Faculty of Medicine, Department of Endocrinology and Metabolism, Ondokuz Mayis University, Samsun, Turkey
| | - Erman Cakal
- Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey
| | - Rifat Emral
- Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara University, Ankara, Turkey
| | - Ugur Unluturk
- Faculty of Medicine, Department of Endocrinology and Metabolism, Hacettepe University, Ankara, Turkey
| | - Derun Ertugrul
- Faculty of Medicine, Kecioren Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
| | - Serpil Salman
- Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Mustafa Sahin
- Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
| | - Selcuk Dagdelen
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | | | - Ilhan Satman
- Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul University, Istanbul, Turkey.,The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - Alper Sonmez
- Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, University of Health Sciences, Ankara, Turkey
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20
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Haymana C, Demirci I, Tasci I, Cakal E, Salman S, Ertugrul D, Ata N, Unluturk U, Dagdelen S, Atmaca A, Sahin M, Celik O, Demir T, Emral R, Sahin I, Caglayan M, Satman I, Sonmez A. Clinical outcomes of non-diabetic COVID-19 patients with different blood glucose levels: a nationwide Turkish study (TurCoGlycemia). Endocrine 2021; 73:261-269. [PMID: 34156609 PMCID: PMC8218282 DOI: 10.1007/s12020-021-02789-9] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/03/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE New coronavirus disease 2019 (COVID-19) has a worse prognosis in patients with diabetes. However, there are insufficient data about the effect of hyperglycemia on COVID-19 prognosis in non-diabetic patients. This study aimed to investigate the relationship between random blood glucose levels measured at the time of diagnosis and prognosis of COVID-19 disease in non-diabetic patients. METHODS A nationwide retrospective cohort of non-diabetic patients with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. The patients were stratified into three groups according to blood glucose levels which were <100 mg/dL in group-1, in the range of 100-139 mg/dl in group-2, and the range of 140-199 mg/dl in group-3. Clinical characteristics and outcomes were compared among the groups. The primary outcome was mortality. RESULTS A total of 12,817 non-diabetic patients (median age [IQR]: 44 [25] years, females: 50.9%) were included. Patients in group-2 (5%) and group-3 (14%) had higher mortality rates than patients in group-1 (2.1%). The rates of hospitalization, hospital stays longer than 8 days, intensive care unit (ICU) admission, ICU stay more than 6 days, and mechanical ventilation were also significantly higher in group-3 patients. Likewise, glucose levels in the range of 140-199 mg/dL were an independent associate of mortality and composite of ICU admission and/or mechanical ventilation. CONCLUSION Hyperglycemia at the time of COVID-19 diagnosis is associated with poor prognosis in non-diabetic patients. Clinicians should be more careful in the treatment of non-diabetic COVID-19 patients with hyperglycemia.
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Affiliation(s)
- Cem Haymana
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Training and Research Hospital, Ankara, Turkey.
| | - Ibrahim Demirci
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, University of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Serpil Salman
- Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Faculty of Medicine, Kecioren Training and Research Hospital, Ankara, Turkey
| | - Naim Ata
- Department of Strategy Development, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Aysegul Atmaca
- Department of Endocrinology and Metabolism, Samsun 19 Mayis University, Faculty of Medicine, Samsun, Turkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Ankara, Turkey
| | - Rifat Emral
- Department of Endocrinology and Metabolism, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Malatya Inonu University, Faculty of Medicine, Malatya, Turkey
| | | | - Ilhan Satman
- Department of Endocrinology and Metabolism, Istanbul University, Faculty of Medicine, Istanbul, Turkey
- Turkish Institute of Public Health and Chronic Diseases, Istanbul, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Ankara, Turkey
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21
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Sonmez A, Demirci I, Haymana C, Tasci I, Dagdelen S, Salman S, Ata N, Sahin I, Emral R, Cakal E, Atmaca A, Sahin M, Celik O, Demir T, Ertugrul D, Unluturk U, Caglayan M, Satman I. Clinical characteristics and outcomes of COVID-19 in patients with type 2 diabetes in Turkey: A nationwide study (TurCoviDia). J Diabetes 2021; 13:585-595. [PMID: 33655669 PMCID: PMC8013711 DOI: 10.1111/1753-0407.13171] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has been reported to be associated with a more severe course in patients with type 2 diabetes mellitus (T2DM). However, severe adverse outcomes are not recorded in all patients. In this study, we assessed disease outcomes in patients with and without T2DM hospitalized for COVID-19. METHODS A nationwide retrospective cohort of patients with T2DM hospitalized with confirmed COVID-19 infection from 11 March to 30 May 2020 in the Turkish Ministry of Health database was investigated. Multivariate modeling was used to assess the independent predictors of demographic and clinical characteristics with mortality, length of hospital stay, and intensive care unit (ICU) admission and/or mechanical ventilation. RESULTS A total of 18 426 inpatients (median age [interquartile range, IQR]: 61 [17] years; males: 43.3%) were investigated. Patients with T2DM (n = 9213) were compared with a group without diabetes (n = 9213) that were matched using the propensity scores for age and gender. Compared with the group without T2DM, 30-day mortality following hospitalization was higher in patients with T2DM (13.6% vs 8.7%; hazard ratio 1.75; 95% CI, 1.58-1.93; P < .001). The independent associates of mortality were older age, male gender, obesity, insulin treatment, low lymphocyte count, and pulmonary involvement on admission. Older age, low lymphocyte values, and pulmonary involvement at baseline were independently associated with longer hospital stay and/or ICU admission. CONCLUSIONS The current study from the Turkish national health care database showed that patients with T2DM hospitalized for COVID-19 are at increased risk of mortality, longer hospital stay, and ICU admission.
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Affiliation(s)
- Alper Sonmez
- Department of Endocrinology and MetabolismUniversity of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research HospitalAnkaraTurkey
| | - Ibrahim Demirci
- Department of Endocrinology and MetabolismUniversity of Health Sciences Turkey, Gulhane Training and Research HospitalAnkaraTurkey
| | - Cem Haymana
- Department of Endocrinology and MetabolismUniversity of Health Sciences Turkey, Gulhane Training and Research HospitalAnkaraTurkey
| | - Ilker Tasci
- Department of Internal MedicineUniversity of Health Sciences Turkey, Gulhane Faculty of Medicine and Gulhane Training and Research HospitalAnkaraTurkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | - Serpil Salman
- Department of Endocrinology and MetabolismMedica ClinicIstanbulTurkey
| | - Naim Ata
- Department of Strategy DevelopmentRepublic of Turkey, Ministry of HealthAnkaraTurkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Faculty of MedicineMalatya İnönü UniversityMalatyaTurkey
| | - Rifat Emral
- Department of Endocrinology and Metabolism, Faculty of MedicineAnkara UniversityAnkaraTurkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Faculty of MedicineUniversity of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research HospitalAnkaraTurkey
| | - Aysegul Atmaca
- Department of Endocrinology and Metabolism, Faculty of MedicineSamsun 19 Mayis UniversitySamsunTurkey
| | - Mustafa Sahin
- Department of Endocrinology and Metabolism, Faculty of MedicineAnkara UniversityAnkaraTurkey
| | - Osman Celik
- Public Hospitals General DirectorateRepublic of Turkey, Ministry of HealthAnkaraTurkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Faculty of MedicineDokuz Eylul UniversityAnkaraTurkey
| | - Derun Ertugrul
- Department of Endocrinology and Metabolism, Faculty of MedicineUniversity of Health Sciences Turkey, Kecioren Training and Research HospitalAnkaraTurkey
| | - Ugur Unluturk
- Department of Endocrinology and Metabolism, Faculty of MedicineHacettepe UniversityAnkaraTurkey
| | | | - Ilhan Satman
- Department of Endocrinology and Metabolism, Faculty of MedicineIstanbul UniversityIstanbulTurkey
- Turkish Institute of Public Health and Chronic DiseasesIstanbulTurkey
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22
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Temiz E, Koyuncu I, Durgun M, Caglayan M, Gonel A, Güler EM, Kocyigit A, Supuran CT. Inhibition of Carbonic Anhydrase IX Promotes Apoptosis through Intracellular pH Level Alterations in Cervical Cancer Cells. Int J Mol Sci 2021; 22:6098. [PMID: 34198834 PMCID: PMC8201173 DOI: 10.3390/ijms22116098] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/29/2021] [Accepted: 06/03/2021] [Indexed: 02/07/2023] Open
Abstract
Carbonic anhydrase IX (CAIX) is a hypoxia-related protein that plays a role in proliferation in solid tumours. However, how CAIX increases proliferation and metastasis in solid tumours is unclear. The objective of this study was to investigate how a synthetic CAIX inhibitor triggers apoptosis in the HeLa cell line. The intracellular effects of CAIX inhibition were determined with AO/EB, AnnexinV-PI, and γ-H2AX staining; measurements of intracellular pH (pHi), reactive oxygen species (ROS), and mitochondrial membrane potential (MMP); and analyses of cell cycle, apoptotic, and autophagic modulator gene expression (Bax, Bcl-2, caspase-3, caspase-8, caspase-9, caspase-12, Beclin, and LC3), caspase protein level (pro-caspase 3 and cleaved caspase-3, -8, -9), cleaved PARP activation, and CAIX protein level. Sulphonamide CAIX inhibitor E showed the lowest IC50 and the highest selectivity index in CAIX-positive HeLa cells. CAIX inhibition changed the morphology of HeLa cells and increased the ratio of apoptotic cells, dramatically disturbing the homeostasis of intracellular pHi, MMP and ROS levels. All these phenomena consequent to CA IX inhibition triggered apoptosis and autophagy in HeLa cells. Taken together, these results further endorse the previous findings that CAIX inhibitors represent an important therapeutic strategy, which is worth pursuing in different cancer types, considering that presently only one sulphonamide inhibitor, SLC-0111, has arrived in Phase Ib/II clinical trials as an antitumour/antimetastatic drug.
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Affiliation(s)
- Ebru Temiz
- Program of Medical Promotion and Marketing, Health Services Vocational School, Harran University, Sanliurfa 63300, Turkey
| | - Ismail Koyuncu
- Department of Medical Biochemistry, Faculty of Medicine, Harran University, Sanliurfa 63290, Turkey; (I.K.); (A.G.)
| | - Mustafa Durgun
- Department of Chemistry, Faculty of Arts and Sciences, Harran University, Sanliurfa 63290, Turkey
| | - Murat Caglayan
- Department of Medical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara 06110, Turkey;
| | - Ataman Gonel
- Department of Medical Biochemistry, Faculty of Medicine, Harran University, Sanliurfa 63290, Turkey; (I.K.); (A.G.)
| | - Eray Metin Güler
- Department of Medical Biochemistry, Faculty of Hamidiye Medicine, University of Health Sciences Turkey, Istanbul 34668, Turkey;
| | - Abdurrahim Kocyigit
- Department of Medical Biochemistry, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey;
| | - Claudiu T. Supuran
- NEUROFARBA Department, Section of Pharmaceutical and Nutriceutical Sciences, Università degli Studi di Firenze, Sesto Fiorentino, 50019 Florence, Italy
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Satman I, Demirci I, Haymana C, Tasci I, Salman S, Ata N, Dagdelen S, Sahin I, Emral R, Cakal E, Atmaca A, Sahin M, Celik O, Demir T, Ertugrul D, Unluturk U, Arga KY, Caglayan M, Sonmez A. Unexpectedly lower mortality rates in COVID-19 patients with and without type 2 diabetes in Istanbul. Diabetes Res Clin Pract 2021; 174:108753. [PMID: 33741352 PMCID: PMC7963521 DOI: 10.1016/j.diabres.2021.108753] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/18/2021] [Accepted: 03/08/2021] [Indexed: 01/08/2023]
Abstract
AIMS Type 2 diabetes mellitus (T2DM) is a risk factor for severe COVID-19. Our aim was to compare the clinical outcomes of patients with and without T2DM during the first hit of COVID-19 in Istanbul. METHODS A retrospective population-based study was conducted including all consecutive adult symptomatic COVID-19 cases. Patients were confirmed with rt-PCR; treated and monitored in accordance with standard protocols. The primary endpoints were hospitalization and 30-day mortality. RESULTS Of the 93,571 patients, 22.6% had T2DM, with older age and higher BMI. Propensity Score matched evaluation resulted in significantly higher rates of hospitalization (1.5-fold), 30-day mortality (1.6-fold), and pneumonia (1.4-fold). They revealed more severe laboratory deviations, comorbidities, and frequent drug usage than the Non-DM group. In T2DM age, pneumonia, hypertension, obesity, and insulin-based therapies were associated with an increased likelihood of hospitalization; whereas age, male gender, lymphopenia, obesity, and insulin treatment were considerably associated with higher odds of death. CONCLUSIONS COVID-19 patients with T2DM had worse clinical outcomes with higher hospitalization and 30-day mortality rates than those without diabetes. Compared to most territories of the world, COVID-19 mortality was much lower in Istanbul, which may be associated with accessible healthcare provision and the younger structure of the population.
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Affiliation(s)
- Ilhan Satman
- Istanbul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul, Turkey; The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey.
| | - Ibrahim Demirci
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Cem Haymana
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey.
| | - Serpil Salman
- Medica Clinic, Endocrinology and Metabolism, Istanbul, Turkey.
| | - Naim Ata
- Department of Strategy Development, Ministry of Health, Ankara, Turkey.
| | - Selcuk Dagdelen
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ibrahim Sahin
- Inonu University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Malatya, Turkey.
| | - Rifat Emral
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Erman Cakal
- University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Aysegul Atmaca
- Ondokuz Mayis University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Samsun, Turkey.
| | - Mustafa Sahin
- Ankara University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Osman Celik
- Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey.
| | - Tevfik Demir
- Dokuz Eylul University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Derun Ertugrul
- University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Ugur Unluturk
- Hacettepe University, Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
| | - Kazim Yalcin Arga
- The Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Istanbul, Turkey; Marmara University, Faculty of Engineering, Department of Bioengineering, Istanbul, Turkey.
| | | | - Alper Sonmez
- University of Health Sciences, Gulhane Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey; University of Health Sciences, Gulhane Faculty of Medicine and Training and Research Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, Ankara, Turkey.
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Altuntas F, Ata N, Yigenoglu TN, Bascı S, Dal MS, Korkmaz S, Namdaroglu S, Basturk A, Hacıbekiroglu T, Dogu MH, Berber İ, Dal K, Kınık K, Haznedaroglu İ, Yılmaz FM, Kılıç İ, Demircioğlu S, Yosunkaya A, Erkurt MA, Turgut B, Caglayan M, Celik O. Convalescent plasma therapy in patients with COVID-19. Transfus Apher Sci 2020; 60:102955. [PMID: 33011076 PMCID: PMC7501849 DOI: 10.1016/j.transci.2020.102955] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/01/2020] [Accepted: 09/06/2020] [Indexed: 12/28/2022]
Abstract
Introduction Passive antibody therapy has been used to immunize vulnerable people against infectious agents. In this study, we aim to investigate the efficacy of convalescent plasma (CP) in the treatment of severe and critically ill patients diagnosed with COVID-19. Method The data of severe or critically ill COVID-19 patients who received anti-SARS-CoV-2 antibody-containing CP along with the antiviral treatment (n = 888) and an age-gender, comorbidity, and other COVID-19 treatments matched severe or critically ill COVID-19 patients at 1:1 ratio (n = 888) were analyzed retrospectively. Results Duration in the intensive care unit (ICU), the rate of mechanical ventilation (MV) support and vasopressor support were lower in CP group compared with the control group (p = 0.001, p = 0.02, p = 0.001, respectively). The case fatality rate (CFR) was 24.7 % in the CP group, and it was 27.7 % in the control group. Administration of CP 20 days after the COVID-19 diagnosis or COVID-19 related symptoms were associated with a higher rate of MV support compared with the first 3 interval groups (≤5 days, 6−10 days, 11−15 days) (p=0.001). Conclusion CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients.
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Affiliation(s)
- Fevzi Altuntas
- University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology and Bone Marrow Transplantation Center, Ankara, Turkey; Ankara Yıldırım Beyazıt University, School of Medicine, Department of Hematology, Ankara, Turkey.
| | - Naim Ata
- Republic of Turkey, Ministry of Health, Department of Strategy Development, Ankara, Turkey.
| | - Tugce Nur Yigenoglu
- University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology and Bone Marrow Transplantation Center, Ankara, Turkey.
| | - Semih Bascı
- University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology and Bone Marrow Transplantation Center, Ankara, Turkey.
| | - Mehmet Sinan Dal
- University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology and Bone Marrow Transplantation Center, Ankara, Turkey.
| | - Serdal Korkmaz
- University of Health Sciences, Kayseri Training and Research Hospital, Department of Hematology, Kayseri, Turkey.
| | - Sinem Namdaroglu
- University of Health Sciences, Bozyaka Training and Research Hospital, Department of Hematology, Izmir, Turkey.
| | - Abdulkadir Basturk
- Selcuk University, School of Medicine, Department of Internal Medicine, Division of Hematology, Konya, Turkey.
| | - Tuba Hacıbekiroglu
- Sakarya University, School of Medicine, Department of Internal Medicine, Division of Hematology, Sakarya, Turkey.
| | - Mehmet Hilmi Dogu
- İstanbul Training and Research Hospital, Department of Hematology, İstanbul, Turkey.
| | - İlhami Berber
- Inonu University, School of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey.
| | - Kursat Dal
- Kecioren Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey.
| | | | - İbrahim Haznedaroglu
- Hacettepe University, School of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
| | | | - İsa Kılıç
- Bursa City Hospital, Department of Anesthesiology, Bursa, Turkey.
| | - Sinan Demircioğlu
- Necmettin Erbakan University, School of Medicine, Department of Internal Medicine, Division of Hematology, Konya, Turkey.
| | - Alper Yosunkaya
- Necmettin Erbakan University, School of Medicine, Department of Anesthesiology, Konya, Turkey.
| | - Mehmet Ali Erkurt
- Inonu University, School of Medicine, Department of Internal Medicine, Division of Hematology, Malatya, Turkey.
| | - Burhan Turgut
- Namık Kemal University, School of Medicine, Department of Internal Medicine, Division of Hematology, Tekirdağ, Turkey.
| | | | - Osman Celik
- Republic of Turkey, Ministry of Health, Public Hospitals General Directorate, Ankara, Turkey.
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Arslan E, Turk H, Caglayan M, Turkmenoglu TT, Gonel A, Tayman C. Protective Effects of Astaxanthin on Nephrotoxicity in Rats with Induced Renovascular Occlusion. Comb Chem High Throughput Screen 2020; 24:1236-1242. [PMID: 32928081 DOI: 10.2174/1386207323666200914104432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/08/2020] [Revised: 07/22/2020] [Accepted: 08/12/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Various effects of Astaxanthin was shown in the studies including its antioxidant, anti-inflammatory, anti-tumor and immunregulator effects. OBJECTIVE The aim of this study was to evaluate the beneficial effects of Astaxanthin on renovascular occlusion induced renal injury and to investigate the possible mechanisms. METHODS The rats were randomly assigned into three groups as follows: Group 1: control group (n=12), Group 2: renal ischemiareperfusion injury group (n=12), Group 3: renal ischemia-reperfusion + asthaxantine treated group (n=12). The control group and the renal ischemia-reperfusion group were given 2cc/kg/g olive oil for 7 days before establishing ischemia to renal tissue. Astaxanthin dissolved in olive oil was given orally to the renal ischemia+astaxanthin group for 7 days before inducing renal ischemia. Caspase-(3, 8, 9), GSH, SOD, Total Thiol, TNF-α, IL-6, 8-OHdG were performed for each group. RESULTS Renal IRI was verified by analysing the pathological changes of renal tissues and the renal functions after renal reperfusion. Much less renal tubular damage was determined the IRI+ASX group in comparison to the IRI group. Caspase-8, -9 and -3 immunoreactivity was observed to be minimal in the control group. Apoptosis was observed to be significantly reduced in the IRI + ASX group with respect to IRI group and close to the level of the control group (p <0.05). Caspase-3 levels of tissue samples were significantly increased in IRI group compared to other groups, but significantly lower in IRI+ASX group with respect to the IRI group (p<0.05). The TOS and OSI levels, indicating increased oxidative stress, were significantly lower in the IRI+ASX group with respect to the IRI group (p <0.001), but still higher than the control group (p <0.001). In addition to GSH, SOD and Total Thiol levels, TAS levels were also significantly higher in IRI + ASX group in comparison to the IRI group (p <0.05). TNF-α, IL-6, lipid hydroperoxide, AOPP and 8-OHdG levels were lower in the IRI+ASX group than the IRI group (p <0.001). MPO, IL-6, TNF-α levels, representing the parameters indicating neutrophil infiltration and inflammation of the renal tissues, significantly increased in IRI group with respect to the other groups (p <0.005). CONCLUSION When all the data obtained in our study were evaluated, ASX was determined to prevent renal damage due to renovascular occlusion to a great extent, through complex mechanisms involving antioxidant, anti-inflammatory and antiapopitotic effects. Biochemical, histological and oxidative stress parameters were improved due to ASX.
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Affiliation(s)
- Erkan Arslan
- Department of Urology, Harran University, Faculty of Medicine. Turkey
| | - Hakan Turk
- Department of Urology, Usak University, Faculty of Medicine. Turkey
| | - Murat Caglayan
- Department of Medicinal Biochemistry, Yildirim Beyazit University, Faculty of Medicine. Turkey
| | | | - Ataman Gonel
- Department of Medicinal Biochemistry, Harran University, Faculty of Medicine. Turkey
| | - Cuneyt Tayman
- Department of Neonatology, University of health sciences, Zekai Tahir Burak Maternity Teaching Hospital, Ankara . Turkey
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Okcu M, Oktayoglu P, Mete N, Bozkurt M, Caglayan M, Nas K. AB0053 A Useful Marker in Assessment of Remission and Activation of Disease in Patients with Rheumatoid Arthritis: Serum Human Neutrophil Peptides 1-3. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2671] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Em S, Oktayoglu P, Caglayan M, Karakoç M, Ucar D, Bozkurt M, Mete N, Sriyildiz MA, Nas K, Yıldız I. SAT0429 The Role of Relaxin in Benign Hypermobility Syndrome. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2153] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Oktayoglu P, Caglayan M, Bozkurt M, Em S, Ucar D, Yazmalar L, Mete N, Nas K, Gezer O. AB0659 Serum levels of high mobility group box 1 protein and its association with quality of life and psychological and functional status in patients with fibromyalgia. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2981] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bozkurt M, oktayoğlu P, uçar D, Em S, Caglayan M, yuksel H, Batmaz I, Sariyildiz MA, Nas K. AB0660 Serum coenzyme-q10 activity and oxidative status in patients with fibromyalgia. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2982] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND Health-related quality of life (QoL) in children with monosymptomatic nocturnal enuresis might be influenced by impaired quality of sleep. The aim of this study was to evaluate possible deteriorations in QoL and sleep quality and the association between these parameters in children with monosymptomatic nocturnal enuresis. METHODS The study consisted of 44 children with monosymptomatic nocturnal enuresis and 27 healthy controls aged 6-15 years. KINDL QoL and Pittsburgh Sleep Quality Index (PSQI) were applied to all children. RESULTS Mean total KINDL scores in enuresis and control groups were 65.1 +/- 11.0 vs. 67.4 +/- 13.7, respectively (P = 0.44). PSQI scores were not significantly different between the groups (P > 0.05l). In the enuresis group, age showed significant negative correlation with self-esteem domain of KINDL (r = -0.39, P = 0.01) and positive correlation with sleep duration sub-score of the PSQI (r = 0.37, P = 0.03). Duration of enuresis showed significantly negative correlation with total KINDL score and self-esteem domain (r = -0.32 and r = -0.39, P = 0.04 and P = 0.01, respectively). There was significant correlation between physical well-being sub-score of KINDL with daytime dysfunction and total scores of PSQI (r = -0.53, P = 0.001 and r = -0.41, P = 0.02, respectively). Daytime dysfunction sub-score of PSQI was significantly correlated with friends sub-score of KINDL (r = -0.33, P = 0.04). CONCLUSIONS As age of the child and duration of enuresis increase, self-esteem domain of QoL worsens. Moreover, there is a significant correlation of physical well-being and friends domains of QoL score and total and daytime dysfunction scores of PSQI. These findings necessitate global evaluation of QoL and sleep quality in children with monosymptomatic nocturnal enuresis to increase efficacy of health care.
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Affiliation(s)
- P Ertan
- Department of Pediatric Nephrology, Celal Bayar University, Mithatpasa cd. 900/15 Goztepe, Izmir, Turkey.
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Serin E, Gurel K, Kiyan A, Caglayan M, Karavas E. Does diagnostic sonography alter thyroid and parathyroid hormone levels? J Clin Ultrasound 2008; 36:12-15. [PMID: 17937422 DOI: 10.1002/jcu.20419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE To investigate possible alterations in the levels of thyroid and parathyroid hormones (PTHs) and thyroglobulin (TG) in healthy individuals following diagnostic sonographic examination of the thyroid gland. METHODS Thirty healthy women with no pathologic findings underwent sonographic examination, followed 6 weeks later by a second examination involving a probe-only application (PA) with the ultrasound scanner switched off. Duration times were identical for both examinations. Blood was drawn before and after the 2 applications. Thyroid hormone, PTH, and TG levels before and after the 2 applications were compared, and the difference between the variations for each parameter in the first and second applications was assessed. Blood samples were taken before and after the sonographic examination and the PA, and the serum concentrations of sensitive thyrotropin, total and free thyroxine, total and free tri-iodothyronine, TG, and PTH were measured. The pre- and post-examination levels of the hormones for the 2 applications were then compared and the difference between the variations for each parameter in the first and second application was then assessed. RESULTS The only significant variations observed were in the TG levels after PA and PTH levels after both sonographic examination and PA. The comparison between the 2 difference values revealed no significant difference except for PTH. CONCLUSION This preliminary report on the possible influence of sonographic examination of the thyroid on the serum levels of thyroid and parathyroid hormones suggests that gland secretions such as PTH may be affected by external factors, including ultrasound. Clinicians should be aware of alterations in hormone levels by external factors.
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Affiliation(s)
- Erdinc Serin
- Department of Biochemistry, Abant Izzet Baysal University, Izzet Baysal Medical Faculty, Golkoy, Bolu, 14280 Turkey
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