Association between Serum Osteopontin Levels and Cardiovascular Risk in Hypothyrodism

Purpose: Cardiovascular effects of hypothyroidism are well known. Osteopontin (OPN) is a new inflammatory marker which was first isolated from the bone. Flow-mediated dilatation (FMD), a noninvasive technique to measure this endothelium-dependent function, has been used in several clinical studies to show cardiovascular risks. The aim of our study was to assess FMD value in hypothyroidism patients and to investigate whether plasma OPN level is a parameter which can predict cardiovascular risks in this group of patients. Material and Method: This study included 39 patients who had high levels of thyroid-stimulating hormone (TSH) and 11 healthy euthyroid controls. Plasma TSH, free thyroxine, fibrinogen, high-sensitive C-reactive protein (hsCRP), fasting plasma glucose, total cholesterol (T-chol), low density lipoprotein (LDL), triglyceride and OPN levels were measured at the time hypothyroidism was first detected and after euthyroid state was achieved with levothyroxine treatment. In parallel with these assessments, brachial FMD measurements were also performed. Results: In hypothyroid patients cardiovascular risk factors such as T-chol, LDL and triglyceride levels were higher than in control group but fibrinogen and hsCRP levels were not different between the groups. OPN levels were similar in patient and control groups, but basal FMD levels were lower in patients with hypothyroidism. After euthyroidism was achieved, OPN levels significantly decreased and FMD levels significantly increased, but a correlation was not detected between these two parameters. Discussion: Our study did not show a significant correlation between OPN and cardiovascular risk parameters. Further studies are needed to use OPN as a cardiovascular risk marker in hypothyroid patients

Mean platelet volume in Graves' disease: A sign of hypermetabolism rather than autoimmunity?

Objective: To evaluate the impact of mean platelet volume (MPV) on predicting disease course among patients with Graves' disease (GD). Methods: This retrospective study was performed between 2013-2016 at the Outpatient Endocrinology Clinic of Baskent University Faculty of Medicine, Adana hospital on 65 patients with GD. Among participants, 30 cases experienced thyrotoxicosis again during the first six months after discontinuing anti-thyroid drug (ATD) sessions that had been carried out for at least 12 months prior to stopping (Relapse group). We also observed 35 patients who exhibited normal thyroid functions within six months following ATD withdrawal (Remission group). MPV levels and thyroid function tests were recorded and total duration of ATD therapy was calculated for all participants. Results: The mean MPV level that was measured at the time of drug withdrawal did not differ between groups, being 8.0 +/- 1.2 fL in the Relapse group vs. 8.0 +/- 1.0 fL in the Remission group (p=0.81). However, we found that the relapse MPV was higher than the withdrawal MPV in the Relapse group (9.2 +/- 1.3 fL) than it was in the Remission group (8.0 +/- 1.2 fL, p=0.00). Conclusions: Higher relapse MPV in Relapse group but similar MPV levels in both groups at ATD withdrawal may be attributed to hypermetabolism or hyperthyroidism rather than autoimmunity of GD

Urinary tract infection in diabetes: Susceptible organisms and antibiogram patterns in an outpatient clinic of a tertiary health care center

We aimed to determine the influence of diabetes mellitus (DM) on uropathogens and antibiotic resistance pattern in urinary tract infection (UTI) in our center. Three hundred fifty-five DM patients and 165 non-DM patients with UTI were included in this retrospective study. Urine samples were processed in the laboratory following standard protocol. Mean age was higher in DM group (63.9 ± 12.4 vs 59.6 ± 17.3 years, respectively, P = 0.001). Females showed much higher UTI prevalence in both groups (85.6% in DM vs 70.3% in non-DM group, P = 0.000). Mean HbA1c level on admission was 9.3% (78 mmol/mol). Mean duration of DM was 13.9 ± 8.5 yr. E.coli was the predominant uropathogen for both (67.3% in DM and 61.8% in non-DM group). Most isolated microorganisms were sensitive to nitrofurantoin (87.0% in DM, vs 83.6% in non-DM group, P = 0.265). Mean DM duration of higher than 10,5 years showed greatest risk of multidrug resistance (MDR) (AUC = 0.58, sensitivity of 63.7% and specificity of 50%, P = 0.019). Diabetic patients with UTI had poor glycemic control and long-standing DM. Nitrofurantoin was the most appropriate antimicrobial agent for empirical use. The MDR was higher in patients with DM lasting longer than 10.5 years. [Med-Science 2019; 8(4.000): 881-6