DİYETLE OBEZ HALE GETİRİLMİŞ SIÇANLARDA NONALKOLİK YAĞLI KARACİĞER HASTALIĞI ÜZERİNE SİTAGLİPTİNİN ETKİSİ

Amaç: Diyetle obez hale getirilmiş sıçanlarda sitagliptinin NAYKH&#8217;na etkisini araştırmak. Gereç ve Yöntem: 24 haftalık, 199-240 gram ağırlığında, erişkin-dişi, toplam 24 adet Sprague-Dawley cinsi sıçan kullanıldı. Sıçanlar rastgele 2 gruba ayrıldı. Kontrol grubu (n:6) standart sıçan diyetiyle beslenirken, diğer grup (n:18) yüksek yağlı diyetle (YYD) 12 hafta beslendi. NAYKH oluşumu sağlandıktan sonra YYD&#8217;le beslenen sıçanlar rastgele 2 gruba ayrıldı. Toplam 16 hafta sadece YYD alan grup NAYKH grubu (n:8) kabul edildi. Sitagliptin grubu (n:10) ise YYD&#8217;le 12 hafta beslendikten sonra, son 4 haftada YYD&#8217;e ek olarak sitagliptin (3 mg/kg) tedavisi aldı. Çalışma boyunca sıçanların kilo alımı takip edildi. Çalışma sonunda tüm sıçanların serum glukozu, trigliserid, kolesterol, AST, ALT, DHEA-S düzeyi ve plazma insülin düzeyini değerlendirmek için kan örnekleri alındı. İnsülin direnci HOMA-IR indeksi ile hesaplandı. Histopatolojik değerlendirme için karaciğer doku örnekleri incelendi. Bulgular: Sitagliptin grubunda NAYKH grubuna göre, serum glukoz (p0.05). DHEA-S düzeyi ile hepatik steatoz arasında ilişki saptanmadı (r=0.009, p=0.967). Sonuç: Sitagliptinin insülin duyarlılığını, lipid profilini düzenlediği ve hepatik steatozu iyileştirdiği gösterildi.Aim: To determine the effects of sitagliptin on NAFLD in rats with diet-induced obesity. Materials and Methods: 24 weeks aged, 199-240 grams, twenty four adult-female Sprague-Dawley rats were used. The rats were randomly separated into 2 groups. The control group (n:6) was fed with standard rat diet. The other group (n:18) was fed with a high fat diet (HFD) to induce NAFLD. After 12 weeks, rats which were fed with a HFD were randomly seperated into 2 groups. NAFLD group was fed with a HFD for an additional 4 weeks. Sitagliptin group received sitagliptin (3 mg/kg) for 4 weeks in addition to HFD. Changes in weight were recorded throughout the study. At the end of the study blood samples were drawn from all rats to determine the levels of serum glucose, triglyceride, cholesterol, AST, ALT, DHEA-S and plasma insulin. Insulin resistance was determined using the HOMA-IR index. Histopathologic evaluation of liver samples were undertaken. Results: Serum glucose (p<0.001) and insulin (p<0.001) values were significantly lower in the sitagliptin group compared to NAFLD group. HOMA-IR index was significantly lower (p<0.001) in the sitagliptin group compared to NAFLD group. The sitagliptin group had lower serum levels of triglycerides (p<0.001) and cholesterol (p<0.001) than NAFLD group. Hepatic steatosis was significantly less (p<0.001) in the sitagliptin group compared to NAFLD group while no difference was seen in hepatic inflammation (p=0.057). The sitagliptin group had no difference in hepatomegaly and liver transaminase levels compared to NAFLD group. No significant association was determined between DHEA-S and hepatic steatosis (r=0.009, p=0.967). Conclusion: Sitagliptin appears to improve hepatic steatosis by increasing insulin sensitivity and regulating lipid profiles in rats

Metabolic syndrome and Visceral Adiposity Index in non-functional adrenal adenomas

ABSTRACT Objective: We aimed to identify metabolic dysfunction in non-functioning adrenal adenomas (NFAAs) and Visceral Adiposity Index (VAI) predictability in the practical estimation of metabolic syndrome (MetS) in NFAAs. Subjects and methods: 134 NFAA patients and 68 control subjects matched for age, sex, and body mass index (BMI) were included in the study. After physical, biochemical, and endocrine evaluation, IDF and NCEP ATP III criteria were used to determine MetS. HOMA-IR and VAI were calculated for both study group subjects. Results: MetS was significantly higher in the NFAA patients. The incidence of MetS by IDF and NCEP criteria was 52.9%,48.5% in the NFAI and 32.3%,30.8% in the control group (p < 0.01, p = 0.02). The risk of MetS was increased in NFAA (75.6 vs. 24.4%, p = 0.017, OR = 1.34, 95% CI = 1.06-1.68). Glucose, HOMA IR, hypertension, and VAI were significantly increased in NFAA patients. The risk of MetS was independently associated with high VAI (79.2 vs. 20.8%, p = 0.001, OR = 2.22; 95% CI = 1.70-2.91). Conclusion: MetS, insulin resistance, and VAI are more prevalant in NFAA patients than in healthy individuals. VAI can be used with high specificity to estimate MetS in NFAA patients

Factors associated with glomerular filtration rate variation in primary hyperparathyroidism after parathyroidectomy

WOS: 000458367000043PubMed: 30761868Background/aim: Prolonged hypercalcemia impairs renal function, and a reduced glomerular filtration rate (GFR) is typical in advanced primary hyperparathyroidism (PHPT). There are scarce data related to predictors of renal impairment in patients with PHPT. Hence, we aimed to evaluate changes in kidney function in PHPT patients after parathyroidectomy (PTX) and identify factors associated with GFR variation in these patients. Materials and methods: One hundred and twenty-five patients with PHPT who underwent surgery between 2012 and 2014 were enrolled in the study. Patients were divided into two groups according to GFR values: patients whose GER was lower than 60 mL/min/1.73 m(2) and higher than 60 mL/min/1.73 m(2). Demographic and laboratory parameters were compared before and 6 months after parathyroidectomy. Results: Prevalence of antihypertensive drug users and patients with renal cysts and parathormone (PTH) and alkaline phosphatase levels were higher in patients with GFR of >60 than in GFR of = 60 but GFR did not change in the two groups after parathyroidectomy. After parathyroidectomy, calcium and PTH decreased but 25(OH)D3 and phosphorus increased in the two groups. In multiple regression analysis, age, calcium, and baseline GFR were independent predictors of GFR variation. Parathyroid adenoma volume and urinary calcium were not independent predictors of GFR change. Conclusion: Older age, higher preoperative calcium, and GFR were factors associated with GFR increase in PHPT patients after parathyroidectomy. Further renal impairment was prevented by parathyroidectomy in PHPT patients

Maternal genetic contribution to pre-pregnancy obesity, gestational weight gain, and gestational diabetes mellitus

Abstract Introduction Pre-pregnancy obesity, gestational diabetes mellitus (GDM), and gestational weight gain (GWG) are associated with each other. This is the first study to investigate whether genetic variants were associated with having GDM, and whether genetic variants-related GDM were associated with adiposity including pre-pregnancy obesity and excessive GWG in Turkish women. Patients and methods Women with GDM (n = 160) and without GDM (n = 145) were included in case-controlled study. Genotyping of the HNF1A gene (p.I27L rs1169288, p.98V rs1800574, p.S487N rs2464196), the VDR gene (p.BsmI rs1544410, p.ApaI rs7975232, p.TaqI rs731236, p.FokI rs2228570), and FTO gene (rs9939609) SNPs were performed by using RT-PCR. Results The FTO AA genotype was associated with an increased risk of having GDM (AA vs. AT + TT, 24.4% vs. 12.4%, OR = 2.27, 95% CI [1.23–4.19], p = 0.007). The HNF1A p.I27L GT/TT genotype was associated with increased GDM risk (GT + TT vs. GG-wild, 79.4% vs. 65.5%, OR = 2.02, 95% CI 1.21–3.38], p = 0.007). However, all VDR gene SNPs and the HNF1A p.A98V, p.S487N were not associated with having GDM (p > 0.05). The FTO AA genotype was associated with an increased risk for pre-pregnancy overweight/obesity (OR = 1.43, 95% CI [1.25–3.4], p = 0.035), but not associated with excessive GWG after adjusting for pre-pregnancy weight (p > 0.05). Pre-pregnancy weight, weight at delivery, and GWG did not differ in both VDR and HNF1A gene carriers (p > 0.05). HOMA-IR and HbA1c were increased in both p.I27L TT and FTO AA genotype carriers (p < 0.05). Conclusion The adiposity-related gene FTO is associated with GDM by the effect of FTO on pre-pregnancy obesity. The diabetes-related p.I27L gene is associated with GDM by increasing insulin resistance

Screening for celiac disease in poorly controlled type 2 diabetes mellitus: worth it or not?

Abstract Background Recent studies have demonstrated that immune factors might have a role in the pathophysiology of insulin resistance and type 2 diabetes mellitus (T2DM). Inappropriate glycemic control in patients with T2DM is an important risk factor for the occurrence of diabetes complications. The prevalence of celiac disease (CD) is high in type 1 diabetes mellitus however, there are scarce data about its prevalence in T2DM. Our aim was to investigate the prevalence of celiac disease among insulin-using type 2 diabetes patients with inappropriate glycemic control. Methods IgA tissue transglutaminase antibodies (tTGA IgA) test was performed as a screening test. A total of 135 patients with T2DM whose control of glycemia is inappropriate (HbAlc value >7%) in spite of using insulin treatment for at least 3-months (only insulin or insulin with oral antidiabetic drugs) and 115 healthy controls were enrolled in the study. Upper gastrointestinal endoscopy with duodenal biopsy was performed to all patients with raised tTGA IgA or selective lgA deficiency. Results Gender, age, body mass index (BMI) and tTGA IgA, kreatinin, calcium, LDL-cholesterol (LDL-C), total cholesterol, 25-OH vitamin D3 levels were similar between groups. Systolic and diastolic blood pressure, waist circumference, fasting plasma glucose, postprandial plasma glucose, urea, sodium, HbA1c, LDL-C, triglyceride, vitamin B12 levels were significantly higher in DM group (p < 0.0001). BMI, high-sensitive CRP, microalbuminuria, and AST, ALT, potassium, phosphorus levels were significantly higher in the T2DM group (p < 0.05). HDL-cholesterol and parathormone levels were significantly lower in the T2DM group (p < 0.05). Two of the 135 patients with T2DM were diagnosed with CD (1.45%). Conclusions The prevalence of celiac disease among patients with type 2 diabetes, with poor glycemic control despite insulin therapy, is slightly higher than the actual CD prevalence in general population. Type 2 diabetic patients with inappropriate control of glycemia in spite of insulin treatment might be additionally tested for Celiac disease especially if they have low C-peptide levels

Components of the Complete Blood Count in Type 2 Diabetes Mellitus with Inadequate Glycemic Control

Objective: Inadequate control of glycemia in diabetic patients is the primary cause of both micro- and macrovascular complications. Several components of complete blood count were investigated and have found to be higher in diabetic patients. We aimed to evaluate white blood cell (WBC), neutrophil, lymphocyte and platelet counts and, red cell distribution width (RDW), mean platelet volume (MPV) and platelet distribution width (PDW) in type 2 diabetes mellitus (T2DM) patients with inappropriorate glycemic management (HbAlc >7%) despite using insulin therapy. Methods: 135 type 2 diabetic patients with inappropriorate blood glucose management (HbAlc value >7 %) despite using insulin therapy for at least 3-month period (only insulin or insulin plus oral hypoglycemic agents) and 121 healthy subjects were included in the study. Demographic, anthropometric and laboratory data were recorded. Results: WBC, neutrophil, lymphocyte and monocyte counts were higher in DM group (p<0.0001). WBC counts were positively correlated with diastolic blood pressure (DBP), body mass index (BMI), waist circumference (WC) and high-sensitive C- reactive protein (hsCRP), fasting plasma glucose (FPG), post-prandial glucose (PPG), HbA1c and triglyceride levels (p<0.05). Neutrophil counts were positively correlated with hsCRP, FPG, HbA1c, BMI, PPG, LDL-Cholesterol (LDL-C) and microalbumin levels (p<0.05). Lymphocyte counts were positively correlated with systolic blood pressure (SBP), DBP, BMI, WC and FPG, HbA1c, LDL-C and triglyceride levels (p<0.05). WBC, neutrophil and lymphocyte counts were negatively correlated with HDL-Cholesterol (HDL-C) levels (p<0.05). PDW was higher in DM group (16.65±0.59 to 16.51±0.51, p:0.043). PDW was positively correlated with age, DBP, FPG, PPG, HbA1c, LDL-C and triglyceride levels (p<0.05). Monocyte to HDL-C ratio was higher in DM group (13.50 ± 5.34 to 10.54 ± 4.29, p<0.0001). Conclusions: In this study white blood cell, neutrophil and lymphocyte counts and PDW were higher in type 2 diabetic patients with inappropriorate glycemic management despite insulin therapy and they were correlated wıth cardio-metabolic risk factors. Leukocyte subtypes and PDW may be used as a marker for cardiovascular diseases in these patients

The effects of single high-dose or daily low-dosage oral colecalciferol treatment on vitamin D levels and muscle strength in postmenopausal women

Abstract Introduction Vitamin D deficiency is a common health problem. Vitamin D supplements are used to improve vitamin D status; however, there are contradictory data related to what doses to give and how often they should be given. Many studies have investigated the effects of vitamin D supplementation on muscle strength, but the results remain controversial. We aimed to compare the effects and safety of single high-dose with daily low-dose oral colecalciferol on 25(OH)D levels and muscle strength in postmenopausal women with vitamin D deficiency or insufficiency. Methods and design Sixty healthy postmenopausal women who had serum vitamin D levels  0.05). A significant increase in vitamin D levels was observed in both groups at 4 and 12 weeks after vitamin D3 treatment. The increase in the single-dose group was significantly higher than the daily low-dosage group at the 4th week (35.9 ± 9.6 ng/mL (89,6 ± 23,9 nmol/L), 16.9 ± 5.8 ng/mL (42,1 ± 14,4 nmol/L), p = 0.01). The increase in the single-dose group was significantly higher than in the daily low dosage group at the 12th week (23.4 ± 4.7 ng/mL (58,4 ± 11,7 nmol/L), 19.8 ± 7.2 ng/mL (49,4 ± 17,9 nmol/L), p = 0.049). The quadriceps muscle strength score increased significantly in the daily group at the 4th week (p = 0.038). The hamstring muscle strength score increased significantly in the daily group at the 12th week (p = 0.037). Conclusion Although daily administration routes are more effective in improving muscle strength, a single administration is more effective in increasing vitamin D levels. Trial registration number ISRCTN14226530 (04.07.2018), Name of the registry: ISRCTN registry, The study was retrospectively registered

The effect of disease activity on thyroid nodules in patients with acromegaly

Nodular thyroid disease is a very common disorder in patients with acromegaly. Insulin-like growth factor-1 (IGF-1) is a thyroid growth factor, and there is a correlation between IGF-1 levels and thyroid volume (TV) in patients with acromegaly. There is no study investigating the impact of somatostatin analog (SSA) treatment on thyroid nodule volume in patients with acromegaly. We aimed to assess thyroid nodule volume change with SSA treatment in patients with persistent acromegaly. We retrospectively analyzed data from 108 consecutive patients with acromegaly who were followed up by our clinic after undergoing surgery between 2002 and 2014. Patients who were cured after surgery were excluded. We only selected 43 patients (21 males, 22 females, mean age 52.8 ± 11.9 years) who did not meet the criteria of remission postoperatively, who were treated with SSA for at least six months and had normal thyroid function. Patients were divided into three groups (well-controlled, controlled, and active) according to their IGF-1 and growth hormone (GH) levels. All patients underwent an evaluation of TV and total thyroid nodule volume (TTNV) by ultrasound. TTNV decreased significantly in patients with well-controlled acromegaly (0.44 [0.75] to 0.23 [0.73], p < 0.001). TTNV did not change in controlled patients (0.18 [1.28] to 0.13 [1.54], p = 0.959); however TTNV increased in patients with active acromegaly (0.77 [1.46] to 1.03 [1.88], p = 0.028). Successful medical treatment of patients with active acromegaly decreases thyroid nodule volume. Sustained exposure to IGF-1 may cause an increase in thyroid nodule volume in patients with acromegaly

The effect of disease activity on thyroid nodules in patients with acromegaly

Nodular thyroid disease is a very common disorder in patients with acromegaly. Insulin-like growth factor-1 (IGF-1) is a thyroid growth factor, and there is a correlation between IGF-1 levels and thyroid volume (TV) in patients with acromegaly. There is no study investigating the impact of somatostatin analog (SSA) treatment on thyroid nodule volume in patients with acromegaly. We aimed to assess thyroid nodule volume change with SSA treatment in patients with persistent acromegaly. We retrospectively analyzed data from 108 consecutive patients with acromegaly who were followed up by our clinic after undergoing surgery between 2002 and 2014. Patients who were cured after surgery were excluded. We only selected 43 patients (21 males, 22 females, mean age 52.8 +/- 11.9 years) who did not meet the criteria of remission postoperatively, who were treated with SSA for at least six months and had normal thyroid function. Patients were divided into three groups (well-controlled, controlled, and active) according to their IGF-1 and growth hormone (GH) levels. All patients underwent an evaluation of TV and total thyroid nodule volume (TTVN) by ultrasound. TTNV decreased significantly in patients with well-controlled acromegaly (0.44 {[}0.75] to 0.23 {[}0.73], p < 0.001). TTNV did not change in controlled patients (0.18 {[}1.28] to 0.13 {[}1.54], p = 0.959); however TTNV increased in patients with active acromegaly (0.77 {[}1.46] to 1.03 {[}1.88], p = 0.028). Successful medical treatment of patients with active acromegaly decreases thyroid nodule volume. Sustained exposure to IGF-1 may cause an increase in thyroid nodule volume in patients with acromegaly