Markers of Metabolic Syndrome in Patients with Pituitary Adenoma: A Case Series of 303 Patients

WOS: 000533394200003PubMed: 31683340To assess the demographic characteristics and hormonal status of patients who presented to our clinic with pituitary adenoma and to demonstrate the presence, prevalence, and relationship of metabolic syndrome parameters in these patients. the study included 303 patients with known or newly diagnosed pituitary adenoma and 52 age- and sex-matched healthy controls. the patients were classified into 3 groups; acromegaly (ACRO) (n = 54),prolactinoma (PRLoma) (n = 163), and non-functional adenoma (NFA) (n = 86). in 55.6 % (n = 172) and 52 % (n = 163) of the patients, respectively. the waist circumference of all patients (p < 0.001) and body mass index (BMI) of patients with PRLoma (p = 0.03) and ACRO (p < 0.001) were found to be significantly higher than in the controls. the HbA1c, insulin and HOMA-IR values were significantly higher in the ACRO and PRLoma groups, whereas the insulin and HOMA-IR values were significantly higher in the NFA group compared with the control group (p < 0.001 and p < 0.001, respectively). When the 3 patient groups were compared, waist circumference and BMI were significantly higher in the ACRO group than in the PRLoma group (p = 0.04 and p = 0.03, respectively).. in patients developing pituitary failure after treatment, age, waist circumference, plasma glucose, low-density lipoproteins and triglyceride values were significantly increased when compared with those without pituitary failure after treatment (p < 0.001). in our study, it was found that there was increased metabolic and cardiovascular risk in functional pituitary adenoma and NFA.Department of BiostatisticsWe thank the Department of Biostatistics for support

Evaluation of Clinical and Microbiological Characteristics o Foot Infections of Patients With Diabetes: Does Antibiotic Susceptibility Change?

WOS: 000448996200004Background: The aim of the present study was to evaluate microorganisms isolated from foot ulcers of patients with diabetes, resistance profile and establish their relationship with amputation. Methods: The study included 51 patients with diabetes who were admitted due to foot ulcer. The ulcers were evaluated according to the Wagner-Meggitt classification system. The specimens obtained by deep-tissue biopsy, aspiration biopsy and/or samples of pus from purulent lesions were sent for culture. Empiric antibiotic was started after collection of samples for culture. Antibiotic therapy was modified according to antibiotic susceptibility test results. The data were analyzed using the SPSS 20 software. Results: Twelve females and 39 males were included in the study. The mean age of the patients was 63.1 +/- 10.9 years, and duration of diabetes was 16.9 +/- 6.9 years. Forty-six patients underwent amputation. The rate of amputation increased with the increasing Wagner grade (P = 0.002). Neuropathy was found in 98% of the patients and in all patients that underwent amputation. About 97% of patients with osteomyelitis had undergone amputation, and these relationships were significant statistically (P = 0.022). The most commonly isolated bacteria were as follows in order of frequency: E. faecalis 28 (13.5%); S. aureus 23 (11%); S. epidermidis 18 (8.6%). Poly microbial infection was detected in 54 of a total of 138 episodes of our patients. The rate of ciprofloxacin resistance was 35% in S. aureus and 40-74% in Gram-negative bacteria. The rate of clindamycin resistance was 47% in S. aureus. Conclusions: In our study, the most commonly isolated microorganisms exhibited a high rate of antibiotic resistance

HbA1c level decreases in iron deficiency anemia

WOS: 000530764300001PubMed: 32377869Background Hemoglobin A1c (HbA1c) is the major form of glycosylated hemoglobin. There are conflicting data on changes in HbA1c levels in patients with iron deficiency anemia (IDA). the present study aimed to investigate the effects of HbA1c levels in the presence of IDA, the effects of iron treatment on HbA1c levels, as well as the relationship between the severity of anemia and HbA1c levels in patients without diabetes. Design and methods A total of 263 patients without diabetes mellitus (DM) who were admitted to Cukurova University, Faculty of Medicine, Department of Endocrinology and Hematology or who were followed up in this clinic and diagnosed as having IDA were included in the study. A total of 131 patients had IDA. the control group comprised 132 age-matched and sex-matched healthy individuals. Results the mean HbA1c level was significantly lower in the group with IDA (5.4%) than in the healthy control group (5.9%; p & x202f; 0.05). the HbA1c levels of the patients with IDA were higher after iron therapy (from 5.4 & x202f;+/- 0.5 to 5.5 & x202f;+/- 0.3; p & x202f;= 0.057). the mean hemoglobin (Hb), hematocrit (Hct), mean cell volume (MCV), mean corpusculer hemoglobin (MCH), and ferritin values also increased after iron therapy (p & x202f;< 0.05). Conclusion the study results showed that IDA was associated with low HbA1c levels, and increased after iron therapy. Based on the study findings, it is necessary to consider the possible effects of IDA on HbA1c levels

Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)

Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. (c) 2019 The Author(s) Published by S. Karger AG, Base