Rational diagnoses of diabetes: the comparison of 1,5-anhydroglucitol with other glycemic markers

Diabetes mellitus (DM) is a frequently encountered disease with important morbidity and mortality. The aim of this study is to document the importance of 1,5-anhydroglucitol (1,5-AG) for the diagnosis of prediabetes and DM, as well as to compare the 1,5-AG with other glycemic markers in order to understand which one is the better diagnostic tool. Between April 2012 and December 2012, 128 participants enrolled in the study. Participants were split into five groups that are IFG, IGT, IFG+IGT, diabetic and control groups by their OGTT results. The diagnostic value of markers was compared by ROC (receiver operating characteristic) method. The mean serum 1,5-AG levels in the diabetic group (33.38 nmol/ml) were lower than, IFG (59.83 nmol/ml), IGT (54.44 nmol/ml), IFG+IGT (51.98 nmol/ml) and control groups (73.24 nmol/ml). When analyzed in the total study population serum 1,5-AG levels did not differ by gender significantly. When analyzed in the total study population, 1,5-AG correlates inversely with age significantly (p = 0.036). In subgroup analysis, in the control group, serum 1,5-AG level was also inversely correlated with age (p = 0.087). The best marker for the diagnosis of prediabetes and DM was fasting plasma glucose (FPG). 1,5-AG was not found to be effective for the diagnosis of DM. This study, contributes to our knowledge of the efficiency and cut-off values of 1,5-AG for the diagnosis of prediabetes and DM. In future, there is a need for larger studies with more standardized and commonly used measurement methods for 1,5-AG, in order to evaluate the efficiency of 1,5-AG for the diagnosis of prediabetes and DM.Bilim PharmaceuticalsThis work is funded by Bilim Pharmaceuticals. The important contributions in the design of this study by Prof. Dr. Selda Demirtas (Ufuk University, Medical Biochemistry Department) gratefully recognized by all

Wpływ suplementacji hormonów tarczycy na ograniczenie przyrostu nasierdziowej tkanki tłuszczowej u chorych z subkliniczną niedoczynnością tarczycy

Background: Subclinical hypothyroidism (SCH) is a common disorder which has adverse cardiovascular effects. Epicardial adipose tissue (EAT), a novel marker of cardiovascular risk, is increased in SCH. Aim: We aimed to investigate whether L-thyroxine treatment can reverse the thickening of EAT in SCH. Methods: Forty-four patients with SCH and 42 euthyroid control subjects were included. EAT thickness was measured using transthoracic echocardiography at baseline and after restoration of the euthyroid status with 3 months of L-thyroxine treatment. Results: At baseline, mean EAT thickness was significantly greater in the SCH group when compared to the control group (6.3 ± 1.7 mm vs. 4.1 ± 0.9 mm, respectively, p < 0.001). There was a significant positive correlation between baseline serum thyroid stimulating hormone (TSH) level and EAT thickness in the SCH group. There was a significant reduction in mean EAT thickness in response to L-thyroxine treatment (6.3 ± 1.7 mm vs. 5.1 ± 1.4 mm, p < 0.001). The decrease in EAT thickness after L-thyroxine treatment when compared to baseline (DEAT) significantly correlated to the difference in TSH levels before and after treatment (DTSH; r = 0.323; p = 0.032). Conclusions: Epicardial adipose tissue thickness is increased in patients with SCH. This thickening was alleviated with restoration of the euthyroid status with L-thyroxine treatment in our study population of predominantly male, relatively old subjects with greater baseline EAT thickness.  Wstęp: Subkliniczna niedoczynność tarczycy (SCH) jest częstym zaburzeniem niekorzystnie wpływającym na układ sercowo-naczyniowy. U chorych z SCH stwierdza się zwiększenie grubości nasierdziowej tkanki tłuszczowej (EAT) — nowego wskaźnika ryzyka sercowo-naczyniowego. Cel: Badanie przeprowadzono w celu ustalenia, czy leczenie L-tyroksyną może zmniejszyć grubość EAT u tych chorych. Metody: Do badania włączono 44 chorych z SCH i 42 osoby z eutyreozą, które stanowiły grupę kontrolną. Na początku badania i po przywróceniu eutyreozy w wyniku 3-miesięcznego leczenia L-tyroksyną zmierzono grubość EAT metodą echokardiografii przezprzełykowej. Wyniki: Na początku badania średnia grubość EAT była istotnie większa w grupie SCH niż w grupie kontrolnej (odpowiednio 6,3 ± 1,7 mm vs. 4,1 ± 0,9 mm; p < 0,001). W grupie SCH stwierdzono istotną dodatnią korelację między początkowym stężeniem TSH w surowicy a grubością EAT. Po leczeniu L-tyroksyną nastąpiła istotna redukcja średniej grubości EAT (6,3 ± 1,7 mm vs. 5,1 ± 1,4 mm; p < 0,001). Zmniejszenie grubości EAT po leczeniu L-tyroksyną w stosunku do wartości początkowych (DEAT) korelowało istotnie z różnicą stężeń TSH przed terapią i po jej zakończeniu (DTSH; r = 0,323; p = 0,032). Wnioski: U chorych z SCH grubość EAT jest zwiększona. W populacji niniejszego badania, złożonej głównie z mężczyzn w starszym wieku z większą początkową grubością EAT, zmniejszono ilość nasierdziowej tkanki tłuszczowej dzięki przywróceniu eutyreozy poprzez leczenie L-tyroksyną.

Adipose tissue 11-beta-Hydroxysteroid Dehydrogenase Type 1 and Hexose-6-Phosphate Dehydrogenase gene expressions are increased in patients with type 2 diabetes mellitus

Aims: We have determined 11-beta-Hydroxysteroid Dehydrogenase Type I (HSD11B1) and Hexose-6-Phosphate Dehydrogenase, (H6PD) mRNA expression levels in adipose tissues from patients with type 2 diabetes mellitus

Effect of surgical staging on 539 patients with borderline ovarian tumors: A Turkish Gynecologic Oncology Group study

WOS: 000327923400010PubMed ID: 24016409Objective. The objectives of this study were to examine demographic and clinicopathologic characteristics and to determine the effects of primary surgery, surgical staging and the extensiveness of staging. Methods. In a retrospective Turkish multicenter study, 539 patients, from 14 institutions, with borderline ovarian tumors were investigated. Some of the demographic, clinical and surgical characteristics of the cases were evaluated. The effects of type of surgery, surgical staging; complete or incomplete staging on survival rates were calculated by using Kaplan-Meier method. Results. The median age at diagnosis was 40 years (range 15-84) and 71.1% of patients were premenopausal. The most common histologic types were serous and mucinous. Majority of the staged cases were in Stage IA (735%). 242 patients underwent conservative surgery. Recurrence rates were significantly higher in conservative surgery group (8.3% vs. 3%). Of all patients in this study, 294 (545%) have undergone surgical staging procedures. Of the patients who underwent surgical staging, 228 (77.6%) had comprehensive staging including lymphadenectomy. Appendectomy was performed on 204 (37.8%) of the patients. The median follow-up time was 36 months (range 1-120 months). Five-year survival rate was 100% and median survival time was 120 months. Surgical staging, lymph node sampling or dissection and appendectomy didn't cause any difference on survival. Conclusion. Comprehensive surgical staging, lymph node sampling or dissection and appendectomy are not beneficial in borderline ovarian tumors surgical management. (C) 2013 Elsevier Inc. All rights reserved

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

Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study)

Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus