Otoimmun tiroiditi bulunan hastalarda D vitamini tedavisinin tiroid fonksiyonları ve tiroid otoantikorları, TNF-α, IL-6, IL-1β düzeyleri üzerine etkisi

Objective: To investigate the relationship between autoimmune thyroid disease and vitamin D treatment. Method: Fifty four (54) patients with both vitamin D deficiency and newly diagnosed euthyroid Hashimoto's thyroiditis (HT) were recruited for this study. The patients were given intramuscular administration of cholecalciferol at a dose of 300,000 IU/month for 3 months. At the time of diagnoses and after the treatment of vitamin D, free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH), antithyroid peroxidase (anti-TPO), antithyroglobulin (anti-TG), 25 (OH) D3, parathormone (PTH), calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) levels were measured in all patients; TNF-a, IL-6 and IL-1&szlig; levels were measured in only 43 patients. Results: A statistically significant difference (p?0.05) was observed between the pre and post treatment FT4, TSH, antiTPO, antiTG, PTH and ALP levels. After the treatment of vitamin D, a statistically significant increase was found in 25 (OH) D3 and FT4 levels, and a significant decrease was found in TSH, antiTPO, antiTG, PTH and ALP levels, whereas no significant difference was noted in FT3, Ca, P, TNF- a, IL-6 and IL-1&szlig; levels. Further, levels of vitamin D were not correlated with FT3, FT4, TSH, antiTPO, antiTG, TNF-a, IL-6 and IL-1&szlig; levels (p?0.05). Conclusions: For patients with both vitamin D deficiency and newly diagnosed HT, treatment of vitamin D had a positive effect on the thyroid antigenicity and thyroid function.Amaç: D vitamini tedavisinin otoimmun tiroid hastalığı ile ilişkisini araştırdık. Yöntem: Çalışmaya D vitamini yetersizliği ve beraberinde yeni tanı alan Hashimoto tiroiditi olan (HT) 54 hasta alındı. Hastalara 3 ay süreyle ayda bir 300.000 IU kolekalsiferol intramuskuler olarak verildi. Tanı esnasında ve D vitamini tedavisi sonrasında serbest T3(FT3), serbest T4 (FT4), tiroid stimulan hormon (TSH), anti tiroid peroksidaz (TPO) ve anti tiroglobulin (TG), 25(OH)D3, parathormon (PTH), kalsiyum (Ca), fosfor (P) ve alkalen fosfataz (ALP) seviyeleri ve yalnız 43 hastada TNF- ?, IL-6, IL-1b seviyeleri ölçüldü. Bulgular: Tedavi öncesi ve sonrası FT4, TSH, antiTPO, antiTG, PTH ve ALP seviyeleri açısından arada istatistiksel olarak anlamlı fark vardı (p<0.05). D vitamini tedavi sonrasında 25 (OH) D3 ve FT4 seviyelerinde istatiksel olarak önemli bir artış olurken TSH, antiTPO, antiTG, PTH ve ALP seviyelerinde ise önemli bir düşüş gözlendi. FT3, Ca, P, TNF- ?, IL-6 ve IL-1b açısından önemli bir fark yoktu. D vitamini seviyesi ile FT3, FT4, TSH, antiTPO, antiTG, TNF- ?, IL-6 ve IL-1b arasında bir korelasyon yoktu. Sonuç: D vitamini eksikliği ve yeni tanı HT'i olan hastalarda D vitamini tedavisinin tiroid antijenitesi ve tiroid fonksiyonu üzerine olumlu yönde etkisi vardır

Real-life safety and efficacy of vildagliptin as add-on to metformin in patients with type 2 diabetes in Turkey - GALATA study

PubMed ID: 25697921Objective: To evaluate tolerability/safety and the efficacy of the combination of vildagliptin plus metformin in a real-life population of patients with type 2 diabetes mellitus (T2DM). Research design and methods: This multicenter, single-arm, 6 month, observational, prospective cohort study was conducted at 39 centers across Turkey. T2DM patients on vildagliptin and metformin for ?4 weeks were enrolled regardless of their previous antidiabetic therapy. Main outcome measures: Efficacy was evaluated by measuring hemoglobin A1c (HbA1c) levels. Tolerability/safety parameters evaluated included hypoglycemic events, gastrointestinal events, peripheral edema and weight gain. Results: This study enrolled 665 patients with a mean±standard deviation (SD) age of 55.1±10.2 years and female predominance (n=394, 59.2%). Safety was assessed in all enrolled patients. Hypoglycemia was reported in 10 (1.5%) patients (95% confidence interval = 0.8-2.7%). Efficacy was assessed in 289 (43.5%) patients treated for 6±1 months; these patients showed a mean decrease in HbA1c of 0.8% from baseline value of 7.8% (p65 years) and body mass index (<30 vs. ?30 kg/m2) (p<0.001 each). In total, 136 adverse events (AEs) were observed in 71 (10.7%) patients; 10 (1.5%) patients experienced hypoglycemia and gastrointestinal AEs were most commonly reported (n=29, 4.4%). Conclusions: In a 'real-life' setting, the vildagliptin and metformin combination was associated with significant improvements in reaching target HbA1c levels, even in elderly and obese patients with T2DM. Moreover, vildagliptin and metformin demonstrated a good overall tolerability/safety profile. © 2015 All rights reserved: reproduction in whole or part not permitted.Novartis Novo Nordisk Boehringer IngelheimThe study was funded by Novartis Pharmaceuticals Turkey.G.A. has disclosed that he has received sponsorship from Novartis and research grants from Novartis and Novo Nordisk; he is on Astra Zeneca’s Advisory Board and is a consultant to Eli Lilly; he is also on the Speakers’ Bureau of AstraZeneca, BMS and Merck. L.K. has disclosed that she has received sponsorship and research grants from Novartis. F.A. has disclosed that she has received research grants from Novartis, Boehringer Ingelheim and Novo Nordisk. H.S.D. has disclosed that she has received sponsorship from Novartis, and has received research grants from Novartis and Sanofi Aventis; she is also on the Speakers’ Bureau of Astra Zeneca. E.T. has disclosed that he has received research grants from Novartis, and is a consultant to Novartis and Astra Zeneca. I.B.A. and E.U. have disclosed that they are employees of Novartis.The authors thank Cagla Ayhan MD and Prof. Sule Oktay MD PhD from Kappa Consultancy Training Research Ltd, Istanbul, who provided editorial support, and Mehmet Berktas MD MICR from Kappa Consultancy Training Research Ltd, Istanbul, who performed statistical analysis funded by Novartis Pharmaceuticals Turkey

Gut microbiota in patients with newly diagnosed acromegaly: A pilot cross-sectional study

Purpose Microbiota has crucial biological importance for human well-being. Bidirectional interaction exists between microbiota and the host, and there have been no studies investigating this interaction in patients with acromegaly. We aimed to analyze the composition of microbiota in patients with newly diagnosed acromegaly. Method Stool samples were obtained from the patients with newly diagnosed acromegaly in the Endocrinology Clinic of Erciyes University Medical School. The composition of microbiota was analyzed, and the results were compared to healthy volunteers matched to the patients in terms of age, gender and body mass index. Results Seven patients (three male, four female) with a mean age of 48 +/- 17.6 years were included in the study. The stool analysis revealed a significantly lower bacterial diversity in the patients with acromegaly. Bacteroidetes phylum was predominating in the patient group, and Firmicutes/Bacteroidetes ratio was altered significantly. Bifidobacterium, Collinsella, Bacteroides, Butyricimonas, Clostridium, Oscillospira, and Dialister were predominating in the control group. Conclusion The gut microbiota is significantly altered in patients with newly diagnosed acromegaly. Further prospective studies are needed to elucidate the causative relationship between acromegaly, colorectal pathologies, and microbial alterations

How does pregnancy affect the patients with pituitary adenomas: A study on 113 pregnancies from Turkey

WOS: 000419489200014PubMed ID: 28634705Objective Data regarding pregnancies in relation to pituitary tumors are limited. The effects of pregnancy on pituitary adenomas and the effects of adenoma itself (hormonal activity, mass effects and pituitary insufficiency) and/or treatment on the ongoing gestation and developing fetus were evaluated. Methods The study was a retrospective study. A questionnaire involving questions regarding medical history before index gestation, history of related pregnancy, result of index gestation and postpartum follow-up of the patients was filled by the investigator in one of the eight Referral Endocrinology Centers from Turkey. Results One hundred and thirteen (83 prolactinoma, 21 acromegaly, 8 NFPA and 1 plurihormonal pituitary adenoma) pregnancies of 87 (60 prolactinoma, 19 acromegaly, 7 NFPA and 1 plurihormonal pituitary adenoma) patients were reviewed. The clinically important pregnancy-related tumor growth of pituitary adenomas was found to be low in previously treated adenomas. Prolactinomas were more likely to increase in size during pregnancy especially if effective prior treatment was lacking. The risk of hypopituitarism is also minimal due to pituitary adenomas during pregnancy. The results of pregnancies did not differ in patients who were on medical treatment or not for prolactinomas and acromegaly during gestation. Neural tube defect and microcephaly associated with maternal cabergoline use; Down syndrome and corpus callosum agenesis associated with maternal bromocriptine use; unilateral congenital cataract, craniosynostosis and microcephaly associated with maternal acromegaly were detected for the first time. Conclusion Medical treatment can be safely done stopped in patients with prolactinoma and acromegaly when pregnancy is confirmed and reinstituted when necessary. Prospective studies may help to determine the effects of medical treatment during gestation on the mother and fetus