The Relationship Between Vitamin B12 and Telomere Length: A Systematic Review

Telomeres are natural nucleoprotein structures that cover the ends of chromosomes. The phenomenon of telomere shortening, which plays a crucial role in maintaining the stability of the genome, occurs gradually over time when cells undergo division due to the end replication issue. Multiple studies have demonstrated a correlation between telomere shortening and a range of illnesses, including diabetes, dyslipidemia, cardiovascular disease, cancer, and mortality. Diet and lifestyle can affect telomere length. There exists a beneficial association between telomere length and the Mediterranean diet, particularly with regards to the consumption of dietary fiber derived from whole grains and vegetables. Micronutrients such as vitamins and trace elements also play a role in cell metabolism.  Some micronutrients, such as vitamin D, folate, and vitamin B12, are associated with telomere biology and cellular aging. Vitamin B12 is essential for DNA synthesis and epigenetic methylation processes. The present systematic review examines the results from clinical trials conducted in humans evaluating the role of vitamin B12 on telomere length. Cellular senescence is a state characterized by inflammation, altered cellular metabolism, genomic instability, and telomere dysfunction, which can be induced by changes in methylation patterns and oxidative stress. Vitamin B12 maintains antioxidative defense. Through these pathways, sufficient amounts of vitamin B12 may potentially play a role in the restoration of DNA damage. Most of the evidence is based on very few randomized clinical trials. Therefore, more extensive prospective cohort studies and better-designed randomized clinical trials are required to validate the correlations outlined in this review

Association Between Insulin Resistance, Nutrition, Fatty Meal Desire and CD36 Receptor

Global olarak beslenme gibi yaşam tarzındaki hızlı değişim ile birlikte insülin direnci ve diyabet prevalansı hızla artış göstermiş ve günümüzde Tip II diabetes mellitus (Tip II DM) epidemik bir sorun haline gelmiştir. Yaşam tarzı müdahalelerinden en önemlisi olan diyetin düzenlenmesi ise tip II DM'nin ortaya çıkmasının engellenmesinde, geciktirilmesinde, komplikasyonların oluşmasında ve önlenmesinde önemli bir role sahiptir. Son yıllarda yapılan çalışmalarda Tip II DM gelişimine neden olan patolojik faktörler arasında yer alan insülin aktivitesi ve insülin sekresyonunun diyabet nedenini belirlemek açısından tek başına yetersiz kaldığı ele alınmaktadır. Buna ek olarak diyabet etiyolojisinde multi-faktöriyel nedenlerin, insülinin yanı sıra farklı reseptörlerin yer aldığı ve bu durumu genetik çalışmaların desteklediği bilinmektedir. Bu reseptörlerden biri olan CD36 reseptörü ise, kardiyovasküler sağlık ve hastalıklar, kanser, diyabet, insülin direnci, tat alma duyusu ve besin seçiminde önemli rol oynamaktadır. Yapılan çalışmalarda yüksek kan CD36 düzeylerinin tip II DM patogenezinde yeni bir belirteç olarak katkı sağlayabileceği yer almaktadır. Ayrıca güncel veriler CD36 reseptörünün yağlı besin seçimi açısından farklı tat ve kokularda görev alabildiğini göstermektedir. Bu derlemede CD36 reseptörü ile insülin direnci ve diyette yağlı besin seçimi arasında ilişki incelenmiştirGlobally, increase of insulin resistance and diabetes prevalence with rapid change in lifestyle like nutrition results in Type II diabetes mellitus (Type II DM) which has become an epidemic problem. Modification of the diet, which is one of the most important lifestyle interventions, plays a crucial role in preventing and delaying of the type 2 diabetes mellitus, and also preventing or delaying the disease related complications. Recent studies have addressed insulin activity and insulin secretion, among the pathologic factors leading to the development of Type II DM, which alone are insufficient to determine the cause of diabetes. In addition to this, it is known that multifactorial causes of diabetes etiology involve different receptors as well as insulin, which is supported by genetic studies. One of these receptors, CD36 receptor, plays an important role in cardiovascular health and diseases, cancer, insulin resistance, taste and food choice. Studies have indicated that high blood CD36 levels may contribute as a new biomarker in the pathogenesis of type II DM. Furthermore, current literature have shown that the CD36 receptor might have role in different taste and smells in terms of fatty food selection. Thus, in this review, the relationship between the CD36 receptor, insulin resistance and the fatty food selection in the diet was examined

DEĞER AKIŞ HARİTALAMA TEKNİĞİNİN OTOMOTİV SEKTÖRÜNDE BİR UYGULAMASI

Bu çalışma, Bursa’da faaliyet gösteren otomotiv parçaları üreten bir firmanın ticari ayna ürün grubunda değer akış haritalama tekniği uygulayarak teslim süresini azaltmayı amaçlamaktadır. Bu doğrultuda, öncelikle ABC analizi ile ürün ailesi seçilmiş, istasyon çevrim sürelerini belirlemek amacıyla zaman etüdü yapılmış ve stoklar sayılmıştır. Mevcut durum haritası çizilerek stok ve taşımaların yoğun olduğu noktalar belirlenmiştir. Değer katan ve katmayan işlem adımlarının ayrıştırılması için NVA/VA analizleri yapılmış ve montaj hattı içerisindeki yürümeleri belirlemek için spagetti diyagramı çizilmiştir. Yapılan analizler sonucunda geliştirilen kaizen önerileri dikkate alınarak gelecek durum haritası çizilmiştir. Bu çalışma ile firmanın teslim süresi %52 kısalmıştır. Ayrıca, sistemin sınırsız imkânlara sahip olduğu ideal bir senaryo için ideal durum haritası çizilmiş, böyle bir durumda teslim süresinin %93 kısaltılabileceği gösterilmiştir

Tip II Diyabetli Hastalarda Beslenme Durumu ile Kanda CD36 Yağ Asit Transport Düzeyi ve Bazı İnflamasyon Belirteçleri Arasındaki İlişkinin Değerlendirilmesi

Ekici, E.M., Investigating the Relationship of Nutritional Status with Blood CD36 Fatty Acid Transport Receptor Levels and Some Inflammation Markers in Type II Diabetes Patients, Hacettepe University, Graduate School of Health Sciences, Nutrition and Dietetics Programme, PhD Thesis, Ankara, 2021. This study was planned to investigate the relationship between the nutritional statuses of individuals including those diagnosed with type II diabetes mellitus (T2DM), those diagnosed with prediabetes and those in the control group and their blood CD36 fatty acid transport receptor levels and some inflammation markers. This study was carried out with 81 individuals at the ages of 25-65 who presented to the Endocrinology Outpatient Clinic of the Department of Internal Medicine at the Faculty of Medicine at Kırıkkale University including 27 individuals diagnosed with T2DM (female: 18, male: 9), 27 individuals with prediabetes (female: 18, male: 9) and 27 individuals without any disorder (female: 18, male: 9). Information was collected from the individuals in person on their sociodemographic characteristics, physical activity statuses and 24-hour retrospective food consumption records for determining their nutritional status, and their anthropometric measurements were taken. Besides the routine blood parameters on which information was obtained from patient files, one tube of fasting blood sample was taken from each participant, and in the sera of these blood samples, CD36, CRP, adiponectin, leptin, omentin, TNF-α and insulin levels were measured. According to the results of the analyses carried out in the study, the blood CD36, glucose, triglyceride, HbA1c, CRP and TNF-α levels and HOMA-IR, TyG-index and sCD36 index levels in the T2DM group were found to be higher, and their blood omentin levels were found to be lower in comparison to the other groups (p<0.05). In this study, the ratio of the energy intake of the control group coming from MUFA was found to be higher than those of the other groups (p<0.05). The CD36 levels of the individuals in the T2DM group were moderately and positively related to their amounts of cholesterol and animal protein taken with diet and moderately and negatively related to their total fiber, soluble and non-soluble fiber intake values. In the study, there was a positive significant relationship between CD36 levels and TNF-α in all three groups (p<0.05). Consequently, while CD36 levels are an important parameter for T2DM, they may be associated with nutrients taken with diet and inflammation markers affecting T2DM.Ekici, E.M., Tip II Diyabetli Hastalarda Beslenme Durumu ile Kanda CD36 Yağ Asit Transport Düzeyi ve Bazı İnflamasyon Belirteçleri Arasındaki İlişkinin Değerlendirilmesi, Hacettepe Üniversitesi, Sağlık Bilimleri Enstitüsü, Beslenme ve Diyetetik Programı, Doktora Tezi, Ankara, 2021. Bu çalışma, tip II diabetes mellitus (T2DM) tanısı almış, prediyabet ve kontrol grubunu içeren bireylerin beslenme durumu ile kanda CD36 yağ asit taşıyıcı reseptör düzeyi ve bazı inflamasyon belirteçleri arasındaki ilişkinin değerlendirilmesi amacıyla planlanmıştır. Çalışma, Kırıkkale Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı, Endokrinoloji Polikliniğine başvuran T2DM tanısı alan 27 (kadın:18, erkek:9), prediyabeti olan 27 (kadın:18, erkek:9) ve herhangi bir rahatsızlığı olmayan 27 birey (kadın:18, erkek:9) olmak üzere, 25-65 yaş arası 81 kişi ile yürütülmüştür. Bireylerden sosyo-demografik özellikler, fiziksel aktivite durumları ve 24 saatlik geriye dönük besin tüketim kayıtları üzerinden beslenme durumunu saptamaya yönelik bilgiler yüz yüze alınmış, antropometrik ölçümleri yapılmıştır. Hasta dosyasından alınan rutin kan parametreleri dışında her bireyden bir tüp açlık kanı alınmış ve alınan bu kan örneklerinin serumlarında CD36, CRP, adiponektin, leptin, omentin, TNF-α ve insülin düzeyleri ölçülmüştür. Çalışma sonunda kan CD36, glukoz, trigliserit, HbA1c, CRP ve TNF-α düzeyleri ile HOMA-IR, TyG-indeksi ve sCD36 indeks düzeyleri T2DM grubunda diğer iki gruba göre daha yüksek kan omentin düzeyi ise daha düşük bulunmuştur (p<0,05). Çalışmada kontrol grubunun günlük aldığı enerjinin MUFA’dan gelen oranı diğer iki gruba göre daha yüksek görülmüştür (p<0,05). T2DM grubunda yer alan bireylerde kan CD36 düzeyi ile diyetle alınan kolesterol ve hayvansal protein miktarı arasında orta düzeyde, pozitif yönde, toplam posa, çözünür ve çözünmez posa alımı arasında ise orta düzeyde, negatif yönde bir ilişki görülmüştür. Çalışmada kan CD36 düzeyi ile TNF-α arasında her üç grupta da pozitif yönde anlamlı bir ilişki görülmüştür (p<0,05). Sonuçta kan CD36 düzeyi T2DM için önemli bir parametre olmakla birlikte, diyetle alınan besin ögeleri ve T2DM’ye etki eden inflamasyon göstergeleri ile ilişkili olabilir

Evaluation of obesity in university students with neck circumference and determination of emotional appetite

KILINC, FATMA/0000-0001-8297-958XWOS: 000470862800012Objective: In this study, it was aimed to evaluate obesity in university students with neck circumference and other anthropometric measurements and to determine their emotional appetite. Method: The study was conducted within the scope of Scientific Research Projects Coordination Unit of Kirikkale University in June-December 2017 in June-December 2017 term and 4873 students were reached. A questionnaire consisting of descriptive information and emotional appetite scale was applied to students and their obesity status were determined by taking anthropometric measurements. Results: Students consist of 56.3% females and 43.7% males. Mean body mass index (BMI) is 23.62 +/- 3.03 kg/m(2) in males and 21.66 +/- 3.08 kg/m(2) in females (p<0.001). Mean neck circumference is 37.50 +/- 2.49 cm in males and 32.18 +/- 3.51 cm in females (p<0.001). According to student's BMI, 18.5% are overweight and obese, to neck circumference 36.6% are obese, and to waist circumference 22.4% are in the risk and high-risk group. 65.8% of males and 19.4% of females are obese according to neck circumference (p<0.001). Waist circumference/height ratio of males is 0.478 +/- 0.054 while that of females is 0.452 +/- 0.053. Central obesity was observed in 30.2% of males and 16.3% of females (p<0.001). A positive correlation was found between body weight, BMI, waist circumference, wrist circumference, waist/height ratio and neck circumference. Emotional appetite status of students and values of total positive scores are different from others in at least one of BMI groups (chi(2) =14.503; p=0.002). Total positive scores of thin students are higher than those who are overweight and obese (p<0.001). Total score in negative emotions/conditions is high in students who are obese according to neck circumference (Z=4.539; p<0.001). In negative and positive emotions/conditions, median score of total emotional appetite scale of males is higher than that of females (p<0.001). Conclusion: According to neck circumference, it is determined that obesity more common in males than females, males' appetites increase more than females' in positive and negative situations, and overweight and obese students exhibit more eating behaviour when they experience negative emotions

The relationship between sleep duration, sleep quality and dietary intake in adults

KILINC, FATMA/0000-0001-8297-958X; Karaismailoglu, Eda/0000-0003-3085-7809WOS: 000494785800001To determine the relationship of specific macro- and micro-nutrients and food groups with sleep duration and sleep quality in adults. This cross-sectional descriptive study was conducted on 2446 adults aged between 20 and 64 years in Turkey. The participants' socio-demographic characteristics, anthropometric measurements, and dietary intake (24-h recall) were taken. The Pittsburgh Sleep Quality Index was used to assess sleep quality. In the study, 48.9% of the participants were male and 51.1% were female, with an average age of 38.7 +/- 12.70 years. Total protein, meat, and processed meat product consumption rates of long sleepers were found to be lower than those of normal sleepers (p < 0.05). Saturated fat intake of short sleepers was higher than that of long sleepers (p < 0.018). Participants with good sleep quality were found to consume higher carbohydrate, fiber, beta-carotene, vitamin E, thiamine, vitamin B-6, total folate, vitamin C, calcium, magnesium, potassium, and iron compared to those with poor sleep quality (p < 0.05). When examined in terms of food groups, fruit consumption was higher in individuals with good sleep quality compared to those with poor sleep quality (p < 0.05). In this study, some macro- and micro-nutrients of the diet were found correlated with sleep duration and quality. Mechanisms mediating the relationship between sleep duration and dietary intake are multi-factorial. Because of the differences in appetite-related hormones, such as leptin and ghrelin, and hedonic factors, future studies will benefit from assessing sleep duration/quality and dietary intake

Evaluation of pediatric rheumatologists' approach to rituximab use: a questionnaire study

Rituximab (RTX) is a chimeric monoclonal antibody that targets the CD20 antigen on B cells and is used in various autoimmune disorders. In this study, we aimed to measure the awareness of pediatric rheumatologists about the use of RTX through a survey. Between February and March 2023, a 42-question survey was sent via email to pediatric rheumatology specialists in Turkey. The participants were questioned for which diagnoses and system involvement they preferred to use RTX, which routine tests they performed, vaccination policy, and adverse events that occurred during or after infusion. Forty-one pediatric rheumatologists answered the survey. They prescribed RTX most frequently for systemic lupus erythematosus (87.8%) and ANCA-associated vasculitis (9.8%). Prior to the administration of RTX, 95% of clinicians checked renal and liver function tests, as well as immunoglobulin levels. The most frequently tested hepatitis markers before treatment were HBsAg and anti-HBs antibody (97.6%), while 85.4% of rheumatologists checked for anti-HCV. Clinicians (31.4%) reported that they postpone RTX infusion 2 weeks following an inactivated vaccine. Sixty-one percent of rheumatologists reported starting RTX treatment 1 month after live vaccines, while 26.8% waited 6 months. The most frequent adverse events were an allergic reaction during RTX infusion (65.9%), hypogammaglobulinemia (46.3%), and rash (36.6%). In the event of hypogammaglobulinemia after RTX treatment, physicians reported that they frequently (58.5%) continued RTX after intravenous immunoglobulin administration.Conclusions: RTX has become a common treatment option in pediatric rheumatology in recent years. Treatment management may vary between clinician such as vaccination and routine tests. What is Known:center dot During the course of rituximab therapy, clinicians should be attentive to specific considerations in pre-treatment, during administration, and in post-treatment patient monitoring.What is New:center dot There are differences in practice among clinicians in the management of RTX therapy. These practice disparities have the potential to impact the optimal course of treatment.center dot This study highlights that standardized guidelines are needed for RTX treatment in pediatric rheumatology, particularly for vaccination policies and routine tests

Re-examining the characteristics of pediatric multiple sclerosis in the era of antibody-associated demyelinating syndromes.

Background: The discovery of anti-myelin oligodendrocyte glycoprotein (MOG)-IgG and anti-aquaporin 4 (AQP4)-IgG and the observation on certain patients previously diagnosed with multiple sclerosis (MS) actually have an antibody-mediated disease mandated re-evaluation of pediatric MS series. Aim: To describe the characteristics of recent pediatric MS cases by age groups and compare with the cohort established before 2015. Method: Data of pediatric MS patients diagnosed between 2015 and 2021 were collected from 44 pediatric neurology centers across Turkiye. Clinical and paraclinical features were compared between patients with dis-ease onset before 12 years (earlier onset) and >= 12 years (later onset) as well as between our current (2015-2021) and previous (< 2015) cohorts. Results: A total of 634 children (456 girls) were enrolled, 89 (14%) were of earlier onset. The earlier-onset group had lower female/male ratio, more frequent initial diagnosis of acute disseminated encephalomyelitis (ADEM), more frequent brainstem symptoms, longer interval between the first two attacks, less frequent spinal cord involvement on magnetic resonance imaging (MRI), and lower prevalence of cerebrospinal fluid (CSF)-restricted oligoclonal bands (OCBs). The earlier-onset group was less likely to respond to initial disease-modifying treatments. Compared to our previous cohort, the current series had fewer patients with onset < 12 years, initial presentation with ADEM-like features, brainstem or cerebellar symptoms, seizures, and spinal lesions on MRI. The female/male ratio, the frequency of sensorial symptoms, and CSF-restricted OCBs were higher than reported in our previous cohort. Conclusion: Pediatric MS starting before 12 years was less common than reported previously, likely due to exclusion of patients with antibody-mediated diseases. The results underline the importance of antibody testing and indicate pediatric MS may be a more homogeneous disorder and more similar to adult-onset MS than previously thought