Betatrophin levels are related to the early histological findings in nonalcoholic fatty liver disease

Betatrophin, a liver hormone, regulates glucose and lipid metabolism. We investigated the betatrophin levels in nonalcoholic fatty liver disease (NAFLD) and searched for any relationship with histological severity and metabolic parameters. Fifty males with NAFLD [Nonalcoholic Steatohepati-tis (NASH) (n = 32); non-NASH (n = 18)] and 30 healthy controls were included. Plasma betatrophin was measured by ELISA method. Insulin sensitivity was assessed by HOMA-IR index. Histological features were scored by the semi quantitative classification and combined as the NAFLD activity score (NAS). Betatrophin levels in the non-NASH group were significantly higher than the controls. Betatrophin was positively correlated to the age, waist circumference, total cholesterol, triglycerides, LDL cholesterol, glucose, insulin, HOMA-IR index and gamma glutamyl transpeptidase levels, and negatively correlated to the steatosis and NAS. In the stepwise linear regression analysis, the triglyceride (β = 0.457, p < 0.001), glucose (β = 0.281, p = 0.02) and NAS (β = −0.260, p = 0.03) were the independent determinants of betatrophin. Betatrophin levels are higher in the early stages of NAFLD and tend to decrease when the disease progresses. This could be an important preliminary mechanistic finding to explain the increased frequency of glucose intolerance during the course of NAFLD

Cabergoline treatment in prolactinoma: Amelioration in obstructive and central sleep apneas

A 44-year-old male patient was admitted to the otolaryngology department with a history of progressive snoring, excessive daytime sleepiness, and reduced libido for the last 6 months. Polysomnography demonstrated the presence of moderate obstructive sleep apnea (OSA) with an apnea-hypopnea index (AHI) of 24.6 events/h, consisting of 77 obstructive and 59 central apneas. The marked number of central apneas in the sleep study and urologic complaints prompted the performance of brain magnetic resonance imaging (MRI), which indicated a pituitary macroadenoma (prolactinoma). Three months after treatment with cabergoline, a control MRI showed a significant reduction in the size of the macroadenoma. The AHI was also significantly decreased (to 11.6 events/h), as were the numbers of obstructive and central apneas. The patient's complaints regarding libido were also regressed. During this treatment period, CPAP therapy has not been tolerated by the patient. Cabergoline treatment reduced the severity of both obstructive and central sleep apneas in this patient

Utilization of statins and LDL-cholesterol target attainment in Turkish patients with type 2 diabetes - a nationwide cross-sectional study (TEMD dyslipidemia study)

Background: Attaining acceptable levels of LDL Cholesterol (LDL-C) significantly improves cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (T2DM). The LDL-C target attainment and the characteristics of patients attaining these targets were investigated in this study. Furthermore, the reasons for not choosing statins and the physicians’ attitudes on the treatment of diabetic dyslipidemia were also examined. Methods: A nationwide, cross-sectional survey was conducted in tertiary centers for diabetes management. Adult patients with T2DM, who were under follow-up for at least a year in outpatient clinics, were consecutively enrolled for the study. LDL-C goals were defined as below 70 mg/dL for patients with macrovascular complications or diabetic nephropathy, and below 100 mg/dL for other patients. Data about lipid-lowering medications were self-reported. Results: A total of 4504 patients (female: 58.6%) were enrolled for the study. The mean HbA1c and diabetes duration was 7.73 ± 1.74% and 10.9 ± 7.5 years, respectively. The need for statin treatment was 94.9% (n = 4262); however, only 42.4% (n = 1807) of these patients were under treatment, and only 24.8% (n = 448) of these patients achieved LDL-C targets. The main reason for statin discontinuation was negative media coverage (87.5%), while only a minority of patients (12.5%) mentioned side effects. Physicians initiated lipid-lowering therapy in only 20.3% of patients with high LDL-C levels. It was observed that the female gender was a significant independent predictor of not attaining LDL-C goals (OR: 0.70, 95% CI: 0.59–0.83). Conclusions: Less than 50 % of patients with T2DM who need statins were under treatment, and only a quarter of them attained their LDL-C targets. There exists a significant gap between the guideline recommendations and the real-world evidence in the treatment of dyslipidemia in T2DM. © 2020, The Author(s).Ankara UniversitesiThe physicians and nurses in every TEMD study center who took role in recruitment of patients are acknowledged as the collaborators of TEMD Dyslipidemia Study (see supplementary data). The authors also appreciatively acknowledge the critical reviews and contributions of Professor Meral Kayikcioglu and Professor Ilker Tasci during the preparation of the manuscript. Consortium members and affiliations TEMD Study Group: Sibel Guldiken19, Semra Ayturk19, Murat Yilmaz20, Mehmet Asik21, Nevin Dinccag18, Ramazan Cakmak18, Fulya Turker18, Cemile Idiz18, Hulya Hacisahinogullari18, Elif Bagdemir18, Busra Yildiz18, Ozlem Haliloglu16, Seda Sancak22, Levent Ozsari23, Eylem Cagiltay23, Oguzhan Deyneli24, Eren Imre24, Sait Gonen25, S Nur Boysan19, Yuksel Altuntas26, Feyza Yener Ozturk26, Meral Mert27, Hamide Piskinpasa27, Hasan Aydin28, Sazi Imamoglu29, Ozen Oz Gul25, Sinem Kucuksarac Kiyici30, Berrin Cetinarslan31, Alev Selek31, Teoman Dogru32, Ali Kirik32, Belgin Efe14, Ahmet Kaya33, Ilker Cordan33, Suleyman Baldane34, Cem Onur Kirac34, Zehra Capa3, Mustafa Cesur35, Ilhan Yetkin36, Demet Corapcioglu37, Sule Canlar37, Okan Bulent Yildiz38, Suleyman Nahit Sendur38, Bekir Cakir9, Ahmet Corakci39, Mustafa Kutlu40, Neslihan Bascil Tutuncu41, Yusuf Bozkus41, Erman Cakal42, Berrin Demirbas43, Sibel Ertek44, Mustafa Altay45, Murat Dagdeviren45, Amir Hossein Abedi1, Sevki Cetinkalp46, Hatice Ozisik46, Guzide Gonca Oruk47, Serkan Yener48, Basak Ozgen Saydam48, Engin Guney49, Mustafa Unubol49, Guzin Fidan Yaylali50, Senay Topsakal50, Zeliha Hekimsoy51, Gulhan Akbaba52, Ibrahim Aslan53, Sefika Dalkiran13, Esen Akbay54, Kamile Gul55, Muge Ozsan Yilmaz6, Emre Bozkirli56, Seher Cetinkaya Altuntas12, Aysegul Atmaca57, Elif Tutku Durmu?57, Turkan Mete58, Faruk Kutluturk59, Ferit Kerim Kucukler60, Oguz Dikbas61, Safak Akin62, Irfan Nuhoglu63, Halil Onder Ersoz63, Taner Bayraktaroglu64, P?nar Sisman65, Ibrahim Sahin66, Sedat Cetin66, Ilyas Capoglu67, Emin Murat Akbas67, R?fk? Ucler68, Mehmet Ali Eren4, Alpaslan Kemal Tuzcu69, Zafer Pekkolay69, Mesut Ozkaya70, Mustafa Araz71.19Trakya University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.20Corlu REYAP Private Hospital, Department of Endocrinology and Metabolism, Turkey.21Canakkale 18 March University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.22University of Health Sciences, School of Medicine, Fatih Sultan Mehmet Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.23University of Health Sciences, School of Medicine, Sultanabdulhamit Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.24Marmara University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.25Istanbul Science University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.26University of Health Sciences, School of Medicine, Sisli Hamidiye Etfal Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.27University of Health Sciences, School of Medicine, ?stanbul Bak?rkoy Dr. Sadi Konuk Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.28Yeditepe University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.29Private Office.30University of Health Sciences, School of Medicine, Bursa Sevket Y?lmaz Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.31Kocaeli University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.32Balikesir University, School of Medicine, Department of Internal Medicine, Turkey.33Necmettin Erbakan University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.34Selcuk University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.35Private Guven Hospital, Department of Endocrinology and Metabolism, Turkey.36Gazi University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.37Ankara University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.38Hacettepe University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.39Ufuk University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.40Private Bay?nd?r Hospital, Department of Endocrinology and Metabolism, Turkey.41Baskent University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.42University of Health Sciences, School of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.43TOBB University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.44Private Memorial Hospital, Department of Endocrinology and Metabolism, Turkey.45University of Health Sciences, School of Medicine, Kecioren Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.46Ege University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.47University of Health Sciences, School of Medicine, Izmir Ataturk Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.48Dokuz Eylul University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.49Adnan Menderes University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.50Pamukkale University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.51Celal Bayar University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.52Mugla University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.53University of Health Sciences, School of Medicine, Antalya Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.54Mersin University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.55Kahramanmaras Sutcu Imam University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.56Baskent University, Adana Training Hospital, Department of Endocrinology and Metabolism, Turkey.5719 May?s University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.58University of Health Sciences, School of Medicine, Samsun Training and Research Hospital, Department of Endocrinology and Metabolism, Turkey.59Gaziosmanpasa University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.60Hitit University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.61Giresun University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.62Recep Tayyip Erdogan University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.63Karadeniz Technical University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.64Bulent Ecevit University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.65Kars Harakani State Hospital, Department of Endocrinology and Metabolism, Turkey.66Inonu University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.67Erzincan University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.68Yuzuncu Yil University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.69Dicle University, School of Medicine, Department of Endocrinology and Metabolism, Turkey.70University of Health Sciences, School of Medicine, Gaziantep Ersin Arslan Research and Training Hospital, Turkey.71Gaziantep University, School of Medicine, Department of Endocrinology and Metabolism, Turkey

BLOOD LIPIDS, DIABETIC COMPLICATIONS AND THE PHYSICIAN ATTITUDES ON DYSLIPIDEMIA TREATMENT; DATA FROM THE TURKISH NATIONWIDE SURVEY OF GLYCEMIC AND OTHER METABOLIC PARAMETERS OF PATIENTS WITH DIABETES

86th Congress of the European-Atherosclerosis-Society (EAS) -- MAY 05-08, 2018 -- Lisbon, PORTUGALWOS: 000442512600170…European Atherosclerosis So

Patterns and preferences of antidiabetic drug use in Turkish patients with type 2 diabetes - A nationwide cross-sectional study (TEMD treatment study).

AIMS: The treatment preferences in type 2 diabetes (T2DM) are affected by multiple factors. This survey aims to find out the profiles of the utilization of antidiabetics and their determinants. METHODS: The nationwide, multicenter TEMD survey consecutively enrolled patients with T2DM (n = 4678). Medications including oral antidiabetics (OAD) and injectable regimens were recorded. Multiple injectable regimens with or without OADs were defined as complex treatments. RESULTS: A total of 4678 patients with T2DM (mean age: 58.5 ± 10.4 years, 59% female) were enrolled. More than half of patients (n = 2372; 50.7%) were using injectable regimens with or without OADs, and others (n = 2306, 49.3%) were using only OADs. The most common OADs were metformin (93.5%), secretagogues (40.1%), and DPP-4 inhibitors (37.2%). The rates of the use of basal, basal-bolus and premix insulin were 26.5%, 39.5% and 22.4%, respectively. Patients using OADs achieved better glycemia, blood pressure and weight control (p < 0.001 for all) but poorer LDL-C control (p < 0.001). The independent associates of complex treatments were diabetes duration, obesity, eGFR, glycated haemoglobin, macro and microvascular complications, education level, and self-reported hypoglycemia. CONCLUSION: This study is the first nationwide report to show that almost half of the patients with T2DM are using injectable regimens in Turkey