Association of polycystic ovary syndrome and a non-dipping blood pressure pattern in young women

OBJECTIVE: The association between polycystic ovarian syndrome and increased cardiovascular disease risk is still a controversial issue. In light of data documenting some common pathways or common end-points, the present study was undertaken to determine whether there is a relationship between sleep blood pressure pattern disturbances and polycystic ovarian syndrome in young women. METHOD: The daytime and nighttime ambulatory blood pressures (BPs) were determined for each subject, according to the actual waking and sleeping times recorded in their individual diaries, in this cross-sectional study. RESULTS: The study group comprised 168 women (mean age: 25.7±5.5) diagnosed with polycystic ovarian syndrome, while the control group included 52 age- and BMI-matched healthy subjects (mean age: 26.1±5.4). When nocturnal BP declines very little or not at all, with the BP falling less than 10% during sleep compared with waking values, this pattern is classified as a non-dipping BP pattern. However, the non-dipping pattern of BP changes was significantly more common in polycystic ovarian syndrome patients compared to the control group (p<0.01). The prevalence of a non-dipping BP pattern was 43.4% (73 patients) in polycystic ovarian syndrome patients and 3.9% (2 patients) in the control group. CONCLUSION: Our cross-sectional study revealed that a non-dipping BP pattern is highly prevalent in polycystic ovarian syndrome patients, even if they are young and non-obese

Evaluation of subclinical atherosclerosis in obese patients with three noninvasive methods: Arterial stiffness, carotid intima-media thickness, and biomarkers of endothelial dysfunction

ABSTRACT Objective: In this study, we aimed to evaluate subclinical atherosclerosis in patients with obesity who had cardiovascular disease risk indicators such as arterial stiffness, which is evaluated using pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and biomarkers of endothelial dysfunction such as endocan, ADAMTS97, and ADAMTS9. Subjects and methods: Sixty obese subjects, including 23 subjects with body mass index (BMI) ≥ 40, 37 subjects with BMI ≥ 30 but < 40, and 60 age-and sex-matched control subjects, were included in our study. Serum endocan, ADAMTS97, and ADAMTS9 levels as well as PWV and CIMT measurements of the subjects in the obese and control groups were performed. Results: In the obesity group, PWV levels were significantly higher than they were in the control group and endocan levels were significantly lower than they were in the control group. When we compared the obese group with BMI ≥ 40 and the control group, the BMI ≥ 40 group had significantly higher PWV and CIMT levels than the control group had, whereas endocan, ADAMTS7, and ADAMTS9 levels were similar to those of the control group. When we compared the obese group with BMI ≥ 30 < 40 to the control group, endocan levels were lower in the group with BMI ≥ 30 < 40, and PWV and CIMT levels were similar to the control group. Conclusions: We found that arterial stiffness and CIMT increased in obese patients with BMI ≥ 40 and that increased arterial stiffness was associated with age, systolic blood pressure, and HBA1C. In addition, we found that the endocan levels were lower in obese patients than they were in nonobese control individuals

Metabolic Parameters in Patients with Adrenal Insidentaloma

ÖZET Amaç: İnsidental olarak tespit edilen adrenal kitlesi olan hastalarda metabolik durumu belirlemek. Gereç ve Yöntemler: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Endokrinoloji ve Metabolizma Hastalıkları Bilim dalında Ocak 2010 ve Şubat 2014 tarihleri arasında yatırılarak fonksiyonel tarama yapılan adrenal insidentaloması olan 67 hasta çalışmaya dahil edildi. Bulgular: 67 hastanın 34ü erkek, 33ü kadındı. Hastaların yaş ortalaması 57.1 12, tüm hastaların vücut kütle indeksi 29.16 kg/m2 idi. Çalışmaya dahil edilen hastalara fonksiyonel tarama olarak; Cushing Sendromu, feok- romasitoma ve primer hiperaldesteronizme yönelik tarama testleri uygulandı. 67 hastanın 8 tanesi fonksiyone olarak (6 feokromasitoma, 1 Cushing Sendromu, 1 primerhiperaldesteronizm) tespit edildi. Hastaların 38 tane- sinde bozulmuş açlık glikozu veya tip 2 Diabetes Mellitus tespit edildi. Tüm hastaların ortalama glukoz değeri 127.618 mg/dl, fonksiyone olmayan hastaların ortalama glukozu 12962 mg/dl, fonksiyone olan hastaların glukoz ortalaması ise 117.232 mg/dl olarak ölçüldü. Tüm hastalarda sistolik kan basıncı 12518 mm/Hg, dias- tolik kan basıncı ise 7710.9 mm/Hg olarak ölçüldü. Fonksiyone hastaların ortalama sistolik basıncı 13510.4 mm/Hg iken, fonksiyone olmayan hastalarda 12419 mm/Hg tespit edildi. Tüm hastaların trigliserit, HDL, LDL kolesterol ölçümleri alındı. Sırasıyla ortalama değerleri; 157.583 mg/dl (normal 150mg/dl), 39.39.5 mg/dl (normal 40mg/dl), 120.137 mg/dl (normal 100mg/dl) bulundu. Sonuç: Çalışmamızda sürrenal insidentaloma hastalarının % 56sında insülin direncini gösteren bozulmuş açlık glukozu ve Tip 2 DM tespit edilmiştir. Klinik olarak fonksiyonel olmayan adrenal adenomların neden olduğu hafif kortizol fazlalığı tam olarak cushingoid görüntü gelişmesi için yeterli değilse de, insülin direnci ve bunun klinik sonuçlarına neden olabilmektedir. Bu artmış vücut kütle indeksi ve/veya insidentalomalı hastalarda subk- linik cushing sendromu sıklığı ile de ilişkili olabilir.ABSTRACT Aim: Our aim is to determine the metabolic state in patients with incidental adrenal mass. Material and Methods: 67 patients in whom functional tests about adrenal incidental mass were assessed in University of Necmettin Erbakan, Faculty of Medicine, Department of Endocrinology and Metabolism, were admitted to the study. Results: Of these 67 patients, 34 were male and 33 were female. Mean age was 57.1±12, mean body mass index was 29.1±6 kg/m2. In patients enrolled to the study; cushings syndrome, pheochromocytoma, primary hyperaldosteronism tests were performed. Functional adrenal mass was detected in 8 patients (6 pheochromocytoma, 1 cushings syndrome, 1 primary hyperaldosteronism). Impaired fasting glucose or type 2 diabetes were identified in 38 patients. Mean glucose was 127.6±18 mg/dL in all patients. Mean glucose in patients with functional and non-functional mass were 117.2±32 mg/dL and 129±62 mg/dL respectively. Mean systolic blood pressure was 125±18 mmHg, and diastolic blood pressure was 77±10.9 mmHg in all patients. Mean systolic pressure was 135±10.4 mmHg in patients with functional mass and 124±19 mmHg in patients with non-functional mass. Mean triglyceride was 157.5 ± 83 mg/dL (normal >150), HDL was 39.3 ± 9.5 mg/dL (normal >40) and LDL was 120.1 ± 37 mg/dL (normal >100) in all patients. Conclusion: In our study, impaired fasting glucose, indicating insulin resistance and Type 2 DM were detected in 56% of patients with adrenal incidentaloma. Although the mild cortisol excess by non-functional adrenal adenomas is not sufficient for the development of cushingoid appearance, it can lead to insulin resistance and its clinical consequences. Increased body mass index may be associated with subclinical Cushings syndrome in patients with incidentaloma

Variniklinle İndüklenen Akut Adrenal Kriz: Olgu Sunumu

Biz bu çalışmada primer adrenal yetmezliği olan erkek olguyu sunduk. Sigara bırakmak için vareniklin kullanılan hastamızda adrenal kriz gelişti. Hasta muhtemel adrenal kriz nedenleri ile ilgili dikkatlice tetkik edildi. Tek farklılık bir hafta önce vareniklin tedavisi başlamasıydı. Vareniklin tedavisi altında akut adrenal kriz gelişen ilk olgu sunumunu rapor ettik. Anaktar kelimeler: Vareniklin, adrenal, yetersizlik.We present a male patient with the diagnosis of primary adrenal insufficiency. He had acute adrenal crisis while receiving varenicline treatment for smoking cessation. The patient was examined carefully for the potential cause of adrenal crisis. His medical history was unremarkable except for varenicline use that started one week ago. We report here the first case of a patient who developed acute adrenal crisis under varenicline treatment

HDR Syndrome Accompanying Type 1 Diabetes Mellitus and Hypopituitarism

HDR (Hypoparathyroidism, Deafness, and Renal Dysplasia) syndrome is an autosomal dominant disorder characterized by the triad of hypoparathyroidism, sensorineural deafness, and renal disease. Approximately 65% of patients with HDR syndrome have all three of these features, while others have different combinations of these features. We aimed to present a case with primary hypoparathyroidism, hearing loss, and nondiabetic chronic kidney disease and diagnosed as HDR syndrome while being followed up for type 1 diabetes mellitus and hypopituitarism

Responses Of Anterior Pituitary Hormones To Fever During Community-Acquired Infections

Aim: The aim of the study was to determine the responses of adrenal corticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH) and prolactin (PRL) levels during community-acquired infections with fever and to compare changes of these hormones to febrile and afebrile episodes. Methods: Plasma levels of ACTH, serum levels of cortisol, TSH and PRL of 60 hospitilized patients were evaluated prospectively. Blood samples from study group were taken 2 times; during pyrexia and one hour after decreasing of fever. Only one blood sample was taken from each control patient and time of blood sampling was same for all of them. Results: 60 hospitalized patients were included to the study. Of these, 29 were study group, 31 were control group. In febrile patients with infection; plasma ACTH levels was higher than the control group (37,35±35,82 pg/mL vs 22,78±28,84 pg/mL) but no statistical significance was found (p=0,101). Serum cortisol levels was higher than the control group (28,88±13,12 ug/dL vs 17,68±7,88 ug/dL) (p<0,001). There were no differences in serum PRL and TSH levels between the two groups. In the study group plasma ACTH and cortisol levels were significantly increased in febrile periods when compared to afebrile periods (32,21±28,51 pg/mL vs 18,93±22,86. pg/mL; p=0,002) and (28,32±12,96 ug/dL vs 23,09±15,05 ug/dL; p=0,024) respectively. In PRL and TSH levels there was no statistically significance. Conclusion: We concluded that plasma ACTH and serum cortisol elevations are common in acute infectious diseases, and they are more sensitive to increasing of body temperature. The two peptides may be involved in central mediation of fever, perhaps limiting the febrile response acting as neuromodulators in central thermoregulatory pathways

Influence of Hypoglycemia During The 100-G Oral Glucose Tolerance Test on Obstetrics Outcomes

OBJECTIVES: We aimed to investigate the impact of hypoglycemia during 100-g oral glucose tolerance test on perinatal outcomes. STUDY DESIGN: Obstetrics records of 411 pregnants who delivered singletons at our institution were reviewed. 31/411 (7,5 %) of patients who were diagnosed as Gestational Diabetes Mellitus were excluded from the study. The study group was consisted of pregnant women who experienced hypoglycemia defined as a plasma glucose level of 60 mg/dL or less during the 100-g oral glucose tolerance test. This group were compared with women who had normal glucose levels during 50-g oral glucose loading test (glucose challenge test) and who had normal values and had no hypoglycemia during 100-g OGTT. RESULTS: We identified 62 hypoglycemic patients (15 %) on 100-g oral glucose tolerance test and 318 non-hypoglycemic patients (77,3 %) as control group. Gestational weight gain was statistically higher in hypoglycemic group. The mean birth weight was 3419±421,9 g in the study group and 3275±491,7 g in the control group (p=0.042). Rates of babies admitted to NICU were similar in both groups. CONCLUSIONS: Women who experience hypoglycemia during the OGTT have a significantly higher incidence of gestational weight gain and higher neonatal birth weights as well. As a result if a pregnant has hypoglycemia during OGTT we should monitorize her and the fetus as well carefully