FREQUENCY OF ASPIRIN RESISTANCE IN PATIENTS WITH TYPE 1 AND 2 DIABETES MELLITUS AND ITS ASSOCIATION WITH METABOLIC PARAMETERS

Objectives: In the present study, we aimed to determine the prevalence of aspirin resistance in patients with Type 1 and 2 diabetes and to study its association with metabolic parameters. Methods: Aspirin resistance of patients (n=158) with Type 2 Diabetes Mellitus (DM) who presented to the center after 7 days of regular aspirin use were compared to age-mathced (55±19) healthy controls (n=164). Similarly, aspirin resistance of patients (n=30) diagnosed with Type 1 DM were compared to age-matched (27±7) healthy subjects (n=41) as the control group. Platelet Function Analyzer (PFA)-100 was used to evaluate the efficacy of aspirin. Results: Aspirin resistance was identified in 72 of 158 patients with Type 2 DM (45.6%) and in 47 of 164 healthy controls (28.6%) (p=0.001). Aspirin resistance had a prevalence of 50% in patients with Type 1 DM and was significantly higher compared to the control group of 41 healthy subjects (12.2%) (p=0.001). No correlations were noted between aspirin resistance and sex, smoking, HbA1c, hypertension and aspirin dose. There was a significant relation between aspirin resistance and LDL-cholesterol in patients with Type 2 DM (p=0.020). Conclusion: Patients with Type 1 and Type 2 DM had a higher frequency of aspirin resistance than the control group. Therefore, treatment choices including administering higher doses of aspirin or using other antiplatelet agents such as clopidogrel should be considered to prevent thrombocytic events in diabetes mellitus

A Case of Refractory Type III Hyperlypoproteinemia Successfully Treated with Plasmapheresis

A 42-year-old male was hospitalized in Department of Endocrinologyfor evaluation of persistent hypertriglyceridemia and hypercholestrolemia.He was normal on physical examination except having multiple xanthomasin elbow, knee and ankle. ApoE genotyping was performed by PCR andapoE phenotype was found to be E2/E2. Firstly, he was treated withatorvastatin (40mg/day) and niacin (1500mg/day) but it was found that thepatient did not respond the after three months of the treatment. Then he wastreated with plasmapheresis twice a week. After three weeks ofplasmapheresis treatment triglyceride and cholesterol levels was markedlydecreased.Plasmapheresis can be highly effective in removing the lipoproteinremnantparticles, leading to generalized improvement in the lipoproteinprofile in severe type III hyperlipidemia, which do not respond conventionalthreapies as in our case

Quinapril for treatment of hypertension in Turkey - Dose titration and diuretic combination treatment strategies

Background and objective: Recently the PatenT (Prevalence, awareness, treatment and control of hypertension in Turkey) study showed that while the prevalence of hypertension in Turkey is high, effective control of BP is infrequently achieved. This study investigated the efficacy and safety of quinapril (as monotherapy or in combination with hydrochlorothiazide [HCTZ]) for achieving BP control (target < 140/90mm Hg) in Turkish subjects with mild to moderate hypertension

Diagnosis of diabetes mellitus and pre-diabetes with fasting plasma glucose, oral glucose tolerance test and A1C level: A1C based screening may be a better diagnostic tool for diabetes mellitus

OBJECTIVE: The International Diabetes Federation estimates that 285 million people around the world have diabetes. The American Diabetes Association (ADA) has proposed hemoglobin A1C &#8805; 6.5% (HbA1c) for the diagnosis of diabetes, and 5.7-6.4% as a risk factor for progression to diabetes. This new criterions accuracy is controversial and has not yet been adopted internationally. We aimed to clarify the power of A1C in diagnosis of diabetes and pre-diabetes. RESEARCH DESIGN AND METHODS: In this retrospective study a total of 1814 patients (622 male, 1192 female) who had concurrent FPG, OGTT and A1C results and diabetes mellitus suspicion were included by using the hospital ProBel system. Diabetic subjects and patients who had been using drugs that may cause diabetes were excluded. RESULTS: According to ADA criteria; 760 of 1814 individuals had diabetes mellitus (41.8 %). With each of these tests (HbA1c, 2-h OGTT and FPG), diabetes was detected in 529 (69.6%), 488 (64.2%) and 328 (43.2%) subjects respectively. Differences between, FPG, 2-h OGTT; FPG and HbA1c; 2-h OGTT and HbA1c were statistically significant (p [Med-Science 2012; 1(4.000): 341-50

The prevalence of non-classic adrenal hyperplasia among Turkish women with hyperandrogenism

The prevalence of non-classic adrenal hyperplasia (NCAH) among Turkish women with hirsutism has not been established so far. Thus, we aimed to evaluate the prevalence of 21-hydroxylase (21-OH) deficiency by ACTH stimulation test among hirsute women. The study population consisted of 285 premenopousal women, aged 16-46 years (mean: 23.2 +/- 0.3). All were hirsute and hyperandrogenic. Androgen secreting tumors of the ovaries and the adrenal glands were excluded as well as thyroid dysfunction and hyperprolactinemia. All the patients were evaluated by 0.25 mg (i.v.) ACTH stimulation test and 17-OHP responses were obtained at 30 and 60 min. The diagnosis of NCAH due to 21-OH deficiency was considered in patients with the poststimulation 17-OHP level exceed 10 ng/ml. Six (2.1%) of the patients had NCAH due to 21-OH deficiency confirmed by genotyping. The rest of the patients were polycystic ovary syndrome (n = 166, 58.2%) and idiopathic hyperandrogenemia (n = 113, 39.7%). There were no patients with idiopathic hirsutism because patients with normal serum androgen levels were excluded. This first and most extensive national study investigating NCAH prevalence among Turkish population showed that NCAH is not prevalent in this population

The prevalence of non-classic adrenal hyperplasia among Turkish women with hyperandrogenism

The prevalence of non-classic adrenal hyperplasia (NCAH) among Turkish women with hirsutism has not been established so far. Thus, we aimed to evaluate the prevalence of 21-hydroxylase (21-OH) deficiency by ACTH stimulation test among hirsute women. The study population consisted of 285 premenopousal women, aged 16-46 years (mean: 23.2 +/- 0.3). All were hirsute and hyperandrogenic. Androgen secreting tumors of the ovaries and the adrenal glands were excluded as well as thyroid dysfunction and hyperprolactinemia. All the patients were evaluated by 0.25 mg (i.v.) ACTH stimulation test and 17-OHP responses were obtained at 30 and 60 min. The diagnosis of NCAH due to 21-OH deficiency was considered in patients with the poststimulation 17-OHP level exceed 10 ng/ml. Six (2.1%) of the patients had NCAH due to 21-OH deficiency confirmed by genotyping. The rest of the patients were polycystic ovary syndrome (n = 166, 58.2%) and idiopathic hyperandrogenemia (n = 113, 39.7%). There were no patients with idiopathic hirsutism because patients with normal serum androgen levels were excluded. This first and most extensive national study investigating NCAH prevalence among Turkish population showed that NCAH is not prevalent in this population

Combined Pituitary Hormone Deficiency Due To Gross Deletions In The Pou1F1 (Pit-1) And Prop1 Genes

Pituitary development depends on a complex cascade of interacting transcription factors and signaling molecules. Lesions in this cascade lead to isolated or combined pituitary hormone deficiency (CPHD). The aim of this study was to identify copy number variants (CNVs) in genes known to cause CPHD and to determine their structure. We analyzed 70 CPHD patients from 64 families. Deletions were found in three Turkish families and one family from northern Iraq. In one family we identified a 4.96 kb deletion that comprises the first two exons of POU1F1. In three families a homozygous 15.9 kb deletion including complete PROP1 was discovered. Breakpoints map within highly homologous AluY sequences. Haplotype analysis revealed a shared haplotype of 350 kb among PROP1 deletion carriers. For the first time we were able to assign the boundaries of a previously reported PROP1 deletion. This gross deletion shows strong evidence to originate from a common ancestor in patients with Kurdish descent. No CNVs within LHX3, LHX4, HESX1, GH1 and GHRHR were found. Our data prove multiplex ligation-dependent probe amplification to be a valuable tool for the detection of CNVs as cause of pituitary insufficiencies and should be considered as an analytical method particularly in Kurdish patients.Wo