PPARG genindeki Pro12Ala polimorfizmi, Türk populasyonunda insülin direnci ve tip 2 diyabet ile ilişkili değildir: Bir vaka-kontrol çalışması

Amaç: Tip 2 diyabet (T2D), diyabetin en sık görülen türüdür ve tüm dünyada olduğu gibi ülkemizde de ciddi bir halk sağlığı sorunu haline gelmiştir. İnsülin sekresyonunun azalması ve/veya insülin direnci (İR) gelişimi, T2D patogenezinde yer alan iki ana bozukluktur. Kromozom 3p25'te yer alan peroksizom proliferatör aktive reseptör gama (PPARG) geni tarafından kodlanan ve esas olarak adipositlerde eksprese edilen PPARG2, glikoz ve lipid metabolizmasının düzenlenmesinde yer alan çok sayıda anahtar geni düzenler. Fonksiyonel önemi dolayısıyla, T2D gelişimi ile ilişkisi ilk rapor edilen aday gen PPARG2 (Pro12Ala varyantı)’dir. Çalışmamızda, PPARG genindeki Pro12Ala'nın IR gelişimi ve T2D riski üzerine etkilerini Konya bölgesinde yaşayan 387 (181 non-obez/ 206 obez) T2D ve 264 (137 non-obez/127 obez) sağlıklı birey olmak üzere toplam 650 kişide değerlendirmeyi amaçladık. Yöntem: Bireylerden alınan kan örneklerinden, T2D ilişkili biyokimyasal parametreler analiz edildi ve sonrasında HOMA-IR (HOMA indeksi) hesaplandı. HOMAIR indeksi 2.5'ten yüksek olan kişiler insüline dirençli olarak kabul edildi. İzole edilen DNA örneklerinde, Pro12Ala genotiplendirmesi RT-PCR tekniği ile yapıldı. İstatistiksel analiz için SPSS18.0 programı kullanıldı. P<0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Obez hasta grubu dışında diğer hasta ve ve kontrol grupları Hardy-Weinberg dengesinde değildi (p<0.05). Dominant, resesif ve aditif modeller kurularak yapılan ilişkilendirme analizine göre Pro12Ala polimorfizminin T2D riski ve ilişkili biyokimyasal parametreler üzerine bir etkisi bulunmadı (p>0.05). Sonuç: Hastalığın poligenik doğası ve çevresel faktörlerin karmaşıklığı, genlerin T2D patogenezindeki etkisinin anlaşılmasını zorlaştırmaktadır. Bu nedenle, PPARG'nin hastalığın genetik zeminindeki olası rolünü ortaya çıkarmak için daha büyük popülasyonlarda daha fazla çalışmaya ihtiyaç vardır. Çalışma Türk toplumunda PPARG ve T2D ilişkisi bakımından sunulan ilk rapordur

Association of serum and follicular fluid leptin and ghrelin levels with in vitro fertilization success

 Objectives: The aim of this study was to evaluate the relationship between in vitro fertilization (IVF) cycle outcomes, serum and follicular fluid (FF) levels of leptin and ghrelin. Material and methods: Forty-four women who underwent intracytoplasmic sperm injection cycles (ICSI) were enrolled in the study. On the third day (D3) of the menstrual cycle, venous blood samples were drawn for serum measurements of leptin and ghrelin. The follicular fluid (FF) and the corresponding oocyte were obtained from a single dominant preovulatory follicle at the time of oocyte pick-up. The FF and D3 serum leptin and ghrelin concentrations were measured by enzyme-linked immunosorbent assay. The relationship between pregnancy rate and serum, follicular fluid levels of leptin and ghrelin were analyzed. Results: Of the 44 cases included, nineteen achieved clinical pregnancy (43.18%). Follicular fluid ghrelin levels were significantly lower in the pregnant group than non-pregnant group (p < 0.05) With respect to FF leptin, there was no statistically significant differences between the pregnant and non-pregnant women (p > 0.05). There was no statistically significant difference in D3 serum ghrelin between pregnant and non-pregnant groups (p > 0.05). However, D3 serum leptin levels were significantly lower in pregnant women than non-pregnant women (p < 0.05). Conclusions: Lower ghrelin levels in the follicular fluid were associated with higher pregnancy rates. Also, D3 serum leptin levels were inversely correlated with clinical pregnancy rates. These findings support the potential role of these molecules on IVF outcomes

Cyproheptadine-Induced Obsessive-Compulsive Symptoms in a Preschool Child

Cyproheptadine is a first-generation antihistamine with additional anticholinergic, antiserotonergic, and local-anesthetic properties. It has been shown effective as an appetite stimulant in the treatment of young children with feeding difficulties and poor growth with or without medical illness. Adverse reactions to cyproheptadine may include sedation, confusion, hallucinations, convulsions, hypotension, palpitations, and tachycardia. Despite cyproheptadine may cause neuropsychiatric side effects, a review of literature showed that there is no report of cyproheptadine induced obsessive compulsive symptoms. Here, we present a preschool girl with sexual and religious obsessions emerged after using cyproheptadine as an appetite stimulant for one week

Spatial Patterns of Infant Mortality in Turkey between 2011 and 2016

Erdugan, Funda/0000-0001-7199-6413WOS:000584994600001Health studies are important for the evaluation of health services and the improvement of poor conditions as well as for the determination of the development levels of countries. The purpose of this study was to demonstrate the spatial patterns of infant mortality, which is considered an indicator of health conditions, in Turkey between 2011 and 2016. The existence of global autocorrelation was first studied using the infant mortality rate, the standardised mortality ratio, and the infant mortality rate which was corrected by Bayes smoothers. Local spatial autocorrelation analysis was performed to determine statistically significant hot spots or clusters in infant mortality. It was determined that the spatial distribution between 2011 and 2016 was not coincidental, and aggregation tendency and spatial dependence were observed in the data. According to local spatial statistics, spatial differences of Southeastern Anatolia and Eastern Anatolia regions appeared in Turkey in terms of infant mortality. Furthermore, the factors related to the infant mortality rate were considered. It was found that the age of marriage for women, the net schooling rates of females in secondary education, the number of midwives, and the gross domestic product (GDP) were related to infant mortality rates. It is important to determine different associated factors in the provinces with high infant mortality rates found in this study and to develop an understanding of what can be done to prevent infant mortality in the future. In the South-eastern Anatolia and Eastern Anatolia regions, it is necessary to produce and implement policies with the scope of reducing the infant mortality rate

Heart rate variability in patients with atrial septal defect and healthy children

Objective: Heart rate variability (HRV) measures are altered in various cardiac and non-cardiac situations in children. The autonomic nervous system is assumed to have a role in the pathophysiology of atrial septal defect (ASD). In this study, we evaluated the autonomic system by measuring HRV in children with ASD

Skin tags associated with obesity and diabetes mellitus in patients with chronic kidney disease

Introduction/Objective. Both chronic kidney disease and skin tags are associated with similar cardiovascular risk factors such as obesity, diabetes mellitus, dyslipidemia, hypertension, etc. The aim of this study was to determine the prevalence of skin tags in patients with chronic kidney disease, and to assess the relationship between skin tags and cardiovascular risk factors such as diabetes, hypertension, dyslipidemia, obesity, and metabolic syndrome. Methods. We evaluated 358 patients [149 (41.6%) female and 209 (58.1%) male, 197 (55%) predialytic and 161 (45%) dialytic] with chronic kidney disease. All the patients were examined for skin tags by the same clinician, and evaluated for body mass index, diabetes mellitus, hypertension, and dyslipidemia. Results. Skin tags were detected in 199 (55%) patients. Prevalence of skin tags was higher in males than in females (p = 0.041) and was also higher in diabetic patients than in nondiabetic ones (p = 0.013). Body mass index was higher in patients with skin tags when compared to patients without skin tags (p = 0.047). Skin tags were detected in 48.3% of normal, in 58% of overweight, and in 66% of obese patients (p = 0.029). Conclusion. The presence of skin tags is merely related to male sex, obesity, and diabetes mellitus in patients with chronic kidney disease