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Öğe Adipocyte volumes and levels of adipokines in diabetes and obesity(Elsevier Sci Ltd, 2008) Gokalp, Deniz; Bahceci, Mithat; Ozmen, Sehmus; Arikan, Senay; Tuzcu, Alpaslan; Danis, RamazanAim: Obesity is a major risk factor for insulin resistance, type 2 diabetes, heart disease, and many other chronic diseases. The factors regulating cytokine production seem to have a role on the determination of adipocyte volume. We aimed to investigate the association of plasma adiponectin and resistin concentrations with adipocyte volumes in obese, diabetic, obese-diabetic and control groups. Methods: Plasma adiponectin, resistin and lipid levels and adipocyte volumes were investigated in obese, non-diabetic, non-obese diabetic, obese diabetic and control groups consisting 100 subjects who planned to undergo elective surgery. Differences in clinical or laboratory parameters among groups were compared by using one-way ANOVA test. Chi-square test was used for comparing the frequencies. Results: The lipid values in all three groups were higher than the control group. A negative correlation was found between adiponectine levels and adipocyte volumes. When adipocyte volumes were compared with other groups, adipocyte volumes were significantly higher in the obese diabetic group (p = 0.000). The adipocyte volumes in the obese group were determined to be higher than the control group. Conclusions: Although a positive correlation was found between adipocyte volumes and adiponectin in literature, adiponectin concentrations in our study were lower. These conditions can be explained by the effect of insulin resistance on the adiponectin levels in obese diabetic groups. Moreover, adiponectin levels are mostly associated with subcutaneous adipose tissue which may have been less. Resistin levels may play an important role in the development of obesity, insulin resistance and diabetes. (C) 2008 Diabetes India. Published by Elsevier Ltd. All rights reserved.Öğe Ectopic lingual thyroid as a rare cause of primary hypothyroidism - A case report(Lippincott Williams & Wilkins, 2008) Pasa, Semir; Beyaz, Coskun; Arikan, Senay; Altintas, Abdullah; Gokalp, Deniz; Cil, Timucin; Tuzcu, AlparslanEctopic lingual thyroid gland is all uncommon abnormality of migration of the thyroid gland. Although it is uncommon, it is often found in the region of the foramen cecum as a lingual thyroid at the base of the tongue in patients whose gland fails to descend. The true incidence of lingual thyroid is unknown. Treatment depends on the presence of symptoms. In this case report, we described a 17-year-old mail who presented with growth retardation due to severe hypothyroidism associated with a lingual thyroid gland. He did not complain of pressure symptoms. We recommended regular follow-up visits to monitor this state of thyroid function and the size and shape of the gland. We wanted to note that ectopic thyroid tissue should be taken into consideration in the differential diagnosis of all lingual and pharyngeal masses, and in the differential diagnosis of hypothyroidism.Öğe An Embryological Cause of Primer Hypothyroidism, Lingual Thyroid(Galenos Yayincilik, 2006) Arikan, Senay; Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Bahceci, SelenLingual thyroid is a rare developmental thyroid abnormality usually affecting females. It is often found in the region of the foramen caecum as a lingual thyroid at the base of the tongue in patients whose gland fails to descend. A 16-year-old female patient with severe hypothyroidism applied to our outpateint clinic. She was complaining from growth retardation, primary amenorrhea, weakness, decreases of school performance and short stature. No thyroid tissue was seen at the usual site with ultrasonography. Scintigrapy with 99mTC pertechnetate showed an ectopic functioning thyroid in the lingual area. CT scan showed a mass in the base of lingular region. The thyroid profile implied severe hypothroidism (free T3: 0,142 ng/ dl, free T4: 0,741 ng/dl, and TSH: 100 mu IU/ml). Patient was accepted as primary hypothyrodism due to ectopic thyroid tissue (lingual thyroid) and substitution treatment with L-thyroxine was started at the dose of 2-3 mu gr/kg. Surgical treatment did not consider because of patient was asymptomatic in terms of pressure. As a result we reported a rare cause of primary hypothyroidism due to ectopic thyroid gland (lingual) in a young female patient.Öğe The evaluation of endothelial function with flow-mediated dilatation and carotid intima media thickness in young nonobese polycystic ovary syndrom patients; existence of insulin resistance alone may not represent an adequate condition for deterioration of endothelial function(Elsevier Science Inc, 2009) Arikan, Senay; Akay, Hatice; Bahceci, Mithat; Tuzcu, Alpaslan; Gokalp, DenizObjective: To evaluate endothelial function with flow-mediated dilatation (FMD) and carotid intima media thickness (IMT) in young nonobese polycystic ovary syndrome (PCOS) patients. Design: Prospective case-control study. Setting: Healthy volunteers and nonobese young PCOS patients in clinical research. Patient(s): Thirty-nine PCOS patients with mean age of 22.82 +/- 5.53 years and 30 body mass index- and age-matched healthy controls were evaluated. Intervention(s): Insulin resistance was calculated with area under the curve, quantitative insulin sensitivity check, and the Matsuda index. Endothelial function was assessed with FMD and carotid IMT by ultrasonography. Main Outcome Measure(s): Antropometric, hormonal, biochemical (insulin and glucose, tumor necrosis factor-alpha, hs-c-reactive protein, and homocysteine levels, and so forth), FMD, and IMT were measured. Result(s): There was a significant insulin resistance in PCOS patients. Serum FSH, total and free testosterone, cortisol, androstenedione, and DHEA-S levels of PCOS patients were also higher than control subjects, but we could not find any significant difference in terms of endothelial function determined with FMD. Conculsion(s): Existence of insulin resistance alone may not bean adequate factor for deterioration of endothelial function and carotid IMT in young, nonobese patients with PCOS. Other factors such as duration of insulin resistance, older age, presence of obesity, and inflammatory markers may play an important role in this process. (Fertil Steril (R) 2009;91:450-5. (C)2009 by American Society for Reproductive Medicine.)Öğe Evaluation of insulin sensitivity in hyperprolactinemic subjects by euglycemic hyperinsulinemic clamp technique(Springer, 2009) Tuzcu, Alpaslan; Yalaki, Serkan; Arikan, Senay; Gokalp, Deniz; Bahcec, Mithat; Tuzcu, SadiyeThe background and aim of the study is to evaluate insulin sensitivity in hyperprolactinemic subjects via euglycemic hyperinsulinemic clamp technique. Sixteen hyperprolactinemic subjects and 12 healthy subjects were included in the study. HOMA-B and HOMA-IR values of groups were calculated. Euglycemic hyperinsulinemic clamp technique was performed in both groups, and the M value of the groups was defined. Mann-Whitney U and chi-square tests were used in statistical analysis. Basal insulin level of hyperprolactinemic patients were higher than the control group (6.85 +/- A 4.68; 3.66 +/- A 0.88 mu U/ml respectively; P < 0.05). Mean HOMA-IR and HOMA-B values of patients were higher than control group (1.49 +/- A 1.30; 0.78 +/- A 0.27 respectively; P = 0.02 and 136.28 +/- A 72.53; 64.77 +/- A 23.31, respectively, P < 0.001). M values of the patients were statistically lower than the control group (5.64 +/- A 2.36; 7.05 +/- A 1.62 kg/mg/min respectively; P < 0.05). (1) Hyperprolactinemic patients were more insulin resistant than control subjects. (2) Insulin resistance in hyperprolactinemic patients is not associated with obesity or anthropometric parameters such as fat content, waist circumference and BMI.Öğe Flow-mediated dilatation in polycystic ovary syndrome women Reply(Elsevier Science Inc, 2009) Arikan, Senay; Akay, Hatice; Bahceci, Mithat; Tuzcu, Alpaslan; Gokalp, Deniz[Abstract Not Available]Öğe Hyperthyroidism may affect serum N-terminal pro-B-type natriuretic peptide levels independently of cardiac dysfunction(Wiley, 2007) Arikan, Senay; Tuzcu, Alpaslan; Gokalp, Deniz; Bahceci, Mithat; Danis, RamazanBackground It is known that NT-proBNP levels increase in cardiac failure. However, NT-proBNP levels in different thyroid states are still unclear. We aimed to evaluate serum NT-proBNP levels in both hyperthyroid and hypothyroid patients without cardiac insufficiency. Subjects and methods Thirty-six patients with hyperthyroidism (42.9 +/- 16.7 years), 25 patients with hypothyroidism (35.4 +/- 13.9 years) and 34 age-matched euthyroid subjects (41.4 +/- 13.8 years) were included in the study. After anthropometric evaluations, body fat analyses were determined by bioelectrical impedance. Electrocardiography and echocardiography were used in cardiac evaluations. Serum NT-proBNP was measured by immunoassay. Results Mean serum NT-proBNP levels in hyperthyroid patients were higher than in both control subjects (13.65 +/- 13.02 vs. 6.50 +/- 4.83 pmol/l, P = 0.002) and hypothyroid patients (13.65 +/- 13.02 vs. 5.98 +/- 5.08 pmol/l, P = 0.003). However, mean serum NT-proBNP levels in hypothyroid patients were not different from those in control subjects. There was a positive correlation between serum NT-proBNP and thyroid hormones (NT-proBNP and FT3: r = 0.324, P = 0.001; NT-proBNP and FT4: r = 0.269, P = 0.009, respectively). Serum NT-proBNP levels were positively correlated with left ventricle end-diastolic diameters (r = 0.232, P = 0.04), interventricular septum thickness (r = 0.315, P = 0.006), and negatively correlated with left ventricular ejection fraction (r = -0.238, P = 0.04). Conclusions Serum NT-proBNP levels may increase in hyperthyroidism independently of cardiac insufficiency. Therefore, hyperthyroidism may lead to cardiac ultrastructural changes undetermined by conventional echocardiography and these changes may be responsible for elevation of NT-proBNP levels. In contrast to decreased thyroid hormones, excess thyroid hormones may have a more pronounced effect on serum NT-proBNP levels.Öğe Increased cortisol level in type 1 diabetic patient may lead decreasing of bone mineral density(Nature Publishing Group, 2007) Tuzcu, Alpaslan; Bayer, Semir; Arikan, Senay; Gokalp, Deniz; Bahceci, Mithat; Canoruc, Naime[Abstract Not Available]Öğe Insulin Resistance in Type 2 Diabetes Mellitus May Be Related to Bone Mineral Density(Elsevier Science Inc, 2012) Arikan, Senay; Tuzcu, Alpaslan; Bahceci, Mithat; Ozmen, Sehmuz; Gokalp, DenizThe mechanism of bone mineral density (BMD) changes in type 2 diabetes mellitus is not clear. We aimed to investigate the effect of insulin resistance in type 2 diabetics on BMD. Insulin resistance was determined using the homeostasis model assessment index (HOMA-IR). Nineteen type 2 diabetic patients with a HOMA-IR < 2.7 (mean age, 51.5 +/- 9.6 yr; body mass index [BMI] 27.3 +/- 5.1 kg/m(2); duration of diabetes, 10.5 +/- 7.3 yr) were included in Group A, and 30 BMI- and age-matched type 2 diabetic patients with a HOMA-IR >= 2.7 were included in Group B. The BMD was measured with dual-energy X-ray absorptiometry. Independent t-test was used for statistical analysis. The Group A values for mean fasting glucose and insulin levels were 160.1 +/- 77.0 mg/dL and 4.79 +/- 2.89 mu U/L, respectively, whereas the Group B values were 195.1 +/- 58.9 mg/dL (p > 0.05) and 19.30 +/- 16.89 mu U/L (p = 0.0001). Significantly higher total lumbar vertebra T-score (p = 0.02) and total lumbar vertebra BMD in Group A were determined than Group B (p = 0.033). The lumbar vertebra total Z-score was significantly lower in Group B (p = 0.042). Marked insulin resistance may have a negative effect on BMD in type 2 diabetics, while the presence of hyperinsulinemia may be associated with the low BMD.Öğe An interesting case of pachydermoperiostosis with idiopathic myelofibrosis associated with monosomy 22(Wiley-Blackwell Publishing, Inc, 2009) Arikan, Senay; Sen, Ilker; Bahceci, Mithat; Tuzcu, Alpaslan; Ayli, MeltemOn physical examination, the patient showed marked drumstick clubbing of the hands (Fig. 1), and a pale general appearance. The causes of digital clubbing are shown in Table 1 (Fawcett RS, Linford S, Stulberg DL. Nail abnormalities: clues to systemic disease. Am Fam Physician 2004; 69: 1417-1424). Deep nasolabial folds were seen on the face. Skin hypertrophy, cutis verticis gyrata, and seborrhea on the face were also observed. The patient also complained of hyperhidrosis. Examination of the cardiovascular system was normal. There was bilateral swelling of the ankle and knee (Fig. 2). Hepatosplenomegaly was found on abdominal examination. Investigations showed hypochromic microcytic anemia [hemoglobin, 8.58 g/dL (normal, 12.2-18.1 g/dL); hematocrit, 28.1% (normal, 37.7-53.7%); white blood cell count, 3430/mm(3) (normal, 4600-10,200/mm(3)); neutrophils, 2470/mm(3) (normal, 2000-6900/mm(3)); lymphocytes, 820/mm(3) (normal, 600-3400/mm(3)); platelets, 162,000/mm(3) (normal, 142,000-424,000 mm(3)); mean corpuscular volume, 73.7 fL (normal, 80-97 fL)]. Anisocytosis, poikilocytosis, microcytosis, and hypochromia were observed on peripheral blood examination, and the erythrocyte sedimentation rate was 37 mm/h. The serum C-reactive protein level was 50.1 mg/L (normal, 0-5 mg/L). Biochemical parameters, including serum calcium, phosphate, alkaline phosphates and liver function tests, were found to be within the normal range. The causes of secondary hypertrophic osteoarthropathy associated with pulmonary, rheumatologic, endocrine, cardiac, and gastroenterologic disorders were excluded. Growth hormone level and thyroid function tests were normal. Antinuclear antibody, TORCH [Toxoplasma immunoglobulin M (IgM), rubella IgM, cytomegalovirus IgM, herpes simplex IgM] panel, and markers of hepatitis were negative. Serum Igs and rheumatoid factor were found to be within the normal range. There was subperiosteal new bone formation on bilateral knee X-ray (Fig. 3). Radiography of the chest, pulmonary function tests, arterial blood gas, and echocardiography were normal. Abdominal ultrasonography revealed hepatosplenomegaly. Amyloid deposition was not determined in rectal biopsy. Reticulin-type myelofibrosis was found on bone marrow biopsy (Figs 4 and 5). In the cytogenetic study, monosomy 22 was detected in four of 20 metaphase plates.Öğe Levels of proinflammatory cytokines and hs-CRP in patients with homozygous familial hypercholesterolaemia(Acta Cardiologica, 2009) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Arikan, Senay; Pirinccioglu, Ayfer Gozu; Bahceci, SelenObjective - Homozygous familial hypercholesterolemia (FH) is an extremely rare (1/1.000.000) condition characterized by markedly increased LDL cholesterol levels and a significantly increased risk of premature coronary heart disease (CHD). We aimed to evaluate the levels of high-sensitivity C-reactive protein (hs-CRP) and proinflammatory cytokines, which are known to be associated with atherogenesis, in patients with this condition. Method and results - A total of 10 patients with homozygous FH (5 women and 5 men, mean age 17.0 +/- 6.9 years, body mass index (BMI) (18.8 +/- 1.9 kg/m(2)) and 16 healthy controls were included. hs-CRP levels, proinflammatory cytokine levels and lipid parameters were measured and compared between patients and control subjects. Homozygous FH patients had significantly higher total cholesterol, LDL-cholesterol and Lp(a) levels and significantly lower triglycericle and HDL cholesterol levels, compared to controls (P = 0.0001, for all). Serum hs-CRP (3.7 +/- 1.3 mg/L vs. 0.6 +/- 0.6 mg/L) and IL-1 beta, IL-2R, IL-6, IL-8, IL- 10, TNF-alpha levels were all significantly higher in the homozygous FH group, compared to controls (P = 0.0001, for all). Conclusions - Homozygous FH patients have significantly higher levels of hs-CRP and circulating proinflammatory cytokines, which may explain their increased risk of atherosclerotic disease. hs-CRP is an important biomarker that may be helpful in the identification of asymptomatic CHD in FH patients.Öğe Massive Metformin Overdose in Two Subjects with Suicidal Behavior: Brief Communication(Ortadogu Ad Pres & Publ Co, 2012) Arikan, Senay; Tuzcu, Alpaslan; Bahceci, Mithat; Kaplan, Mehmet Ali; Gokalp, DenizLactic acidosis is a well-recognized side effect of metformin, especially in patients with renal failure. Only a few cases of deliberate self-poisoning with metformin have been described in the literature. The mechanism of metformin-associated lactic acidosis is complex. In the absence of acute overdose, metformin-associated lactic acidosis rarely develops in patients without comorbidities such as renal or hepatic insufficiency or acute infection. We report two patients who had a large dose of metformin in an attempt to harm themselves and presented with lactic acidosis. In our experience, metformin intoxication may lead a high anion gap metabolic acidosis after a suicide attempt. Sodium bicarbonate infusion is able to correct the acid-base metabolism sufficiently in subjects with normal renal functions.Öğe Morgagni Hernia in a Girl With Turner Syndrome(Galenos Yayincilik, 2008) Arikan, Senay; Bahceci, Mithat; Tuzcu, Alpaslan; Cigdem, Murat Kemal; Kaya, RamazanThis report describes the delayed presentation of right-side Morgagni hernia in a 15-year-old girl with Turner syndrome. It is commonly associated with a number of systemic malformations and abnormalities. Morgagni hernia is a rare type of congenital diaphragmatic hernia, which may not be symptomatic until adulthood when the patient presents with acute symptoms or incarceration. As this result, patients with Turner syndrome should be investigated for Morgagni hernia because there may be an association between the two, and Morgagni hernia may be asymptomatic.Öğe A new mutation in WFS1 gene (c.1522-1523delTA, Y508fsX421) may be responsible for early appearence of clinical features of Wolfram syndrome and suicidal behaviour(Maghira & Maas Publications, 2006) Aluclu, Mehmet Ufuk; Bahceci, Mithat; Tuzcu, Alpaslan; Arikan, Senay; Gokalp, DenizOBJECTIVE: Wolfram syndrome (WS) is an autosomal recessive disorder characterized by the association of juvenile-onset diabetes mellitus and optic atrophy. It is also known by the acronym DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness). PATIENTS, METHODS AND RESULTS: We diagnosed Wolfram syndrome in 2 mate siblings and determined a new mutation (c. 1522-1523delTA, Y508fsX421). Both affected siblings were homozygous, other family members were heterozygous. Dilated renal outflow tracts in the third decade, and neuropsychiatric disorders including bipolar disorder and neurosensorial deafness appear in the fourth decade in ordinary WS, whereas these features appeared in second decade in our patients. This mutation may be responsible for early appearance of dilated renal outflow tracts and multiple neurological abnormalities. Psychiatric disturbances such as suicide were reported at increased frequency in Wolfram patients and in heterozygous carriers. Suicidal behaviour occurred in our patients when they were yet 11 and 13 years old. Therefore, our findings may indicate that there may be a relationship between this WFS1 mutation and mood disorder such as suicidal behaviour. CONCLUSIONS: We determined a new mutation (c. 1522-1523delTA, Y508fsX421) in WS1 gene in 2 siblings with Wolfram syndrome. This mutation may be responsible for early appearance of clinical features of Wolfram syndrome, and there may be a relationship between this mutation and suicidal behaviour.Öğe Postprandial hyperlipidemia in overt and subclinical hypothyroidism(Elsevier Science Bv, 2012) Arikan, Senay; Bahceci, Mithat; Tuzcu, Alpaslan; Celik, Fatma; Gokalp, DenizBackground and aims: Lipid alterations in overt hypothyroidsm (OH) were well known, but its changes in subclinical hypothyroidism (SCH) and postprandial period were not clear. The aim of this study is to evaluate postprandial lipemia by oral lipid tolerance test (OLTT) in patients with OH and SCH. Materials and methodology: Twenty-five OH and 27 SCH, totally 52 hypothyroid patients [mean age 38.3 +/- 12.8 year, body mass index (BMI): 29.0 +/- 5.8 kg/m(2)] and 23 BMI- and age-matched healthy controls (mean age 36.7 +/- 11.9 years; BMI: 27.1 +/- 6.9 kg/m(2)) were included to the study. Anthropometric measurements and HOMA-IR levels were measured. Basal and postprandial lipid profile at 2nd, 4th, 6th and 8th hours were determined by oral lipid tolerance test. Results: There were not any statistical differences among three groups (control, OH and SCH) in terms of mean fasting levels of total cholesterol, LDL-cholesterol, VLDL-cholesterol, and triglyceride. On the contrary, mean triglyceride levels at postprandial 8th hour in both OH and SCH patients were higher than control subjects (p=0.017 and p=0.049, respectively). Again mean postprandial 8th hour VLDL-cholesterol levels in OH group were also higher than control subjects (p=0.05). In addition mean HOMA-IR value of SCH and OH patients was similar with control subjects (1.5 +/- 1.4 in OH; 1.3 +/- 0.8 in SCH; 2.2 +/- 2.2 in control group). Conclusions: Although total, LDL and VLDL-cholesterol, and triglyceride levels were not different from healthy controls, triglyceride and/or VLDL-cholesterol levels apparently increased with OLTT in both OH and SCH patients. Decreased lipid clearance may be responsible for this result. (c) 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.Öğe Predictive value of serum NT-proBNP levels in type 2 diabetic people with diabetic nephropathy(Elsevier Ireland Ltd, 2012) Danis, Ramazan; Ozmen, Sehmus; Arikan, Senay; Gokalp, Deniz; Alyan, OmerObjective: The serum N-terminal fragment of pro brain natriuretic peptide (NT-proBNP) level in type 2 diabetic subjects with or without diabetic nephropathy (DN) is still unclear. We aimed to evaluate the relationship between serum NT-proBNP levels and different stages of diabetic nephropathy, and identify probable factors predicting serum NT-proBNP level. Subjects and methods: This cross-sectional study included 20 normoalbuminuric (Group-I), 28 microalbuminuric (Group-II), 20 macroalbuminuric type 2 diabetic patients (Group-III), and 20 healthy volunteers (Group-IV). Serum NT-proBNP levels were measured with highly sensitive and specific immunoassay. Results: Mean NT-proBNP levels were 32 +/- 55, 91 +/- 95, 331 +/- 297, 42 +/- 34 pg/ml for Groups I-IV, respectively. When patients with LVH were excluded, mean logNT-proBNP was still significantly higher in Group-III than all other groups. The three diabetic groups were similar in age, BMI, HbA1c, fasting serum glucose, and GFR. In a multivariate linear regression model, adjusting for factors significantly correlated with NT-proBNP levels, the patient group, presence of LVH, and hemoglobin remained as an independent predictor of serum NT-proBNP. These variables explained 68% of the variability of NT-proBNP (adjusted R-2 = 0.683). Conclusions: Mean serum NT-proBNP level of macroalbuminuric diabetic patients was higher than normoalbuminuric and microalbuminuric diabetic patients, and healthy control subjects even after exclusion of LVH. NT-proBNP may be a useful and predictive marker of diabetic nephropathy. (C) 2011 Elsevier Ireland Ltd. All rights reserved.Öğe Rhabdomyolysis-Induced Acute Renal Failure Following Fenofibrate Therapy: A Case Report and Literature Review(Hindawi Ltd, 2010) Danis, Ramazan; Akbulut, Sami; Ozmen, Sehmus; Arikan, SenayFenofibrate, a fibric acid derivative, is used to treat diabetic dyslipidemia, hypertriglyceridemia, and combined hyperlipidemia, administered alone or in combination with statins. Rhabdomyolysis is defined as a pathological condition involving skeletalmuscle cell damage leading to the release of toxic intracellular material into circulation. Its major causes include muscle compression or overexertion; trauma; ischemia; toxins; cocaine, alcohol, and drug use; metabolic disorders; infections. However, rhabdomyolysis associated with fenofibrate is extremely rare. Herein we report a 45-year-old female patient who was referred to our department because of generalizedmuscle pain, fatigue, weakness, and oliguria over the preceding 3 weeks. On the basis of the pathogenesis and clinical and laboratory examinations, a diagnosis of acute renal failure secondary to fenofibrate-induced rhabdomyolysis wasmade. Weekly followups for patients who are administered fenofibrate are the most important way to prevent possible complications.Öğe Serum resistin and adiponectin levels in young non-obese women with polycystic ovary syndrome(Taylor & Francis Ltd, 2010) Arikan, Senay; Bahceci, Mithat; Tuzcu, Alpaslan; Kale, Ebru; Gokalp, DenizSubjects and methods. Newly diagnosed 31 young non-obese women with PCOS (mean age 21.8 +/- 5.4 years; body mass index (BMI): 23.8 +/- 6.6 kg/mÖğe Serum tumour necrosis factor-alpha and interleukin-8 levels in acromegalic patients: acromegaly may be associated with moderate inflammation(Wiley-Blackwell Publishing, Inc, 2009) Arikan, Senay; Bahceci, Mithat; Tuzcu, Alpaslan; Gokalp, Deniz[Abstract Not Available]Öğe Sheehan's syndrome and its impact on bone mineral density(Informa Healthcare, 2009) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Arikan, Senay; Ozmen, Cihan Akgul; Cil, TimucinIntroduction. Although there have been few studies investigating osteoporosis in isolated hormone deficiencies or other causes of hypopituitarism, the relationship between Sheehan's syndrome (SS) and osteoporosis has not been investigated. In the present study, we aimed to evaluate bone mineral density (BMD) in patients with SS in comparison with healthy women. Methods. Sixty-one patients with SS and 62 matched healthy controls were included. Biochemical, hormonal assessments and BMD evaluations were carried out in patients and controls, and a subgroup analysis according to menopausal status was done (premenopausal < 50 years; postmenopausal > 50 years). Results. The mean levels of serum anterior pituitary hormones were significantly lower in pre- and postmenopausal patients with SS compared with respective control groups (p < 0.0001). For both pre- and postmenopausal subjects, compared with respective controls, serum calcium and ALP levels, femur-T score, femur-Z score, spine (L1-L5)-T score, spine (L1-L5)-Z score and BMD values were lower, and phosphorus and parathyroid hormone (PTH) levels were higher in patients with SS. Conclusions. Patients with SS had low BMD. The possible mechanism responsible for osteoporosis may be hypogonadism, growth hormone deficiency and disorders of parathyroid hormone and calcium metabolism. But the contribution of each anterior pituitary hormone deficiency on bone loss should be clarified in further prospective studies.
