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Öğe Biochemical parameters and Helicobacter pylori seropositivity of patients with cerebral infarct(Saudi Med J, 2005) Turgut, C; Aluclu, MU; Hamdanoglu, D; Kale, E; Bahceci, M[Abstract Not Available]Öğe The comparison of insulin sensitivity in non-diabetic hemodialysis patients treated with and without recombinant human erythropoietin(Georg Thieme Verlag Kg, 2004) Tuzcu, A; Bahceci, M; Yilmaz, E; Bahceci, S; Tuzcu, SBackground: Patients with end-stage renal disease (ESRD) are known to have insulin resistance. Treatment with EPO is associated with improvement in insulin sensitivity in uremic patients. The aim of this study was to compare insulin sensitivity and pancreatic B cell function in adult non-diabetic uremic hemodialysis patients treated with or without rHuEPO. Subjects and Methods: Three groups of subjects were included to the study: hemodialysis patients treated with rHuEPO [EPO(+) group] or without rHuEPO [EPO(-) group], and healthy controls. Anthropometrical parameters, lipid levels, fasting glucose and insulin levels were measured in all subjects. Homeostasis Model Assessment (HOMA) was used to compare insulin sensitivity. ANOVA, independent t-test, and Pearson correlation were used for statistical analysis. Results: Mean insulin level of control group (20.04 +/- 7.2 pmol/l) was significantly lower than EPO(+) group (p<0.04) and EPO(-) group (p<0.0001). HOMA-(%B) levels in the EPO(+) group were significantly lower than in the EPO(-) group (106 +/- 42, 140 +/- 63 respectively, p<0.02). HOMA(%B) levels in the control group (66 17) were significantly lower than in the EPO(+) and EPO(-) group (p<0.005 an p<0. respectively). HOMA-(%S) levels in the EPO(+) groups was significantly higher than in the EPO(-) group (91 +/- 40, 56 +/- 26, respectively; p<0.01). HOMA-(%S) levels of control group (125 +/- 24) was significantly higher than EPO(+) and EPO(-) groups (p<0.02, p<0.0001 respectively). We found a positive correlation between duration of erythropoietin treatment and insulin sensitivity (r = 0.484, p<0.002). Conclusions: Firstly, patients treated with EPO are insulin sensitive compared to patients not treated with EPO. Secondly, duration of erythropoietin treatment is positively correlated with insulin sensitivity in hemodialysis patients.Öğe The determination of insulin sensitivity in hemodialysis and continuous ambulatory peritoneal dialysis in nondiabetic patients with end-stage renal disease(Saudi Med J, 2005) Tuzcu, A; Bahceci, M; Yilmaz, ME; Turgut, C; Kara, IHObjectives: To determine the beta-cell function and insulin sensitivity with homeostasis model assessment (HOMA) and area under curve (AUC) in nondiabetic uremic hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients cross sectionally. Methods: The study was performed between January to August 2001 in the Department of Nephrology, Dicle University School of Medicine, Diyarbakir, Turkey. Fifty-one HD patients, 45 CAPD patients, and 50 healthy control subjects were included in the study. Height, weight, waist and hip circumference, fat mass and percentage of body fat, and body mass index (BMI) were measured. The total high density lipoprotein (HDL) and low density lipoprotein (LDL)-cholesterol, triglyceride, urea, creatinine, insulin, potassium, parathyroid hormone (PTH) and 1,25 dihydroxycholecalciferol levels were measured. Oral glucose tolerance test (OGTT) was performed in the mid-week dialysis-free interval in HD patients, whereas after at least a night without dialysis exchanges in CAPD group. Area under curve both of insulin and glucose were calculated. The HOMA [insulin sensitivity (%S)] and AUC were used as indices of tissue insulin sensitivity. Results: The LDL-cholesterol levels of patients with CAPD was higher than the HD group (p<0.001) and control group (p<0.0001). The baseline glucose levels of the 2 groups were not significantly different. Baseline insulin levels of CAPD group were higher than the HD group (p<0.001) and the control group (p<0.0001). Area under curve for glucose (AUCgluc) and insulin (AUCins) value of CAPD patients were higher than the HD patients than the control group (p<0.0001). The HOMA [beta-cell function (%B)] values of CAPD group were higher than both HD (p<0.02) and control Group (p<0.04). The HOMA [insulin sensitivity (%S)] levels of CAPD group was significantly lower than the HD patients (p<0.002) and the control group (p<0.001). Conclusions: The CAPD treatment may lead to insulin insensitivity in non-diabetic end-stage renal disease patients and the high glucose content of CAPD Solutions may be responsible for insulin resistance in CAPD patients.Öğe Insulin sensitivity and hyperprolactinemia(Editrice Kurtis S R L, 2003) Tuzcu, A; Bahceci, M; Dursun, M; Turgut, C; Bahceci, SIt has been shown that prolactin (PRL) induces glucose intolerance, hyperinsulinemia and insulin resistance in several animal species. In women with microprolactinomas, the sensitivity to insulin is lower in hyperprolactinemia than in normoprolactinemia. Thirty non-obese women with hyperprolactinemia and 30 healthy non-obese women were included into the study. Age, body weight (bw), height, body mass index (BMI), waist circumference, hip circumference and waist to hip ratio of both patients with hyperprolactinemia and control subjects were not different. Mean serum prolactin level was higher in hyperprolactinemic patients than in control group (84.5 +/- 51.1 ng/ml and 13.8 +/- 5.3 ng/ml respectively, p<0.002). Mean HOMA-(%B) index of hyperprolactinemic patients was higher than in control subjects (121 +/- 49 and 84 +/- 38, respectively, p<0.02). Mean HOMA-(%S) index was lower in hyperprolactinemic patients (56 39 and 105 55, respectively, p<0.006). Serum total testosterone, free testosterone, androstenedione, estradiol, cortisol, sex hormone binding globulin and DHEA-S levels in both hyperprolactinemic women and healthy subjects, statistically did not show any difference between the two groups. The present data indicate that hyperprolactinemia is associated with an insulin-resistant state. This resistant state may not be a result of obesity, androgenic hormones, and SHBG or pregnancy. It may be the result of serum free fatty acids (FFA) levels, decrement in the number of insulin receptors (by a down-regulation of insulin receptors) or post-binding defect in insulin action or more. (C) 2003, Eclitrice Kurtis.Öğe Is demodex folliculorum larger in diabetic patients?(European Acad Dermatology & Venereology, 2002) Akdeniz, S; Bahceci, M; Tuzcu, AK; Harman, M; Alp, S; Bahceci, S[Abstract Not Available]Öğe Is hyperprolactinemia associated with insulin resistance in non-obese patients with polycystic ovary syndrome?(Editrice Kurtis S R L, 2003) Bahceci, M; Tuzcu, A; Bahceci, S; Tuzcu, SInsulin resistance is common in polycystic ovary syndrome (PCOS). Moderate elevations in serum PRL concentration may contribute to insulin resistance in PCOS. The aim of this study was to determine PRL on development of insulin resistance in non-obese hyperprolactinemic patients with PCOS. Ninety-eight non-obese subjects with PCOS and 100 non-obese healthy control were accepted in the study. Serum glucose, lipids, androgens, free androgen index (FAI), gonadotropins, fat mass and percentage, SHBG, and insulin levels were measured. Homeostasis model assessment (HOMA) was used as index of pancreatic beta-cell function and tissue insulin sensitivity. Independent t-test was used in comparison of results. In patients with PCOS, FAI and mean HOMA-(%B) level were higher than in the control group (p<0.0001), whereas mean HOMA-(%S) in subjects with PCOS was lower than in the control group (p<0.0001). Patients with PCOS were divided into subgroups according to their serum prolactin level (<24 or greater than or equal to24 ng/ml). Although FAI was not different, mean insulin and HOMA-(%B) levels in hyperprolactinemic patients were higher than in normoprolactinemic subjects (p<0.001). HOMA-(%S) in hyperprolactinemic patients with PCOS was lower than in normoprolactinemic patients (p<0.002). In conclusion, PCOS is associated with insulin resistance; non-obese hyperprolactinemic PCOS patients may be more insulin-resistant than normoprolactinemics and there may be an association between hyperprolactinemia and insulin resistance in PCOS. (C) 2003, Editrice Kurtis.Öğe Is serum C-reactive protein concentration correlated with HbA1c and insulin resistance in Type 2 diabetic men with or without coronary heart disease?(Springer, 2005) Bahceci, M; Tuzcu, A; Ogun, C; Canoruc, N; Iltimur, K; Aslan, CBackground and aims: C-reactive protein (CRP) is an inflammatory marker that predicts coronary heart disease (CHD) risk. Diabetes mellitus (DM) counts as a CHD risk equivalent. We aimed to compare serum high sensitivity CRIP (hs-CRP) levels in Type 2 diabetic (T2DM) men without CHD, non-diabetic CHD patients and T2DM patients with CHD. Subjects and methods: Four groups were formed; Group 1 [DM(+) CHD(-), no.=25], Group 2 [DM(-) CHD(+) no.=25], Group 3 [DM(+), CHD(+), no.=25], and Group 4 (controls, no.=30). Serum hs-CRP, insulin, glucose, total, HDL-, LDL- and VLDL-cholesterol, triglyceride levels and homeostasis model assessment for insulin resistance (HOMA-IR) index were determined. Results: Mean hs-CRP level of Group 1 (0.6 +/- 0.29) was not different statistically from Group 2 (1.44 +/- 0.97). Mean hs-CRP levels were higher in men with CHD, whether they were diabetic (Group 3; 3.83 +/- 2.01 mg/dl) or non-diabetic (Group 4), than in control subjects (0.16 +/- 0.15; p=0.0001 and p < 0.004, respectively). Mean hs-CRP level of Group 3 was also higher than Group 2 (p=0.0001). There was a positive correlation between serum hs-CRP and glycated hemoglobin (HbA(1c); r=0.277, p < 0.01), fasting insulin (r=0.336, p < 0.02) and HOMA-IR (r=0.348, p < 0.02) in T2DM men with or without CHD. Conclusions: T2DM men without CHD had similar CRP levels with non-diabetic CHD patients, whereas CRP levels of T2DM men with CHD were higher than non-diabetic men with CHD. Because of a positive correlation between serum hs-CRP and HbA(1c) fasting insulin and HOMA-IR, inflammation, insulin resistance and hyperglycemia jointly contribute to the cardiovascular risk in T2DM men. (c) 2005, Editrice Kurtis.Öğe Morphologic and functional alterations of the thyroid gland in rabbits treated with lithium(Georg Thieme Verlag, 1996) Aydin, I; Aslan, I; Bahceci, M; Aydin, M[Abstract Not Available]Öğe A novel missense mutation of 5-alpha reductase type 2 gene (SRD5A2) leads to severe male pseudohermaphroditism in a Turkish family(Elsevier Science Inc, 2005) Bahceci, M; Ersay, AR; Tuzcu, A; Hiort, O; Richter-Unruh, A; Gokalp, DObjectives. To analyze the steroid 5-alpha reductase type 2 gene (SRD5A2) in 2 siblings with severe male pseudohermaphroditism suspected to have 5-alpha reductase deficiency in a Turkish family. Methods. Two female siblings of a family with 7 children were referred to the urology department because of bilateral inguinal masses. The patients had presented after birth with ambiguous genitalia, but no further diagnostic procedures had been performed, and they were raised as girls until the ages of 13 and 15 years. At this time, both had striking ambiguity of the genitalia, with a clitoris-like phallus, severely bifid scrotum, pseudovaginal perineoscrotal hypospadias, a rudimentary prostate, and inguinal testes. Karyotype was 46,XY. Basal and stimulated levels of serum testosterone (T), dihydrotestosterone (DHT), and T/DHT ratio indicated 5-alpha reductase deficiency. Molecular genetic analysis was performed on deoxyribonucleic acid from peripheral blood leukocytes by single-stranded conformational polymorphism analysis and direct sequencing. Results. Analysis of the SRD5A2 gene revealed a new homozygous missense mutation in exon 2. At codon 123, we identified a GGA to AGA change resulting in a missense amino acid change from glycine to arginine (G123R). Both parents and the 2 healthy sisters and 3 brothers were all heterozygous at codon 123 for the same mutation. Conclusions. We report a novel homozygous missense mutation in exon 2 of the 5-alpha reductase type 2 gene that led to severe undervirilization in 2 siblings.Öğe Octreotide may be useful in diabetic foot ulcers with purulent discharge and deep penetrating sinuses(Bio Scientifica Ltd, 2005) Bahceci, M; Tuzcu, A; Gokalp, D; Akdeniz, S[Abstract Not Available]Öğe Polyglandular autoimmune syndrome type III accompanied by common variable immunodeficiency(Parthenon Publishing Group, 2004) Bahceci, M; Tuzcu, A; Pasa, S; Ayyildiz, O; Tuzcu, SWe identified polyglandular autoimmune (PGA) syndrome type III in a 24-year-old nurse with common variable immunodeficiency (CVID). An immune-mediated disorder, membranoproliferative glomerulonephritis, was diagnosed when she was 15 years old. Clinical examination and laboratory findings revealed a PGA syndrome due to the presence of hypergonadotropic hypogonadism, insufficient growth hormone response and thyroid autoimmunity. The patient had neither adrenal disease nor hypoparathyroidism. Therefore we concluded that this patient has PGA syndrome type III. This is an interesting case, because we could not find any previous report Of such coexistence between PGA type III and CVID in a Medline search. Coexistence of these two entities may be a result of autoimmunity and the association of both conditions with human leukocyte antigen.Öğe Serious clopidogrel associated renal hematoma in a type 2 diabetic patient with primary hyperparathyroidism after extracorporeal shock wave lithotripsy(Saudi Med J, 2005) Bahceci, M; Tuzcu, A; Akay, F; Agil, C; Akay, HRenal hematoma after extracorporeal shock wave lithotripsy (SWL) is a rare complication. We report a case of a large renal hematoma following SWL that resulted in nephrectomy in a type 2 diabetic patient with primary hyperparathyroidism using clopidogrel due to coronary heart disease (CHD). Although it was claimed that preoperative use of clopidogrel was not associated with increased bleeding, all patients who are scheduled for SWL should be interrogated in terms of using of platelet aggregation inhibitors such as clopidogrel, and these drugs should be interrupted appropriately before undergoing SWL.Öğe Serum C-reactive protein (CRP) levels and insulin resistance in non-obese women with polycystic ovarian syndrome, and effect of bicalutamide on hirsutism, CRP levels and insulin resistance(Karger, 2004) Bahceci, M; Tuzcu, A; Canoruc, N; Tuzun, Y; Kidir, V; Aslan, CBackground/Aims: Insulin resistance is associated with serum C-reactive protein (CRP) levels. We aimed to evaluate the effect of bicalutamide on insulin resistance and serum CRP levels in non-obese polycystic ovarian syndrome (PCOS) patients. Methods: 40 non-obese patients (BMI less than or equal to25 kg/m(2)) with PCOS and, 40 age- and BMI-matched healthy women were studied. Patients received bicalutamide orally at the dose of 25 mg/day. Serum CRP levels were measured with immunometric assay. Homeostasis model assessment (HOMA-IR) index was used for insulin resistance. Results: Mean Ferriman-Gallwey score (FGS) (p = 0.001), insulin (p = 0.001), serum glucose (p = 0.001), prolactin (p < 0.003), total (p < 0.04) and free testosterone (p = 0.001) and free androgen index (FAI) levels (p = 0.001) of PCOS subjects were higher than in the control group. Mean HOMA-IR of PCOS patients was higher than in control subjects (2.43 +/- 1.2 and 0.94 +/- 0.37, p = 0.001). CRP levels in subjects with PCOS was also higher than in control subjects (4.27 +/- 1.33 and 0.98 +/- 0.19, p = 0.001). After bicalutamide treatment, FGS, free and total testosterone and FAI decreased (p = 0.001). HOMA-IR, prolactin and CRP levels did not show any statistical difference with bicalutamide treatment. Conclusions: PCOS patients had insulin resistance and a high CRP level. Bicalutamide treatment did not influence insulin resistance and CRP level in PCOS, and this ineffectiveness of bicalutamide on CRP levels may be the result of insulin resistance and/or high prolactin levels at this time. Copyright (C) 2004 S. Karger AG, Basel.Öğe Serum prolactin levels in patients with head trauma and effect of octreotide on prolactin secretion(Bio Scientifica Ltd, 2005) Bahceci, M; Ozbay, A; Yildirim, M[Abstract Not Available]Öğe Serum prostate specific antigen levels in women with polycystic ovary syndrome and the effect of flutamide plus desogestrel/ethinyl estradiol combination(Editrice Kurtis S R L, 2004) Bahceci, M; Bilge, M; Tuzcu, A; Tuzcu, S; Bahceci, SBackground: Prostate-specific antigen (PSA) is expressed in many female tissues and its concentrations were higher in hirsute subjects. We aimed to determine serum PSA level in hirsute women and evaluate the effect of flutamide+ desogestrel/ethynil estradiol combination. Subjects and study design: Thirty patients with polycystic ovary syndrome (PCOS) and 30 healthy controls were studied. Hirsutism was defined by modified Ferriman-Gallwey score (FGS). Free androgen index (FAI) was used for hyperandrogenism. Patients received flutamide (500 mg/d) and oral contraceptive (desogestrel+ethinyl estradiol) for 9 months. Results: Mean FGS (p<0.0001), insulin (p<0.01), FAI (0.0001), androstenedione (p<0.0001), LH (p<0.05), and free testosterone (p<0.003) levels of patients with PCOS were higher than the control group. Mean serum total and free PSA level of PCOS patients were higher than the control group (p<0.0001 and p<0.0001). We found a positive correlation between total PSA levels and FGS (r=0.568, p<0.001), FAI and FGS (r=0.456 and p<0.01). There was also a positive correlation between FAI and total PSA (r=0.503 and p<0.005). At the end of treatment, FGS, androstenedione, free and total testosterone, FAI, serum PSA and LH levels decreased significantly [serum total PSA was 0,0208 +/- 0,0178 ng/ml at baseline and 0,0061 +/- 0,0044 ng/ml after treatment (p<0.0001)]. Conclusions: 1. Serum prostate specific antigen level is higher in patients with PCOS; 2. There is a positive correlation among FGS, FAI and PSA levels; 3. Serum PSA levels decrease with antiandrogen treatment; 4. Serum PSA measurement might be a marker for hirsutism. (C) 2004, Editrice Kurtis.Öğe Subclinical hypothyroidism may be associated with elevated high-sensitive c-reactive protein (low grade inflammation) and fasting hyperinsulinemia(Japan Endocrine Society, 2005) Tuzcu, A; Bahceci, M; Gokalp, D; Tuzun, Y; Gunes, KThe association between coronary heart disease and subclinical hypothyroidism (SCH) is unclear. We aimed to determine hs-CRP concentrations in patients with SCH. Seventy-seven patients (age 34.6 +/- 13.7 yr) with SCH (TSH >4.2 muIU/ml and serum free thyroxine level between 0.932-1.71 ng/dL), and 80 control subjects (age 33.9 +/- 13.3 yr) were studied. Thyroid hormones, C-reactive protein, insulin, glucose, total, HDL, LDL and VLDL-cholesterol levels and HOMA-IR index were also determined. TSH levels of SCH group were higher than control (7.4 +/- 2.9 and 1.55 +/- 0.78 muIU/ml, respectively, p=0.0001). However, FT4 levels were lower than control subjects (1.18 +/- 0.22 ng/dL and 1.38 +/- 0.26, respectively, p=0.001). Serum hs-CRP levels of subjects with SCH were higher than control subjects (4.2 +/- 0.8 mg/l and 1.05 +/- 0.3 mg/l respectively, p=0.0001). Insulin levels of SCH group were higher than control (8.5 +/- 4.3 muU/ml and 7.1 +/- 3.1 muU/ml respectively, p<0.02) but, Homa-IR levels of the two groups were not different. Mean total and LDL-cholesterol levels of SCH group were higher than control (p=0.01 and p<0.02). We also found a positive correlation between hs-CRP levels and insulin (r=0.362, p=0.002 in men, r=0.358, p=0.0001 in women), TSH (r=0.611, p=0.0001 in men, r=0.411 p=0.0001 in women), and prolactin (r=0.340, p=0.01 in men r=0.553, p=0.0001 in women). Conclusions: Patients with SCH, irrespective of gender, have higher serum hs-CRP, insulin, total and LDL-cholesterol levels than healthy subjects. 2-High hs-CRP level, and thereby low grade inflammation may be associated with fasting hyperinsulinemia before insulin resistance becomes evident in patients with SCH.
