Yazar "Bahceci, Mithat" seçeneğine göre listele

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    An acromegalic patient with low Insulin-Like Growth Factor-1 levels: it may not be found to be elevated during diagnosis of acromegaly each time
    (2015) Bahceci, Mithat; Tuzcu, Alpaslan; Durmaz, Şenay Arıkan; Gökalp, Deniz; Ayağ, Hatice; Güzel, Aslan
    Akromegali tanısı aşırı GH ve Insulin-Like Growth Factor-1 (IGF-1) sekresyonunun gösterilmesine dayanır. IGF-1 akromegalinin aktivasyonunun en güvenilir göstergesidir. Bununla birlikte plazma IGF-1 düzeylerinin değişikliklerinin yorumlanmasında bazı tuzaklar vardır. Biz kötü kontrollü tip 2 diabetes mellitus ve malnütrisyon ile ilişkili olarak düşük IGF-1 ve artmış GH düzeyleri olan bir akromegalili olguyu sunmayı amaçladık.Otuzsekiz yaşındaki kadın hasta hiperglisemi, halsizlik, öksürük, dispne, yüksek ateş yakınmaları yüzünden acil servise baş vurdu. On yıldır ellerinde ve ayaklarında büyüme olmasından yakınmaktaydı ve uzun zamandır kaşektikti. OGTT sırasında serum growth hormon düzeyleri yaş ve cinsiyete göre olan normal sınırlardan yüksek bulundu. Fakat IGF 1 and IGFBP-3 normal referans aralığından düşük ölçüldü. Hipofizin manyetik rezonans görüntülemesinde 3x2.5 cm çaplı bir pituiter makroadenom saptandı. Sonuç olarak, artmış IGF-1 düzeyleri akromegali tanı ve aktivitesinde çok önemlidir, ancak tip 2 diyabetli akromegalilerde IGF-1' in dikkatli yorumlanması gereklidir
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    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, Ramazan
    Aim: 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.
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    Adult langerhans cell histiocytosis
    (Ortadogu Ad Pres & Publ Co, 2007) Cil, Timucin; Goekalp, Deniz; Tuzcu, Alparslan; Isikdogan, Abdurrahman; Bahceci, Mithat
    Langerhans cell histiocytosis is a group of idiopathic disorders characterized by the abnormal proliferation of specialized bone marrow-derived Langerhans cells. There are one to two cases per million population. Most reports are based only on anecdotal experience in adult patients. Surgical excision, radiotherapy and chemotherapy, either alone or in combination are the main treatment options. In this report, we present a rare case of Langerhans cell histiocytosis in a 32 years-old-woman who developed symptomatic diabetes insipidus and multiple bone and cranial metastases during the disease course. This paper discusses controversial treatment modalities.
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    Analysis of thrombophilic genetic mutations in patients with Sheehan's syndrome: is thrombophilia responsible for the pathogenesis of Sheehan's syndrome?
    (Springer, 2011) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Ayyildiz, Orhan; Yurt, Murat; Celik, Yusuf; Alpagat, Gulistan
    The gene mutations of Factor V R506Q (FV-Leiden), prothrombin (FII G20210A), methylene tetrahydrofolate reductase (MTHFR) C677T and A1298C and PAI-1 4G/5G are well-established risk factors for thrombosis. We aimed to investigate the prevalence of these gene mutations and their possible impact on the development of pathogenesis in patients with Sheehan's syndrome (SS). 40 female patients with SS compared to a control group of 45 healthy women. The presence of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G gene mutations were assessed by polymerase chain reaction analysis with a light cycler analyzer. An odds ratio of greater than one is considered to increase the risk of SS disease as found in Factor V Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G polymorphism, as follows respectively: 1.13, 1.85, 6.00, 8.14 and 1.45. MTHFR C677T and MTHFR A1298C polymorphism were found significantly higher in SS patients than the control group (P < 0.001), however FV-Leiden, FII G20210A and PAI-1 4G/5G polymorphism showed no significant difference (P > 0.05). The level of plasma total homocysteine (tHcy) was significantly higher in patients with SS than in the control group (P < 0.001). We suggest that the genetic mutations of FV-Leiden, FII G20210A, MTHFR C677T, MTHFR A1298C and PAI-1 4G/5G increase the risk of SS. Also, high plasma tHcy levels may be a risk factor for the development of SS.
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    Assessment of bleeding disorders in Sheehan's syndrome: Are bleeding disorders the underlying cause of Sheehan's syndrome??
    (Informa Healthcare, 2011) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Ayyildiz, Orhan; Erdemoglu, Mahmut; Alpagat, Gulistan
    Sheehan's syndrome (SS) is an adenopituitary insufficiency caused by hypovolemia secondary to excessive blood loss during or after childbirth. However, the mechanism of postpartum hemorrhage and ischemia is not clear. We aimed to evaluate the bleeding disorders among patients with SS, in comparison with healthy controls. In addition, we investigated underlying causes in postpartum hemorrhage that begin the event. The present study was conducted at the Dicle University School of Medicine. Forty-eight patients with SS and 50 age-matched female healthy controls were included. Biochemical and hormonal variables were measured, as was platelet function by means of closure times (PFA-100 testing using collagen plus epinephrine and collagen plus ADP), von Willebrand factor (vWF) level, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), and coagulation factors. Although PT and INR were significantly higher in patients with SS (both P < 0.01), aPTT and levels of fibrinogen, vWF, and factors II, V, VII, VIII, IX, X, XI, and XII did not differ significantly. Closure times with collagen/epinephrine and collagen/ADP also did not differ significantly between patients with SS and control patients. The nonspecific etiology and presence of excessive postpartum hemorrhage in patients with SS suggest that coagulation disorders may play a role in their predisposition to bleeding. The increased PT and INR noted might implicate bleeding diathesis as the underlying etiology, although no significant decreases were noted in factor levels. Further studies are needed to elucidate this complex mechanism of this disorder.
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    Belirgin diabetik nöropatisi olmayan diabetli çocuklarda işitme fonksiyonlarının değerlendirilmesi
    (1999) Meriç, Faruk; Akbulut, Nursel; Topçu, İsmail; Osma, Üstün; Cüreoğlu, Sebahattin; Bahceci, Mithat
    Bu çalışmada, Tip l diabetli hastalarda konvansiyonel odiometrik testlerle Beyinsapı Uyarılmış işitme Potansiyelleri (BUİP) kullanılarak işitme fonksiyonları araştırıldı. Hasta grubu diabet süreleri 3 ay ile 60 ay (ort. 12,4±16,98) arasında değişen 30 hastadan, kontrol grubu ise non-diabetik 30 olgudan oluşturuldu. HbA1c değerleri, diabet grubunda kontrol grubundan anlamlı derecede yüksek bulundu. Saf ses odiometrisi, timpanometri ve akustik refleks ölçüm sonuçları, hasta ve kontrol grubunda normaldi. BUİP'de II ve V. dalga mutlak latansları ile I-V interpik latansında kontrol grubuna göre anlamlı uzama saptandı. Diabetli hastalarda nöropati gelişmekte olduğunu göstermede klasik odiometrik tetkikler yetersiz kalmakta. BUİP ise oldukça yararlı bilgiler vermektedir. Bu nedenle, diabetik hastalarda gelişebilecek nöropati takibinde BUİP objektif bir test olarak gözükmektedir.
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    A Case with Lipoid Proteinosis Intersected with Diabetes Mellitus
    (Galenos Yayincilik, 2009) Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Yildirm, Muzeyyen; Akdeniz, Sedat; Ozekinci, Selver; Urakci, Zuhat
    Lipoid proteinosis (LP) is a rare disorder inherited as an autosomal recessive trait. LP is characterized by deposition of hyaline-like material in the skin, mucous membranes, and other tissues. LP has been mapped to chromosome 1q21, the locus for the extracellular matrix protein 1 (ECM1) gene. In this case report, we aimed to present a case with LP accompanied by diabetes mellitus, and to discuss the possible mechanisms of diabetes in LP. A 16-year-old girl presented to the endocrinology department with hyperglycemia. She reported a history of progressive hoarseness of her voice since she was two years old. Our patient meets the clinical and histopathological criteria for the diagnosis of LP. Her fasting glucose was 310 mg/dl. Plasma insulin and C-peptide levels were 5.1 uU/ml and 1.57 ng/ml, respectively. Hemoglobin A1c was 12.3%. HOMA-IR (Homeostasis Model Assessment-Insulin Resistance) ratio was 3.1 (normal range <3.7). Serum islet cell antibodies, anti-GAD antibodies and anti-insulin antibodies were negative. Diabetes mellitus was diagnosed and insulin treatment was initiated. In conclusion, possible mechanism of diabetes mellitus may be result of the diffuse deposition of amorphous material into the capillary vessels or in pancreas. The other possible mechanism responsible for the association of diabetes mellitus and insulin resistance in LP patients may be sharing a mutation at 1q21 locus. Future studies which aimed screening of insulin resistance and diabetes mellitus in LP patients may be helpful to explain this association.
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    Combined pituitary hormone deficiency due to gross deletions in the POU1F1 (PIT-1) and PROP1 genes
    (Nature Publishing Group, 2017) Bertko, Eleonore; Klammt, Juergen; Dusatkova, Petra; Bahceci, Mithat; Gonc, Nazli; ten Have, Louise; Kandemir, Nurgun
    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.
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    Diabetes mellitus in pregnancy and perinatal outcome
    (2000) Bayhan, Gökhan; Yalınkaya, Ahmet; Erden, Ali Ceylan; Yayla, Murat; Bahceci, Mithat
    [Abstract Not Available]
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    The effects of flutamide on lipid profile, insulin sensitivity, hirsutism and gonadotropins in women with polycystic ovary syndrome
    (1999) Ertem, Melikşah; Tuzcu, Alpaslan; Yükselen, Vahit; Bahceci, Mithat; Dursun, Mehmet
    In this study, we evaluated metabolic changes and the effects of flutamide in 22 women with PCOS. Flutamide was administered for a 6-month period in a dose of 750 mg/day. The basal and after treatment body mass index, waist: hip ratio, blood glucose, insulin, lipids, Ferriman-Gallwey scoring (FGS), gonadotropins, testosterone, trasaminazed and glucose: insulin (G:I) ratio were measured. For comparison, ANOVA was used. The sixth month mean FGS was significantly lower than the basal values (18.5±7.4 and 12.5±4.5, P<0.01). The mean basal G:I ratio was 3.31±1.12 and 6.21±2.53 at the sixth month. The sixth month G:I ratio was significantly higher (P<0.001). The total and LDL-cholesterol were decreased by flutamide (from 144±23 to 123±23 and from 88±32 to 60±25 mg/dl respectively. P<0.02 and P<0.01), whereas, the HDL-cholesterol level was increased with flutamide (from 44.8±3.9 to 46.5±3.2 mg/dl and P<0.001). LH (from 14.7±6.7 to 8.4±3 mlU/ml), LH/FSH ratio (from 3.4±1.7 to 1.9±0.6), total testosterone (from 0.87±0.29 to 0.61±0.18 ng/ml) and free testosterone (from 4.29±1.18 to 2.14±0.9 pg/ml) were decreased by flutamide (P<0.05). Thus, we reached three conclusions:1-Flutamide may improve insulin insensitivity. 2-In PCOS, flutamide decreases total and LDL-cholesterol, and increases HDL-cholesterol. 3-Flutamide may improve the LH/FSH ratio and induce a decrease in testosterone.
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    An Embryological Cause of Primer Hypothyroidism, Lingual Thyroid
    (Galenos Yayincilik, 2006) Arikan, Senay; Gokalp, Deniz; Tuzcu, Alpaslan; Bahceci, Mithat; Bahceci, Selen
    Lingual 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.
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    Evaluation of Bone Mineral Density in Terms of Veiling, Socioeconomiical Status and Educatiional Level in Turkish Women Over 40 Years. Veiling May Be A Risk Factor For Osteoporosis
    (Galenos Yayincilik, 2006) Bahceci, Mithat; Ertem, Meliksah; Saka, Gunay; Gokalp, Deniz; Karacomak, Zuhre; Akdeniz, Nurten; Tuzcu, Alpaslan
    Background and aims: Headscarf is a mild kind of veiling, worn for various intentions. We aimed to evaluate effect of veiling, educational status, living area and nutrition on BMD in women over 40 years. Subjects and methods: Four hundred thirty nine moslem women, living in different region (suburb and house provided to workers) of Diyarbakir, aged over 40 years (with mean age 48,9+ 11,3 years) were included to study. The predicted factors influencing BMD were investigated by using a questionnaire. Body weights and heights were measured. BMI was expressed as weight (kilograms) per height (meters) squared. Body fat percent and fat mass were determined by bioelectric impedance. Bone Mineral Density (BMD) was determined with radiographic absorptiometry (RA) in three middle fingers. Results: Living in suburban region (p=0.0001), family history of osteoporosis (p<0.002), low education level (p=0.0001), insufficient calcium intake (p<0.001), parity over 4 (p=0.0001), low body height (p=0.0001), veiling (p=0.0001) and low body weight (p< 0.002) and height (p=0.0001) and duration of menopause (p=0.0001) were the factors with negative effects on BMD. Prevalence of osteoporosis was also higher in illiterate women (p=0.0001), women living in slum (p=0.0001), veiled women (p=0.0001), insufficient nutritional status (p< 0.03) and positive family history for osteoporosis (p< 0.002). Conclusions: In addition to well known factors for osteoporosis such as living in slum, illiteracy, high parity number, insuficient nutrition, and duration of menopause; veiling may also be an important factor for low BMD. Veiled women should be screened for low BMD and osteoporosis regularly.
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    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, Deniz
    Objective: 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.)
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    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]
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    Four decades without diagnosis: Sheehan's syndrome, a retrospective analysis
    (Taylor & Francis Ltd, 2016) Gokalp, Deniz; Alpagat, Gulistan; Tuzcu, Alpaslan; Bahceci, Mithat; Tuzcu, Sadiye; Yakut, Fatime; Yildirim, Azad
    Aim: Sheehan's syndrome (SS) remains a frequent cause of hypopituitarism in undeveloped and developing countries, but due to improvements in obstetric care, it is rare in developed countries. We aimed to share the results of a retrospective study analyzing the demographic, clinical, imaging, and hormonal characteristics of a large group of patients with SS, and also increase awareness of this syndrome especially in developed countries. Methods: The medical records of 124 patients with SS patients who were followed up in the Endocrinology Department of Dicle University between 1995 and 2015 were assessed retrospectively. Results: The mean period of diagnostic delay was 20.37 +/- 8.34 years on average. 5.7% of patients with SS were literate; 62% of patients delivered at home. Anemia was identified in 64.5% of SS patients. Mean blood sodium levels were 129.8 +/- 11.3 mEq/L. The mean urine densities were 1013 +/- 6.5. Osteoporosis and osteopenia were found in 44 (35.4%) and 71 (57.2%) patients, respectively, According to pituitary magnetic resonance imaging (MRI) analyses, 92 (74.2%) patients with SS had completely empty sella, 29 (23.3%) had partially empty sella, and 1 patient had microadenoma, and 2 had normal pituitary MRI results. Conclusions: Improved obstetric care and effective interventions for postpartum hemorrhage have limited the prevalence of SS in developed countries. However, in developing countries like Turkey, SS due to postpartum bleeding remains common. Thus, physician's awareness of the symptoms of SS is urgently required to avoid the associated morbidity and mortality.
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    Gonadektomi yapılan sıçanlarda lipid parametre değişimleri
    (1997) Aydın, Mutay; Çolpan, Leyla; Aydın, İsmet; Aslan, İbrahim; Bahceci, Mithat
    Bu çalışmada 8 erkek, 8 dişi toplam 16 gonadektomi-li Spraque-Dawley yetişkin sıçanda sex steroidlerinin serum lipid düzeylerine etkisi araştırıldı. Tüm hayvan¬lar standart pellet yemle beslendi. Gonedektomiden 60 gün sonra sıçanların kalplerinden kan örnekleri alındı. Alınan kan örneklerinde serum total kolesterol, trigliserid, HDL kolesterol, LDL kolesterol, apolipop-rotein A1 ve apolipoprotein B düzeyleri ölçüldü. P<0.05 değerleri istatistiksel ölçüde anlamlı kabul edildi. Kontrol grubuyla karşılaştırıldığında, total ko¬lesterol, trigliserid ve trigliseridÂotal kolesterol oranı gonadektomi yapılan dişi sıçanlarda yüksek bulundu (p < 0.001). Gonedektomili erkek örneklerde kan lipid düzeylerinde kontrol grubuna bakışla anlamlı fark saptanmadı. Apolipoprotein düzeyleri kontrol grubu¬na göre gonadektomi yapılan her iki cinste de anlamlı değişme göstermedi. Bu verilere göre; 1) Östrojen yetersizliği plazma lipid düzeylerini arttırmakta, bunun aksine androjen lipid değerlerinde anlamlı fark oluşturmamaktadır. 2) Androjen ve östrojenlerin her ikisininde gonadektomi-nin erken döneminde serum apolipoprotein konsant¬rasyonlarını değiştirici etkileri yoktur.3) Kan damarlarının morfolojik değerlendirilmesi aterosklero-tik gelişmede daha ileri bilgi için gereklidir. Anahtar Kelimeler: Gonadektomi, Sex Hormonu, Total Kolesterol, Trigliserid, LDL, HDL, Apolipoprotein A1, Apolipoprotein B.
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    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, Ramazan
    Background 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.
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    Hyperthyroidism may be associated with hypoleptinemia in spite of insulin resistance
    (2015) Bahceci, Mithat; Tuzcu, Alpaslan; Karaahmetoğlu, Selma; Atay, Çiğdem; Gökalp, Deniz; Durmaz, Şenay Arıkan
    Amaç: Tiroid hormonlarının leptin üzerine etkisi tartışmalıdır. Biz hipertiroidili kadınlarda tedavi öncesi ve tedavi sonrası serum leptin düzeylerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Yeni tanı konulan 27 hipertiroidili kadın (yaş 35±10 yıl, vücut kitle indeksi (BMI) 26,21±5,44 kg/m²) ve yaş ve BMI'I benzer 30 sağlıklı kadın (yaş 36±10 yıl, BMI 25,48±6,97 kg/m²) çalışmaya alındı. BMI, vücut yağ kitlesi (FM) ve yağ yüzdesi (%F) belirlendi. Standart oral glukoz tolerans testi yapıldı ve insulin direncini belirlemek için glukozun eğri altında kalan alanı (AUCglu120) her kişi için hesaplandı. Serum leptin düzeyleri tedavi öncesi ve tedavi sonrası radioimmunoassay ile belirlendi. Bulgular: Hipertiroidili hastalarda serum leptin düzeyleri kontrol grubundan düşüktü (19,95±19,81 ve 35,90±22,73 ng/dl, p<0,01). Hipertiroidi grubunda hipertiroid koşullarda leptin düzeyleri de ötiroid durumdan daha düşüktü (19,95±19,81 ve 24,54±19,99 ng/dl, p=0,028). Hipertiroidi tedavisi ile serum leptin düzeyleri belirgin olarak artış gösterdi ve kontrol grubundan farksız hale geldi. Fakat antropometrik parametreler tedavi ile belirgin farklılık göstermedi. Hipertiroidili kadınlarda AUCglu120 değerleri kontrol grubundan yüksekti (165704±3276 ve 12567±2102 mg.dk/dl, p<0,001). Tedavi sonrasında hipertiroidili kadınlarda AUCglu120 değerleri azaldı ve kontrolden farksız hale geldi. Sonuçlar: Serum leptin düzeyleri hipertiroidili kadınlarda düşüktür ve hipertiroidinin tedavisi ile hipoleptinemi düzeltilebilir. Hipertiroidide düşük serum leptin düzeyleri vücut yağı ve BMI ile açıklanamaz. Daha da önemlisi hipertiroidide glukoz dağılımı bozulabilir ve serum leptin düzeylerinden bağımsız olarak ötiroidizm ile iyileşebilir
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    İç hastalıkları polikliniğine başvuran asemptomatik kişilerde subklinik hipotiroidizm prevalansı ve subklinik hipotiroidili hastaların biyokimyasal, klinik ve antropometrik özellikleri
    (2004) Parmaksız, Yusuf; Bahceci, Mithat; Tuzcu, Alpaslan; Gökalp, Deniz
    Amaç: Bölgemizdeki subklinik hipotiroidili hastaların prevalansını saptamak ve subklinik hipotiroidi saptanan hastaların antropometrik ölçümleri, lipid parametreleri ile sağlıklı populasyonun aynı parametreleri arasında fark olup olmadığını ortaya koymak. Materyal Metod: Dicle Üniversitesi Tıp Fakültesi Hasta¬nesi genel dahiliye polikliniğine çeşitli sebeplerle başvuran yaşları 15 ile 78 arasında değişen 255 kişi çalışma kapsamına alındı. Hastaların boy, ağırlık,-BMI, tansiyon arteryel, nabız atım sayısı, bel ve kalça çevreleri saptandı. Açlık serum glikoz, total kolesterol, trigliserid, LDL-kolesterol, HDL-kolesterol, VLDL- kolesterol ve tiroid hormon düzeyleri (T4, T3, FT4, FT3, TSH) ölçüldü. Anti-tiroglobulin ve anti-tiroid peroksidaz antikorlarının pozitifliği immun fluorescans yöntemi ile belirlendi. Bu veriler sonucunda subklinik hipotiroidi prevalansı saptandı ayrıca subklinik hipotiroidi tanısı alan ve almayan hastaların parametereleri Mann-Whitney U testi ve Ki-kare testi ile karşılaştırıldı. Bulgular: Çalışma yapılan gruptaki subklinik hipotiroidi prevalansı % 5,1 olarak bulundu. TSH düzeyi subklinik hipotiroidili hastalarda anlamlı olarak yüksek bulundu (p < 0.0001). Subklinik hipotiroidili hastaların total T4 ve serbest T4 düzeyleri kontrol grubundan anlamlı olarak düşük saptandı (sırası ile p < 0.003, p < 0.03). Subklinik hipotiroidili hastalarda anti-TPO antikor pozitifliği anlamlı derecede yüksekti (p < 0.007). Subklinik hipotiroidi saptanan hastaların antropometrik ölçümleri, lipid parametreleri, kan basıncı ve nabız atım sayısı konrol grubundan istatistiksel olarak farklı bulunmadı. Sonuç olarak: 1-Hastaneye başvuran bireylerdeki Subklinik hipotiroidizm prevalansı % 5,1 civarındadır. 2-Subklinik, hipotiroidizm ile anti-TPO antikor pozitifliği arasında anlamlı bir, ilişki görülmüştür. Bu da subklinik hipotiroidizm gelişiminde otoimmunitenin önemini göstermektedir. 3-Subklinik.hipotiroidili hastalarda fiziksel, metapolik ve biyokimyasal değerler, normal kişilerden farklı değildir. Bu sebeple tiroid hormonu verilmesi zorunlu görülmemektedir.
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    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]