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    Association of clinical and laboratory parameters with ambulatory arterial stiffness index in acromegaly patients
    (Professional Medical Publications, 2018) Kilinc, Faruk; Pekkolay, Zafer; Demircan, Fatih; Gozel, Nevzat; Tuzcu, Alpaslan Kemal
    Objective: In this study, we determined the relationship between the ambulatory arterial stiffness index (AASI) and clinical and laboratory parameters in patients with acromegaly. Methods: Sixty-five patients with acromegaly, who visited to Dicle University Medical Faculty Department of Endocrinology (33 females and 32 males), were included in this study. The study control group consisted of 65 subjects. Demographic and clinical data were recorded. Laboratory data (complete blood count, blood urea nitrogen, creatinine, electrolytes, albumin, lipid profile, growth hormone [GH], insulin-like growth factor-1, and the 75-g oral glucose tolerance test) performed over the last year were evaluated. The AASI was obtained from 24-hour ambulatory blood pressure monitoring records of all patients. This study was completed in 15 months from 2013 to 2015. Results: Twelve patients (18.4%) had diabetes and 21 patients (32%) had hypertension. The mean AASI value was 0.41 +/- 0.14. The mean AASI value in the control group was 0.25 +/- 0.09. Growth hormone (GH) levels were positively correlated with the AASI values. AASI values tended to be higher in hypertensive subjects than that in normotensive individuals. Conclusions: Our results show that the AASI value increased in patients with acromegaly, independent of the increase in blood pressure. The AASI was strongly dependent on the degree of the GH increase in patients with acromegaly and may have an important role predicting cardiovascular risk in patients with acromegaly.
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    Elevated neutrophil-to-lymphocyte ratio in the diagnosis of subacute thyroiditis
    (Mattioli 1885, 2018) Kilinc, Faruk; Ergun, Yakup; Pekkolay, Zafer; Tuzcu, Sadiye Altun; Gozel, Nevzat; Tuna, Mazhar Muslum; Tuzcu, Alpaslan Kemal
    Subacute thyroiditis (SAT) is a self-limiting inflammatory condition of the thyroid gland in which multinucleated giant cells constitute a key histological finding. The neutrophil-lymphocyte ratio (NLR), determined from peripheral blood, is accepted as an available and practical indicator of the systemic inflammation. The purpose of this study was to determine the neutrophil-to-lymphocyte ratio (NLR), a novel marker of inflammation, in patients with SAT and to compare these values with those from healthy subjects. A total of 150 participants were included in the study, 75 SAT patients and 75 healthy volunteers. Retrospectively, demographic and laboratory data of the subjects were obtained from our institution's database. Patients with active infection, diabetes mellitus, malignancy, other chronic inflammatory diseases and hematologic disorders were excluded from the study. Values for complete blood count (CBC) and serum laboratory parameters of SAT patients were the baseline values obtained at the time of SAT diagnosis. Control subjects consisted of healthy volunteers who visited our institution for a routine check-up. A total of 75 subacute thyroiditis patients 54 (72%) were female and 21 (28%) were males and 50 (66.6%) were female and 25 (33.3%) were male and 75 were healthy adults were included. The mean age was 39.95 +/- 14.2, years for patients with SAT and 37.53 +/- 13.45 years for the control group. There was no significant difference between the age for groups (P = 0.13). NLR levels were found to be 3,56 +/- 2,64 in patients with SAT; NLR levels were found to be 1.41 +/- 0.9 in the control group. NLR levels were significantly higher in patients with SAT compared to the control group. Our study showed that increased NLR may be useful as an indicator of the presence of SAT, especially in complicated cases. The assessment of neutrophil-lymphocyte ratio in conjunction with radiological and clinical findings will assist in the achievement of an accurate diagnosis. Larger, prospective studies are required to determine its usefulness in assessing diagnostic potential and treatment outcomes in SAT patients.
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    The Evaluation of Mean Platelet Volume in Hepatitis C Infection
    (Galenos Yayincilik, 2014) Demircan, Fatih; Kilinc, Faruk; Gozel, Nevzat; Erkalma Senates, Banu; Senates, Ebubekir
    Objective: Mean platelet volume (MPV) is a simple test that can be detected by routine blood counts and is considered a risk factor for atherothrombosis. In our study, we aimed to compare platelet count and mean platelet volume of patients with diagnosis of hepatitis C with healthy patients groups. Materials and Methods: In this study, blood test results, age and gender of 107 HCV patients and 100 healthy individuals who admitted to our internal medicine polyclinic between January 2010 and August 2013 were evaluated retrospectively. Patient information was obtained from hospital records. Serum platelet counts, MPV, total cholesterol, triglycerides, LDL cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) levels were recorded. Results: Of the 107 patients diagnosed with HCV, 55 (51.4%) were males and 52 (48.6%) were females and the mean age was 45.0 +/- 11.0 years (range 23-66). In the control group, 51 patients were males and 49 were females, the mean age was 43.9 +/- 12.0 years (range 17-67). The mean ALT and AST levels of the patients with HCV were 58.8 +/- 76.0 IU/L (12-401) and 79.7 +/- 124.6 IU/L (14-670), respectively; in the control group it was 31.6 +/- 12 IU/L (15-82) and 33.1 +/- 10 IU/L (15-78), respectively and the difference between the groups was significant (p<0.001). The mean triglyceride level was significantly higher in the HCV group (205.5 +/- 53.3 mg/dL) than that in the control group (185.5 +/- 34.4 mg/dL) (p<0.001). The mean platelet count was 152.2 +/- 53.8 x 10(3)/mm(3) in patients with HCV infection and it was 190.7 +/- 66.8 x 10(3)/mm(3) in the control group; the difference between the groups was significant (p<0.001). The mean MPV was 9.1 +/- 1.7 fL in HCV group and 7.4 +/- 1.0 fL in the healthy group, and the difference was statistically significant (p<0.001). Conclusion: In conclusion, according to our study; significant elevation in MPV level in patients with HCV infection may be responsible for the effect of the virus that leads to platelet dysfunction. This condition supports the relationship between the existence of HCV infection and the risk of atherothrombosis.
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    The Impact of Red Blood Cell Distribution Width and Neutrophil/Lymphocyte Ratio on the Diagnosis of Major Depressive Disorder
    (Springer London Ltd, 2016) Demircan, Fatih; Gozel, Nevzat; Kilinc, Faruk; Ulu, Ramazan; Atmaca, Murat
    Introduction: Major depressive disorder (MDD) is an important risk factor for cardiovascular mortality and morbidity. Red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) can be obtained with a basic hemogram test. These parameters have been found as a predictor of mortality in the general population and in several diseases such as cardiovascular disease. Methods: Our study included 100 patients with newly diagnosed MDD and 100 healthy control patients (who had no depressive symptoms and without heart disease) admitted to our outpatient clinics. Patients with MDD were started on selective serotonin reuptake inhibitor (SSRI) treatment and followed up for 3 months. Both MDD and control patients' laboratory tests and physical, neurological, and psychiatric examinations were performed both at diagnosis and after 3 months of treatment. Results: In total, 100 patients with MDD were evaluated and 80 were included in our study. The control group consisted of 91 healthy individuals. The mean age was 44 +/- 10.6 years for patients with MDD and 39.8 +/- 11.4 years for the control group. There was no significant difference between the age for groups (P = 0.13); 55% of patients with MDD and 33% of the control group was male. NLR levels were found to be 2.55 +/- 0.7 and RDW levels were found to be 14.3 +/- 2.6 in patients with MDD; NLR levels were found to be 1.41 +/- 0.8 and RDW levels were found to be 13.4 +/- 1.8 in the control group. RDW and NLR levels were significantly higher in patients with MDD compared to the control group. The significant difference between the levels of RDW and NLR in patients with MDD and the control group was dissolved after SSRI treatment (P < 0.001). RDW [ median 14.3, interquartile range (IQR) 2.8 vs. median 13.25, IQR 2.45; P < 0.001] and NLR (median 2.3, IQR 1.1 vs. median 2.0, IQR 1.15; P < 0.001) levels were significantly higher in patients with MDD compared to the control group. Conclusion: Our study showed that hematological inflammatory markers might be useful parameters that can be used in patients with MDD for coronary artery disease risk. Specifically, RDW and NLR seem to be more hopeful. Advanced, detailed, and larger studies are needed.
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    The incidence rate of hepatosteatose in virus carriers with inactive Hepatitis B
    (Science & Innovation, Ltd, 2014) Demircan, Fatih; Gozel, Nevzat; Denk, Affan; Kilinc, Faruk
    Objective - The aim of this study is to examine the data retrospectively from patients with inactive HBV whose livers were evaluated by ultrasonography and to investigate hepatosteatosis as well as related parameters in this patient group. Material and Methods - In our study, the data of 134 patients, who have applied to the Internal Disease Polyclinic of Elazig cagn Private Medical Center between January 2010 and August 2013 being diagnosed as carriers for inactive HBV and then performed abdominal ultrasonography, were evaluated retrospectively. Information for each patient was accessed by means of both the internal disease polyclinic in our hospital and patient epicrisis reports. The observed levels of plasma trigliserides, LDL cholesterol, AST, ALT, GGT, and ALP were all recorded. Findings - Out of 134 subjects, 72 were male while 62 were female accounting for 54% and 46%, respectively. The mean age of the patients were found to be 44.8 +/- 10.6 years old. Hepatosteatosis was found in 92 patients accounting for 68.7 %. The mean of age in some patients diagnosed with steatosis was found 50.1 +/- 7.6 years, while the others without steatosis was 33.2 +/- 6.0 years suggesting a significant difference compared to the former (p = 0.001). Furthermore, a consistency in difference was also found between these two groups with and without hepatosteatosis in terms of average triglyceride levels (p = 0.001). The mean GGT levels were consistently higher in the group with hepotosteatosis (p = 0.004). No significant difference was found between these two groups regarding their mean cholesterol levels of AST, ALT, ALP, and LDL. Conclusion - In patients with asymptomatically HBV infection, an increased risk for hepatosteatosis comes along with an increased levels of plasma triglycerides and GGT in the course of aging.
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    Increased Serum Sclerostin Levels in Patients With Active Acromegaly
    (Endocrine Soc, 2020) Pekkolay, Zafer; Kilinc, Faruk; Gozel, Nevzat; Onalan, Ebru; Tuzcu, Alpaslan Kemal
    Context: Bone mineral density is normal in acromegalic patients and the cause of increased fracture risk that characterizes active acromegaly is unknown. Objective: This study compared serum sclerostin levels between patients with active acromegaly and healthy individuals. Design, Setting, and Participants: The serum sclerostin levels of patients with active acromegaly were compared with those of healthy volunteers in a cross-sectional study. The mean age of the 30 acromegaly patients (male/female: 14/16) was 47.26 +/- 12.52 years (range, 18-64 years) and that of the healthy volunteers (male/female: 17/13) was 44.56 +/- 10.74 years (range, 19-62 years). IGF-1 and GH levels were measured using an electrochemiluminescence method, and serum sclerostin levels using an ELISA. The Mann-Whitney U test was used to compare sclerostin levels between the 2 groups. The correlations of sclerostin level with IGF-1 and GH were determined using Spearman's test. Results: The 2 groups did not differ in age or sex (P > 0.05). The median GH and IGF-1 levels in the patient group were 2.49 ng/mL (range, 0.22-70.00 ng/mL) (interquartile range [IQR], 1.3-4.52) and 338.5 ng/mL (range, 147-911 ng/mL) (IQR, 250-426), respectively. The median GH and IGF-1 levels in the control group were 0.95 ng/mL (range, 0.3-2.3) and 144 ng/mL (range, 98-198), respectively. The median sclerostin level was 29.95 ng/mL (range, 7.5-78.1 ng/mL) (IQR, 14.37-37.47) in the acromegaly group and 22.44 ng/mL (range, 8.45-36.44 ng/mL) (IQR, 13.71-27.52) in the control group (P < 0.05). There was a moderate positive correlation between the sclerostin and IGF-1 levels (rho = 0.54; P < 0.01), and between the sclerostin and GH levels (rho = 0.41; P < 0.05). Conclusions: High sclerostin levels may contribute to the increased fracture risk seen in patients with acromegaly.