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    Impaired endothelial function in patients with mild primary hyperparathyroidism improves after parathyroidectomy
    (Wiley, 2015) Tuna, Mazhar M.; Dogant, Bercem A.; Arduc, Ayse; Imga, Narin Nasiroglu; Tutuncu, Yasemin; Berker, Dilek; Guler, Serdar
    Background Primary hyperparathyroidism (PHPT) is associated with cardiovascular morbidity; however, data on the reversibility of cardiovascular disease in mild primary hyperparathyroidism are conflicting. The aim of this study was to assess endothelial function in patients with mild PHPT before and after parathyroidectomy (Ptx). Methods We prospectively evaluated 53 patients with mild PHPT (Group 1; 45 women, eight men; aged 52 +/- 3.1 years) and 46 healthy control subjects (Group 2; 38 women, eight men; aged 46 +/- 9.5 years). Endothelial function was measured as flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT) using Doppler ultrasonography. Patients with diabetes mellitus, coronary heart disease, impaired renal function, hyperthyroidism, hypothyroidism and a history of smoking were excluded from the study. Patients were studied at baseline and 6-12 months after the first evaluation. Results There were no differences with respect to age, gender and BMI between the two groups. Hypertension prevalence was three times higher in group 1 than in controls. % FMD was lower in group 1 than in group 2 (2.6 +/- 1.2 vs 14.8 +/- 9.6, P < 0.001). CIMT was higher in patients with PHPT than controls (0.69 +/- 0.18 vs 0.61 +/- 0.12, P = 0.045). This significance remained when hypertensive patients were excluded from the analysis. While FMD and CIMT improved significantly after Ptx, there were no differences in mild PHPT patients who followed without parathyroidectomy. Conclusion FMD and CIMT are impaired in patients with mild PHPT compared to controls and improved significantly after a successful Ptx. Ptx improves endothelial function in patients with mild PHPT that may lead to decreased cardiovascular morbidity and mortality.
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    Non-functioning adrenal incidentalomas are associated with higher hypertension prevalence and higher risk of atherosclerosis
    (Springer, 2014) Tuna, Mazhar Muslum; Imga, Narin Nasiroglu; Dogan, Bercem Aycicek; Yilmaz, Fatma Meric; Topcuoglu, Canan; Akbaba, Gulhan; Berker, Dilek
    Introduction Adrenal incidentalomas (AIs) have been associated with an increased incidence of several cardiovascular risk factors. The aim of this study was to investigate plasma adiponectin, leptin, resistin, homocysteine, high sensitive C-reactive protein levels, and carotid intima media thickness (CIMT) in patients with non-functioning AI (NFAI). Materials and methods This study included data from 28 patients with NFAI (Group 1) and 41 controls (Group 2). Of the patients, 50 were female and 19 were male, and the mean age was 46.7 (range 37-65) years. Results There were no significant differences between Group 1 and 2 in terms of age, sex, or BMI. Hypertension prevalence was significantly higher in the NFAI group than in the control group (p = 0.01). Both groups had similar lipid, blood glucose, homocysteine, uric acid, high-sensitivity CRP levels. Adiponectin, leptin, and resistin levels were similar in both groups. CIMTs were significantly higher in the NFAI group. Conclusion There is increasing evidence that several cardiometabolic risk factors occur with higher prevalence in non-functioning adrenal incidentaloma patients compared to age-matched healthy subjects. In our study, hypertension prevalence and CIMT were higher in the NFAI group. Serum adipokine levels were similar for both groups.
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    Thyrotoxic Hypokalemic Periodic Paralysis: A Case Report
    (2014) Karadeniz, Mine Karadeniz; Berker, Dilek; Karakılıç, Ersen; Tuna, Mazhar Müslüm; Işık, Serhat; Tütüncü, Yasemin; Imga, Narin Nasiroglu
    Hypokalemic periodic paralysis is a rare disorder characterized by reversible attacks of muscle weakness accompanied by episodic hypokalemia. The most common causes of hypokalemic periodic paralysis (HPP) are familial periodic paralysis, thyrotoxic periodic paralysis (TPP) and sporadic periodic paralysis, respectively. There are generally some precipitating factors such as stress, vigorous exercise and high carbohydrate food consumption which all ease the occurrence of attacks. The duration of attacks range from 2-36 hours and can be shortened by K+ supplementation in appropriate situations. 28 years old male, admitted to our clinic with severe weakness at his legs and arms, on laboratory examination severe hypocalemia due to overt thyrotoksicosis detected. After antithyroid drug therapy his symptoms and hypocalemia resolved. After three months of therapy he underwent total thyroidectomy because of incompliance to medical therapy. Rapid recognition and management of the disorder were the key factors to avoid fatal complications.