Browsing by Author "Altay, Canan"
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Item Determining residual adipose tissue characteristics with MRI in patients with various subtypes of lipodystrophy(Türk Radyoloji Derneği, 2017-05-29) Altay, Canan; Seçil, Mustafa; Demir, Tevfik; Atik, Tahir; Akıncı, Gülçin; Kutbay, Nilüfer Özdemir; Temeloğlu, Ela Keskin; Şimşir, Ilgin Yıldırım; Özışık, Seçil; Demir, Leyla; Tuna, Emine Burçin; Aytaç, Hasibe; Onay, Hüseyin; Akıncı, Barış; Eren, Erdal; Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Endokrinoloji Anabilim Dalı.; 0000-0002-1684-1053; AAM-1734-2020; AAH-1155-2021; 36113153400PURPOSE We aimed to investigate residual adipose tissue with whole-body magnetic resonance imaging to differentiate between subtypes of lipodystrophy. METHODS A total of 32 patients 12 with congenital generalized lipodystrophy [CGL], 1 with acquired generalized lipodystrophy [AGL], 12 with familial partial lipodystrophy [FPLD], and 7 with acquired partial lipodystrophy [APL]) were included. RESULTS Despite generalized loss of metabolically active adipose tissue, patients with CGL1 caused by AGPAT2 mutations had a significant amount of residual adipose tissue in the scalp, earlobes, retro-orbital region, and palms and soles. No residual adipose tissue was noted particularly in the head and neck, palms and soles in CGL2 caused by BSCL2 mutations. CGL4 caused by mutations in the PTRF gene was characterized with well-preserved retro-orbital and bone marrow fat in the absence of any visible residual adipose tissue in other areas. No residual adipose tissue was observed in AGL. Despite loss of subcutaneous fat, periarticular adipose tissue was preserved in the lower limbs of patients with FPLD. Retro-orbital adipose tissue was surprisingly preserved in APL, although they lacked head and neck fat. CONCLUSION Lipodystrophies are a heterogeneous group of disorders characterized by generalized or partial loss of adipose tissue, which can be congenital or acquired. Our results suggest that residual adipose tissue characteristics can help distinguish different subtypes of lipodystrophy.Publication Magnetic resonance spectroscopy to assess hepatic steatosis in patients with lipodystrophy(Aves, 2020-08-01) Altay, Canan; Seçil, Mustafa; Adıyaman, Süleyman Cem; Saydam, Başak Özgen; Demir, Tevfik; Akıncı, Gülçin; Şimşir, Ilgın Yıdırım; Eren, Erdal; Keskin, Ela Temeloğlu; Demir, Leyla; Onay, Hüseyin; Topaloğlu, Haluk; Yürekli, Banu Sarer; Kutbay, Nilüfer Özdemir; Gen, Ramazan; Akıncı, Barış; EREN, ERDAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Endokrinolojisi Anabilim Dalı.; 0000-0002-1684-1053; JPK-3909-2023Background/Aims: Lipodystrophy is a rare metabolic disorder characterized by a near-total or partial lack of subcutaneous adipose tissue and is associated with insulin resistance. We aimed to evaluate the efficacy of magnetic resonance spectroscopy (MRS) imaging to explore the fat content of the liver in patients with lipodystrophy and to determine the relationship between liver fat accumulation and clinical presentations of lipodystrophy. Materials andMethods: Between July 2014 and February 2016, 34 patients with lipodystrophy were assessed by MRS for the quantification of hepatic steatosis. All patients had metabolic abnormalities associated with insulin resistance. Metabolic parameters and the MRS findings were analyzed to identify potential correlations between liver fat content and disease severity.Results: The MRS fat ratios (MRS-FRs) were markedly higher, indicating severe hepatic steatosis in lipodystrophy. Patients with generalized and partial lipodystrophy had comparable levels of MRS-FRs, although patients with generalized lipodystrophy were significantly younger. Patients with genetic lipodystrophy had elevated MRS-FRs compared with those with acquired lipodystrophy (p=0.042). The MRS-FR was positively correlated with liver enzyme alanine aminotransferase (p=0.028) and serum adiponectin (p=0.043).Conclusion: Our data suggest that MRS might be an effective, non-invasive imaging method to quantify hepatic fat content in patients with lipodystrophy. Further studies are needed to validate the technique and threshold values, which would allow accurate comparison of data acquired by different machines and centers.Publication Renal complications of lipodystrophy: A closer look at the natural history of kidney disease(Wiley, 2018-07-01) Akıncı, Barış; Ünlu, Sadiye Mehtat; çelik, Ali; Şimsir, Ilgın Yıldırım; Şen, Sait; Nur, Banu; Keskin, Fatma Ela; Saydam, Başak Özgen; Özdemir, Nilüfer Kutbay; Yurekli, Banu Sarer; Ergür, Bekir Uğur; Sönmez, Melda; Atık, Tahir; Arslan, Atakan; Demir, Tevfik; Altay, Canan; Tunç, Ulku Aybüke; Arkan, Tuğba; Gen, Ramazan; Eren, Erdal; Akıncı, Gülçin; Yiımaz, Aslıhan Araslı; Bilen, Habib; Özen, Samim; Çeltik, Aygül; Erdeve, Şenay Savaş; Çetinkaya, Semra; Onay, Hüseyin; Sarıoğlu, Sulen; Oral, Elif Arıoğlu; EREN, ERDAL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Çocuk Sağlığı ve Hastalıkları Anabilim Dalı/Çocuk Endokrinolojisi Bilim Dalı; 0000-0002-1684-1053; JPK-3909-2023ObjectivesLipodystrophy syndromes are a group of heterogeneous disorders characterized by adipose tissue loss. Proteinuria is a remarkable finding in previous reports.Study designIn this multicentre study, prospective follow-up data were collected from 103 subjects with non-HIV-associated lipodystrophy registered in the Turkish Lipodystrophy Study Group database to study renal complications in treatment naive patients with lipodystrophy.MethodsMain outcome measures included ascertainment of chronic kidney disease (CKD) by studying the level of proteinuria and the estimated glomerular filtration rate (eGFR). Kidney volume was measured. Percutaneous renal biopsies were performed in 9 patients.ResultsSeventeen of 37 patients with generalized and 29 of 66 patients with partial lipodystrophy had CKD characterized by proteinuria, of those 12 progressed to renal failure subsequently. The onset of renal complications was significantly earlier in patients with generalized lipodystrophy. Patients with CKD were older and more insulin resistant and had worse metabolic control. Increased kidney volume was associated with poor metabolic control and suppressed leptin levels. Renal biopsies revealed thickening of glomerular basal membranes, mesangial matrix abnormalities, podocyte injury, focal segmental sclerosis, ischaemic changes and tubular abnormalities at various levels. Lipid vacuoles were visualized in electron microscopy images.ConclusionsCKD is conspicuously frequent in patients with lipodystrophy which has an early onset. Renal involvement appears multifactorial. While poorly controlled diabetes caused by severe insulin resistance may drive the disease in some cases, inherent underlying genetic defects may also lead to cell autonomous mechanisms contributory to the pathogenesis of kidney disease.