Browsing by Author "ERSOY, CANAN"
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Publication Anthropometric outcomes in type 2 diabetic patients with new dapagliflozin treatment; actual clinical experience data of six months retrospective glycemic control from single center(Elsevier, 2019-01-01) Calapkulu, Murat; Cander, Soner; Gül, Özen Öz; Ersoy, Canan; CANDER, SONER; ÖZ GÜL, ÖZEN; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; CJH-1319-2022 ; AAH-8861-2021; AAI-1005-2021Introduction: Dapagliflozin is an antidiabetic drug that has been used as a member of the new antidiabetic drug group that acts by inhibiting SGLT-2 and increasing urinary glucose excretion. With numerous controlled experimental studies of dapagliflozin, evaluation of real-life data after entry into clinical practice is an important condition. In our study, the effects of dapagliflozin on glycemic control and anthropometric measurements were investigated retrospectively.Methods: A-total of thirty-one type 2 diabetics were enrolled in the study. Data of before dapagliflozin and three and six months of treatment were recorded.Results: Dapagliflozin reduced HbA1c levels by 0,9% at 3 months and 0,79% at 6 months. Fasting plasma glucose decreased 41,1 mg/dl in the 3rd and 42 mg/dl in the 6th, postprandiyal glucose decreased 86,3 mg/dl in the 3rd and 74,2 mg/dl in the 6th. In the 3rd and 6th, body weights decreased by 3,3 kg and 4,2 kg, BMI decreased by 1,3 kg/m(2) and 1,6 kg/m(2) respectively. Similarly, it was observed that the waist circumference decreased by 1,3 cmat the end of 6th.Conclusion: Our data show that SGLT-2 inhibitors provide glycemic control with reduce HbA1c levels by 0.8-0.9%, and reduce fasting and postprandial plasma glucose levels without increasing the risk of hypoglycemia and causing weight lose around 5% at the six mounths. SGLT-2 inhibitors were found to be more effective in reduce postprandiyal plasma glucose in patients who did not use insulin and fasting plasma glucose in patients with diabetes mellitus less than 10 years. (c) 2018 Published by Elsevier Ltd on behalf of Diabetes India.Publication Association between resistance to cinacalcet and parathyroid gland hyperplasia in kidney transplant recipients with persistent hypercalcemia(Avicenna Organ Transplant Center, 2020-01-01) ORUÇ, AYŞEGÜL; Ersoy, Alparslan; ERSOY, ALPARSLAN; Yıldız, Abdülmecid; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Kocaeli, Ayşen Akkurt; Erturk, E.; ERTÜRK, ELİF; Ersoy, C.; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0002-0342-9692; JQI-3400-2023; AAI-1005-2021; JFB-3910-2023; AAH-4002-2021; KFR-7347-2024Background: Persistent hypercalcemia and hyperparathyroidism after successful kidney transplantation can be detrimental in some recipients and should be ameliorated.Objective: To point out the concerns regarding resistance to cinacalcet in kidney transplant recipients with persistent hypercalcemia.Methods: 14 renal transplant recipients who received cinacalcet treatment because of persistent hypercalcemia were included in the study. Serum creatinine, estimated glomerular filtration rate (eGFR), calcium, phosphorus, and intact parathyroid hormone (PTH) levels at the baseline and throughout the treatment, and ultrasonography and parathyroid scintigraphy findings were recorded.Results: Cinacalcet treatment was initiated after a mean +/- SD of 20.7 +/- 19.7 months of transplantation and maintained for 16.9 +/- 7.9 months. Serum calcium levels were significantly decreased with the cinacalcet treatment. There were no significant changes in serum creatinine, eGFR, phosphorus, and PTH levels. In all participants, serum calcium levels were increased from 9.8 +/- 0.6 to 11.1 +/- 0.6 mg/dL (p<0.001) within 1 month of cessation of cinacalcet. 7 recipients with adenoma-like hyperplastic glands underwent parathyroidectomy (PTx) due to failure with cinacalcet.Conclusion: Cinacalcet may be an appropriate treatment for a group of recipients with hypercalcemia without adenoma-like hyperplastic glands or who had a contraindication for surgery. Recipients with enlarged parathyroid gland may resist to cinacalcet-induced decrease in serum PTH, although the concomitant hypercalcemia may be corrected.Publication Comparison between sleeve gastrectomy and exenatide on type 2 diabetic patients(Mary Ann Liebert, 2020-02-28) Elbasan, Onur; Şişman, Pınar; Peynirci, Hande; Yabacı, Ayşegül; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; AAH-8861-2021Background: Diabetes and obesity are major causes of mortality and morbidity that are increasing all over the world. As obesity is a major risk factor for type 2 diabetic patients, weight loss is important in the treatment of type 2 diabetic patients. In our study, our aim was to evaluate the effects of exenatide and laparoscopic sleeve gastrectomy (LSG) in obese type 2 diabetic patients on the clinical and laboratory parameters.Methods: Twenty-five LSG and 25 exenatide patients followed up in our outpatient clinic were involved in the study.Results: At the end of the 6-month follow-up, weight loss was similar to 35.4 kg in the surgery group and 11.5 kg in the exenatide group. Although postprandial glucose and hemoglobin A1c were significantly decreased in both groups, the decrease was significantly higher in LSG group compared to the exenatide group. Although there was no significant change in fasting blood glucose (FBG) in the exenatide group, there was a significant decrease in FBG in LSG group.Conclusion: LSG is a method that should be performed up on indication and much more radical compared to exenatide administration, but appears to be a more efficient application that corrects diabetes- and obesity-related metabolic parameters compared to exenatide therapy in type 2 diabetic obese patients.Publication Comparison of the effects of medical and surgical treatments in giant prolactinoma: A single-center experience(Springer, 2021-07-08) Hakyemez, Bahattin; Cander, Soner; CANDER, SONER; Oz Gul, Ozen; ÖZ GÜL, ÖZEN; Eylemer, Eda; Gunes, Elif; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Gullulu Boz, Elif; GÜLLÜLÜ BOZ, SAİDE ELİF; Yilmazlar, Selcuk; YILMAZLAR, SELÇUK; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi.; AAA-3274-2019Purpose Giant prolactinomas, which have extremely large sizes and high prolactin (PRL) values, are rarely seen. Although medical therapy is effective, surgical treatment is more frequently applied due to slightly lower response rates and compression symptoms. This study aimed to compare the medical and surgical treatment results in giant prolactinomas. Methods Thirty-nine patients who were followed up in our center for giant prolactinoma were included in the study, and the response rates of the patients were evaluated after the medical and surgical treatments. The treatment responses were compared in terms of tumor volume, PRL level, visual field, and pituitary function. Results The outcomes of the 66 treatment periods (medical n = 42; surgical n = 24) in 39 patients (mean age, 47.2 years; men, 89.7%) were evaluated. The most common presentations were hypogonadism and visual defects. The mean longest tumor diameter at diagnosis was 52.2 +/- 11.8 mm, and the median PRL levels were 5000 ng/mL. PRL level normalization was achieved in 69% with medical therapy, and a curative response was obtained in only two patients with surgery. Tumor volume reduction was 67% (no cure) in the medical and 75% (13% cure) in the surgical groups (p = 0.39). Improvement of visual field was 70.8% in the medical and 84.2% in the surgical group (p = 0.12). Conclusion In our study, it was observed that medical therapy was effective and safe in patients with giant prolactinomas. The use of surgical treatment should be limited to prolactinomas with compression or post-resistance to medical treatment in serious cases.Publication Demographic and clinical features of medullary thyroid carcinoma(Turkiye Klinikleri, 2020-12-01) Şişman, Pınar; Bicer, Buket; Öztop, Hikmet; ÖZTOP, HİKMET; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Cander, Soner; CANDER, SONER; Ocakoglu, Gokhan; OCAKOĞLU, GÖKHAN; Ersoy, Canan; ERSOY, CANAN; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Bursa Uludağ Üniversitesi/Tıp Fakültesi; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0002-1114-6051; AAH-5180-2021; AAJ-6536-2021; HTQ-8395-2023; AAH-8861-2021; HLG-6346-2023; AAI-1005-2021Objective: Medullary thyroid carcinoma (MTC) is an aggressive neuroendocrine tumor affecting the parafollicular C cells of the thyroid gland. This study aimedto analyze demographic and clinical factors that might affect the prognosis of MTC andevaluate the long-term outcomes of surgery in MTC patients at a single center. Material and Methods: A total of 36 patients with a confirmed MTC diagnosis based on histopathological examination and underwent surgery-during 2000-2015 were examined. Archived files of these patients were reviewed, and data on clinical, biochemical, and radiological test results were assessed. Factors affecting disease-free survival were also evaluated. Results: Theduration of the follow-up of the patients was 80.3 +/- 76.1 months. MEN2A was detected in three patients (8.3%). Twelve patients (33.3%) had metastasis at the time of diagnosis. During the follow-up period, local recurrence was observed in 13 (36.1%) patients. Nine patients (25%) presented metastasis at follow-up. The mean disease-free survival was high in sporadic MTC compared to hereditary MTC. Conclusion: The study observed asignificant contribution to the hereditary nature of the disease on prognosis. However,other prognostic factors such as gender, nodule characteristics, recurrence and metastasis, and treatment modalities did differsignificant. Patients with MTC should be evaluated to know if the disease is sporadic or hereditary. The small sample size in this study restricts the power of statistical analysis;therefore, further prospective studies are necessary to reveal the other contributory prognostic factors in MTC.Publication Effect of omega-3 polyunsaturated fatty acid supplementation on glysemic control and renal function in type 2 diabetic patients with chronic kidney disease(Oxford Universitesi, 2021-05-01) Usta, Mehmet; Ayar, Yavuz; Goksel, Gultekin; Karagoz, Isminur Saka; Ersoy, Alpaslan; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; 0000-0003-4607-9220; GSE-0029-2022; O-9948-2015; AGF-0767-2022Publication Effect of parathyroidectomy timing in kidney transplant recipients on graft function(Başkent Üniversitesi, 2021-04-01) Oruc, Aysegul; Ersoy, Alparslan; Yildiz, Abdulmecit; Gul, Ozen Oz; Ersoy, Canan; Oruc, Aysegul; ORUÇ, AYŞEGÜL; Ersoy, Alparslan; ERSOY, ALPARSLAN; Yildiz, Abdulmecit; YILDIZ, ABDULMECİT; Gul, Ozen Oz; ÖZ GÜL, ÖZEN; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0342-9692; 0000-0002-1332-4165; AAH-8861-2021; AAH-4002-2021Objectives: Persistent hyperparathyroidism can have a deleterious effect on graft function in kidney transplant recipients, although serum calcium, phosphorus, and parathyroid hormone levels tend to normalize after successful transplant. Parathyroidectomy can result in sustained amelioration of persistent hyperparathyroidism despite graft failure risk and unfavorable graft outcomes. Data on this issue are limited and conflicting. Here, we evaluated the effects of parathyroidectomy on graft function in kidney transplant recipients.Materials and Methods: This retrospective study included 249 adult kidney transplant recipients (121 deceased-donor/128 living-donor; 142 males/107 females; mean age of 39.3 +/- 11.6 y; mean follow-up of 46.5 +/- 23.5 mo). Participants were grouped as those without (n = 222), those with pretransplant (n = 12), and those with posttransplant (n = 15) parathyroidectomy. Graft outcomes and serum calcium, phosphorus, and parathyroid hormone levels were studied.Results: Serum calcium levels at baseline and at 1, 3, 6, and 12 months and parathyroid hormone levels at baseline and at 6 and 12 months were higher and serum phosphorus levels at 3, 6, and 12 months were lower in the posttransplant parathyroidectomy group versus the other groups (P <.001). We observed no significant differences between groups regarding serum calcium, phosphorus, and parathyroid hormone levels at last visit. Estimated glomerular filtration rates at 3, 6, and 12 months and at last visit in the pretransplant parathyroidectomy group were higher than in those without parathyroidectomy (P <.05) and higher at 6 and 12 months than in the posttransplant parathyroidectomy group (P <.05). No significant differences regarding graft loss and patient mortality were observed among the 3 groups (P >.05).Conclusions: Parathyroidectomy resulted in sustained decreased levels of serum calcium and parathyroid hormone. We observed no graft failure risk associated with parathyroidectomy in our study. Parathyroidectomy before transplant is advantageous with better graft function.Publication Efficacy and safety of three-times-daily versus twice-daily biphasic insulin aspart 30 in patients with type 2 diabetes mellitus inadequately controlled with basal insulin combined with oral antidiabetic drugs(Elsevier Ireland, 2019-02-25) Yang, Wenying; Ersoy, Canan; Wang, Guixia; Ye, Shandong; Liu, Jun; Miao, Heng; Asirvatham, Arthur; Werther, Shanti; Kadu, Priti; Chow, Francis; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; AAH-8861-2021Aims: To compare the efficacy and safety of biphasic insulin aspart 30 (BIAsp 30) administered three times daily (TID) vs. twice daily (BID), plus metformin, in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on basal insulin +/- 1 oral antidiabetic drug (OAD).Methods: Randomised, multinational, open-label, treat-to-target trial. Subjects inadequately controlled (HbA1c 7.5-10.0%) on basal insulin and metformin +/- 1 OAD were randomised to BIAsp 30 TID (n = 220) or BIAsp 30 BID (n = 217). Primary endpoint was change from baseline in HbA1c after 24 weeks of treatment.Results: Most (400/437, 91.5%) subjects completed the trial. The majority (276/400 [69.0%]) were from the China region. After 24 weeks, HbA1c decreased comparably in both BIAsp 30 groups (-1.7% vs. -1.6% [-19 vs. -18 mmol/mol], for TID and BID dosing, respectively; estimated treatment difference: -0.09% [-0.23; 0.06] 95% CI, -1 mmol/mol [-3; 1], p = 0.26). Safety profiles, including number of subjects experiencing hypoglycaemia, were similar.Conclusions: BIAsp 30 administered either TID or BID with metformin was a safe and effective option when intensifying treatment after failure of basal insulin and OADs in patients with T2DM. Adding a third injection at lunchtime may be preferable if HbA1c remains above target, if the lunchtime meal is the largest meal of the day, or if persistent postprandial hyperglycaemia after lunch is observed.Publication Evaluating a physicians' perspective on the use of probiotics and vitamins against coronavirus disease(Pakistan Medical Assoc, 2022-11-01) Göktaş, Olgun; Ersoy, Canan; Göktaş, Olgun; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Aile Hekimliği Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı; EXQ-8413-2022; AAH-8861-2021Objective: To evaluate the perspective of family physicians on probiotics and vitamins against coronavirus disease-2019.Methods: The cross-sectional study was conducted from June 1 to 30, 2021, after approval from the ethics review committee of Bursa Uludag University, Bursa, Turkey, and comprised family physicians of either gender working at family health centres in the country. Data was collected using an online questionnaire to measure the sociodemographic characteristics, habits, health status related to coronavirus disease-2019, and their knowledge, awareness and behaviour towards the use of probiotics and vitamins during the pandemic. Data was analysed using SPSS 25.Results: Of the 218 family physicians, 130(59.6%) were male and 88(40.4%) were female. The overall mean age was 46.82 +/- 5.85 years, mean professional experience was 22.32 +/- 8.75 years, and mean experience in family medicine was 10.14 +/- 3.51 years. The knowledge and awareness level about coronavirus disease-2019 was high 4.18 +/- 0.58, exposure to the disease 3.36 +/- 0.83 and their inclination towards the use of vitamins and probiotics 1.68 +/- 0.75 was low. Among the participants, 90(41.3%) used probiotic products and 120(55%) used drugs, such as vitamins and minerals. Vitamin C 99(45.4%) was the most commonly used supplement.Conclusion: Physicians' knowledge and awareness and a realistic scientific approach are important when recommending supplements, such as probiotics, vitamins and minerals, to individuals during the pandemic.Publication Evaluation of upper gastrointestinal system in acromegaly(Masson Editeur, 2019-09-01) Şişman, Pınar; Pekgöz, Murat; Bayrakçı, Ismail; Şişman, Mete; Cander, Soner; CANDER, SONER; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Ertürk, Erdinç; ERTÜRK, ERDİNÇ; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi; AAH-8861-2021; AAI-1005-2021; AAJ-6536-2021Purpose. - Acromegaly causes multiple comorbidities, including gastrointestinal disorders. The present study evaluated the frequency of hiatal hernia and other upper gastrointestinal pathologies in patients with acromegaly, given that visceromegaly and reduced nitric oxide levels in acromegaly may impact diaphragm and lower esophageal sphincter function and thus possibly the development of hiatal hernia.Methods. - Thirty-nine acromegaly patients followed our center for the previous 6 months were recruited. Upper gastrointestinal endoscopy was performed once in all patients to evaluate hiatal hernia, esophagitis, gastroduodenitis and ulcer.Results. - Twenty-three patients were male and 16 female. Upper gastrointestinal endoscopy found hiatal hernia, esophagitis and gastroduodenitis or gastric ulcer in 3 (7.6%), 2 (1.7%) and 31 (79.4%) patients, respectively. Pathologic examination of gastric antrum biopsy found intestinal metaplasia in 12 (30.7%) patients, and Helicobacter pylori was positive in 13 (33.3%). There were no significant correlations between age, gender, disease duration or preoperative adenoma size on the one hand and hiatal hernia or other endoscopic findings on the other. Similarly, neither surgical success nor recurrence was associated with endoscopic findings.Conclusions. - The study showed that prevalence of gastritis, duodenitis, peptic ulcer and intestinal metaplasia is higher and prevalence of hiatal hernia lower in acromegaly patients than in the healthy population. Various unknown disease-related pathophysiological conditions may play a role; there is a need for further studies.Publication Factors affecting hypertension in the adult population of the Marmara region, Turkey: A descriptive field study(Hindawi, 2020-12-31) Göktaş, Olgun; Şentürk, Tunay; Ersoy, Canan; Göktaş, Olgun; ŞENTÜRK, TUNAY; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Aile Hekimliği Birimi/Aile Sağlığı Merkezi.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Endokrinoloji ve Metabolizma Bilim Dalı.; 0000-0003-3291-5187; 0000-0001-9031-9039; 0000-0003-4510-6282; AAH-8861-2021; JHW-6055-2023; DYK-7009-2022Introduction. Hypertension is an increasingly prevalent global public health problem. Nutritional culture and lifestyle are among the factors related to hypertension. The aim of this study was to evaluate the prevalence and influential factors of hypertension in the adult population of the Marmara region, Turkey. Methods. The study was conducted in 10 provinces in the Marmara region between June 01, 2018, and November 30, 2018. Participants included 2353 patients over 18 years of age diagnosed with hypertension by any of the 30 family physicians working in the Family Health Centers in these provinces. After the participants provided written consent, a survey consisting of 25 questions was administered by their family physicians. SPSS 25.0 (IBM Corporation, Armonk, New York, United States) was used for all statistical analysis calculations. Results. The patients included 1449 females (61.6%) and 904 males (38.4%). Among the respondents, 1555 (73.1%) had primary hypertension etiology and 572 (26.9%) had secondary etiology. While 1614 patients (68.6%) did not exercise at all, 739 patients (31.4%) reported exercising; 1026 patients (43.9%) did not restrict salt in their diet; and 1134 patients (48.2%) had a family history of hypertension. Conclusion. Since individual and environmental factors affect the etiology of hypertension, it is recommended that family physicians address these factors first as part of a holistic approach for hypertension prevention, diagnosis, treatment, and follow-up.Publication How the COVID-19 outbreak affected patients with diabetes mellitus?(Springer India, 2021-06-28) Şişman, Pınar; Polat, Irmak; Aydemir, Ensar; Karşı, Remzi; Gül, Özen Öz; Cander, Soner; Ersoy, Canan; Ertürk, Erdinç; AYDEMİR, ENSAR; ÖZ GÜL, ÖZEN; CANDER, SONER; ERSOY, CANAN; ERTÜRK, ERDİNÇ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; 0000-0003-4300-2965 ; AAA-7171-2022 ; GBT-4320-2022 ; CJH-1319-2022 ; AAH-8861-2021 ; AAJ-6536-2021Background Global COVID-19 outbreak has been such a stressful experience for most of the people. Using a web-based cross-sectional study, we aimed to evaluate the acute stress response, depression, and anxiety in patients with diabetes mellitus (DM) during the COVID-19 pandemic, and to examine the effect of these psychiatric problems on diet habits and glycemic controls of patients. Methods This web-based survey of COVID-19 was sent to the patients through the Whatsapp platform. All participants reported their demographic data, diabetes-related information, changes in self-monitoring blood glucose measurements, physical parameters, and eating habits after COVID-19, then completed Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale, Revised (IES-R) questionnaires which assessed acute stress sypmtoms, anxiety, and depression. Results Three hundred and four patients with DM [(141 type 1 DM (T1D) and 163 type 2 (T2D)] were included in the study. In our study, female gender, higher BMI and weight, decreased in financial income after outbreak, presence of diabetic complications and comorbid diseases (i.e., retinopathy, neuropathy, diabetic foot, hypertension, dyslipidemia), worsened glycemic levels, increased carbohydrate consumption, and snacking were associated with higher anxiety and depression scores. Depression was higher in patients with T2D and duration of illness was correlated with acute stress level. Conclusions It is important to be aware of the possibility of acute stress, depression, and anxiety after pandemic in patients with DM whose glycemic control is impaired. Psychological problems should not be ignored beyond physical inactivity and worsening eating habits.Publication Identifying clinical characteristics of hypoparathyroidism in Turkey: HIPOPARATURK-NET study(Springer, 2022-02) Değertekin, Ceyla Konca; Yavuz, Dilek Gogas; Pekkolay, Zafer; Saygılı, Emre; Uğur, Kader; Koca, Arzu Or; Ünübol, Mustafa; Topaloğlu, Ömercan; Aydoğan, Berna İmge; Kutbay, Nilüfer Özdemir; Hekimsoy, Zeliha; Yılmaz, Nusret; Balcı, Mustafa Kemal; Tanrıkulu, Seher; Ünsal, Yasemin Aydoğan; Ersoy, Canan; Omma, Tülay; Keskin, Müge; Yalçın, Mehmet Muhittin; Yetkin, İlhan; Soylu, Hikmet; Karaköse, Melia; Yılmaz, Merve; Karakılıç, Ersen; Pişkinpaşa, Hamide; Batman, Adnan; Akbaba, Gülhan; Elbuken, Gülşah; Bahadir, Cigdem Tura; Kılınç, Faruk; Bilginer, Muhammet Cüneyt; İyidir, Özlem Turhan; Cantürk, Zeynep; Yılmaz, Banu Aktaş; Sayıner, Zeynel Abidin; Eroğlu, Mustafa; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalı; AAH-8861-2021Hypoparathyroidism is an orphan disease with ill-defined epidemiology that is subject to geographic variability. We conducted this study to assess the demographics, etiologic distribution, treatment patterns and complication frequency of patients with chronic hypoparathyroidism in Turkey. This is a retrospective, cross-sectional database study, with collaboration of 30 endocrinology centers located in 20 cities across seven geographical regions of Turkey. A total of 830 adults (mean age 49.6 +/- 13.5 years; female 81.2%) with hypoparathyroidism (mean duration 9.7 +/- 9.0 years) were included in the final analysis. Hypoparathyroidism was predominantly surgery-induced (n = 686, 82.6%). The insulting surgeries was carried out mostly due to benign causes in postsurgical group (SG) (n = 504, 73.5%) while patients in nonsurgical group (NSG) was most frequently classified as idiopathic (n = 103, 71.5%). The treatment was highly dependent on calcium salts (n = 771, 92.9%), calcitriol (n = 786, 94.7%) and to a lower extent cholecalciferol use (n = 635, 76.5%) while the rate of parathyroid hormone (n = 2, 0.2%) use was low. Serum calcium levels were most frequently kept in the normal range (sCa 8.5-10.5 mg/dL, n = 383, 46.1%) which might be higher than desired for this patient group. NSG had a lower mean plasma PTH concentration (6.42 +/- 5.53 vs. 9.09 +/- 7.08 ng/l, p < 0.0001), higher daily intake of elementary calcium (2038 +/- 1214 vs. 1846 +/- 1355 mg/day, p = 0.0193) and calcitriol (0.78 +/- 0.39 vs. 0.69 +/- 0.38 mcg/day, p = 0.0057), a higher rate of chronic renal disease (9.7% vs. 3.6%, p = 0.0017), epilepsy (6.3% vs. 1.6%, p = 0.0009), intracranial calcifications (11.8% vs. 7.3%, p < 0.0001) and cataracts (22.2% vs. 13.7%, p = 0.0096) compared to SG. In conclusion, postsurgical hypoparathyroidism is the dominant etiology of hypoparathyroidism in Turkey while the nonsurgical patients have a higher disease burden with greater need for medications and increased risk of complications than the postsurgical patients.Publication Retrospective analysis of vitamin D status on inflammatory markers and course of the disease in patients with COVID-19 infection(Springer, 2021-04-05) Ünsal, Yasemin Aydoğan; Gül, Özen Öz; Cander, Soner; Ersoy, Canan; Aydemir, Ensar; Ateş, Coşkun; Uzun, Ziya ; Armağan, Ersin; Ünsal, Oktay; Ertürk, Elif; AYDOĞAN ÜNSAL, YASEMİN; ÖZ GÜL, ÖZEN; CANDER, SONER; ERSOY, CANAN; AYDEMİR, ENSAR; ATEŞ, COŞKUN; ERTÜRK, ELİF; Armağan, Ersin; Uzun, Ziya; Bursa Uludağ Üniversitesi/Tıp Fakültesi; 0000-0002-1566-3099; 0000-0002-1332-4165; 0000-0001-6303-7896; 0000-0001-8519-784X; 0000-0003-4565-9848; 0000-0003-1363-2966; HSE-4469-2023; GBT-4320-2022; CJH-1319-2022; AAH-8861-2021; AAB-6671-2022; CDO-0747-2022; GQW-5454-2022; CBW-8706-2022; JQI-3400-2023Purpose The aim of the study was to investigate the association between serum 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection and parameters of immune function and clinical outcomes. Methods Fifty-six patients, who were admitted to the emergency clinic and diagnosed with COVID-19 infection, were included in the study. Data on clinical characteristics, inflammatory parameters and vitamin D status were recorded for each patient. All the participants had data on 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection. Results The patients were stratified as those with vitamin D status less than 20 ng/mL and higher than 20 ng/mL. A group with vitamin D status less than 20 ng/mL had lower lymphocyte counts and lower haemoglobin levels that was statistically significant (respectively; p = 0.021, p = 0.035). Higher C-reactive protein (CRP) levels were seen in the vitamin D-deficient group (p = 0.013). It was observed that vitamin D status of the patients who required oxygen therapy were lower than those who did not require oxygen therapy, not statistically significant (p = 0.05). Patients who did not use vitamin D supplementation within 6 months prior to COVID-19 infection had more likely to be diagnosed with pneumonia (p = 0.004). Conclusion Cases with lower vitamin D status had increased inflammatory markers and worse clinical outcomes than patients with higher vitamin D status. This study suggests that vitamin D status can be used as a prognostic factor in COVID-19 patients, and vitamin D supplementation can be recommended to improve the clinical outcomes in COVID-19 infection.Publication Short term effect of laparoscopic sleeve gastrectomy on clinical, renal parameters and urinary ngal levels in diabetic and non diabetic obesity(Editura Acad Romane, 2019-07-01) Elbasan, Onur; Şişman, P.; Peynirci, Hande; Yabacı, Ayşegül; Dirican, Melehat; DİRİCAN, MELEHAT; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Cander, Soner; CANDER, SONER; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0001-8580-9471; AAH-8861-2021; AAG-6985-2021; AAI-1005-2021Background. Although diseases such as diabetes, hypertension, obstructive sleep apnea and hyperlipidemia are clearly documented as obesity associated diseases, it is not well-known whether obesity causes renal pathologies. The aim of the present study was to evaluate the effect of weight loss following laparoscopic sleeve gastrectomy on clinical, renal parameters and urinary Neutrophil gelatinase-associated lipocalin (NGAL) levels in diabetic and non-diabetic obese patients.Methods. Nineteen morbidly obese patients (10 diabetic and 9 non diabetic) who underwent laparoscopic sleeve gastrectomy were evaluated clinically (anthropometric measurements) and biochemically before surgery and at 6 months from surgery.Results. Significant decreases in weight, BMI, FPG, PPG and HbA1c levels were observed in the diabetic group when the baseline and 6th month parameters of the patients were compared. There was also a significant decrease in SBP and DBP. At 6th month following laparoscopic sleeve gastrectomy, renal parameters such as creatinine, mAlb/creatinine, NGAL/creatinine did not differ in the diabetic group. In the nondiabetic group, serum creatinine levels were significantly decreased, but other renal parameters such as mAlb/creatinine and NGAL/creatinine were not significantly different.Conclusions. Our findings revealed significant decreases in weight, body mass index and glycemic parameters after sleeve gastrectomy in diabetic and non-diabetic patients, while no significant alteration was noted in renal functions, urinary NGAL and microalbumin levels.Publication The evaluation of the role of bmi and insulin resistance on inflammatory markers, PAL-1 levels and arterial stiffness in newly diagnosed type 2 diabetes mellitus patients(Edizioni Minerva Medica, 2021-03-01) Koca, Nizameddin; Ayar, Koray; Bal, Öznur; Ersoy, Canan; ERSOY, CANAN; Bursa Uludağ Üniversitesi Hastanesi/Tıp Fakültesi/İç Hastalıkları Kliniği/Endokrinoloji ve Metabolizma Bilim Dalı; AAH-8861-2021BACKGROUND: Increased cardiovascular risk, represented by endothelial inflammation, probably starts with the very first course of type-2 diabetes (T2DM). Almost 85.2% of all T2DM patients are overweight or obese. Thrombosis accounts 80% of all deaths in patients with diabetes. The thrombotic-fibrinolytic equilibrium shifts in favor of thrombosis by plasminogen activator inhibitor-1 (PAI-1). PAI-1 secretion is induced primarily by CRP. PAI-1 overexpression predisposes unstable plaque development. The contribution of obesity and diabetes to this process is not clearly understood. In this study, we aimed to investigate comparison of inflammatory markers, PAI-1 levels and arterial stiffness according to BMI and impaired glucose metabolism in patient with newly diagnosed T2DM.METHODS: Newly diagnosed 60 T2DM patients were enrolled. Demographics and measurements were noted. Liver (AST, ALT), kidney (urea, creatinine, albumin/creatinine ratio), metabolic (fasting blood glucose, post-prandial blood glucose, insulin, c-peptide, HbA1c, total cholesterol, low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglyceride) parameters, inflammatory markers [hsCRP, fibrinogen]), PAI-1 levels and pulse wave velocity was measured from all participants. The results were compared.RESULTS: Inflammatory markers and PAI-1 levels were significantly elevated in obese group compared to overweight participants. The correlation analysis showed that waist and hip circumferences, high-sensitive CRP, fibrinogen and PAI-1 levels were positively correlated with BMI but not with HbA1c levels.CONCLUSIONS: The results of our study showed that lipid levels, glycemic and blood pressure values of the obese and overweight patients were similar. BMI affects inflammatory markers and PAI-1 levels independent of glucose regulation and insulin resistance in newly diagnosed T2DM. According to the current study BMI is found to be more prominent in terms of inflammatory markers and PAI-1 levels compared to insulin resistance and impaired glucose metabolism in newly diagnosed T2DM.Publication Turkish nationwide survey of glycemic and other metabolic parameters of patients with Diabetes mellitus (TEMD study)(Elsevier, 2018-12-01) Sönmez, Alper; Haymana, Cem; Bayram, Fahri; Salman, Serpil; Dizdar, Oğuzhan Sıtkı; Gürkan, Eren; Çarlıoğlu, Ayse Kargili; Barçin, Cem; Sabuncu, Tevfik; Satman, İlhan; Güldiken, Sibel; Aytürk, Semra; Yılmaz, Murat; Aşık, Mehmet; Dinccag, Nevin; Çakmak, Ramazan; Türker, Fulya; İdiz, Cemile; Hacışahinoğullari, Hülya; Bağdemir, Elif; Yıldız, Buşra; Yumuk, Volkan Demirhan; Haliloğlu, Özlem; Sancak, Seda; Özsarı, Levent; Çağıltay, Eylem; Deyneli, Oğuzhan; İmre, Eren; Gönen, Sait; Boysan, S. Nur; Altuntaş, Yüksel; Öztürk, Feyza Yener; Mert, Meral; Pişkinpaşa, Hamide; Aydın, Hasan; İmamoğlu, Sazı; Ersoy, Canan; Özgül, Özen; Küçüksaraç Kıyıcı, Sinem; Çetinarslan, Berrin; Selek, Alev; Doğru, Teoman; Kırık, Ali; Kebapçı, Nur; Efe, Belgin; Kaya, Ahmet; Cordan, İlker; Baldane, Süleyman; Kirac, Cem Onur; Demirci, İbrahim; Capa, Zehra; Cesur, Mustafa; Yetkin, Ilhan; Çorapçıoğlu, Demet; Canlar, Şule; Yıldız, Okan Bulent; Sendur, Süleyman Nahit; Cakir, Bekir; özdemir, Didem; Çorakci, Ahmet; Kutlu, Mustafa; Bascil Tutuncu, Neslihan; Bozkuş, Yusuf; Çakal, Erman; Demirbaş, Berrin; Ertek, Sibel; Altay, Mustafa; Dağdeviren, Murat; Abedi, Amir Hassein; Çetinkalp, Sevki; Özışık, Hatice; Oruk, GÜzide Gonca; Yener, Serkan; Saydam, Başak Özgen; Güney, Engin; Unubol, Mustafa; Yaylalı, Güzin Fidan; Topsakal, Şenay; Hekimsoy, Zeliha; Akbaba, Gülhan; Aslan, İbrahim; Balcı, Mustafa Kemal; Dalkıran, Şefika; Akbay, Esen; Gül, Kamile; Agbaht, Kemal; Yılmaz, Müge Özsan; Bozkırlı, Emre; Tetiker, B. Tamer; Altuntaş, Seher Çetinkaya; Atmaca, Ayşegül; Durmuş, Elif Tutku; Mete, Türkan; Kutlutürk, Faruk; Küçükler, Ferit Kerim; Dikbaş, Oğuz; Akın, Şafak; Nuhoğlu, İrfan; Ersöz, Halil Önder; Bayraktaroğlu, Taner; Şişman, Pınar; Şahin, İbrahim; Çetin, Sedat; Capoğlu, İlyas; Akbaş, Emin Murat; Üçler, Rıfkı; Eren, Mehmet Ali; Tuzcu, Alpaslan Kemal; Pekkolay, Zafer; Özkaya, Mesut; Araz, Mustafa; TEMD Study Grp; ERSOY, CANAN; Özgül, Özen; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı; AAH-8861-2021; DLV-5369-2022Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus.Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control.Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups.Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease.