Person: CANDER, SONER
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CANDER
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Publication Effects of endocrine-disrupting chemicals on obesity and diabetes(Aves, 2023-10-01) Cander, Soner; Yetkin, İlhan; CANDER, SONER; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı; CJH-1319-2022The increasing incidence of obesity and type 2 diabetes mellitus (T2DM) is a global problem. Although the obesity epidemic is mostly associated with a lack of physical activity and diet, several chemicals have been demonstrated to have a potential role in its pathophysiological mechanisms. An accumulating volume of evidence indicates that a subclass of endocrine-disrupting chemicals (EDCs) can impair hormonally regulated metabolic processes, particularly in the case of exposure early in life when the defense mechanisms of the human body are yet to be fully developed. These chemicals are called "obesogenic EDCs" and might cause some people to gain weight despite their attempts to increase physical activity and limit calorie intake. Similarly, background exposure to some environmental EDCs has been associated with diabetes and impaired glucose metabolism. Certain widespread EDCs, including pesticides, dioxins, and bisphenol A, in animal models may change beta function and insulin resistance. These EDCs, which may accumulate in adipose tissue and cause a pro-inflammatory response, can also be found at measurable levels in human blood and can either imitate or block some hormonal reactions. In this review, we evaluate EDCs in relation to obesity and T2DM in light of the current literature.Publication Effect of rosiglitazone and insulin combination therapy on inflammation parameters and adipocytokine levels in patients with Type 1 DM(Hindawi, 2015-03-17) Güçlü, Metin; Gül, Özen Öz; Cander, Soner; Ünal, Oğuzkaan; Özkaya, Güven; Sarandöl, Emre; Ersoy, Canan; Güçlü, Metin; ÖZ GÜL, ÖZEN; CANDER, SONER; Ünal, Oğuzkaan; ÖZKAYA, GÜVEN; SARANDÖL, EMRE; ERSOY, CANAN; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; 0000-0001-5082-9894; 0000-0003-0297-846X; A-4421-2016; ABE-1716-2020; AAI-1005-2021; ABI-4847-2020; AAH-8861-2021; HUR-0563-2023; IPU-7626-2023Aim. To investigate the efficacy of combined therapy of insulin and rosiglitazone on metabolic and inflammatory parameters, insulin sensitivity, and adipocytokine levels in patients with type 1 diabetes mellitus (type 1 DM). Material and Methods. A total of 61 adults with type 1 DM were randomly and prospectively assigned in open-label fashion to take insulin and rosiglitazone 4mg/day (n - 30) or insulin alone (n = 31) for a period of 18 weeks while undergoing insulin therapy without acute metabolic complications. Results. Combination therapy did not significantly improve metabolic and inflammatory parameters, insulin sensitivity, and adiponectin levels. While leptin and resistin levels decreased in both groups (group 1: resistin 6.96 +/- 3.06 to 4.99 +/- 2.64, P = 0.006; leptin 25.8 +/- 17.6 to 20.1 +/- 12.55, P = 0.006; group 2: resistin 7.16 +/- 2.30 to 5.57 +/- 2.48, P = 0.031; leptin 16.72 +/- 16.1 to 14.0 +/- 13.4, P = 0.007) Hgb and fibrinogen levels decreased only in group 1 (Hgb 13.72 +/- 1.98 to 13.16 +/- 1.98, P = 0.015, and fibrinogen 4.00 +/- 1.08 to 3.46 +/- 0.90, P = 0.002). Patients in both groups showed weight gain and the incidence of hypoglycemia was not lower. Discussion. The diverse favorable effects of TZDs were not fully experienced in patients with type 1 DM. These results are suggesting that insulin sensitizing and anti-inflammatory characteristics of TZDs were likely to be more pronounced in patients who were not totally devoid of endogenous insulin secretion.Publication A rare cause of hypopituitarism: Pituitary tuberculosis(Aves, 2012-01-01) Gül, Özen Öz; Ertürk, Erdinç; Cander, Soner; Ünal, Oğuz Kaan; Hakyemez, Bahattin; İmamoğlu, Şazi; ÖZ GÜL, ÖZEN; ERTÜRK, ERDİNÇ; CANDER, SONER; Ünal, Oğuz Kaan; HAKYEMEZ, BAHATTİN; İmamoğlu, Şazi; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; AAI-1005-2021; AAI-2318-2021; AAJ-6536-2021; HUR-0563-2023; GGN-5983-2022; FCO-4676-2022Pituitary tuberculosis is a rare condition that can present with hypopituitarism even without any evidence of systemic tuberculosis and is easily confused with pituitary adenomas. Headache and hypopituitarism are the most common presenting symptoms. We report the case of pituitary tuberculosis in a 39-year-old male patient who presented with panhypopituitarism. Although it is rare and difficult to diagnose, pituitary tuberculosis should be considered in every nonfunctional sellar masses, especially in fairly small ones with unexpected hypopituitarism.Publication Can diabetes insipidus be used as a marker for multisystemic and progressive disease in langerhans cell histiocytosis?(Kuwait Medical Assoc, 2021-12-01) Koca, Nizameddin; Cander, Soner; CANDER, SONER; Gul, Ozen Oz; ÖZ GÜL, ÖZEN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji Anabilim Dalı.; 0000-0003-1457-4366; 0000-0002-1332-4165; V-9228-2017Langerhans cell histiocytosis (LCH) is a rare disease with an yearly incidence of nine cases per a million in children and 1-2 cases per a million adults. 68.6% of LCH presented with multisystem involvement. A 40-year-old woman who was admitted to endocrinology outpatient clinic with symptoms of polyuria, polydipsia and headache was diagnosed with diabetes insipidus (DI). Desmopressin treatment was initiated, but six months after therapy, re-evaluation revealed progression in hypophyseal mass. Thoracoscopic biopsy shows LCH with multisystemic involvement. She did not respond clinically to systemic chemotherapy and external radiotherapy and died due to pneumonia.LCH should be taken into consideration in patients diagnosed with DI. DI is almost always the hallmark of hypothalamic pituitary axis involvement and a sign of multisystemic involvement.Publication Differences between atypical parathyroid tumors and parathyroid adenomas in patients with primary hyperparathyroidism(Springer India, 2023-09-29) Aydemir, Ensar; AYDOĞAN ÜNSAL, YASEMİN; ÖZ GÜL, ÖZEN; AYDEMİR, ENSAR; ATEŞ, COŞKUN; Ateş, Coşkun; CANDER, SONER; Cander, Soner; Saraydaroğlu, Özlem; SARAYDAROĞLU, ÖZLEM; Ersoy, Canan; ERSOY, CANAN; Ertürk, Erdinc; ERTÜRK, ERDİNÇ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; 0000-0003-4300-2965; 0000-0003-4565-9848; 0000-0002-1332-4165; AAJ-6536-2021; AAB-6671-2022; AAA-7171-2022Atypical parathyroid tumor is a rare disease that can be challenging to distinguish from parathyroid adenoma. Atypical parathyroid tumor shows some laboratory and histopathological features with parathyroid cancer. This study attempts to compare clinical, laboratory, radiologic, and histopathological characteristics in atypical parathyroid tumor and parathyroid adenoma. This was a retrospective study based on the database of eighty-two subjects who underwent surgery for primary hyperparathyroidism at a tertiary referral center between 2010 and 2021. Forty-one patients with atypical parathyroid tumor were matched by age and gender to controls with parathyroid adenoma. Clinical, laboratory, radiologic, and characteristics were obtained from the hospital database. Forty-five (54.8%) of primary hyperparathyroidism patients were symptomatic, 36 (90%) had nephrolithiasis, 6 (15%) had fracture, and 3 (7.5%) had hypercalcemic crisis. Atypical parathyroid tumor patients present with significantly increased serum calcium, parathormone, and alkaline phosphatase levels (P < .001, all). No significant difference was observed in the results of bone mineral density, T-scores, and Z-scores. The size of adenoma was significantly greater in the atypical parathyroid tumor group (24 (8.8-70) mm vs. 12 (3.8-32) mm, P = 0.005). Our study revealed that increased preoperative serum calcium, parathormone, alkaline phosphatase concentrations, and parathyroid adenoma size on ultrasound may have predicted the atypical parathyroid tumor.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 An unusual case of adult-onset multi-systemic langerhans cell histiocytosis with perianal and incident thyroid involvement(Bioscientifica Ltd, 2017-02-01) Gül, Özen Öz; Şişman, Pınar; Cander, Soner; Gözden, Erdem; Kurt, Meral; Saraydaroğlu, Özlem; Kırdak, Turkay; Ersoy, Canan; Ertürk, Erdinç; ÖZ GÜL, ÖZEN; Şişman, Pınar; KURT, MERAL; CANDER, SONER; Gözden, Erdem; SARAYDAROĞLU, ÖZLEM; Kırdak, Turkay; ERSOY, CANAN; ERTÜRK, ERDİNÇ; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Hematoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyasyon Onkolojisi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Anabilim Dalı.; AAI-1005-2021; DUS-9872-2022; HUR-0563-2023; EWL-5375-2022; AAA-3961-2020; AAH-9701-2021; CZX-7145-2022; AAH-8861-2021; AAJ-6536-2021Langerhans cell histiocytosis (LCH) is a rare sporadic disease characterized by histiocytic neoplastic infiltration of various organ systems and a wide spectrum of clinical manifestations, ranging from benign and self-limiting to lethal. Herein, we report a rare case of adult-onset multi-systemic LCH in a 36-year-old male patient with an initial perianal presentation and incidental finding of subsequent thyroid gland involvement in the follow-up period. The patient with a history of perianal LCH treated with surgical excision and local radiotherapy was referred to our Endocrinology Department upon detection of hypermetabolic nodular lesions in the left lateral lobe of thyroid gland on positron emission tomography-computed tomography (PET/CT)scan in the nineth month of follow-up. Current evaluation revealed euthyroid status, a hypoechoic solid lesion of 13 x 9 mm in size with irregular borders in the left thyroid lobe on thyroid USG and cytologic assessment of thyroid nodule. The patient was diagnosed with suspected, oncocytic lesion, Hashimoto thyroiditis or LCH. The patient underwent total thyroidectomy and pathological assessment confirmed the diagnosis of Langerhans cell histiocytosis. Assessments in the sixth month of postoperative follow-up revealed euthyroid status with no thyroid tissue remnants or pathological lymph node on thyroid USG. In view of the multifocal lesions indicating multi-system disease, a systemic chemotherapy protocol with combination of prednisone (PRED) and vinblastine (VBL) has been planned by the hematology department.Publication Insulinoma case admitted with reactive hypoglycemia symptoms(Bentham Science Publ, 2020-01-01) Koca, Nizameddin; Ugraş, Nesrin; Cander, Soner; CANDER, SONER; Gül, Ozen Oz; ÖZ GÜL, ÖZEN; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Patoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; AAI-1005-2021Aim: To present an insulinoma case with post-prandial hypoglycemic symptoms associated with glucose inducible endogenous hyperinsulinemia.Case: A 52-year-old female patient was evaluated for hypoglycemic symptoms especially those occuring within 3 hours after consuming sugary foods. These symptoms were persistent for a year and a half. She was diagnosed with reactive (post-prandial) syndrome and followed a recommended diet and was given acarbose but there was no improvement. The results suggested post-prandial endogenous hyperinsulinemia related hypoglycemia. Multiphasic computerized tomography revealed an 11x15x12 mm size mass lesion, anteriorly in the head and uncinate process of the pancreas and then the patients were treated surgically with pancreatic enucleation and cured.Conclusion: Distinguishing post-prandial syndrome by careful history and clinical evaluation in patients with postprandial symptoms is of great importance in terms of cost-effectivity. However, it should not be forgotten that although organic pathologies are mostly presented with fasting hypoglycemia, they may also cause post-prandial symptoms. Severity and progression of the symptoms that point to neuroglycopenia is important, and in this condition the most convenient clinical approach to the patient should be performed with careful and appropriate assessment steps.Publication Serum uric acid is not associated with diabetic nephropathy in patients with type 2 diabetes(Carbone Editore, 2015-03-30) Gül, Cuma Bülent; Yıldız, Abdülmecit; Gül, Özen Öz; Hartavi, Mustafa; Cander, Soner; Eroğlu, Ayça; Keni, Nermin; Bayındir, Ayşenur; Ersoy, Alparslan; Ersoy, Canan; YILDIZ, ABDULMECİT; ÖZ GÜL, ÖZEN; Hartavi, Mustafa; CANDER, SONER; Eroğlu, Ayça; Keni, Nermin; Bayındır, Ayşenur; ERSOY, ALPARSLAN; ERSOY, CANAN; Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; 0000-0002-0710-0923; AAI-1005-2021; AAH-5054-2021; AAH-8861-2021; HIG-9032-2022; CUI-5353-2022; HUR-0563-2023; COU-0270-2022; FEA-3241-2022; CFL-1808-2022Introduction: Although epidemiologic studies suggest a link between serum uric acid (SUA) and vascular complications in diabetes, the relationship of uric acid with diabetic nephropathy remains unclear. We aimed to investigate the relationship between SUA and the degree of albuminuria in patients with type 2 diabetes (T2D).Materials and methods: The cross-sectional study included 223 T2D patients. Nephropathy was graded as follows: nor-moalbuminuria, urinary albumin excretion (UAE) less than 30 mg per gram of creatinine (mg/g Cr); microalbuminuria, 30 to 300 mg/g Cr; or macroalbuminuria, more than 300 mg/g Cr. SUA was measured using a uricase-peroxidase enzymatic method.Results: The degree of nephropathy was as follows: normoalbuminuria in 163 subjects, microalbuminuria in 45 subjects, and macroalbuminuria in 15 patients. SUA did not differ significantly according to the degree of albuminuria. In addition, multivariable analysis demonstrated that hyperuricemia was not an independent predictor of neither microalbuminuria nor macroalbuminuria in T2D patients.Conclusion: Hyperuricemia does not reflect the severity of nephropathy in T2D patients.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.
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