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Öğe The Adiponectin variants contribute to the genetic background of type 2 diabetes in Turkish population(ELSEVIER, 2014) Arikoglu, Hilal; Ozdemir, Hulya; Kaya, Dudu Erkoc; Ipekci, Suleyman Hilmi; Arslan, Ahmet; Kayis, Seyit Ali; Gonen, Mustafa SaitAdiponectin, an adipose tissue specific protein encoded by the Adiponectin gene, modulates insulin sensitivity and plays an important role in regulating energy homeostasis. Many studies have shown that single nucleotide polymorphisms (SNPs) in the Adiponectin gene are associated with low plasma Adiponectin levels, insulin resistance and an increased risk of type 2 diabetes mellitus. The aim of the present study was to evaluate the contribution of the Adiponectin gene polymorphisms in genetic background of type 2 diabetes in a Turkish population. In total, 169 unrelated and non-obese diabetic patients and 119 age- and BMI-matched nondiabetic individuals with no family history of diabetes were enrolled in this study. We detected a significant association between type 2 diabetes and two SNPs: SNP - 11391G>A. which is located in the promoter region of the Adiponectin gene, and SNP + 276G > T, which is found in intron 2 of the gene (P < 0.05). The silence SNP G15G ( + 45T > G) in exon 1 and SNP + 349A > G in intron 2 also showed a weak association with type 2 diabetes (P = 0.06 and P = 0.07, respectively), while SNPs - 3971A>G in intron 1 and Y111H, R112C and H241P in exon 3 showed no association (P > 0.05). In conclusion, these findings suggest that Adiponectin gene polymorphisms might be effective on susceptibility for type 2 diabetes development which emerged from the interactions between multiple genes, variants and environmental factors. (C) 2013 Elsevier B.V. All rights reserved.Öğe Assessment of Evidence for Positive Association and Seroprevalence of Hepatitis B and C in Diabetic Patients in a Developing Country(BMJ PUBLISHING GROUP, 2015) Korkmaz, Huseyin; Kesli, Recep; Pamuk, Bans Onder; Ipekci, Suleyman Hilmi; Terzi, Yuksel; Kebapcilar, LeventBackground and Aim: The data related to the association between hepatitis virus infections and diabetes mellitus (DM) are conflicting. The aim of this study was to investigate the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and to determine the risk factors affecting the prevalence in Turkish patients with type 1 DM and type 2 DM. Methods: The study consisted of 736 diabetic and 505 nondiabetic patients. Serological investigation for the hepatitis B surface antigen (HBsAg) and the HCV antibody (anti-HCV) was performed with a third-generation commercial chemiluminescence assay. The presence of HBsAg was considered as indicator of HBV infection. The HCV infection in the patients with positive anti-HCV was confirmed by a real-time polymerase chain reaction assay. The patients were divided according to their HBV and HCV infection status, and their demographic features, diabetes properties, general risk factors, and aminotransferase levels were analyzed. Results: There was no significant difference in the seropositivity rate for the HBsAg (3.8% vs 3.0%, P > 0.43; odds ratio, 1.292; 95% confidence interval, 0.683-2.444). However, anti-HCV seropositivity was significantly increased in the DM group (3.3% vs 1.8%, P < 0.03; odds ratio, 2.398; 95% confidence interval, 1.025-5.609). Increased aminotransferase levels and a history of blood transfusions were positively correlated with both HBV and HCV infection. Moreover, a history of surgical procedures and high glycated hemoglobin A1c levels were positively associated with HBsAg antigen seropositivity. Conclusions: Although no significant difference in the seropositivity of the HBsAg was determined, a high prevalence of HCV infection was detected in the DM patients compared to healthy controls.Öğe Cornea in PCOS patients as a possible target of IGF-1 action and insulin resistance(SPRINGER HEIDELBERG, 2014) Kebapcilar, Ayse Gul; Tatar, Mehmet Gurkan; Ipekci, Suleyman Hilmi; Gonulalan, Gulsum; Korkmaz, Huseyin; Baldane, Suleyman; Celik, CetinPrevious studies suggest that serum IGF-1 is higher in women with polycystic ovary syndrome (PCOS). The ophthalmologic effects of IGF-1 excess have not yet been investigated in women with PCOS. The aim of the current study is to compare the corneal thickness of patients with PCOS and those of healthy subjects. Forty three patients with PCOS and 30 age-matched and gender-matched healthy individuals were enrolled in this cross-sectional study. Central corneal thickness (CCT) was measured in patients with PCOS and in healthy individuals with an ultrasound pachymeter. IGF-1 values were also determined in the study group. Women with PCOS had significantly higher levels of IGF-1 and homeostasis model assessment (HOMA-IR) levels than the control group. Right and left CCT measurements were higher in the PCOS group than in the control group. A positive correlation between IGF-1 and right and left CCT was identified in both groups. In multiple linear stepwise regression analyses, IGF-1 independently and positively associated with HOMA-IR in women with PCOS. A correlation between total testosterone and CCT was identified in the whole group. In multiple stepwise regression analyses, total testosterone independently and positively associated with left central corneal thickness in the whole group. These findings indicate that PCOS has target organ effects on the eye. Consequently, it can change central corneal thickness. Higher IGF-1 levels seem to be the main causes of increased corneal thickness. Insulin resistance in PCOS is one of the underlying causes and promotes increase in IGF-1. We suggest a careful and detailed corneal evaluation in PCOS patients to prevent the potential risk of increased CCT, in addition to the already-known complications.Öğe Diabetic ketoacidosis occurring in patient on newly started insulin glargine u300(AVES, 2018) Kirac, Cem Onur; Ipekci, Suleyman Hilmi; Kebapcilar, LeventInsulin glargine U300 is a 3-fold, concentrated, long-acting insulin analog providing a more stable effect compared with insulin glargine U100. However, stable plasma insulin concentration is reached on day 4 of the treatment. Patients with type 1 and type 2 diabetes mellitus with decreased insulin reserve are at an increased risk of diabetic ketoacidosis when there is insufficient exogenous plasma insulin concentration. Herein, we present a case of diabetic ketoacidosis occurring in a patient with insulin glargine U300 and emphasize the pharmacokinetic properties of insulin glargine U300.Öğe Do We Need to Replace GH to Correct Anemia in Hypopituitarism?(ENDOCRINE SOC, 2014) Kulaksizoglu, Mustafa; Ipekci, Suleyman Hilmi; Gonulalan, Gulsum; Ozturk, Mine; Kaya, Ahmet; Gonen, Mustafa Sait; Cakir, Mehtap[Abstract not Available]Öğe Effects of Single Nucleotide Polymorphisms in K-ATP Channel Genes on Type 2 Diabetes in a Turkish Population(ELSEVIER SCIENCE INC, 2012) Gonen, Mustafa Sait; Arikoglu, Hilal; Kaya, Dudu Erkoc; Ozdemir, Hulya; Ipekci, Suleyman Hilmi; Arslan, Ahmet; Kayis, Seyit AliBackground and Aims. ATP-sensitive potassium (K-ATP) channels of pancreatic beta-cells play a key role in glucose-stimulated insulin secretion mechanism. The Kir6.2 protein, forming the K-ATP channel pore inwardly, and the SUR1 protein that surrounds it forming the outside part of the channel were encoded by ABCC8 and KCNJ11 genes, respectively. Recent studies reported that the single nucleotide polymorphisms (SNPs) established in these genes are associated with defects in insulin secretion and type 2 diabetes mellitus (T2DM). We aimed to investigate the allele profiles and the risk alleles of the ABCC8 and KCNJ11 genes and to highlight the associations with the disease in patients in Konya region of Turkey where T2DM is common. Methods. In this study, 169 patients with T2DM and 119 healthy controls were included. A total of 29 SNPs in ABCC8 and KCNJ11 genes were screened by PCR-SSCP technique and sequenced. Biochemical parameters and genotype-phenotype relationships were analyzed using variance analysis. Results. R1273R silent substitution in exon 31 and 16/-3t -> c substitution in noncoding region of exon 16 of ABCC8 gene showed a significant association (OR 4.8 [95% CI 2.41-9.77], p < 0.001 and OR 3.5 [95% CI 1.64-7.40], p < 0.001 under dominant and recessive models, respectively). We detected a significant association between E/K heterozygote genotype and reduced plasma insulin level in patients with T2DM (p < 0.05). Conclusions. ABCC8 exons 16 and 31 variants increase susceptibility to T2DM and KCNJ11 E23K decreases insulin secretion in a Turkish population (C) 2012 MISS. Published by Elsevier Inc.Öğe Influence of Exercise on Leptin, Adiponectin and Quality of Life in Type 2 Diabetics(GALENOS YAYINCILIK, 2015) Dede, Nesrin Dogan; Ipekci, Suleyman Hilmi; Kebapcilar, Levent; Arslan, Mihriban; Kurban, Sevil; Yildiz, Mustafa; Gonen, Mustafa SaitPurpose: This study aimed to investigate the influence of aerobic exercise on the quality of life and leptin and adiponectin levels in patients with type 2 diabetes mellitus. Material and Method: Patients were randomized into two groups: aerobic exercise-training and control group. Parameters were assessed at baseline and end of the twelve-week follow-up for 60 type 2 diabetic patients who completed the program. The 36-item Short Form Health Survey was administered to the patients. Results: The exercise-training group results showed a decrease in adiponectin and leptin levels, a reduction of waist circumference and percentage of body fat (p=0.007, 0.023, 0.012 and 0.048, respectively). The leptin levels in the aerobic exercise group were positively correlated with body mass index (r=0.303, p=0.021) and percentage of body fat (r=0.371, p=0.005); they were negatively correlated with physical problems (r=-0.482; p=0.009) and pain (r=-0.540; p=0.003). Exercise led to statistically significant improvements in the SF-36 physical functioning and mental health subscales (p=0.020 and 0.023, respectively). Discussion: The association of better HbA1c, waist circumference, and percentage of body fat with improved mental and physical scores may be related to a decrease in leptin levels, despite a significant reduction in serum adiponectin levels.Öğe Is the Mean Platelet Volume a Predictive Marker of a Low Apgar Score and Insulin Resistance in Gestational Diabetes Mellitus? A Retrospective Case-Control Study(PREMCHAND SHANTIDEVI RESEARCH FOUNDATION, 2016) Kebapcilar, Levent; Kebapcilar, Ayse Gul; Ilhan, Tolgay Tuyan; Ipekci, Suleyman Hilmi; Baldane, Suleyman; Pekin, Aybike; Kulaksizoglu, MustafaIntroduction: Gestational diabetes is defined as various degrees of glucose intolerance diagnosed or detected for the first time during pregnancy and is the most common metabolic complication of pregnancy. Early diagnosis and adequate treatment are important to prevent complications. Preeclampsia, polyhydramnios, fetalmacrosomia, and operative delivery are some of the complications seen in pregnant women diagnosed with Gestational Diabetes Mellitus (GDM). Aim: The present study was designed to determine whether there was an association between Mean Platelet Volume (MPV) in predicting poor fetal outcome, insulin resistance, neonatal Apgar scores and gestational age for women with GDM. Materials and Methods: In this retrospective study, we enrolled 101 pregnant women with GDM together with a group of 138 healthy controls. MPV, insulin and homeostatic model assessment (HOMA-IR) values were measured at 24-28 weeks of the pregnancy. An independent samples t-test was used to compare MPV values. Multivariate linear regression models were used to establish relations between MPV values, HOMAIR, insulin levels and Apgar score. Results: There was a significant positive correlation between MPV values, HOMA-IR and Insulin levels and a negative correlation with Apgar score at 1 min and 5 min in the GDM group (r=0.227, p=0.02; r=0.206, p=0.03; r=-0.485, p<0.001; and r=-0.399, p<0.001, respectively). In the multivariate logistic regression analysis, a high MPV value was most consistently associated with a low Apgar 1 min score (beta=-0.387, p=0.003) in the GDM group. An MPV of >8.0 fL had a sensitivity of 82% and a specificity of 75% for the prediction of GDM. Conclusion: We investigated the potential of MPV values in predicting low Apgar scores and insulin resistance in women with GDM.Öğe Spectral-Domain Optical Coherence Tomography Findings in Lipemia Retinalis(SLACK INC, 2016) Ozturk, Banu Turgut; Bozkurt, Banu; Mesen, Ali; Gonul, Saban; Ipekci, Suleyman HilmiSevere hypertriglyceridemia can give rise to a fundus appearance with whitish-colored retinal vessels called lipemia retinalis. A 52-year-old man with hypertriglyceridemia presented with a best-corrected visual acuity of 20/20 in both eyes and creamy-white retinal vessels on fundus. Spectral- domain optical coherence tomography (SDOCT) revealed hyperreflective and engorged retinal vessels and white dots mainly accumulated in the inner nuclear and ganglion cell layer. Follow-up fundus examination after plasmapheresis sessions revealed normal retinal vessels. The hyperreflective appearance of the retinal vessels in OCT reversed rapidly 5 days after the treatment, whereas hyperreflective dots in retina disappeared slowly in 3 months. OCT is useful in demonstrating inner retinal changes associated with lipemia retinalis at histopathological level. The hyperreflective dots in inner retina associated with leakage from superficial retinal capillaries attested the correlation of their location with their origin.Öğe Successful preoperative treatment by plasmapheresis of hyperthyroidism with hydatidiform mole(AVES, 2018) Kirac, Cem Onur; Baldane, Suleyman; Kebapcilar, Ayse Gul; Ipekci, Suleyman Hilmi; Ucar, Mustafa Gazi; Celik, Cetin; Kebapcilar, LeventWe recently encountered the case of an 18-year-old female complaining of abdominal pain, fatigue, nausea, vomiting, tremor of the hands, and vaginal bleeding. Her blood test revealed highly elevated human chorionic gonadotropin (hCG) levels, suppressed thyroid-stimulating hormone (TSH) levels, and increased free thyroid hormone levels. Molar pregnancy and hyperthyroidism were suspected based on highly elevated hCG levels and suppressed TSH levels with the co-existence of ultrasono-graphic findings of the uterus and thyroid Doppler images. Her symptoms and thyroid hormone levels responded well to plasmapheresis. Subsequently, the patient underwent dilatation and curettage for hydatidiform mole. Histopathology of the products verified the diagnosis of complete hydatidiform mole with no invasion. The patient is currently stable, and her hCG and thyroid hormone levels are within normal reference ranges.Öğe An uncommon presentation of Sjogren's syndrome and brucellosis(PERGAMON-ELSEVIER SCIENCE LTD, 2014) Celik, Gulperi; Ozturk, Ercument; Ipekci, Suleyman Hilmi; Yilmaz, Sema; Colkesen, Fatih; Baldane, Suleyman; Kebapcilar, LeventWe describe herein a case of hypokalemia due to proximal renal tubular acidosis (RTA) and Fanconi's syndrome (FS) and nephrogenic diabetes insipidus with DIC - a rare complication of Sjogren's syndrome (SS) and brucellosis. The interesting feature of this case was the presentation with severe hypokalemia, causing acute flaccid quadriparesis with cardiac arrest which is extremely rare. The patient was a 48-year-old woman who suffered cardiopulmonary arrest an hour after hospitalization. Analysis of a blood sample obtained before her cardiopulmonary arrest yielded surprising results: laboratory investigations showed profound hypokalemia (1.1 mEq/L) with renal K wasting, hyperchloremic metabolic acidosis with normal anion gap, hypophosphatemia with hypouricemia, glucosuria, and proteinuria. A diagnosis of RTA and FS were made. On the seventh day, she looked acutely ill, temperature 38.8 C and pale, and her physical examination revealed purpuric skin lesions on both legs. The serum antibrucella titration agglutination test was found to be 1 of 160 positive with a nosocomial infection. The clinical and laboratory findings were consistent with disseminated intravascular coagulation (DIC). She was unable to concentrate her urine and so a diagnosis of nephrogenic diabetes insipidus (NDI) was reached. A thorough survey for the cause of FS, RTA and NDI revealed that she had xerophthalmia and xerostomia accompanied by high anti-Ro antibody, positive Schirmer test, confirming the diagnosis of SS. (C) 2014 Elsevier Ltd. All rights reserved.
