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    The association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C: An observational, multicenter study in Turkey
    (AVES, 2014) Dökmeci, Abdulkadir; Üstündağ, Yücel; Hülagu, Saadettin; Tuncer, İlyas; Akdoğan, Meral; Demirsoy, Hüseyin; Köklü, Seyfettin
    Background/Aims: To evaluate the association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C. Materials and Methods: A total of 104 chronic hepatitis C patients were included in this non-interventional, open-label, observational, multicenter, cross-sectional study conducted at 20 gastroenterology clinics in Turkey. The primary end point was the correlation between stage of hepatic fibrosis and insulin resistance evaluated via the homeostasis model of assessment-insulin resistance index. Confounders of hepatic fibrosis and insulin resistance were the secondary end points. Results: The mean age of patients was 52.8 years; 65.4% were female. Type 2 diabetes was present in 6.8% and insulin resistance noted in 38.0% of patients. Further, 45.7% of the patients had mild (A0/A1) and the remaining had moderate/severe (A2/A3) hepatic necroinflammatory activity. Patient distribution according to Metavir fibrosis stage was as follows: F0/F1 (57.0%); F2 (6.5%); F3 (23.7%); and F4 (12.9%). A univariate analysis revealed significant positive correlations between Metavir fibrosis stage and insulin resistance (r=0.297; p=0.007). Logistic regression analysis showed that significant predictors of insulin resistance were high alanine transaminase levels (odds ratio, 0.97; 95% confidence interval, 0.944-0.997) and liver fibrosis stage (odds ratio, 0.114; 95% confidence interval, 0.021-0.607). Conclusion: Our findings revealed significant associations between insulin resistance and hepatic fibrosis.
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    Long-Term Clinical Outcomes of Entecavir and .tenofovir in Hepatitis B Cirrhosis
    (Wiley-Blackwell, 2012) Köklü, Seyfettin; Tuna, Yaşar; Gülşen, Murat T.; Demir, Mehmet; Köksal, Aydın S.; Kockar, Muhammed C.; Aygün, Cem
    [Abstract not Available]
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    Serum TNF- Alpha Levels in Acute and Chronic Pancreatitis
    (2009) Kıyıcı, Aysel; İbiş, Mehmet; Akbulut, Seval; Köklü, Seyfettin; Uçar, Engin; Ünlü, Ali
    Aim: Acute and chronic pancreatitis are inflammations of pancreatic tissue which have systemic effects and clinical presentations such as bacteremia and septic shock. Inflammatory markers have growing importance in diagnosis and identification of the severity of the pancreatitis. We aimed to determine TNF-alpha levels in acute and chronic pancreatitis and evaluate the relation between TNF-alpha levels and the pancreatic enzyme concentrations in two forms of the disease. Methods: 13 patients with acute pancreatitis, 36 patients with chronic pancreatitis and 14 healthy controls were included to our study. TNF-alpha determinations were performed with ELISA method. Results: TNF-alpha concentrations were 13.30±4.42 (7.04-21.35) pg/ml and 9.88±4.68 (3.99-27.73) pg/ml 10.09±1.01 (8.69-14.96) pg/ml in patients with acute and chronic pancreatitis and healthy controls respectively. TNF-alpha concentrations were significantly higher in patients with acute pancreatitis than the patients with chronic pancreatitis. But there was no significant difference between healthy controls and patients with either acute or chronic pancreatitis for TNF-alpha levels. There was no significant correlation between TNF-alpha concentrations and pancreatic enzyme levels. Conclusion: We concluded that in acute pancreatitis TNF-alpha levels were higher than the chronic form of the disease. But its concentrations did not correlate with the severity of the disease. By investigation of the other inflammatory markers and acute phase reactants with TNF-alpha, this process will be more clarified.