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    Association Between Apolipoprotein E Polymorphism and Subclinic Atherosclerosis in Patients with Type 1 Diabetes Mellitus
    (TURKISH PEDIATRIC ENDOCRINOLOGY & DIABETES SOCIETY, 2012) Atabek, Mehmet Emre; Ozkul, Yusuf; Eklioglu, Beray Selver; Kurtoglu, Selim; Baykara, Murat
    Objective: The most important cause of morbidity and mortality in type 1 diabetes mellitus (DM) is atherosclerosis. Apolipoprotein E (Apo E) polymorphism is accused of being the genetic risk factor for atherosclerosis. The aim of the present study was to determine which Apo E polymorphism was related to atherosclerosis in patients with type 1 DM. Methods: Seventy-four patients with type 1 DM were enrolled in the study. Age, diabetes duration, daily insulin dose, microalbuminuria, and major cardiovascular risk factors including anthropometric and metabolic parameters were assessed in each patient. Non-invasive ultrasonographic measurements were also performed. For determination of Apo E genotype, DNA was extracted from venous blood from all subjects using standard methods. Apo E genotyping was performed using a PCR-restriction fragment-length polymorphism assay. Results: Systolic blood pressure and carotid artery intima-media thickness (CA-IMT) were increased in subjects with E4/E4 polymorphism. According to univariate analysis, when adjusted for all risk factors, genotypes did not differ for total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides (p>0.05). However, E3/E3, E3/E4 and E4/E4 genotypes were found to be associated with an increase in CA-IMT (p<0.001). Conclusions: Our results suggest that the polymorphism associated with atherosclerosis in type1 DM is Apo E4/E4.
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    Effectiveness of pentoxifylline on the cross-sectional area of intima media thickness and functions of the common carotid artery in adolescents with type 1 diabetes
    (WALTER DE GRUYTER & CO, 2011) Atabek, Mehmet Emre; Kurtoglu, Selim; Selver, Beray; Baykara, Murat
    Objective: The aim of the present study was to evaluate the effect of oral pentoxifylline on the cross-sectional area of intima media thickness (CSA-IMT) and functions of the common carotid artery, a marker of early atherosclerosis, in adolescents with type 1 diabetes. Patients and methods: Non-invasive ultrasonographic measurements were made in 56 type 1 diabetic patients. The diabetic patients were matched first in terms of age, diabetes duration, major cardiovascular risk factors, including anthropometric and metabolic parameters as well as ultrasonographic measurements, then one individual within each pair randomized into a pentoxifylline group and a placebo (control) group (i.e., 32 on pentoxifylline group and 24 on placebo). Pentoxifylline was administered for 6 months. We investigated the change of CSA-IMT, compliance, distensibility, diastolic wall stress (DWS), and incremental elastic modulus of the common carotid artery at 6 months after pentoxifylline. Results: In comparison of changes in common carotid artery measurements between the two groups, the pentoxifylline treatment group had significantly higher values than the controls for CSA-IMT (-2.6 +/- 0.1 vs. 0.7 +/- 0.4 mm(2), p=0.001) and for DWS (-0.38 +/- 0.02 vs. -0.05 +/- 0.05 mm Hgx10(2), p<0.001). In a multivariate regression model for all patients, being in pentoxifylline group was the best predictor of the change DWS (beta=-0.52, p<0.001). Conclusion: Our preliminary results suggest that pentoxifylline has an antiatherogenic action and might modulate risk factors for atherosclerosis in type 1 diabetes.
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    Evidence for an association between insulin resistance and premature carotid atherosclerosis in childhood obesity
    (KARGER, 2006) Pirgon, ÖzgÜr; Atabek, Mehmet Emre; Kıvrak, Ali Sami; Erkul, Ibrahim; Kurtoglu, Selim
    [Abstract not Available]
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    Growth Patterns of Children of Same Geographic Background Reared in Different Environments
    (GALENOS YAYINCILIK, 2014) Yuca, Sevil Ari; Cesur, Yasar; Kurtoglu, Selim; Mazicioglu, Mustafa Mumtaz; Cimbek, Emine Ayca
    Objective: Growth charts are essential tools used to assess children's health status. The aim of the present study was to determine the effect of environmental factors on the growth of children of a common geographic background. We constructed growth charts for children living in the East of Turkey and compared them with those for Turkish children living in other regions or countries. Methods: Growth data were obtained from 6 917 school children living in Eastern Turkey. The median values on smoothed percentile curves for the study subjects were compared with those for Turkish children living in the West of Turkey, in Western Europe and in Germany. Results: Children living in Turkey were lighter than their European peers at early ages. Weight curves of children living in the West of Turkey reached those of their European peers, after 11 years of age in boys and after 12 years of age in girls. At all ages, girls and boys in our region had the lowest weight values. Between 7 and 11 years of age, the median height in boys and girls were similar in the West of Turkey and in Europe. At older ages, median height was higher in Turkey. Girls and boys living in Eastern Turkey were the shortest children until 16 years of age; after that age, their height was similar to their peers. Conclusions: Weight may interact with environmental factors, but genetic potential appears to be the most important factor determining height at 17 years of age. Growth patterns of children should be evaluated using specific reference values for specific regions.
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    Insulin detemir improves glycemic control and reduces hypoglycemia in children with type 1 diabetes: findings from the Turkish cohort of the PREDICTIVE (TM) observational study
    (WILEY, 2009) Kurtoglu, Selim; Atabek, Mehmet Emre; Dizdarer, Ceyhun; Pirgon, Ozgur; Isguven, Pinar; Emek, Sevil
    Background: Insulin detemir is a basal insulin analog designed to produce a superior pharmacokinetic profile to basal formulations of human insulin. It has shown consistently improved tolerability ill comparison to neutral protamine Hagedorn (NPH) insulin in adult cohorts, but there are relatively few publications involving pediatric cohorts. Methods: The efficacy and safety of insulin detemir in children with type I diabetes was assessed using data from the Turkish cohort of PREDICTIVE(TM) (a large, multinational, observational) study. The children investigated were using basal-bolus therapy involving NPH insulin or insulin glargine at baseline but were switched to insulin detemir as part of routine clinical care by their physicians. Results: Twelve weeks of treatment with insulin detemir significantly reduced mean hemoglobin A1c (9.7-8.9%, p < 0.001) and mean fasting glucose [185-162 mg/dL (10.3-9 mmol/L), p < 0.01]. Fasting glucose variability was also lower after treatment with insulin detemir than previously (oil either NPH or glargine, p < 0.05). The frequencies of total, major and nocturnal hypoglycemic events were significantly reduced with insulin detemir relative to baseline, with all estimated mean of 6.89 fewer events/patient/yr overall (p < 0.001) and 2.6 fewer nocturnal events/patient/yr (p < 0.01). Weight and insulin dose remained relatively unchanged. Conclusions: Twelve weeks of treatment with insulin detemir improved glycemic control and reduced hypoglycemia ill children with type I diabetes. This improved tolerability might allow further dose titration and therefore additional improvements in glucose control.
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    Possible effect of leptin on renal magnesium excretion in adolescent patients with type 1 diabetes
    (WILEY, 2006) Atabek, Mehmet Emre; Kurtoglu, Selim; Pirgon, Ozgur
    Background : Hypomagnesaemia and hyperleptinemia are common in patients with diabetes. Moreover, it has been demonstrated that leptin stimulates diuresis and natriuresis. The aim of this study was to evaluate the relationship between serum leptin, serum magnesium (Mg) and urinary Mg/urinary creatinine levels in patients with type 1 diabetes. Methods : Serum leptin and Mg and urinary Mg/urinary creatinine levels were measured in 67 patients with diabetes (33 girls and 34 boys). The age, diabetes duration, anthropometric and metabolic parameters of the subjects were matched between girls and boys. The relation of serum leptin levels to serum and urinary Mg/urinary creatinine levels was assessed. Results : Serum leptin levels of girls with diabetes were higher than those of the boys (14 +/- 5.3 mu g/L vs 5.8 +/- 1.5 mu g/L, P < 0.001, respectively). The differences for serum Mg and for urinary Mg/urinary creatinine levels were not significant between girls and boys with diabetes. Leptin levels were correlated with urinary Mg/urinary creatinine levels in both girls and boys (r = 0.39, P = 0.02 and r = 0.37, P = 0.03, respectively). In a multivariate regression model, leptin emerged as independent correlates for mean urinary Mg/urinary creatinine in both girls and boys with the total variance explained being 14%, and 15%, respectively. Conclusion : The data suggest that serum leptin might be related to increased urinary Mg loss in patients with type I diabetes.
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    Relation of in utero lead exposure with insulin-like growth factor-I levels and neonatal anthropometric parameters
    (ELSEVIER GMBH, URBAN & FISCHER VERLAG, 2007) Atabek, Mehmet Emre; Kurtoglu, Selim; Pirgon, Ozgur; Uzum, Kazim; Saraymen, Recep
    Our aim was to establish whether independent relationships exist between either anthropometric parameters or insulin-like growth factor-I (IGF-I) and cord blood lead levels in newborns. Umbilical cord blood samples and anthropometric data were obtained at delivery. Cord blood lead levels were analyzed by atomic absorption spectrophotometer. IGF-I levels were measured using RIA. Blood lead levels >= 100 mu g/l were considered elevated in accordance with CDC guidelines. Data on all variables of interest were obtained for 54 term neonates. The mean cord blood lead level was 144 +/- 89 mu g/l with a range of 51-355 mu g/l. Twenty-nine (53.7%) neonates had blood lead levels >= 100 mu g/l. However, only 5 (9.2%) of the neonates had blood lead levels of >= 250 mu g/l. No statistically significant difference was found in case of anthropometric parameters and IGF-I levels between neonates with high lead levels (>= 100 mu g/l) and with low lead levels (< 100 mu g/l) in cord blood (p > 0.05). There was a significant correlation between lead and birth weight in neonates with high lead levels (r: -0.49, p = 0.01) but not other anthropometric data and IGF-I levels. A multivariate regression analysis using the full range of lead values adjusted for the relevant confounders such as gestational age and socioeconomic status was performed. In the model birth weight (p: 0.01, beta: -0.81) birth length (p: 0.05, beta: 0.41) and midarm-circumferences (p: 0.05, beta: 0.30) were the best predictors of lead levels, with the total variance explained being 36%. Significant relationship was found between birth weight and lead burden in newborns. Whether serum lead level predicts the development of failure to thrive in these children remains to be determined in follow-up studies. (c) 2006 Elsevier GmbH. All rights reserved.