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Öğe A bibliometric analysis of academic publication on diabetic retinopathy disease trends during 1980-2014: A global and medical view(International Journal of Ophthalmology, 2016) Çağlar, İsmail Çağatay; Demir, Emre; Küçükler, Ferit Kerim; Durmuş, MustafaAIM: To investigate diabetic retinopathy (DR) literature using the Institute for Scientific Information (ISI) Web of Science (WoS) database and to analyse the correlation results between socio-economic development datas and number of DR publications. METHODS: The statistical analysis of the documents published during 1980-2014 was analysed. The data of this study were based on the database of WoS. "Diabetic retinopathy" was used as the keywords to search the WoS database. RESULTS: The United States ranked first in the DR research with 1840 publications and 24.38% of the world production followed by England and Japan. Besides, the most productive country was Iceland. A high correlation was found between number of publications and 2014 gross domestic product (GDP) values of 81 countries (r=0.800, PÖğe A rare presentation of subclinical Cushing’s syndrome as a pubic fracture(Japanese Society of Internal Medicine, 2014) Arduç, Ayşe; Ayçiçek Doğan, Berçem; Akbaba, Gülhan; Dağdelen, İffet; Küçükler, Ferit Kerim; Işık, Serhat; Özu?uz, Ufuk; Berker, Dilek; Güler, SerdarOsteoporosis and bone fractures are commonly seen in patients with Cushing’s syndrome (CS). Fractures usually occur in the vertebrae and ribs whereas pubic fractures are less common. Similar to obvious hypercortisolemia, subclinical hypercortisolemia can increase the risk of fractures. However, in subclinical cases, bone fractures are very rarely seen as the presenting symptom. We herein report the case of a 62-year-old postmenopausal woman who was presented with a pubic fracture. During the evaluation of the fracture, thoracoabdominal magnetic resonance imaging of the patient demonstrated an adrenal mass. Although the patient did not show any signs of overt hypercortisolism, an endocrinologic evaluation revealed hypercortiso-lism due to an adrenal tumor. Adrenalectomy was performed, which resulted in a cure of the disease. During the orthopedic follow-up, the patient’s pubic area pain gradually improved, and the pubic fracture healed without any accompanying new bone fractures. One year after the surgery, a remarkable improvement was detected in the patient’s bone density in spite of the lack of administration of any medications for osteoporosis. Subclinical CS can present as a pubic fracture, and awareness of this relationship can help physicians to diagnose the disease. © 2014 The Japanese Society of Internal Medicine.Öğe Acute pancreatitis and type 2 diabetes mellitus: who is guilty?(2015) Küçükler, Ferit Kerim; Şimşek, Yasin; Bağlıcaklıoğlu, Murat; Adalı Köroglu, Gupse; Güler, SerdarMany factors play a role in the etiology of acute pancreatitis and its pathogenesis is not fully understood. Dipeptidyl peptidase 4 (DPP-4) inhibitors are a new group of agents for the treatment of Diabetes Mellitus (DM). There are some controversies about specific adverse events such as pancreatitis and hypersensitivity reactions. A 50-year-old morbid obese woman presented with upper abdomen pain after the eating food, nausea and vomiting. She was diagnosed with type 2 diabetes mellitus 7 years ago. Vildagliptin had been added to her treatment six months ago. Abdominal examination revealed epigastric tenderness with guarding. Laboratory data revealed elevated pancreatic enzymes. Abdominal computed tomography (CT) showed features of pancreatitis. Vildagliptin was stopped and patient's symptoms had diminished in parallel with normalization of pancreatic enzymes; and at the 5th day patient was discharged with healthy condition. She was free of symptoms and all laboratory data were normal at the 30th day after discharge. It is important to keep in mind that diabetic patients have an increased risk of pancreatitis which may be related to obesity, hyperlipidemia and/or drugs.Öğe Analysis of kyphosis, vertebral fracture and bone mineral density measurement in women living in nursing homes(Saudi Arabian Armed Forces Hospital, 2018-07) Çağlıyan Türk, Ayla; Şahin, Füsun; Küçükler, Ferit Kerim; Deveci, HülyaObjectives: To analyze the relationship between vertebral fracture, degree of kyphosis, and BMD in women living in nursing homes. Methods: This cross-sectional study was carried out in the Department of Physical Medicine and Rehabilitation, Hitit University Hospital, Corum, Turkey, between January 2014 and January 2015. Of the 126 female patients who participated in the study, 48 lived in nursing homes (nursing-home-group [NHG]), 78 lived in non-nursing home settings (control-group [CG]). Vertebral fractures were evaluated via the semi-quantitative Genant method. Cases in which a Cobb angle measured 40 degrees or more resulted in a diagnosis of kyphosis. Results: The mean age of participants in the NHG was 77.2±7.6 years and 76.8±6.2 years in the CG (p>0.05). The kyphosis rate in the NHG was found to be higher at 52.1% compared to 27.7% for the CG (p<0.001). In the NHG, 68.7% had osteoporosis, 31.3% had osteopenia; in the CG, 55.2% had osteoporosis, 32% had osteopenia, 12.8% had normal values (p<0.05).The vertebral fracture rate was 37.5% in the NHG and 24.3% in the CG (p>0.05). The Cobb angle had correlation with the number of fractures in both groups (p<0.05). Conclusions: The osteoporosis and kyphosis rates of women living in NHG were higher than those of women living in CG. As kyphosis and the number of fractures are correlated, it is important to analyze kyphosis in women residing in NHG. © 2018, Saudi Arabian Armed Forces Hospital. All rights reserved.Öğe Anti-Müllerian hormone exhibits a great variation in infertile women with different ovarian reserve patterns(Blackwell Publishing, 2017) Görkem, Ümit; Küçükler, Ferit Kerim; Toğrul, Cihan; Güngör, TayfunBackground: Several conflicting studies with results on the biological variability of serum anti-Müllerian hormone (AMH) levels have been reported. Most of the studies have not focused on whether the level of AMH fluctuations shows variability by a baseline ovarian follicular reserve. Aim: To reveal whether intracyclic variation in AMH levels occurs among women with adequate, high and diminished ovarian reserve patterns. Study design: In this prospective cross-sectional study, 171 infertile women between the ages of 18 and 42 years were recruited. All participants were divided into three types of ovarian reserve patterns (adequate, high and diminished). Serum samples were tested for levels of follicular AMH (F-AMH), luteal AMH (L-AMH), estradiol (E2), and follicle stimulating hormone (FSH) and progesterone. Results: The median age of the 171 participating women was 28 (18–42) years. The three ovarian reserve groups had similar body mass index (BMI) and E2 (P = 0.797 and P = 0.135, respectively). The serum AMH levels of all women and the three ovarian reserve groups in the follicular phase were higher compared to those in the luteal phase (P < 0.001). There were strong positive correlations between follicular and luteal AMH levels in adequate, high and diminished reserve groups (Spearman r = 0.864, P < 0.001 vs r = 0.899, P < 0.001 vs r = 0.863, P < 0.001, respectively). Conclusion: Serum AMH levels were higher during the follicular phase than the luteal phase in women with adequate, high and diminished ovarian patterns. Since the highest AMH levels are demonstrated during the follicular phase, the optimal time to measure AMH concentration might be during the follicular phase. © 2017 The Royal Australian and New Zealand College of Obstetricians and GynaecologistsÖğe Are adipokines associated with gestational diabetes mellitus?(Turkish-German Gynecological Association, 2016) Görkem, Ümit; Küçükler, Ferit Kerim; Toğrul, Cihan; Güngör, TayfunObjective: To investigate the association of maternal serum levels of chemerin, retinol binding protein-4 (RBP-4), and visfatin with gestational diabetes mellitus (GDM). Material and Methods: 158 pregnant women were screened between 24 and 28 weeks of gestation. They were divided into two groups: GDM group (n=76) and control group (n=82). Maternal serum concentrations of chemerin, RBP-4, visfatin, insulin, and homeostasis model assessment-insulin resistance (HOMA-IR) were assessed. Results: There were no differences in age and gestational age between the GDM group and the control group (p=0.058 and p=0.820, respectively). Body mass index (BMI) at 24 to 28 weeks of gestation was higher in the GDM group (p<0.001). The serum concentrations of RBP-4, chemerin, and visfatin did not demonstrate significant differences between the GDM and control groups (p=0.871, p=0.100, and p=0.886, respectively). Significant differences in serum level of insulin and HOMA-IR were found between the GDM and control groups (14.94 vs 9.87, p<0.001 and 3.73 vs 1.77, p<0.001, respectively). Correlation analyses of chemerin, RBP-4, visfatin, insulin, and HOMA-IR in both groups revealed a weak degree of positive correlation between RBP-4 and chemerin (Spearman r=0.251, p=0.026) and a strong positive correlation between maternal insulin and HOMA (Spearman r=0.868, p<0.001). Conclusion: No differences were found in serum chemerin, RBP-4, and visfatin between pregnant women with GDM and healthy pregnant women. Further prospective studies will be essential to elucidate the contribution of adipokines to GDM and the positive correlation between maternal RBP-4 and chemerin. © 2016 by the Turkish-German Gynecological Education and Research Foundation.Öğe Ciddi kalp yetmezliği ve vertebra kırıkları ile tanı alan cushing sendromu olgusu(Galenos, 2015) Arduç, Ayşe; Işık, Serhat; Akbaba, Gülhan; Küçükler, Ferit Kerim; Berker, Dilek; Güler, SerdarCushing sendromunda (CS) kardiyovasküler hastalıklar ve osteoporoz nedeni ile mortalite ve morbidite artmaktadır. Klinik bulgular ve mortalite hiperkortizoleminin şiddeti ve süresi ile ilişkilidir. Biz CS tanısının gecikmesinden kaynaklanan ciddi komplikasyonlarla başvuran bir olguyu sunduk. Elli iki yaşındaki erkek hasta bacaklarda şişlik, nefes darlığı ve bel ağrısı şikayetleri ile başvurdu. Özgeçmisinde 2 yıldır çoklu antihipertansif tedavi ve yoğun insülin tedavisine rağmen kontrol altına alınamayan hipertansiyon ve diyabet ile 6 aydır kalp yetmezliği mevcuttu. Fizik muayenede pletore, bufalo hörgücü, abdominal obezite, karında mor strialar, pretibial ödem saptandı. Laboratuvar incelemesinde adrenokortikotropik hormon (ACTH) <5 pg/ml, sabah plazma kortizolü 26,33 ?g/dl, gece plazma kortizolü 26,38 ?g/dl, idrar kortizolü 272 ?g/24 saat saptandı. Klasik 2 mg ve 8 mg deksametazon supresyon testlerinde plazma kortizolünde baskılanma yoktu (sırası ile 30,7 ?g/dl ve 35,54 ?g/dl). Ekokardiyografide ejeksiyon fraksiyonu düşük (%40) ölçüldü, direkt grafide vertebralarda kompresyon fraktürleri mevcuttu. Adrenal CT’de sol sürrenalde 4x4 cm boyutlarında adenom ile uyumlu lezyon mevcuttu. Adrenal kaynaklı CS tanısı ile sol surrenalektomi yapıldı ve patolojik incelemede adrenokortikal adenom saptandı. Operasyon sonrası hastanın diyabet, hipertansiyon ve osteoporozunda kısmi düzelme oldu. Vertebra fraktürlerine yönelik operasyon planlandı. Diyabet ve hipertansiyon gibi hastalıkların daha şiddetli seyretmesi ve tedaviye dirençli olmaları durumunda klinisyenin CS varlığı açısından uyanık olması gerekmektedir. Tanının gecikmesi mortalite ile sonuçlanabilecek ağır komplikasyonlara yol açabilir.Öğe Declared and real physical activity in obese individuals as assessed by the questionnaire and accelerometer(Edizioni Minerva Medica, 2020) Gökçe, İsmail; Can, Sema; Demirkan, Erkan; Küçükler, Ferit Kerim; Turgal, EbruBACKGROUND: Due to the lack of precise research data related to the evaluation of the physical activity level (PAL) among obese individuals, the aims of the study were to evaluate declared and real volume of physical activity, and to assess the correlations between these methods. METHODS: The study consisted of 30 female (M-age =32.9 +/- 7.3 years) and 16 male (M-age=36.4 +/- 8.4 years) a total of 46 obese volunteer individuals were included (M-bmi:37.6 +/- 6.6 kg/m(2), M-bmi: 34.2 +/- 43 kg/m(2); body fat percentage: 42.1% and 35.2%, respectively). A cross-sectional study was conducted on the obese people. The inionnation form was prepared for obese individuals who applied the Health Institutions and body composition measurements were performed with Tanita BC-1000. PAL was assessed objectively by a Sense Wear Armband (SWA) for 7 consecutive days- and seven day later the participants fill out the International Physical Activity Questionnaire - Short Form (IPAQ-SF). For statistical analysis, the data were presented as mean values, Standard deviations (SD), frequency (f), and percentage (%). Spearman's Rho Correlation were used, and the significant level was P<0.05. RESULTS: According to IPAQ and SWA, 69.6% (10.9% plus 58.7%) of the participants (N.=32) estimated activity levels as correct. The PAL of 30.4% (N.=14) of the participants does not seem to be consistent. According to the IPAQ and SWA, the rates of moderate-vigorous physical activity (MVPA) were 80.4%, 67.4% respectively. Weak correlation was found-between IPAQ-MET and SWA-step/day and SWA-MET respectively (r((s))=0.381; 0.410 (P<0.01). CONCLUSIONS: Physical activity level being assessed by a subjective method was different from the objective method in obese individuals. In addition to this, sample groups and limitations should be taken into consideration when determining suitable methods.Öğe Evaluation of ovarian reserve in women with overt or subclinical hypothyroidism(Termedia Publishing House Ltd., 2018) Küçükler, Ferit Kerim; Görkem, Ümit; Şimşek, Yasin; Kocabaş, Ramazan; Güler, SerdarIntroduction: Thyroid dysfunction is among the most common autoimmune disorders in women of reproductive age. Previous studies have shown the association between autoimmune thyroid disease (AITD) and infertility. Anti-Müllerian hormone (AMH) is secreted by granulosa cells and is a useful marker for assessment of ovarian reserve. In the present study, we sought to evaluate the ovarian reserves of women with autoimmune thyroid disorder by measurement of AMH values. Material and methods: This prospective study included women with newly diagnosed AITD aged between 20 and 40 years. Patients were divided into three groups: Subclinical hypothyroidism (SCH, n = 21), overt hypothyroidism (OH, n = 21) and controls (CG, n = 32). Study parameters included serum free T4, free T3, thyroid-stimulating hormone, anti-thyroglobulin, anti-thyroid peroxidase antibodies, follicle-stimulating hormone, luteinizing hormone, estradiol and AMH concentrations measured in the early follicular phase. Antral follicle count (AFC) was assessed with ultrasound. Body mass index (BMI) and waist circumference of the patients were noted. Results: No significant difference was found among SCH, OH and CG in regard to ovarian reserves measured by AMH values (p = 0.19) and AFC (p = 0.80). A significant negative correlation was found between AMH and BMI (r = -0.382, p = 0.001). Anti-Müllerian hormone and waist circumference (r = -0.330, p = 0.004) were also negatively correlated. Conclusions: Although AMH values were not significantly different among groups, AMH values were lower in OH and SCH patients, indicating a possible need for close monitoring of these patients. © 2016 Termedia & Banach.Öğe Evaluation of prehypertension and masked hypertension rate among clinically normotensive patients(Taylor and Francis Ltd, 2016) Ünsal, Selim; Özkara, Adem; Albayrak, Turgay; Öztürk, Yasin; Beysel, Selvihan; Küçükler, Ferit KerimBackground: The present cross-sectional study was aimed to identify pre-hypertension and masked hypertension rate in clinically normotensive adults in relation to socio-demographic, clinical and laboratory parameters. Methods: A total of 161 clinically normotensive adults with office blood pressure (OBP) <140/90 mmHg without medication were included in this single-center cross-sectional study. OBP, home BP (HBP) recordings and ambulatory BP monitoring (ABPM) were used to identify rates of true normotensives, true pre-hypertensives and masked hypertensives. Data on sociodemographic and clinical characteristics were collected in each subject and evaluated with respect to true normotensive vs. pre-hypertensive patients with masked hypertension or true pre-hypertensive. Target organ damage (TOD) was evaluated in masked hypertensives based on laboratory investigation. Results: Masked hypertension was identified in 8.7% of clinically normotensives. Alcohol consumption was significantly more common in masked hypertension than in true pre-hypertension (28.6 vs. 0.0%, p = 0.020) with risk ratio of 2.7 (95% CI 1.7-4.4). Patients with true pre-hypertension and masked hypertension had significantly higher values for body mass index, waist circumference, systolic and diastolic OBP and HBP (p < 0.05 for each) compared to true normotensive subjects. ABPM revealed significantly higher values for day-time and night-time systolic and diastolic BP (p = 0.002 for night-time diastolic BP, p < 0.001 for others) in masked hypertension than true pre-hypertension. Conclusions: Given that the associations of pre-hypertension with TOD might be attributable to the high prevalence of insidious presentation of masked hypertension among pre-hypertensive individuals, ABPM seems helpful in early identification and management of masked hypertension in the pre-hypertensive population. © 2016 Taylor & Francis Group, LLC.Öğe Evaluation of the common mistakes made by patients in the use of Levothyroxine(Elsevier, 2014) Küçükler, Ferit Kerim; Akbaba, Gülhan; Arduç, Ayşe; Şimşek, Yasin; Güler, SerdarDear Editor, Hypothyroidism is a common disorder [1] whose diagnosis frequency has gradually risen. Although synthetic thyroxine (T4), L-triiodothyronine (T3), and T3/T4 combinations are available for correction of hypothyroidism, the treatment of choice is T4 alone for the vast majority of patients. The bioavailability of a drug depends on many factors such as drug disintegration and dissolution, time of drug intake, storage conditions, diet, and the tablet's size. The T4 is recommended to be taken as a single dose with a glass of water, preferably on an empty stomach, at least 0.5 h to 1 h before breakfast.Öğe Impact of obesity on the metabolic control of type 2 diabetes: results of the Turkish nationwide survey of glycemic and other metabolic parameters of patients with diabetes mellitus (Temd Obesity Study)(S. Karger AG, 2019) Sönmez, Alper; Yumuk, Volkan; Haymana, Cem; Demirci, İbrahim; Barçın, Cem; Kıyıcı, Sinem; Güldiken, Sibel; Örük, Gonca; Saydam, Başak Özgen; Baldane, Süleyman; Kutlutürk, Faruk; Küçükler, Ferit Kerim; Deyneli, Oğuzhan; Çetinarslan, Berrin; Sabuncu, Tevfik; Bayram, Fahri; Satman, İlhanBackground: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro- A nd microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. © 2019 The Author(s) Published by S. Karger AG, Basel.Öğe Increased Risk of Unfavorable Metabolic Outcome in Patients with Clinically Nonfunctioning Pituitary Adenomas(Georg Thieme Verlag, 2015) Ayçiçek Doğan, Berçem; Tuna, Mazhar Müslüm; Arduç, Ayşe; Başaran, Mehtap Navdar; Küçükler, Ferit Kerim; Dağdelen, İffet; Şensöz Berker, Dilek; Güler, SerdarThe aim of this study was to investigate atherosclerotic risk markers in women with clinically nonfunctioning pituitary adenomas (CNFAs). Records of 47 women with CNFAs and 73 healthy women who were treated as outpatients between January 2010 and March 2014 were evaluated retrospectively. All study data were obtained from file records. Lipid parameters, mean platelet volume (MPV), total testosterone (TT), androstenedione (AS), and dehydroepiandrostenedione sulfate (DHEAS) were recorded. Insulin resistance (IR) was calculated with homeostatic model assessment-insulin resistance (HOMA-IR). Among the atherosclerotic risk markers, the HOMA-IR and AS levels were higher in patients with CNFAs than in healthy subjects (p=0.003, p=0.021, respectively). A positive correlation between AS and insulin/HOMA-IR levels was found among the metabolic parameters in the patients with CNFAs (p=0.001, r=0.550, p=0.004, r=0.498, respectively). The data showed that patients with CNFAs had high atherosclerotic risk markers such as insulin resistance and hyperandrogenemia. Insulin resistance may also cause hyperandrogenemia in patients with CNFAs.Öğe Low level of Nesfatin-1 is associated with gestational diabetes mellitus(Taylor and Francis Ltd, 2016) Küçükler, Ferit Kerim; Görkem, Ümit; Şimşek, Yasin; Kocabaş, Ramazan; Gülen, Şebnem; Güler, SerdarIntroduction: Gestational diabetes mellitus (GDM) occurs in similar to 10-25% of pregnancies. Nesfatin-1, plays a role in carbohydrate metabolism by inhibiting glucagon secretion, besides has a glucose-dependent insulinotropic effect. Explanation of the GDM pathogenesis is important due to preventing gestational complications. We aimed to investigate relationship between GDM and Nesfatin-1. Material and methods: Seventy-nine pregnant subjects were randomly allocated to either GDM group (GDG, n = 38) or control group (CG, n = 41). For GDM diagnosis, 50 and 100 g oral glucose tolerance test (OGTT) were used. Nesfatin-1, insulin and other parameters were measured for all subjects. The homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.Results: Nesfatin-1 was found lower and insulin was found higher in GDG than CG. Negative correlation has been founded between Nesfatin-1 with weight, BMI, fasting glucose, serum glucose level at first hour of the 50 g OGTT and HOMA-IR.Conclusion: In this study, patients with GDM had lower Nesfatin-1 levels than without GDM. Therefore, when the Nesfatin-1 effects on the GDM pathogenesis is clear, it may be contributed to diagnosis and treatment of the GDM.Öğe No relationship between osteocalcin and the microvascular complications of type 2 diabetes(Galenos Yayıncılık, 2014) Küçükler, Ferit Kerim; Bardak, Simge; Çelik, Tuğrul; Tütüncü, Yasemin; Akbaba, Gülhan; Işık, Serhat; Karaahmetoğlu, Selma; Eskioğlu, Erdal; Berker, Dilek; Güler, SerdarPurpose: Osteocalcin, one of the osteoblast-specific proteins is produced and secreted by osteoblasts. Although osteocalcin has been thought to play a role only in bone formation, recent studies have shown that it also enhances insulin sensitivity and insulin secretion from pancreatic beta cells. Several studies have reported lower serum osteocalcin levels in patients with type 2 diabetes mellitus (T2DM) than in non-diabetic individuals; and a negative correlation between microvascular complications and osteocalcin levels in type 1 diabetes mellitus (T1DM) patients. We investigated the relationship between microvascular complications and serum undercarboxylated osteocalcin (uOC) levels in T2DM patients.Material and Method: One hundred seventy-nine patients with T2DM aged between 30 and 60 years were randomly included in the study; 101 patients with microvascular complications formed the patient group, and the other 78 without a microvascular complication formed the control group. The patients were evaluated for diabetic nephropathy, retinopathy and neuropathy. The ELISA method was used to measure uOC levels.Results: The two groups were statistically similar with regard to age, gender and body mass index (BMI). Duration of diabetes was shorter in control group than in patient group (p<0.05). HbA1c level in patient group was significantly higher than in controls (p<0.05). There was no statistically significant difference in uOC levels between the groups (p>0.05).Discussion: There was no relationship between serum osteocalcin levels and the microvascular complications of T2DM. © 2014, Galenos Yayincilik. All rights reserved.Öğe Normocalcemic hyperparathyroidism is associated with complications similar to those of hypercalcemic hyperparathyroidism(Springer Tokyo, 2016) Tuna, Mazhar Müslüm; Çalışkan, Mustafa; Ünal, Mustafa; Demirci, Taner; Ayçiçek Doğan, Berçem; Küçükler, Ferit Kerim; Özbek, Mustafa Nuri; Berker, Dilek; Delibaşı, Tuncay; Güler, SerdarNormocalcemic primary hyperparathyroidism (NC-PHPT) is a variant of hyperparathyroidism, characterized by normal serum calcium levels, high parathyroid hormone (PTH) and normal 25-OH vitamin D status. The present study aimed to compare complications related to hyperparathyroidism in patients with NC-PHPT and hypercalcemic PHPT (HC-PHPT). We retrospectively evaluated the records of 307 PHPT patients between January 2010 and March 2013. We excluded patients with impaired renal function and liver failure. All patients underwent a biochemical and hormonal examination including serum glucose, albumin, total calcium, phosphorus, creatinine, lipoproteins, PTH and 25-OH vitamin D. Nephrolithiasis and bone mineral density were documented based on a review of the medical records. The study population consisted of 36 (12 %) males and 271 (88 %) females with a mean age of 53.3 ± 9.5 years (29–70 years). Twenty-three of the patients were diagnosed with NC-PHPT (group 1) and 284 were diagnosed with HC-PHPT (group 2). There were no significant differences in terms of age, gender, prevalence of hypertension, low bone mineral density and kidney stones between the groups. The mean thyroid-stimulating hormone (TSH) and low-density lipoprotein (LDL) levels were significantly higher in group 1 than in group 2. Our study found that patients with NC-PHPT have similar several complications as patients with HC-PHPT. NC-PHPT patients have higher TSH levels despite being within the normal range, and higher LDL-C levels than patients with HC-PHPT. However, this relationship needs to be clarified in future studies with larger cohorts. © 2015, The Japanese Society for Bone and Mineral Research and Springer Japan.Öğe Obesity does not compromise ovarian reserve markers in infertile women(Georg Thieme Verlag, 2019) Görkem, Ümit; Küçükler, Ferit Kerim; Toğrul, Cihan; Gülen, ŞebnemIntroduction In the literature, conflicting results from studies examining the relationship between obesity and ovarian reserve have been reported. The purpose of the study is to investigate whether obesity adversely affects serum concentrations of ovarian reserve markers in infertile women with different ovarian reserve status. Materials and Methods A total of 402 women were assigned to three groups according to body mass index (BMI; < 25 kg/m 2 : normal, n = 198; 25.0-29.9 kg/m 2 : overweight, n = 126; and ? 30 kg/m 2 : obese, n = 78). The women were also divided into two groups according to waist circumference (WC; < 80 cm: normal, n = 103; and ? 80 cm: obese, n = 299). Participants were also categorized into three types of ovarian reserve patterns: normal (n = 146), high (n = 112), and poor ovarian reserve (n = 144). The serum anti-Mullerian hormone (AMH), estradiol (E2), and follicle-stimulating hormone (FSH) levels were assayed and compared in all groups. Results There were no significant differences in BMI and WC in the three ovarian reserve groups. There were significant differences between all ovarian reserve groups for AMH, E2, and FSH (p < 0.001 for all). The comparisons of ovarian reserve parameters (AMH, E2, and FSH) and obesity parameters (BMI and WC) revealed no significant differences in women with all ovarian reserve patterns. Conclusion The parameters of ovarian reserve do not seem to be affected by increased BMI and WC. Thus, AMH may be considered as a reliable marker of ovarian reserve. © The Royal Society of Chemistry.Öğe Osteoporosis and silent vertebral fractures in nursing home resident elderly men in Turkey(Elsevier Inc., 2017) Küçükler, Ferit Kerim; Şimşek, Yasin; Çağlıyan Türk, Ayla; Arduç, Ayşe; Güler, SerdarOsteoporosis is an important cause of vertebral fractures and there is an increased risk for osteoporosis in nursing home residents. Most of the men with osteoporosis and osteoporotic fractures are not diagnosed and do not receive treatment. Our study aim was to determine osteoporosis and silent vertebral fracture prevalence in male nursing home residents in Corum, Turkey. This cross-sectional study included 2 groups of patients: 71 male nursing home residents (nursing home group) with a mean age of 76.0 ± 0.8 years and 44 men living in their own homes (control group) with a mean age of 74.4 ± 0.7 years. Bone mineral densitometry was performed in all subjects, and results were evaluated according to the World Health Organization criteria. Vertebral deformity was evaluated using the spinal deformity index, and fracture risk was calculated using the Fracture Risk Assessment Tool. In all participants, serum calcium, phosphorus, 25 (OH) vitamin D, parathyroid hormone, and alkaline phosphates levels were measured and medical histories were recorded. Osteoporosis was detected in 25.3% of men residing in nursing homes and in 8.8% of men living in their own homes. Silent vertebral fracture was present in 27.8% of patients older than 65 years. Vertebral fracture rate was higher in nursing home residents (42.2%) than men living in their own homes (17.6%); 5.6% of nursing home group and 8.9% of control group patients were aware of their fractures. Our results demonstrated that male nursing home residents are at a higher risk for both osteoporosis and vertebral fractures compared to the men living in their own homes. © 2015 International Society for Clinical DensitometryÖğe Pilates ve Düşük Şiddetli Kardiyo Egzersizlerinin Kadınlarda İnsülin Direnci Üzerine Etkisi(2020) Mumcu, Ömer; Sıngın, Rabia Hürrem Özdurak; Yamaner, Faruk; Küçükler, Ferit KerimAmaç: İnsülin direnci gelişmiş kadınlarda pilates ve düşük şiddetli kardiyo egzersizlerinin insülin direncine etkisini incelemektir. Gereç ve Yöntem: Çalışmaya son altı ayda düzenli olarak herhangi bir egzersiz programına katılmamış ve ilaç tedavisi görmeyen, insülin direnci gelişmiş 20-40 yaş aralığında kadınlar dahil edildi. 45 gönüllü kadın eşit olarak düşük şiddetli kardiyo egzersizi (DŞKE), pilates egzersizi (PE) ve kontrol (K) guruplarına ayrıldı. Egzersiz gruplarına haftada 3 gün, bir çalışmada 60 dakikalık pilates veya düşük şiddetli kardiyo egzersiz programı uygulandı. Kadınların 12 haftalık egzersiz uygulaması öncesi ve sonrası kilo, vücut kütle indeksi (VKİ), bel ve kalça çevresi, bel-kalça oranı (BKO) gibi antropometrik ölçümlerinin yanı sıra trigliserit (TG), yüksek dansiteli lipoprotein (HDL), düşük dansiteli lipoprotein (LDL), total kolesterol (TC), açlık kan şekeri (AKŞ), açlık insülin (Aİ) ve insülin direnci (İD) gibi kan parametreleri ölçüldü. Grupların ön test ve son test ölçümleri Wilcoxon İşaret T testi, gruplar arası farklılıklar Kruskal Wallis H testi, grupların ikili karşılaştırmaları ise Mann Whitney U testi kullanılarak SPSS 18.0 programında analiz edildi. Bulgular: DŞKE ve PE egzersizlerinin kilo, VKİ, bel ve kalça çevresinde istatistiksel olarak anlamlı azalmaya neden olduğu, C grubunda ise istatistiksel olarak anlamlı bir fark olmadığı saptandı. Her iki egzersizin AKŞ, Aİ ve İD değerlerinde istatistiksel olarak anlamlı bir azalmaya neden olduğu saptandı. LDL (p=0.04) ve TC (p=0.03) seviyelerinin DŞKE gurubunda azaldığı gözlemlenirken, PE gurubunda değişmediği görüldü. 12 haftalık egzersiz sonrasında guruplar arasında Aİ ve İD değerlerinde istatistiksel olarak anlamlı bir fark olduğu (p=0.01), AKŞ değerlerinde ise guruplar arasında anlamlı bir fark olmadığı görüldü. K gurubu ile karşılaştırıldığında DŞKE gurubunda İD’nin (p=0.04) istatistiksel olarak anlamlı düzeyde azaldığı görüldü. Sonuç: 12 haftalık DŞKE programının İD düzeyini azaltmaya yardımcı olduğu görülmüştür. Programlara esneklik ve dengeyi artıran, pilates gibi destekleyici egzersiz türleri de eklenmelidir.Öğe PO355 Relationship Between 25 (Oh) Vitamin D And Microvascular Complications Of Type 2 Diabetes Mellitus(Elsevier Ireland Ltd, 2014) Küçükler, Ferit Kerim; Şimşek, Yasin; Bardak, Simge; Gürsoy, Alptekin; Güler, SerdarBackground: Diabetes is a widespread disease and, therefore, studies relation with diabetes and its complications are very important for patients. People with diabetes are at high risk of microvascular complications including diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. Vitamin D has traditionally been associated with calcemic activities and homeostasis of bone.
