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Öğe Acute monocytic leukemia with pituitary involvement: a case report(Galenos Yayıncılık, 2015) Tuna, Mazhar Müslüm; Afacan Öztürk, Berna; Nasıroğlu İmga, Narin; Ayçiçek Doğan, Berçem; Işık, Serhat; Dağtaş, Simten; Özet, Gülsüm; Berker, Dilek; Güler, SerdarCentral nervous system involvement is rare in acute myeloid leukemia (AML) cases. Pituitary involvement seems much more rarely with unknown frequency. A 29-year-old male patient was admitted to our clinic with the complaints of visual disturbance and poor performance status. His medical history revealed AML- M5 diagnosed fve years ago and allogeneic hematopoietic stem cell transplantation performed in 2010. During follow-up in remission, his complaints had begun. In our clinic, the patient was diagnosed with AML M5 relapse associated with panhypopituitarism and central diabetes insipidus. Chemoradiotherapy was initiated immediately and hormone replacement therapy started due to hypopituitarism. His complaints partially resolved. He is still being followed up with intermittent intrathecal and systemic chemotherapy. Although rare, leukemic infltration of the pituitary gland should be evaluated in leukemic patients with visual disturbance, hypopituitarism or central diabetes insipidus. © 2015 Galenos Yayincilik, All rights reserved.Öğe Are there any causes for increased thyroid volume in women with prolactinoma?(Elsevier Masson SAS, 2015) Ayçiçek Doğan, Berçem; Taşçı, Tuğba; Arduç, Ayşe; Tuna, Mazhar Müslüm; Berker, Dilek; Güler, SerdarPurpose: The aim of this study was to evaluate thyroid volume in women with prolactinoma and investigate the relationship between anabolic hormones [insulin, insulin like growth factor (IGF-1), estrogen] and thyroid volume in the patients. Material-method: Sixty-three euthyroid women with prolactinoma and 60 healthy euthyroid women were included. Serum prolactin (PRL), thyroid-stimulating hormone (TSH), thyroxine (free T4), free tri-iodothyronine (free T3), insulin resistance (IR) which was estimated by the homeostasis model assessment, thyroidal microsome (anti-TPO), antithyroglobulin antibodies (TgAb), estradiol (E2), and insulin like growth factor (IGF-1) were evaluated, and thyroid volume was calculated by B-mode doppler USG. Results: The mean thyroid volume was significantly higher in women with prolactinoma (82.5 ± 15.1 mL) than in healthy women (76 ± 15.1 mL)(P = 0.014), but no correlation was found between thyroid volume and serum PRL levels (P = 0.967). There were also no differences between thyroid volume, anabolic hormones (E2, IGF-1), and insulin resistance in women with prolactinoma (P = 0.776, P = 0.786, P = 0.647, respectively). Conclusions: Our study did not show an association between anabolic hormones and increased thyroid volume in women with prolactinoma. © 2015 Elsevier Masson SAS.Öğe Autoimmune fibrotic adverse reactions in one-year treatment with cabergoline for women with prolactinoma(Bentham Science Publishers B.V., 2016) Ayçiçek Doğan, Berçem; Arduç, Ayşe; Tuna, Mazhar Müslüm; Berker, Dilek; Demirci, Nilgün; Demirtaş, Semra; Çiçekcioğlu, Hülya; Güler, SerdarAim: Cabergoline is related to an elevated risk of fibrotic adverse reactions including cardiac valvular and pleuropulmonary fibrosis. We investigated pulmonary and cardiac valve fibrosis and immunological markers before and after 3 and 12 months of treatment with cabergoline in women with prolactinoma. Material-Methods: The study included thirty-two women with newly diagnosed prolactinoma and 28 healthy women. CAB cumulative dose was 7.8±5.5 mg after 3-month therapy, and 31±22 mg after 12-month follow-up. The risk of autoimmune adverse fibrotic reactions related to CAB treatment including cardiac valvulopathy and pulmonary fibrosis were assessed by a transthoracic echocardiography and pulmonary function tests, respectively. Immunological markers including Antistreptolysin O, Rheumatoid factor, Immunglobuline E, Antinuchlear antibody were also evaluated. Results: Before the start of CAB therapy, the total prevalence of trace grade of mitral, aortic, pulmonic, and tricuspid valve regurgitations were found as 34%, 3%, 6.3%, and 39 % respectively in women with prolactinoma. After improving of prolactin levels with CAB treatment, no change was found in the prevalence of the all valve regurgitations. There was no deterioration in pulmonary function tests. Rheumatoid factor was found higher in newly diagnosed women with prolactinoma than in healthy women (p=0.01), and this was improved by CAB therapy (p=0.005). Conclusion: The prospective study indicated that sufficient cabergoline doses for a period of one year treatment of prolactinoma were not found to be related to fibrotic adverse reactions including cardiac valvular and pulmonary fibrosis or increased levels of immunological marker, apart from rheumatoid factor. For the first time Rf was found higher in newly diagnosed women with prolactinoma and was improved after cabergoline therapy. © 2016 Bentham Science Publishers.Öğe Changes in the before and after thyroxine treatment levels of adipose tissue, leptin, and resistin in subclinical hypothyroid patients(Springer-Verlag Wien, 2016) Akbaba, Gülhan; Berker, Dilek; Işık, Serhat; Tuna, Mazhar Müslüm; Koparal, Suha; Vural, Murat; Yılmaz, Fatma Meriç; Topçuoğlu, Canan; Güler, SerdarBackground: Subclinical hypothyroidism (SH) occurs when serum thyroid stimulating hormone (TSH) concentrations are raised and serum thyroid hormone concentrations are normal. The effect of SH on the proinflammatory adipose cytokine releasing visceral adipose tissue (VAT) is not clear. The aim of this study is to identify the difference between the pre and posttreatment levels of VAT, leptin, and resistin in SH patients. Methods: There were 51 SH patients and 43 age- and gender-matched healthy subjects included in the study. Thyroid functions, biochemical tests, leptin, resistin, and visceral and subcutaneous fat measurements were made. The measurements were repeated in the SH group in the third month following L-thyroxin treatment. Results: Initially, high sensitivity C-reactive protein, carotid artery intima-media thickness (mm), leptin, and resistin levels were significantly higher in the SH group compared to the controls, while the other parameters were similar. While no correlation was observed between TSH levels and adipokines, a positive correlation was detected between waist circumference and leptin levels (r = 0.549, p < 0.01). Visceral adipose tissue was positively correlated to age, waist circumference, and leptin levels, but negatively correlated to free thyroxin (T4) levels (r = 0.419, p = 0.009; r = 0.794, p < 0.01; r = 0.515, p < 0.01 and r = - 0.416, p = 0.009, respectively). A significant decrease was observed in VAT volume, leptin, and resistin levels of SH patients following levothyroxine treatment. Conclusion The reduced VAT volume, leptin, and resistin levels in SH patients following treatment may support the idea that TSH affects adipose tissue functions. © 2015, Springer-Verlag Wien.Öğe Characterization of V804M-mutated RET proto-oncogene associated with familial medullary thyroid cancer, report of the largest Turkish family(Springer International Publishing, 2015) Navdar Başaran, Mehtap; Tuna, Mazhar Müslüm; Karakılıç, Ersen; Ayçiçek Doğan, Berçem; İmga Nasıroğlu, Narin; Berker, Dilek; Güler, SerdarPurpose: Analysis of the RET proto-oncogen is very important for diagnosis and prognosis of medullary thyroid cancer (MTC). Genotype-phenotype correlation is also well known. Here we report features of the largest known family in Turkey with the V804M-mutated RET proto-oncogene. Methods: Thirty members from three generations were evaluated. A RET proto-oncogen mutation, calcitonin (Ct) measurement and thyroid ultrasound were performed on all individuals. Seventeen members had V804M mutation. Fourteen of these patients underwent total thyroidectomy and additional central lymph node dissection for five subjects. Results: The mean age of patients with MTC was 46.5 (30-61) years. The mean calcitonin level of RET positive members was 13.27 pg/mL (1-49.8 pg/mL). Three had a basal Ct level above normal limits. Seven of the 14 patients were diagnosed with MTC, and two were diagnosed with papillary thyroid cancer without MTC. One patient had central neck metastasis. Hyperparathyroidism or pheochromocytoma was not detected in any case. Patients who were RET negative, had normal Ct levels and no suspected nodule on ultrasound examination. Conclusions: Our study revealed a relatively good prognosis in patients with V804M mutation. Despite the surgery was performed in older age no advance disease was observed. © 2014 Italian Society of Endocrinology (SIE).Öğe Diabetes insipidus and anterior pituitary insufficiency due to breast cancer metastasis(Türkiye Klinikleri, 2016) Arduç, Ayşe; Alımlı, Ayşe Gül; Ayçiçek Doğan, Berçem; Tuna, Mazhar Müslüm; Berker, Dilek; Güler, SerdarMetastases from breast cancer to the pituitary gland are uncommon. We present a 35-year-old woman with diabetes insipidus and anterior pituitary insufficiency resulting from breast cancer metastases to the pituitary gland. The patient presented with reduced consciousness, fatigue, polyuria, and polydipsia. Hypernatremia (sodium: 154 mmol/L), hypostenuria (urine density: 1001), and hypopituitarism were present on laboratory evaluation. Magnetic resonance imaging (MRI) revealed heterogeneous pituitary gland, thickened pituitary stalk (8mm), and loss of normal hyperintense signal of the posterior pituitary. Based on the clinical, laboratory, and MRI findings, the patient was diagnosed with diabetes insipidus and anterior pituitary insufficiency due to pituitary metastases from breast cancer. She received desmopressin, L-thyroxine, and prednisolone, which resulted in improvement of her symptoms and laboratory results. The patient, who also received Gamma Knife radiosurgery and chemotherapy, died six months later due to disseminated metastases. Although pituitary metastasis is rare, it should be kept in mind in patients with breast cancer since early detection and treatment can improve symptoms of patients. © 2016, Galenos Yayincilik. All rights reserved.Öğe Does acquired hypothyroidism affect the hearing functions?(Galenos Yayıncılık, 2015) Arduç, Ayşe; Işık, Serhat; Alluşoğlu, Serpil; İriz, Ayşe; Ayçiçek Doğan, Berçem; Tuna, Mazhar Müslüm; Göçer, Celil; Berker, Dilek; Güler, SerdarPurpose: It is well known that congenital hypothyroidism can cause hearing loss. However, conflicting results were found in studies investigating hearing functions in acquired hypothyroidism. Therefore, we evaluated the audiometric findings in patients with acquired hypothyroidism. Material and Method: The study included 58 patients with hypothyroidism and age- and gender-matched 34 healthy controls. Twenty eight (48.27%) patients had subclinical hypothyroidism, and 30 (51.73%) had obvious hypothyroidism. All subjects had a normal otoscopic examination and tympanometry. Pure tone audiometry at 250, 500, 1000, 2000, 4000, 6000, and 8000 Hertz (Hz) was performed in both groups. Blood pressure measurements and the levels of plasma electrolytes, lipids and vitamin B12 were available in all subjects. Results: Hypothyroidism group and control group were similar with respect to systolic and diastolic blood pressures and plasma glucose, lipid, vitamin B12, calcium, sodium, potassium, and chloride levels. Significantly higher audiometric thresholds (dB) at 250 (10 (0-45) vs. 5 (0-15), p<0.001) and 500 Hz (10 (0-40) vs. 10 (-5-15), p=0.003) were recorded in hypothyroid patients compared to that in healthy controls. Hearing thresholds at 250 and 500 Hz correlated positively with thyroid-stimulating hormone (TSH), and negatively with free triiodothyronine and free thyroxine. Subclinical hypothyroid patients had a higher hearing threshold at 250 Hz than healthy controls (p=0.001). Discussion: Our study demonstrated that hearing ability decreases in hypothyroidism, even in subclinical hypothyroidism. The changes in TSH and thyroid hormone levels seem to be directly related to the hearing loss in this population of patients. © 2015, Galenos Yayincilik. All rights reserved.Öğe Effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with idiopathic hypogonadotropic hypogonadism(Blackwell Publishing Ltd, 2015) Ayçiçek Doğan, Berçem; Karakılıç, Ersen; Tuna, Mazhar Müslüm; Arduç, Ayşe; Berker, Dilek; Güler, SerdarObjective: Idiopathic hypogonadotropic hypogonadism is a rare disorder. This study evaluated the effect of androgen replacement therapy on atherosclerotic risk markers in young-to-middle-aged men with this disorder. Design and methods: Forty-three male patients aged 30 (range: 24-39 years) who were newly diagnosed with idiopathic hypogonadotropic hypogonadism and 20 age-, sex- and weight-matched controls (range: 26-39 years) were included in the study. Androgen replacement therapy was given according to the Algorithm of Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes (2010; Journal of Clinical Endocrinology and Metabolism, 95, 2536). The patients were assessed at a pretreatment visit and 3 and 6 months after the treatment. Inflammatory markers and lipid parameters were evaluated. Endothelial function was assessed with brachial flow-mediated dilation of a brachial artery and high-resolution ultrasonography of the carotid intima-media thickness. Results: The carotid intima-media thickness (P < 0·001) was higher and the brachial flow-mediated diameter (P = 0·002) was lower in patients with idiopathic hypogonadotropic hypogonadism compared to the control subjects at the pretreatment visit. There was a negative correlation between the total testosterone level and carotid intima-media thickness (r = -0·556, P = <0·001). The carotid intima-media thickness and per cent flow-mediated diameter were significantly improved in the patient group 6 months after the androgen replacement therapy (P = 0·002 and 0·026, respectively). Conclusions: This study indicated that low total testosterone levels can be considered a significant marker of atherosclerosis in patients with idiopathic hypogonadotropic hypogonadism and that androgen replacement therapy significantly reduces atherosclerotic risk markers in these patients after 6 months. © 2014 John Wiley & Sons Ltd.Öğe Epicardial Fat Thickness and Left Ventricular Mass in Subjects with Adrenal Incidentaloma(Endocrine Soc, 2014) Nasıroğlu İmga, Narin; Uçar Elalmış, Özgül; Tuna, Mazhar Müslüm; Ayçiçek Doğan, Berçem; Şahin, Deniz; Berker, Dilek; Güler, Serdar[Abstract Not Available]Öğe Evaluation of adipocytokine levels and vascular functions in young aged to middle aged men with idiopathic hypogonadotrophic hypogonadism(Maghira and Maas Publications, 2014) Tuna, Mazhar Müslüm; Ayçiçek Doğan, Berçem; Karakılıç, Ersen; Arduç, Ayşe; Işık, Serhat; Yılmaz, Fatma Meriç; Topçuoğlu, Canan; Berker, Dilek; Güler, SerdarOBJECTIVE: Hypogonadism has major effects on the urogenital system, in addition to other systems, the cardiovascular system in particular. There have been few studies conducted on markers of atherosclerosis, such as flow mediated dilatation (% FMD), carotid intima-media thickness (CIMT) and adipocytokine levels in idiopatic hypogonadotropic hypogonadal (IHH) males mostly in adult patients. The aim of this study was to evaluate the relationship between androgens and adipocytokines and parameters of vascular functions in hypogonadal men. j MATERIALS AND METHODS: The study population consisted of 11 treatment naive IHH patients (group 1) and 15 age-matched healthy control males (group 2). A fasting blood sample was obtained for leptin, adiponectin and resistin. The endothelial functions were evaluated by studying % FMD and CIMT by high resolution B-mode ultrasound. RESULTS: No significant differences in age, body mass index, systolic and diastolic blood pressure were recorded between the two groups. The leptin level was significantly higher in group 1, whereas adiponectin and resistin levels were same between two groups. There was a negative correlation between total testosterone and carotid intima-media thickness (r=-0.656, p=0.008), and a negative correlation between total testosterone and leptin level (r=-0.794, p<0.001). No correlation was found between leptin and CIMT (p=0.184). CONCLUSION: Testosterone deficiency in hypogonadal men is associated with vascular parameters of atherosclerosis. The findings may establish indications for testosterone replacement therapy in hypogonadal men. © 2014 Neuroendocrinology Letters.Öğe Evaluation of Atherosclerosis after Cessation of Cabergoline Therapy in Patients with Prolactinoma: Preliminary Results of a Prospective Cohort Study(Endocrine Soc, 2014) Ayçiçek Doğan, Berçem; Arduç, Ayşe; Tuna, Mazhar Müslüm; Nasıroğlu İmga, Narin; Işık, Serhat; Berker, Dilek; Güler, Serdar[Abstract Not Available]Öğe Evaluation of hearing functions in patients with euthyroid Hashimoto’s thyroiditis(Humana Press Inc., 2015) Arduç, Ayşe; Işık, Serhat; Alluşoğlu, Serpil; İriz, Ayşe; Ayçiçek Doğan, Berçem; Göçer, Celil; Tuna, Mazhar Müslüm; Berker, Dilek; Güler, SerdarSensorineural hearing loss has been reported in various autoimmune diseases. The relationship between Hashimoto’s thyroiditis (HT) and the auditory system has not been previously evaluated. In this study, we investigated the effect of euthyroid HT on the hearing ability of adult patients. The study included 30 patients with newly diagnosed euthyroid HT and 30 age- and gender-matched healthy controls. All subjects had a normal otoscopic examination and tympanometry, and they were negative for rheumatoid factor, antinuclear, anti-smooth muscle, antimitochondrial, antineutrophilcytoplasmic, and antigliadin antibodies. Pure tone audiometry exams at 250, 500, 1000, 2000, 4000, 6000, and 8000 Hertz (Hz) were performed in both groups. Thyroid peroxidase antibody and thyroglobulin antibody (anti-Tg) levels were higher in HT group while TSH, free T4, free T3, plasma electrolytes, glucose, lipid profile, vitamin B12, and blood pressure measurements were similar between the two groups. Higher audiometric thresholds and a higher prevalence of hearing loss at 250, 500, and 6000 Hz were detected in the HT patients than in the healthy controls (P < 0.05). Hearing levels at 250 and 500 Hz correlated positively with anti-Tg levels (? = 0.650, P = 0.002; ? = 0.719, P < 0.001, respectively), and this association remained significant in linear regression analysis. Anti-Tg-positive HT patients had higher hearing thresholds at 250 and 500 Hz than anti-Tg-negative HT patients. Hearing thresholds were similar between anti-Tg-negative HT patients and the control subjects. This study demonstrated that hearing functions are impaired in HT patients. Thyroid autoimmunity seems to have an important impact on a decreased hearing ability, particularly at lower frequencies, in this population of patients.Öğe Evaluation of Immunohistochemical Staining Features in Acromegaly Patients- Comparing with Clinical Findings(Endocrine Soc, 2014) Tuna, Mazhar Müslüm; Karakılıç, Ersen; Navdar Başaran, Mehtap; Ayçiçek Doğan, Berçem; Nasiroğlu İmga, Narin; Arduç, Ayşe; Güler, Serdar[Abstract Not Available]Öğe Feokromositomanın nadir bir sebebi; nörofibromatozis tip 1-noonan sendromu(Galenos, 2014) Tuna, Mazhar Müslüm; Navdar Başaran, Mehtap; Ayçiçek Doğan, Berçem; Karakılıç, Ersen; Çavdarlı, Büşranur; Tütüncü, Yasemin; Berker, Dilek; Güler, SerdarNörofibromatozis Tip 1 (NF-1); otozomal dominant geçişli ve yaklaşık 1/3000 sıklığında görülen bir hastalıktır. Hastalık cafe au lait lekeleri, nörofibromlar, optik gliom, lisch nodülleri ve diğer sistem tutulumları ile giden nörokutan bir sendromdur. Noonan sendromu dismorfik yüz bulguları, konjenital kalp hastalığı, boy kısalığı, boyun anomalileri ve göğüs deformiteleri ile karakterize heterojen bir sendromdur. NF-Noonan sendromu ise her iki klinik tablonun bir arada bulunduğu oldukça nadir görülen bir durumdur. Feokromositoma eşlik etmesi nadir görülmekle birlikte tedavi edilmediğinde mortal seyretmektedir. Sağ üst kadranda kitle nedeni ile başvuran ve feokromositoma ve NF 1-Noonan sendromu birlikteliği tanısı alan hastayı sunduk.Öğe High prevalence of Hashimoto's thyroiditis in patients with polycystic ovary syndrome: Does the imbalance between estradiol and progesterone play a role?(Taylor and Francis Ltd, 2015) Arduç, Ayşe; Ayçiçek Doğan, Berçem; Bilmez, Sevgi; İmga Nasıroğlu, Narin; Tuna, Mazhar Müslüm; Işık, Serhat; Berker, Dilek; Güler, SerdarObjective: Some similar factors, such as genetic susceptibility and subinflammation/autoimmunity, contribute to development of both polycystic ovary syndrome (PCOS) and Hashimoto’s thyroiditis (HT), suggesting a potential pathogenic link between the two common disorders. In this study, we investigated the relationship between PCOS and HT, considering the possible effect of PCOS-related hormonal and metabolic factors on thyroid autoimmunity. Methods: Eighty-six reproductive-age women diagnosed with PCOS according to Rotterdam criteria and 60 age-BMI matched control women were included in the study. All subjects had thyroid function tests, thyroid peroxidase anti-body (anti-TPO), thyroglobulin anti-body (anti-Tg), LH, FSH, estradiol, progesterone, androgens, fasting glucose, insulin, lipid, homeostasis model assessment insulin resistance (HOMA-IR) levels, thyroid and pelvic ultrasounds. Results: TSH, anti-TPO (p?=?0.017), anti-Tg (p?=?0.014), LH, DHEAS, testosterone, and HOMA-IR levels were significantly higher and progesterone were lower in PCOS women than in controls. Free T4, free T3, FSH, estradiol levels and thyroid volume were similar between the two groups. A higher percentage of PCOS patients had elevated TSH (26.7 and 5%; p?=?0.001), anti-TPO (26.7 and 6.6%; p?=?0.002), and anti-Tg (16.2 and 5%; p?=?0.039). HT was more common in PCOS patients compared to controls (22.1 and 5%; p?=?0.004). Estradiol (p?=?0.003) were higher in anti-TPO positive PCOS women than anti-TPO negative ones. Anti-TPO was correlated positively with estradiol, estradiol/progesterone ratio, and TSH. Conclusions: This study demonstrated a higher prevalence of HT, elevated TSH, anti-TPO, and anti-Tg levels in PCOS patients. Increased estrogen and estrogen/progesterone ratio seem to be directly involved in high anti-TPO levels in PCOS patients.Öğe Higher body mass index and larger waist circumference may be predictors of thyroid carcinoma in patients with Hürthle-cell lesion/neoplasm fine-needle aspiration diagnosis(Blackwell Publishing Ltd, 2015) Arduç, Ayşe; Ayçiçek Doğan, Berçem; Tuna, Mazhar Müslüm; Ateş Tütüncü, Yasemin; Işık, Serhat; Berker, Dilek; Güler, SerdarObjective High body mass index (BMI) has been found to be associated with raised thyroid cancer risk, particularly in women. We examined the associations for BMI and waist circumference (WC) with thyroid cancer risk among women with Hürthle?cell lesion/neoplasm (HLN) on fine?needle aspiration biopsy (FNAB) with the hypothesis that BMI and WC could guide the management of these challenging indeterminate lesions. Methods This cross?sectional study included 224 women with HLN who underwent thyroidectomy. In all patients, TSH and thyroid auto?antibodies were evaluated, and thyroid nodule features were recorded. Patients were grouped according to BMI (<30 or ?30 kg/m2) and WC (<88 or ?88 cm). Relationships of thyroid cancer with BMI and WC were assessed using logistic regression analysis. Results Mean weight, BMI (31·26 ± 5·1 vs 26·47 ± 5·9, P < 0·001), WC (98·23 ± 7·6 vs 86·18 ± 11, P = 0·001), and proportion of patients with high BMI (?30 kg/m2) (65·9 vs 33·8%, P < 0·001) or large WC (?88 cm) (84·1 vs 47·9%, P < 0·001) were significantly higher in malignant group compared to benign group. In regression analysis, BMI and WC significantly associated with existence of malignancy. Malignancy risk was 3·819?fold higher (95% CI: 2·068–7·054) in BMI?30 kg/m2 group compared to BMI<30 kg/m2, which was independent of TSH and age. Large WC was also associated with increased risk (OR = 5·593, 95% CI: 2·736–11·434). Baseline tumour characteristics were similar according to BMI and WC groups. Conclusions A great BMI and large WC were associated with higher thyroid cancer risk in patients with FNAB diagnosis of HLN. Further studies are needed to use BMI or WC in the management of patients with HLN.Öğe Impaired endothelial function in patients with mild primary hyperparathyroidism improves after parathyroidectomy(Blackwell Publishing Ltd, 2015) Tuna, Mazhar Müslüm; Ayçiçek Doğan, Berçem; Arduç, Ayşe; İmga Nasıroğlu, Narin; Ateş Tütüncü, Yasemin; Berker, Dilek; Güler, SerdarBackground Primary hyperparathyroidism (PHPT) is associated with cardiovascular morbidity; however, data on the reversibility of cardiovascular disease in mild primary hyperparathyroidism are conflicting. The aim of this study was to assess endothelial function in patients with mild PHPT before and after parathyroidectomy (Ptx). Methods We prospectively evaluated 53 patients with mild PHPT (Group 1; 45 women, eight men; aged 52 ± 3·1 years) and 46 healthy control subjects (Group 2; 38 women, eight men; aged 46 ± 9·5 years). Endothelial function was measured as flow-mediated dilation (FMD) and carotid intima-media thickness (CIMT) using Doppler ultrasonography. Patients with diabetes mellitus, coronary heart disease, impaired renal function, hyperthyroidism, hypothyroidism and a history of smoking were excluded from the study. Patients were studied at baseline and 6-12 months after the first evaluation. Results There were no differences with respect to age, gender and BMI between the two groups. Hypertension prevalence was three times higher in group 1 than in controls. % FMD was lower in group 1 than in group 2 (2·6 ± 1·2 vs 14·8 ± 9·6, P < 0·001). CIMT was higher in patients with PHPT than controls (0·69 ± 0·18 vs 0·61 ± 0·12, P = 0·045). This significance remained when hypertensive patients were excluded from the analysis. While FMD and CIMT improved significantly after Ptx, there were no differences in mild PHPT patients who followed without parathyroidectomy. Conclusion FMD and CIMT are impaired in patients with mild PHPT compared to controls and improved significantly after a successful Ptx. Ptx improves endothelial function in patients with mild PHPT that may lead to decreased cardiovascular morbidity and mortality. © 2014 John Wiley & Sons Ltd.Öğe Increased lipid levels improves after treatment with Cabergolin in patients with Prolactinoma(2015) Tuna, Mazhar Müslüm; Navdar Başaran, Mehtap; Arduç, Ayşe; Ayçiçek Doğan, Berçem; Berker, Dilek; Güler, SerdarIt has been suggested that hyperprolactinemia may be associated with obesity and dyslipidemia. However it is not fully understood that dyslipidemia is occurs independently or due to obesity. The study was aimed to investigate lipid abnormalities and androgen hormone levels before and after cabergolin (CAB) treatment in non- obese premenauposal patients with prolactinoma. This study was a single-centre, prospective, case-control study, consisted of 53 patients with symptomatic prolactinoma (group 1) and 57 healty women (group 3). All subjects underwent a physical examination, anthropometric measurement and a 12 hour fasting blood sample for fasting blood glucose and lipid levels. 49 patients with prolactinoma were reevaluated for metabolic parameters after one year of cabergolin treatment (group 2). The median age was 34 in group 1, and 33 in group 3 (p=0.522). The initially higher body mass index (BMI) in patients with prolactinoma became similar after one year of treatment those with control group (p=0.475). While LDL-C was significanly higher in group 1 than in controls, HDL was significanly lower in group 1. Also post- treatment values of LDL-C (p=0.440) and HDL-C (p=0.612) were not different from the control group. No correlation was found between baseline prolactin levels and FSH, LH, LDL-C, HDL-C (p=0.129, p=0.658, p=0.817, p=0.760 respectively). In conclusion, beneficial metabolic changes were seen in patients with prolactinoma after treatment with cabergoline. Thus considering the metabolic profile and an appropriate treatment goal is important in the clinical management of patients with prolactinoma.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 Insulin resistance and androgen levels in eugonadic and hypogonadic women with prolactinoma(Edizioni Minerva Medica, 2016) Ayçiçek Doğan, Berçem; Berker, Dilek; Arduç, Ayşe; Tuna, Mazhar Müslüm; İmga Nasıroğlu, Narin; Karakılıç, Ersen; Navdar Başaran, Mehtap; Işık, Serhat; Ateş Tütüncü, Yasemin; Ünal, Mustafa; Güler, SerdarBACKGROUND: Hyperprolactinemia is the most common endocrinologic disorder in causing menstrual irregularities. Although the correlation between hyperprolactinemia and menstrual dysfunction is widely known, the etiology of menstrual cycle disorders is not profoundly understood in patients with prolactinoma. We aimed to investigate the correlation between prolactin levels and insulin resistance and hyperandrogenism in patients with prolactinoma. METHODS: Sixty-four patients with microprolactinoma and 33 healthy women were enrolled. Thirty-six of these patients with prolactinoma (group 1) had an estradiol (E2) level under 30 pg/mL, and 28 (group 2) had an E2 level greater than 30 pg/mL. Blood samples were drawn to measure the levels of the following hormones: Follicle stimulating hormone (FSH), luteinizing hormone (LH), E2, prolactin (PRL), total testosterone (TT), androstenedione (AS) and dehydroepiandrostenedione sulphate (DHEAS). Body Mass Index (BMI of ?30 kg/m2) was excluded from the study. Insulin resistance (IR) was calculated by the HOMA-IR. RESULTS: BMI was higher in patients with prolactinoma than the control group (P=0.02, P=0.025, respectively). IR and glucose intolerance existence were higher in patients with prolactinoma (P=0.007, P=0.097, respectively) than the healthy women, but these differences did not exist between eugonadic and hypogonadic women with prolactinoma (P=0.020, P=0.032, respectively, Bonferroni correction). TT and AS were higher in eugonadic women with prolactinoma than the control group (P=0.004, P=0.003, Bonferroni correction, respectively). CONCLUSIONS: Our study revealed that the relationship between hyperprolactinemia and IR/glucose intolerance is irrespective of gonadal status in women with prolactinoma. Also, the study concluded that hyperandrogenism may be a cause of menstrual dysfunction in eugonadic women with prolactinoma. © 2014 EDIZIONI MINERVA MEDICA.
