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Öğe Assessment of insulin resistance in the idiopathic hirsutism(Karger, 2007) Sarac, Fulden; Saygili, Fusun; Ozgen, Gokhan; Tuzun, Mehmet; Yilmaz, Candeger; Kabalak, TaylanBackground: Idiopathic hirsutism (IH) is the second most common cause of hirsutism, after polycystic ovary syndrome and occurs in about 15% of hirsute women. There are not many studies showing whether patients with IH also have insulin resistance. In the present study, we aimed to investigate the insulin sensivity in IH with non-obese and changing hormone levels during the hyperinsulinemic- euglycemic clamp. Methods: Twenty ( 20) non-obese women with IH ( Group I) ranging in age from 20 to 30 ( mean 25 8 5) years were studied. Hirsutism in women with normal testosterone ( T) levels and regular menstrual cycles is as defined IH. Twenty ( 20) healthy women (mean age 23 +/- 2 years) (Group II) were included in this study as the control group. Insulin sensitivity was assessed with modified euglycemic insulin clamp technique. Samples of prolactin, luteinizing hormone (LH), follicle-stimulating hormone, adrenocorticotropic hormone ( ACTH), dehydroepiandrosterone sulfate, cortisol, estradiol, progesterone, 17-OH progesterone (17-OHP), total T, and free T ( FT) were obtained at baseline and at 2nd hour during clamp. Results: Steady-state ( 120 min) glucose disposal rates were higher in Group II than Group I ( 7.51 +/- 0.83 vs. 5.76 +/- 1.89 mg/kg/min). Mean FT, ACTH, cortisol, LH, prolactin and 17-OHP levels were found to have decreased statistically significantly (p < 0.05) in Group I. Mean FT, ACTH, and prolactin levels were found to have decreased statistically significantly (p < 0.05) in Group II during the clamp. Mean baseline levels of FT, LH and prolactin were greater in women with hirsutism than in the control subjects ( p < 0.05). Insulin mediated glucose disposal was lower in the normal weight women with IH than in those without hirsutism. Conclusions: Mean FT, 17-OHP and dehydroepiandrosterone sulfate levels decreased during euglcemic-hyperinsulinemic clamp in IH. Copyright +/- 2007 S. Karger AG, Basel.Öğe Demographic, clinical, laboratory, ultrasonographic, and cytological features of patients with Hashimoto's thyroiditis: results of a university hospital of 769 patients in Turkey(Humana Press Inc, 2009) Erdogan, Mehmet; Erdem, Nihat; Cetinkalp, Sevki; Ozgen, Ahmet Gokhan; Saygili, Fusun; Yilmaz, Candeger; Tuzun, Mehmet; Kabalak, TaylanWe investigated the demographic and clinical features of patients with Hashimoto's thyroiditis who had been diagnosed and treated in Ege University, the main referral center in the Aegean region of Turkey. Medical records of patients who had been followed in the endocrinology clinic of Ege University were retrospectively evaluated. Patients who had been diagnosed as having any thyroid disorder were determined. Patients with Hashimoto's thyroiditis were selected among those patients. Seven hundred and sixty-nine patients fulfilled diagnostic criteria for Hashimoto's thyroiditis (725 females, 44 males; mean age 41.76 +/- A 12.49 years). 62.7% of patients were between 30 and 50 years of age. 53.3% of females and 63.6% of males had diffuse enlargement of the thyroid gland. TSH level was above 4.0 IU/l in 25.6% of females and 27.4% of males. Anti-tyroglobulin antibody was positive in 92% of females and 93.2 % of males. Anti-thyroid peroxidase antibody was positive in 98.4 % of females (713 patients) and 100% of males. Thyroid ultrasonography demonstrated single nodule in 52.2% and multiple nodules in 11.3% of female patients; and single nodule 32% and multiple nodules in 20% of male patients. Fine-needle aspirations of the nodules were performed in 207 patients, and none of those biopsies was diagnosed as malignant. Women with suspicious biopsis were operated. After surgery, we found that, 2% (n = 4) of patients with FNAC diagnosis of suspicious biopsies were papillary carcinoma and the other patients (3% (n = 6)) were lymphocytic thyroiditis. Age and sex distribution and laboratory findings of our patients were comparable to the previous reports. Nodule formation was the most common ultrasonographic finding in our patients, probably due to pseudonodularity. We found four women patients with thyroid cancer in our population.Öğe Demographic, clinical, laboratory, ultrasonographic, and cytological features of patients with Hashimoto's thyroiditis: results of a university hospital of 769 patients in Turkey(Humana Press Inc, 2009) Erdogan, Mehmet; Erdem, Nihat; Cetinkalp, Sevki; Ozgen, Ahmet Gokhan; Saygili, Fusun; Yilmaz, Candeger; Tuzun, Mehmet; Kabalak, TaylanWe investigated the demographic and clinical features of patients with Hashimoto's thyroiditis who had been diagnosed and treated in Ege University, the main referral center in the Aegean region of Turkey. Medical records of patients who had been followed in the endocrinology clinic of Ege University were retrospectively evaluated. Patients who had been diagnosed as having any thyroid disorder were determined. Patients with Hashimoto's thyroiditis were selected among those patients. Seven hundred and sixty-nine patients fulfilled diagnostic criteria for Hashimoto's thyroiditis (725 females, 44 males; mean age 41.76 +/- A 12.49 years). 62.7% of patients were between 30 and 50 years of age. 53.3% of females and 63.6% of males had diffuse enlargement of the thyroid gland. TSH level was above 4.0 IU/l in 25.6% of females and 27.4% of males. Anti-tyroglobulin antibody was positive in 92% of females and 93.2 % of males. Anti-thyroid peroxidase antibody was positive in 98.4 % of females (713 patients) and 100% of males. Thyroid ultrasonography demonstrated single nodule in 52.2% and multiple nodules in 11.3% of female patients; and single nodule 32% and multiple nodules in 20% of male patients. Fine-needle aspirations of the nodules were performed in 207 patients, and none of those biopsies was diagnosed as malignant. Women with suspicious biopsis were operated. After surgery, we found that, 2% (n = 4) of patients with FNAC diagnosis of suspicious biopsies were papillary carcinoma and the other patients (3% (n = 6)) were lymphocytic thyroiditis. Age and sex distribution and laboratory findings of our patients were comparable to the previous reports. Nodule formation was the most common ultrasonographic finding in our patients, probably due to pseudonodularity. We found four women patients with thyroid cancer in our population.Öğe The effect of dialysis methods on thyroid hormone levels(1998) Hamulu, Füsun; Karabulut, Bülent; Saydam, Güray; Özgen, Gökhan; Ok, Ercan; Kabalak, TaylanThyroid functions were evaluated in 85 patients with end-stage renal failure, 44 treated by hemodialysis (HD) and 41 by con-tinuous ambulatory peritoneal dialysis(CAPD) and compared with 18 healthy subjects. Serum total triiodothyronine (TT3) were low in both HD and CAPD groups (p<0.001 and p< 0.015 respectively). Serum free thyroxine (fT4) concentration was low in HD (p<0.027) and free triiodothyronine (fT3) was low in the CAPD group (p<0.01) with respect to normal. There was no striking difference between the two study groups' serum total thyroxine (TT4), TT3, fT4, fT3 and thyroid stimulating hor-mone (TSH) levels.Öğe Effects of bisphosphonates on lipid metabolism(Maghira & Maas Publications, 2008) Guney, Engin; Kisakol, Gurcan; Ozgen, A. Gokhan; Yilmaz, Candeger; Kabalak, TaylanOBJECTIVES: Bisphosphonates are widely used for the treatment of metabolic bone disorders and their effects on lipid metabolism have also been investigated. Some studies reported that bisphosphonates have beneficial effects on serum cholesterol levels. In this study we aimed to assess the effects of bisphosphonates on lipid levels in hyperlipidemic patients who received bisphosphonates because of osteoporosis. METHODS: 49 female patients (age: 54.2 +/- 7.2 years) with diagnosis of osteoporosis and hyperlipidemia were enrolled. Patients received alendronate 10 mg/day and they were followed up for 6 months. Pretreatment total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, apolipoprotein A1 and apolipoprotein B levels were measured and compared with post-treatment levels. RESULTS: Pretreatment and post-treatment levels of total cholesterol were 255.2 +/- 34.3; 233.02 +/- 37.0 mg/dL, triglyceride levels were 153.0 +/- 57.3; 129.1 +/- 54.4 mg/dL, and LDL levels were 170.7 +/- 30.5; 160.0 +/- 34.2 mg/dL, respectively. Reductions in total cholesterol, triglyceride and LDL-cholesterol levels were statistically significant; whereas differences in HDL-cholesterol, apolipoprotein-A1 and apolipoprotein-B levels were not significant. CONCLUSIONS: Data from our study suggest that alendronate therapy may have beneficial effects on lipid metabolism. Thus, when hyperlipidemia is detected in patients receiving bisphosphonates, it is considered reasonable to follow the patient for a while before initiating antihyperlipidemic agent to prevent unnecessary use of drugs.Öğe Graves hastalarında FRTL-5 (Fisher rat thyroid cell line) kullanarak tiroid stimulan antikorların saptanması(Ege Üniversitesi, 1993) Kabalak, TaylanFRTL-5 hücreli TSH'lı ortamda büyüyebilir ve tiroit hücrelerine özgü fonksiyonel özellikleri gösterir. Bu çalışmada FRTL-5 hücreleri kullanılarak Graves hastalarına özgü TSAb'ların ölçümü amaçlanmış ve yine bu bioassay'in progzonu belirlemedeki rolü araştırılmıştır. Çalışmaya 6'sı erkek yaş ortalaması 36 (25-56) olan 18 hasta alınmıştır. TT3, fT4, TSH'ları ölçülen hastaların tiroit sintigrafileri yapılmıştır. TSAb'lar ise FRTL-5 hücrelerinin hasta serumu ile karşılaşmasından sonra I125 uptake'indeki artış ile belirlenmiştir. Aktif Graves hastalarının tümünün serumu ile FRTL - 5 hücrelerinin I125 uptake'inde artış olmuştur. Aynı şekilde anti-M'i pozitif olan hastaların %61'inin serumu ile FRTL-5 hücrelerinin I125 uptake'i artmış olarak bulunmuştur. FRTL-5 hücrelerinin kullanıldığı bu bioassay TSAb'ların saptanmasında zaman ve emek isteyen bir prosedür olsa da duyarlı bir yöntemdir.Öğe Review of Factors Contributing to Nodular Goiter and Thyroid Carcinoma(Karger, 2020) Yildirim Simsir, Ilgin; Cetinkalp, Sevki; Kabalak, TaylanThere is an increased incidence of thyroid nodules and cancer. in this article, the reasons for this increase are evaluated and discussed. the factors causing increases in the incidence of nodules are the same as those causing increases in thyroid cancer. There are publications from all over the world regarding the rising incidence of thyroid cancer; it is especially associated with papillary cancer. the literature was reviewed and evaluated with regard to this significant phenomenon. Thyroid-stimulating hormone (TSH) is the main mitotic factor. Any agent that elevates TSH will stimulate nodule formation. Therefore, the incidence of thyroid nodules is high in endemic goiter regions due to iodine deficiency. This paper has described many of the factors causing this higher incidence. of note, metabolic syndrome and insulin resistance are important factors associated with the increased incidence of nodular goiter and papillary thyroid cancer today. However, these data must be confirmed by other studies in the future.Öğe Thyroid Diseases, Metformin and the AMP Kinase Pathway(Turkiye Klinikleri, 2021) Soyaltin, Utku; Ozgen, Gokhan; Kabalak, TaylanAn increase in the adenosine monophosphate (AMP)/adenosine triphosphate ratio activates AMP-activated protein kinase (AMPK), leading to inhibition of the mammalian target of rapamycin signaling pathway that is associated with autophagy, mitochondriogenesis, glucose uptake, mRNA stabilization, and cell cycle regulation. Metformin activates AMPK and inhibits mitochondria! oxidative phosphorylation. Currently, there is an increasing interest in investigating the effects of metformin on thyroid diseases. Recent data show an association between metformin treatment and lower incidence of thyroid cancer, better survival of patients with thyroid cancer, and lower thyroid volume and nodule size. Insulin-like growth factor receptor and AKT pathways are the AMPK-independent mechanisms through which metformin acts on thyroid diseases. Although metformin has a promising role in adjuvant therapy for thyroid cancers, well-designed prospective trials are required before reaching a final decision.Öğe Tip 2 diyabet gelişimi ile glutamin: Fruktoz-6-fosfat amido transferaz (GFAT) aktivitesi arasındaki ilişkinin araştırılması(Ege Üniversitesi, 2005) Zihnioğlu, Figen; Duman, Erdal; Kabalak, Taylan; Önal, Seçil; Telefoncu, Azmi; Yılmaz, Candeğer[Abstract Not Available]
