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Öğe Association of osteopontin and tumor necrosis factor-alpha levels with insulin resistance in obese patients with obstructive sleep apnea syndrome(Editrice Kurtis S R L, 2011) Sarac, F.; Basoglu, O. K.; Gunduz, C.; Bayrak, H.; Avci, C. Biray; Akcicek, F.Objective: The aims of this study were to compare the tumor necrosis factor (TNF)-alpha and osteopontin levels, to identify the relationship between insulin resistance (IR) and osteopontin levels in obese patients with and without obstructive sleep apnea syndrome (OSAS). Method: The study population included 62 obese patients (35 males, 27 females) with OSAS and was compared with 26 obese patients (16 males, 10 females) without OSAS as a control group. Polysomnographic evaluation, spirometric tests and arterial blood gas sampling were performed on the obese patients with OSAS. Plasma levels of INF-alpha and osteopontin were measured by enzyme-linked immunosorbent assays during the process. IR was estimated using the homeostasis model assessment (HOMA). Results: Mean plasma levels of fasting glucose, insulin, HOMA, liver function test, hematocrit, leukocyte, TSH, free T(4), fibrinogen, INF-alpha, and osteopontin were similar in the 2 groups. In patients with OSAS, mean osteopontin levels were positively correlated with mean fasting insulin levels (r=0.306, p=0.01), HOMA (r=0.299, p=0.01), apnea-hypopnea index (r=0.377, p=0.03) and Epworth Sleepiness Scale (r=0.299, p=0.01). However, mean INF-alpha levels were negatively correlated with Epworth Sleepiness Scale (r=-0.298, p=0.01) in the patients with OSAS. Conclusions: It was observed that INF-alpha and osteopontin levels showed no difference between obese patients with and without OSAS. However, osteopontin levels increased with fasting insulin, IR, OSAS severity, and daytime sleepiness. (J. Endocrinol. Invest. 34: 528-533, 2011) (C) 2011, Editrice KurtisÖğe Causes of high bone alkaline phosphatase(Diagnosis Press Ltd, 2007) Sarac, F.; Saygili, F.Serum alkaline phosphatase (ALP) is a member of a family of zinc metalloprotein enzymes that function to split off a terminal phosphate group from an organic phosphate ester. Many things may cause increases of ALP activity in serum, the most common being obstructive liver disease and metabolic bone disease. An increase of the liver or particularly the bone isoform (bone specfic ALP) in serum can provide valuable diagnostic information. Bone specific alkaline phosphatase isoenzyme is elevated as a result of increased osteoblastic activity. The highest total ALP values have been attributed to an increased bone isoenzyme level due to Paget disease or rickets/osteomalasia. The enzyme activity, which is localized in the plasma membrane of osteoblasts before extracellular release, correlates with the extent of the disease on skeletal surveys and with parameters of bone resorption. This isoenzymes is normally elevated in growing children and adults over the age of fifty. Causes of high bone ALP include bone growth, healing fracture, acromegaly, osteogenic sarcoma, or bone metastases, leukemia, myelofibrosis, and rarely myeloma; so ALP is used as a tumor marker. Hyperthyroidism, by its effects upon bone, may also elevate ALP We presented two patients have raised alkaline phosphatase. Isoenzyme studies confirmed its bony origin.Öğe CHITOTRIOSIDASE ENZYME ACTIVITY IN PATIENTS WITH METABOLIC SYNDROME(Walter De Gruyter & Co, 2011) Barutcuoglu, B.; Basol, G.; Sarac, F.; Kabaroglu, C.; Gul, I.; Habif, S.; Bayindir, O.Öğe Effects of sibutramine on thermogenesis in obese patients assessed via immersion calorimetry(Health Communications Inc, 2006) Sarac, F.; Pehlivan, M.; Celebi, G.; Saygili, F.; Yilmaz, C.; Kabalak, I.Glucose utilization studies show that sibutramine-induced thermogenesis is mediated via selective sympathetic activation of brown adipose tissue. The goal of the present study was to use a new calorimetry method in which resting metabolic rate is enhanced to evaluate the effects of sibutramine treatment on thermogenesis. Sixty obese women were included in the study. Subjects were divided into 2 equal groups-the placebo and sibutramine treatment groups. The sibutramine group was given sibutramine 10 mg daily for 12 wk. At baseline and at the end of the 12-wk treatment period, thermogenic measurements were taken with the use of water immersion calorimetry. Subjects were examined at weeks 4, 8, and 12 of treatment to identify adverse effects. Body mass index, measured at 31.5 +/- 2.05 kg/m(2) in the placebo group, decreased to 30.4 +/- 2.94 kg/m(2) after 12 wk (P=.07). In the sibutramine group, it decreased from 33.5 +/- 4.1 kg/m(2) to 30.9 +/- 4.8 kg/m(2) (P <.05). In the sibutramine group, mean thermogenic response changed from a baseline value of 1.27 +/- 0.29 kcal/kg/h to 1.44 +/- 0.13 kcal/kg/h after 12 wk of treatment. In the placebo group, the baseline value was 1.56 +/- 0.27 kcal/kg/h; it changed to 1.33 +/- 0.36 kcal/kg/h at the end of 12 wk. The findings of this study suggest that sibutramine treatment promotes thermogenesis, thus facilitating weight loss. Calorimetry enhances resting metabolism through more efficient heat transfer from the body.Öğe GLUCOSE TOLERANCE TESTS IN THE SINGLETON AND TWIN PREGNANCY(Editura Acad Romane, 2009) Sarac, F.; Tutuncuoglu, P.; Tavmergen, E.; Saygili, F.; Ozgen, A. Goekhan; Tuzun, M.Objective. Gestational diabetes mellitus (GDM) is defined as glucose intolerance that is detected for the first time during pregnancy. Normal pregnancy induces insulin resistance through the diabetogenic effects of placental hormones. Glucose tolerance test results in twin and singleton pregnancies were compared in this study. Subjects and Methods. A total of 360 pregnant women were Studied. 200 women (mean age 31.60 +/- 2.10 yr) had singleton pregnancies (Group I) and 160 women (mean age 28.20 2.70 yr) had twin pregnancies (Group II). 50- g, 1- hour glucose tolerance test was conducted oil the first prenatal visit. An abnormal glucose screen defined as glucose >= 140 mg/dL was followed by a 100g, 3-hour glucose tolerance test. Gestational diabetes was defined as the presence of two or more abnormal values during the 3-hour test. Results. Gestational diabetes was found in 4 of the 200 (2%) singleton pregnant women and 8 of the 160 (5%) twin pregnant women. Group I (Singleton) was further divided into two Subgroups according to whether the 1-hr plasma glucose level was < 140 mg/dl (Group Ia) or > 140 ma/dL (Group Ib). Likewise, Group II pregnancies was also divided into two subgroups oil the same basis. Mean screening test glucose levels were found to be 127.8 +/- 14.94 mg/dL ill Group la and 150.8 +/- 18.1 mg/dL in Group Ib women. Mean screening test glucose levels of Group IIa subjects was 92.80 +/- 18.30 mg/dL while that of Group IIb Subjects was 154.8 +/- 27.0 mg/dL. Mean 1(st) h glucose levels of 100-g glucose tolerance test was found to be 131.4 +/- 32.58 mg/dL in Group I, and 112.5 +/- 39.6 mg/dL in Group II. Mean 2(nd) h glucose tolerance test values were 133.2 +/- 28.8 mg/dL in Group I and 100.6 +/- 28.8 mg/dL in Group II. Mean 3(rd) h glucose tolerance test values were 107.6 +/- 23.58 mg/dl in Group I and 72 +/- 16.9 mg/dL in Group II. Conclusion: Glucose screening results and 100-g, 3- hour glucose tolerance test values have been found to be lower in twin pregnancies than in singleton pregnancies. Therefore, we suggest that these findings be taken into account in developing diagnostic criteria for gestational diabetes ill twin or more pregnancies.Öğe Is obesity a possible modifier of periodontal disease as a chronic inflammatory process? A case-control study(Wiley-Blackwell, 2014) Buduneli, N.; Biyikoglu, B.; Ilgenli, T.; Buduneli, E.; Nalbantsoy, A.; Sarac, F.; Kinane, D. F.Background and Objective: This cross-sectional case-control study was conducted to provide a comparative evaluation of clinical periodontal measurements, together with serum levels of certain bioactive peptides and inflammatory cytokines, in relation to obesity. For this purpose, clinical periodontal measurements and the levels of serum leptin, adiponectin, interleukin-6 (IL-6), C-reactive protein and soluble intercellular adhesion molecule-1 of obese female individuals and their nonobese counterparts were compared. Material and Methods: Sixty obese (body mass index (BMI) > 30) and 31 nonobese (BMI < 30) female subjects were recruited for the present study. Before any periodontal intervention, serum samples were obtained and full-mouth clinical periodontal measurements were recorded at six sites per tooth. ELISA was used for the biochemical analysis. Data were tested statistically. Results: Clinical attachment level was significantly higher in the obese group compared with the nonobese control group (p < 0.05). Serum levels of leptin and IL-6 were significantly higher in the obese group (p < 0.05). BMI correlated with the serum levels of inflammatory molecules (p < 0.05), but not with clinical periodontal parameters, in the obese group. Conclusion: In conclusion, obesity does not seem to have a prominent effect on clinical periodontal parameters but it does have many correlations with circulating inflammatory molecules. As suggested in the literature, increased levels of leptin and IL-6 in the obese group might be one explanation for a possible relationship between obesity and periodontal disease. A prospective study is warranted to clarify, in greater detail, the effects of obesity on periodontal health.Öğe No relationship between lipoprotein-associated phospholipase A2, proinflammatory cytokines, and neopterin in Alzheimer's disease(Pergamon-Elsevier Science Ltd, 2016) Savas, S.; Kabaroglu, C.; Alpman, A.; Sarac, F.; Yalcin, M. A.; Parildar, Z.; Özkınay, Ferda; Kumral, E.; Akcicek, F.Objective: Lipoprotein-associated phospholipase A2 (Lp-PLA(2)) is a reported risk factor for dementia. However, the relationship between Alzheimer's disease (AD) and Lp-PLA(2) is still debatable and, to the best of our knowledge, no study has evaluated the associations between levels of Lp-PLA(2), proinflammatory cytokines, and neopterin in AD. Methods: In total, 59 patients with AD and 38 non-demented individuals were included in the case-control study. Fasting serum concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), neopterin, and Lp-PLA(2) were determined using ELISA. The associations between AD and each of the variables were analyzed by logistic regression. Results: The median Lp-PLA(2) levels in AD and controls were similar (P = 0.29, not significant). Median serum neopterin and IL-6 levels were significantly higher in patients with AD than in controls (P = 0.0001 and P = 0.03, respectively). In regression analyses, median neopterin levels, a lower level of education, and female gender were significantly associated with AD when compared with controls (OR, 31.44, 95% CI 3.59-275.28, P=0.002; OR, 4.35, 95% CI 1.13-16.61, P = 0.032; OR, 7.25, 95% CI 1.88-28.00, P = 0.004, respectively). Conclusion: In contrast to previous evidence suggesting its role in dementia and AD, Lp-PLA(2) enzyme levels were higher in the controls, and no relationship between Lp-PLA(2) and either proinflammatory cytokines or neopterin was identified in AD. Elevated neopterin levels may be considered inflammatory markers of AD. (C) 2016 Elsevier Inc. All rights reserved.Öğe POLYMORPHISMS IN HETEROZYGOUS AND HOMOZYGOUS PERILIPIN GENE, C.1113T > C AND C.1119C > T, ARE INCREASED IN OBESE WOMEN(Editura Acad Romane, 2012) Sarac, F.; Berdelli, A.; Atan, M.; Yilmaz, C.; Akcicek, F.Background. Obesity involves both genetic and environmental influences, but the mechanisms of the genetic effects are not well understood. Objective. The aims of the study were to investigate the frequency of perilipin gene polymorphism in order to identify the relationship between insulin resistance and gene polymorphism in obese women. Subjects and methods. Study population included 31 obese women and 10 women with normal weight as a control group. All of the entire coding exons of PLIN gene were amplified by polymerase chain reaction (PCR). Insulin resistance (IR) was estimated using the homeostasis model assessment (HOMA-IR). Results. In the obese group, 29 (93.6%) patients were homozygous and 1 patient (3.2%) was heterozygous for the c.580C>.G (p.Pro194A1a) (rs.6496589) mutation and I patient (3.2%) was Pro194A1a. Homozygous.Val156Leu. heterozygous mutation at exon 5 at PLIN gene (p=0.072). As for exon 8 at PLIN gene in obese group, 6 patients (19.3%) had heterozygous for the c.1113T>C (Pro371Pro) (rs2304796) mutation, and 12 patients (38.7%) had heterozygous for the c.1113T>C and c.1119C>T (p.Val373Val) (rs2304795) mutation, and 4 patients (12.9%) had homozygous for the c.1113T>C and c.1119C>T mutations (p=0.009). In obese patients with no nucleotide substitution at exon 8, mean levels of systolic and diastolic blood pressures were higher than those of obese subjects with gene polymorphism. However, there were no statistically significant differences for HOMA-IR levels between obese women with and without perilipin gene polymorphism. Conclusions: Perilipin gene polymorphisms such as heterozygous and homozygous for the c.1113T>C and c.1119C>T (rs2304795) at exon 8 were associated with obesity risk. However, no relationship was found between insulin resistance and polymorphisms of perilipin gene in obese women.Öğe Role of inflammatory biomarkers in nephropathy and atherosclerosis in type 2 diabetes mellitus patients with microalbuminuria(Wiley, 2021) Cirkin, H.; Bagca, B. Goker; Kilavuz, A.; Sarac, F.; Selvi, N.; Birkay, C. Avci; Sagin, H.[No Abstract Available]Öğe Thermogenic response and leptin levels rise after recovery of the euthyroid state(Editrice Kurtis S R L, 2010) Sarac, F.; Oezgen, A. Goekhan; Celebi, G.; Pehlivan, M.; Uluer, H.; Yilmaz, C.Objective: The aims of the study were to compare: a) the thermogenic responses in subclinical hypothyroidism (SH) and euthyroid state; b) the relationship between thermogenic response and leptin level. Methods: Thirty women diagnosed with SH (mean age 39.9+/-4.1 yr; body mass index 23.2+/-2.5 kg/m(2)) were enrolled in the study. Thyroid function tests, leptin, and lipid profiles were measured during SH and after stable euthyroidism was recovered. Thermogenic response was measured by Water Immersion Calorimetry during SR and after the euthyroid state was attained. Results: The mean level of thermogenic response was found to be 1.45+/-0.43 kcal/kg.h in women with SR. It changed to 1.54+/-0.77 kcal/kg.h (p=0.01) in the euthyroid state; the change was statistically significant. Mean level of leptin was found to be 7.22+/-2.6 ng/ml in SH; and 15.8+/-8.0 ng/ml in the euthyroid state. There was a positive correlation between leptin and free T(3) (r=0.460, p=0.009) levels in SH. There were positive correlations between leptin level and fat mass in SH (r=0.820, p=0.01) and in the euthyroid state (r=0.700, p=0.03). Conclusions: No correlations were found between thermogenic response and leptin levels in SH and in the euthyroid state. Thermogenic response and leptin levels rose after the euthyroid state was recovered. (J. Endocrinol. Invest. 33: 254-257, 2010) (C) 2010, Editrice Kurtis
