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    Effects of telmisartan and valsartan on insulin resistance, visfatin and adiponectin levels in hypertensive patients with metabolic syndrome
    (Editura Acad Romane, 2008) Sarac, S.; Sarac, Fulden; Tutuncuoglu, P.
    Objective. The aims of this study were to compare the effect of telmisartan and valsartan on the blood and insulin sensitivity and adiponectin levels in hypertensive patients with metabolic syndrome. Patients and Methods. One hundred twenty male patients who met the criteria for metabolic syndrome defined as in ATP III enrolled in the sudy. All patients were randomized to receive treatment with telmisartan 80 mg (n=70) or valsartan 160 mg (n=50) once daily for 6 months. Serum insulin concentration was measured by chemiluminescence, plasma levels of adiponectin and visfatin by Enzyme linked immunosorbent assay kit (ELISA). Insulin resistance (IR) was estimated using the homeostasis model assessment (HOMA). Results: Mean HOMA-IR and adiponectin and visfatin levels were measured 3.00 +/- 0.9 and 5.93 +/- 0.3 mgr/ml and 23.45 +/- 6.1 mgr/ml in patients before starting treatment of telmisartan, respectively. They were changed to 2.4 +/- 0.5 and 6.71 +/- 0.5 mg/ml and 21.40 +/- 5.0 mg/ml at a 6 months period. In valsartan group, mean HOMA-IR and adiponectin and visfatin levels were measured 2.9 +/- 0.5 and 5.50 +/- 0.9 mg/ml 19.05 +/- 3.9 mg/ml before treatment, respectively. After a 6 months period, mean HOMA-IR and adiponectin and visfatin levels were found 3.00 +/- 0.9 and 6.24 +/- 0.7 mg/ml and 20.76 +/- 4.5 mg/ml, respectively. Conclusion: Telmisartan produced significant reductions from baseline in HOMA-IR and insulin levels, whereas valsartan did not. Both telmisartan and valsartan did no changed serum visfatin levels but they increased serum adiponectin concentrations by RAS blockade.
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    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.