Person: YAVUZ, DİLEK
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YAVUZ
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DİLEK
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Publication Metadata only Epicardial Fat Tissue Thickness Correlates with Endothelial Dysfunction and Other Cardiovascular Risk Factors in Patients with Metabolic Syndrome(MARY ANN LIEBERT, INC, 2010) YAVUZ, DİLEK; Aydin, Hasan; Toprak, Ahmet; Deyneli, Oguzhan; Yazici, Dilek; Tarcin, Oezlem; Sancak, Seda; Yavuz, Dilek; Akalin, SemaBackground: Epicardial adipose tissue has shown to be related to cardiovascular risk. The aim of this study is to investigate the relationship between epicardial adiposity and endothelial function in metabolic syndrome. Methods: Fifty patients with metabolic syndrome were recruited. Anthropometric measurements, fasting blood glucose, insulin, lipid profile, high-sensitivity C-reactive protein (hsCRP), fibrinogen, apolipoprotein A (Apo A), Apo B1, and lipoprotein (a) [Lp(a)] were determined. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Epicardial fat thickness was measured via two-dimensional M-mode echocardiography. Endothelial function was assessed as flow-mediated dilatation at the brachial artery. Results: Epicardial fat tissue thickness was shown to be correlated negatively with FMD and positively with age, diastolic blood pressure, hsCRP, fibrinogen, HOMA-IR, and lipid parameters. Multiple regression analysis showed epicardial fat tissue thickness to be an independent factor influencing the endothelial function. Conclusions: Epicardial fat tissue may be a useful parameter in the assessment of patients with metabolic syndrome.Publication Open Access Effect of Vitamin D Deficiency and Replacement on Endothelial Function in Asymptomatic Subjects(ENDOCRINE SOC, 2009-10-01) VELİOĞLU ÖĞÜNÇ, AYLİZ; Tarcin, Ozlem; Yavuz, Dilek Gogas; Ozben, Beste; Telli, Ahu; Ogunc, Ayliz Velioglu; Yuksel, Meral; Toprak, Ahmet; Yazici, Dilek; Sancak, Seda; Deyneli, Oguzhan; Akalin, SemaContext: Vitamin D receptors are present in many tissues. Hypovitaminosis D is considered to be a risk factor for atherosclerosis. Objective: This study explores the effects of vitamin D replacement on insulin sensitivity, endothelial function, inflammation, oxidative stress, and leptin in vitamin D-deficient subjects. Design, Setting, and Patients: Twenty-three asymptomatic vitamin D-deficient subjects with 25-hydroxyvitamin D [25(OH)D] levels below 25 nmol/liter were compared with a control group that had a mean 25(OH)D level of 75 nmol/liter. The vitamin D-deficient group received 300,000 IU im monthly for 3 months. The following parameters were evaluated before and after treatment: vitamin D metabolites, leptin, endothelial function by brachial artery flow mediated dilatation (FMD), insulin sensitivity index based on oral glucose tolerance test, and lipid peroxidation as measures of thiobarbituric acid reactive substances (TBARS). Results: FMD measurements were significantly lower in 25(OH)D-deficient subjects than controls (P = 0.001) and improved after replacement therapy (P = 0.002). Posttreatment values of TBARS were significantly lower than pretreatment levels (P < 0.001). A positive correlation between FMD and 25(OH)D (r = 0.45; P = 0.001) and a negative correlation between FMD and TBARS (r = -0.28; P < 0.05) were observed. There was a significant increase in leptin levels after therapy, and the leptin levels were positively correlated with 25(OH)D levels (r = 0.45; P < 0.05). Conclusions: This study shows that 25(OH)D deficiency is associated with endothelial dysfunction and increased lipid peroxidation. Replacement of vitamin D has favorable effects on endothelial function. Vitamin D deficiency can be seen as an independent risk factor of atherosclerosis. Hypovitaminosis D-associated endothelial dysfunction may predispose to higher rates of cardiovascular disease in the winter. (J Clin Endocrinol Metab 94: 4023-4030, 2009)Publication Metadata only Effects of restoration of the euthyroid state on epicardial adipose tissue and carotid intima media thickness in subclinical hypothyroid patients(HUMANA PRESS INC, 2015) ÖZBEN SADIÇ, BESTE; Yazici, Dilek; Ozben, Beste; Toprak, Ahmet; Yavuz, Dilek; Aydin, Hasan; Tarcin, Ozlem; Deyneli, Oguzhan; Akalin, SemaEpicardial adipose tissue (EAT) thickness is a novel cardiovascular risk indicator, whereas carotid intima media thickness (CIMT) is a known marker of subclinical atherosclerosis. The aim of this study was to measure EAT thickness and CIMT in subclinical hypothyroid (SCH) patients and to determine the effect of restoration of the euthyroid state on these variables. The study included 43 patients with SCH (mean age: 35.2 +/- 10.7 years; F-M ratio: 42: 1) and 30 healthy controls (mean age: 34.5 +/- 8.2 years; F-M ratio: 25: 5). EAT thickness and CIMT were measured via conventional echocardiography and ultrasonography. Among the patients, 23 were followed up with L-thyroxine replacement until restoration of the euthyroid state and re-evaluated 6 months after baseline. Basal EAT thickness was higher in the SCH patients than in the controls (3.2 +/- 0.7 vs. 2.3 +/- 0.3 mm-p < 0.0001), whereas CIMT was similar in both groups (0.50 +/- 0.09 vs. 0.48 +/- 0.04 mm). EAT thickness was correlated with CIMT in the patient group (r = 0.39, p = 0.01), but this correlation was not evident based on multivariate analysis when corrected for age and body mass index (r(2) = 0.47 and p = 0.0001 for the model). In the follow-up patient subgroup, both EAT thickness and CIMT decreased significantly following L-thyroxine treatment, when normal TSH levels were attained (3.4 +/- 0.7 vs. 2.3 +/- 0.5 mm-p = 0.007 and 0.51 +/- 0.09 vs. 0.46 +/- 0.07 mm-p = 0.01, respectively). EAT thickness was greater in the SCH patients than in controls, whereas CIMT was similar in both groups. Restoration of the euthyroid state with L-thyroxine treatment was associated with significant decreases in EAT thickness and CIMT in the group of patients that received L-thyroxine treatment and, as such, might reduce the cardiovascular risk associated with SCH.Publication Metadata only Epicardial adipose tissue thickness in type 1 diabetic patients(SPRINGER, 2011) ÖZBEN SADIÇ, BESTE; Yazici, Dilek; Ozben, Beste; Yavuz, Dilek; Deyneli, Oguzhan; Aydin, Hasan; Tarcin, Ozlem; Akalin, SemaInsulin resistance is getting important in the course of type 1 diabetes mellitus. Visceral fat depot is associated with insulin resistance and assessment of epicardial fat thickness is a way of measuring visceral fat. The aim of the study was to measure epicardial adipose tissue (EAT) thickness and to determine its relationship with waist-hip-ratio (WHR) and estimated glucose disposal rate (eGDR) in adult type 1 diabetic patients. Thirty-six type 1 diabetic patients (aged 31 +/- 8 years; Female/Male: 22/14) and 43 age, gender and BMI matched healthy controls were included. Fasting blood glucose (FBG), hemoglobin A1c, and lipid profiles were measured. Waist-hip-ratio (WHR) was calculated. Daily insulin dose/kg of patients were recorded and eGDR of all subjects was calculated. Epicardial adipose tissue (EAT) thickness was evaluated by echocardiography. EAT thickness of the type 1 diabetic patients was significantly higher than controls (3.30 +/- 1.06 vs. 2.30 +/- 0.34 mm, P < 0.0001). EAT thickness was correlated with age (P = 0.05; r = 0.35), WHR (P = 0.003; r = 0.67), daily insulin dose/kg (r = 0.45, P = 0.005), and eGDR (r = -0.55, P = 0.0004). Multivariate analysis revealed WHR and eGDR to be related to EAT among age, WHR, daily insulin dose/kg, eGDR, FBG, and hemoglobin A1c (r(2) of the model = 0.64). Epicardial adipose tissue thickness is increased in type 1 diabetic patients compared to controls and is related to WHR and eGDR in this group of patients. This measurement may point to the presence of insulin resistance in type 1 diabetic patients.Publication Metadata only Anti-Saccaromyces Cerevisiae antibodies (ASCA) are elevated in autoimmune thyroid disease ASCA in autoimmune thyroid disease(SPRINGER, 2010) YAVUZ, DİLEK; Yazici, Dilek; Aydin, Sibel Zehra; Yavuz, Dilek; Tarcin, Ozlem; Deyneli, Oguzhan; Direskeneli, Haner; Akalin, SemaEnvironmental factors have been implicated in the development of autoimmune thyroid disease (AITD). Anti-Saccaromyces Cerevisiae Antibodies (ASCA) were shown to be elevated in several autoimmune diseases. The aim of the study was to determine ASCA levels and their relationship with thyroid autoantibodies in patients with AITD. One-hundred and twelve patients with AITD (age 41.1 +/- 12.8 years; F/M: 96/16) and 103 healthy controls (38.5 +/- 10.3 years; F/M: 82/21) were included. Twenty-four patients had Graves disease (GD), and 88 had Hashimoto's thyroiditis (HT). ASCA IgA and IgG, TSH, free T4, anti-thyroglobulin, and anti-thyroid peroxidase antibody concentrations were determined. ASCA IgA positivity in patients with GD (16.6%) was similar to patients with HT (13.6%) and was higher than controls (5.8%). No significant difference was present between the frequencies of IgG positivity among GD (12.5%), HT (7.9%), and control groups (5.8%). The mean levels of ASCA IgA and IgG were comparable within the groups. No correlation of ASCA and anti-thyroglobulin and antithyroid peroxidase levels was observed. Increased IgA ASCA positivity is observed in patients with GD, suggesting a role of environmental stimuli in its pathogenesis. The role of ASCA in the etiology of AITD needs to be further examined.Publication Metadata only Bulky gastrinoma of the common bile duct: Unusual localization of extrapancreatic gastrinoma - case report(AVES, 2011) YAVUZ, DİLEK; Tarcin, Ozlem; Yazici, Dilek; Ince, Umit; Deyneli, Oguzhan; Sancak, Seda; Aydin, Hasan; Yavuz, Dilek; Akalin, SemaZollinger-Ellison syndrome is characterized by elevated levels of serum gastrin associated with increased gastric acid secretion, gastrointestinal ulcerations and diarrhea. Most gastrinomas (75%) occur sporadically and are located within the gastrinoma triangle. Extraduodenal, extrapancreatic and extranodal gastrinomas have been shown in 5.6% of the patients with Zollinger-Ellison syndrome who underwent surgery. We report a 44-year-old female who had been complaining of nausea and diarrhea for 12 years. Abdominal computed tomography and magnetic resonance imaging detected a homogeneous, regular-shaped 6 x 7 cm solid mass, located between the liver, right kidney and inferior vena cava. Somatostatin receptor positive scanning led us to investigate a neuroendocrine tumor. Serum gastrin level was found very high and the patient underwent surgery. Local excision of the tumor was performed, and an 8x6x5 cm, well-capsulated, solitary mass, originating from the common bile duct was removed. The unique feature of our case is the unusual localization, and although the tumor was very large in size, only capsule invasion was observed with no evidence of distant metastasis.Publication Metadata only Effect of Vitamin D Deficiency and Replacement on Endothelial Function in Asymptomatic Subjects EDITORIAL COMMENT(LIPPINCOTT WILLIAMS & WILKINS, 2010) YAVUZ, DİLEK; Tarcin, Ozlem; Yavuz, Dilek Gogas; Ozben, Beste; Telli, Ahu; Ogunc, Ayliz Velioglu; Yuksel, Meral; Toprak, Ahmet; Yazici, Dilek; Sancak, Seda; Deyneli, Oguzhan; Akalin, Sema