Person: YAVUZ, DİLEK
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YAVUZ
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DİLEK
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Publication Open Access Status of weight change, lifestyle behaviors, depression, anxiety, and diabetes mellitus in a cohort with obesity during the covid-19 lockdown: Turk-com study group(2022-08-01) YAVUZ, DİLEK; KÜÇÜK YETGİN, MERAL; Yazıcı D., Fersahoğlu M. M., Fersahoğlu T., Bulut N. E., Çiğiltepe H., Çeler Ö., Sancak S., Sulu C., Durcan E., Şahin S., et al.Introduction: The coronavirus disease 2019 (COVID-19) pandemic led to a lockdown period. Confinement periods have been related to unhealthy lifestyle behaviors. Our study aimed to determine weight change, changes in eating and exercise habits, the presence of depression and anxiety, and diabetes mellitus (DM) status in a cohort of patients with obesity. Methods: The study was undertaken in nine centers of Collaborative Obesity Management (COM) of the European Association for the Study of Obesity (EASO) in Turkey. An e-survey about weight change, eating habits, physical activity status, DM status, depression, and anxiety was completed by patients. The International Physical Activity Questionnaire (IPAQ) score was used to determine physical activity in terms of metabolic equivalents (METs). A healthy nutrition coefficient was calculated from the different categories of food consumption. The Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) Questionnaire were used for determining depression and anxiety, respectively. Results: Four hundred twenty-two patients (age 45 +/- 12.7 years, W/M = 350/72) were included. The healthy nutrition coefficient before the pandemic was 38.9 +/- 6.2 and decreased to 38.1 +/- 6.4 during the pandemic (p < 0.001). Two hundred twenty-nine (54.8%) patients gained weight, 54 (12.9%) were weight neutral, and 135 (32.3%) lost weight. Patients in the weight loss group had higher MET scores and higher healthy nutrition coefficients compared with the weight gain and weight-neutral groups (p < 0.001). The PHQ and GAD scores were not different between the groups. Percent weight loss was related to healthy nutrition coefficient (CI: 0.884 [0.821-0.951], p = 0.001) and MET categories (CI: 0.408 [0.222-0.748], p = 0.004). One hundred seventy patients had DM. Considering glycemic control, only 12 (8.4%) had fasting blood glucose <100 mg/dL and 36 (25.2%) had postprandial BG <160 mg/dL. When patients with and without DM were compared in terms of dietary compliance, MET category, weight loss status, PHQ-9 scores, and GAD-7 scores, only MET categories were different; 29 (11.7%) of patients in the nondiabetic group were in the highly active group compared with 5 (2.9%) in the diabetic group. Conclusion: The COVID-19 lockdown resulted in weight gain in about half of our patients, which was related to changes in physical activity and eating habits. Patients with DM who had moderate glycemic control were similar to the general population in terms of weight loss but were less active.Publication Open Access Vitamin D receptor and estrogen receptor gene polymorphisms in men with type 2 diabetes: Effects on Bone Metabolism(2022-12-01) ÜSTAY, ÖZLEM; YAVUZ, DİLEK; YÜKSEL, MERAL; YAVUZ D., YÜKSEL M., Sancak S., Yazici D., ÜSTAY Ö., Deyneli O., Akalin S.Purpose There is an increased fracture risk in type 2 diabetes mellitus [DM] patients independent of bone mineral density [BMD], both in men and women. Estrogen receptor [ER]-alpha and vitamin D receptor [VDR] gene polymorphisms may predispose patients to increased osteoporosis and fracture risk. This study aims to analyze the relationship of the ER-alpha gene and VDR gene polymorphisms with indicators of bone turnover and BMD in male type 2 diabetic patients. Methods Type 2 diabetic men diagnosed with diabetes for at least one year and healthy controls were included in this cross-sectional study. BMD was measured by dual X ray absorptiometry. Gene polymorphisms were evaluated with polymerase chain reaction-restriction length polymorphism. Serum iPTH, calcium, beta-CrossLaps (cTx), osteocalcin, and free testosterone levels were also evaluated. Results Participants were 141 type 2 diabetic men [55 +/- 8 years] and 100 healthy controls [53 +/- 7 years]. BMD measurements were not statistically different between the groups. While iPTH [p < 0.05] and serum calcium levels [p = 0.03] were higher in men with type 2 DM; beta-CrossLaps [p = 0.0001], osteocalcin [p = 0.005], and free testosterone [p = 0.04] were lower than controls. The differences in terms of the frequencies of VDR Apa, Taq, Bsm, Fok and ER-alpha polymorphisms were not statistically significant between the groups. No relationship was observed between polymorphisms and BMD in both groups. Conclusions VDR and ER-alpha gene polymorphisms seem to have no effect on BMD and bone turnover in men with DM.Publication Open Access Low serm Fibroblast Growth Factor-21 levels is not associated with Carotid intima-media thickness in acromegaly patients(2022-07-01) YAVUZ, DİLEK; Uygur M. M., Yazici D. D., YAVUZ D.Introduction Elevated fibroblast growth factor-21 (FGF-21) levels are related to carotid intima-media thickness (CIMT), a well-established marker of atherosclerosis. Acromegaly has also been linked to increased CIMT. There has been no data considering the association between FGF-21 levels and atherosclerosis in acromegaly patients. This study aimed to evaluate FGF-21 levels and CIMT in acromegalic patients in relation to atherosclerotic complications. Design Case-control study. Materials and methods The study group included 70 acromegaly patients and 72 healthy volunteers from the Department of Endocrinology and Metabolism Disease, Marmara University Medical School. FGF-21, growth hormone, insulin-like growth factor I, lipids, glucose, insulin levels were assessed. CIMT was measured from the common carotid artery wall on B-mode ultrasound. Results Median FGF-21 levels were significantly lower in the acromegaly group than in the control group. CIMT was higher in acromegaly patients compared to controls. Although there was no correlation between FGF-21 levels and CIMT in patients with acromegaly, a positive correlation was found between high-density lipoprotein-cholesterol and FGF-21 levels. Glucose metabolic markers were the determining factors of the FGF-21 levels in acromegaly patients. Conclusion Our study is the first to examine the relationship between serum FGF-21 levels and atherosclerosis in acromegaly patients. The lower serum FGF-21 levels in acromegaly subjects might be associated with the improving effects of growth hormone on liver fat. Acromegaly was linked to higher CIMT, but there was no correlation between FGF-21 levels and CIMT. The role of FGF-21 in acromegaly as a marker of atherosclerosis requires additional research.Publication Open Access Lipodystrophy frequency according to insulin treatment regimen in type 2 diabetic patients: Is insulin injection frequency matters in analog insulin era(2022-04-01) YAVUZ, DİLEK; Gunhan H., Elbasan O., Imre E., Yavuz D. G.© 2022, Acta Endocrinologica Foundation. All rights reserved.Objectives. We aimed to determine lipodystrophy frequency according to insulin treatment regimen and insulin injection frequency in type 2 diabetic patients. Methods. A total of 345 type 2 diabetic patients under insulin treatment for at least one year were included in this cross-sectional study. Patients were examined for presence of lipodystrophy, insulin injection frequency and dosage. Lipodystrophy was evaluated with visual inspection and palpation of all injection sites. Patients were evaluated into three categories according to daily insulin dose requirement: Group 1= Standard-dose insulin users 0.6 U/ kg/day; Group 2= Medium-dose insulin users 0.61-1.9 U/kg/ day, Group 3= High-dose insulin users ≥2 U/kg/day. Results. Lipodystrophy was seen in 28% of the patients. Lipodystrophy was significantly higher in group 3. There was no significant difference between the groups in terms of lipodystrophy size. Duration of insulin treatment, daily total insulin dose, daily insulin dose per weight and number of daily insulin injections were significantly higher in the group with lipodystrophy. Daily injection number of long-acting, rapidly-acting analog and total insulin injections were significantly higher in group 3 than group 1 and 2. Number of daily insulin injections and lipodystrophy frequency were significantly higher in basal-bolus insulin user group. Multivariate analysis showed that insulin injection frequency is the independent risk factor for lipodystrophy. Conclusion. Lipodystrophy is still a clinical problem in patients with high-dose insulin requirement and frequent insulin injections. Reducing daily insulin requirement and daily number of injections should be given priority in the management of patients to prevent the development of lipodystrophy.Publication Metadata only Hipoparatiroidi: Etiyoloji, klinik ve tanıya gidiş(Akademisyen Yayınevi Kitabevi, 2023-01-01) YAVUZ, DİLEK; Yavuz D.Hipoparatiroidi (hipoPT) hipokalsemi ve eşlik eden düşük/ölçülemeyecek kadar düşük paratiro id hormon (PTH) düzeyleri ile karakterize ender bir hastalıktır (1). Hipoparatiroidi tanısı biyokimyasal olarak dü zeltilmiş kalsiyum veya iyonize kalsiyum düzeyi nin normalin altında olması ve eşlik eden uygun suz serum PTH düşüklüğü/ölçülemeyecek kadar düşük olması ile konur (1,2). Hipoparatiroidi prevalansı Kuzey Amerika’da 100,000 de 37, Avrupa’da 100,000 de 22 olarak rapor edilmiştir. Ülkemizdeki prevalansı bilinme mektedir. Hipoparatiroidi, renal yetmezlik, böbrek taşı, posterior subkapsüler katarakt, intraserebral kal sifikasyon riskini arttırmaktadır. Kardiyovasküler hastalık, kemik kırığı ve malinite riskini de art tırabileceği rapor edilmektedir. Kronik hipokal semi, hiperkalsiüri ve diğer komorbid sorunların mortaliteye etkisi açık değildir. Uzun dönemde hipoPT tedavisinde yetersizlik, akut ve kronik komplikasyonlar hastalığın morbiditesini etkile yen unsurlardır (1,2Publication Metadata only Osteogenezis imperfekta tanılı 10 hasta: Klinik özellikler, sonuçlar ve tedavi yanıtı(2022-05-20) YAVUZ, DİLEK; Dashdemirova S., Yavuz D.Publication Metadata only Factors associated with bone metabolism parameters in primary hyperparathyroidism before and after surgery(2021-12-01) AKÇAY, SEÇKİN; YAVUZ, DİLEK; AKÇAY S., YAVUZ D.Publication Metadata only Beyin, akciğer ve kemik metastazı ile presente olan papiller tiroid kanseri: Tiroid kanserleri iyi huylu davranmayabilir(2022-10-20) YAVUZ, DİLEK; Yunusov E., Öner H., Yavuz D.Publication Open Access Prevalence of vitamin d deficiency and hypervitaminosis d among adult patients admitted to the tertiary care hospitals in Turkey(2022-06-01) YAVUZ, DİLEK; APAYDIN, TUĞÇE; HAKLAR, GONCAGÜL; YAVUZ D., ERSOY R., Altuntas Y., Bilen H., Pamuk B., APAYDIN T., Temizkan S., Altuntas H., Mert M., AKALIN A., et al.Objective: Vitamin D deficiency is a common health problem around the world. This study aimed to evaluate the nationwide prevalence of vitamin D status in tertiary care hospitals in Turkey. Methods: Retrospectively, the data on vitamin D levels from 33 tertiary care hospitals’ clinical biochemistry laboratories around Turkey between January and December were collected. Results: In total, 706 434 serum samples from adult subjects (female/male: 469 028/237 406; 66.4%/33.6%) were included. While vitamin D levels were sufficient in 20.3% (n=14 222), they were insufficient in 21.9% (n=154 360) and deficient in 57.8% (n=408 882). We observed the highest rates of deficiency in those aged between 18 and 29 years (62.9%, n=70 235) and lowest rates between 60 and 69 years (52.3%, n=61 121) and between 70 and 79 years (52.3%, n=32 397). Hypervitaminosis D was detected in 5.5% of adult subjects; highest rates of hypervitaminosis D were observed in those who were over 80 years (6.6%) and 70-79 years (6.5%) and the lowest in 18-29 years (2.8%). Discussion: In this cohort, over half of the subjects admitted to the tertiary care hospitals in Turkey had vitamin D deficiency and required vitamin D supplementation. The elderly population had the lowest prevalence of vitamin D insufficiency and the highest prevalence of hypervitaminosis D.Publication Metadata only Superior glycemic control with once-weekly insulin icodec with a dosing guide app vs. once-daily (OD) basal insulin analogs in insulin-naive T2D-ONWARDS 5(2023-01-01) YAVUZ, DİLEK; Bajaj H. S., Aberle J., Davies M. J., Donatsky A. M., Frederiksen M., Yavuz D., Gowda A., Lingvay I., Bode B. W.