Person: APAYDIN, TUĞÇE
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APAYDIN
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TUĞÇE
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Publication Metadata only Determinants of High-Dose Insulin Usage and Upper Extremity Muscle Strength in Adult Patients With Type 2 Diabetes(ELSEVIER, 2021) YAVUZ, DİLEK; Imre, Eren; Apaydin, Tugce; Gunhan, Hatice Gizem; Yavuz, Dilek GogasObjectives: In this study, we aimed to determine the association between upper extremity muscle strength and insulin dose in patients with type 2 diabetes. Methods: A total of 236 patients with type 2 diabetes under insulin treatment for at least 1 year were included in this cross-sectional study. Patients were divided into 3 groups based on their total daily insulin dose (TDID): group 1, TDID >2 U/kg/day or >200 units/day; group 2, TDID 1 to 2 U/kg/day or 51 to 199 U/day; and group 3, TDID <0.5 U/kg/day or 50 U/day. High-dose insulin use was defined as total daily insulin dose >2 U/kg or >200 U/day. Muscle strength was measured using a handgrip dynamometer. Results: High-dose insulin users were younger and had higher measures of generalized and central obesity and glycated hemoglobin. There was no significant difference in muscle strength between the groups. Low muscle strength was seen in 26.7% of all patients. Patients with low muscle strength were older, had lower insulin dose treatment and had better glycemic control than patients with normal muscle strength. Handgrip strength was inversely correlated with age, body mass index and duration of diabetes, but not with TDID. Conclusions: Patients with type 2 diabetes with high-dose insulin use had similar upper extremity muscle strength measurements with standard-dose insulin users. Studies with more patients are needed to determine the relationship between muscle mass, muscle strength and high-dose insulin use. (c) 2020 Canadian Diabetes Association.Publication Metadata only Capillary microarchitectural changes in Cushing's syndrome(Academic Press Inc., 2022) ILGIN, CAN; Apaydin T., Yalcinkaya Y., Ilgin C., Gogas Yavuz D.Purpose: Macrovascular alterations are prominent in Cushing's syndrome (CS). Microvascular abnormalities are yet to be established. This cross-sectional observational study aimed to evaluate microvascular changes in nailfold capillaries and their association with disease status and carotid intima-media thickness (CIMT) as a marker of atherosclerosis. Methods: A total of 70 patients with CS [46 (65.7%) ACTH-dependent pituitary adenoma and 24 (34.3%) adrenocortical adenomas] and 100 healthy controls were enrolled. The microvascular structure was evaluated using nailfold video-capillaroscopy (NVC). Results: The median number of capillaries was less [10 mm (IQR: 2, min-max:7–14) vs. 11 mm (IQR: 2, min-max:9–19) (p < 0.001)], the median limb diameter and capillary width were wider in the CS group than in the controls (p = 0.016 and p = 0.002, respectively). Microhemorrhages within limited areas were more frequent in the CS group than in the controls (p = 0.046). Observed capillary changes were similar among the patients with CS with remission or active disease. CIMT levels were higher in the CS group than in the controls and similar in subjects with active disease and remission. Univariate logistic regression analyses revealed that the number of capillaries and capillary widths were associated with body mass index (BMI), the presence of type 2 diabetes mellitus, HbA1c, and CIMT. Conclusion: Morphologic alterations present similarly in nailfold capillaries in subjects with CS regardless of disease status, resembling changes in chronic atherosclerotic diseases. Microvascular changes in nailfold capillaries measured using NVC can be used as a marker in the assessment of cardiovascular risk in patients with CS. © 2022 Elsevier Inc.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 Open Access Corticomedullary Mixed Tumor of the Adrenal Gland with Apparent F-18-Fluorodeoxyglucose Activity But No 68GA-DOTATATE Uptake on Positron Emission Tomography/Computed Tomography(2022-07-01) ENGÜR, CEREN ÖZGE; APAYDIN, TUĞÇE; ÖNEŞ, TUNÇ; ÖZGÜVEN, SALİH; Engur C. O. , Apaydin T., ÖNEŞ T., Gozu H. I. , ÖZGÜVEN S.Corticomedullary mixed tumor (CMT) is a single adrenal tumor mass composed histologically by an admixture of adrenal cortical and medullary cells. It is a rare condition, with approximately 20 cases reported to date. To our knowledge, the positron emission tomography (PET) imaging findings of this mostly benign tumor have not been reported in the literature. We present a case of CMT who was evaluated with both F-18-fluorodeoxyglucose (F-18-FDG) and Ga-68-DOTATATE. The hypermetabolic tumor seen on F-18-FDG PET/computed tomography scan showed no abnormal uptake by Ga-68-DOTATATE.Publication Metadata only Skin autofluorescence Is associated With low bone mineral density in type 2 diabetic patients(2021) YAVUZ, DİLEK; Yavuz, Dilek Gogas; Apaydin, TugceAlthough the risk of bone fracture is increased in type 2 diabetes (T2DM), bone mineral density (BMD) is increased rather than decreased. Accumulation of advanced glycation end products (AGEs) adversely influences the fracture resistance of bone in T2DM. We hypothesized that SAF is also associated with BMD levels in type 2 diabetic patients and aimed to evaluate the association of SAF with BMD and the presence of osteoporosis. This cross-sectional case-control study included 237 patients with T2DM (F/M: 133/104, 56.2±11.9 yrs) and 100 age- and sex-matched controls (F/M: 70/30, 54.8±8.8 yrs). Skin autofluorescence, a validated non-invasive measure of tissue AGEs, is used to detect the accumulation of AGEs in skin collagen using AGE Reader (DiagnOptics B.V., Groningen, The Netherlands). In addition, BMD was measured with DEXA (Lunar DPX-L). Patients with T2DM had higher SAF values compared to control group (2.21±0.53 AU vs. 1.79±0.33 AU, p < 0.001). Male subjects had higher SAF compared to women (2.34±0.53 AU vs. 2.11±0.50 AU, p < 0.001). Subjects with below -2.5 femoral neck or lumbar T scores had higher SAF measurements compared to subjects with normal T scores (2.46±0.53 AU vs. 2.18±0.52 AU, p = 0.006). Femoral neck BMD was lower in subjects with T2DM (0.946±0.345 g/cm2 vs. 1.005±0.298 g/cm2, p = 0.002). There was a negative correlation between SAF and femoral neck BMD (r=-0.24, p < 0.001), femoral neck T scores (r=-0.24, p < 0.001), L1-4 BMD (r=-0.10, p = 0.005), L1-4 T score (r=-0.16, p=0.001) and a positive correlation between SAF and age (r=0.44, p < 0.001), body mass index (r:0.16, p = 0.002) and HbA1c (r=0.37, p < 0.001). Accumulation of skin AGEs was increased, and BMD levels were decreased in diabetic patients. A negative association between SAF and BMD was detected, indicating a relationship between higher AGE accumulation and low BMD and osteoporosis in diabetic patients. Long-term prospective studies are needed to identify the practical use of SAF measurement in diabetic bone disease.Publication Metadata only Does concomitant prolactin measurement increase the accuracy of inferior petrosal sinus sampling?(SPRINGER, 2022) YAVUZ, DİLEK; Apaydin, Tugce; Yasar, Mehmet; Baltacioglu, Feyyaz; Haklar, Goncagul; Yavuz, Dilek GogasIntroduction Prolactin (PRL) measurement during inferior petrosal sinus sampling (IPSS) can be helpful to improve the accuracy. We aimed to evaluate the effect of measuring PRL levels as a predictor for the accuracy of IPSS and evaluate its impact on the lateralization of adenomas. Methods In this retrospective cohort study, we reviewed 51 patients who had undergone IPSS for the investigation of ACTH-dependent hypercortisolism. Results Forty-nine patients had proven Cushing's disease (CD), one had EAS, and the remaining one patient had adrenal adenoma. Forty-seven patients had an above 2 ACTH IPS/P ratio at baseline, and all the post-corticotropin-releasing hormone (CRH) ACTH IPS/P ratios of patients with proven CD were above 3. In these two patients whose ACTH IPS/P ratio at baseline was below 2, PRL IPS/P ratios were above 1.8 in only the dominant side, which was considered secondary to a prolactin intersinus gradient due to the biological effects of the tumor. PRL-adjusted ACTH IPS/P ratios were > 1.3 in all patients with proven CD; it was 0.7 in the patient with EAS. Surgically confirmed positive lateralization was observed in 55.1% of patients with the ACTH gradient, but when PRL-adjusted ACTH IPS/IPS ratios were used in addition to the ACTH gradient, the ratio increased to 67.3%. Conclusion Although PRL-adjusted ACTH IPS/P ratios can be helpful to improve the accuracy of results during IPSS procedures, a prolactin intersinus gradient towards the ACTH-dominant side in patients with CD may invalidate PRL as an indicator of pituitary venous outflow.Publication Open Access Serum Paraoxonase-1 Activity and Paraoxonase Q192 Gene Polymorphism in a Young, Healthy Population(TURKIYE KLINIKLERI, 2021) YAVUZ, DİLEK; Yavuz, Dilek Gogas; Ustay, Ozlem; Atak, Palmet Gun; Telli, Ahu; Apaydin, Tugce; Sirikci, OnderObjective: Paraoxonase-1 (PON1) enzyme and PON Q192R gene polymorphism are associated with atherosclerosis in many middle-aged individuals and high populations at risk of cardiovascular disease. This study aimed to determine serum PON-1 and arylesterase (ARE) activities, PON Q192R polymorphism, and their association with gender, lipoprotein levels, and carotid intima-media thickness (CIMT) among young healthy individuals. Material and Methods: Four hundred fifteen healthy volunteers (F/M: 213/202, 19-25 years) were included in the study. Serum lipoprotein levels and PON1, ARE activities were measured using spectrophotometric methods. PON 192Q polymorphism was evaluated by polymerase chain reaction, and CIMT was measured using Doppler ultrasonography. Results: Serum PON1 activity and PON Q192R polymorphism frequencies were similar between men and women, while ARE activity was significantly higher in women. PON1 activity was considerably higher in RR carriers than in QQ and QR carriers among both men and women. Serum high-density lipoprotein level was lower, and CIMT was higher in men compared to women. Conclusion: PON1 enzyme activities did not differ according to gender, and ARE activity was higher in women. High PON1 activity is associated with PONQ192 RR polymorphism carriers. PON Q192 gene polymorphism could be a determinant of PON activity.Publication Metadata only The association of free testosterone levels with coronavirus disease 2019(2022) ILGIN, CAN; Apaydin, Tugce; Sahin, Bahadır; Dashdamirova, Saida; Dincer Yazan, Ceyda; Elbasan, Onur; Ilgin, Can; Bilgin, Hüseyin; Cam, Haydar Kamil; Bahramzada, Gunel; Kucuk, Aleyna; Haklar, Goncagul; Iliksu Gozu, HulyaPublication Open Access Morbid obesity leads to increased skin autofluorescence independent of metabolic syndrome components(2022-01-01) APAYDIN, TUĞÇE; YAVUZ, DİLEK; APAYDIN T., YAVUZ D.Background/aim: Obesity, diabetes mellitus, and metabolic syndrome (MetS) are associated with increased accumulated skin advanced glycation end products. We aimed to evaluate the association of MetS components with skin autofluorescence (SAF) in patients with morbid obesity. Material and methods: Eight hundred and one patients with morbid obesity and 94 age-matched controls with normal body mass index (BMI) and normal glucose metabolism were included. Advanced glycation end products (AGEs) were measured using SAF in the forearm, with an AGE reader. Results: The prevalence of MetS in patients with morbid obesity was 65.5% (n = 525). Type 2 diabetes mellitus (type 2 DM) and hypertension were present in 40.9% (n = 328) and 43.7% (n = 357). Patients with morbid obesity and those with MetS had higher SAF measurements compared with the control group, 1.85 ± 0.44 arbitrary unit (AU) and 1.86 ± 0.43 AU vs. 1.72 ± 0.30 AU, respectively (p = 0.016). There was no difference in SAF levels between patients with and without MetS. SAF measurements of patients without MetS were not statistically different from the control group (p = 0.076). Patients with five MetS criteria had higher SAF measurements compared with patients with fewer MetS components (p = 0.019). There was no difference in SAF levels between patients with type 2 DM, impaired glucose metabolism, and patients with normal glucose metabolism (p = 0.513). Conclusion: Although MetS and type 2 DM are known as factors related to increased SAF levels, obesity can cause elevated SAF measurements in different ways independent of concomitant comorbid diseases. Larger studies with longer follow-ups are needed to enlighten the underlying mechanism.Publication Open Access Endocrine Effects of Coffee Consumption(TURKIYE KLINIKLERI, 2020) YAVUZ, DİLEK; Dincer, Ceyda; Apaydin, Tugce; Gogas Yavuz, DilekCaffeine has been found to exert various biological effects including, antiangiogenic, antiproliferative, antimetastatic activity, increased fat oxidation and mobilization of glycogen in muscle, increased lipolysis, and reduction of body fat. The aim of this review is to analyze the endocrine effects of coffee consumption. A systematic literature search was conducted on PubMed and Web of Science databases seeking articles published until May 2019, dealing with coffee consumption and diabetes, osteoporosis, thyroid gland, adrenal, and gonads. The results of the most epidemiologic studies reported that coffee consumption has positive effects on combating type 2 diabetes risk, has no significant effects on bone mineral density levels but fracture risk was shown to be higher in the high coffee consumer group. Coffee intake has no significant effect on thyroid cancer, increases sex hormone binding globulin levels, has no effect on fertility but higher consumption was related to spontaneous abortion. Studies pertaining to coffee consumption and endocrine effects have contrary results. More randomized clinical studies with a long term follow up period are required.