Person: BEREKET, ABDULLAH
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BEREKET
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ABDULLAH
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Publication Open Access Normative Data of Thyroid Volume-Ultrasonographic Evaluation of 422 Subjects Aged 0-55 Years(GALENOS YAYINCILIK, 2015-06-05) BEREKET, ABDULLAH; Aydiner, Omer; Aydiner, Elif Karakoc; Akpinar, Ihsan; Turan, Serap; Bereket, AbdullahObjective: To establish local normative data of thyroid volume assessed by ultrasonography in subjects aged 0-55 years living in Istanbul, Turkey. Methods: Subjects without any known history of thyroid disease, of major surgery and/or chronic disease were enrolled in the study and evaluated by physical examination and thyroid ultrasonography. Thyroid gland and isthmus at usual location, each lateral lobe volume with three dimensions, ectopic thyroid tissue and echogenicity of the gland were assessed. Results: Initially, 494 subjects were enrolled in the study. Subjects showing heterogeneous thyroid parenchyma (n=21) and/or nodule (n=51) in ultrasonography were excluded. Final analysis covered 422 subjects (216 males, 206 females). Thyroid volume was found to significantly correlate with height, weight, age and body surface area (r=0.661, r=0.712, r=0.772 and r=0.779, respectively; p<0.0001 for all). These correlations were even stronger in subjects younger than 18 years (r=0.758, r=0.800, r=0.815 and r=0.802, respectively; p<0.0001 for all). Conclusion: The study provides updated reference norms for thyroid volume in Turkish subjects which can be used in the diagnosis and follow-up of patients with thyroid diseases.Publication Open Access Growth curves for Turkish Girls with Turner Syndrome: Results of the Turkish Turner Syndrome Study Group(GALENOS YAYINCILIK, 2015-09-05) BEREKET, ABDULLAH; Darendeliler, Feyza; Yesilkaya, Ediz; Bereket, Abdullah; Bas, Firdevs; Bundak, Ruveyde; Sari, Erkan; Aydin, Banu Kucukemre; Darcan, Sukran; Dundar, Bumin; Buyukinan, Muammer; Kara, Cengiz; Mazicioglu, Mumtaz M.; Adal, Erdal; Akinci, Aysehan; Atabek, Mehmet Emre; Demirel, Fatma; Celik, Nurullah; Ozkan, Behzat; Ozhan, Bayram; Orbak, Zerrin; Ersoy, Betul; Dogan, Murat; Atas, Ali; Turan, Serap; Goksen, Damla; Tarim, Omer; Yuksel, Bilgin; Ercan, Oya; Hatun, Sukru; Simsek, Enver; Okten, Aysenur; Abaci, Ayhan; Doneray, Hakan; Ozbek, Mehmet Nuri; Keskin, Mehmet; Onal, Hasan; Akyurek, Nesibe; Bulan, Kezban; Tepe, Derya; Emeksiz, Hamdi Cihan; Demir, Korcan; Kizilay, Deniz; Topaloglu, Ali Kemal; Eren, Erdal; Ozen, Samim; Demirbilek, Huseyin; Abali, Saygin; Akin, Leyla; Eklioglu, Beray Selver; Kaba, Sultan; Anik, Ahmet; Bas, Serpil; Unuvar, Tolga; Saglam, Halil; Bolu, Semih; Ozgen, Tolga; Dogan, Durmus; Cakir, Esra Deniz; Sen, Yasar; Andiran, Nesibe; Cizmecioglu, Filiz; Evliyaoglu, Olcay; Karaguzel, Gulay; Pirgon, Ozgur; Catli, Gonul; Can, Hatice Dilek; Gurbuz, Fatih; Binay, Cigdem; Bas, Veysel Nijat; Saglam, Celal; Gul, Davut; Polat, Adem; Acikel, Cengizhan; Cinaz, PeyamiObjective: Children with Turner syndrome (TS) have a specific growth pattern that is quite different from that of healthy children. Many countries have population-specific growth charts for TS. Considering national and ethnic differences, we undertook this multicenter collaborative study to construct growth charts and reference values for height, weight and body mass index (BMI) from 3 years of age to adulthood for spontaneous growth of Turkish girls with TS. Methods: Cross-sectional height and weight data of 842 patients with TS, younger than 18 years of age and before starting any therapy, were evaluated. Results: The data were processed to calculate the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile values for defined ages and to construct growth curves for height-for-age, weight-for-age and BMI-for-age of girls with TS. The growth pattern of TS girls in this series resembled the growth pattern of TS girls in other reports, but there were differences in height between our series and the others. Conclusion: This study provides disease-specific growth charts for Turkish girls with TS. These disease-specific national growth charts will serve to improve the evaluation of growth and its management with growth-promoting therapeutic agents in TS patients.Publication Open Access Rickets in the Middle East: Role of environment and genetic predisposition(ENDOCRINE SOC, 2008-05-01) BEREKET, ABDULLAH; Baroncelli, Giampiero I.; Bereket, Abdullah; El Kholy, Mohamed; Audi, Laura; Cesur, Yasar; Ozkan, Behzat; Rashad, Mona; Fernandez-Cancio, Monica; Weisman, Yoseph; Saggese, Giuseppe; Hochberg, Ze'evContext: The Middle East has a high incidence of rickets, and it is also common in Europe-dwelling children of Middle Eastern origin. Objective: The objective of the study was to explore the mechanisms leading to rickets in children of the Middle East. Design and Setting: We conducted a prospective study in 98 rachitic and 50 controls (aged 6 months to 4 yr) from university and community outpatient hospitals in Egypt and Turkey. Main Outcome Measures: We collected epidemiological, maternal, nutritional, radiographic, and biochemical parameters; markers of bone turnover; and vitamin D receptor (VDR) gene polymorphisms. Results: Epidemiological factors had a key role in pursuit of rickets; Egyptian and Turkish patients had lower (P < 0.01) dietary calcium intake than controls and the recommended dietary intakes, and serum 25-hydroxyvitamin D levels were reduced in patients, the difference with controls being significant (P < 0.001) only in Turkey, although rickets was more severe in Egypt as determined by the x-ray score (P < 0.05). In Turkey, the F VDR allele frequency was significantly (P < 0.05) increased in patients. The BB VDR genotype was associated with lower serum 25-hydroxyvitamin D levels in both patients and controls and with severity of rickets. Conclusions: In Turkey most patients had vitamin D deficiency, whereas in Egypt they had mostly calcium insufficiency combined with vitamin D deficiency. In this environ, VDR genotypes may predispose to rickets by increased frequency of the F allele. The unique environs and genetic predisposition have to be accounted for in the design of preventive measures, rather than using European or American recommended dietary intake for calcium and vitamin D.Publication Open Access Current Practice in Diagnosis and Treatment of Growth Hormone Deficiency in Childhood: A Survey from Turkey(GALENOS YAYINCILIK, 2015-03-05) BEREKET, ABDULLAH; Poyrazoglu, Sukran; Akcay, Teoman; Arslanoglu, Ilknur; Atabek, Mehmet Ernie; Atay, Zeynep; Berberoglu, Merih; Bereket, Abdullah; Bideci, Aysun; Bircan, Iffet; Bober, Ece; Can, Sule; Cesur, Yasar; Darcan, Sukran; Demir, Korcan; Dundar, Bumin; Ersoy, Betul; Esen, Ihsan; Guven, Ayla; Kara, Cengiz; Keskin, Mehmet; Kurtoglu, Selim; Memioglu, Nihal; Ozbek, Mehmet Nuri; Ozgen, Tolga; Sari, Erkan; Siklar, Zeynep; Simsek, Enver; Turan, Serap; Yesilkaya, Ediz; Yuksel, Bilgin; Darendeliler, FeyzaObjective: Approaches to diagnosis and treatment of growth hormone deficiency (GHD) in children vary among countries and even among centers in the same country. This survey, aiming to facilitate the process of preparing the new consensus on GHD by the Turkish Pediatric Endocrinology and Diabetes Society, was designed to evaluate the current practices in diagnosis and treatment of GHD in different centers in Turkey. Methods: A questionnaire covering relevant items for diagnosis and treatment of GHD was sent out to all pediatric endocrinology centers. Results: Twenty-four centers returned the questionnaire. The most frequently used GH stimulation test was L-dopa, followed by clonidine. Eighteen centers used a GH cut-off value of 10 ng/mL for the diagnosis of GHD; this value was 7 ng/mL in 4 centers and 5 ng/mL in 2 centers. The most frequently used assay was immunochemiluminescence for determination of GH, insulin-like growth factor-1 and insulin-like growth factor binding protein-3 concentrations. Sex steroid priming in both sexes was used by 19 centers. The most frequently used starting dose of recombinant human GH (rhGH) in prepubertal children was 0.025-0.030 mg/kg/day and 0.030-0.035 mg/kg/day in pubertal children. Growth velocity was used in the evaluation for growth response to rhGH therapy in all centers. Anthropometric measurements of patients every 3-6 months, fasting blood glucose, bone age and thyroid panel evaluation were used by all centers at follow-up. Main indications for cessation of therapy were decreased height velocity and advanced bone age. Fourteen centers used combined treatment (rhGH and gonadotropin-releasing analogues) to increase final height. Conclusion: Although conformity was found among centers in Turkey in current practice, it is very important to update guideline statements and to modify, if needed, the approach to GHD over time in accordance with new evidence-based clinical studies.Publication Open Access GCK gene mutations are a common cause of childhood-onset MODY (maturity-onset diabetes of the young) in Turkey(WILEY-BLACKWELL, 2016-09) BEREKET, ABDULLAH; Haliloglu, Belma; Hysenaj, Gerald; Atay, Zeynep; Guran, Tulay; Abali, Saygin; Turan, Serap; Bereket, Abdullah; Ellard, SianObjectiveInactivating heterozygous mutations in the GCK gene are a common cause of MODY and result in mild fasting hyperglycaemia, which does not require treatment. We aimed to identify the frequency, clinical and molecular features of GCK mutations in a Turkish paediatric cohort. Design and PatientsFifty-four unrelated probands were selected based on the following criteria: age of diagnosis 17years, family history of diabetes in at least two generations, anti-GAD/ICA negative, BMI<95.p and follow-up with diet, oral antidiabetic drug or low-dose insulin treatment (05U/kg/d). A MODY probability score () was calculated and 21 patients with a score 75%, HbA1c levels 75% (585mmol/mol) and fasting blood glucose (FBG) levels 99-145mg/dl (55-80mmol/l) were selected for Sanger sequencing of the GCK gene. Targeted next-generation sequencing for all known monogenic diabetes genes was undertaken for any patient without a GCK gene mutation. ResultsGCK gene mutations (pathogenic or likely pathogenic variants) and a novel intronic variant of uncertain significance (c.208+3A>T) were identified in 13/54 probands (24%). Twelve of these patients had a MODY probability score 75%. FBG level and 2-h glucose level in OGTT were 12314mg/dl (68 +/- 07mmol/l) (107-157mg/dl) and 181 +/- 30mg/dl (101 +/- 16mmol/l) (136-247mg/dl), respectively. Average of glucose increment in OGTT was 58 +/- 27mg/dl (32 +/- 15mmol/l) (19-120mg/dl), and mean HbA1c level was 65 +/- 05% (475 +/- 55mmol/mol) (59-76%). Five novel missense mutations were identified (p.F123S, p.L58P, p.G246A, p.F419C, and p.S151C). Two patients treated with low-dose insulin before the molecular analysis were able to stop treatment. ConclusionsApproximately 1 in 4 MODY cases in this Turkish paediatric cohort have a GCK mutation. Selection of patients for GCK gene analysis using the MODY probability score was an effective way of identifying most (11/12) patients with a GCK mutation.Publication Open Access Vitamin D Status Across Age Groups in Turkey: Results of 108,742 Samples from a Single Laboratory(GALENOS YAYINCILIK, 2020-09-01) BEREKET, ABDULLAH; Yesiltepe-Mutlu, Gul; Aksu, Ekin Deniz; Bereket, Abdullah; Hatun, SukruObjective: The aim was to determine vitamin D status in the general population in Turkey between 2011 and 2016, and to evaluate the effectiveness of the national vitamin D supplementation programme. Methods: Serum 25-hydroxyvitamin D (25-OHD) measurement data were retrieved from an internationally accredited laboratory, operating nationwide. A total of 108,742 measurements of 25-OHD were analyzed using the cut-off values of 0-11 ng/mL, 12-19 ng/mL, 20-49 ng/mL, 50-70 ng/mL and > 70 ng/mL for vitamin D deficiency, insufficiency, sufficiency, possibly harmful and excess respectively. Results: The mean +/- standard deviation 25-OHD level was 21.6 +/- 13.3 ng/mL. Mean 25-OHD concentrations by age groups were: 37.3 ng/mL, 30.1 ng/mL and 23.7 ng/mL for <1, 1-10 and 11-18 year old groups, respectively. Mean 25-OHD levels of children <1 year and 1-3 years of age were significantly higher than those found in other age groups. The prevalence of vitamin D deficiency (<12 ng/mL) was lowest in children at 1-3 years of age (5%). In subjects older than 18 years of age, mean 25-OHD levels were 18.2 ng/mL, 20.1 ng/mL, 21.9 ng/mL and 21.1 ng/mL for age groups 19-30, 31-50, 51-70 and >70 years, respectively. Conclusion: Successful implementation of the national vitamin D supplementation programme, appears to have nearly eliminated vitamin D deficiency for children under I-years of age. However, the positive impact of the vitamin D supplementation diminishes as children get older suggesting that supplementation may be required in the older children and adults. In addition, improved awareness of the benefits and risks of excess vitamin D should prevent unnecessary and excessive use of vitamin D supplements.Publication Open Access Misalignment among adolescents living with obesity, caregivers, and healthcare professionals: ACTION Teens global survey study(2022-11-01) BEREKET, ABDULLAH; Halford J. C. G., BEREKET A., Bin-Abbas B., Chen W., Fernandez-Aranda F., Garibay Nieto N., Lopez Siguero J. P., Maffeis C., Mooney V., Osorto C. K., et al.Background There is limited evidence regarding the experiences, challenges, and needs of adolescents living with obesity (ALwO), their caregivers, and healthcare professionals (HCPs). Objectives The cross-sectional, survey-based global ACTION Teens study aimed to identify perceptions, attitudes, behaviours, and barriers to effective obesity care among ALwO, caregivers of ALwO, and HCPs. Methods ALwO (aged 12 to N = 5275), caregivers (N = 5389), and HCPs treating ALwO (N = 2323) from 10 countries completed an online survey (August-December 2021). Results Most ALwO perceived their weight as above normal (76% vs. 66% of caregivers), were worried about its impact on their health (85% vs. 80% of caregivers), and recently made a weight loss attempt (58%). While 45% of caregivers believed ALwO would slim down with age, only 24% of HCPs agreed. Most commonly reported weight loss motivators for ALwO were wanting to be more fit/in better shape according to ALwO (40%) and caregivers (32%), and improved confidence/social life according to HCPs (69%). ALwO weight loss barriers included lack of hunger control (most commonly reported by ALwO/caregivers), lack of motivation, unhealthy eating habits (most commonly agreed by HCPs), and lack of exercise. Conclusions Misalignment between ALwO, caregivers, and HCPs-including caregivers\" underestimation of the impact of obesity on ALwO and HCPs\" misperception of key motivators/barriers for weight loss-suggests a need for improved communication and education.