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YOLDEMİR, AHMET TEVFİK

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YOLDEMİR

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AHMET TEVFİK

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2016 - 20173
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Author: YAVUZ, DİLEK × Subject: INSULIN-RESISTANCE ×

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    The evaluation of endothelial function and structure in hirsute patients in reproductive age
    (ELSEVIER SCIENCE BV, 2016) YOLDEMİR, AHMET TEVFİK; Atasayan, Kemal; Yoldemir, Tevfik; Ramoglu, Sedef; Yavuz, Dilek Gogas
    Objective: To evaluate the endothelial function and structure in patients with hirsutism in reproductive age. Study design: The study was conducted on 69 consecutive women admitted with complaints of hirsutism and 63 voluntary healthy women, as controls. A total of 132 subjects who applied to the Gynecology and Infertility Outpatient Clinics were included. Participants with modified Ferriman Gallway (mFG) score over 8 were considered to be hirsute. The demographic, metabolic, hormonal characteristics, risk factors of cardiovascular disease, CIMT (carotis intima media thickness) and FMD (flow-mediated dilatation) were compared between hirsute women and those in the control group. A prospective case-control study was performed. Results: There was no statistically significant difference in CIMT (0,50 0,08 vs 0,52 0,08, p = 038) and FMD (10,80 6,83 vs 9,57 6,52, p = 0.34) values between the study and control groups, respectively. There was no statistically significant correleation between CIMT and FMD values with age, body mass index (BMI), waist circumference, hip circumference, waist/hip ratio, CRP (C-reactive protein), total cholesterol, LDL (low density lipoprotein), HDL (high density lipoprotein), total testosteron, FAI (free androjen index), androstenedion, SHBG (sex hormone binding globuline), DHEA-S, hirsutism score, sistolic blood pressure, diastolic blood pressure, HOMA-IR (homeostatic model of assesment insuline resistance) value. Conclusion: The effect of the presence of hirsutism on either CIMT and FMD values, among young patients was not significant. Since endothelial dysfunction might became evident after a long period of physiopathological process, our findings obtained from younger patients may not really show the impact of hirsutism on endothelial function in short term. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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    Determinants of low bone mineral density in premenopausal polycystic ovary syndrome patients
    (TAYLOR & FRANCIS LTD, 2017) YOLDEMİR, AHMET TEVFİK; Karadag, Cihan; Yoldemir, Tevfik; Yavuz, Dilek Gogas
    Objective: The aim of this study was to evaluate the bone mineral density (BMD) values and to determine the associations between BMD and insulin sensitivity, hyperandrogenemia, body mass index (BMI), and sex hormones in premenopausal polycystic ovary syndrome (PCOS) patients. Methods: A hundred and three women with PCOS and sixty age- and BMI-matched healthy control women were enrolled to this cross-sectional study. Serum androgen and estradiol (E2) levels were measured. Homeostasis model assessment of insulin resistance (HOMA-IR) and MATSUDA insulin sensitivity index (ISI) were calculated. BMD was measured with a dual X-ray absorptiometer. Results: Lumbar BMD (LBMD) and femoral neck BMD (FnBMD) values were significantly lower in PCOS group than controls [(p<0.01) and (p<0.01)]. In PCOS group, hyperandrogenemic women had higher LBMD and FnBMD values than normoandrogenemic PCOS patients [(p<0.01) and (p<0.01)]. In PCOS group, LBMD was significantly correlated with HOMA-IR (r=0.617; p<0.01), MATSUDA ISI (r=-0.665; p<0.01), serum E2 (r=0.488; p<0.01), total testosterone (r=0.436; p<0.01), and androstenedione (r=0.337; p<0.01) levels. Similar correlations observed for FnBMD. Conclusions: Despite the positive effects of hyperandrogenemia and hyperinsulinemia, PCOS patients have lower bone mineral density due to hypoestrogenism. Insulin resistance, BMI, estrogen, and androgen levels are the determinants of BMD in PCOS.
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    Does cardiovascular risk vary according to the criteria for a diagnosis of polycystic ovary syndrome?
    (WILEY, 2017) YOLDEMİR, AHMET TEVFİK; Ramoglu, Sedef; Yoldemir, Tevfik; Atasayan, Kemal; Yavuz, Dilek Gogas
    AimThe risk of cardiovascular disease is higher in women with polycystic ovary syndrome (PCOS) compared to healthy individuals. Chronic inflammation, insulin resistance, hyperandrogenemia, hyperlipidemia and increased oxidative stress are known to have a role in the formation of atherosclerosis and cardiovascular disease. The aim of our study was to evaluate if cardiovascular risk varied according to different PCOS criteria, using carotid intima-media thickness (CIMT), which is an important marker of major cardiovascular events in the later stages of life. MethodsThe study group included 52 women aged 18-35 diagnosed with PCOS, and the control group comprised 45 age-matched healthy women. Body mass index, CIMT, fasting serum glucose and insulin levels and hormonal and lipid profiles were compared between the groups. ResultsThere was no significant difference in CIMT levels between the groups. The CIMT levels in the PCOS group did not differ whether hyperandrogenism, polycystic ovary-like appearance on ultrasound or oligo/anovulation status were present or not. Furthermore, when all cases were divided into subgroups according to BMI values, the CIMT values were similar between the groups. ConclusionBecause PCOS and atherosclerosis both have a complex nature, it is likely that the evaluation of CIMT alone may not be sufficient to determine endothelial dysfunction in a reproductive age group.