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    Does Autonomic Dysfunction Exist in Postmenopausal Osteoporosis?
    (Lippincott Williams & Wilkins, 2011) Tosun, Aliye; Dogru, Mehmet Tolga; Aydin, Gulumser; Keles, Isik; Arslan, Ayse; Guneri, Mahmut; Ebinc, Haksun
    Tosun A, Dogru MT, AydNn G, Keles I, Arslan A, Guneri M, Orkun S, Ebinc H: Does autonomic dysfunction exist in postmenopausal osteoporosis? Am J Phys Med Rehabil 2011;90:1012-1019. Objective: The aim of this study was to investigate the presence of autonomic dysfunction in patients with osteoporosis. Design: This is a prospective controlled trial. Sixteen postmenopausal female patients with osteoporosis and 10 age-matched postmenopausal nonosteoporotic controls were included in the study. Participants were divided into the postmenopausal osteoporosis group and the nonosteoporotic control group according to bone mineral densities. Heart rate variability parameters and sympathetic skin responses were studied to evaluate autonomic functions. Results: The latencies of sympathetic skin responses obtained from both hands were significantly increased in the patient group when compared with the control group. The sympathetic skin response amplitude of the right hands and both feet of the patient group were found to be decreased significantly when compared with that of the control group. A 24-hr high-frequency value was significantly decreased in the patient group than in control group. A 24-hr low-/high-frequency value was significantly higher in the patient group than in the control group. Conclusions: Autonomic dysfunction characterized with increased sympathetic and decreased parasympathetic activity may be present in osteoporosis, and cardiac functions in patients with osteoporosis may also be affected by accompanying autonomic dysfunction.
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    Effects of statin treatment on serum sex steroids levels and autonomic and erectile function
    (Elsevier Science Inc, 2008) Dogru, M. Tolga; Basar, M. Murad; Simsek, Ali; Yuvanc, Ercan; Guneri, Mahmut; Ebinc, Haksun; Batislam, Ertan
    OBJECTIVES To investigate the effect of statin treatment on serum sex steroid levels, heart rate variability, erectile function, and libido in patients with hyperlipidemia. METHODS A total of 74 patients (mean age 44.7 +/- 7.1 years) with hyperlipidemia were enrolled into this study. After a cardiac examination, the serum lipid levels were measured, and the 24-hour Holter monitoring, heart rate variability, and autonomic test results were also evaluated. Erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire. Later, atorvastatin 40 mg/day was initiated in all patients and used for the subsequent 12 months. All diagnostic tests (cardiac, biochemical, and autonomic and the IIEF questionnaire) were performed again at 6 and 12 months of follow-Lip. RESULTS A statistically significant decrease was found in the serum lipid levels at 6 months (P<0.05). In contrast, the average IIEF scores (24.7 +/- 6.4 at baseline) had increased to 25.0 +/- 4.9 and 26.1 +/- 5.9 at 6 and 12 months of follow-up, respectively. Although the parasympathetic activities increased and sympathetic activities decreased with atorvastatin treatment, these changes were not statistically significant (P>0.05). In paired comparison, significant differences were found among the IIEF scores of the three periods (P = 0.013). The difference was more evident after 6 months of treatment (IIEF1vs2 = 0.475; IIEF1vs3 = 0.027; IIEF2vs3 = 0.012). CONCLUSIONS Although improvement in the lipid profile occurred early during the statin treatment, restoration of erectile function appeared later, which Could be attributed to the restoration of endothelial functions by lowered serum lipid levels.