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Öğe Blink reflex in hypothyroidism(Lippincott Williams & Wilkins, 2007) Nazliel, Bijen; Yilmaz, Murat; Gökçe, Mustafa; Yetkin, İlhan; Baysal, Ali İhsanAim: The aim of the present study was to evaluate the usefulness of the blink reflex as a method for obtaining an early diagnosis of central nervous system dysfunction in hypothyroid patients who do not have signs or symptoms of nervous system dysfunction. Materials and Methods: Forty-two patients (3 males, 39 females), mean age 40 (+/- 11), with newly diagnosed primary hypothyroidism and 30 healthy control subjects were included in the study. In all patients, the cause of hypothyroidism was chronic autoimmune thyroiditis. For blink reflex testing, subjects lay supine on a bed in a warm room with eyes gently closed. Recordings were performed with an EMG machine (Nihon Kohden/Neuropack), with a filter setting of 20 Hz to 10 kHz, using an analysis time of 50 ms. Recordings were performed with surface recording electrodes (Dantec 13K60, Copenhagen, Denmark). Results: Second ipsilateral response (R2Y) and second contralateral response (R2C) latencies in hypothyroidism were prolonged relative to controls, and the differences were statistically significant (P < 0.001 and P < 0.001, respectively). Latency of R1, R2Y, and R2C did not correlate with free T3, free T4, or TSH values in the hypothyroid group. Conclusion: The finding of abnormal blink reflex responses in hypothyroid individuals raises the notion that they may be useful in detecting early changes and in the follow-up of the patients with the disorder.Öğe Frequency of adiponectin gene polymorphisms in polycystic ovary syndrome and the association with serum adiponectin, androgen levels, insulin resistance and clinical parameters(Taylor & Francis Ltd, 2010) Demirci, Hüseyin; Yilmaz, Murat; Ergun, Mehmet Ali; Yurtcu, Erkan; Bukan, Neslihan; Ayvaz, GöksunMaterials and methods. Ninety-six patients with PCOS and 93 healthy control subjects were included in the study. Insulin resistance was estimated via HOMA-IR. Serum adiponectin levels were measured by ELISA. For determination of adiponectin gene polymorphisms, PCR was performed with appropriate primers after genomic DNA was obtained from the peripheral blood of the patients and control subjects. Results. Adiponectin levels were low in patients with PCOS than control subjects. There was no significant statistical difference between the PCOS and control groups with respect to the frequency of polymorphisms and the genotype distribution. Adiponectin gene polymorphisms were not associated with the anthropometric parameters, hyperandrogenism and adiponectin levels in PCOS. However, the fasting insulin level and insulin resistance were significantly higher and more frequent, respectively, in the polymorphic group compared to the other genotypes among patients with PCOS. Conclusion. The risk of PCOS, hyperandrogenism in patients with PCOS and low serum adiponectin levels cannot be directly attributed to T45G adiponectin gene polymorphisms in exon 2, rather these polymorphisms may be associated with insulin resistance and hyperinsulinemia in PCOS.Öğe Impact of adiponectin on left ventricular mass index in non-complicated obese subjects(Japan Endocrine Soc, 2008) Ebinc, Haksun; Ebninc, Fatma Ayerden; Oezkurt, Zuebeyde Nur; Dogru, Mehmet Tolga; Tulmac, Murat; Yilmaz, Murat; Caglayan, OsmanTo evaluate the relationship between the adiponectin levels and left ventricular mass index (LVMI) in uncomplicated obese subjects. Fifty-nine subjects were assigned to the obese (BMI >= 30 kg/ml) and 58 to the lean (BMI<30 kg/m(2)) group. Plasma glucose, insulin, serum total cholesterol and high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides and adiponectin were measured. Insulin resistance was determined by the Homeostasis Assessment Model (HOMA-IR). The left ventricular functions of all subjects were determined by 2D and pulse wave Doppler echocardiography. LVMI was calculated as left ventricular mass (LVM) normalized for height in M-2.7. The obese group displayed significantly higher LVMI and late mitral inflow velocity. Thirty-three obese subjects met the criteria for left ventricular hypertrophy (LVH) and had lower serum adiponectin levels compared with obese subjects without LVH and lean subjects (p<0.05). Adiponectin was negatively correlated with LVMI (R: -0.277, p: 0.002). Furthermore, during the partial correlation analysis where HOMA-IR was controlled, the negative correlation between adiponectin and LVMI progressed (r: -0.283, p: 0.002). The linear regression analysis showed an independent relationship between LVMI and adiponectin. (beta: -0.214, p: 0.01) Obesity is associated with LVH. This study showed direct influence of adiponectin on LVMI.Öğe Insulin Like Growth Factor-I and IGF-Binding Protein-3 Levels in A Healthy Adult Turkish Population(Ortadogu Ad Pres & Publ Co, 2011) Karakoc, Mehmet Ayhan; Ozkan, Secil; Ayvaz, Goksun; Toruner, Fusun; Yilmaz, Murat; Kan, Erdal; Arslan, MetinObjective: Insulin-like growth factor-I (IGF-I) and IGF binding protein-3 (IGFBP-3) levels are important markers in diagnosis of growth hormone (GH) related disorders. The normal levels of IGF-I and IGFBP-3 vary among different ethnic groups, and using the references derived from different populations may sometimes be misleading during diagnosis, treatment and follow-up. We examined the levels of IGF-I and IGFBP-3 in healthy adult Turkish population. Material and Methods: Eight hundred and thirty-three subjects (512 females, 321 males) were enrolled in the study. Serum IGF-I and IGFBP-3 levels were measured by immunoradiometric assay in all participants. The study population was divided into age groups (18-20, 21-23, 24-25, 26-30, 31-40, 41-50, >50 years of age) and gender groups (females and males separately in the population <= 30 years of age, combined in age groups over 30 years of age) according to the references defined by the kit manufacturer and the results were compared to the reference values provided by the manufacturer that represents a reference population. Results: Serum IGF-I levels were statistically higher than the reference levels in all age groups of women s 30 years of age (p<0.05). In men, IGF-I levels were significantly higher (p<0.05) only in 26-30 years age group. In gender-combined groups over 30 years of age, IGF-I levels were statistically higher than the reference levels (p<0.05). Serum IGFBP-3 levels were significantly lower than the reference values in 24-25 years age group in both genders and in 18-20 years of age in males (p<0.05). Serum IGFBP-3 levels were significantly higher in 26-30 years age group in males and in all gender-combined groups >30 years of age (p<0.05). Conclusion: Serum IGF-I concentrations of our study population are generally higher than the reference values of the commercial kit. Centers dealing with GH disorders might benefit from defining their own population's normal values for IGF-I and IGFBP-3 to overcome possible diagnostic and follow-up pitfalls.Öğe LIPID PEROXIDATION AND THE ANTIOXIDANT CAPACITY OF DIALYSIS PATIENTS: The Effects of a Single Hemodialysis Session with Different Dialysis Membranes(Gazi Univ, Fac Med, 2008) Derici, Ulver; Ebinc, Fatma Ayerden; Yilmaz, Murat; Kulaksizoglu, Sevsen; Arinsoy, Turgay; Sindel, SukrurObjective: To estimate lipid peroxidation and the antioxidant defense capacity of dialysis patients and the effects of different types of dialysis membranes on these parameters. Methods: Fifty-four dialysis patients and 30 healthy controls were included in this study. Ten of the dialysis patients were on continuous ambulatory peritoneal dialysis treatment and the rest were on hemodialysis with either polycarbonate membrane (n=10) or hemophan membrane (n=34). Polycarbonate membranes were switched with a vitamin E-coated dialyzer in the subsequent dialysis session. Total antioxidant status and malondialdehyde levels were studied to determine the antioxidant defense capacity and lipid peroxidation, respectively, before and after the dialysis session. Results: Plasma total antioxidant status levels were lower (1.51 +/- 0.2 mmol/l vs. 1.75 +/- 0.20 mmol/l p<0.05) and malondialdehyde levels were higher (2.2 +/- 1.17 nmol/ml vs. 0.60 +/- 0.20 nmol/ml p<0.05) in all dialysis patients compared to the control group. After one hemodialysis session, there were no significant alterations in parameters for either type of dialysis membrane. Conclusion: All dialysis patients have an increased oxidative status. A single hemodialysis session with different dialysis membranes does not seem to significantly change the oxidant or antioxidant levels.Öğe Pro12Ala polymorphism of the peroxisome proliferator-activated receptor-gamma gene in women with polycystic ovary syndrome(Taylor & Francis Ltd, 2006) Yilmaz, Murat; Ergün, Mehmet Ali; Karakoc, Ayhan; Yurtcu, Erkan; Cakir, Nuri; Arslan, MetinAim. The present study was designed to examine the relationship between Pro12Ala polymorphism of the peroxisome proliferator-activated receptor-gamma gene (PPAR-gamma) and clinical and hormonal characteristics in women with polycystic ovary syndrome (PCOS). Materials and methods. One hundred patients with PCOS and 100 healthy subjects were included in the study. Serum levels of sex steroids were measured. Insulin resistance was evaluated by homeostasis model assessment (HOMA). The responses of glucose and insulin to an oral glucose tolerance test were analyzed by calculating the respective area under the curve (AUC) by the trapezoidal method. We used the restriction fragment length polymorphism technique and polymerase chain reaction to examine Pro12Ala polymorphism in exon 2 of PPAR-gamma. Results. Pro12Ala polymorphism of PPAR-gamma was significantly elevated in control subjects (22%) compared with PCOS subjects (15%). All of the Pro12Ala polymorphisms of PPAR-gamma were heterozygous. When PCOS subjects with the Pro allele and the Ala allele of PPAR-gamma were compared, the latter had lower free testosterone, androstenedione, dehydroepiandrosterone sulfate, insulin and C-peptide levels, as well as lower luteinizing hormone/follicle-stimulating hormone ratio, HOMA insulin resistance index, AUC(insulin), Ferriman-Gallwey score, acne, body mass index and waist-to-hip ratio. Conclusion. We suggest that Pro12Ala polymorphism of the PPAR-gamma gene maybe a modifier of insulin resistance in women with PCOS.Öğe Relationship of left ventricular mass to insulin sensitivity and body mass index in healthy individuals(Taylor & Francis Ltd, 2006) Ebinç, Haksun; Ayerden Ebinç, Fatma; Nur Özkurt, Zübeyde; Doğru, Tolga; Yilmaz, MuratObjective-The objective of this study was to investigate the contribution of insulin resistance, hyperinsulinaemia and obesity, independently of other major factors, to changes in left ventricular mass a cardiovascular risk indicator, in a healthy population without co-morbid states such as diabetes or hypertension. Methods and results-This cross-sectional relational study was perfomed in 153 healthy subjects, comprising 76 men and 77 women with ages ranging from 23 to 67 years. All of them were normotensive and had a normal oral glucose tolerance test, none had cardiovascular disease and none were taking any medication. Weight, height and waist circumference were measured and BMI was calculated.A blood sample was drawn in the fasting state: plasma glucose, insulin, serum total and high density lipoprotein (HDL), low density lipoprotein cholesterol and triglycerides were measured. Insulin resistance was determined by the 'Homeostasis Assessment Model' (HOMA-IR). Subjects were studied by echocardiography. The left ventricular mass was calculated by using the anatomically validated formula of Devereux et al. Results - Left ventricular mass significantly and positively correlated with BMI, age, systolic and diastolic blood pressure and fasting blood glucose. The correlation of left ventricular mass with fasting blood glucose was not maintained after controlling for BMI. BMI, fasting blood glucose, HOMAIR, systolic and diastolic blood pressure showed significant differences with higher values for people with left ventricular hypertrophy. The logistic regression analysis showed a strong association between left ventricular hypertrophy and BMI (p < 0.05). Conclusion - Insulin resistance and fasting insulin is not associated with left ventricular hypertrophy in healthy people, independent of obesity. Obesity appears to be an independent risk factor for left ventricular hypertrophy.
