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    Doppler ultrasonographic findings in cases with Hashimoto thyroiditis
    (Kuwait Medical Assoc, 2020) Gokosmanoglu, Feyzi; Aksoy, Erkan; Onmez, Attila; Ergenc, Hasan
    Objective: To investigate the effect of thyroid-stimulating hormone (TSH) levels on hemodynamic indexes in color doppler ultrasonography in patients with Hashimoto's disease Design: Prospective observational study Setting: Departmant of Endocrinology, Medical Park Hospital, Ordu, Turkey Subjects: One hundred and twelve patients Intervention: The patients were divided into two groups: Group 1, TSH: 0.35-4.94 mIU/L; and Group 2, TSH >4.94 mIU/L. The mean peak systolic velocity (mPSV), mean end diastolic velocity (EDV) and mean resistive index (RI) of the inferior thyroid artery were measured using doppler ultrasonography at the appropriate angle (45-60 degrees C). Main outcome measure: The mPSV, EDV and RI of the inferior thyroid artery Results: A total of 48.21% of the patients (n=54) were in Group 1 and 51.78% of them (n=58) were in Group 2. In our study, we found that as the TSH levels increased, the thyroid blood flow and RI decreased in patients with Hashimoto's disease and with clinical and subclinical hypothyroidism compared with normal ones. Conclusion: The TSH level in Hashimoto's disease and the vascular RI increases as the parenchymal damage increases.
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    The effects of pathophysiological changes in Type-2 diabetic patients on thyroid dysfunction and nodular goiter development in Turkey
    (Düzce Üniversitesi, 2023) Ergenç, Zeynep; Karaca Ocak, Özlem; Aksoy, Erkan; Ergenç, Hasan
    Objective: The prevalence of thyroid dysfunction is higher in patients with diabetes, and its diagnosis could cause better diabetes management. The purpose of the present study is to examine the impact of pathophysiological changes in patients with Type-2 diabetes on the frequency of thyroid dysfunction, thyroid autoimmunity, thyroid nodule, and thyroid cancer in Turkey. Methods: The study was conducted on a total of 3.276 patients with Type-2 diabetes who underwent thyroid tests and thyroid ultrasonography (US). The demographic characteristics, biochemical and hormonal values, thyroid US reports, and histopathology reports were collected from the patient's electronic records. Results: Thyroid autoimmunity positive TPOab 15.9% (n = 524) and/or positive TGab 9.9% (n = 327), the rate of positivity of both antibodies (TPOab + TGab) in the same patient, and total thyroid autoimmunity was found to be 32.57% (n=1067) in Type-2 diabetic patients. Thyroid dysfunction was detected in 18.3% (n = 602) of these patients. The distribution of thyroid dysfunction was 9.09% (n = 298) subclinical hypothyroidism, 4.1% (n = 135) clinical hypothyroidism, 3.1% (n = 102) subclinical hyperthyroidism, 2.0% (n = 67) clinical hyperthyroidism. Also, 67.9% (n = 2225) thyroid nodules, and 5% (n = 164) thyroid cancer were detected. Conclusion: Thyroid dysfunction was found to have increased in patients with Type-2 diabetes at significant levels.
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    Thyroid Homeostasis After Bariatric Surgery in Obese Cases
    (Springer, 2020) Gokosmanoglu, Feyzi; Aksoy, Erkan; Onmez, Attila; Ergenc, Hasan; Topkaya, Sibel
    Background The aim of this study was to determine changes in thyroid hormones and morphology with weight loss after bariatric surgery in obese patients. Methods This prospective study was performed in our endocrinology and surgery clinic. Pre- and post-bariatric surgery thyroid function tests and thyroid ultrasonography parameters were compared. Results Four hundred seventy-two patients were included in the study. Mean weight loss after surgery was 30.7 +/- 5.1 kg. TSH levels decreased statistically significantly parallel with weight loss and decreased BMI (p = 0.025) after bariatric surgery. However, no statistically significant change was observed in fT4 or fT3 levels (p > 0.05). A significant increase in thyroid parenchyma echogenicity, correlated with weight loss and time elapsed since surgery, was detected at ultrasonography (US) grayscale histogram analysis compared with muscle echogenicity (p = 0.032). An increase in echogenicity was even detected in patients with isoechoic thyroid parenchyma before surgery. Fasting insulin and HOMA-IR levels decreased after surgery (p = 0.010 and p = 0.001, respectively). Patients were divided into three groups based on weight loss. In group 3, preoperative TSH of 4.1 +/- 0.7 decreased to 1.6 +/- 0.7 postoperatively (p = 0.001), while preoperative HOMA-IR of 4.9 +/- 1.9 decreased to 2.4 +/- 0.8 postoperatively (p = 0.001). Conclusions Obesity causes thyroid hormone resistance through a mechanism similar to insulin resistance and leads to an increase in TSH similar to hyperinsulinemia. Our findings show that echogenicity at thyroid US increases in line with weight loss following bariatric surgery.