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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 relationship between Vitamin D deficiency and polycystic ovary syndrome
    (Makerere Univ, Fac Med, 2020) Gokosmanoglu, Feyzi; Onmez, Attila; Ergenc, Hasan
    Background: Vitamin D deficiency is frequently seen in patients with polycystic ovary syndrome (PCOS) and has been shown to exhibit multiple effects on the disease process. The purpose of this study was to investigate the role of vitamin D deficiency in complex PCOS pathophysiological pathways. Methods: Two hundred sixty-seven patients with PCOS were divided into two groups Group 1 with 25(OH)D3 deficiency, and Group 2 with normal 25(OH)D3. Biochemical and hormonal parameters (androgen hormones, gonadotropins, and thyroid function tests) were compared between the two groups. Results: Eighty-six percent of the patients (n=231) were in Group 1 and 14% (n=36) in Group 2. Statistically significantly higher concentrations of serum testosterone, dehydroepiandrosterone-sulfate and LH were determined in Group 1 (p<0.05). 25(OH)D3 concentrations were negatively correlated with body mass index (r=-0.459), serum testosterone (r =-0.374) and dehydroepiandrosterone-sulfate levels (r=-0.418); (all; p< 0.05). Conclusion: The study findings show that low 25(OH)D3 levels are associated with high androgen levels in women with PCOS. Vitamin D deficiency should be considered as an additional risk factor in the development of PCOS. We think that providing vitamin D supplementation for women from identified deficiency areas can reduce the risk of PCOS development.
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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.