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Öğe Carotid Doppler ultrasonographic findings of dapagliflozin use in type 2 diabetic patients(Taylor & Francis Ltd, 2021) Onmez, Attila; Gokosmanoglu, Feyzi; Baycelebi, Gulsah; Arikan, Ali AhmetAim: Sodium-glucose cotransporter 2 inhibitors have been shown to reduce the risk of cardiovascular disease in type 2 diabetes (T2DM) patients. The purpose of this study was to evaluate cardiovascular disease risk indirectly through Doppler ultrasonography (USG) of carotid artery vascular markers in T2DM patients using dapagliflozin. Methods: One hundred forty-five patients presenting to our clinic between March 2016 and June 2018 and diagnosed with T2DM were included in the study. These were divided into two groups - a dapagliflozin group of 85 patients and a 60-member non-dapagliflozin control group. Common carotid artery end-diastolic velocity (EDV), peak systolic velocity (PSV), and resistive index (RI) parameters were evaluated using Doppler USG in both groups. Results: The mean duration of follow-up was 2.2 +/- 0.4 years. Mean ages were 45 +/- 14 years in the dapagliflozin group and 42 +/- 15 in the control group. Mean HbA1c was 7.4 +/- 1.6 in the dapagliflozin group and 7.3 +/- 2.1 in the control group. Common carotid artery, PSV, and EDV parameters were higher (p = .012/p = .036), while RI was lower (p < .001), in the dapagliflozin group than in the control group. Conclusion: Vascular resistance was lower in the group using dapagliflozin for diabetes management.Öğe Doppler ultrasonographic findings in cases with Hashimoto thyroiditis(Kuwait Medical Assoc, 2020) Gokosmanoglu, Feyzi; Aksoy, Erkan; Onmez, Attila; Ergenc, HasanObjective: 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.Öğe The effect of COVID-19 lockdown on glycemic control in patients with type 2 diabetes mellitus in Turkey(Elsevier Sci Ltd, 2020) Onmez, Attila; Gamsizkan, Zerrin; Ozdemir, Seyma; Kesikbas, Enis; Gokosmanoglu, Feyzi; Torun, Serkan; Cinemre, HakanBackground and aims: A national lockdown to prevent the spread of coronavirus disease (COVID-19) in Turkey was introduced in March 2020. We think that lockdowns may lead to weight gain and worsening of glycemic parameters in patients with type 2 diabetes mellitus (DM). The purpose of this study was to investigate how type 2 DM patients were affected by the lockdown. Method: Type 2 DM patients unable to attend regular follow-ups due to lockdown over a 75-day period between March and June 2020 and who again attended polyclinic follow-up when the lockdown was lifted were included in the study. These patients' glycemic control and weight status were compared with the pre-lockdown period. In addition, patients' general habits, and adherence to diet and exercise were evaluated, while their general health was assessed using the Short-Form 36-item survey. Result: The research involved 101 type 2 DM patients, 57 men (56.5%) and 44 women (44.5%), with a mean age of 55 +/- 13. Patients' mean pre-lockdown weight was 84.7 +/- 16.4 kg, rising to 85.5 +/- 16.8 kg post-lockdown, although the increase was not statistically significant (p = 0.781). In terms of glycemic parameters, Hba1c rose from 7.67 +/- 1.76 to 8.11 +/- 2.48, and fasting glucose from 157.9 (83-645) mg/dl to 163.2 (84-550) mg/dl, none of which were statistically significant (p = 0.253, p = 0.079, respectively). Conclusion: In addition to weight gain among type 2 DM patients during the Covid 19 lockdown, statistically insignificant increases were also observed in such glycemic parameters. This was a small sample and further studies with larger sample are needed. (C) 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.Öğe The relationship between Vitamin D deficiency and polycystic ovary syndrome(Makerere Univ, Fac Med, 2020) Gokosmanoglu, Feyzi; Onmez, Attila; Ergenc, HasanBackground: 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.Öğe Thyroid Homeostasis After Bariatric Surgery in Obese Cases(Springer, 2020) Gokosmanoglu, Feyzi; Aksoy, Erkan; Onmez, Attila; Ergenc, Hasan; Topkaya, SibelBackground 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.
