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    The effects of vildagliptin in liver functions in type 2 diabetic patients
    (Bayrakol Medical Publisher, 2019) Gökosmanoğlu, Feyzi; Önmez, Attila; Topkaya, Sibel
    Aim: In Type 2 diabetic patients, the prevalence of liver disease is high when compared with the general population. For this reason, the hepatic safety of anti-diabetes agent is important. However, there are uncertainties about the long-term efficiency and reliability of vildagliptin treatment. In this study, we have reviewed the findings obtained from the clinical use of vildagliptin and its effects on the liver. Material and Method: The study was conducted on 243 patients who were followed-up in our clinic between September 2016 and May 2018. The data were obtained by reviewing the patient files retrospectively. Result: A decrease was detected in the aminotransferases after the treatment with vildagliptin, which was statistically significant (ALT: decreased from 78 +/- 17 to 48 +/- 14 IU/L (p = 0.029), AST: decreased from 63 +/- 13 to 41 +/- 11 IU/L (p=0.035); GGT: 20.5 +/- 3.2 and 19.1 +/- 6.3 (p=0.682)). Vildagliptin reduces the insulin resistance and Body Mass Index in patients. Discussion: It was determined that Vildagliptin is a safe treatment option for Type 2 Diabetes management.
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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.