Biomedical subjects

Gurcan Kisakol

Publications and source records attributed to Gurcan Kisakol.

9 recordsLinked to original sources

PubMed2004

Assessment of anxiety in subclinical thyroid disorders.

It is well known that manifest thyroid dysfunction causes mood disorders. In the literature there are few studies related with subclinical thyroid dysfunction and anxiety. We aimed to determine if there exists a relation between the anxiety and subclinical thyroid dysfunction. This study was carried out in the Meram Medical Faculty of Selçuk University, Department of Endocrinology and Metabolism. Eighty-five outpatients were enrolled into the study. In the presence of normal fT(3) and fT(4), patients were grouped as subclinical hyperthyroid with TSH lower than 0.1 mU/L (n = 24), subclinical hypothyroid with TSH higher than 4.5 mU/L (n = 32) and euthyroid subjects (n = 29). Beck's Anxiety Inventory (BAI) was administered to all patients. There was no any statistically significant difference between euthyroid and study groups in terms of age, gender, weight and height (p<0.05). One-way ANOVA showed that both of the subclinical hypothyroid and subclinical hyperthyroid groups had significantly higher anxiety scores than euthyroid group (F: 11.4, p<0.001). Manifest hypothyroidism and hyperthyroidism, as causes of mental and neurological dysfunction have been known for a long time, but the relation between subclinical thyroid dysfunction and anxiety is less well studied. We have found that subclinical thyroid dysfunction increases the anxiety of patients whether hyperthyroid or hypothyroid. Overlap of symptoms common to both thyroid dysfunction and anxiety is an important limitation in this study. Mood changes especially anxiety due to subclinical thyroid dysfunction may have an important impact on the patient's quality of life. Negative effect on quality of life may be an indication of treatment in these patients. It is the first study evaluating anxiety in subclinical hypothyroidism in the literature.

Adult↗

PubMed2003

Low serum total thyroxine and free triiodothyronine in patients with hepatic encephalopathy due to non-alcoholic cirrhosis.

PRINCIPLES: We evaluated serum thyroid hormone levels in non-alcoholic cirrhotic patients with and without hepatic encephalopathy. METHODS: 15 consecutive patients with hepatic encephalopathy secondary to non-alcoholic cirrhosis (8 males and 7 females, age 37-75 years) and 33 non-alcoholic cirrhotic patients without encephalopathy (22 males and 11 females, age 36-74 years) were investigated. A control group consisted of 20 healthy subjects (10 men and 10 women aged 26-69 years). The levels of serum triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), free T3 (FT3) and free T4 (FT4) were studied in serum samples drawn in the morning. Thyroid function tests were set in relation to the severity of hepatic dysfunction and to the presence or absence of hepatic encephalopathy. RESULTS: Serum levels of FT3 and total T4 (but not total T3 and FT4) were significantly lower in patients with hepatic encephalopathy compared to decompensated cirrhotic patients without encephalopathy (p = 0.006 for T4, P <0.05 for FT3). Prothrombin-time also differed significantly between decompensated cirrhotic patients (Child C) with and without encephalopathy groups (p = 0.002). CONCLUSIONS: These results suggest that patients with hepatic encephalopathy secondary to decompensated non-alcoholic cirrhosis are typified by low FT3 and low total T4, as well as by a prolonged prothrombin time. Low FT3 does not obviously put patients at risk for hepatic encephalopathy, and thyroid parameters are secondary and late events.

Adult↗

PubMed2003

Effect of weight loss on bone metabolism: comparison of vertical banded gastroplasty and medical intervention.

BACKGROUND: We studied the effects of weight loss on bone metabolism. METHODS: 16 consecutive surgically-treated (14 female, 2 male) morbidly obese patients and 65 obese (53 male, 12 female) medically-treated patients were enrolled in an observational study. Surgical treatment for morbidly obese patients was vertical banded gastroplasty (VBG). Studies were performed prior to and 12 months after the start of treatment. Bone mineral density (BMD), bone turnover markers, sex steroids, calcium excretion and parathyroid hormone measurements were done at each visit. RESULTS: Weight loss was more prominent with surgical than with medical treatments. Bone loss was also pronounced in the surgical treatment group, and occurred at the hip level only (P<0.05). Compared to previously reported studies, where the effects of malabsorptive treatments for obesity on bone metabolism were studied, calcium excretion and parathyroid hormone levels did not change after VBG or medical therapy. For both groups, bone markers indicated an increased bone turnover, evidenced by increased urinary excretion of deoxypyridinoline and serum levels of osteocalcin (P<0.05). Sex steroid measurements revealed a decrease in estradiol levels in the surgical treatment group, but not in medical treatment group. This finding was thought to be secondary to less weight loss in the medical group. CONCLUSION: Our data indicate that weight loss causes bone loss. The bone loss is independent of the method of weight reduction. However, the mechanism of the bone loss is not clear. It may be explained partly by reduced estradiol levels in female patients. Because the mechanisms of bone disease after weight loss remain unclear, it is difficult to determine the most effective treatment. It is important to detect osteopenia early, before fractures occur. Measuring BMD appears to be the only reliable method for screening.

Absorptiometry, Photon↗

PubMed2003

Rhabdomyolysis in a patient with hypothyroidism.

We describe a case of rhabdomyolysis associating hypothyroidism. Hypothyroidism frequently leads to myalgias, muscle stiffness, cramps and sometimes elevated levels of muscle enzymes, but rhabdomyolysis is quite rare. This report describes a case of rhabdomyolysis associating hypothyroidism in a 19-year old man. Muscle enzyme levels were typical of rhabdomyolysis. Muscle biopsy and electromyographic findings were compatible with hypothyroid myopathy. Muscle functions completely recovered with levothyroxine therapy. The present case represents rhabdomyolysis secondary to undiagnosed hypothyroidism in a developed stage which manifests itself with rhabdomyolysis.

Adult↗

PubMed2003

Bone and calcium metabolism in subclinical autoimmune hyperthyroidism and hypothyroidism.

Bone turnover is reported to increase in favour of resorption in overt hyperthyroidism and the rate of resorption is associated with the levels of thyroid hormones. Hypothyroidism, on the other hand, was shown to cause no disturbance of calcium kinetics and found to associate lower trabecular resorption surfaces and increased bone cortical thickness. Similar studies are very rare in subclinical thyroid disorders and consequently we aimed to examine calcium and bone metabolism in subclinical thyroid disorders. Thirteen patients with subclinical hyperthyroidism secondary to untreated Graves' disease, 20 patients with subclinical hypothyroidism and 10 healthy subjects participated in this survey. Briefly calcium, phosphorus, and creatinine (Cre), urinary deoxypyridinoline (U-DPD) and serum osteocalcin (OC) were measured as biochemical markers for calcium metabolism. Concerning serum Ca and phosphorus levels, there were no differences between three of the groups, but urinary Ca excretion was higher in subclinical hyperthyroid patients compared to control and hypothyroid subjects. Hypothyroid patients had similar U-DPD levels with control subjects (p = 0.218). Serum OC and U-DPD were higher in subclinical hyperthyroid compared to control subjects (p<0.001 and p<0.001 respectively). We demonstrated a higher bone turnover and greater calcium excretion in subclinical hyperthyroid patients. Additionally, we found that subclinical hypothyroidism is not associated with disturbed calcium metabolism. As persistent increase in bone turnover is responsible for accelerated bone loss, patients with Graves' disease may have increased risk for osteoporosis.

Adult↗

PubMed2002

Effect of surgical weight loss on free radical and antioxidant balance: a preliminary report.

BACKGROUND: This study observes the effect of surgical weight loss on free radical and antioxidant vitamin balance. PATIENTS AND METHODS: 22 consecutive morbidly obese patients undergoing vertical banded gastroplasty (VBG) were chosen for the study. Postoperative studies were done at 12 and 24 weeks. Plasma antioxidant and vitamin determinations were performed by HPLC method. RESULTS: Subjects lost a significant amount of weight (P < 0.01). Compared to preoperative measurements, postoperative measurements of plasma beta-carotene were not statististically different both at 12 and 24 weeks (13.86 +/- 1.26 microg/dl, 12.35 +/- 1.2, P = 0.44; 14.33 +/- 2.03, P = 0.77; preoperatively, 12 and 24 weeks respectively). Alpha-tocopherol increased slightly at the 12th week; the difference was not significant (8.50 +/- 0.77; 9.56 +/- 0.82, P = 0.37; preoperatively and 12th week respectively). The levels of alpha-tocopherol rose at 24th week significantly (10.89 +/- 0.55, P = 0.028). The indicator of lipid peroxidation (malondialdehyde) decreased with weight loss (1.505 +/- 0.11 micromol/L preoperatively; 0.75 +/- 0.062 at 12th week, P = 0.01; 0.712 +/- 0.05 at 24th week, P < 0.01). CONCLUSION: Our data show that free radical generation falls markedly in association with weight loss after VBG. Surgical weight loss leads to significant decrease in oxidant production and also leads to increase in some antioxidant vitamins. The demonstration of decreased free radical generation and correction of balance between free radicals and antioxidant vitamins has important implications for oxidative mechanisms underlying obesity-associated disorders.

Adult↗

PubMedDate not supplied

Effects of insulin and sulphonylureas on insulin-like growth factor-I levels in streptozotocin-induced diabetic rats.

OBJECTIVE: Diabetes Mellitus is associated with decreased insulin-like growth factor-I (IGF-I) levels and also, poor growth in diabetes is related with low circulating levels of IGF-I. Insulin acts via an increase of IGF-I synthesis on growth. We studied the effects of insulin and sulphonylureas on serum IGF-I levels and aimed to evaluate the restoration of IGF-I in different therapeutic strategies. DESIGN AND SETTING: Thirty male rats were used in the study and diabetes was induced by a single intraperitoneal injection of streptozotocin (35 mg/kg body weight). After confirmation of hyperglycemia, rats were divided into three groups. The first group was treated with insulin, and second group with glimepiride, third group was not treated (control group). IGF-I levels were measured at basal, after streptozotocin and at the end of the treatment period. RESULTS: Serum IGF-I levels were found to decrease from 577.2 ng/ml to 253.0 ng/ml after streptozotocin (p<0.005). After 1 month, IGF-1 levels were found 524.0 ng/ml in insulin group, 449.3 ng/ml in sulphonylurea group, and 313.1 ng/ml in control group. The increase in IGF-I was statistically significant in insulin group (p<0.005), and in sulphonylurea group (p<0.05), but it was not significant in control group (p>0.05). CONCLUSIONS: Serum IGF-I levels decrease in diabetes and insulin treatment restores IGF-I depletion significantly. And although less effective, treatment with glimepiride restores IGF-I levels significantly.

Animals↗

PubMedDate not supplied

Real-time sonography for screening of gallbladder motility in diabetic patients: relation to autonomic and peripheral neuropathy.

OBJECTIVES: Diabetes mellitus is known as one of the factors causing the cholesterol gallstone. Gallstone incidence is about 30% in diabetic patients over 20 years of age. Pathophysiology is still not clear. The aim of the present study was to investigate gallbladder (GB) functions in diabetic patients and determine its relationship with peripheral and autonomic neuropathy. DESIGN: Study was performed between October 2001 and may 2002 in fifty-one diabetic patients of similar age and weight. Diabetic patients (n=51) were chosen randomly among diabetic patients, who were being followed in Diabetes Out-patient clinics of Selcuk University, Meram Medical Faculty. Twenty-eight control subjects were chosen from healthy volunteers. We measured fasting and post-prandial gallbladder volumes and ejection fractions by real-time ultrasonography. The patients were divided into three groups; group A (n=18) had no diabetic autonomic and peripheral neuropathy, group B (n=13) had diabetic peripheral neuropathy, group C (n=13) had diabetic autonomic neuropathy. RESULTS: No significant difference in any biochemical parameters between diabetic and control group could be found. Fasting gallbladder volume was significantly higher in the diabetic group (5.31 +/- 0.28 cm(3)) compared to control group (4.19 +/- 0.25 cm(3), p<0.01). But there was no difference within diabetic subgroups. Gallbladder ejection fraction was significantly reduced in diabetic patients in groups B and C (29.7 +/- 1.43%, 28.7 +/- 1.28%) compared to group A (44.8 +/- 2.4%; p<0.05, p<0.025 respectively). CONCLUSIONS: Cholesterol crystal formation as a result of increased gallbladder volume and decreased ejection fraction in diabetic patients may result from hypotonicity and stasis and thus this may lead to gallstones.

Autonomic Nervous System Diseases↗

PubMedDate not supplied

Gastric emptying in subclinical hyperthyroidism.

INTRODUCTION AND AIM: About 15% of hyperthyroid patients suffer from gastrointestinal symptoms such as diarrhea, constipation, nausea and early satiety the problem. Published reports on the topic of gastric emptying in hyperthyroidism are rare and discrepant in their results. PATIENTS AND METHODS: Thirteen patients (8 women, 5 male; aged 41.92+/-1.491 SE yr) with a recently established diagnosis of subclinical hyperthyroidism due to Graves-Basedow disease and as control group 10 age-matched healthy subject (7 women, 3 male; 39.6+/-2.918 SE yrs) participated in this study. Scintigraphic method (food labeled with 99mTc sulfur colloid) was used for measurement of gastric emptying. RESULTS: Gastric emptying time was similar in both subclinical hyperthyroid and control groups (p=0.413). DISCUSSION: There are few studies on the subject of gastric emptying in hyperthyroidism with either delayed emptying or with emptying time similar to controls. In the only one study in subclinical hyperthyroidism, gastric emptying was found to be delayed. We also found that gastric emptying was delayed in subclinical hyperthyroidism. On the basis of this and other studies, we may suggest that in subclinical hyperthyroidism, gastric emptying of solids were similar to that in age-matched healthy control subjects and gastrointestinal dysfunction is dependent on severity of the hyperthyroid state and might be a result of impaired neuro-hormonal regulation. Yet the data must be supported on larger groups.

Adult↗