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    Characteristics of patients with hypertension in a population with type 2 diabetes mellitus. Results from the Turkish Nationwide SurvEy of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Hypertension Study)
    (Elsevier Sci Ltd, 2021) Sabuncu, Tevfik; Sonmez, Alper; Eren, Mehmet Ali; Sahin, Ibrahim; Corapcioglu, Demet; Ucler, Rifki; Akin, Safak
    Background: The present survey aimed to find out the demographical and clinical characteristics of patients with hypertension in a population with type 2 diabetes mellitus (T2DM) in Turkey. Methods: Patients with T2DM who were followed-up in tertiary endocrine units for at least last one year were recruited. Demographic, clinical and biochemical data of the patients were collected. Hypertension was defined as taking anti-hypertensive medications or having office arterial blood pressure (ABP) >140/90 mmHg or home ABP > 130/80 mmHg. Results: A total of 4756 (58.9% women) diabetic patients were evaluated. The percentage of patients with hypertension was 67.5% (n = 3212). Although 87.4% (n = 2808) of hypertensive patients were under treatment, blood pressure was on target in 52.7% (n = 1479) of patients. Hypertension proportions were higher in woman (p = 0.001), older, more obese, and those who had longer diabetes duration, lower education levels, higher frequency of hypoglycemic events (all p < 0.001) and higher triglyceride levels (p = 0.003). LDL cholesterol level and the percentage of smokers were lower in hypertensive group than in non-hypertensive group (both p < 0.001). The percentage of macro and microvascular complications was higher in the hypertensive group than in the normotensive one (both p < 0.001). In multivariate logistic regression analysis, being a woman (OR: 1.26, 95% CI: 1.04-1.51, p = 0.016), smoking (OR: 1.38, 95% CI: 1.05-1.80, p = 0.020), regular physical activity (OR: 1.24, 95% CI: 1.01-1.53, p = 0.039) and the presence of macrovascular complications (OR: 1.38 95% CI: 1.15-1.65, p = 0.001) were the significant predictors of good ABP regulation. The ratios of masked and white coat hypertension were 41.2% and 5.7%, respectively. Conclusion: Our findings indicate that two-thirds (67.5%) of adult patients with T2DM have hypertension. Co-existence of hypertension increases the frequency of macro and microvascular diabetic complications in these patients. Despite the critical role of hypertension in morbidity and mortality, only half of the patients have favorable ABP levels. Masked hypertension seems to be another important issue in this population. (c) 2020 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
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    A comparison of neutrophil-lymphocyte ratio and body fat percentage in hashimoto’s disease induced hypothyroid patients
    (2020) Korkmaz, Emine; Cadirci, Dursun; Gonel, Ataman; Eren, Mehmet Ali
    Aim: Inflammatory mechanisms are activated when the body mass index is increased and in cases of Hashimoto’s Thyroiditis (HT). The neutrophil-lymphocyte ratio (NLR), which is used as a new and easily accessible inflammatory marker, may be related to the body mass index. The objective of this study is to compare the NLR and body fat percentage in patients with Hashimoto’s disease induced hypothyroidism.Material and Methods: The study consisted of 29 patients diagnosed with HT induced hypothyroidism based on the clinical and laboratory findings. The control group consists of 29 healthy individuals who do not suffer from any disease known to increase TSH level. Body analysis is performed for all cases that are included in the study, and the height, weight, body fat percentage, lean body mass, visceral adiposity, basal metabolic rate, and body fluid percentages are calculated, and complete blood count, TSH, FT3, FT4, Anti-TPO tests were performed following 3-4 cc venous blood sample collection from all cases.Results: There were not any significant difference between the patient and control group in terms of gender, BMI, body fat percentage, lead body mass, visceral adiposity, fluid percentage, and basal metabolic rate data (p>0.05). NLR rate was 1.95±1.37 in patient group and 2.52±1.40 in control group. Significant difference was identified in NLR (p=0.025), fat percentage (p=0.002), lean mass (p=0.002) and visceral adiposity data (p=0.006) between the HT patients and control group when the male patients were removed from the groups. NLR was identified statistically significantly low in the patient group when compared to the control group (p0.012). There was no significant correlation between NLR and lean mass, TSH, BMI, visceral adiposity, fluid percentage, and age parameters in both groups.Conclusion: NLR, like other common inflammatory markers, is an inexpensive and easily accessible marker that can be used in hospitalized patients. However, it would be more appropriate to evaluate the conditions that may have effects on the results such as patients drug use and bone marrow suppression. It can be said that more evidence is needed to use NRL as a marker for HT management.
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    Summary of Bariatric Surgery Guideline of the Society of Endocrinology and Metabolism of Turkey
    (Aves, 2017) Sabuncu, Tevfik; Kiyici, Sinem; Eren, Mehmet Ali; Sancak, Seda; Sonmez, Alper; Guldiken, Sibel; Kutluturk, Faruk
    Obesity is a common condition affecting approximately one-third of the adult population worldwide. Obesity results in a number of medical, psychosocial and economical problems, in many patients, it is usually difficult to achieve the desired weight loss with medical therapies, several surgical approaches for weight loss have been developed in the recent years and are described as bariatric or metabolic surgery. Though bariatric surgery promotes dramatic and reliable improvement in obesity and related complications, yet proper patient selection and careful selection of the bariatric method along with good pre- and post-operative management is very important for a successful therapy. Therefore, the authors aim to present a short review on the Bariatric Surgery Guideline of the Society of Endocrinology and Metabolism of Turkey. The indications and contraindications for bariatric surgery, description of commonly used bariatric surgical methods, preoperative preparation of obese patients prior to the surgery, early and late postoperative management and follow-up of the patients have been summarized in this review. This review has been written in accordance with the opinions and recommendations of the Hypertension, Lipid Metabolism and Obesity Study Group of the Society of Endocrinology and Metabolism of Turkey.