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    Adrenomedullin: Possible predictor of insulin resistance in women with polycystic ovary syndrome
    (Springer, 2012) Sahin, I.; Celik, O.; Celik, N.; Keskin, L.; Dogru, A.; Dogru, I.; Yurekli, M.
    The aim of the study was to investigate adrenomedullin (ADM) levels and its relation with insulin resistance in women with polycystic ovary syndrome (PCOS). Twenty-nine women with PCOS and 29 age- and body mass index (BMI)-matched control subjects were included in the study. PCOS was defined according to criteria by the Rotterdam European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM)-sponsored PCOS consensus workshop group. A full clinical and biochemical examination including basal hormones and metabolic profile was performed. Insulin resistance was calculated by using the homeostasis model assessment of insulin resistance index (HOMA-IR). Plasma ADM levels were measured by high performance liquid chromatographic (HPLC) method. Plasma ADM, fasting insulin levels and HOMA-IR were significantly higher in patients with PCOS than the control group. ADM levels were positively correlated with insulin levels and HOMA-IR index. The best cut-off value of ADM levels to identify the presence of insulin resistance (HOMA-IR >= 2.7) was 30.44 ng/ml. Calculated odds ratio of insulin resistance by using logistic regression analysis, as predicted by ADM, was 0.15 (95% confidence interval, 0.037-0.628; p=0.009). In multiple regression analysis, ADM level was an independent predictor of HOMA-IR index. Our finding indicated that ADM levels increased in women with PCOS in accordance with HOMA-IR. ADM could be a significant independent determinant of insulin resistance in women with PCOS. (J. Endocrinol. Invest. 35: 553-556, 2012) (C) 2012, Editrice Kurtis
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    Comparison of the effect of liraglutide and metformin therapy on the disease regulation and weight loss in obese patients with Type 2 diabetes mellitus
    (Verduci Publisher, 2022) Keskin, L.; Yaprak, B.
    OBJECTIVE: Obesity and Type 2 diabetes mellitus are growing health problems all over the world. The aim of this study is the comparison of 3 mg liraglutide and metformin combination, metformin monotherapy on the blood glucose regulation, weight loss and lipid panel in the patients with Type 2 diabetes melli-tus whose BMI is >= 30 kg/m(2). PATIENTS AND METHODS: 276 patients in-cluded in the study were divided into two groups (1:1); liraglutide (3 mg) + metformin combination (L+M) and metformin monotherapy (M) (2x1,000 mg) (exercise and diet were regulated in both groups). Patients' body composition measure-ments were performed and fasting blood glu-cose, postprandial blood glucose, HbA1c, tri-glyceride, total cholesterol, LDL, HDL levels were measured by TANITA device prior to the therapy and in the week 12 of the therapy. RESULTS: The average age of 276 patients included in the study was 49.70 +/- 7.93 years. A statistically significant decrease was noted in weight, BMI, fasting blood glucose, postprandi-al blood glucose, HbA1c values of both groups at the end of the third month. 11.3 kg of weight was lost on average in L+M group (-12.3%); 4.5 kg of weight was lost in the monotherapy group (-4.9%). A decrease of 14.3% was seen in the body fat mass, 2.1% in the muscle mass in L+M group and a decrease of 4.4% in the body fat mass and 6.1% in the muscle mass in the mono -therapy group. The decrease in the body fat was higher at a statistically significant level in L+M group and the decrease in the muscle mass was higher in the monotherapy group. HbA1c de-creased by 17.9% in L+M group (-1.49 +/- 0.46, Co-hen's d=2.68), 5.3% in the monotherapy group (-0.37 +/- 0.26, Cohen's d=0.90). The decrease in TG, total cholesterol, LDL was higher at a sta-tistically significant level in L+M group. The increase in HDL level was higher in the mono -therapy group (L+M=22.7%, M=35.4%). A weight loss that was over 10% occurred in 4.3% of the patients in the monotherapy group and 68.1% of the combined therapy group at the end of 12 weeks (95% C.I. OR=19.49-121.65). CONCLUSIONS: The effect of the combination of liraglutide 3 mg and metformin on blood glu-cose regulation, weight loss (fat loss, muscle conservation) was found to be superior to the metformin monotherapy in the obese patients with Type 2 diabetes mellitus according to the early period results.
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    Evaluation of microvascular complications in patients with new diagnosis type 2 diabetes
    (Verduci Publisher, 2023) Yaprak, B.; Keskin, L.
    OBJECTIVE: The incidence of microvascular complications such as diabetic retinopathy, diabetic nephropathy and diabetic neuropathy has increased in newly diagnosed diabetes patients. The aim of this study was to determine the factors affecting the incidence of microvascular complications in newly diagnosed patients with type 2 diabetes.PATIENTS AND METHODS: This study was conducted on 97 newly diagnosed type 2 DM patients who applied to Malatya Training and Research Hospital Endocrinology outpatient clinic between September 2021 and July 2022. The patient files were reviewed retrospectively and their age, height, weight, body mass index (BMI), fasting/postprandial blood glucose measurements, serum HDL cholesterol, LDL cholesterol, total cholesterol, triglyceride, HbA1c levels, glomerular filtration rate (GFR) and complications of retinopathy, nephropathy, and neuropathy were recorded. Mann-Whitney U, t-test, Kruskal-Wallis, Binary logistic regression analy-sis, and Chi-square analysis were used to ana-lyze the data.RESULTS: The mean age of the patients included in the study was 47.40 +/- 7.78 (min: 23 -max: 62). Non-proliferative retinopathy was ob-served in 74.2% of patients, proliferative retinopathy in 25.8%, diffuse neuropathy in 49.5% and mononeuropathy was detected in 9.3% of them. Fasting blood glucose, postprandial blood glu-cose and HbA1c values were found to be high-er in patients with proliferative retinopathy than in patients without retinopathy. Fasting blood glucose, postprandial blood glucose and HbA1c values were found to be higher in patients with neuropathy than in patients without neuropa-thy. In addition, patients with mononeuropa-thy had statistically significantly higher HbA1c values than patients with diffuse-type neurop-athy. It was found that the urine protein val-ues of patients with mononeuropathy were sig-nificantly higher than those without neuropa-thy and those with diffuse neuropathy. Each 0.677-unit increase in HbA1c increases the risk of proliferative retinopathy 1.98-fold, and every 1.018-unit increase increases the risk of neu-ropathy 2.76-fold. Proliferative retinopathy and mononeuropathy rates were discovered to be higher in patients with a family history.CONCLUSIONS: Microvascular complications are common in newly diagnosed T2DM patients and an increase in HbA1c is a significant risk factor. Every newly diagnosed T2DM patient should be screened for microvascular complications.