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Öğe Cardiac Findings on Non-Contrast Thoracic Tomography in Patients with Acromegaly(2022) Keskin, Lezan; Ilgar, Mehtap; Yaprak, Bülent; Akçiçek, Mehmet; Aslantürk, OkanAim: Acromegaly occurs as a result of excessive and permanent secretion of growth hormone from the pituitary. Mortality is mostly related to cardiovascular system involvement. In our study, we aimed to evaluate the correlation between epicardial fat volume (EFV) and growth hormone level in thorax computed tomography in patients with acromegaly and coronary artery calcification, pulmonary artery diameter, ascending aorta diameter, cardiothoracic ratio (CTO) measurements with the control group patients. Method: Our study was retrospective and included 16 patients with acromegaly who were previously diagnosed and treated by the endocrinology clinic and a control group consisting of 32 patients matched for gender and age.In thorax CT, EFV measurement of the patients was performed and main pulmonary artery diameters, ascending aorta diameters, cardio thoracic ratios, presence of coronary artery calcification were evaluated. Results: The number of patients with large ascending aorta was higher in patients with acromegaly and it was statistically significant (p=0.041). Although the rate of patients with large main pulmonary artery diameter was higher in patients with acromegaly, no significant difference was found between the groups (p=0.355). There was no significant difference between the groups in terms of increased CTO (p=0.818) and coronary artery calcification (p=0.157). Conclusion: In our study, a difference was found between the acromegaly and control group patients only in terms of ascending aorta diameters, but no significant difference was found in terms of other parameters. We think that regular follow-up and treatment of patients is effective in this result. Cardiovascular risks can be reduced in patients with acromegaly with early diagnosis, regular follow- up and treatment.Öğe Diffusion-weighted imaging features of brain in obesity(Elsevier Science Inc, 2008) Alkan, Alpay; Sahin, Ibrahim; Keskin, Lezan; Cikim, Ayse Sertkaya; Karakas, Hakki Muammer; Sigirci, Ahmet; Erdem, GulnurPurpose: Obesity is characterized by an altered distribution of body fluid. However, distribution of fluid (extracellular/intracellular) in brain tissues has not been studied in obese subjects yet. The purpose of this study was to detect possible brain diffusion changes especially in satiety and hunger related centers in obese subjects by diffusion weighted imaging (DWI). Methods: Conventional MRI and DWI of the brain was obtained from 81 obese patients (obese=68, morbid obese= 13) and 29 age-matched, nonobese. The apparent diffusion coefficient (ADC) values were calculated in hypothalamus; amygdala; hippocampal gyrus-1 thalamus; insula; cingulate gyrus; orbitofrontal, dorsomedial and dorsolateral frontal, middle temporal and occipital cortex; cerebellum; midbrain and corpus striatum. Results: The ADC values of hypothalamus, hippocampal gyrus, amygdala, insula, cerebellum and midbrain were significantly increased in patients (n:81) when compared to nonobese subjects. The ADC values of thalamus, hippocampal gyrus, amygdala, orbitofrontal, occipital, dorsolateral and middle temporal cortex, insula and midbrain were significantly increased in morbid obese when compared to nonobese subjects. The ADC values of orbitofrontal and occipital cortex were significantly higher in morbid obese than the values in the obese. The body mass index positively correlated with ADC values of amygdala, insula, orbitofrontal and middle temporal cortex. Conclusion: We observed increased ADC values of distinct locations related to satiety and hunger that suggest altered fluid distribution and/or vasogenic edema in obese subjects. Awareness of this abnormalities in brain tissue composition/function in obesity may contribute to better understanding of the underlying mechanisms. (0 2008 Elsevier Inc. All rights reserved.Öğe How effective is the obesity treatment on improving oxidative stress? Is there any difference between drugs?(2022) Keskin, Lezan; Şahin, İbrahim; Yavuz, Dilek Gogas; Yüksel, Meral; Taşkapan, Mehmet ÇağatayIntroduction: Obesity shortens the life period and decreases its quality, causing several complications. Recently, oxidative stress produced by lipid peroxydation is considered a cardiovascular risk factor. In this study, we aimed to investigate the relationship between weight loss with lipid profile, insulin resistance, and lipid peroxidation products malondialdehyde (MDA, oxidant) and paraoxonase-1 (PON1, antioxidant) levels which is protective in atherosclerosis, and to evaluate alteration on oxidative stress. Methods: Patients diagnosed as obese at the Endocrinology and Metabolic Diseases Outpatient Clinics of Inonu University Faculty of Medicine between December 2005 and February 2008 were studied. 103 patients were included in the study. Study population was divided into two treatment groups. In the first group, 120 mg of orlistat, three times daily, and in the second group, sibutramine 15 mg per day were given in addition to appropriate diet therapy. The patients were evaluated at the end of three months treatment period. Results: Dramatic changes in body weight, Body Mass Index (BMI), and waist and hip circumference were observed during the three-month evaluation in patients receiving orlistat or sibutramine. Additionally, significant improvements were measured in systolic- diastolic blood pressure levels, lipid levels, and insulin resistance. The decrease in the MDA level and the increase in the PON level were similar and significant in both patient groups. Discussion and Conclusion: The treatment of obesity, aimed at reducing body weight, acts to reduce oxidative stress by increasing paraoxonase-1 activity (antioxidant) and reducing the amount of the peroxidation product malondialdehyde (oxidant), regardless of the type of medication administered.Öğe Obezite tedavisi oksidatif stresi düzeltmede ne kadar etkili? İlaçlar arasında fark var mı?(İnönü Üniversitesi, 2009) Keskin, LezanObezite; neden olduğu pek çok komplikasyon nedeniyle hem yaşam süresini kısaltır hem de kalitesini azaltır. Mortaliteyi artıran en önemli komplikasyonlar kardiyovasküler sistem ile ilgili olanlardır. Son zamanlarda lipid peroksidasyonu sonucu oluşan oksidatif stres kardiyo-vasküler bir risk olarak kabul edilmektedir. Çalışmamızda kilo kaybı ile lipid profili, insülin direnci, peroksidasyon ürünü malondialdehit(MDA-oksidan) ve aterosklerozda koruyucu rol üstlendiği bildirilen Paraoksonaz-1(PON1-antioksidan) düzeyleri arasındaki ilişkiyi araştırmayı ve böylece oksidatif stresdeki değişimi belirlemeyi amaçladık. Materyal ve Metot: 2005 yılı Ağustos ayı ile 2008 Şubat ayı arasında İnönü Üniversitesi Tıp Fakültesi Turgut Özal Tıp Merkezi Endokrinoloji ve Metabolizma Hastalıkları Polikliniğine obezite nedeniyle başvuran hastalar çalışma için ön değerlendirmeye alındı. Çalışmaya toplam 103 hasta (14'ü erkek, 89'u kadın) alındı. Karaciğer ve böbrek fonksiyon testleri anormal olan hastalar çalışmaya alınmadı. Hastalar uygun diyetle beraber 2 gruba ayrıldı. Orlistat 3x120 mgr ve sibutramin 1x15 mgr verildi. 3. ay kontrolleri değerlendirildi. Bulgular: Orlistat ve sibutramin ilaç tedavisi alan hastaların başlangıç ve 3. ay kontrollerindeki kilo, BKİ, bel, kalça değerlerinde anlamlı değişiklikler tespit edildi. İlave olarak sistolik- diastolik basınç, lipid düzeyleri, insülin direnci üzerindeki anlamlı düzelmeler tespit edildi. Oksidan (MDA) düzeyinde azalma ve Antioksidan(PON) düzeylerinde artış her iki ilaç ta da benzer ve anlamlı idi. Sonuç: Antiobezite tedavisi ile sağlanan kilo kaybı; kullanılan ilaçlardan bağımsız olarak peroksidasyon ürünü MDA(oksidan) azaltıp ve paraoksonaz-1(antioksidan) düzeylerini artırarak oksidatif stresi azaltmaktadır.Öğe Vitamin D receptor gene BsmI, FokI, ApaI, TaqI polymorphisms and bone mineral density in a group of Turkish type 1 diabetic patients(Springer-Verlag Italia Srl, 2011) Yavuz, Dilek Gogas; Keskin, Lezan; Kiyici, Sinem; Sert, Murat; Yazici, Dilek; Sahin, Ibrahim; Yuksel, MeralPrevious studies have suggested an influence of vitamin D receptor alleles on bone metabolism and on susceptibility to type 1 diabetes mellitus in different ethnic populations. We aimed to investigate the distribution of vitamin D receptor (VDR) alleles in relation to biochemical bone turnover parameters and bone densitometry measurements in a group of Turkish type 1 diabetic patients. One hundred and seventeen patients (M/F 57/60, 27.6 +/- A 7.3 y duration of diabetes 8.1 +/- A 6.3 y) and 134 healthy controls (M/F 61/73, 26.2 +/- A 5.3 y) were included in the study. Bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry (DEXA). The vitamin D receptor gene (VDR) polymorphisms FokI, Bsm1, Apa1, and Taq1 were examined using a PCR-based restriction analysis. Serum levels of calcium, phosphor osteocalcin, intact parathyroid hormone, and C telopeptide were measured. Vitamin D receptor Bsm1 Fok1, Apa1, and Taq1 genotype distributions were not different between patient with diabetes and control groups. BMD was 0.77 +/- A 0.2 g/cm(2) vs. 0.97 +/- A 0.2 g/cm(2) (P = 0.0001) for the femur, 1.0 +/- A 0.1 g/cm(2) vs. 1.13 +/- A 0.1 g/cm(2) (P = 0.001) for type 1 diabetic patients and controls. Bone turnover markers were significantly lower in type 1 diabetic group. BMD measurements and bone metabolic markers were not different between the genotypes in either the patient with diabetes or the controls. The VDR gene polymorphisms, Bsm1, Fok 1, Apa1, and Taq1 showed no influence on bone metabolism in our group of type 1 diabetic patients.
