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    The Frequency of Vitamin D Deficiency in Obese Patients on Bariatric Surgery Wait List: Is there any Association with Co-existence of Prediabetes or Diabetes?
    (2019) Topaloğlu, Ömercan; Evren, Bahri; Yoloğlu, Saim; Sahin, Selale; Şahin, İbrahim
    Abstract: Objective: The impact of co-existence of prediabetes on 25 (OH)D3 deficiency is less known. We investigated the prevalence and predictors of 25(OH)D3 deficiency in obese adults on the bariatric surgery waitlist. Material and Methods: One hundred ninety-nine patients without known chronic diseases including diabetesmellitus (DM) and hypertension were included. Anthropometric, biochemical, and hormonal [fasting insulin, C-peptide, 25(OH)D3] parameters were analyzed. Insulin resistance (IR) was calculated using the homeostasis model assessment of IR (HOMA-IR). Patients having HOMA-IR of ?2.5 were considered insulin resistant. Patients were divided into subgroups according to body mass index (BMI), fasting blood glucose, HOMA-IR, glycated hemoglobin A1c (HbA1c), and 25(OH)D3 levels. Results: According to HbA1c levels, prediabetes and DM were diagnosed in 39.6% (n=79) and 27.1% (n=54) of patients. The 25(OH)D3 levels were severely deficient, deficient, and insufficient in 47.2%, 36.7%, and 10.6%of patients; however, the levels were sufficient (?30 ng/mL) only in 5.5%. The mean 25(OH)D3 level was 9.59, 9.76, and 12.08 ng/mL in nondiabetic, prediabetic, and diabetic patients (p>0.05). BMI and 25(OH)D3 levels were negatively correlated (p=0.045, r=-0.142). HOMA-IR was not correlated with 25(OH)D3 levels (p=0.98); it was similar in patients with different 25(OH)D3 levels. Age ?40 years andmale gender were significant predictors for severe 25(OH)D3 deficiency, but IR, prediabetes, and DM were not significant predictors. Conclusion: Increased BMI was associated with decreased 25(OH)D3 levels. The co-existence of prediabetes does not seem to affect 25(OH)D3 levels. Age ?40 years and male gender were significant predictors for severe 25(OH)D3 deficiency. Severe 25(OH)D3 deficiency was frequent in obese patients on the bariatric surgery waitlist. Vitamin D deficiency was also shown in other studies on obesity. 25(OH)D3 levels should be measured in all patients undergoing bariatric surgery and managed accordingly. The effect of preoperative vitamin D replacement on postoperative weight loss will clarify the association between vitamin D levels and obesity.
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    Increase in C-peptide levels after resolution of hyperglycemia in patients with type 2 diabetes mellitus: Myths or facts?
    (2020) Topaloglu, Omercan; Evren, Bahri; Yologlu, Saim; Sahin, Selale; Sahin, Ibrahim
    Aim: Long term control of glucotoxicity was shown to increase the secretion of insulin and C-peptide (Cp). We aimed to investigate the change in Cp levels after short term glycemic control in patients with uncontrolled type 2 diabetes mellitus (DM).Material and Methods: Patients with type 2 DM with uncontrolled hyperglycemia were included. Basal fasting Cp levels were measured both at admission (Cp-admission) and after control of hyperglycemia prior to discharge (Cp-discharge). Cp-difference was calculated as (Cp-discharge)-(Cp-admission). The patients were divided as group 1 (positive Cp-difference) and group 2 (negative Cp-difference), and group A (Cp-difference ≥+0.5) and group B (Cp-difference ≤-0.5).Results: Of the patients (n=123), 61.8% had positive Cp-difference, and mean Cp-differences were 0.16 (±1.59), 0.96 (±1.03), and -1.11 (±1.51) in all patients, group1 and 2; respectively (p=0.001). Mean body weight, creatinine and Cp-discharge were higher in group 1(p=0.045, p=0.013, p=0.001; respectively). Mean age, body mass index(BMI), diabetes duration, hospitalization, proteinuria, fasting and postprandial glucose, glucose-discharge, HbA1c, lipids, TSH, free T4, Cp-admission were similar in group 1 and 2.Cp-difference was correlated positively with Cp-discharge(p=0.001), negatively with Cp-admission (p=0.001). There were no significant differences between subgroups (age, BMI, diabetes duration, use of secretagogue, diabetic ketaoacidosis history, HbA1c (10 or ≥10%), hyperlipidemia, microvascular complication) regarding to Cp-difference. Positive predictors of positive Cp-difference were cardiovascular disease (p=0.004; Odds Ratio(OR)=3.006) and higher Cp-discharge(p=0.001; OR=6.420);positive predictors of Cp-difference ≥+0.5 were male, lower Cp-admission and higher Cp-discharge.Conclusion: Our results indicate that short-term glycemic control has little but significant positive effect on basal Cp. Having cardiovascular disease was positive predictor for positive Cp-difference.
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    Information and Practices about Childrens’ Dental Health of the Mothers Have 2-4 Year Old and Who Applied Sıtmapınarı Family Health Center in the City of Malatya
    (Medicine Science, 2016) Gunes, Gulsen; Seyitoglu, Duygu Celik; Sahin, Selale
    Öz: Türk Diş Hekimleri Birliğine göre; okul öncesinde çürük ve sonuçlarını taşıyan çocukların yaygınlığı % 80'lerin üzerinde bulunmaktadır. Diş fırçalamanın, çürük riskini anlamlı olarak azalttığı bilinen bir gerçektir. Erken çocukluk döneminde diş sağlığının korunması ve bazı alışkanlıkların kazandırılması annelerin bilgi ve tutumlarıyla çok ilişkilidir. Bu çalışmamızda amacımız; annelerde çocuklarının ağız ve diş sağlığıyla ilgili bilgi düzeylerini ve uygulamalarını belirlemektir. Araştırma kesitsel tipte bir çalışma olup Sıtmapınarı Aile Sağlığı Merkezine başvuran 2-4 yaşında çocuğu olan annelerle yapıldı. 331 anneye 21 sorudan oluşan anket formu uygulandı. Anket formu sosyodemografik özelliklerin yanında annelerin ağız ve diş sağlığı uygulamalarına ve bilgi düzeylerine ilişkin sorulardan oluşmaktaydı. Çalışmanın yapılabilmesi için Malatya Klinik Araştırmalar Etik Kurulu'ndan ve Malatya Halk Sağlığı Müdürlüğün'den izin alındı. Verilerin analizinde Ki-kare, Unparied T testi ve One Way Anova testi kullanıldı. Çalışmamıza katılan annelerin % 40,5' i çocuğunun dişini fırçalamaktadır. Annelerde diş macunu florlu olması gerektiğini bilme oranı %24,8, florun ne işe yaradığını bilme oranı ise %28,2'dir. Annelerin % 33,2' si çürük oluşması kolaylaştıran çocuğunun yemeğinin tadını aynı kaşıkla kontrol etme uygulaması içindedirler. Annelerin çocuklarının dişini fırçalama uygulamalarını ve ağız diş sağlığı bilgi düzeylerini annenin eğitim düzeyi, sosyoekonomik durumu, çalışıyor olup olmaması, kendi dişlerini fırçalama durumu anlamlı olarak etkilemektedir (p<0,05). Annenin yaşı açısından ise fark saptanmamıştır (p>0,05). Ağız ve diş sağlığını kötü yönde etkileyen uygulamalar yaygındır. Toplumdaki bu yanlış uygulamalara müdahale edilmelidir. Flor jel ve vernik uygulamasının nedenleri ve diş fırçalamanın önemi konusunda anneler bilinçlendirilmelidir Başlık (İngilizce): Malatya Sıtmapınarı ASM ’ye Başvuran 2-4 Yaş Çocuğu Olan Annelerin Çocuklarının Diş Sağlığına Ait Bilgi Düzeyi ve Uygulamaları Öz (İngilizce): According to the Dental Association of Turkey, the prevalence of the preschool children having caries and bearing its consequences is over 80%. It is a common known fact that brushing teeth decreases the risk of caries in teeth at a meaningful level. Protection of dental health in early childhood and giving the habits of keeping the teeth healthy to children are closely related with the knowledge and attitudes of mothers. In this study our purpose is to determine knowledge and practices of mothers about dental and oral health of their children. The study is a cross-sectional study, and has been conducted with the mothers having children between the ages 2-4 who applied to Sıtmapınarı Family Health Center. A questionnaire consisting of 21 questions was applied to 331 mothers. The questionnaire form included questions on the socio-demographic characteristics of the mothers as well as their information levels on the practices on oral and dental health. In the analyses of the data, the Chi-Square Test, Unpaired T Test and One Way Anova Tests were used. 40,5% of the children of the mothers who participated in our study brush their teeth. The rate of knowing that the toothpaste must include fluorine among the mothers has been determined as 24,8%; and the rate of knowing why the fluorine is added to the toothpastes has been determined as 28,2%. 33,2% of the mothers are inclined to check the food of their children with the same spoon their children are using during the meal, which makes it easier for caries to appear. The educational level, socio-economic status, working or not working of mother, brushing their own teeth or not influenced the brushing the teeth behavior of the children and the knowledge levels of the mothers on dental and oral health (p<0,05). There was no differences in terms of the age of the mothers (p>0,05). In conclusion, wrong practices that influence the oral and dental health in a bad way are very common. The intervention about oral and dental health should be done in community. Mothers must be informed on the reasons of the fluorine gel and polisher agents, and also on the importance of brushing teeth
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    Investigation of DMFT Index and Saliva Values in Morbidly Obese and Obese Patients
    (Duzce Univ, Fac Medicine, 2023) Ayan, Gizem; Dayi, Burak; Sahin, Selale; Evren, Bahri
    Objective: Obesity is a global chronic disease that affects both developed and developing countries. The purpose of this study was to examine the effect of morbid obesity and obesity on the decayed, missing, and filled teeth (DMFT) index and saliva values. Method: This study included 50 morbidly obese, 50 obese, and 50 control group patients aged 18-68 years. The DMFT index of the patients was determined through a clinical examination. The saliva kit was used to determine the saliva values [unstimulated saliva flow rate (USFR), stimulated saliva flow rate (SSFR), saliva viscosity (SV), saliva pH (SpH), and saliva buffering capacity (SBC)]. The patients were surveyed to learn about their oral health habits, nutritional habits, and socioeconomic status. Results: No significant difference was found in the number of decayed teeth, filled teeth, USFR, or SV between the groups (p > 0.05). The DMFT index, number of missing teeth, SSFR, SpH, and SBC all showed significant differences between the groups (p < 0.05). The significant variables associated with DMFT, according to the multiple linear regression model, were the frequency of dental visits (f3 = 0.365), age (f3 = 0.322), and SSFR (f3 = -0.256). Conclusion: Obese patients have a low saliva rate, low saliva pH, low buffering capacity, high DMFT index, and a high number of missing teeth.
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    The prevalence and predictors of prediabetes in the patients on liver transplant wait list
    (2018) Şahin, İbrahim; Kayaalp, Cüneyt; Sahin, Selale; Yoloğlu, Saim; Evren, Bahri; Topaloğlu, Ömercan
    Abstract: Aim: Studies addressing the prevalence of prediabetes among liver transplantation (LT) candidates are limited. We aimed to investigate the prevalence and predictors of prediabetes in the patients on LT wait list. Material and Methods: One hundred one adult patients on LT wait list were included. Patients with known diabetes were excluded. Clinical, demographic and laboratory features were analyzed retrospectively. The patients were grouped by fasting blood glucose (FBG), age, gender, body mass index (BMI), and other clinical parameters. Results: Mean age of the patients was 47.98 ± 14.53; and 63.3% were males. Prediabetes and new-onset diabetes mellitus were diagnosed in 34(33.6%) and 6(5.9%) of the patients. Mean age was significantly higher in prediabetes group comparing to normal FBG. 52.47% (n = 53) of the patients was obese, 27.7% (n = 28) overweight, 19.8% in normal weight. The distribution of BMI subgroups was similar in FBG subgroups (p = 0.447). There were significant positive correlations between age, and BMI or FBG (p = 0.021 and p = 0.002, respectively). Being older (? 40 years-old) was found to be a predictor for prediabetes (p = 0.010, Odds Ratio = 4.986). BMI was not a predictor for prediabetes (p = 0.151). Conclusions: Our results suggested that the prevalence of prediabetes was increased in patients on LT wait list. Age but not BMI seems to be a significant predictor of prediabetes.
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    The prevalence and predictors of prediabetes in the patients on liver transplant wait list
    (2018) Topaloglu, Omercan; Evren, Bahri; Yologlu, Saim; Sahin, Selale; Kayaalp, Cüneyt; Sahin, Ibrahim
    Aim: Studies addressing the prevalence of prediabetes among liver transplantation (LT) candidates are limited. We aimed to investigate the prevalence and predictors of prediabetes in the patients on LT wait list. Material and Methods: One hundred one adult patients on LT wait list were included. Patients with known diabetes were excluded. Clinical, demographic and laboratory features were analyzed retrospectively. The patients were grouped by fasting blood glucose (FBG), age, gender, body mass index (BMI), and other clinical parameters. Results: Mean age of the patients was 47.98 ± 14.53; and 63.3% were males. Prediabetes and new-onset diabetes mellitus were diagnosed in 34(33.6%) and 6(5.9%) of the patients. Mean age was significantly higher in prediabetes group comparing to normal FBG. 52.47% (n = 53) of the patients was obese, 27.7% (n = 28) overweight, 19.8% in normal weight. The distribution of BMI subgroups was similar in FBG subgroups (p = 0.447). There were significant positive correlations between age, and BMI or FBG (p = 0.021 and p = 0.002, respectively). Being older (≥ 40 years-old) was found to be a predictor for prediabetes (p = 0.010, Odds Ratio = 4.986). BMI was not a predictor for prediabetes (p = 0.151). Conclusions: Our results suggested that the prevalence of prediabetes was increased in patients on LT wait list. Age but not BMI seems to be a significant predictor of prediabetes