The Journal of Clinical Endocrinology & Metabolism
Context The aims of the study are to compare characteristics of subacute thyroiditis (SAT) relate... more Context The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. Methods This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19–related SAT (Cov-SAT), SARS-CoV-2 vaccine–related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. Results Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid pe...
Context. Visceral adipose tissue (VAT) is a strong predictor of carbohydrate metabolism disorders... more Context. Visceral adipose tissue (VAT) is a strong predictor of carbohydrate metabolism disorders. Abdominal bioelectrical impedance analysis (A-BIA) is a simple method for the measurement of VAT and is a promising tool in screening and follow-up of abdominal obesity. However the role of A-BIA in dieting individuals has not been evaluated adequately in longitudinal followup studies. Objective. The aim of this study is to determine the role of A-BIA in identifying the changes in metabolic predictors after diet and/or exercise therapy. Design. All patients who sought weight loss treatment underwent baseline assessment and were prescribed a program of diet. After a mean follow-up of 3.2 months, data were analyzed. Subjects and Methods. Ultimately, 103 participants who reported adhering to the diet, enrolled to the study. We tested associations between changes in body composition measures and changes in laboratory measures using correlations and multivariate linear regression analysis. Results. Mean loss of body weight was 3.4±2.8 kg. All but waist-to-hip ratio, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels changed significantly (p<0.001). Decreases in body weight, body mass index (BMI), and VAT level significantly correlated with decreases in fasting blood glucose, fasting insulin level, and HOMA-IR score (r=0.230-0.371). In multiple linear regression analysis changes in BMI and VAT significantly correlated with change in HOMA-IR score (F(7.93)=2.283, p=0.034, R2=0.147). Conclusion. Decreases in BMI and VAT, as determined by A-BIA, were predictors of changes in metabolic laboratory measures. A-BIA is useful for followup of patients receiving diet therapy for weight loss.
Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subc... more Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subclinical hyperthyroidism (SCH) are limited. Subclinical hyperthyroidism induction by administering L-Thyroxine (LT4) is the standard treatment method in differentiated thyroid carcinoma (DTC) follow-up. Our aim was to investigate whether anxiety, depression and quality of life are affected in DTC patients followed-up with exogenous SCH. Materials and methods: The patients were divided into exogenous SCH by LT4-DTC (n = 127), euthyroid-DTC (n = 66) and exogenous euthyroid-benign thyroid noduüle (BTN) who underwent thyroidectomy for benign thyroid pathology (n = 85) groups. Results: The rate of moderate/severe anxiety was significantly higher in SCH-DTC than euthyroid-BTN group (27.5%, n = 35 vs. 9.4%, n = 8) (P = 0.001). TSH levels and Beck anxiety inventory (BAI) scores were significantly negatively correlated(P = 0.009 r =-0.16). Free T4 and BAI were significantly positively correlated (P = 0.04 r = 0.4). The groups were similar in terms of depression severity (P = 0.15). Subclinical hyperthyroid-DTC group scored significantly lowerthan euthyroid-BTN group in all scales of SF-36 quality of life survey. Conclusion: LT4-induced SCH, which is a part of traditional DTC treatment, can exacerbate the anxiety symptoms in patients and disrupt their quality of life, depending on the level of fT4.
Introduction: Amiodarone is an effective drug for life-threatening arrhythmias like recurrent ven... more Introduction: Amiodarone is an effective drug for life-threatening arrhythmias like recurrent ventricular fibrillation and atrial fibrillation. Amiodarone creates rarely genitourinary side effects are seen. These are epididymitis, testicular dysfunction and impotance. Amiodarone aggregates and triggers inflammation in the head of the epididym. Case report: We present the case of a patient who developed epididymitis after 17 months of amiodarone therapy, using a low dose (100 mg per day). Although cessation of medication or dose lowering was not performed, remission of the patient only by analgesics is a distinct case reported in urological literature. Conclusions: This case stresses the importance of considering an adverse effect of amiodarone treatment as a cause when making a differential diagnosis of epididymitis.
Medical principles and practice : international journal of the Kuwait University, Health Science Centre, Jan 23, 2018
The objective of this study was to assess the anti-proliferative pleiotropic effects of statins o... more The objective of this study was to assess the anti-proliferative pleiotropic effects of statins on thyroid function, volume and nodularity. One hundred and six hyperlipidemic patients were included in this prospective study. Sixty nine patients in the statin groups received atorvastatin (16 patients received 10 mg, 18 received 20 mg) or rosuvastatin (20 patients received 10 mg, 15 received 20 mg); 37 patients in the control group assessed as not requiring drugs only made lifestyle changes. All patients were evaluated for lipid variables [total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C)], and thyroid function and structure using ultrasonography on admission and 6 months later. After 6 months, no differences in thyroid function, thyroid volume, number of thyroid nodules or nodule size were observed in statin and control groups. In subgroup analysis, total thyroid volume decreased more in patients receiving...
Background: Recent evidence suggests that increased visceral adiposity is a strong independent ri... more Background: Recent evidence suggests that increased visceral adiposity is a strong independent risk factor for cardiovascular death and all-cause mortality in hemodialysis (HD) patients. Irisin, which is a novel myokine, can play critical roles in diabetes and adiposity. The purpose of our study was to investigate whether serum irisin levels are associated with body mass index, waist circumference (WC), and total fat mass in non-diabetic patients undergoing maintenance HD. Methods: This cross-sectional study included 108 non-diabetic HD patients and 40 age-and sexmatched apparently healthy subjects. Serum irisin concentrations were determined using an enzyme-linked immunosorbent assay. Body fat composition (TBF-410 Tanita Body Composition Analyzer) was measured and calculated. Results: Serum irisin levels did not differ between HD patients and the healthy controls (523.50 ± 229.32 vs. 511.28 ± 259.74, p ¼ 0.782). Serum irisin levels were associated with age (r ¼ 0.314; p ¼0.006), HOMA-IR (r ¼ 0.472; p ¼ 0.003), WC (r ¼ 0.862; p < 0.001), and total fat mass (r ¼ 0.614; p < 0.001). In multivariate regression analysis, WC (b ¼ 1.240, p < 0.001) and total fat mass (b ¼ 0.792, p ¼ 0.015) were the variables that were significantly associated with irisin concentrations (R 2 ¼ 0.684, p < 0.001) after adjusting for confounding factors (age and HOMA-IR). Conclusions: These results suggest that serum irisin levels are related to visceral adiposity in nondiabetic HD patients.
The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diag... more The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diagnosis of chronic autoimmune thyroiditis (CAT) patients. The study group consisted of 50 patients with first-diagnosed CAT and 40 control subjects (CS). In all patients with CAT and CS, sonoelastographic measurements were made in both thyroid lobes. Optimal cut-off values were chosen to maximize the sum of sensitivity and specificity. Positive predictive value (PPV), negative predictive value (NPV), and accuracy values were also calculated. Quantitative elastographic analysis evaluated by SWE in CAT patients (2.56 +/- 0.30 m/s) was significantly higher compared with CS (1.63 +/- 0.12 m/s) (p<0.001). The optimal cut-off value was 2.42 m/s. SWE had 77% sensitivity, 71% specificity, 92% PPV, 81% NPV, and 87% accuracy for the presence of CAT. Our data indicate that SWE correctly defines the elasticity of thyroid parenchyma, and this technique may assist in the diagnosis and treatment monit...
The Journal of Clinical Endocrinology & Metabolism
Context The aims of the study are to compare characteristics of subacute thyroiditis (SAT) relate... more Context The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. Methods This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19–related SAT (Cov-SAT), SARS-CoV-2 vaccine–related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. Results Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid pe...
Context. Visceral adipose tissue (VAT) is a strong predictor of carbohydrate metabolism disorders... more Context. Visceral adipose tissue (VAT) is a strong predictor of carbohydrate metabolism disorders. Abdominal bioelectrical impedance analysis (A-BIA) is a simple method for the measurement of VAT and is a promising tool in screening and follow-up of abdominal obesity. However the role of A-BIA in dieting individuals has not been evaluated adequately in longitudinal followup studies. Objective. The aim of this study is to determine the role of A-BIA in identifying the changes in metabolic predictors after diet and/or exercise therapy. Design. All patients who sought weight loss treatment underwent baseline assessment and were prescribed a program of diet. After a mean follow-up of 3.2 months, data were analyzed. Subjects and Methods. Ultimately, 103 participants who reported adhering to the diet, enrolled to the study. We tested associations between changes in body composition measures and changes in laboratory measures using correlations and multivariate linear regression analysis. Results. Mean loss of body weight was 3.4±2.8 kg. All but waist-to-hip ratio, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels changed significantly (p<0.001). Decreases in body weight, body mass index (BMI), and VAT level significantly correlated with decreases in fasting blood glucose, fasting insulin level, and HOMA-IR score (r=0.230-0.371). In multiple linear regression analysis changes in BMI and VAT significantly correlated with change in HOMA-IR score (F(7.93)=2.283, p=0.034, R2=0.147). Conclusion. Decreases in BMI and VAT, as determined by A-BIA, were predictors of changes in metabolic laboratory measures. A-BIA is useful for followup of patients receiving diet therapy for weight loss.
Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subc... more Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subclinical hyperthyroidism (SCH) are limited. Subclinical hyperthyroidism induction by administering L-Thyroxine (LT4) is the standard treatment method in differentiated thyroid carcinoma (DTC) follow-up. Our aim was to investigate whether anxiety, depression and quality of life are affected in DTC patients followed-up with exogenous SCH. Materials and methods: The patients were divided into exogenous SCH by LT4-DTC (n = 127), euthyroid-DTC (n = 66) and exogenous euthyroid-benign thyroid noduüle (BTN) who underwent thyroidectomy for benign thyroid pathology (n = 85) groups. Results: The rate of moderate/severe anxiety was significantly higher in SCH-DTC than euthyroid-BTN group (27.5%, n = 35 vs. 9.4%, n = 8) (P = 0.001). TSH levels and Beck anxiety inventory (BAI) scores were significantly negatively correlated(P = 0.009 r =-0.16). Free T4 and BAI were significantly positively correlated (P = 0.04 r = 0.4). The groups were similar in terms of depression severity (P = 0.15). Subclinical hyperthyroid-DTC group scored significantly lowerthan euthyroid-BTN group in all scales of SF-36 quality of life survey. Conclusion: LT4-induced SCH, which is a part of traditional DTC treatment, can exacerbate the anxiety symptoms in patients and disrupt their quality of life, depending on the level of fT4.
Introduction: Amiodarone is an effective drug for life-threatening arrhythmias like recurrent ven... more Introduction: Amiodarone is an effective drug for life-threatening arrhythmias like recurrent ventricular fibrillation and atrial fibrillation. Amiodarone creates rarely genitourinary side effects are seen. These are epididymitis, testicular dysfunction and impotance. Amiodarone aggregates and triggers inflammation in the head of the epididym. Case report: We present the case of a patient who developed epididymitis after 17 months of amiodarone therapy, using a low dose (100 mg per day). Although cessation of medication or dose lowering was not performed, remission of the patient only by analgesics is a distinct case reported in urological literature. Conclusions: This case stresses the importance of considering an adverse effect of amiodarone treatment as a cause when making a differential diagnosis of epididymitis.
Medical principles and practice : international journal of the Kuwait University, Health Science Centre, Jan 23, 2018
The objective of this study was to assess the anti-proliferative pleiotropic effects of statins o... more The objective of this study was to assess the anti-proliferative pleiotropic effects of statins on thyroid function, volume and nodularity. One hundred and six hyperlipidemic patients were included in this prospective study. Sixty nine patients in the statin groups received atorvastatin (16 patients received 10 mg, 18 received 20 mg) or rosuvastatin (20 patients received 10 mg, 15 received 20 mg); 37 patients in the control group assessed as not requiring drugs only made lifestyle changes. All patients were evaluated for lipid variables [total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C)], and thyroid function and structure using ultrasonography on admission and 6 months later. After 6 months, no differences in thyroid function, thyroid volume, number of thyroid nodules or nodule size were observed in statin and control groups. In subgroup analysis, total thyroid volume decreased more in patients receiving...
Background: Recent evidence suggests that increased visceral adiposity is a strong independent ri... more Background: Recent evidence suggests that increased visceral adiposity is a strong independent risk factor for cardiovascular death and all-cause mortality in hemodialysis (HD) patients. Irisin, which is a novel myokine, can play critical roles in diabetes and adiposity. The purpose of our study was to investigate whether serum irisin levels are associated with body mass index, waist circumference (WC), and total fat mass in non-diabetic patients undergoing maintenance HD. Methods: This cross-sectional study included 108 non-diabetic HD patients and 40 age-and sexmatched apparently healthy subjects. Serum irisin concentrations were determined using an enzyme-linked immunosorbent assay. Body fat composition (TBF-410 Tanita Body Composition Analyzer) was measured and calculated. Results: Serum irisin levels did not differ between HD patients and the healthy controls (523.50 ± 229.32 vs. 511.28 ± 259.74, p ¼ 0.782). Serum irisin levels were associated with age (r ¼ 0.314; p ¼0.006), HOMA-IR (r ¼ 0.472; p ¼ 0.003), WC (r ¼ 0.862; p < 0.001), and total fat mass (r ¼ 0.614; p < 0.001). In multivariate regression analysis, WC (b ¼ 1.240, p < 0.001) and total fat mass (b ¼ 0.792, p ¼ 0.015) were the variables that were significantly associated with irisin concentrations (R 2 ¼ 0.684, p < 0.001) after adjusting for confounding factors (age and HOMA-IR). Conclusions: These results suggest that serum irisin levels are related to visceral adiposity in nondiabetic HD patients.
The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diag... more The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diagnosis of chronic autoimmune thyroiditis (CAT) patients. The study group consisted of 50 patients with first-diagnosed CAT and 40 control subjects (CS). In all patients with CAT and CS, sonoelastographic measurements were made in both thyroid lobes. Optimal cut-off values were chosen to maximize the sum of sensitivity and specificity. Positive predictive value (PPV), negative predictive value (NPV), and accuracy values were also calculated. Quantitative elastographic analysis evaluated by SWE in CAT patients (2.56 +/- 0.30 m/s) was significantly higher compared with CS (1.63 +/- 0.12 m/s) (p<0.001). The optimal cut-off value was 2.42 m/s. SWE had 77% sensitivity, 71% specificity, 92% PPV, 81% NPV, and 87% accuracy for the presence of CAT. Our data indicate that SWE correctly defines the elasticity of thyroid parenchyma, and this technique may assist in the diagnosis and treatment monit...
Uploads
Papers by canan demir