Our results did not show a significant correlation between circulating ghrelin and clinical or laboratory markers of disease activity in RA. Surprisingly, obestatin correlated with some inflammatory markers. So, obestatin seems to be more valuable than ghrelin in the pathogenesis of RA.

Inhibition of TNF-alpha with etanercept in BLM-IS was resulted in a significant reduction of the dermal sclerosis, collagen accumulation and the number of infiltrating myofibroblastic cells. TNF-alpha may play a key role in the progression of BLM-IS and TNF-alpha antagonists may be useful in the management of scleroderma.

Objective:Non syndromic monogenic obesity is a rare cause of early onset severe obesity in the childhood period. This form may not be distinguishable from other forms of severe obesity without genetic analysis, particularly if patients do not exibit any physical abnormalities or developmental delay. The aim of this study was to screen 41 different obesity-related genes in children with non-syndromic early onset severe obesity.Methods:Children with severe (body mass index-standard deviation score >3) and early onset (<7 years) obesity were screened by next-generation sequencing based, targeted DNA custom panel for 41 known-obesity-related genes and the results were confirmed by Sanger technique.Results:Six novel variants were identified in five candidate genes in seven out of 105 children with severe obesity; two in SIM1 (p.W306C and p.Q36X), one in POMC (p.Y160H), one in PCSK1 (p.W130G fs Ter8), two in MC4R (p.D126E) and one in LEPR (p.Q4H). Additionally, two previously known variations in MC4R were identified in four patients (p.R165W in three, and p.V166I in one).Conclusion:We identified six novel and four previously described variants in six obesity-related genes in 11 out of 105 childrens with early onset severe obesity. The prevalence of monogenic obesity was 10.4% in our cohort.

Background Thyroid disorders are associated with many cardiovascular risk factors. The importance of thyroid hormones in the pathophysiology of heart failure is underlined by the European guidelines of the European Society of Cardiology. However, the role of subclinical hyperthyroidism (SCH) in subclinical left ventricular (LV) systolic dysfunction is not entirely clear. Methods This cross‐sectional study included 56 SCH patients and 40 healthy volunteers. The 56 SCH group was divided into two subgroups depending on the presence of fragmented QRS (fQRS). In both groups, left ventricular global area strain (LV‐GAS), global radial strain (GRS), global longitudinal strain (GLS), and global circumferential strain (GCS) were obtained with four‐dimensional (4D) echocardiography. Results GAS, GRS, GLS, and GCS values were significantly different in SCH patients and in healthy volunteers. GLS and GAS values were lower in the fQRS+ than in the fQRS− group (−17.06 ± 1.00 vs. −19.08 ± 1.71, p < .001, and −26.61 ± 2.38 vs. −30.61 ± 2.57, p < .001, respectively). ProBNP was positively correlated with LV‐GLS (r = 0.278, p = .006) and LV‐GAS (r = 0.357, p < .001). Multiple linear regression analysis showed that fQRS was an independent predictor of LV‐GAS. Conclusions 4D strain echocardiography may be helpful for the prediction of early cardiac dysfunction in patients with SCH. The presence of fQRS may be an indicator of subclinical LV dysfunction in SCH.

The effect of body mass index on the sexual functions of morbidly obese female patientsObjective: The aim of this study is to investigate whether morbidly obese female patients are suffering sexual dysfunction, in addition to analyzing the effect of body mass index (BMI) on sexual functions. Method: A total of 72 morbidly obese women admitted to the Endocrinology Department, whose BMI scores were 40 or over, and 28 healthy women age-matched with the morbidly obese group, whose BMI scores were under 30 were included in this study. Considering the effects on sexual functioning, the patients and the control group were evaluated by a psychiatric specialist. women with a psychiatric disorder according to DSM-5, taking medicines that could affect sexual functions, and those with a chronic physical or any neurological disease or being pregnant or breastfeeding were excluded from the study. A sociodemographic data form and the Arizona Sexual Experiences Scale (ASEX) were administered to both the treatment and control group. Results: Statistical analyses revealed that morbidly obese female patients more frequently suffered from sexual dysfunction compared to the control group. The Arizona Sexual Experiences Scale (ASEX) and all subscale scores except the sexual satisfaction rate were significantly higher in morbidly obese female patients than in the control group. There was no correlation found between the BMI and sexual function in the analyses conducted. Conclusion: In our study, morbidly obese female patients were found to show more impairments in all areas of sexual functions except sexual satisfaction rate when compared to the control group. Previous studies have suggested that obesity is the cause of sexual dysfunction in men; however, the same relationship could not be demonstrated in women. In a limited study of female patients, conflicting results were attributed to the inability to control variables. The fact that variables such as depression, anxiety, and chronic physical illness, which may affect sexual function, had been assessed in our study is important for accurately interpreting the findings. The data in our study reveals the importance of investigating sexual functions in morbidly obese female patients. Keywords: Arizona Sexual Experiences Scale, morbid obesity, sexual dysfunctions ÖZET Morbid obez kadın hastalarda vücut kitle indeksinin cinsel işlevler üzerine etkisiAmaç: Bu çalışmanın amacı morbid obez kadın hastalarda cinsel işlev bozukluğu olup olmadığının araştırılması ve vücut kitle indeksinin (VKİ) cinsel işlevler üzerine etkisinin incelenmesidir. Yöntem: Bu çalışmaya İnönü Üniversitesi Tıp Fakültesi Endokrinoloji Bilim Dalı'na başvuran ve VKİ'si en az 40 olan 72 kadın morbid obezite hastası ve bu hastalarla yaş olarak eşleştirilmiş VKİ'si 30'un altında olan 28 sağlıklı kadın dâhil edilmiştir. Cinsel işlevleri etkileyebildiği bilindiğinden hasta ve kontrol grubu bir psikiyatri uzmanı tarafından değerlendirilerek DSM 5'e göre bir psikiyatrik hastalığı olanlar, cinsel işlevleri etkileyebile...

Malignant thyroid lesions are the most common malignancy of the endocrine glands with increasing rates in the last two decades. Papillary thyroid cancer is the most common thyroid malignancy. In our study, we aimed to quantitatively evaluate the levels of DNA repair proteins MSH2, MLH1, MGMT, which are representative blocks of patients diagnosed with papillary carcinoma, chronic thyroiditis, or colloidal goiter. Total or subtotal thyroidectomy material of 90 patients diagnosed with papillary carcinoma, nodular colloidal goiter, or chronic thyroiditis between 2009 and 2012 were retrospectively evaluated. Tissue samples obtained from paraffin blocks were stained with MGMT, MSH2, MLH1 proteins and their immunohistochemistry was evaluated. Prepared sections were examined qualitatively by an impartial pathologist and a clinician, taking into account the staining method under the trinocular light microscope. Although there was no statistically significant difference in MGMT, MSH2, MLH1, follicular cell positivity, staining intensity, and immunoreactivity values, papillary carcinoma cases showed a higher rate of follicular cell positivity, and this difference was more pronounced between papillary carcinoma and colloidal goiter. In the MSH2 follicular cell positivity evaluation, the difference between chronic thyroiditis and colloidal goiter was significant (p = 0.023). The difference between chronic thyroiditis and colloidal goiter was significant in the MSH2 staining intensity evaluation (p = 0.001). The difference between chronic thyroiditis and colloidal goiter was significant in MLH1 immunoreactivity evaluation (p = 0.012). Papillary carcinoma cases were demonstrated by nuclear staining only for MSH2 and MLH1 proteins as opposed to hyperplastic nodules. The higher levels of expression of DNA repair genes in malignant tumors compared to benign tumors are attributed to the functional activation of DNA repair genes. Further studies are needed for DNA repair proteins to be a potential test in the development and progression of thyroid cancer.

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as an electronic poster (EP703). However, we expanded the statistical analysis before the preparation of article.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 diabetes mellitus (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 and male 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.Amaç: Eşlik eden prediyabetin 25(OH)D3 eksikliği üzerindeki etkisi az bilinmektedir. Bariyatrik cerrahi bekleme listesindeki obez hastalarda, 25(OH)D3 eksikliğinin prevalansı ve prediktörlerini araştırmayı amaçladık. Gereç ve Yöntemler: Diabetes mellitus (DM) ve hipertansiyon gibi bilinen kronik hastalıkları olmayan 199 hasta dâhil edildi. Antropometrik, biyokimyasal ve hormonal [açlık insülin, C-peptid, 25(OH)D3] parametreler analiz edildi. İnsülin direnci, "homeostasis model assessment of IR (HOMA-IR)" ile hesaplandı. HOMA-IR≥2,5 olan hastalarda insülin direnci [insulin resistance (IR)] varlığı kabul edildi. Hastalar beden kitle indeksi (BKİ), açlık kan şekeri, HOMA-IR, hemoglobin A1c (HbA1c) ve 25(OH)D3 düzeyine göre gruplandırıldı. Bulgular: HbA1c düzeyine gö...