OBJECTIVE:This study was performed to evaluate the effects of metabolic parameters and thyroid dysfunction on the development of non-alcoholic fatty liver disease (NAFLD).METHODS:The current study evaluated a total of 115 patients, 75 female and 40 male. Physical examination and anthropometric measurements were applied to all participants. Hypothyroidism was considered at a thyroid stimulating hormone level ≥ 4.1 mIU/L. Patients with euthyroidism and patients with hypothyroidism were compared. Abdominal ultrasonography was used to diagnose non-alcoholic fatty liver disease. The participants were further compared with regard to the presence of non-alcoholic fatty liver disease. Logistic regression modeling was performed to identify the relationship between non-alcoholic fatty liver disease and independent variables, such as metabolic parameters and insulin resistance.RESULTS:Non-alcoholic fatty liver disease was identified in 69 patients. The mean waist circumference, body mass index, fasting plasma insulin, HOMA-IR (p<0.001) and FT3/FT4 ratio (p=0.01) values were significantly higher in the patients with NAFLD compared to those without it. Multivariate regression analysis revealed that FT3/FT4 ratio, waist circumference and insulin resistance were independent risk factors for non-alcoholic fatty liver disease.CONCLUSION:Insulin resistance, enlarged waist circumference, elevated body mass index, higher FT3/FT4 ratio and hypertriglyceridemia are independent risk factors for NADLF, whereas hypothyroidism is not directly related to the condition.
Background Factors causing progression from nonalcoholic fatty liver to nonalcoholic steatohepatitis (NASH) and liver cirrhosis remain relatively unknown. We aimed to evaluate the power and effectiveness of the free triiodothyronine (FT3)-to-free thyroxine (FT4) ratio to predict non-alcoholic fatty liver disease (NAFLD)/liver fibrosis and NASH cirrhosis severity. Methods Patients (n = 436) with NASH-associated liver cirrhosis (n = 68), patients with liver biopsy-proven NAFLD (n = 226), or healthy participants (n = 142) were enrolled between January 2010 and January 2020. The aspartate aminotransferase-to-thrombocyte ratio (APRI), NAFLD fibrosis score, albumin–bilirubin score (ALBI), aspartate aminotransferase (AST)-to-alanine aminotransferase (ALT) ratio, FT3-to-FT4 ratio, and Fibrosis-4 (FIB-4) were calculated and evaluated. Results All parameters were significantly higher in NASH cirrhosis than in the healthy group. Body mass index, ALT, fasting insulin, homeostatic model assessment for insulin resistance, and triglyceride levels were significantly higher in liver biopsy-proven NAFLD than in the healthy group. The APRI, NAFLD fibrosis score, ALBI, AST-to-ALT ratio, FT3-to-FT4 ratio, and FIB-4 were significantly higher in the NASH cirrhosis group than in the healthy group. In patients with biopsy-proven NAFLD, the FT3-to-FT4 ratio was significantly lower than in the healthy group. Conclusion The FT3-to-FT4 ratio is an effective and useful indicator to predict NAFLD/liver fibrosis and NASH cirrhosis severity.
Background: This study is performed to evaluate vitamin D levels and metabolic parameters in patients with prediabetes, compared to healthy controls.Methods: This study was conducted between October and December 2013 in İstanbul Haseki Training and Research Hospital, internal medicine department. We enrolled total 247 individuals, 122 prediabetic (PreDM) patients (79 female, 43 male) and 125 control healthy individuals (94 female, 31 male) between 20-65 ages who admitted randomizely to the outpatient clinic with non spesific complaints. FPG, urea, creatinine, calcium, phosphate, albumin, alkaline phosphatase, thyriod stimulan hormon (TSH), 25 hydroxy vitamin D (25[OH]D), parathormon (PTH), c-peptide, insulin were analyzed.Results: Pre DM patients’ mean plasma 25[OH]D level (25.7±14.9 nmol/l) was statistically lower than the control group (31.4±17.8 nmol/l). Pre DM patients’ mean plasma insulin, c-peptide, calcium, PTH, HOMA-IR (10.8±8.7 IU/ml, 3.3±2.0 ng/ml, 9.7±0.4 mg/dl, 56.5±22.5 pg/ml, 3.0±2.68, respectively) levels were statistically higher than the control group’s (6.3±3.8 IU/ml, 2.4±1.0 ng/ml, 9.5±0.5 mg/dl, 44.0±16.0 pg/ml, 1.4±0.8, respectively) mean levels. There were negative correlations between 25[OH]D and BMI (r:- 0.13, p:0.03), FBG (r:- 0.14, p:0.02) and plasma insulin (r:-0.16, p:0.01) values. A multivariate logisitic regression model for prediabetes was performed and variables as female gender, age, HOMA-IR and lower 25[OH]D values were risk factors for pre DM.Conclusions: Serum low 25[OH]D level correlated with insulin resistance and metabolic parameters in prediabetic patients. Also, it may play an important role in the development of type 2 diabetes.
ÖzAmaç: Gestasyonel diabetes mellitus (GDM) postpartum dönemde tip 2 DM gelişimi ve metabolik disfonksiyon için yüksek risk faktörüdür. Bu sebeple biz gestasyonel diyabetik hastaların postpartum dönemde metabolik parametrelerini değerlendirdik.Yöntemler: 2011-2014 yılları arasında, Haseki Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Polikliniği'nde 24. gebelik haftasında açlık ve tokluk plazma kan glikozu yüksek tespit edilerek oral glikoz tolerans testi uygulanıp, GDM tanısı konularak endokrinoloji polikliniğine yönlendirilmiş olan 40 hasta 05 Mart 2014 tarih ve karar no: 91 sayılı etik kurul onayı alınarak postpartum dönemde çalışmaya alındı. Hastalar altıncı aydan başlayarak kontrole çağırıldı ve boy, kilo, beden kitle indeksi (BKİ), ölçümsel parametreleri değerlendirildi. Ek olarak, hemoglobin A1c (HbA1c), açlık kan glikozu, tokluk kan glikozu, insülin, lipid profili, üre, kreatinin, spot idrarda protein/kreatinin parametrelerine bakıldı. Bulgular: Takip edilen periyotta yedi hastada postpartum DM gelişti (%17,5). Postpartum diyabetik hastalarda ortalama açlık kan glikoz düzeyi ve HbA1c değerleri anlamlı olarak yüksek bulundu (p=0,001; p=0,005). Ortalama BKİ, bel çevresi, trigliserid düzeyleri iki grup arasında benzer bulundu (p=0,521, p=0,607, p=0,240).Sonuç: Gestasyonel diyabetik hastalarda gebelik sonrası DM gelişimi açısından kesin bir bulguya rastlanmadı. Ancak GDM, postpartum DM gelişimi için risk faktörüdür.Anahtar Sözcükler: Diabetes mellitus, gestasyonel diabetes mellitus, metabolik parametreler Aim: Gestational diabetes mellitus (GDM) is associated with an increased risk for type 2 DM and metabolic dysfunction after pregnancy. Therefore, we aimed to evaluate the metabolic parameters in women with a history of GDM Methods: In this study, we included a total of 40 patients with high fasting and postprandial glucose levels and abnormal oral glucose tolerance test at 22-28 weeks of pregnancy who attended the endocrinology outpatient clinic between 2011 and 2014. We evaluated the metabolic parameters, weight, height and body mass index (BMI) at six months postpartum. In addition, fasting and postprandial glucose, insulin, hemoglobin A1c (HbA1c), urea, and creatinine levels, spot urine protein-to-creatinine ratio, and lipid profile were analyzed.Results: Postpartum DM was detected in seven patients (17.5%) in the follow-up period. Mean fasting glucose level and HbA1c values were statistically significantly higher in subjects with postpartum diabetes (p=0.001, p=0.005, respectively). Mean BMI, waist circumference, and triglyceride levels were similar between those with and without postpartum diabetes (p=0. 521, p=0.607, p=0.240, respectively) Conclusion: In our study, there was no finding predicting postpartum DM in patients with GDM, however, GDM increases the risk of postpartum DM. Keywords GirişDiabetes mellitus (DM), çeşitli etiyolojik nedenlerle insülin hormonu sekresyonunun ve/veya insülin hormonu etkisinin eksikliği sonucu karbonhidrat, protein ve yağ metabolizmasında bozukluklara ...
Background: Familial mediterranean fever (FMF) is a disease frequently seen in some races and characterized by recurrent attacks affecting various organs with chronic inflammation. As a result of chronic inflammation, microvascular changes may occur. In this study, we aimed to investigate the association between pulmonary function tests and inflammatory markers in FMF patients.Methods: Seventy-five FMF patients followed up at the Department of Internal Medicine who did not have any comorbidity affecting lung functions and 64 healthy subjects were enrolled. Both groups underwent CO (carbon monoxide) diffusion analysis and pulmonary function tests. Inflammatory markers of the groups were recorded as well and compared with CO diffusion and pulmonary function tests.Results: FVC%, FEV1, FEV1%, FEV1/FVC, PEF, FEF25-75% values of the patient group was significantly lower than those in the control group. When compared, DLCO%, DLCO/VA, DLCO/VA% were also significantly lower than controls. There was a significant correlation between pulmonary function tests and ESR, hsCRP and fibrinogen levels.Conclusions: Inflammation in FMF patients may lead to damage on pulmonary tissue that causes an impairment in pulmonary functions.
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