[Purpose] Physical activity and regular exercise play an important role in glycemic control, which is considered an important part of the treatment of type 2 diabetes mellitus. This study evaluated physical activity level and its relationship with quality of life in patients with type 2 diabetes mellitus. [Subjects and Methods] We evaluated 129 subjects with type 2 diabetes mellitus through a face-to-face interview using the short version of the International Physical Activity Questionnaire and Diabetes-39. Demographic data, diabetes symptoms, time of initial diagnosis, and treatment procedure/approaches were recorded. [Results] Of the study subjects, 51 (39.5%) had low, 67 had moderate (51.9%), and 11 (8.5%) had high activity levels. The mean weekly sitting duration was 302 minutes. The mean weekly walking time was 231.7 minutes. Except for the “diabetes control” domain, scores for all the subgroups and the total score in the quality-of-life assessment had a statistically significant negative correlation with physical activity level. [Discussion] Physical inactivity negatively affects the quality of life of diabetic patients. A planned exercise education program and incorporation of exercise into the lifestyle can improve the quality of life of patients with type 2 diabetes mellitus.

IntroductionDiabetes mellitus (DM), the most common endocrine disorder globally, is increasingly prevalent. It causes serious medical and socioeconomic problems due to its microvascular and macrovascular complications. It is common knowledge that diabetes is an independent risk factor for atherosclerotic heart disease (1). Thus, early detection of atherosclerotic complications in diabetes is vital to decreasing morbidity and mortality.Osteoprotegerin (OPG) is a glycoprotein and a member of the tumor necrosis factor receptor family initially found in the bone. Its main function is to inhibit both the differentiation and action of osteoclasts by binding and neutralizing the receptor activator for NF-kB ligand (RANKL), which is known to have osteoclast-inducing activity (2). Recent studies showed that increased OPG levels were an independent risk factor for atherosclerosis and cardiovascular diseases, and suggested that this cytokine could be used as a marker of coronary artery disease (3).Ankle-brachial index (ABI) is the ratio of ankle systolic blood pressure to arm systolic blood pressure. ABI measurement is a noninvasive indicator of peripheral artery disease and atherosclerosis and is independent of symptom presence. Various studies have shown that low ABI (≤0.9) is related to increased mortality, coronary heart disease, congestive heart failure, stroke, and dementia (4-13).In our study, we investigated the availability of OPG as a marker of atherosclerosis by comparing serum OPG levels with ABI in type 1 and type 2 diabetic patients with no macrovascular complications. Materials and methodsThis was a cross-sectional study. We recruited 31 type 1 DM and 31 type 2 DM patients without any macrovascular complications from our diabetes outpatient clinic, and 20 healthy consecutive patients, who did not have any chronical diseases and were not on any medications for Background/aim: The aim of this study was to investigate the availability of osteoprotegerin (OPG) as a marker of atherosclerosis and compare serum OPG levels with ankle-brachial index (ABI) in diabetic patients. Materials and methods:A total of 31 type 1 and 31 type 2 diabetic patients without macrovascular complications and 20 healthy volunteers were included. Serum OPG levels and ABI were measured. Results:The duration of diabetes was significantly higher in type 1 diabetics than in type 2, although there was no significant difference between mean HbA1c levels. There was a weak and inverse correlation between OPG and atherosclerosis in type 1 diabetics only (P = 0.046, r = -0.360). There was a weak, positive correlation between ABI and HbA1c in all participant groups (P = 0.047, r = 0.220), and a weak-medium correlation in type 2 diabetics (P = 0.021, r = 0.414). After the adjustment of OPG levels to atherosclerosis risk factors, only the age factor was found to be effective on OPG. Conclusion:The inverse correlation of serum OPG with atherosclerosis in type 1 diabetics suggests that atherosclerosis may be related to increased duration of diabetes. Si...

ÖZETAmaç: Obezite oranları tüm dünyada artmakta ve epidemi boyutlarına ulaşmaktadır. Komplikasyonlar ve ilgili hastalıklar gözönüne alındığında önemli bir morbidite ve mortalite nedenidir. Tiroid patolojileri de büyüyen bir endokrin problemdir ve toplumumuzda, özellikle genç kadınlardaki insidans artışı dikkat çekicidir ve sıklıkla obezite ve diğer endokrin problemler de eşlik etmektedir. Bu çalışmada, obez hastalarda tiroid fonksiyon parametrelerinin değerlendirilmesi ve aradaki ilişkinin ortaya konması amaçlanmıştır.Yöntemler: Ocak 2012-Mart 2013 tarihleri arasında İstanbul Eğitim ve Araştırma Hastanesi obezite polikliniğine başvuran toplam 180 hasta çalışmaya dahil edildi. Hasta dosyaları taranarak özgeçmişleri, yaş, cinsiyet, vücut kitle indeksleri(VKİ) ve serbest T3 (fT3), serbest T4 (fT4), tiroid stimülan hormon (TSH), anti-tiroglobulin antikor (anti-TG) ve anti-tiroid peroksidaz antikor (anti-TPO) parametreleri ve tiroid ultrasonografileri kaydedilerek değerlendirildi. Değerlendirme için SPSS istatistiksel analiz yöntemi kullanıldı. Sonuç: Obezite; bozulmuş tiroid fonksiyonlarıyla sıklıkla birliktelik gösteren hastalıklardan biridir. Özellikle hipotiroidi ve Hashimoto tiroiditi obez hastalarda sık görülmektedir. Çalışmamızda obezlerde %21,57 gibi yüksek bir oranda hipotiroidi ve subklinik hipotiroidi saptanması bu ilişkiyi desteklemektedir. Ayrıca ötiroidik hastalarda artmış sıklıkla tiroidit ve tiroid otoantikorları saptanması da dikkat çekicidir. Toplumumuzda, özellikle genç kadınlarda artan tiroid patolojisi ile obezite birlikteliği son derece dikkat çekicidir. İnsülin direnci, metabolik sendrom ve obezite bu hastalarda son derece yaygındır ve bunlar genelde kilo kaybına da direnç gösterir. Bozulmuş tiroid fonksiyonları nedeniyle yavaşlayan metabolizma hızı da bu duruma katkı sağlar. Bu nedenle hastalar hem obezite, hem tiroid patolojileri yönünden taranmalı, gerekli tedavi ve takiplerine ivedi olarak başlanmalıdır.( JAREM 2014; 2: 74-6) Anahtar Sözcükler: Obezite, tiroid fonksiyonları, vücut kitle indeksi ABSTRACT Objective: Obesity rates are increasing globally and it is becoming an epidemic. Considering the complications and diseases related to obesity, it is a cause of significant morbidity and mortality. Thyroid pathologies is a growing endocrine problem, too and especially in young women in our society its growing incidence is remarkable and it is usually accompanied by obesity and other endocrine problems. In this study, we aimed to evaluate the parameters of thyroid function in obese patients and establish the relationship. Methods:The study included 180 patients who were admitted to the obesity outpatient clinic of Istanbul Education and Research Hospital between January 2012-and March 2013. The medical histories, age, sex, body mass index (BMI), free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), anti-thyroglobulin antibody (anti-TG) and anti-tiroid peroxidase antibody (anti-TPO) levels and thyroid ultrasonographies of the patients were all screened from patient files and were...

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Konstriktif perikardit, perikardın elastikiyetinin azalması ve/veya kalınlaşması sonucu myokardı komprese ederek ventriküllerin diastolik doluşunu azaltan bir perikard hastalığıdır. Perikarttaki inflamatuar proçesin sonucu olarak oluşur. Perikartta fibroziz sıklıkla kalsifikasyon ve parietal-viseral perikard yapraklarında adezyon görülür. Konstriktif perikarditte artan venöz basınç inferiyor vena kava ve hepatik venlerde basıncı arttırarak karaciğeri etkiler. Konstriktif perikardite bağlı karaciğer yetmezliğinde hepatomegali, anormal karaciğer fonksiyon testleri, asit ve ödem görülebilir. On yedi yaşında erkek hasta nefes darlığı, karında şişlik yakınmaları ile başvurdu. Muayenesinde TA: 120/80 mmHg, n: 84/dak. ritmik, sağ hemitoraksta orta zondan itibaren solunum sesleri alınamıyordu ve bu alanlarda matite tespit edildi. Batında göbek hizasından itibaren açıklığı yukarı bakan yer değiştiren matitesi vardı. Karaciğer 3 cm kadar künt kenarlı olarak palpe edildi. Her iki alt ekstremitede uyluktan itibaren yaygın varisleri vardı. Hasta konstriktif perikardit ve buna bağlı plörezi, asit, vena kava inferior kompresyonu ve bunun sonucunda gelişen alt ekstremite varisleri, varikosel tanılarıyla perikardiyektomi için kalp cerrahisi ünitesine sevk edildi.