Objective: In this study, we aimed to evaluate serum irisin and apelin levels in patients with subclinical hypothyroidism (SCH) when they were subclinical hypothyroid and become euthyroid after levothyroxine therapy and association of these adipokines with markers of atherosclerosis such as serum homocysteine levels and carotid intima-media thickness (IMT). Subjects and methods: The study included 160 patients with newly diagnosed subclinical hypothyroidism due to Hashimoto's thyroiditis and 86 euthyroid healty subjects. Serum glucose and lipid profile, insulin, HOMA, TSH, free T3, free T4, anti-thyroperoxidase and anti-thyroglobulin antibodies, homocysteine, apelin and irisin levels were measured in all study subjects. Thyroid and carotid ultrasound examinations were performed. The subclinical hypothyroid group was reevaluated after 12-weeks of levothyroxine therapy when they became euthyroid. Results: Clinical characteristics of the patient and control group were similar. Glucose, insulin and HOMA levels, lipid parameters and free T3 were similar between the two groups.. Serum homocystein was higher and apelin was lower in patients with SCH, but irisin levels were similar between the two groups. While thyroid volume was lower, carotid IMT was significantly greater in patients with SCH (pCarotidIMT:0,01). After 12-weeks of levothyroxine therapy, all the studied parameters remained unchanged except, serum freeT4, TSH, homocystein and apelin. While homocystein decreased (p: 0,001), apelin increased significantly (p = 0,049). In multivariate analysis, low apelin levels significantly contributed to carotid IMT (p = 0,041). Conclusions: Apelin-APJ system may play a role in vascular and cardiac dysfunction in patients with SCH and treatment of this condition may improve the risk of cardiovascular disease.

BackgroundIn order to apply the right treatment for hemostatic disorders in pediatric patients, laboratory data should be interpreted with age-appropriate reference ranges.ObjectivesThe purpose of this study was to determining age-dependent reference range values for prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen tests, and D-dimer tests.Materials and MethodsA total of 320 volunteers were included in the study with the following ages: 1 month - 1 year (n = 52), 2 - 5 years (n = 50), 6 - 10 years (n = 48), 11 - 17 years (n = 38), and 18 - 65 years (n = 132). Each volunteer completed a survey to exclude hemostatic system disorder. Using a nonparametric method, the lower and upper limits, including 95% distribution and 90% confidence intervals, were calculated.ResultsNo statistically significant differences were found between PT and aPTT values in the groups consisting of children. Thus, the reference ranges were separated into child and adult age groups. PT and aPTT values were significantly higher in the children than in the adults. Fibrinogen values in the 6 - 10 age group and the adult age group were significantly higher than in the other groups. D-dimer levels were significantly lower in those aged 2 - 17; thus, a separate reference range was established.ConclusionsThese results support other findings related to developmental hemostasis, confirming that adult and pediatric age groups should be evaluated using different reference ranges.

Objective: Although anemia is frequently seen in children, there isn't adequate number of study related with this issue. In this study, we aimed to investigate iron, folate and vitamin B12 status in children and adolescents in a single center in the Aegean region of our country. Method: We retrospectively evaluated the children without chronic disease who were admitted to our hospital between 2008-2016 (n=7310). Ferritin, iron and iron binding capacity were measured by Olympus 2700 analyzer. Folate and vitamin B12 were measured using Immulite 2000 and Cobas E411 analyzer, respectively. MCV and hemoglobin were measured with Beckman Coulter LH750. Kruskal-Wallis and Mann-Whitney U tests were used for comparison between groups. Results: Children (2743 boys, and 4567 girls) aged between 1-18 years old were screened. The percentage of iron, folate, vitamin B12 and combined iron and vitamin B12 deficiencies were found to be 21.7%, 8%, 16.9%, and 4.7% respectively, while 18.8% of all children were in the anemic group. The incidence of combined iron and vitamin B12 in anemic group was found to be high (10.2%), although anemic and nonanemic groups were similar with respect to vitamin B12 and folate deficiencies. Conclusion: Iron deficiency may mask the megaloblastic anemia caused by vitamin B12 and folate deficiency. Effective preventive social nutrition programs may be useful in preventing anemia.

Objectives: We aimed to investigate serum neudesin levels that has neural, metabolic functions in patients with polycystic ovary syndrome (PCOS). Material and methods:The study included 180 women (age range, 18-44 years) with a diagnosis of PCOS and a control group that included 100 healthy females (age range, 18-46 years). Body mass index (BMI), waist circumference, Ferriman-Gallwey score, was evaluated and plasma glucose, lipid profile, estradiol, progesterone, total testosterone, prolactin, insulin, dehydroepiandrosterone sulfate (DHEA-S), FSH, LH, free T3, free T4, thyroid stymulating hormone (TSH), anti-thyroperoxidase (anti-TPO) antibody and neudesin levels were evaluated in all participants.Results: BMI and waist circumference were similar between two groups. Ferriman-Gallwey score was significantly higher in the patient group. Fasting blood glucose, HbA1C, lipid parameters except triglyceride levels, free T3, free T4, TSH, anti-TPO were similar between the two groups. Triglyceride, insulin and HOMA values were significantly higher in PCOS patients. While follicle-stimulating hormone (FSH), estradiol, progesterone, prolactin and DHEAS levels were similar, LH was significantly higher in patients with PCOS. Serum neudesin level was significantly lower in PCOS patients with respect to controls (p = 0.015).Neudesin was positively correlated with insulin (r = 0.224, p = 0.037), and progesterone (r = 0.716, p = 0.001). Multiple regression analysis revealed that neudesin correlated with only progesterone (beta = 0.308, p = 0.001). Conclusions:Due to the association of decreased levels of neudesin with PCOS and correlation of neudesin with progesterone, neudesin may be related with one of patophysiologic pathways of PCOS. Still, it is not certain that decreased neudesin is involved in the pathogenesis of PCOS or is the result of the disorder.

Digoxin is monitored because of its narrow range of therapeutic doses and risk of toxicity. Thus, we aimed to evaluate the effect of different blood collection tubes on digoxin levels and its stability. Methods: Samples from 30 volunteers who received digoxin therapy were collected in 5 different tubes: no additive and gel-free glass tube (Z-tube) (reference tube), clot-activator tubes containing gel (Vacusera), clot-activator tubes containing gel (serum separator tube), barrier-free lithium heparinized tube (LiH), and new lithium heparinized tube with a barrier (Barricor). Digoxin levels in tubes were analyzed at 0 and 48 hours (h). Results: No statistical difference was found between 0 and 48 h results in other tubes, except for LiH, and the difference in LiH was also not clinically significant. Digoxin levels in other tubes were not statistically different according to the reference tube, except for Barricor. The digoxin level in Barricor was clinically significantly higher than that in the reference tube. Although a strong correlation was found in the digoxin level between Barricor and Z-tubes, a proportional increase in digoxin level in Barricor was determined. Conclusion: The digoxin levels in the tubes may be used interchangeably, except for Barricor. The reliability and accuracy of digoxin levels may be increased by the identification of a new therapeutic range for Barricor.