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Background/aim: This study was performed to assess the diagnostic accuracy of shear wave elastography by virtual touch tissue imaging quantification in patients with diffuse thyroid gland pathology and to differentiate Graves' disease from Hashimoto's thyroiditis. Materials and methods: Thirty patients with Hashimoto's thyroiditis and 22 patients with Graves' disease were evaluated with conventional ultrasonography and shear wave elastography by virtual touch tissue imaging quantification. Thirty healthy participants formed the control group. Ten elastographic measurements of each thyroid lobe were performed in all three study groups. The mean shear wave velocity was calculated and compared between the patients and controls. Results: The mean shear wave velocity of the controls (1.92 ± 0.14 m/s) was significantly lower than that of the patients with Graves' disease (2.71 ± 0.22 m/s) and Hashimoto's thyroiditis (2.50 ± 0.20 m/s). Patients with Graves' disease had significantly higher shear wave velocities than those with Hashimoto's thyroiditis (P < 0.001). Conclusion: Shear wave elastography by virtual touch tissue imaging quantification can be used to discriminate a normal thyroid gland from diffuse thyroid gland pathology after conventional sonography and may assist in the diagnosis of Graves' disease and Hashimoto's thyroiditis.

BackgroundFamilial hypercholesterolemia (FH) is an autosomal dominant genetic disorder characterized by premature mortal cardiovascular complications. Liver transplantation (LT) is the only curative treatment option. In this study, the long‐term clinical follow‐up data of 8 patients who underwent LT with a diagnosis of FH in our center are presented.Materials and MethodsA total of 638 LT were performed between December 1985 and June 2019 at Baskent University, of which 8 patients underwent LT with a diagnosis of FH and were evaluated retrospectively.ResultsOf the 8 patients, 4 underwent deceased donor and 4 living donor transplantation. Five patients had preoperative cardiovascular disease and consequent interventional operations. There was significant reduction in postoperative LDL‐C and TC levels starting from the first week, and stabilizing at the first month and first year. The median survival time of patients was 5 years (2‐12 years). All patients are still alive. None of the complications of patients with preoperative cardiovascular complications had progressed.ConclusionLiver transplantation is the preferred curative treatment for the pathophysiology of FH. In our study, LDL‐C levels were brought under control with LT performed on patients with FH. Median 5‐year follow‐up of patients showed that the progression of cardiac complications was abated.

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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.

ÖzetAmaç: Çalışmanın amacı, metabolik sendrom (MetS) kriterleri içinde yer almayan fakat adipozite göstergesi kabul edilen parametrelerin, MetS'u olan ve olmayan kadınlar arasında farklılık gösterip göstermediğini ortaya koymak ve bu parametrelerin MetS'u u predikte eden kesim noktalarını saptamaktır. Gereç ve yöntem: Bilinen glikoz metabolizma bozukluğu olmayan 393 kadın birey (18-70 yaş) alındı. Bu bireylerden NCEP ATPIII kriterlerine göre MetS'u olan ve olmayanlar tespit edildikten sonra, tüm katılımcıların antropometrik ve vücut yağ dağılımı ölçümleri alındı ve laboratuar parametreleri çalışıldı. ROC eğrileri çizildi ve eğri altında kalan alanlar hesaplandı. Parametrelerin MetS'u predikte eden kesim noktaları ve bu kesim noktalarının duyarlılık ve özgüllük oranları belirlendi. Bulgular: Vücut kitle indeksi (VKİ), boyun çevresi, visseral yağ düzeyi, gövde yağ yüzdesi, HOMAIR indeksi ve insülin düzeyleri için eğri altında kalan alanların 0,7'nin üstünde olduğu; kalça çevresi, bel-kalça oranı, total yağ kitlesi, total yağ yüzdesi, LDL-K, düzeyi ve TSH düzeyi için eğri altında kalan alaların ise 0,7'nin altında olduğu saptanmıştır. VKİ için 27,7 kg/m2, boyun çevresi için 33,8 cm, bel çevresi için 91,5 cm, visseral yağ düzeyi için 10,8 birim, gövde yağ yüzdesi için %43,1, HOMAIR indeksi için 2,14 ve insülin düzeyi için 8,7 μU/mL değerlerinin, MetS'u predikte etmedeki duyarlılıkları %80 ve üstünde bulunmuştur. Sonuç: VKİ, boyun çevresi, visseral yağ düzeyi, gövde yağ yüzdesi, HOMAIR indeksi ve insülin düzeyleri MetS'u öngörmede değerli ölçütlerdir.

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Abstract. Vitamin B12 deficiency may have indirect cardiovascular effects in addition to hematological and neuropsychiatric symptoms. It was shown that the monocyte count-to-high density lipoprotein cholesterol (HDL-C) ratio (MHR) is a novel cardiovascular marker. In this study, the aim was to evaluate whether MHR was high in patients with vitamin B12 deficiency and its relationship with cardiometabolic risk factors. The study included 128 patients diagnosed with vitamin B12 deficiency and 93 healthy controls. Patients with vitamin B12 deficiency had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), MHR, C-reactive protein (CRP) and uric acid levels compared with the controls (median 139 vs 115 mmHg, p < 0.001; 80 vs 70 mmHg, p < 0.001; 14.2 vs 9.5, p < 0.001; 10.2 vs 4 mg/dl p < 0.001; 6.68 vs 4.8 mg/dl, p < 0.001 respectively). The prevalence of left ventricular hypertrophy was higher in vitamin B12 deficiency group (43.8%) than the control group (8.6%) (p < 0.001). In vitamin B12 deficiency group, a positive correlation was detected between MHR and SBP, CRP and uric acid (p < 0.001 r:0.34, p < 0.001 r:0.30, p < 0.001 r:0.5, respectively) and a significant negative correlation was detected between MHR and T-CHOL, LDL, HDL and B12 (p < 0.001 r: −0.39, p < 0.001 r: −0.34, p < 0.001 r: −0.57, p < 0.04 r: −0.17, respectively). MHR was high in vitamin B12 deficiency group, and correlated with the cardiometabolic risk factors in this group, which were SBP, CRP, uric acid and HDL. In conclusion, MRH, which can be easily calculated in clinical practice, can be a useful marker to assess cardiovascular risk in patients with vitamin B12 deficiency.