We aimed to evaluate sarcopenia and sarcopenic obesity (SO) in patients with type 2 diabetes mellitus (T2DM), possible relationships with serum irisin and myostatin levels, and the effect of glycemic control on SO. Ninety T2DM patients were included in this a cross-sectional study. Sarcopenia was determined by evaluating muscle mass (bioelectrical impedance analysis), muscle strength (HGS), and gait speed (GS). Patients with muscle mass loss with functionally reduced muscle strength and/or performance were considered sarcopenic. In addition, participants were divided into 3 groups according to the FM (fat mass)/FFM (fat-free mass) ratio [group 1:5th-50th percentiles; group 2:50th-95th percentiles and group 3: ≥95 percentiles (sarcopenic obese)]. Irisin, myostatin levels and metabolic parameters were measured in all patients. The prevalence of sarcopenia and SO was 25.6% and 35.6%, respectively. Irisin levels were lower in sarcopenic patients, while glycosylated hemoglobin (A1c), body mass index (BMI), FM, and FM index were higher ( P < .05). From group 1 to group 3, BMI, FM, FM index, GS, myostatin, and A1c increased, and muscle mass percentage, HGS, and irisin decreased ( P < .05). A positive correlation was found between FM/FFM and myostatin and a negative correlation between FM/FFM and irisin (r = 0.303, P = .004 vs. r = −0.491, P < .001). Irisin remained an important predictor of SO, even after adjusting for confounding variables (OR:1.105; 95% CI:0.965–1.338, P = .002). The optimal cut-off value for irisin to predict SO was 9.49 ng/mL (specificity = 78.1%, sensitivity = 75.8%). In addition, A1c was an independent risk factor for SO development (OR:1.358, P = .055). This study showed that low irisin levels (<9.49ng/mL) and poor glycemic control in T2DM patients were an independent risk factor, especially for SO.

Background Hematological parameters like red cell distribution width (RDW) and mean platelet volume (MPV) were reported to be associated with inflammation, atherosclerosis, and chronic kidney disease (CKD) progression. In this study, we evaluated RDW and MPV along with clinical features in patients with advanced CKD. We also aimed to detect clues for causative relations concerning these parameters, renal function and comorbidities. Methods Stage 3-5 CKD patients (627 total) were included (mean age 63.1 years, 48.3% male). Patients with malignancies, cirrhosis, infections, severe anemia, and systemic inflammation were excluded. Patients were evaluated for clinical features and grouped for comparison using median RDW and MPV. Linear regression models were generated to predict potential influences on RDW and MPV. Results Mean estimated glomerular filtration rate (eGFR) was 27.3 mL/min/1.73m 2 . Mean Charlson Comorbidity Index (CCI) score was 5.83 ± 2.06. Patients with high RDW (n = 303) were older with higher CRP and CCI, they also had lower eGFR, hemoglobin, and albumin (P < 0.001 for all). Patients with low MPV (n = 311) had lower eGFR, and platelet counts (P = 0.015 and 0.017). eGFR was negatively correlated with RDW after adjusting for age, gender and comorbidities. In a further adjusted model RDW was associated with CRP, CCI, hemoglobin and albumin (P < 0.05 for all), not with eGFR. MPV was positively correlated with eGFR in our adjusted, and fully adjusted regression models (P = 0.003). Conclusion In this study, we found that high RDW is associated with comorbidity burden, anemia, and inflammatory status in patients with advanced CKD. Meanwhile, low MPV seems to be associated with worse renal function.

Gestational diabetes mellitus (GDM) is a condition that is very common during pregnancy and has negative consequences for both mother and fetus. Insulin resistance has been shown as an important cause in the pathogenesis of GDM and lowlevel inflammation is suggested to be one of the underlying causes of insulin resistance. We aimed to investigate whether the neutrophil-lymphocyte ratio (NLR), which is an indicator of systemic inflammation, is a predictor for GDM. A total of 228 pregnant women, including 128 GDM (patient group) and 100 healthy pregnant were included in the study. GDM was diagnosed with a 1-step approach between 24 and 28 weeks of pregnancy. We found a significant increase in NLR in the 1st and 3rd trimesters in the GDM group compared to healthy pregnant women, which supports that systemic inflammation starts in the early stages of pregnancy and continues throughout pregnancy. We also reported a positive correlation between NLR and fasting plasma glucose and body mass index in both trimesters. We showed that first trimester NLR independently predicted the development of GDM. Abbreviations: BMI = body mass index, CI = confidence interval, DM = diabetes mellitus, FPG = fasting plasma glucose, GDM = gestational diabetes mellitus, HDL = high-density lipoprotein, hsCRP = high-sensitivity C-reactive protein, LDL = lowdensity-lipoprotein, NLR = neutrophil-lymphocyte ratio, OR = odds ratio, PG = plasma glucose, PLR = platelet/lymphocyte rate, ROC = receiver operating characteristic, SPSS = Statistical Package for Social Sciences, T-C = total cholesterol, TG = triglyceride, Th = T helper.

Amaç: Sağlık hizmetlerinin etkinlik ve kalitesini değerlendirmede kullandığımız performans ölçümleri hizmetin iyileştirilmesini hedefler. Bu çalışmada Hatay Mustafa Kemal Üniversitesi Sağlık Uygulama ve Araştırma Hastanesi'nde yatarak ve ayaktan tedavi alan hastaların memnuniyet düzeylerinin araştırılması ve ilişkili olabilecek sosyodemografik, fiziki ve beşeri değişkenlerin incelenmesi amaçlanmıştır. Gereç veYöntem: Kesitsel nitelikteki çalışma Şubat-Mart 2015 döneminde yatan 105, ayaktan 101 hastada yapılmış, gruplara ayrı anket formları uygulanmıştır. Anketlerde hastaların sosyodemografik özellikleri ile hastanenin personel ve fiziki durumlarıyla ilgili memnuniyet soruları bulunmaktadır. Memnuniyet soruları 5'li likert tipinde olup, 1-5 arasında puanlandırılmıştır. Puanı 4 ve üzerinde olanlar memnun kabul edilmiştir. Analizlerde Mann Whitney-U ve Kruskall Wallis testleri kullanılmıştır.Bulgular: Ayaktan başvuran hastaların %56'sının kadın, %39,6'sının en fazla ilkokul mezunu olduğu, %51,5'inin şehir merkezinde yaşadığı, %87,1'inin sosyal güvencesinin olduğu ve %51,5'inin daha önce de hastaneye geldiği saptanmıştır. Ayaktan hastaların %87,6'sı sağlık personelinden, %82,5'i doktordan, %63,7'si de genel hastane durumundan memnundur. Yatarak tedavi gören hastaların %50,5'inin erkek, %57,2'sinin en fazla ilkokul mezunu olduğu, %43,8'inin ilçede yaşadığı, %81,9'unun sosyal güvencesinin olduğu ve %48,6'sının daha önce hastanemize geldiği saptanmıştır. Yatan hastaların %79'u hemşire, %78,1'i sağlık personeli, %73,8'i doktor, %64,8'i oda, %62'si genel hastane durumu, %49,0'u yemek durumundan memnundur. Çiftçi ve esnaflar, işçi ve memurlara göre, ilkokul ve altı mezun olanlar da ortaokul ve üstü mezunlara göre daha memnunlardır (p<0.05).Sonuç: Ayaktan ve yatarak tedavi gören hastaların genel olarak hastane sağlık hizmetlerinden memnun olduğu, ancak sağlık personeli memnuniyetinin genel hastane memnuniyetinden daha fazla olduğu saptanmıştır.

Introduction: Sarcopenia was determined to be associated with increased arterial stiffness in the nondialysis patient population, but there is no available data on this subject in dialysis patients.Methods: A total of 79 patients were included in the study. Sarcopenia was diagnosed according to the EWSGOP-2 criteria. Arterial stiffness was measured noninvasively with a mobile-O-Graph device.Results: Skeletal muscle mass was observed to be positively correlated with weight, body mass index, creatinine, and uric acid, while negatively correlated with augmentation index. There was a correlation between augmentation index and sodium, phosphorus, systolic blood pressure, diastolic blood pressure, cardiac index, muscle percentage, fat percentage, and skeletal muscle mass. When the determinants of augmentation index in the linear regression analysis were viewed, just the systolic blood pressure and skeletal muscle mass were observed to be the determinant. Conclusion: Decreased skeletal muscle mass contributes to increased arterial stiffness in hemodialysis patients.