No abstract

Vaspin, a recently identified adipokine, is a visceral adipose tissue-derived serine protease inhibitor that may have insulin sensitizing effect on adipose tissue. Herein, we measured vaspin level in patients with different stages of diabetic nephropathy (DNP), and investigated the correlation of the vaspin level with other inflammatory parameters. 106 adult type 2 diabetic patients with no known chronic inflammatory disease were included and grouped according to the stage of DNP: Albuminuria <30 mg/day and estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73m 2 (Group-1); albuminuria 30-300 mg/day and eGFR >60 mL/min/1.73m 2 (Group-2); albuminuria >300 mL/min and eGFR <60 mL/min/1.73m 2 (Group-3). Demographic, clinical and laboratory data were recorded as well as vaspin, high sensitivity C-reactive protein (hsCRP), interleukin (IL)-1 and tumor necrosis factor (TNF)-a levels. There were 38, 35 and 33 patients in Group 1, 2 and 3, respectively. Groups were similar regarding age and gender. Vaspin level did not differ between groups. When all the groups were considered, vaspin was positively correlated with IL-6 level (r ¼ 0.215, p ¼ 0.041). No correlation of vaspin was found with IL-1, TNF-a and hsCRP levels (p ¼ 0.580, r ¼ 0.054; p ¼ 0.463, r ¼ 0.072; p ¼ 0.812, r ¼ 0.025, respectively). Vaspin levels of the patients with GFR !60 mL/min/1.73m 2 was less than that of patients with GFR <60 mL/min/ 1.73m 2 (p ¼ 0.03). Age and IL-6 were found to be the major determinants of vaspin level with linear regression analysis. In patients with DNP, vaspin level does not change within the early stages of DNP; while it is higher in patients with decreased GFR, which may be related with increasing inflammation regardless of the stage of the kidney disease.ARTICLE HISTORY

Amaç: Diyabet toplumun önemli bir kısmını etkileyen ve özellikle komplikasyonlarıyla önemli bir morbidite-mortalite sebebi olan bir hastalıktır. Çalışmamızda diyabetik hastaların takipleri sırasında istenecek MPV ve hsCRP gibi tetkiklerin aslında komplikasyon gelişimi hakkında bizleri uyarıcı parametreler olarak değerlendirilebileceğine dikkat çekmek istedik. Yöntemler: Haseki Eğitim ve Araştırma Hastanesi Diyabet polikliniğinde 2005-2009 yılları arasında takip edilen 139 hasta çalışmaya dahil edildi. Bu hastalar mikrovasküler komplikasyonu olan (olgu) ve olmayan (kontrol) olarak iki gruba ayrıldı. Hastaların kreatinin, Hba1c, hemogram, hsCRP, albümin, trigliserit ve total-hdlldl kolesterol düzeyleri çalışıldı. Yaş, diyabet yaşı, vücut kitle indeksi ve bel çevreleri değerlendirildi. Hastaları gruplarken dikkate alınan mikrovasküler komplikasyona dair bilgilerine (göz dibi incelemesi-24 saatlik idrar tetkiki) dosyaları incelenerek ulaşıldı. Bulgular: Olgu grubu 49 kadın 34 erkek olmak üzere 83 kişiydi. Kontrol grubu ise 32 kadın 24 erkek 56 kişiydi. Olgu grubunun yaş, diyabet süresi, hemoglobin, hematokrit, kreatinin ve HbA1c değerleri kontrol grubuna göre anlamlı derecede yüksekti. Ayrıca olgu grubunun albümin değeri de kontrol grubuna kıyasla Abs tract Aim: Diabetes is an important cause of mortality and morbidity affecting especially individuals with its complications. We aimed to draw attention to the fact that MPV and hsCRP can be evaluated as warning parameters in terms of development of the complications of diabetes. Methods: 139 patients who were followed up in the diabetes outpatient clinics in Haseki Training and Research Hospital between years 2005-2009 were included in this study. The study group consisted of 83 patients (49 females, 34 males) with microvascular complications. The control group was composed of 56 patients (32 females, 24 males) without microvascular complications. The levels of creatinine, HbA1c, hemogram, hsCRP, albumin, triglyceride and total-HDL-LDL cholesterol were measured in all patients. Age, diabetes age, body mass index and waist circumference were also evaluated. Information about microvascular complications (fundoscopic examination or 24-hour urine investigation) was obtained from the patient files. Results: Age, age of onset of diabetes, hemoglobin, hematocrit, creatinine and HbA1c values in the study group were significantly higher compared to that in the control group. In addition, the albumin values in the study group were lower than in the control group.

Introduction: To evaluate whether normalisation of serum thyroid-stimulating hormonelevels with levothyroxine is related with metabolic parameters and psychologic wellbeing. Method: The observational, case-control study was conducted from to May to July 2019 in the outpatient thyroid clinics of Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey, and compried hypothyroid patients in the euthyroid state with levothyroxine treatment and euthyroid controls. Psychological wellbeing was assessed using the General Health Questionnaire-12, and metabolic parameters with lipid levels and body composition were analysed for both the groups. Data was analysed using SPSS 25. Results: Of the 159 subjects, 110(69%) were case with a mean age of 50.1±11.7 years, and 49(31%) were controls with a mean age of 47.3±15.2 years. There was no significant difference related to thyroid-stimulating hormonel levels between the groups (p=0.191). Free throxine levels were significantly higher in the cases, while free triiodothyroinine levels were higher in the controls (p<0.001). Total cholesterol and triglycerides levels were significantly higher in the cases than the controls (p<0.05). The cases had lower basal metabolic rate and fat free mass than the controls, but the difference was not significant (p>0.05). The cases scored higher in terms of wellbeing than the controls, but the difference was not significant (p>0.05). Conclusion: Thyroid hormone replacement needs to be adjusted to provide a satisfactory treatment for hypothyroid patients with normal thyroid-stimulating hormone levels who remain clinically and biochemically asymptomatic. In symptomatic patients, peripheral parameters of hypothyroidism, such as lipid levels, ---Continue

Soluble TNF-like weak inducer of apoptosis (sTWEAK) is a member of the TNF super family with many biological activities. There is a limited number of studies on the role of sTWEAK in chronic kidney disease. We aimed in this study to examine the relation of sTWEAK with albuminuria and inflammatory markers in patients with type 2 diabetes mellitus (DM). One hundred and eighteen diabetic patients with varying levels of albuminuria were included. Group 1 comprised patients with albuminuria less than 30 mg/day, while Group 2 and Group 3 were composed of patients with albuminuria between 30–300 mg/day or more than 300 mg/day, respectively. Groups were compared for sTWEAK levels besides demographic, clinical and biochemical data. There was no difference between groups regarding sTWEAK and TNF-α levels. IL-1 levels in Group 1 were higher than in Group 3. hsCRP levels were significantly higher in Group 3 compared to other groups. Use of a renin angiotensin system blocker did not have any effect on sTWEAK, TNF-α and hsCRP levels, while IL-1 level was significantly lower in patients using a renin angiotensin blocker. A statistically significant positive correlation was detected between sTWEAK and IL-1 levels (r=0.245; p=0.008). The groups were found to be similar regarding sTWEAK and TNF-α level. This finding may be interpreted as there being no effect of proteinuria on sTWEAK levels. But the close correlation between proteinuria and IL-1, and between IL-1 and sTWEAK may be a clue for an indirect relationship. Lack of difference between groups regarding sTWEAK levels may be due to involvement of patients with GFR more than 60 ml/minute only.