OBJECTIVE:To assess the relationship between low maternal serum 25-hydroxyvitamin D levels and gestational diabetes mellitus in Turkish pregnant women according to the severity of 25-hydroxyvitamin D deficiency and assess intact parathyroid hormone levels in women with gestational diabetes mellitus and controls with low and sufficient 25-hydroxyvitamin D levels.METHODS:We analyzed serum 25-hydroxyvitamin D and intact parathyroid hormone levels in 234 women with gestational diabetes mellitus and 168 controls. To define the deficiency status, 25-hydroxyvitamin D levels were further classified into severely deficient, deficient, insufficient and sufficient groups.RESULTS:Women with gestational diabetes mellitus had significantly lower 25-hydroxyvitamin D levels compared to controls (30.8±16.3 vs. 36.0±16.2 nmol/L). However, when subgroups of 25-hydroxyvitamin D were analyzed, gestational diabetes mellitus was significantly more common only in women with severely deficient 25-hydroxyvitamin D levels. After adjusting for covariates, only severely deficient 25-hydroxyvitamin D levels were independently associated with an increased relative risk of gestational diabetes mellitus. The relative risk of gestational diabetes mellitus in women with insufficient and deficient 25-hydroxyvitamin D levels was not statistically significant. Intact parathyroid hormone concentrations were also significantly higher in women with gestational diabetes mellitus compared to the controls (45.3±26.2 vs. 38.7±27.6 pg/ml).CONCLUSIONS:The results obtained from this study provide novel data indicating that only severely deficient maternal serum 25-hydroxyvitamin D levels are significantly associated with an elevated relative risk of gestational diabetes mellitus, even after adjusting for established risk factors of gestational diabetes mellitus.

AIm:To compare anterior pituitary functions between subjects with total and partial primary empty sella (PES) and to assess whether all cases with PES need endocrinological evaluation. mATERIAL and mETHods: Eighty-one subjects with PES (34 total and 47 partial) were included in the study. Basal anterior pituitary and its target hormones were assessed and those with low insulin like growth factor-1 and/or low basal cortisol levels underwent insulin tolerance test (ITT).REsuLTs: 67.4% of the subjects with total and 14.9% of those with partial PES had different degrees of hypopituitarism. However, the frequency of hypopituitarism was significantly higher in cases with total PES. The odds ratio (OR) and 95% confidence interval (CI) of secondary hypothyroidism, secondary adrenal, growth hormone and gonadotropin deficiency in subjects with total compared to those with partial PES were as follows: OR = 20.0, 95% CI 4.16 -95.9, OR = 2.4, 95% CI 1.34 -5.7, OR = 15.3, 95% CI 4.48 -52.6 and OR = 10.6, 95% CI 3.37 -33.5, respectively. CoNCLusIoN:A substantial number of subjects with PES, particularly those with total PES, have pituitary hormone deficiency, so regardless of the type of PES, all subjects must be promptly and carefully evaluated for anterior pituitary hormone deficiency.KEywoRds: Primary empty sella, Hypopituitarism, Clinical evaluation, MRI ÖZ AmAÇ: Bu çalışmada parsiyel ve total primer boş sella (PBS) olguları arasında ön hipofiz fonksiyonları bakımından karşılaştırma yapılması ve tüm olgularda endokrinolojik değerlendirme gerekliliğinin saptanması amaçlanmıştır. yÖNTEm ve GEREÇLER: PBS tanısı konan 81 olgu (34 total ve 47 parsiyel) çalışmaya dahil edildi. Tüm olguların bazal ön hipofiz ve bunların hedef hormonlarının düzeylerine bakıldı, insülin benzeri büyüme faktörü-1 ve/veya bazal kortizol düzeyi düşük olan olgulara insülin tolerans testi (İTT) uygulandı.BuLGuLAR: Total PBS'sı olan olguların % 67,4'ü ve parsiyel PBS'sı olan olguların %14,9'unda değişik düzeylerde hipopituitarizm saptandı. Ancak total PBS'sı olan olgularda hipopituitarizm belirgin olarak daha yüksek bulundu. Sekonder hipotiroidizm, sekonder adrenal yetmezlik, büyüme hormonu ve gonadotropin eksikliklerinin total PBS'sı olan olgularda parsiyel PBS'sı olan olgulara kıyasla odds oranları (OR) ve %95 güven aralıkları (%95 GA) sırasıyla OR = 20,0; %95 GA 4,9;OR = 2,4; %95 GA 1,7;OR = 15,3; %95 GA 4,[48][49][50][51][52]6 ve OR = 10,6; %95 GA 3,37 -33,5 bulundu. soNuÇ: Bu çalışmanın sonuçları özellikle total PBS'sı olan olgular olmak üzere PBS'sı olan olguların önemli bir kısmında değişik düzeylerde hipopituitarizmin varlığını göstermektedir. Bu nedenle PBS'nın tipine bakılmaksızın tüm olgular ön hipofiz hormon yetmezliği bakımından en kısa sürede uygun bir şekilde değerlendirilmelidirler.ANAHTAR sÖZCÜKLER: Primer boş sella, Hipopituitarizm, Klinik değerlendirme, MRG

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The low levels of HDL in AP cases during acute attack are associated with severity of the disease.

In hypothyroid cases, H. pylori gastritis may be responsible for an inadequate response to the treatment. H. pylori eradication in the cases receiving high doses of thyroxine has a risk for thyrotoxicosis.