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    Comparison of three different creatinine clearance calculation methods in patients with type 2 diabetes mellitus
    (2018) Kundaktepe, Fatih Orkun; Erdem, Mustafa Genco; Helvacı, Şerife Ayşen
    Aim: To determine the most accurate and useful method for calculating creatinine clearance by comparing the results of different methods. Methods: Type 2 Diabetic 100 patients who have been followed by Okmeydani Training and Research Hospital internal medicine and/or diabetes policlinics. Individuals with Type 1 Diabetes Mellitus and acute kidney disease were excluded from the study. Results: Glomerular filtration rate calculated with Cockroft-Gault formula was significantly affected by creatinine, weight and age (p<0.05 for all) in a univariate model. In a multivariate model this was significantly independently affected by creatinine, weight and age (p<0.05 for all). Glomerular filtration rate measured with Modification of Diet in Renal Disease formula was significantly affected by creatinine and age (p<0.05 for all) and in a univariate model. In a multivariate model this was significantly independently affected by creatinine (p<0.05). Glomerular filtration rate measured with 24h urine was significantly affected by creatinine, weight and age (p<0.05 for all). In a multivariate model this was significantly independently affected by weight (p<0.05). Conclusion: In this study, those three methods were similar and positively correlated to each other. Such findings prove that those three different methods are compatible with each other at glomerular filtration calculation and they are all useful in clinical practice. Practical and accurately intensive follow up of those patients will give a chance of better understanding this process and will help us with intervention as soon as possible when needed.
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    Could Prior COVID-19 Affect the Neutralizing Antibody after the Third BNT162b2 Booster Dose: A Longitudinal Study
    (Mdpi, 2023) Erdem, Mustafa Genco; Unlu, Ozge; Buber, Suleyman; Demirci, Mehmet; Kocazeybek, Bekir Sami
    Vaccination is an essential public health measure for preventing the spread of illness during this continuing COVID-19 epidemic. The immune response developed by the host or the continuation of the immunological response caused by vaccination is crucial since it might alter the epidemic's prognosis. In our study, we aimed to determine the titers of anti-S-RBD antibody and surrogate neutralizing antibody (snAb) formed before and after the third dose of the BNT162b2 vaccination (on the 15th, 60th, and 90th days) in healthy adults who did not have any comorbidity either with or without prior SARS-CoV-2 infection. In this longitudinal prospective study, 300 healthy persons were randomly included between January and February 2022, following two doses of BNT162b2 immunization and before a third dosage. Blood was drawn from the peripheral veins. SARS-CoV-2 NCP IgG and anti-S-RBD IgG levels were detected by the CMIA method, and a surrogate neutralizing antibody was seen by the ELISA method. Our study included 154 (51.3%) female and 146 (48.7%) male (total 300) participants. The participants' median age was 32.5 (IQR:24-38). It was discovered that 208 individuals (69.3%) had never been infected with SARS-CoV-2, whereas 92 participants (30.7%) had SARS-CoV-2 infections in the past. Anti-S-RBD IgG and nAb IH% levels increased 5.94- and 1.26-fold on day 15, 3.63- and 1.22-fold on day 60, and 2.33- and 1.26-fold on day 90 after the third BNT162b2 vaccine dosage compared to pre-vaccination values (Day 0). In addition, the decrease in anti-S-RBD IgG levels on the 60th and 90th days was significantly different in the group without prior SARS-CoV-2 infection compared to the group with past SARS-CoV-2 infection (p < 0.05). In conclusion, it was observed that prior SARS-CoV-2 infection and the third BNT162b2 vaccine dose led to a lower decrease in both nAb and anti-S-RBD IgG levels. To evaluate the vaccine's effectiveness and update immunization programs, however, it is necessary to perform multicenter, longer-term, and comprehensive investigations on healthy individuals without immune response issues, as there are still circulating variants.
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    Evaluation of the effect of gluten-free diet and Mediterranean diet on autoimmune system in patients with Hashimoto's thyroiditis
    (Wiley, 2024) Ulker, Mutlu Tuce; Colak, Gozde Aritici; Bas, Murat; Erdem, Mustafa Genco
    Hashimoto's thyroiditis is an autoimmune disease in which thyroid cells are attacked through cell-and antibody-mediated immune processes. A gluten-free diet reduces antibody concentration and regulates thyroid autoimmunization. Mediterranean diet reduces oxidative stress. This study evaluates the short-term effects of Mediterranean, gluten-free, and Mediterranean gluten-free dietary patterns on thyroid function and autoantibody levels of patients. The 40 patients with Hashimoto's thyroiditis included in the study were randomly divided into four groups (defined as gluten-free, Mediterranean, Mediterranean gluten-free, and controls) for 12 weeks. Thyroid function tests, autoantibody levels, and food consumption were recorded at the beginning and end of the study. There was no statistically significant difference in TSH levels of the groups before the intervention, but a statistically significant difference was found afterward (p < 0.05). Free T-3 hormone levels showed a statistically significant difference across the groups before and after the intervention (p < 0.05). Free T-3 hormone levels increased significantly in all intervention groups after the intervention, with the highest increase in the Mediterranean group (p < 0.05). In the intervention groups, anti-TPO and anti-Tg levels decreased after the intervention; however, this difference was not significant across groups (p > 0.05). In addition, body weight, body mass index, waist and hip circumference averages decreased significantly in all intervention groups compared with controls (p < 0.05). The study achieved an increase in Free T-3 hormone levels in the intervention groups. The most marked difference was seen in the Mediterranean gluten-free diet model, which may be due to the anti-inflammatory effect of both Mediterranean and gluten-free diets and the loss of body weight as a result of the intervention.
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    Oral Microbiota Signatures in the Pathogenesis of Euthyroid Hashimoto's Thyroiditis
    (Mdpi, 2023) Erdem, Mustafa Genco; Unlu, Ozge; Ates, Fatma; Karis, Denizhan; Demirci, Mehmet
    One of the most prevalent autoimmune illnesses in the world is Hashimoto's thyroiditis, whose pathogenesis is still unknown. The gut-thyroid axis is frequently examined, and although oral health affects thyroid functions, there are limited data on how oral microbiota is linked to Hashimoto's thyroiditis. The study aims to identify the oral microbiota from saliva samples taken from treated (with levothyroxine) and untreated female euthyroid Hashimoto's thyroiditis patients as well as healthy controls who were age- and sex-matched to compare the oral microbiota across the groups and to contribute preliminary data to the literature. This study was designed as a single-center cross-sectional observational study. Sixty (60) female patients with euthyroid Hashimoto's thyroiditis (HT) and eighteen (18) age- and gender-matched healthy controls were included in this study. Unstimulated saliva samples were collected. After DNA isolation, sequencing was performed by targeting the V3-V4 gene regions of the 16S rRNA on the MiSeq instrument. R scripts and SPSS were used for bioinformatic and statistical analysis. No significant differences were found in the diversity indices. However, Patescibacteria phylum showed a significantly higher abundance (3.59 vs. 1.12; p = 0.022) in the oral microbiota of HT patients compared to HC. In the oral microbiota, the euthyroid HT group had approximately 7, 9, and 10-fold higher levels of the Gemella, Enterococcus, and Bacillus genera levels than healthy controls, respectively. In conclusion, the results of our study demonstrated that Hashimoto's thyroiditis causes changes in the oral microbiota, whereas the medicine used to treat the condition had no such effects. Therefore, revealing the core oral microbiota and long-term follow-up of the HT process by conducting extensive and multicenter studies might provide some important data for understanding the pathogenesis of the disease.
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    Relationships among oncostatin M, insulin resistance, and chronic inflammation: a pilot study
    (Sbem-Soc Brasil Endocrinologia & Metabologia, 2020) Akarsu, Murat; Hurşitoğlu, Mehmet; Toprak, Zeki; Yoldemir, Şengül Aydın; Altun, Özgür; Toprak, İlkim Deniz; Özcan, Mustafa; Yürüyen, Gülden; Uğurlukişi, Bilal; Erdem, Mustafa Genco; Kirna, Kerem; Demir, Pınar; Çapar, Gazi; Arman, Yücel; Tukek, Tufan
    Objective: Activated macrophages (M1-type macrophages) in adipose tissue secrete many proinflammatory cytokines that induce insulin resistance (IR). Oncostatin M (OSM), a member of the interleukin-6 (1.6) family of Gp130 cytokines, plays an important role in a variety of biological functions, including the regulation of inflammatory responses. Proinflammatory cytokines released in patients with IR trigger a chronic, low-grade inflammatory reaction in blood vessel walls. This inflammator response leads to endothelial damage, which is the main mechanism for atherosclerosis and many cardiovascular diseases. Animal studies have reported a relationship between OSM and IR. To the best of our knowledge, however, few clinical studies have examined this topic.Therefore, we studied the relationship between serum levels of OSM and IR. Subjects and methods: This prospective cross-sectional case-control study enrolled 50 people with IR (according to the HOMA IR and QUICKI indices) and 34 healthy controls. The fasting blood concentrations of insulin, glucose, blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride, total cholesterol, C-reactive protein (CRP), and OSM were determined. Results: There were no significant differences between the two groups in age, sex, and HbA1c levels. Univariate analyses showed that waist circumference (WC) and levels of fasting glucose, insulin, CRP, HDL-C, OSM, HOMA-IR, and QUICKI differed between the two study groups. In multivariate analyses, both IR indices (QUICKI and HOMA) and OSM differed between the two groups. Conclusion. OSM was correlated with the IR indices (QUICKI and HOMA). For simplicity, it might replace the other IR indices in the future. Further detailed studies are needed to confirm this.
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    An unusual case of hypopituitarism associated with non-small cell lung cancer
    (Mattioli 1885, 2017) Özer L.; Erdem, Mustafa Genco; Orhan B.; Gülmez A.; Düzenci D.; Canhoroz M.; Özkan, Y.; Artas H.
    Background: Non-small cell lung cancer (NSCLC) is the most common cause of cancer-related death which can present with various clinical situations. Hypopituitarism when encountered with NSCLC may be due to diverse etiologies including pituitary metastasis, hypophysitis, pituitary infarction or a consequence of therapeutical interventions such as surgery or radiotherapy. Result: We present an unusual case of hypopituitarism in a NSCLC patient associated with a benign disorder, a sinus mucocele and thereby review the pathogenesis of hypopituitarism accompanying malignant diseases. Conclusion: Our case represents an example of association of a benign disorder with malignancy causing severe deterioration of life quality. Although rare, pituitary metastasis is the initial possible diagnosis in the setting of non-small cell lung cancer. © Mattioli 1885.