Mustafa Araz

Serum prolidase activity as a marker of osteoporosis in type 2 diabetes mellitus.

OBJECTIVES Prolidase is a specific imidodipeptidase involved in collagen degradation. The increase in the enzyme activity is believed to be correlated with the increased intensity of collagen degradation This study aimed to evaluate serum prolidase activity and urinary deoxypyridinoline cross links in type 2 diabetic subjects with and without osteoporosis assessed by bone mineral density. DESIGN AND METHODS Seventy-five patients (54 F/21 M) with type 2 DM and 43 age and gender matched healthy subjects (30 F/13 M) were recruited for this study. Serum prolidase activity was assessed with colorimetric determination. Urinary deoxypyridinoline (Dpy) was determined with electrochemiluminesence immunoassay. RESULTS Serum prolidase activity was significantly lower in patients with type 2 DM than in the healthy controls (mean +/- SEM; 43.3 +/- 1.4 U/L and 53.3 +/- 2.2 U/L respectively, p: 0.000). Non osteoporotic diabetic patients had lower serum prolidase activity (median: 25th-75th percentiles; 39.5: 30.3-50.5 U/L) than osteoporotic diabetic patients (50.0: 41.8-56.3 U/L, p: 0.030) and healthy controls (52.0: 43.0-58.0 U/L, p: 0.004). Urinary Dpy excretion was not different between osteoporotic and nonosteoporotic diabetic patients. However it was lower in both diabetic groups than the healthy controls. We did not observe a statistically significant difference between the serum prolidase activity of dislipidemic/normolipidemic, hypertensive/normotensive, obese/nonobese, insulin/OAD treated, poorly/well-controlled patients and patients with/without diabetic nephropathy and retinopathy (p > 0.05). CONCLUSION This study shows a significant decrease in serum prolidase activity in patients affected with type 2 DM, which may be interpreted as evidence of decreased bone resorption. Our data also suggest that serum prolidase activity may be a better marker of osteoporosis in diabetic state than Dpy.

Angiotensin-converting enzyme gene polymorphism and microvascular complications in Turkish type 2 diabetic patients

The aim of this study was to investigate whether an association exists between the angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism and microvascular complications of type 2 diabetes mellitus in Turkish patients. A total of 239 type 2 diabetic patients and 138 sex and age matched control subjects were included into the study. The I/D polymorphism was determined by polymerase chain reaction (PCR). Nephropathy status was determined according to urinary albumin/creatinine ratio (microg/mg) (<30 normoalbuminuria, 30-300 microalbuminuria, >300 macroalbuminuria) and retinopathy was evaluated by fundoscopic examination and by flourescein fundus angiography. The distribution of ACE I/D polymorphism and allele frequencies in diabetic patients were not significantly different from controls, DD genotype 32.2 versus 37.2%; ID genotype 50.6 versus 47.1%; and II 17.2 versus 15.2%; D allele 57.5 versus 61.2%; I allele 42.5 versus 38.8%. Genotype distribution between normo-, micro- and macroalbuminuric patients did not differ significantly (DD:ID:II (%), normoalbuminuria, 35:46:19; microalbuminuria, 28:55:17; macroalbuminuria, 31:55:14). There was also no difference in genotype distribution between patients with and without retinopathy (DD:ID:II (%), retinopathy positive, 32:51:17; retinopathy negative, 33:49:18). In conclusion, the ACE I/D polymorphism does not seem to be associated with diabetic nephropathy and retinopathy in Turkish type 2 diabetic patients.

Frequency of silent myocardial ischemia in type 2 diabetic patients and the relation with poor glycemic control

Abstract.The aim of the study was to investigate the frequency of silent myocardial ischemia in type 2 diabetic patients without any clinical or laboratory findings of myocardial ischemia and to examine the related factors for silent myocardial ischemia. A total of 116 type 2 diabetic patients (82 women) with a disease duration of 5–20 years were included in the study. All patients underwent stress and resting myocardial perfusion single-photon emission computed tomographic (SPECT) study with 99mTc-MIBI. Coronary angiography was performed in patients with ischemia established at myocardial perfusion SPECT. Ischemia was determined in 18 (15.5%) patients by myocardial perfusion SPECT. Coronary angiography performed in 17 of these patients confirmed coronary stenosis >50% in 11 patients. Thus, the prevalence of silent myocardial ischemia was 9.6%. Significant relations were found between silent myocardial ischemia and male sex, high HbA1C level and retinopathy. Type 2 diabetic patients (especially men) with poorly controlled diabetes mellitus or retinopathy should be screened for silent myocardial ischemia.

Childhood Obesity and the Role of Dopamine D2 Receptor and Cannabinoid Receptor-1 Gene Polymorphisms

AIMS The dopaminergic and endocannabinoid systems are involved in regulation of feeding behavior. The aim of the study is to examine the possible relation between polymorphisms of the dopamine D2 receptor (DRD2) and cannabinoid receptor-1 (CNR1) genes and childhood obesity. METHODS A hundred obese children and 100 healthy controls were analyzed for DRD2 Taq1A and Taq1B and CNR1 1359G/A polymorphisms. Genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism. RESULTS There were no statistically significant differences in DRD2 Taq1A and DRD2 Taq1B genotypes or allelic frequencies between obese children and controls (p>0.05). In patients with Taq1B2 allele, morbid obesity was less frequent (p=0.010). The frequency of the A allele of CNR1 1359G/A polymorphism was significantly higher in obese children than in controls (21.0% vs. 13.0%, p=0.0166). The frequency of genotypes AG and GG of the CNR1 1359G/A SNP was different between obese children and control subjects (for AG: 34.0% vs. 22.0%, p=0.0294; for GG: 62.0% vs. 76.0%, p=0.0162, respectively). CONCLUSIONS No significant difference was found between genotypes and alleles of DRD2 Taq1A and DRD2 Taq1B polymorphism in patients and controls, while the CNR1 receptor 1359G/A polymorphism and the presence of the A allele may be one risk factor for susceptibility to obesity.

FREQUENCY OF NEONATAL HYPOGLYCEMIA IN LARGE FOR GESTATIONAL AGE INFANTS OF NON-DIABETIC MOTHERS IN A COMMUNITY MATERNITY HOSPITAL

Large for gestational age (LGA) infants are at increased risk for hypoglycemia. The aim of the study was to determine the frequency of neonatal hypoglycemia in LGA infants of non-diabetic mothers in a Community Maternity Hospital in Gaziantep, Turkey. Hospital records of 5229 infants of non-diabetic mothers were examined retrospectively. Newborns with birth weight more than 4000 g were defined as LGA. The control group consisted of 100 appropriate for gestational age (AGA) newborns. Capillary blood glucose was measured at the second hour of life. Glucose values lower than 40 mg/dL (2.2 mmol/L) were defined as hypoglycemia. Ninety-six (1.8%) of the 5229 infants were found to be LGA. The mean capillary glucose levels of the LGA newborns were significantly lower than those of the AGA newborns (54 mg/dL (3.0 mmol/L) vs. 95 mg/dL (5.2 mmol/L), p < 0.0001). Neonatal hypoglycemia was established in 16 of 96 LGA infants (16.7%). In the control group hypoglycemia was absent. The rate of hypoglycemia in LGA infants was significantly higher than the rate in the AGA infants (p = 0.0000). As hypoglycemia is not rare in LGA infants and can have serious consequences, blood glucose levels should be screened routinely in LGA infants.

Mitochondrial uncoupling protein 2 (UCP2) gene polymorphisms are associated with childhood obesity and related metabolic disorders

Abstract Objective: This study aimed to investigate the possible role of uncoupling protein 2 (UCP2) gene polymorphisms in childhood obesity and related metabolic disorders. Methods: Obese patients (n=100) and healthy controls (n=100) were analyzed for -866G>A and insertion/deletion (I/D) polymorphisms of the UCP2 gene by polymerase chain raction and/or restriction fragment length polymorphism. Results: UCP2 I/D polymorphism showed an association with obesity. The insertion homozygous genotype (II) was higher in obese patients (p=0.0001), while the DD genotype was higher in controls (p=0.0034). Body mass index and relative weight were lower in patients carrying the A allele of the -866G>A polymorphism (p=0.021 and p=0.047, respectively). There was an association between insulin resistance and –866A allele carrier patients with consanguineous parents (p=0.005). Conclusion: Insertion homozygous genotype and the allele of I/D polymorphism were found to be risk factors for childhood obesity and related metabolic disorders. The -866A allele was associated with susceptibility to central adiposity, hypercholesterolemia, hypertriglyceridemia and insulin resistance.

Angiotensin-converting enzyme gene polymorphism and coronary heart disease in Turkish type 2 diabetic patients.

OBJECTIVE It has been suggested that the insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) may be associated with atherosclerosis. The aim of the study was to examine the association between ACE gene polymorphism and coronary heart disease in Turkish type 2 diabetic patients. METHODS AND RESULTS A total of 152 (97 female, 55 male) type 2 diabetic patients were included into the study. All patients underwent myocardial perfusion scintigraphic examination and forty-five of them with a perfusion defect underwent coronary angiography.Thirty-eight patients with a coronary stenosis of more than 50% on coronary angiography were considered as having coronary heart disease. The I/D polymorphism was determined by polymerase chain reaction. There was no statistically significant difference in genotypic and allelic frequencies of the ACE I/D polymorphism among patients with and without coronary heart disease (DD:ID:II (%), 32:58:11 and 39:44:17, respectively). CONCLUSIONS ACE gene polymorphism is not a significant parameter to determine coronary heart disease in Turkish type 2 diabetic patients.Objective — It has been suggested that the insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) may be associated with atherosclerosis.The aim of the study was to examine the association between ACE gene polymorphism and coronary heart disease in Turkish type 2 diabetic patients. Methods and results — A total of 152 (97 female, 55 male) type 2 diabetic patients were included into the study. All patients underwent myocardial perfusion scintigraphic examination and forty-five of them with a perfusion defect underwent coronary angiography.Thirty-eight patients with a coronary stenosis of more than 50% on coronary angiography were considered as having coronary heart disease.The I/D polymorphism was determined by polymerase chain reaction.There was no statistically significant difference in genotypic and allelic frequencies of the ACE I/D polymorphism among patients with and without coronary heart disease (DD:ID:II (%), 32:58:11 and 39:44:17, respectively). Conclusions — ACE gene polymorphism is not a significant parameter to determine coronary heart disease in Turkish type 2 diabetic patients.

Association of melatonin receptor 1 B gene (rs10830963 and rs9192552) polymorphısm with adolescent obesity and related comorbidities in Turkey

Objective To examine the role of rs10830963 and rs8192552 polymorphisms in melatonin receptor 1 B (MTNR1B) gene on the development of obesity and related comorbidities among adolescents in South-Eastern Turkey. Methods The present study included 200 unrelated adolescents (100 obese, 100 normal weight). The rs8192552 and rs10830963 polymorphisms in the MTNR1B gene were genotyped using a PCR SNaPshot assay. Results No statistically significant association was observed between MTNR1B gene rs8192552/rs10830963 polymorphisms and adolescent obesity. In adolescents with an rs8192552 E allele, homeostasis model assessment for insulin resistance (IR) level was lower and IR was less common. In morbidly obese adolescents with an rs8192552 E allele, total cholesterol level was lower. In obese adolescents with metabolic syndrome, plasma fasting glucose level was higher in rs10830963G allele carriers. In obese girls, body weight was lower in those with a rs10830963 C allele, whereas in obese boys, body weight and waist circumference were higher in those with a rs10830963 C allele. Conclusions The MTNR1B gene was not confirmed as an obesity susceptibility gene in adolescents. However, an association between the MTNR1B gene and IR/hypercholesterolemia/metabolic syndrome was observed in obese adolescents. A sex-specific effect on obesity was also identified.

Adolescent obesity and the role of the fat mass and obesity-associated gene polymorphism

PURPOSE The association between fat mass and obesity-associated (FTO) gene and obesity is unclear in both adults and adolescents. The aim of this study was to examine the role of the FTO gene variant rs9939609 as a candidate gene for obesity and the relationship between insulin resistance (IR), metabolic syndrome (MetS), estimated glomerular filtration rate (eGFR) and neutrophil-to-lymphocyte ratio (NLR). METHODS Obese adolescents (n=100) and healthy controls (n=100) were included. Rs9939609 polymorphism in the FTO gene was genotyped by PCR-SNaPshot. RESULTS The prevalence of insulin resistance (IR), metabolic syndrome (MetS) and hyperfiltration were 47%, 60% and 27%, respectively. There were no significant differences in genotype and allele frequencies between obese adolescents and controls; however, prevalence of MetS in female patients with A allele carriers was more frequent and prevalence of hyperfiltration was less frequent with T allele carriers (P.

A Rare Cause of Adrenal Mass: Primary Adrenal Lymphoma: Case Report

36 Primer adrenal lenfoma (PAL) nadir görülmekte olup, literatürde 200’den az vaka sunumu vardır. Vakaların %70’ten fazlasını difüz büyük B-hücreli lenfoma (DBBHL) oluşturmaktadır. Genellikle 65 yaşından sonra görülmektedir. Erkeklerde daha sıklıkla saptanmaktadır. Hastalar ateş, kilo kaybı ve adrenal yetmezlik belirtileri ile başvurmaktadır.1,2 Tümör çapları büyük olup, ortalama 8 cm ve genellikle bilateraldir. Hastaların çoğunda tümör destrüksiyonuna bağlı adrenal yetmezlik gelişmektedir.1,3,4 Adrenal Kitlenin Nadir Bir Nedeni: Primer Adrenal Lenfoma