Nese Ersoz Gulcelik

SERUM VASPIN LEVELS IN TYPE 2 DIABETIC WOMEN IN RELATION TO MICROVASCULAR COMPLICATIONS

OBJECTIVE Vaspin is a novel adipokine that has insulin sensitizing effects. The association between serum vaspin levels and diabetic complications is unknown. In this study, we aimed to evaluate serum vaspin levels as related to glycemic status and the presence of complications in a group of type 2 diabetic women. MATERIALS AND METHODS We evaluated 37 type 2 diabetic female patients and 37 control female subjects who were matched for age and body-mass index. Anthropometric measurements, insulin, hemoglobin A1c (HbA1c), C-reactive protein, and serum vaspin levels were measured in each participant. Furthermore, the patients were evaluated for diabetic neuropathy, nephropathy, and retinopathy. RESULTS In diabetic patients, serum vaspin levels correlated positively with HbA1c and correlated negatively with insulin levels and homeostasis model assessment. The patients with HbA1c levels <or=7% had lower levels of serum vaspin than patients with HbA1c levels >7% (0.11+/-0.06 ng/ml versus 0.20+/-0.09 ng/ml, P<0.05). In patients with neuropathy, retinopathy, and nephropathy, serum vaspin levels were lower than in patients without neuropathy (0.10+/-0.07 ng/ml versus 0.17+/-0.09 ng/ml, P=0.041), retinopathy (0.11+/-0.06 ng/ml versus 0.18+/-0.09 ng/ml, P=0.019), and nephropathy, (0.11+/-0.05 ng/ml versus 0.18+/-0.09 ng/ml, P=0.02). Diabetic patients receiving metformin therapy had lower vaspin levels than patients not receiving metformin. CONCLUSION Diabetic women with good glycemic control have lower levels of vaspin than those with poor glycemic control. However, presence of microvascular complications is also associated with low vaspin levels. In order to use serum vaspin levels as a marker, evaluating patients for complications and medications interfering with serum vaspin levels seems appropriate.

Risk of Malignancy in Patients With Follicular Neoplasm: Predictive Value of Clinical and Ultrasonographic Features

OBJECTIVE To identify clinical and ultrasonographic features that may help in predicting malignant tumors in patients with a diagnosis of follicular neoplasm on findings from fine-needle aspiration cytology (FNAC) because FNAC diagnosis of follicular neoplasm does not differentiate a benign tumor from a malignant tumor. DESIGN Prospective study of 98 patients having a diagnosis of follicular neoplasm on FNAC. SETTING Tertiary cancer referral center. PATIENTS Ninety-eight patients with thyroid nodules diagnosed by FNAC as being a follicular neoplasm. INTERVENTIONS Ultrasonography was performed in each patient, and microcalcifications, echo structure, and echogenicity of the nodules were assessed. All patients underwent surgery. MAIN OUTCOME MEASURES Sensitivity, specificity, positive predictive value, and negative predictive value of ultrasonographic features. RESULTS Thyroid cancer was diagnosed in 26 patients (27%). Ultrasonographic features (eg, a solid echo structure, microcalcifications, and a hypoechoic pattern) were predictive for malignant neoplasms. The variable associated with the highest sensitivity was the presence of a solid nodule (88.5%), and the variable associated with the highest specificity was the presence of microcalcifications (94.4%). The combination of the 3 ultrasonographic features (solid echo, hypoechoic pattern, and microcalcifications) resulted in a sensitivity of 95.0% and a specificity of 98.6%. Older age, male sex, solitary nodule, and larger nodule size were not predictive for malignant neoplasms in patients with follicular neoplasm cytologic findings. CONCLUSIONS We confirmed that the best compromise between the risk of missing carcinomas and the need for reducing unnecessary surgical procedures would consist of submitting to surgery those nodules presenting a solid echo structure, microcalcifications, or a hypoechoic pattern. Low-risk patients may be observed closely if they are willing to accept a small risk of cancer and if they appreciate the need for a close clinical follow-up.

Role of adipocytokines in predicting the development of diabetes and its late complications

Diabetes is an important health problem since the incidence of diabetes is continuously increasing. Early diagnosis is important as type 2 diabetes begins long before we diagnose it, leading to a complicated course of the disease. In order to prevent delay in the diagnosis of type 2 diabetes, novel predictors and pathways for type 2 diabetes are mounting. Diabetic complications are common cause of morbidity and mortality among subjects with diabetes. In the pathogenesis of diabetic complications some factors other than chronic hyperglycemia may be involved. Adipocytokines play important roles in the pathogenesis of diabetes mellitus, insulin resistance, and associated metabolic conditions such as hypertension and dyslipidemia. The investigations on the role of adipocytokines in developing diabetes and its complications have been made. In this review, we discussed the implications of adipocytokines in predicting diabetes and diabetic complications, with particular attention on the roles of adiponectin, leptin, visfatin, and vaspin.

Associations between Adiponectin and Two Different Cancers: Breast and Colon

OBJECTIVES Breast and colon cancer are neoplasms well known to be related to obesity. Adiponectin, a protein that increases in obesity, seems to be involved in the relationship but clinical data are limited. METHODS In this study, we therefore evaluated the serum adiponectin levels in 87 breast and 27 colon cancer patients and assessed the relation with BMI, menopausal status, receptor status and stage of disease. RESULTS Serum adiponectin levels were lower in cancer cases (8583 ± 2095 ng/ml for breast cancer, 9513 ± 2276 for colon cancer) than in controls (13905 ± 3263). CONCLUSION A low serum adiponectin level may be associated with both breast and colon cancer, and that this association is not statistically significant for either receptor or menopausal status in breast cancer groups.

Rosuvastatin induces apoptosis in cultured human papillary thyroid cancer cells

Statins show antiproliferative activity in various cancer cells. The aim of this study was to evaluate the effects of rosuvastatin treatment on papillary thyroid carcinoma. The papillary thyroid carcinoma (B-CPAP) and normal (Nthy-ori 3-1) thyroid cell lines were treated with rosuvastatin at 12.5, 18.5, 25, 50, 100, and 200 μM concentrations. After 48 and 72 h of rosuvastatin treatment, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide, Ki-67 immunolabeling, FACS analysis, electron microscopy, caspase-3, and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) analysis were performed. Decreased cell viability and G1 phase arrest were detected in papillary thyroid cell line treated with rosuvastatin. Positive immunoreactivity of Ki-67 and dose-dependent increase in S phase on Nthy-ori 3-1 cells were also detected. B-CPAP cells showed intense vacuolisation and autophagosomes with low concentrations and 48 h incubations, while Nthy-ori 3-1 cells showed these changes at higher concentrations. A decrease in the percentage of cells showing autophagy was determined with increasing concentrations of rosuvastatin in B-CPAP cells. Rosuvastatin treatment also caused a dose- and time-dependent increase in caspase-3 activity and apoptotic index by TUNEL assay in B-CPAP cells compared with the Nthy-ori 3-1 cells. Apoptotic cells with nuclear condensation and fragmentation were observed in B-CPAP cell line. Rosuvastatin induced autophagic changes in B-CPAP papillary thyroid cancer cells in lower doses and caused a shift from autophagy to apoptosis. Rosuvastatin may be an alternative treatment for refractory papillary thyroid cancer. Further in vivo studies are necessary to clarify the effects of rosuvastatin in papillary thyroid carcinoma and the clinical implications of rosuvastatin treatment.

Pigment epithelium‐derived factor increases in type 2 diabetes after treatment with metformin

Pigment epithelium‐derived factor (PEDF) has anti‐angiogenic, immunomodulatory and anti‐inflammatory properties. In addition to the significant role it plays in reducing diabetic complications, PEDF is now used in the treatment of certain cancers. It possibly plays a role in insulin resistance cases, too. However, whether metformin treatment has any significant effects on PEDF levels is not known. In this study, we investigated the regulation of PEDF in type 2 diabetes in relation to fat mass and insulin resistance before and after the use of metformin for treatment.

Serum vaspin levels in hypothyroid patients

OBJECTIVE To elucidate the link between TSH and obesity, the relationship between TSH and adipocytokines were previously studied. Animal studies demonstrated a possible relationship between vaspin levels and thyroid functions. In this study, we aimed to investigate vaspin levels in hypothyroid states and its relationship with insulin resistance parameters in humans. DESIGN Prospective observational study. METHODS We enrolled 27 overt hypothyroid, 33 subclinical hypothyroid and 41 euthyroid patients. We measured the body mass index (BMI), fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance index (HOMA-IR), lipid profile, TSH, free triiodothyronine, free thyroxine and vaspin levels. The change in vaspin levels in 12 overt hypothyroid patients after establishment of euthyroidism was analysed. RESULTS All groups were age-matched. Overt hypothyroid group had higher BMI values (P<0.05) than other groups. No significant difference was observed in insulin levels and HOMA-IR among the groups (P>0.05). Adjusted vaspin levels for BMI and age were similar among the groups. Mean vaspin levels in overt, subclinical and euthyroid patients were 1.20 ± 1.17, 1.48 ± 0.93 and 0.95 ± 0.75  ng/ml respectively (P>0.05). There was no significant association between vaspin levels and BMI, fasting glucose, insulin and HOMA-IR (P>0.05). Establishing euthyroidism in hypothyroid patients did not result in a significant change in vaspin levels (before and after treatment, 1.35 ± 1.06 and 1.25 ± 0.68  ng/ml, respectively; P>0.05). CONCLUSION We herein present novel data indicating vaspin levels are neither altered in overt and subclinical hypothyroidism nor have a relationship with features of insulin resistance in hypothyroid patients.

PREDICTIVE INDEX FOR CARCINOMA OF THYROID NODULES AND ITS INTEGRATION WITH FINE-NEEDLE ASPIRATION CYTOLOGY

The objective of this study was to select patients for resection of thyroid malignity among patients with thyroid nodules by integration of predictive indices with fine‐needle aspiration cytology (FNAC).

Neopterin and hsCRP are not correlated in gestational diabetes mellitus

Abstract Objective: To determine serum neopterin and high sensitive C-reactive protein (hsCRP) levels in patients with and without gestational diabetes mellitus (GDM). Methods: Neopterin and hsCRP levels were quantified in 28 women with GDM and 20 pregnant women with normal glucose tolerance (NGT). Postpartum neopterin and hsCRP levels were measured in a follow-up study. Results: Neopterin levels were significantly higher in women with GDM than in women with NGT (15.89 ± 8.19 nmol/L versus 10.4 ± 3.8 nmol/L, p < 0.008, respectively), however the levels significantly decreased after delivery in GDM group (15.89 ± 8.19 nmol/L versus 11.63 ± 5.96 nmol/L, p < 0.001). hsCRP levels were not different between women with and without GDM (5.74 ± 3.91 versus 5.73 ± 3.34, p = 0.9, respectively). In contrast, hsCRP levels decreased after delivery in patients with GDM (5.74 ± 3.91 versus 3.78 ± 2.78, p < 0.01). Neopterin levels were correlated with maternal age (r = 0.3, p = 0.02) and fasting glucose (r = 0.4, p = 0.004), postprandial glucose (r = 0.3, p = 0.01), HbA1c (r = 0.3, p = 0.02), whereas hsCRP levels were correlated with pre-pregnancy (r = 0.3, p = 0.04) and pregnancy body mass index (r = 0.4, p = 0.008). No correlation between serum neopterin and hsCRP levels was found (p = 0.9). Conclusion: Neopterin levels increased in patients with GDM; hence, it may be related to inflammation. However, the lack of correlation between neopterin and hsCRP suggests the role of different attitudes of these two parameters in the course of pregnancy and GDM.

Optimal timing for surgery after adriamycin treatment in rats.

PurposeTo determine the optimal timing of surgery after adriamycin treatment, we investigated the time-related effect of adriamycin on wound healing over a long period.MethodsWe divided 119 female Sprague-Dawley rats into seven treatment groups. Group 1 was subjected to laparatomy only. All the other groups were given 8 mg/kg adriamycin intravenously followed by laparotomy on the same day (group 2), 7 days later (group 3), 14 days later (group 4), 21 days later (group 5), 28 days later (group 6), or 35 days later (group 7). On postoperative day 7, the sutures were removed, abdominal bursting pressure was measured, and tissue samples were taken for histopathological evaluation and analysis of hydro-xyproline content.ResultsBursting pressures were significantly lower in groups 3, 4, 5, and 6 than in group 1. The hydroxyproline content and histopathological evaluation supported these findings.ConclusionsOur results showed that the optimal timing for surgery after adriamycin treatment is before the 7th day or after the 35th day. If surgery is performed between these days, there is a high risk of impaired wound healing.