Relationship of dehydroepiandrosterone sulfate levels with atherosclerosis in patients with subclinical hypothyroidism.

BACKGROUND: Subclinical hypothyroidism is related with increased risk of cardiovascular diseases. The decreased levels of dehydroepiandrosterone sulphate (DHEA-S) are associated with hyperlipidemia, atherosclerosis and obesity. The lower levels of DHEA­S might be an important factor in development of atherosclerosis in subclinical hypothyroidism. METHODS: A total of 126 patients (62 with subclinical hypothyroidism and 64 healthy individuals) were included in this prospectively designed study between January 2017 and December 2019. All individuals were evaluated according to DHEA­S levels, carotid intima media thickness (CIMT) and anthropometric measurements. Blood samples were obtained from patients after 8 h fasting. The groups were statistically compared. RESULTS: The mean ages of control group and patients with subclinical hypothyroidism were 36.9 ± 11.0 years and 39.6 ± 11.0 years, respectively (p = 0.165). The mean waist circumferences in controls and patients were 89 ± 10.7 cm and 91.3 ± 11.1 cm, respectively (p < 0.001). The DHEA­S levels were 131.04 ± 96.02 µg/dl in patients, and these levels were significantly decreased in patients with subclinical hypothyroidism (p = 0.024). The levels of DHEA­S were found to be negatively correlated with CIMT (p < 0.001, c = 0.406). CONCLUSIONS: The early detection of cardiac and metabolic dysfunctions in subclinical hypothyroidism is important to avoid complications. We found a negative correlation between DHEA­S levels and metabolic and cardiovascular risk factors in subclinical hypothyroidism. We believe that our results would attract more attention to the studies investigating relationships between DHEA­S levels and cardiovascular complications of subclinical hypothyroidism.

The Relationship between Polycystic Ovary Syndrome and Serum Periostin Level.

OBJECTIVE: To determine the changes of circulating periostin levels in polycystic ovary syndrome (PCOS) and its relationship with metabolic disorders. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Konya Research and Training Hospital, Turkey between September 2018 and April 2020. METHODOLOGY: Patients with PCOS were compared with healthy individuals as control. The demographics, laboratory findings, anthropometric measurements, the levels of serum periostin and carotid intima media thickness (CIMT) were evaluated and compared. RESULTS: There was no significant difference between patients with PCOS (n = 53) and controls (n = 35), according to demographic and laboratory findings and anthropometric measurements. The CIMT in patients with PCOS and control groups were measured as 0.5 ± 0.06 mm and 0.43 ± 0.1 mm, respectively (p <0.003). The levels of periostin in the patients with PCOS and control groups were found to be 6.43 ± 6.19 ng/mL and 3.61 ± 3.79 ng/mL, respectively (p <0.018). No statistically significant correlations were found according to periostin levels and metabolic variables. CONCLUSION: Although there was no significant correlation between the periostin levels and the metabolic variables in patients with PCOS as compared to those without the periostin levels, but CIMT were higher in PCOS group. Key Words: Atherosclerosis, Carotid intima-media thickness, Insulin resistance, Periostin protein, Polycystic ovary syndrome.

Serum vitamin D level is related to disease severity in pediatric alopecia areata.

BACKGROUND: Alopecia areata (AA) is the most common cause of inflammatory hair loss. AA is considered an autoimmune disease and occurs with various autoimmune disorders. Recent studies have revealed connection between autoimmune diseases and vitamin D deficiency. OBJECTIVES: In this study, we investigated vitamin D status in AA and its relationship with disease severity, number of patches, and disease duration. METHODS: This study included 20 pediatric patients with AA and 34 pediatric healthy controls. The serum vitamin D levels were evaluated. RESULTS: The mean serum 25(OH)D concentration of patients was 15.47±7.66 ng/mL and of control group was 11.09±10.53 ng/mL. There was no statistically significant difference between two groups (P: .084). Vitamin D concentration had significantly and negatively correlated with SALT score (P<.001 and r: -.831), number of patch (P<.001 and r: -.989), and disease duration (P<.001 and r: -.997). CONCLUSION: Vitamin D deficiency is not the only etiologic factor in AA pathogenesis, but in the presence of other etiological factors, this deficiency can aggravate AA severity, and thus, vitamin D supplementation may be beneficial in treatment of pediatric AA.

The effect of hypothyroidism on color contrast sensitivity: a prospective study.

BACKGROUND: Thyroid hormone has been shown to control retinal cone opsin expression, the protein of color vision, in adult rodents. OBJECTIVES: The aim of this study was to evaluate the effect of hypothyroidism on color contrast sensitivity in adult overt hypothyroid patients. METHODS: Thirty-eight overt hypothyroid (31 females, 7 males) subjects and 20 euthyroid (16 females, 4 males) controls were studied prospectively. Color vision examination was performed by Chromatest, a software program analyzing the tritan (blue-yellow) color contrast threshold (tritan CCT) and protan (red-green) color contrast threshold (protan CCT). Color contrast sensitivity analyses of hypothyroid subjects were performed on admission and after L-thyroxine treatment when biochemical euthyroidism was achieved. RESULTS: After a median period of 90 (90-210) days, 24 (19 females, 5 males) patients were euthyroid and eligible for a second color vision examination. Baseline tritan CCT and protan CCT values were significantly higher in the hypothyroid group compared to euthyroid controls, which clinically translates into impaired color contrast sensitivity (p < 0.001 and p < 0.001, respectively). There was a significant decrease in tritan CCT (p = 0.002) and protan CCT (p < 0.001) values in the hypothyroid group after euthyroidism was achieved, which denotes improvement in color contrast sensitivity. CONCLUSIONS: It is a novel finding of the current study that color contrast sensitivity is impaired in hypothyroidism and significantly improves after euthyroidism is achieved.

Cornea in PCOS patients as a possible target of IGF-1 action and insulin resistance.

OBJECTIVES: Previous studies suggest that serum IGF-1 is higher in women with polycystic ovary syndrome (PCOS). The ophthalmologic effects of IGF-1 excess have not yet been investigated in women with PCOS. The aim of the current study is to compare the corneal thickness of patients with PCOS and those of healthy subjects. METHODS: Forty three patients with PCOS and 30 age-matched and gender-matched healthy individuals were enrolled in this cross-sectional study. Central corneal thickness (CCT) was measured in patients with PCOS and in healthy individuals with an ultrasound pachymeter. IGF-1 values were also determined in the study group. RESULTS: Women with PCOS had significantly higher levels of IGF-1 and homeostasis model assessment (HOMA-IR) levels than the control group. Right and left CCT measurements were higher in the PCOS group than in the control group. A positive correlation between IGF-1 and right and left CCT was identified in both groups. In multiple linear stepwise regression analyses, IGF-1 independently and positively associated with HOMA-IR in women with PCOS. A correlation between total testosterone and CCT was identified in the whole group. In multiple stepwise regression analyses, total testosterone independently and positively associated with left central corneal thickness in the whole group. CONCLUSIONS: These findings indicate that PCOS has target organ effects on the eye. Consequently, it can change central corneal thickness. Higher IGF-1 levels seem to be the main causes of increased corneal thickness. Insulin resistance in PCOS is one of the underlying causes and promotes increase in IGF-1. We suggest a careful and detailed corneal evaluation in PCOS patients to prevent the potential risk of increased CCT, in addition to the already-known complications.

Thyroid lipomatosis.

Thyroid lipomatosis is a rare condition characterized by the presence of abundant mature adipose tissue in the thyroid gland. We herein report the case of a 43-year-old man with chronic renal failure caused by amyloidosis presenting with an asymmetrically enlarging thyroid gland. The patient's thyroid hormone levels were normal, and test results for thyroid autoantibodies were negative. A thyroid scan showed diffuse uptake of the radioisotope with a cold area in the left lobe. The pathology of the thyroidectomy material indicated thyroid lipomatosis, and minimal amyloid staining was noted around the thyroid follicles. Thyroid lipomatosis should therefore be kept in mind when making a differential diagnosis of fatty infiltration of amyloid goiter.

Demographic, clinical and mutational characteristics of Turkish familial Mediterranean fever patients: results of a single center in Central Anatolia.

Clinical and genetic findings of familial Mediterranean fever (FMF) may be variable in different populations. Environmental factors may also affect phenotypic features of FMF. In this study, we investigated demographic, clinical and mutational features of FMF patients who were treated in a single reference hospital in Turkey. Two hundred and sixty patients (169 females, 91 males, mean age 30.44 +/- 10.29 years) were included in this study. All patients were evaluated regarding MEFV gene mutations. The mean age of disease onset was 17.21 +/- 8.66 years (range 2-40 years). The mean duration between the disease onset and diagnosis was 9.39 +/- 8.92 years. Seventy percent of patients had symptoms before 20 years of age (early onset FMF). Arthritis and erysipelas like erythema (ELE) were more common, and the mean duration between the disease onset and diagnosis was longer in early onset FMF patients. The frequency of attacks per year, and disease severity score (DSS) was higher in early onset patients. Homozygote mutation of M694V was detected in 37 (20.2%) and 4 (5.2%) patients in early onset FMF and adult onset FMF groups, respectively (p < 0.05). Histological diagnosis of amyloidosis was established in 7 patients (2.7%). The age of disease onset was earlier, and arthritis and ELE were more frequent, and DSS was higher in patients with M694V/M694V mutation. In conclusion, mean delay to diagnosis in our FMF population is quite high. Early and adult onset forms may differ regarding some clinical, molecular and prognostic characteristics. Disease activity was higher in patients with homozygote mutation of M694V.

Familial Mediterranean fever with chronic ascites: a case report and a review of literature.

Familial Mediterranean fever (FMF) is an autosomal recessive inflammatory disease especially seen in Turks, Sephardic Jews, Armenians, and Arabs. Peritoneal and pleural inflammation, arthritis, erysipelas-like erythema, and arthralgia are well-known features of FMF. A small amount of peritoneal fluid collection can be seen during peritoneal attacks in FMF patients, but chronic ascites is a rather rare complication. We herein report a female FMF patient who developed chronic ascites. She was compound heterozygote for M694V/M680I mutation of the MEFV gene. Aspiration of the ascites fluid revealed a small amount of erythrocytes and mesothelial cells. After dose adjustment of colchicine the amount of ascites decreased. In conclusion, FMF should be considered in the differential diagnosis of chronic ascites in populations where the disease is endemic.