Prevalence of anemia and related factors among women in Turkey.

OBJECTIVE: To determine the prevalence of anemia and related factors among women in Turkey. METHODS: This descriptive study was conducted at the outpatient clinics of the Department of Internal Medicine, Ege University Medical School. Randomly selected women were given questionnaires regarding their socio-demographic and obstetric characteristics. The data were coded and analyzed using SPSS version 17.0 software. Statistical analyses with 95% confidence intervals were considered to be significant if p<0.05. RESULTS: The study results showed an anemia prevalence of 27.8% in the study sample. Among all anemia diagnoses among the participants, 56.0% were determined to have iron deficiency, 37.1% iron-deficiency anemia, and 6.9% severe anemia. It was observed that anemia was detected among women who were 15-49 years of age (p<0.05), menstruating (p<0.05), had a history of Cesarean section (p<0.05), and had not entered menopause (p<0.05). Based on forward-stepwise-logistic regression analysis, the most important parameter was concluded to be age group, which was followed by menopausal status. CONCLUSIONS: The study results suggest that the anemia prevalence rate is specifically higher among women of reproductive age. To prevent anemia at a low cost, it is recommended to provide women with relevant information and well-planned interactive educational programs.

Detection of impaired cognitive function in rat with hepatosteatosis model and improving effect of GLP-1 analogs (exenatide) on cognitive function in hepatosteatosis.

The aims of the study were to evaluate (1) detection of cognitive function changing in rat with hepatosteatosis model and (2) evaluate the effect of GLP-1 analog (exenatide) on cognitive function in hepatosteatosis. In the study group, 30% fructose was given in nutrition water to perform hepatosteatosis for 8 weeks to 18 male rats. Six male rats were chosen as control group and had normal nutrition. Fructose nutrition group were stratified into 3 groups. In first group (n = 6), intracerebroventricular (ICV) infusion of exenatide (n = 6) was given. ICV infusion of NaCl (n = 6) was given to second group. And also, the third group had no treatment. And also, rats were evaluated for passive avoidance learning (PAL) and liver histopathology. Mean levels of latency time were statistically significantly decreased in rats with hepatosteatosis than those of normal rats (P < 0.00001). However, mean level of latency time in rats with hepatosteatosis treated with ICV exenatide was statistically significantly increased than that of rats treated with ICV NaCl (P < 0.001). Memory performance falls off in rats with hepatosteatosis feeding on fructose (decreased latency time). However, GLP-1 ameliorates cognitive functions (increased latency time) in rats with hepatosteatosis and releated metabolic syndrome.

Early menopause association with employment, smoking, divorced marital status and low leptin levels.

AIMS: The aims of this study were (1) to investigate the determining risk factors related to early menopause and (2) to compare the relationships between demographic characteristics and hormonal status and leptin levels in subjects with early (no surgical) and natural menopause. STUDY DESIGN: The prospective study was conducted on 500 women with early and 2700 women with natural menopause. Detailed information was collected about their employment status, past and present smoking habits, coffee and alcohol use, educational level and other factors relevant to health. Thirty participants with early menopause and 30 participants with natural menopause were evaluated for hormone and leptin levels. RESULTS: Employment status (OR: 1.94), current smoking (OR: 1.80) and divorced marital status (OR: 1.79) were found to be significant risk factors for early menopause. Mean levels of leptin in natural and early menopause were measured 11.40 ± 4.1 ng/ml and 8.01 ± 3.9 ng/ml, respectively (p = 0001). Leptin levels in the early (r = 0.765, p = 0.001) and natural (r = 0.750, p = 0.001) menopause subjects correlated positively with oestradiol (E2) levels. CONCLUSION: This study shows that early onset of menopause is correlated with smoking, employment status, divorced marital status and lower leptin levels.

Clinical and demographic aspects of Paget disease of bone: A multicentric study from Turkey.

OBJECTIVE: Paget disease of bone (PDB) is a metabolic bone disease that has been rarely reported in the Eastern countries. This study aimed to evaluate the clinical and demographic characteristics of patients with PDB followed up at endocrinology clinics in Turkey. METHODS: An invitation was sent to tertiary endocrinology clinics to complete a survey on the demographic, clinical, radiological, and laboratory parameters, as well as treatment modalities of patients with PDB. This study enrolled clinically and radiologically proven 185 patients with PDB from 18 endocrinology centers based in 10 cities of Turkey. RESULTS: This cohort of PDB had female preponderance (women/men: 105/80) with a mean age, during diagnosis, of 57±10 years. Most of the patients (59.6%) were symptomatic at diagnosis. Bone pain and headache were the predominant clinical symptoms. Polyostotic disease was observed in 67.5% (n=125) of patients. Frequently affected bones were skull (41.6%), pelvis (53.5%), spine (41%), and femur (25.4%). Moreover, 17 patients with skull involvement had hearing loss. Mean serum alkaline phosphatase (ALP) level (552±652 IU/L; range: 280-5762 IU/L) was over the normal reference cutoff with normal serum calcium levels. Intravenous bisphosphonates (zoledronic acid, 5 mg; pamidronate, 60-90 mg) were the most used drugs (75%) for the treatment of PDB. Most of the patients (87.1%) treated with intravenous bisphosphonates responded well, with a decrease in serum ALP level (117±114 IU/L) in the 12th month of therapy. Furthermore, 16 patients relapsed after the second year of therapy; 3 patients did not respond to the initial intravenous bisphosphonate treatment. CONCLUSION: The patients with PDB followed up by endocrinology clinics of Turkey exhibited polyostotic disease with classical clinical, radiological, and biochemical features and women's predominance with good response to intravenous bisphosphonate therapy.

A cross-sectional study on sarcopenia using EWGSOP1 and EWGSOP2 criteria with regional thresholds and different adjustments in a specific geriatric outpatient clinic.

PURPOSE: The aim of this study was to determine the prevalence of sarcopenia according to different methods in older outpatients using regional threshold values of muscle mass and muscle strength. METHODS: We used data from our university hospital's geriatric outpatient clinic specific to endocrinological problems, retrospectively. Sarcopenia was defined according to European Working Group on Sarcopenia in Older People (EWGSOP)1 and EWGSOP2 criteria using regional threshold values of skeletal muscle mass (SMM) with the use of different adjustments, and also according to EWGSOP2 with regional threshold values of grip strength. RESULTS: Among 248 study participants, 53.6% were obese. There was no sarcopenic patient with the height square adjusted regional SMM thresholds for EWGSOP1 and EWGSOP2. Sarcopenia prevalence was 11.7% with EWGSOP2, and 41.1% by the use of regional grip strength thresholds for EWGSOP2 with body mass index adjustments for SMM. The comparison of EWGSOP1 versus EWGSOP2 was not possible due to lack of sarcopenic patients with height adjustment. CONCLUSIONS: The prevalence of sarcopenia varied significantly with the application of different adjustment methods for SMM, and the use of regional grip strength thresholds in the specific patient group with normal to overweight and obese individuals. The use of regional thresholds of grip strength increased the prevalence of EWGSOP2-defined sarcopenia. The impact of the adjustment methods, the characteristics of the study population, and the regional thresholds should be taken into consideration while evaluating the results of sarcopenia studies.

Effects of hormone replacement therapy on insulin resistance and platelet function tests.

OBJECTIVES: The aim of this study was to evaluate measures of insulin resistance and platelet function in postmenopausal women with oral or transdermal hormone replacement therapy (HRT). SUBJECTS AND METHODS: Eighty women divided into four groups of 20 each were enrolled in the study. Group 1: postmenopausal hysterectomized women who received only transdermal estradiol (13.9 mg/12.5 cm(2)); group 2: women with intact uterus who were treated with estrogen-progestin combination (HRT); group 3: postmenopausal women who were treated with the selective estrogen receptor modulator tibolone, and group 4: women who were not taking any drugs for HRT were chosen as a control group (group 4). RESULTS: In group 2, homeostasis model assessment of insulin resistance and fasting insulin levels were 2.90 +/- 0.37 and 9.3 +/- 3.0 microU/ml, respectively, prior to administration of HRT. These levels were reduced to 1.91 +/- 0.41 (p = 0.001) and 7.1 +/- 2.7 microU/ml (p = 0.002), respectively, after drug therapy. Mean levels of high-sensitivity C-reactive protein (hsCRP) were decreased with HRT only in group 2 (p = 0.002). No changes for biochemical and hematological parameters were observed in the other groups. Platelet function tests showed no differences after HRT in any group. CONCLUSIONS: Estrogen-progestin combination HRT decreased measures of insulin resistance and hsCRP levels, but had no effect on platelet function tests in postmenopausal women.

Prevalence of sarcopenia and related factors in community-dwelling elderly individuals.

OBJECTIVES:  To determine the prevalence of sarcopenia and related factors in individuals aged ≥65 years living in the Bornova district of Izmir, Turkey. Sarcopenia is one of the most serious health problems among elderly individuals. METHODS:  This cross-sectional study was conducted in the Bornova district of Izmir, Turkey, between February-July 2015. This study participants were comprised of 909 individuals aged ≥65 years. The dependent variable was the presence of sarcopenia and the European Working Group on Sarcopenia in Older People (EWGSOP) approach was used for determining sarcopenia. The independent variables were socio-demographic and economic characteristics, healthy life behaviors and health status/condition. Data were collected at home through face-to-face interviews and measurements, analysed using chi-square test, t-test and logistic regression analysis. RESULTS:  The participants' mean age was 72.8±6.2 (range: 65-100) years, and 60.2% were female (n=582). The prevalence of sarcopenia was 5.2% and that of low gait speed was 41.0%, low grip strength was 57.0%, low calf circumference was 6.1% and the combination of low gait speed and low grip strength was 14.3%. Risk factors of sarcopenia included increasing age, physical inactivity, low body mass index and the presence or risk of malnutritionConclusion: The prevalence of sarcopenia was 5.2% in this population and increased with age, physical inactivity, low body mass index and the presence or risk of malnutrition.

Prolactin levels and examination with breast ultrasound or mammography.

OBJECTIVE: Stresses including surgery, exercise, nipple stimulation, and chest wall injury such as mechanical trauma, burns, surgery, herpes zoster of thoracic dermatomes, hypoglycaemia and acute myocardial infarction cause significant elevation of prolactin levels. The aim of the present study was to evaluate the changes in prolactin level during mammography and ultrasonographic examination. MATERIALS AND METHODS: Seventy-four premenopausal (mean age, 32.1+/-7.3 y) and 81 post-menopausal women (mean age, 48.3+/-8.9 y) were enrolled into the study. Premenopausal women were evaluated with ultrasound (Senographe 600 T [General Electric]) and post-menopausal women were examined with mammography (Mammomat 3000 [Siemens]). Blood samples for prolactin were taken prior to ultrasound or mammography and 15, 30 and 45 min after ultrasound or mammography. RESULTS: Mean baseline serum prolactin level was 7.2+/-0.9 ng/ml in premenopausal women before ultrasound. Mean baseline serum prolactin level was 5.4+/-0.4 ng/ml in post-menopausal women before mammography. It was found that there were no significant changes in prolactin levels after ultrasound or mammography (P > 0.05). Mean levels of baseline prolactin were statistically significant higher in premenopausal than in post-menopausal women (P = 0.03). CONCLUSION: Mammography and ultrasonographic examination have no acute effect on serum prolactin levels in either group. There is no need to wait before measuring the prolactin level after mammographic or ultrasonographic breast examination.

The relationship between lipoprotein-associated phospholipase A2 with cardiovascular risk factors in testosterone deficiency.

OBJECTIVE: Lipoprotein-associated phospholipase A2 (Lp-PLA2) which is believed to play a role in atherosclerotic inflammatory process due to its function in hydrolysis of phospholipids and release of pro-inflammatory products, is considered as a novel biomarker for vascular risk. In this study we aimed to investigate the alterations in Lp-PLA2 and its relationship with other cardiovascular risk factors in patients with testosterone deficiency. MATERIAL AND METHODS: Forty hypogonadic male and 30 healthy male aged between 18-50 years were enrolled in this study. Height-weight, waist-to-hip circumference, body mass index (BMI) blood pressure, and body fat measurements were performed in all subjects. Blood glucose, albumin, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, high sensitive C-reactive protein (hs-CRP), apo-A1, apo-B, fibrinogen, insulin, total testosterone, sex hormone binding globulin (SHBG), small dense low-density lipoprotein (sd-LDL), paraoxonase 1, oxidized low-density lipoprotein (ox-LDL) and Lp-PLA 2 values were measured. Free and bioavailable testosterone levels were calculated. Data management was carried out with the statistical program SAS Version 9.2. Statistical evaluations were performed using Analysis of Variance (ANOVA), Kruskal-Wallis test, Wilcoxon test, correlation analysis and chi-square analysis. P values <0.05 were considered statistically significant. RESULTS: In patients with hypogonadism, significant increase in Lp-PLA2 levels were accompanied with risk factors of atherosclerosis, such as increase in total cholesterol, apo-B, sd-LDL, weight, BMI, body fat percentage, and decrease in paraoxonase 1 levels. Although the differences were not significant, similarly ox-LDL, hs-CRP, triglyceride, LDL-cholesterol levels were found to be higher in patients with hypogonadism compared to the control group. The mean level of Lp-PLA2 was the highest when compared with the group of secondary hypogonadism with the lowest testosterone level. CONLUSION: Our study has demonstrated that the testosterone deficiency increases cardiovascular risk via its effects on lipid metabolism and Lp-PLA2 can be used to assess this risk.

Association of sarcopenia with depressive symptoms and functional status among ambulatory community-dwelling elderly.

OBJECTIVE: Sarcopenia, functional disability, and depression are common problems in the elderly. Sarcopenia is associated with physical disability, functional impairment, depression, cardiometabolic diseases, and even mortality. This study aims to determine the association of sarcopenia with depression and functional status among ambulatory community-dwelling elderly aged 65 years and older. MATERIALS AND METHOD: The sample of this cross-sectional study consisted of 28,323 people, aged 65 years and older, living in Bornova, Izmir. Multi-stage sample selection was performed to reach 1007 individuals. However, 966 elderly people could be reached, and 861 elderly people who can walk were included in the study. The data were collected by the interviewers at home through face-to-face interview. RESULTS: The mean age was 72.2 ±â€¯5.8 (65-100) years. The prevalence of functional disability, depressive symptoms, and sarcopenia were 21.7%, 25.2%, and 4.6%, respectively. In multivariate analysis depression was associated with sarcopenia, being illiterate and divorced, perception of the economic situation as poor/moderate, increased number of chronic diseases, and having at least one physical disability. IADL associated functional disability with sarcopenia, being illiterate/literate and female, increased age and number of medications, and the BMI. CONCLUSION: Sarcopenia in ambulatory community-dwelling elderly is significantly associated with depressive symptoms and functional disability. Elderly people at high risk of sarcopenia should be screened for functional disability and depression. Appropriate interventions should also be implemented.

Quality of life for obese women and men in Turkey.

INTRODUCTION: Obesity is a complex, multifaceted disease that is widespread and growing in the developing world. People who are obese experience health-related quality-of-life impairments. METHODS: We administered the SF-36 Health Survey questionnaire to 1752 obese adults and 400 normal-weight adults in Izmir City, Turkey. We then compared the mean scores of the two groups by sex in eight quality-of-life domains. RESULTS: Differences in scores between obese women and normal-weight women were statistically significant in seven of eight SF-36 domains; differences in scores between obese men and normal-weight men were statistically significant in six of eight domains. Obese women were significantly more impaired than obese men in four of eight domains. Among obese women, 45.0% experienced a reduced quality of life, compared with only 13.2% of normal-weight women. Similarly, 41.3% of obese men experienced a reduced quality of life, compared with only 9.3% of normal-weight men. CONCLUSION: Obesity is associated with poor levels of health, particularly poor levels of physical and social well-being.

Out-of-Reference Range Thyroid-Stimulating Hormone Levels in Levothyroxine-Treated Primary Hypothyroid Patients: A Multicenter Observational Study.

OBJECTIVE: Although levothyroxine (LT4) replacement therapy for hypothyroidism has been established as safe, inexpensive and effective, many studies from different countries reported out-of-reference range thyroid-stimulating hormone (TSH) values for the hypothyroid patients under LT4 treatment. The aim of this study was to determine TSH levels of primary hypothyroid patients under LT4 treatment and to assess self-reported compliance with daily LT4 intake in tertiary care centers in Turkey. DESIGN: In this cross-sectional, observational study, adult patients with primary hypothyroidism, receiving LT4 treatment for at least 6 months, were included. The patients were from 12 tertiary care centers in 9 cities of Turkey. TSH and free T4 levels were recorded from patient files and self-reported compliance with daily LT4 intake was assessed by interviewing the subjects at the last visit. RESULTS: A total of 1,755 subjects (46 ± 13 years; F/M: 89.9/10.1%) with primary hypothyroidism were enrolled. Of the hypothyroid subjects, 44.8% had out-of-reference range serum TSH levels. TSH values were over the reference range (TSH > 4 mIU/L) in 26.2% and were under the reference range (TSH < 0.5 mIU/L) in 18.6% of the patients. Total duration of LT4 treatment was 5.9 ± 4.7 years and mean dose was 1.2 ± 0.6 µg/kg/day. Non-compliant patients (31.1%) had higher TSH levels (6.9 ± 16 vs 3.8 ± 0.9 mIU/L, P = 0.01) compared to compliant patients. CONCLUSION: The results of this study revealed that nearly half of the hypothyroid patients had out-of-reference range serum TSH values, despite under LT4 treatment. Compliance with LT4 treatment seems to be one of the major determinants to reach the target TSH levels in hypothyroid patients.

Gingival crevicular fluid and serum levels of APRIL, BAFF and TNF-alpha in rheumatoid arthritis and osteoporosis patients with periodontal disease.

BACKGROUND: This study was performed to evaluate gingival crevicular fluid (GCF) and serum levels of a proliferation inducing ligand (APRIL) and B cell activating factor (BAFF) and compare this to differences between TNF-alpha levels in rheumatoid arthritis (RA), osteoporosis (OPR) and systemically healthy women with periodontal disease (SH). DESIGN: Gingival crevicular fluid (GCF) and serum samples were obtained before any periodontal intervention from 17 RA, 19 OPR patients and 13 SH women with periodontitis. Full-mouth clinical periodontal measurements were recorded. APRIL, BAFF and TNF-α levels were determined by ELISA. Statistical analysis was performed using multivariate analysis, ANOVA and Spearman correlation. RESULTS: Pocket depths differed in site-specific comparisons, but otherwise clinical measurements were similar in the three study groups. Multivariate least squares regression ANOVA adjusted for age and for plaque index indicated that total amounts of TNF-α and concentrations of TNF-α, BAFF and APRIL were significantly greater in the RA patients than in the SH group (p<0.05), and GCF concentrations of BAFF were greater in OPR patients than in SH. Serum TNF-α and BAFF were significantly higher in the RA group compared to SH (p<0.05) and serum TNF-α was greater in RA than in OPR (p<0.05). APRIL and BAFF correlated with RANKL levels in GCF and serum (p<0.05). CONCLUSION: Despite long-term usage of anti-inflammatory drugs in the RA and OPR patients, increased TNF-family cytokines, might suggest that these patients have a propensity to overproduce these inflammatory mediators but whether this results from greater disease activity or contribute to greater disease activity remains moot.

Gingival crevicular fluid, serum levels of receptor activator of nuclear factor-κB ligand, osteoprotegerin, and interleukin-17 in patients with rheumatoid arthritis and osteoporosis and with periodontal disease.

BACKGROUND: This study is performed to evaluate gingival crevicular fluid (GCF) and serum levels of soluble receptor activator of nuclear factor-κB ligand (sRANKL), interleukin (IL)-17A, IL-17E, IL-17F, IL-17A/F, and osteoprotegerin (OPG) in women with rheumatoid arthritis (RA), osteoporosis (OPR), and those who are systemically healthy (SH), all with periodontal disease. METHODS: GCF and serum samples were obtained before any periodontal intervention from 17 women with RA, 19 with OPR, and 13 who were SH with periodontitis. Full-mouth clinical periodontal measurements were recorded. sRANKL, OPG, and IL-17 levels were determined by enzyme-linked immunosorbent assay. RESULTS: Clinical periodontal measurements were similar in the three study groups. Although the total amounts of GCF albumin, OPG, IL-17A, and IL-17A/F were similar in the study groups, there were statistically significant differences in GCF concentrations of sRANKL, OPG, IL-17A, IL-17E, IL-17F, and IL-17A/F. The sRANKL/OPG ratios were significantly higher in the RA group than in the OPR and SH groups (P <0.05). Serum sRANKL, sRANKL/OPG, and IL-17A/IL-17E ratios were significantly higher, whereas OPG concentrations were significantly lower in the RA group compared to other groups (P <0.05). Serum IL-17A concentrations were significantly higher in the RA and OPR groups than in the SH group (P <0.05). CONCLUSION: Increased inflammatory mediator levels in patients with RA, despite the long-term use of various anti-inflammatory drugs, suggest that these patients may have a propensity to overproduce these inflammatory mediators.

Metabolic syndrome, insulin resistance, fibrinogen, homocysteine, leptin, and C-reactive protein in obese patients with obstructive sleep apnea syndrome.

OBJECTIVE: The prevalence of obstructive sleep apnea syndrome (OSAS) and metabolic syndrome is increasing worldwide, in part linked to epidemic of obesity. The purposes of this study were to establish the rate of metabolic syndrome and to compare fibrinogen, homocysteine, high-sensitivity C-reactive protein (hsCRP), leptin levels, and homeostasis model assessment insulin resistance (HOMA-IR) in the obese patients with and without OSAS. METHODS: The study population included 36 consecutive obese patients with OSAS (23 males; mean age, 50.0 ±19.7 years), and 34 obese patients without OSAS (17 males; mean age, 49.7±11.1 years) were enrolled as control group. Metabolic syndrome was investigated; fibrinogen, homocysteine, CRP, and leptin levels were measured, and IR was assessed. RESULTS: Metabolic syndrome was found in 17 (47.2%) obese OSAS patients, whereas only 29.4% of obese subjects had metabolic syndrome (P > 0.05). Obese patients with OSAS had significantly higher mean levels of triglyceride (P < 0.001), total-cholesterol (P = 0.003), low-density lipoprotein-cholesterol (P = 0.001), fasting glucose (P = 0.01), HOMA-IR (P <0.001), thyroid-stimulating hormone (P = 0.03), fibrinogen (P < 0.003), hsCRP (P <0.001), and leptin (P = 0.03) than control group . Besides, leptin level was positively correlated with waist (r = 0.512, P = 0.03) and neck circumferences (r = 0.547, P = 0.03), and fasting glucose (r = 0.471, P = 0.04) in OSAS patients, but not in obese subjects. CONCLUSION: This study demonstrated that obese OSAS patients may have an increased rate of metabolic syndrome and higher levels of serum lipids, fasting glucose, IR, leptin, fibrinogen, and hsCRP than obese subjects without sleep apnea. Thus, clinicians should be encouraged to systematically evaluate the presence of metabolic abnormalities in OSAS and vice versa.

Cardiac valve evaluation and adipokine levels in obese women treated with sibutramine.

OBJECTIVE: The aims of present study were 1) to evaluate cardiac valve characteristics, 2) to determine the plasma concentrations of fibrinogen, high sensitivity C-reactive protein (hsCRP), adiponectin, and tumor necrosis factor-alpha (TNF-alpha) in the obese women before and after 19 months sibutramine treatment in the obese women. METHODS: Sixty obese women were enrolled in this prospective, randomized study. Thirty women received 10 mg once daily dose of sibutramine for 19 months. The rest of the obese women received 15 mg once daily dose of sibutramine for 19 months. All patients were evaluated with echocardiography. Plasma levels of adiponectin and TNF-alpha were measured by enzyme-linked immunosorbent assay (ELISA) and hsCRP by immunoturbimetric assay. Student paired and unpaired t tests were used to compare the 10 mg or 15 mg dose sibutramine effects either in groups or between the groups. RESULTS: There were no signs of significant regurgitation or thickening of the mitral and aortic valves on echocardiographic evaluation performed after 19 months of treatment. Parameters of systolic function after 10 or 15 mg treatment were not different from pretreatment characteristics. Minimal tricuspid regurgitation was found in one (1/27) patient treated with 10 mg sibutramine after 19 months. Among obese patients treated with 15 mg sibutramine one patient (1/28) had minimal mitral valve regurgitation and 2 patients (2/28) had minimal aortic insufficiency. Stage II diastolic dysfunction in the 15 obese treated with 15 mg regressed to stage I diastolic dysfunction (50%). Stage II diastolic dysfunction in the 10 obese treated with 10 mg regressed to stage I diastolic dysfunction (33.3%). Mean levels of TNF-alpha(p=0.04), fibrinogen (p=0.03) and hsCRP (p=0.04)i decreased and adiponectin (p=0.03) levels increased in the obese treated with 10 mg sibutramine. Likewise, in the patients treated with 15 mg sibutramine, mean levels of TNF- alpha(p=0.01), fibrinogen (p= 0.02), and hsCRP (p= 0.04) decreased and adiponectin (p= 0.02) levels increased. CONCLUSION: Nineteen months of sibutramine treatment does not affect heart valve and systolic functions, however, diastolic dysfunction severity reduced with sibutramine treatment. Also In addition, mean levels of adiponectin, TNF- alpha, fibrinogen and hs- CRP change with 19 months sibutramine treatment.

Calcium, vitamin D supplements with or without alendronate and supragingival calculus formation in osteoporotic women: a preliminary study.

OBJECTIVES: Long-term calcium intake is related to the formation of urinary stones. Structure and composition of kidney and gallstones are similar to dental calculus. Saliva is the source of calcium for supragingival dental calculus formation. The aim of this preliminary study was to evaluate the possible effects of long-term calcium and vitamin D supplementation with or without alendronate administration on salivary electrolyte concentrations and supragingival calculus formation in osteoporotic women. METHODS: Thirty-one female patients with osteoporosis for at least 3 years participated in this study. Eighteen women were taking calcium plus vitamin D plus alendronate, while 13 women were taking only calcium plus vitamin D supplements. Eleven systemically healthy women volunteered for the control group. Whole saliva samples were collected from all women before initiation of any periodontal intervention. Plaque index, probing depth, clinical attachment level, bleeding on probing, and calculus index were recorded at six sites/tooth. Salivary concentrations of ionic calcium, potassium, magnesium and sodium were determined by atomic absorption spectrophotometer. Results were evaluated statistically by non-parametric tests. RESULTS: No significant differences were found in clinical parameters or results of saliva analysis between the study groups (p > 0.05). CONCLUSION: Within the limits of this preliminary study, it is suggested that long-term calcium and vitamin D supplementation with or without alendronate does not appear to have a significant effect on supragingival calculus formation or saliva total calcium, potassium, magnesium and sodium concentrations. Larger-scale studies investigating the possible effects of various treatment modalities of osteoporosis on supragingival calculus formation are required to better clarify this issue.

Diabetes and impaired glucose tolerance prevalences in Turkish patients with impaired fasting glucose.

Impaired fasting glucose (IFG) like impaired glucose tolerance (IGT) has increased risk of progressing to diabetes mellitus (DM). The aim of the study was to evaluate prevalance of IGT and type 2 DM with oral glucose tolerance test (OGTT) in Turkish patients who had fasting glucose of 110 and 125 mg/dl. Hundred and forty-eight (67.3%) women and 72 (32.7%) men (30-65 years old with mean age of 51.3 +/- 8.7 year) who had fasting glucose range 110-125 mg/dl were evaluated with OGTT. Seventy-two patients had IGT (32.8%), 74 (33.6%) patients had type 2 diabetes and 74 (33.6%) patients had normal glucose tolerance (NGT). Mean fasting glucose and insulin levels were higher in the IGT group than in the NGT group. Mean level of total cholesterol was higher in DM than that in NGT and IGT groups. Mean triglyceride (TG) (P = 0.476), high-density lipoprotein (HDL) (P = 0.594), low-density lipoprotein (LDL) (P = 0.612), Apoproteine A (P = 0.876), Apoproteine B (P = 0.518), uric acid (P = 0.948) and ferritin (P = 0.314) were found higher in diabetic patients. Lipoproteine a (P = 0.083), fibrinogen (P = 0.175) and hsCRP (P = 0.621) levels were higher in IGT. Mean HOMA S% levels of NGT, IGT and DM were found to be 65.0 +/- 13.0%, 60.9 +/- 16.0% and 50.1 +/- 11.1%, respectively. HOMA B% levels were measured to be 80.4 +/- 29.1% in NGT, 85.3 +/- 14.59% in IGT and 60.1 +/- 10.1% in DM. Significant difference was found between IFG and DM (P = 0.043) groups. The prevalences of diabetes and IGT were found to be 33.63 and 32.7% in IFG, respectively.

Cardiovascular risk factors in obese women and their first-degree relatives.

OBJECTIVE: Evidence for a connection between obesity and cardiovascular disease is derived from epidemiological studies. The aim of this study was to evaluate the cardiovascular risk factors in obese women and their first-degree relatives. METHODS: Fifty-five obese women and their 154 first-degree relatives (daughter, son, sister, brother), 60 non-obese women and their 100 first-degree relatives were enrolled in this cross-sectional controlled study. Blood pressure, heart rate, body mass index (BMI), waist-to-hip ratio (WHpR), waist circumference (WC) and lipid levels were measured in all participants. Serum concentrations of insulin were measured by chemiluminescence method, plasma levels of high sensitive C-reactive protein (hs CRP) by immunoturbimetric assay and fibrinogen by coagulation method. Measurement of insulin resistance (IR) was calculated using homeostasis model assessment (HOMA). Statistical analysis was preformed using Chi-square, Student's t and Mann-Whitney U tests. The relationship between obesity indices and cardiovascular risk factors were studied using linear regression analysis. RESULTS: Mean values of BMI in female and male relatives were found as 25.10+/-2.5 kg/m2 and 23.5+/-4.98 kg/m2, respectively. In relatives, the frequencies of obesity, overweight and normal weight were found to be 8.9%, 25.8% and 65.1%, respectively. Central obesity was found higher in males than in females in the first-degree relatives, using WC (28.5% vs. 14.3%, p=0.001) or WHpR (30.9% vs. 24.5%, p=0.002). Elevated blood pressure (>or=140/90 mmHg) was recorded in 23.6% of obese women and in 8.4% of their relatives. Mean HOMA-IR levels of obese women and their relatives were found as 3.26+/-0.7 and 2.07+/-1.1, respectively. Mean hs CRP levels of obese women and their relatives were 0.98+/-0.08 mg/dl and 0.23+/-0.03 mg/dl, respectively (p=0.002). Mean fibrinogen levels of obese women and their relatives were 443.21+/-45.9 mg/dl and 321.10+/-38.23 mg/dl, respectively. CONCLUSION: In obese women and their relatives, body mass index and waist circumferences are related with blood pressure, total cholesterol, fibrinogen and insulin resistance. If there are obese women in family, first-degree relatives have 1.8 fold increased obesity frequency. Body mass index increases together with cardiovascular risk factors. In early term, prevention of obesity may decrease developing of cardiovascular risk.