Yazar "Aktas, Gulali" seçeneğine göre listele
Listeleniyor 1 - 20 / 21
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Association between nasal polyps and novel inflammatory parameters(Scientific Publishers of India, 2017) Apuhan, Tayfun; Aktas, GulaliNasal polyposis represents as a chronic hyperplastic sinusitis associated with chronic inflammation. In present retrospective study, we aimed to compare the Mean Platelet Volume (MPV), Red Cell Distribution Width (RDW) and Neutrophil to Lymphocyte Ratio (NLR) values of patients with nasal polyposis to those in healthy subjects. We included 35 nasal polyp patients and 45 healthy subjects into the study. White Blood Cell count (WBC), Neutrophil Count (NEU), Lymphocyte Count (LYM), Hemoglobin (Hb), Hematocrit (HTC), Mean Corpuscular Volume (MCV), RDW, Platelet Count (PLT) and MPV were recorded after obtaining from computerized database. There was statistically significant difference between study and control groups (p<0.001). Decreased MPV and elevated RDW and NLR are characteristics of nasal polyposis. These parameters may also be helpful in assessing the success of treatment. Further studies with a larger study population are needed to detect the possible correlation between MPV, RDW and NLR values in patients with nasal polyps. © 2017, Scientific Publishers of India. All rights reserved.Öğe A Case of Giant Hepatic Hydatid Cyst Infected with Morganella morganii and the Literature Review(Hindawi Ltd, 2012) Hakyemez, Ismail Necati; Sit, Mustafa; Aktas, Gulali; Tas, Tekin; Mengeloglu, Firat Zafer; Kucukbayrak, AbdulkadirHydatid cyst disease is a common worldwide zoonosis. Most of the cysts are located in the liver. Abscess formation due to infection of the cyst is an important complication. M. morganii, a Gram-negative Bacillus, is a quite rare cause of liver abscess. A 77-year-old woman was admitted to hospital with complaints of fever, chills, nausea, vomiting, loss of appetite, and abdominal pain located in the right-upper quadrant. Her history was positive for hepatic hydatid cyst disease ten years ago. Physical examination revealed a painful mass filling the right-upper quadrant and extending down to umbilicus. Indirect hemagglutinin test for hydatid cyst was positive at a titer of 1/320. Giant liver abscess due to infected hydatid cyst was found in computed tomography scan. Surgeons performed cystectomy and cholecystectomy. Cefazoline, cefuroxime, and metronidazole were administered empirically, but all the three agents were replaced with intravenous ceftriaxone after M. morganii was isolated from the cultures of the abscess material. Clinical signs of the patient resolved at the second week of treatment, and she was discharged.Öğe Characteristics of the type 2 diabetic patients with hypoglycemia in a tertiary referral hospital(Zaslavsky Publishing House, 2021) Bilgin, Satilmis; Aktas, Gulali; Kurtkulagi, Ozge; Atak, Burcin M.; Kahveci, Gizem; Demirkol, Muhammed E.; Duman, Tuba T.Background. Hypoglycemia is an important complication of the treatment of type 2 diabetes mellitus, which constitutes a barrier in stringent diabetic control. Beside it constitutes nearly 10 % of emergency department admissions that caused by adverse drug events, it may also increase morbidities and mortality by inducing, cardiac arrhythmias, neurological impairment and ischemic events. Hypoglycemia is the most common side effect of insulin treatment, however, oral antidiabetic agents may also induce hypoglycemic complications. In present retrospective study, we purposed to observe general characteristics and laboratory data of the type 2 diabetic patients whom presented with mild or moderate/severe hypoglycemia. Materials and methods. Patients with type 2 diabetes mellitus whom presented to our institution with hypoglycemia between January 2019 and January 2020 were retrospectively analyzed. General characteristics and laboratory data of the subjects recorded. Patients grouped into two groups, group I consisted of subjects with mild hypoglycemia and group II consisted of patients with moderate/severe hypoglycemia. Data of the subjects in groups I and II were compared. Results. There were 15 subjects in group I and 23 in group II. HbA1c and other laboratory markers were not significantly different in study groups. Similarly diabetes duration and anti-diabetic treatment were not significantly different in study groups. The rate of geriatric patients was significantly higher in group II compared to group I (p = 0.04). Conclusions. Subjects with moderate/severe hypoglycemia tend to be more frequently in geriatric age and HbA1c not correlates with the degree of the hypoglycemia. Since neither duration of diabetes, nor anti-diabetic treatment were associated with the severity of the hypoglycemia, each case should be evaluated individually to prevent further episodes which could increase morbidity and mortality in diabetic population. © 2021. The Authors.Öğe Controlling Nutritional Status (CONUT) score is a novel marker of type 2 diabetes mellitus and diabetic microvascular complications(Taylor & Francis Ltd, 2024) Aktas, Gulali; Duman, Tuba Taslamacioglu; Tel, Burcin AtakObjectives: Type 2 diabetes mellitus (T2DM) and its microvascular complications are characterized by chronic inflammation. The Controlling Nutritional Status (CONUT) score is a tool used to assess nutritional status and is often associated indirectly with inflammatory processes. We aimed to compare the CONUT scores of T2DM patients with those of healthy volunteers and to compare T2DM patients with and without microvascular complications. Methods: Patients diagnosed with T2DM and healthy volunteers (as controls) were included in the study. The CONUT score is calculated using the following formula: serum albumin score + total cholesterol score + total lymphocyte count score. CONUT scores of T2DM patients and healthy controls, as well as those of diabetics with and without microvascular complications, were compared. Results: The CONUT scores of the T2DM and control groups were (1 [0-7]) and (0 [0-2]), respectively (p < 0.001). The sensitivity and specificity of the CONUT score (<1.5 threshold) in detecting T2DM were 43% and 90%, respectively (AUC: 0.67, p < 0.001, 95% CI: 0.64-0.71). Moreover, the CONUT score was an independent risk factor for T2DM (OR: 0.34, p < 0.001, 95% CI: 0.22-0.52). The CONUT score of T2DM patients with microvascular complications (2 [0-7]) was significantly higher than that of T2DM patients without microvascular complications (0 [0-4]) and control subjects (0 [0-2]) (p < 0.001). A CONUT score higher than 1.5 had 83% sensitivity and 92% specificity in detecting T2DM with microvascular complications (AUC: 0.91, p < 0.001, 95% CI: 0.89-0.93). Conclusion: The CONUT score could be useful in detecting diabetic microvascular complications in clinical practice, as it is an inexpensive and easy-to-assess marker.Öğe Could a reduced hemoglobin, albumin, lymphocyte, and platelet (HALP) score predict autoimmune hepatitis and degree of liver fibrosis?(Assoc Medica Brasileira, 2024) Ustaoglu, Muge; Aktas, Gulali; Kucukdemirci, Omer; Goren, Ibrahim; Bas, BerkOBJECTIVE: Autoimmune hepatitis is a rare inflammatory disease of the liver that is characterized by elevated liver enzymes. The hemoglobin, albumin, lymphocyte, and platelet score, which is derived from hemoglobin, serum albumin, circulating lymphocyte count, and platelet count, is also associated with inflammatory conditions. The aim was to examine the hemoglobin, albumin, lymphocyte, and platelet score of patients with autoimmune hepatitis and to compare it to that of healthy individuals in this retrospective analysis. METHODS: Subjects diagnosed with autoimmune hepatitis were enrolled in the study, and healthy individuals were enrolled as controls. Moreover, autoimmune hepatitis subjects were grouped into mild or moderate/advanced fibrosis. Furthermore, aspartate to platelet ratio index, Fibrosis-4, and hemoglobin, albumin, lymphocyte, and platelet scores of the autoimmune hepatitis patients and controls were compared. In addition, the hemoglobin, albumin, lymphocyte, and platelet score of the autoimmune hepatitis patients with mild fibrosis is compared to that of those with moderate/advanced fibrosis. RESULTS: The mean hemoglobin, albumin, lymphocyte, and platelet score of the autoimmune hepatitis patients was 44.2 +/- 14.5 while this value was 76.8 +/- 15.5 in control subjects. The hemoglobin, albumin, lymphocyte, and platelet score was significantly reduced in autoimmune hepatitis patients than healthy controls (p<0.001). The hemoglobin, albumin, lymphocyte, and platelet score was significantly and negatively correlated with C-reactive protein, aspartate, alanine transaminase, gamma glutamyl transferase, aspartate to platelet ratio index, and Fibrosis-4 values. A hemoglobin, albumin, lymphocyte, and platelet score that was lower than 52.3 had 83% sensitivity and 73% specificity in predicting autoimmune hepatitis. The sensitivity and specificity of the hemoglobin, albumin, lymphocyte, and platelet score were higher than the Fibrosis-4 score in predicting moderate/advanced fibrosis in autoimmune hepatitis. CONCLUSION: We suggest that the hemoglobin, albumin, lymphocyte, and platelet score be used as an additional noninvasive diagnostic tool for autoimmune hepatitis and to predict moderate/advanced liver fibrosis in patients with autoimmune hepatitis.Öğe Current usage of long-acting insulin analogs in patients with type 2 diabetes mellitus(Routledge Journals, Taylor & Francis Ltd, 2024) Aktas, Gulali; Taslamacioglu Duman, TubaIntroductionInsulin treatment is fundamental to diabetes management. Basal insulin therapy reduces intraday glycemic fluctuations upon reaching a steady state. Besides better blood glucose regulation and achieving target HbA1c values in patients, it also offers protection from diabetes complications. In this review, we aimed to compare basal-acting insulins in light of the literature.Areas coveredWe reviewed current evidence related to diabetes treatment with basal insulins. This includes discussions on clinical trials and meta-analyses concerning first and second-generation ultra-long-acting basal insulins. Treatment indications for long-acting basal insulins, which have shown benefits and are considered superior or comparable to others in the literature, are derived from current clinical studies and meta-analyses, which form the basis of the recommendations in this review.Expert opinionFirst and second-generation basal insulins do not show much superiority over each other in terms of blood glucose regulation and reaching the target HbA1c. However, second-generation basal insulins cause fewer hypoglycemic events. We recommend using the appropriate basal insulin in patient-based, individualized treatments. Basal insulin Icodec may become more widely used over time, owing to its association with less hypoglycemia and a reduction in the number of injections.Öğe Diagnostic Value of HALP Score in Detecting Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus(Thieme Medical Publ Inc, 2024) Tel, Burcin Meryem Atak; Tel, Mustafa Ramiz; Bilgin, Satilmis; Duman, Tuba Taslamacioglu; Aktas, GulaliIntroduction Hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been used to predict the prognosis in several types of cancers for the last few years. We aimed to reveal whether HALP score has high sensitivity and specificity in the detection of diabetic nephropathy. Methods A cross-sectional study developed in Abant Izzet Baysal University Hospital in Bolu, Turkiye. Patients with type 2 diabetesmellitus (DM) were enrolled in the study. Study cohort included patients with diabetic nephropathy and patients without diabetic nephropathy. Pregnant women, subjects with malignancy, active infections conditions, and rheumatologic or hematologic diseases were excluded. We retrospectively analyzed and compared the HALP scores of the type 2 DM patients with and without diabetic nephropathy. Moreover, we sought correlation between HALP score and fasting glucose, glycated hemoglobin (HbA1c), and estimated glomerular filtration rate (eGFR). Results A total of 356 DM patients, 162 with nephropathy and 194 without nephropathy were included in the study. The HALP score was 44.86 (4.5-119.9) in the nephropathic group, while it was 55.14 (13.2-173.7) in the nonnephropathic group (p < 0.001). HALP score was negatively correlated with HbA1c (r = -0.66, p - 0.003) and fasting glucose (r = -0.65, p = 0.002), while positive correlation was found between HALP score and eGFR (r = 0.13, p = 0.02). HALP score lower than 45.9% have 73% sensitivity and 52% specificity in detecting diabetic nephropathy (area under the curve: 0.64, p<0.001, 95% confidence interval: 0.59-0.70). Conclusion We suggest that HALP score can become a simple and easy to assess marker for diabetic nephropathy in addition to standard tests.Öğe Enjoy or quit: impact of coffee on cardiac and metabolic health(Lippincott Williams and Wilkins, 2024) Gunes, Yilmaz; Aktas, GulaliCoffee is one of the most consumed beverages worldwide. The effects of coffee on the body are primarily attributed to its key active ingredient, caffeine, a methylxanthine derivative with stimulant effects. However, coffee contains over one hundred bioactive compounds apart from caffeine, such as phenolic compounds, chlorogenic acids, tannin, thiamin, spermidine, quinides, trigonelline, lignins, and minerals like potassium and magnesium, all of which may contribute to its effects on the body. Each of these compounds may have beneficial effects. A common misconception is that coffee consumption should be avoided, especially by those with cardiovascular problems. However, recent data support the safety of moderate habitual consumption of two to three cups of coffee per day. Furthermore, this moderate regular consumption is associated with reduced cardiovascular mortality, lower blood pressure, and improved metabolic state. Many recent studies report additional medical benefits associated with coffee consumption. In this article, we review recent literature on the cardiometabolic effects of regular coffee drinking, including its impact on cardiac arrhythmia, blood pressure, and glucose and lipid metabolism. To sum up the medical evidence in the literature, individuals who drink modest amounts of coffee should feel comfortable continuing to enjoy it, provided they do not experience adverse effects. Copyright © 2024 China Heart House.Öğe Evaluation of psychiatric morbidity and quality of life in inactive HbsAg carriers(Academic Journals, 2011) Kucukbayrak, Abdulkadir; Canan, Fatih; Alcelik, Aytekin; Aktas, Gulali; Kocoglu, Esra; Tas, TekinHepatitis B virus (HBV) infection develops in forms from asymptomatic carrier to cirrhosis. There are several studies examining the quality of life of patients with HBV in literature. However, only two studies have investigated the psychiatric morbidity in hepatitis B patients. In this study, we evaluated psychiatric morbidity and quality of life in inactive HbsAg carriers. This case-controlled study was performed among 26 healthy volunteers as control group and 31 inactive HbsAg carriers. Seven (22.5%) of our Hepatitis B patients were found to have an Axis I psychiatric diagnosis. For the carriers, the diagnoses made were major depression (3 patients), major depression with conversion disorder (1 patient), moderate depressive disorder (1 patient), cyclothymic disorder (1 patient), and obsessive-compulsive disorder (1 patient). No significant difference was found between carriers and controls in terms of quality of life scores and anxiety and depression scores. According to these findings, the patients with hepatitis should undergo psychiatric evaluation by a specialist. Also, physicians should be aware that emotional and psychiatric support is not necessary for all of the patients with hepatitis B.Öğe The Evaluation of Red Cell Distribution Width in Chronic Hemodialysis Patients(Hindawi Ltd, 2014) Tekce, Hikmet; Tekce, Buket Kin; Aktas, Gulali; Tanrisev, Mehmet; Sit, MustafaBackground. Red cell distribution width (RDW) has been used as a marker of iron deficiency; however, it is accepted as a marker of cardiovascular survival. We aimed to study RDW levels in hemodialysis (HD) patients and the association between RDW and inflammatory, nutritional, and volume markers. Methods. We included 296 HD patients with sufficient iron storage and without anemia or hypervolemia. We grouped patients into four groups according to clinical parameters, albumin, and C-reactive protein (CRP). Results. The lowest RDW levels were found in group 1 (13.2%). Although RDW of group 2 was higher than that of group 1, it was still in normal range (14.7% versus 13.2%, P = 0.028). RDW levels of groups 3 (17.8%) and 4 (18.5%) were significantly higher than those of groups 1 and 2 and above normal range. A positive correlation was detected between RDW and HD duration, interdialytic weight gain (IDWG), serum phosphate, and CRP levels and a negative correlation was detected with serum albumin. HD duration, CRP, IDWG, and serum albumin have been found as independent predictors of RDW elevation. Conclusions. Results of the present study reflect adverse effects of inflammation, malnutrition, and excess IDWG on RDW elevation in an HD study cohort with sufficient iron storage and without anemia and hypervolemia.Öğe Evaluation of serum oxidative stress levels and antioxidant capacity in prediabetes(Elsevier Inc., 2024) Balci, Buse; Tekce, Buket Kin; Aktas, GulaliPrediabetes is a metabolic disorder marked by blood sugar levels that are elevated than usual but not yet high enough to be classified as type 2 diabetes. It is known that raised oxidative stress and insufficient antioxidant status play a role in the pathogenesis of type 1 and type 2 diabetes. In this study, we aimed to measure total oxidative stress and antioxidant status in prediabetic patients and compare them with healthy volunteers. Subjects with prediabetes according to their HbA1c and blood sugar levels in their routine tests were included in the study. The control group consisted of healthy volunteers who visited our clinics for routine health screening and had no health problems. TAS and TOS levels of the groups were compared. Mean TAS and median TOS values ??were significantly different among study and control groups (p < 0.001 for both). Blood TOS level was a reliable risk factor of prediabetes, taking into account TAS, weight, triglycerides, and GFR. Higher oxidative stress and lower antioxidant levels were found in prediabetic patients compared to healthy ones. Diabetes development and related complications can be prevented by interventions for these markers in serum. © 2024 The Author(s)Öğe Evaluation of the relationship between the prealbumin/fibrinogen ratio and diabetic nephropathy in patients with type 2 diabetes mellitus(Amer Inst Mathematical Sciences-Aims, 2024) Tel, Burcin Meryem Atak; Tel, Ramiz; Duman, Tuba; Bilgin, Satilmis; Kaya, Hamza; Bardak, Halil; Aktas, GulaliIntroduction: Our aim was to compare the prealbumin/fibrinogen ratio (PFR) of diabetic patient populations with or without diabetic nephropathy. Materials and methods: People with type 2 diabetes who attended the internal medicine outpatient clinic were enrolled in the study. Two groups were formed according to the proteinuria of the patients: Diabetic nephropathy and non-nephropathy group. Diabetic nephropathy was calculated using the mathematical formula of spot urine albumin/spot urine creatinine x100. Patients with proteinuria above 200 mg/g were considered to have nephropathy. PFR was simply calculated by dividing prealbumin by fibrinogen. Results: A total of 152 patients who attended our outpatient clinic were enrolled in the study. There were 68 patients in the diabetic nephropathy group and 84 in the non-nephropathy group. The prealbumin/fibrinogen ratios (PFR) were significantly lower in the nephropathic group [0.061 (0.02-0.16)] than the non-nephropathic group [0.0779 (0.01-0.75)] (p = 0.002). Conclusions: We suggest that decreased levels of PFR can indicate diabetic nephropathy in subjects with type 2 diabetes mellitus.Öğe Importance of the Geriatric Nutritional Risk Index in survival among the geriatric population(Wiley, 2024) Aktas, GulaliÖğe Insulin Abuse: A Case Report of Munchausen Syndrome(Bentham Science Publ Ltd, 2024) Basaran, Elif; Tastekin, Nihal; Aytekin, Yunus Emre; Aktas, GulaliHypoglycaemia in individuals with diabetes is defined as the presence of signs or symptoms in addition to potentially occurring abnormal plasma glucose levels in the patient. Munchausen Syndrome (MS) is characterized by the deliberate induction of physical or psychological symptoms or the act of pretending to have symptoms. Patient reports of this factitious disease pattern are limited in the literature. The diagnosis and treatment of this syndrome, which is among factitious disorders, is very difficult. Endocrinological complaints are very common among those admitted to the hospitals.Background Unnecessary and numerous examinations cause financial losses and loss of time for both the individual and the healthcare system. In this case report, we aimed to discuss the management of a patient who tried to gain secondary gain by creating artificial hypoglycemia attacks.Case Report In this case report, the diagnosis of Munchausen syndrome given to a 28-year-old female patient who was diagnosed with type I diabetes and repeatedly admitted to the hospital due to hypoglycemia attacks is discussed.Conclusion Munchausen syndrome is an important and often overlooked diagnosis that should be kept in mind due to the possibility of individuals harming themselves unpredictably, as well as causing disruptions in the healthcare system and wasting time due to numerous and unnecessary examinations and evaluations. For this reason, it is a diagnosis that should be kept in mind in cases of unexplained hypoglycemia attacks.Öğe Kyphoplasty for osteoporotic fractures: Experience of a single center(Ondokuz Mayis Universitesi, 2018) Dagistan, Yasar; Dagistan, Emine; Gezici, Ali Rıza; Sari, Kutlu; Aktas, GulaliOsteoporosis increases the risk of spontaneous fractures of skeleton by enhancing the microstructure of the bones. Kyphoplasty is preferred for decreasing the pain and disability in treatment of spinal fractures. We aimed to report our clinical experience in kyphoplasty for spinal fracture treatment and to express a brief literature review. We performed balloon kyphoplasty in 14 patients with osteoporotic spinal fractures between January 2012 and July 2015. Nine of the patients were women and 5 were men. Age of the patients ranged between 59 to 81 years. We think that spinal fractures should be initially treated with conventional methods, however, kyphoplasty should be done without a delay because it is very effective in pain and other complications of the fracture and a relatively safer method than other interventions. © 2018 OMUÖğe MEAN PLATELET VOLUME INCREASES IN TYPE 2 DIABETES MELLITUS INDEPENDENT OF HBA1C LEVEL(Carbone Editore, 2014) Cakir, Lutfullah; Aktas, Gulali; Enginyurt, Ozgur; Cakir, Sahika AltasAims: Diabetes mellitus is an important health problem worldwide and associated with subclinical inflammation. Several inflammatory markers have been studied in these conditions. Mean platelet volume and red cell distribution width are hemogram parameters that are suggested to be related with inflammation. We aimed to study hemogram parameters of type 2 diabetic patients, and compare to healthy subjects, retrospectively. Methods: We included patients with type 2 diabetes mellitus in this retrospective study. Healthy subjects admitted to our institution for a routine check-up were included as control group. Laboratory data such as, white blood cell count (WBC), hemoglobin (Hb), red cell distribution width (RDW), platelet count (PLT) and mean platelet volume (MPV) and concomitant HbA1c values of the participants recorded. Results: We could not found a significant difference in RDW levels between groups. On the other hand, MPV was significantly elevated in study group compared to control subjects. Conclusion: We suggest that MPV is associated with type 2 diabetes mellitus. Prospective studies with a larger cohort are necessity to define the relationship of MPV and the level of metabolic control.Öğe Primary hyperaldosteronism as a rare cause of hypokalemia(National Academy of Medical Science and Ministry of Health of Ukraine, 2020) Kurtkulagi, Ozge; Aktas, Gulali; Kocak, M. Zahid; Atak, Burcin M.; Duman, Tuba T.; Bilgin, Satilmis; Savli, HalukPrimary hyperaldosteronism (PHA) is a syndrome characterized by increased aldosterone release and suppressed renin-angiotensin cascade. Hypertension, alteration in potassium homeostasis, and target tissue damage are characteristic features of the disease. The importance of recognizing PHA is due to the fact that it has a very negative cardiovascular and renal effect which can result in death. In this case report, we present a patient with resistant hypokalemia whom consequently diagnosed with PHA. A 54-year-old female patient who was scheduled for operation due to congenital hip dislocation was found to have decreased serum potassium in her preoperative laboratory tests. Therefore, the patient was referred to the internal medicine outpatient clinic with a serum potassium value of 2.1 mmol/L. Her systolic and diastolic blood pressures were 150 and 90 mmHg, respectively. On electrocardiogram, prominent U waves were noted. Therefore, potassium replacement was initiated at once by intravenous route. The potassium value in spot urine was 12.4 mmol/L. A 24 hour urine collected and urinary potassium excretion in 24 hours of urine was detected as 15 mmol/L, which means transtubular potassium gradient was greater than 4 mmol/L. Since she was hypertensive during clinical follow up in the ward, hypertension along with hypokalemia raised the clinical suspicion of hyperaldosteronism. Serum aldosterone renin ratio was measured as 155 %. A computerized tomography scan revealed (22 × 16 mm) neoplasm which was suggestive of adrenal adenoma in the right adrenal gland. Cushing Syndrome was ruled out with a normal cortisol level and pheochromocytoma was ruled out by normal levels of metanephrine in the 24 hours of urine. Spironolactone 50 mg was initiated and serum potassium was raised to normal range. She scheduled for unilateral adrenalectomy and discharged with full recovery of hypokalemia. Since PHA has undesired cardiovascular and renal effects which may increase mortality and morbidity, establishing the diagnosis as soon as possible is crucial. Hypertensive patients with hypokalemia or adrenal incidentaloma or obstructive sleep apnea syndrome, resistant hypertensive subjects, patients with moderate or severe hypertension, and hypertensive patients with a family history of PHA should undergo screening for PHA. In conclusion, we suggest that PHA should be kept in mind in differential diagnosis of the patients with hypertension and hypokalemia. © 2020 National Academy of Medical Science and Ministry of Health of Ukraine. All rights reserved.Öğe The relationship between tumor budding and survival in colorectal carcinomas(Assoc Medica Brasileira, 2020) Aktas, GulaliÖğe The relationship of vitamin D levels with hemogram indices and metabolic parameters in patients with type 2 diabetes mellitus(Amer Inst Mathematical Sciences-Aims, 2024) Basaran, Elif; Aktas, GulaliBackground: Vitamin D deficiency and Type 2 Diabetes (T2DM) are two important health problems that have rapidly increased prevalences in recent years. Chronic inflammation and susceptibility to infection are the characteristic features of T2DM. Vitamin D deficiency has been associated with high serum inflammatory marker levels due to its immunomodulatory effect. Moreover, studies have pointed out that vitamin D insufficiency could be associated with T2DM. Additionally, in recent years, inflammatory markers derived from hemogram have been associated with diabetes and its complications. Therefore, in our study, vitamin D levels, metabolic markers (i.e., serum uric acid, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol), and hemogram indices were analyzed in well controlled and poorly controlled T2DM patients. Furthermore, we compared those variables in vitamin D deficient and non-deficient groups. Methods: Laboratory data, including vitamin D and hemogram markers, were compared between poorly and well controlled T2DM patients who visited the outpatient internal medicine clinics of our institution. Results: A total of 240 T2DM individuals were included in the present study: 170 individuals had vitamin D deficiency and 70 individuals had normal vitamin D levels, who served as controls. The median neutrophil to lymphocyte ratio (NLR) value was 2.2 (0.74-7.4) in the vitamin D deficient group and 2.02 (0.73-5.56) in the vitamin D normal group (p = 0.025). Among the study parameters, the NLR and glycated hemoglobin (HbA1c) levels showed a significant positive correlation (r = 0.30, p < 0.001). The sensitivity and specificity of the NLR to predict vitamin D deficiency were determined as 60% and 49%, respectively (AUC: 0.59, p = 0.03, 95% CI: 0.51-0.67). The sensitivity and specificity of the NLR to predict an improved control of diabetes were 72% and 45%, respectively (AUC: 0.67, p < 0.001, 95% CI: 0.60-0.74). Conclusions: We think that NLR can be helpful in follow up of T2DM and vitamin D deficiency.Öğe Serum C-reactive protein to albumin ratio as a reliable marker of diabetic neuropathy in type 2 diabetes mellitus(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2024) Aktas, GulaliIn various diseases characterized by inflammation, the C-reactive protein to albumin ratio (CAR) serves as a marker of inflammation. Type 2 diabetes mellitus (T2DM) is frequently complicated by diabetic neuropathy (DN) and timely diagnosis is crucial for treatment and potential reversal of this complication. Since both DN and T2DM are associated with chronic, low-grade inflammation, our study aimed to evaluate CAR levels in type 2 diabetic subjects with DN and compare them to those in subjects without DN. Patients presenting to our institutional outpatient clinics were divided into two groups based on the presence of DN. Data on characteristics and laboratory measures, including CAR,were compared between the DN and non-DN groups. The median CAR in the DN and non-DN groups was 2.19% (range 0.2%-49%) and 0.56% (range 0.02%-5.8%), respectively (P < 0.001). CAR showed significant positive correlations with weight (r = 0.19, P = 0.01), body mass index (BMI) (r = 0.11, P = 0.03), waist circumference (r = 0.10, P = 0.046), fasting glucose (r = 0.14, P = 0.004), serum creatinine (r = 0.25, P < 0.001), triglyceride (r = 0.17, P < 0.001), and LDL-cholesterol (r = 0.13, P = 0.001) levels, and an inverse correlation with estimated glomerular filtration rate (eGFR) (r = -0.16, P < 0.001). Additionally, CAR demonstrated a sensitivity of 78% and specificity of 73% for predicting DN at a threshold of 1.02% (area under curve [AUC] 0.84, 95% confidence interval [CI] 0.82-0.87, P < 0.001). High CAR levels were independently associated with an increased risk of DN (odds ratio [OR] 1.34, 95% CI 1.08-1.62, P < 0.001). Elevated CAR levels may thus be considered a potential marker for DN in T2DM patients.
