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    Compliance to levothyroxine treatment of the patients with hypothyroidism during SARS-CoV-2 pandemic era
    (Zaslavsky Publishing House, 2021) Bilgin, Satilmis; Meryem, Burcin; Tel, Atak; Duman, Tuba Taslamacioglu; Kurtkulagi, Ozge; Kahveci, Gizem Bakir; Sagdic, Tugrul
    Background. Hypothyroidism requires treatment with levothyroxine (L-T4) to keep patients euthyroid. The rate of hospital admissions for chronic conditions decreased during COVID-19 era. We aimed to observe whether hospital admissions of the patients with hypothyroidism decreased during COVID-19 compared to the same time period in 2019. We also aimed to find out the rate of treatment compliance in subjects with hypothyroidism during pandemic era. Materials and methods. This cross-sectional study was performed on patients who applied to Internal Medicine Department of Abant Izzet Baysal University Hospital, and who received L-T4 replacement therapy due to hypothyroidism. 108 hypothyroidism patients were included in the study with their consent forms. The patients were divided into 2 groups according to the treatment compliance; either as compliant or incompliant patients. Results. The last TSH level of compliant group was significantly lower than incompliant group (p < 0.001). The last fT4 level of the compliant group was significantly higher than that of the incompliant group (p = 0.04). The median of the LT-4 treatment used irregularly was 35 (10–90) days in incompliant group and was 0 (0–0) days in compliant group (p < 0.001). The number of irregularly L-T4 used days was significantly positively correlated with last TSH value (r = 0.564, p < 0.001), and negatively correlated with last FT4 value (r = –0.492, p < 0.001). Mean corpuscular volume (MCV) of the compliant and incompliant groups were 85 (69.1–97.5) fL and 89 (66–96.6) fL, respectively (p = 0.03). Retrospective nature and relatively small study population are two main limitations of our study. Conclusions. Compliance to treatment is very important to achieve euthyroid hormone levels in patients with hypothyroidism during COVID-19 pandemic. Elevated MCV levels could predict incompliance to treatment in hypothyroidism. © 2021. The Authors.
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    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, Gulali
    Introduction 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.