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Öğe The association between serum uric acid to high density lipoprotein-cholesterol ratio and non-alcoholic fatty liver disease: The abund study(Associação Médica Brasileira, 2021) Kösekli, Mehmet Ali; Kurtkulağı, Özge; Kahveci, Gizem; Duman, Tuba Taslamacıoğlu; Tel, Burçin Meryem Atak; Bilgin, Satılmış; Demirkol, Muhammed Emin; Aktaş, GülaliOBJECTIVE: Non- alcoholic fatty liver disease, which is characterized by lipid being deposited into hepatocytes, affects nearly one in three adults globally. Inflammatory markers were suggested to be related with hepatic steatosis. Uric acid to HDL cholesterol ratio is proposed as a novel inflammatory and metabolic marker. We aimed to compare Uric acid to HDL cholesterol ratio levels of patients with Non-alcoholic fatty liver disease to those of healthy controls and find out potential correlations between Uric acid to HDL cholesterol ratio and other inflammatory and metabolic markers of Non-alcoholic fatty liver disease. METHODS: Patients with a diagnosis of Non-alcoholic fatty liver disease who were on clinical follow-up in our institution were enrolled in the study as the Non- alcoholic fatty liver disease group, while healthy volunteers were enrolled as the control group. The Uric acid to HDL cholesterol ratio of the groups was compared and potential correlations were studied between Uric acid to HDL cholesterol ratio and fasting blood glucose, transaminases, serum lipids (triglyceride, LDL- cholesterol), weight, and body mass index. RESULTS: The Uric acid to HDL cholesterol ratio of the Non-alcoholic fatty liver disease (13 +/- 5%) group was significantly higher compared to the Uric acid to HDL cholesterol ratio of the control (10 +/- 4%) group (p<0.001). Uric acid to HDL cholesterol ratio was significantly and positively correlated with fasting blood glucose, transaminases, triglyceride, body weight, waist circumference, hip circumference, and body mass index. A ROC analysis revealed that a Uric acid to HDL cholesterol ratio level greater than 9.6% has 73% sensitivity and 51% specificity in determining Non-alcoholic fatty liver disease. CONCLUSION: Due to the inexpensive and easy-to-assess nature of Uric acid to HDL cholesterol ratio, we suggest that elevated Uric acid to HDL cholesterol ratio levels be considered a useful tool in diagnosing hepatic steatosis.Öğe Association between thyroid hormone status and complete blood count parameters in anemic patients(Universiti Putra Malaysia Press, 2021) Atak Tel, Burçin M.; Aktaş, Gülali; Duman Taslamacıoğlu, Tuba; Kurtkulağı, Özge; Bilgin, Satılmış; Kahveci, Gizem; Sağdıç, TuğrulIntroduction: Anemia and thyroid conditions effect each other in clinical practice. Anemia may induce alteration in thyroid hormone status and various thyroid conditions induce various types of anemia. In present study, we aimed to study the thyroid function tests of the anemic subjects and to compare characteristics and laboratory features of the three groups; hypothyroid, hyperthyroid, and euthyroid subjects. Methods: Anemic subjects divided into three groups according to the thyroid hormone status, either as hyperthyroid, hypothyroid and euthyroid groups. Hemogram indices and laboratory parameters compared between three groups. Results: Mean red cell distribution width (RDW) of hypothyroid anemic subjects was significantly lower than the RDW of euthyroid anemic subjects (p=0.003). White blood cell (WBC) count of hypothyroid anemic subjects was significantly reduced compared to the euthyroid (p<0.001) and hyperthyroid (p=0.047) anemic subjects. Significant inverse correlation between RDW and TSH (r=-0.25, p=0.001), between RDW and hemoglobin (r=-0.44, p<0.001), between RDW and hematocrit (r=-0.35, p<0.001) and between RDW and mean corpuscular volume (r=-0.53, p<0.001) were noted. Conclusions: Since anemia is common in thyroid conditions, besides its role in differential diagnosis of the anemia, RDW could also serve as an adjunct diagnostic tool in estimation of the thyroid hormone status in anemic subjects.Öğe C-reactive protein to lymphocyte count ratio is a promising novel marker in hepatitis C infection: The clear hep-c study(Associação Médica Brasileira, 2022) Demirkol, Muhammed Emin; Aktaş, Gülali; Bilgin, Satılmış; Kahveci, Gizem; Kurtkulağı, Özge; Duman, Tuba TaslamacıoğluOBJECTIVE: Chronic hepatitis C (CHC) is one of the most important health problems affecting the significant rate of world population and it may lead to cirrhosis and hepatocellular carcinoma. C-reactive protein to lymphocyte count ratio (CLR) is used in estimating inflammatory burden. Therefore, this study aimed to compare CLR values between CHC patients and healthy controls and between CHC patients with and without fibrosis. METHODS: Patients with CHC infection who visited outpatient and inpatient internal medicine clinics of our institution between January 2021 and December 2021 were enrolled to this retrospective study. CLR of the patients with CHC and healthy controls were compared. We further compared CLR of CHC patients with and without fibrosis. RESULTS: Median CLR of CHC and control subjects was 2.61 (5.13%) and 0.31 (0.37%), respectively. CLR of the CHC group was significantly increased compared to the CLR of the controls (p<0.001). There was a significant positive correlation between CLR and APRI score (r=0.15, p=0.04). The sensitivity and specificity of CLR in determining CHC above 0.58% level were 84% and 82%, respectively (AUC: 0.884, p<0.001, 95%CI 0.84- 0.93). In subgroup analysis, CLR was 3.97 (6.6%) for CHC patients with fibrosis and 1.7 (4.4%) for CHC subjects without fibrosis (p=0.001). CONCLUSIONS: Increased CLR in patients with CHC may be an alarming finding of liver fibrosis, as CLR is associated with both CHC and hepatic fibrosis.Öğe C-reactive protein-to-lymphocyte ratio is a reliable marker in patients with COVID-19 infection: the CLEAR COVID study(Mexican Acad Surgery, 2022) Demirkol, Muhammed Emin; Bilgin, Satılmış; Kahveci, Gizem; Kurtkulağı, Özge; Tel, Burçin Meryem Atak; Duman, Tuba Taslamacıoğlu; Aktaş, GülaliObjective: COVID-19 infection is characterized with elevation of inflammatory markers in bloodstream. A novel inflammatory marker, C-reactive protein (CRP)-to-lymphocyte ratio (CLR), is suggested to be associated with inflammation. We aimed to compare the CLR values of the deceased COVID-19 patients to the CLR of survived subjects. Materials and Methods: The patients with COVID-19 whom presented to outpatient or inpatient clinics of AbantIzzet Baysal University Hospital were enrolled to the present retrospective study. Subjects were grouped as either deceased or survived. CLR values of the groups were compared. Results: Study cohort was consisted of 568 subjects in deceased and 4753 patients in survived group. Median CLR of the deceased and survived groups were 90 (0.2-1679)% and 11 (0.2-1062)%, respectively (p < 0.001). The sensitivity (75%) and specificity (70%) of CLR (> 23.4% level) in detecting mortality were higher than those of CRP and ferritin (AUC: 0.80, p < 0.001, 95% CI: 0.78-0.82). Conclusion: We suggest that elevated CLR levels in COVID-19 patients on admission should alert physicians for poor outcome.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 Correlation between serum triglyceride to hdl cholesterol ratio and blood pressure in patients with primary hypertension(Wiley, 2022) Kurtkulağı, Özge; Aktaş, Gülali; Duman, Tuba Taşlamacıoğlu; Bilgin, Satılmış; Tel, Burçin Meryem Atak; Kahveci, GizemHypertension (HT) is associated with significant morbidity and mortality. The efficacy of the treatment in HT patients is mostly depending on the office or home blood pressure monitoring. Triglyceride to high density lipoprotein (HDL) cholesterol ratio (THR) is an inflammatory and metabolic predictor. We aimed to compare THR levels of the HT patients with poorly controlled blood pressure levels to those with well-controlled hypertensive subjects. In present cross sectional study, we grouped patients with HT either as well or poorly controlled hypertensive subjects according to the blood pressure measurement. THR of the groups compared. The THR of the poorly controlled HT group (3.9 [1.91-88.7]%) was significantly higher than the THR of the well-controlled HT group (3.07 [0.71-35.8]%), (p < .001). The sensitivity and specificity of THR higher than 3.26% in predicting poor blood pressure control were 72% and 52%, respectively (AUC: 0.64, p <.01, %95 CI: %59-70). High THR levels in HT patients may warrant closer monitorization of blood pressure since it may predict poor blood pressure control in this population.Öğe Could triglyceride to high density lipoprotein-cholesterol ratio predict hepatosteatosis?(2021) Kurtkulaği, Özge; Bilgin, Satilmis; Kahveci, Gizem; Tel, Burçin Meryem Atak; Kösekli, Mehmet AliAim: The triglyceride / HDL cholesterol (TG/HDL-c) ratio is increased in a variety of diseases including, coronary heart disease and type 2 diabetes mellitus. However, its role in non-alcoholic hepatosteatosis is not well understood. In present study, we aimed to compare the TG/HDL-c levels of the patients with non-alcoholic hepatosteatosis to those of the healthy subjects. Methods: Medical data of the patients with non-alcoholic hepatosteatosis whom presented to the outpatient internal medicine clinics of our institution were retrospectively analyzed. Healthy subjects whom admissions to our clinics were due to check up were enrolled to the study as control group. TG/HDL-c of the groups compared. Results: TG/HDL-c level of the liver steatosis group (5 (2-22) %) was higher than the control group (2.7 (1-8) %), (p<0.001). TG/HDL-c was significantly and positively correlated with fasting blood glucose (r=0.31, p<0.001), C - reactive protein (r=0.25, p<0.001) and LDL-cholesterol (r=0.3, p<0.001) levels. A TG/HDL-c value greater than 3.1% has 91% sensitivity and 77% specificity in detecting hepatosteatosis. Conclusions: We suggest that TG/HDL-c ratio could be a useful marker of non-alcoholic hepatosteatosis due to its inexpensive and easy to assess nature.Öğe Does c-reactive protein to serum albumin ratio correlate with diabetic nephropathy in patients with type 2 diabetes mellitus? The care time study(ELSEVIER SCI LTD, 2021) Bilgin, Satılmış; Kurtkulağı, Özge; Tel, Burcin Meryem Atak; Duman, Tuba Taslamacıoğlu; Kahveci, Gizem; Khalid, Atiqa; Aktaş, GülaliAims: Diabetic Nephropathy (DN) is a complication of Diabetes Mellitus and is associated with chronic and low-grade inflammatory burden. Novel inflammatory predictors, such as, C-reactive protein to serum albumin ratio (CAR) has been studied various inflammatory conditions, recently. Increased inflammatory burden accompany to both type 2 Diabetes Mellitus (T2DM) and DN, hence we aimed to compare CAR levels of the T2DM subjects with DN to those of without DN. Methods: Patients with T2DM were enrolled to the study. Study population grouped into two according to the presence (group A) or absence (group B) of DN. Characteristics and laboratory data, as well as CAR levels; of the study groups were compared. Results: Median CAR levels of the groups A and B were 2.17% (0.02-13.2) and 0.39% (0.02-4.39), respectively (p < 0.001). CAR was found to be an independent risk factor for diabetic nephropathy (adjusted to age, BMI, fasting glucose, HbA1c, and body weight). One unit (0.1%) elevation in CAR increased the risk of nephropathy by 3.5 folds (p < 0.001, 95%CI: 2.24-5.45). CAR levels greater than 0.82% have 79% sensitivity and 78% specificity in predicting DN (AUC: 0.86 [95% CI: 0.80-0.92]; p < 0.001). Conclusions: In conclusion, elevated CAR levels are higher in type 2 diabetic patients with diabetic nephropathy. According to the ROC curve, a level higher than 0.82% presents the best sensitivity and specificity in the association with the presence of DN. (c) 2021 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.Öğe Does mean platelet volume/lymphocyte count ratio associate with frailty in type 2 diabetes mellitus?(Comenius University in Bratislava, 2021) Bilgin, Satılmış; Aktaş, Gülali; Kahveci, Gizem; Atak Tel, Burçin Meryem; Kurtkulağı, Özgür; Duman Taslamacıoğlu, TubaOBJECTIVES: Frailty is a common problem in patients with type 2 diabetes mellitus (T2DM). It is considered to be associated with inflammation. Novel markers derived from hemogram, such as neutrophil/lymphocyte ratio (NLR) and mean platelet volume/lymphocyte ratio (MPVLR), are proposed as inflammatory markers. In present study, we aimed to compare NLR and MPVLR levels of frail patients with T2DM to non-frail diabetic subjects. METHODS: Diabetic subjects were grouped in frail and non-frail groups according to the Edmonton Frail Scale. General characteristics and laboratory data of the frail and non-frail groups were compared. RESULTS: The MPVLR of the frail (3.9 [1.4–13.2] %) group was significantly higher than that of the non-frail (3.4 [1.5–6.9] %) group (p = 0.02). MPVLR was positively and significantly correlated with Edmonton Frail Scale score (r = 0.21, p = 0.03). A MPVLR level greater than 3.41 % has 71 % sensitivity and 51 % specify in predicting frailty. CONCLUSION: We suggest that elevated MPVLR could be a finding that marks frailty in diabetic subjects. Inexpensive and easy-to-assess nature of the MPVLR may be useful in predicting frailty in type 2 diabetic population (Tab. 2, Fig. 1, Ref. 32). Text in PDF www.elis.skÖğe Evaluation of the effectiveness of long-acting insulin analogs in patients with type 2 diabetes mellitus(Springer Heidelberg, 2023) Duman, Tuba Taslamacıoğlu; Aktaş, Gülali; Tel, Burçin Meryem Atak; Bilgin, Satılmış; Kahveci, Gizem; Kurtkulağı, ÖzgeAim In this study, we aimed to evaluate the effectiveness of long-acting insulin analogs in the treatment of type 2 diabetes mellitus (T2DM) in our clinic. Methods Patients with T2DM who were prescribed long-acting insulin analog therapy in our internal medicine outpatient clinic between November 2017 and December 2019 were included in the study. Patients' age, gender, duration of diabetes, HbA1c values, insulin doses and injections in previous treatment, and fasting blood glucose levels before the initiation of long-acting insulin analog were recorded. Fasting blood glucose levels after the initiation of long-acting insulin analog therapy, HbA1c values, total insulin doses in the new treatment and the number of injections, and follow-up times were also recorded from the institutional database. Data of the patients during previous treatment and novel treatment were compared. Results Forty patients were included in our study. Six patients who did not attend their controls and two patients who were observed to be non-compliant even though they presented to control visit were excluded from the study. The remaining 32 patients were enrolled in the study. The average treatment follow-up period of the patients was 6 (3-8) months. Fasting blood glucose (p = 0.014) and HbA1c (p = 0.004) values were significantly reduced after long-acting insulin analog therapy compared to the values during previous treatment. Similarly, total daily insulin dose was decreased after long-acting insulin analog treatment compared to the insulin dose before long-acting insulin analog treatment (p < 0.001). The decrease in the number of daily insulin injections after long-acting insulin analogs treatment compared to the number of injections before long-acting insulin analog treatment was statistically significant (p < 0.001). Conclusion We think that the addition of new long-acting insulin analogs to the treatment in patients with T2DM may be beneficial in achieving the target blood glucose, A1c, and may also be associated with treatment compliance.Öğe Frailty in diabetic subjects during COVID-19 and its association with HbA1c, mean platelet volume and monocyte//lymphocyte ratio(Via Medica, 2022) Tel, Burçin Meryem Atak; Bilgin, Satılmış; Kurtkulağı, Özge; Kahveci, Gizem; Duman, Tuba Taşlamacıoğlu; Sağdıç, Tuğrul; Aktaş, GülaliBackground: Frailty is associated with increased risk of hospitalization in diabetic patients. Both SARS-CoV-2 pandemic and type 2 diabetes mellitus contribute to the frailty. In this study we aimed to observe clinical and laboratory indices of the diabetic subjects during COVID-19 pandemic who were either frail or not according to Edmonton frail score. Material and methods: During the pandemic era, 100 consecutive patients with type 2 diabetes mellitus divided into two groups either as frail or non-frail according to the Edmonton Frail Scale scores. Laboratory and clinical features of the frail and non-frail subjects were compared. Results: Frail patients were older than the non-frail diabetics. Blood urea, serum creatinine, eGFR, plasma albumin, total cholesterol, triglyceride, HbA1c, mean platelet volume (MPV), and monocyte lymphocyte ratio (MLR) levels of the frail and non-frail groups were significantly different. Moreover, Edmonton frail score was significantly and positively correlated with blood urea, serum creatinine, MLR, MPV, HbA1c and inversely correlated with eGFR and plasma albumin levels. Conclusions: We think that HbA1c, MPV and MLR could be surrogate markers of frailty in diabetic elderly during COVID-19 outbreak. Strategies to keep them in normal range do not only improve diabetes control but also reduce the risk of frailty in this population.Öğe Haemoglobin and red cell distribution width levels in internal medicine patients indicate recurrent hospital admission during COVID-19(Termedia Publishing House Ltd, 2022) Tel, Burçin Atak; Kahveci, Gizem; Bilgin, Satılmış; Kurtkulağı, Özge; Duman, Tuba Taslamacıoğlu; Demirkol, Muhammed Emin; Aktaş, GülaliBackground. The novel coronavirus pandemic (COVID-19) has caused significant change in the daily life of humans, as well as in access to medical care. Objectives. We aimed to compare the general characteristics, medical diagnoses and laboratory data of patients referred to the outpatient internal medicine clinics of our institution and to observe relevant factors that correlate with the number of hospital admissions in this population. Material and methods. Patients who visited our outpatient clinics of internal medicine between March 2020 and June 2020 were enrolled. Age, gender, medical diagnoses, number of admissions, cause of admission and laboratory parameters on first admission were recorded. Patients who visited outpatient clinics only once were grouped as group I, and patients admitted more than once were grouped as group II. General characteristics and laboratory data of groups I and II were compared. Results. Patients with cancer were more common in group II compared to group I (p < 000.1). Haemoglobin (Hb) (p = 0.001) was significantly lower, and red cell distribution width (RDW) (p = 0.007) was significantly higher in group II compared to group I. RDW was positively (r = 0.23, p < 0.001) correlated, and Hb inversely (r = -0.19, p < 0.001) correlated, with the number of hospital admissions in the study population. Conclusions.We think that decreased Hb and increased RDW values in patients during the pandemic should alert physicians for possible recurrent hospital admissions in the near future and may promote taking measures to reduce multiple medical admissions.Öğe Hashimoto's thyroiditis is associated with elevated serum uric acid to high density lipoprotein-cholesterol ratio(Sciendo, 2021) Kurtkulağı, Özge; Tel, Burçin Meryem Atak; Kahveci, Gizem; Bilgin, Satılmış; Duman, Tuba Taslamacıoğlu; Ertürk, Aslı; Balcı, Buse; Aktaş, GülaliBackground. Hashimoto's thyroiditis (HT) is an auto-immune condition characterized with lymphocytic and fibroblastic infiltration of the thyroid gland. The rate of uric acid and HDL cholesterol - so called as uric acid to HDL ratio (UHR) has been shown to be elevated in inflammatory conditions diseases. We aimed to compare UHR and other laboratory parameters of the patients with HT to those values in healthy controls. Methods. The patients diagnosed with HT by medical history, physical examination, elevated thyroid autoantibodies in serum and characteristic sonographic findings in outpatient internal medicine clinics of our institution were enrolled to the present retrospective study. Age and sex matched healthy volunteers were enrolled as controls. UHR of the HT patients and control subjects were compared. Results. The mean UHR of the HT group was 11% +/- 4 %, while UHR of the control group was 8% +/- 2% (p<0.001). UHR was significantly and positively correlated with thyroid stimulating hormone (TSH) (r=0.26, p=0.01) and negatively correlated with free T4 (FT4) (r=-0.22, p=0.04) levels. The sensitivity and specificity of the UHR level were greater than 8.3%: were 74% and 52%, respectively (AUC: 0.74, p<0.001, 95% CI: 0.64-0.84). Conclusion. We suggest that UHR is a reliable and useful marker for HT. Therefore, it may be helpful in establishing the diagnosis of HT in addition to other diagnostic tools.Öğe Inappropriate medication use in older adults according to Beers Criteria in a Tertiary Referral Hospital, in Bolu, Turkey(Science & Innovation, Ltd, 2021) Tel, Burçin Meryem Atak; Aktaş, Gülali; Duman, Tuba Taslamacıoğlu; Kurtkulağı, Özge; Kahveci, Gizem; Demirkol, Muhammed Emin; Bilgin, SatılmışAims - We aimed to study the medications used by older adults for any potentially inappropriate medications. Material and Methods - A hundred and four consecutive subjects over 65 years of age who visited our clinic were enrolled in the study. Possible inappropriate medications were defined according to Beers Criteria. Results - A total of 57 women and 49 men were enrolled in the study. Mean ages of the women and men were 78.6 +/- 6.1 years and 77.4 +/- 5.4 years, respectively (p=0.30). While 18 subjects (17%) had no increased risk due to inappropriate use of medications, 30 were on inappropriate medications that increased renal failure risk, 5 were on inappropriate medication that amplified neurological side effects, 12 were on inappropriate medications that augmented bleeding risk, 20 were on inappropriate medication that lack safety and efficacy data, and 30 were on inappropriate medication that amplified the risk of falls. The number of increased risks according to Beers Criteria was significantly and positively correlated with number of medications used (r=0.366, p<0.001) and the number of comorbidities (r=0.312, p=0.001). Conclusion - The number of increased risks due to inappropriate use of medicines in older adults is positively correlated with the number of medicines used and the number of accompanied diseases. Therefore we suggest that the medicines used by older people should be reviewed in all settings, and unnecessary drugs should be avoided to be prescribed.yÖğe Platelet to lymphocyte ratio in differentiation of benign and malignant thyroid nodules(2021) Bilgin, Satilmis; Kahveci, Gizem; Tel, Burçin Meryem Atak; Kurtkulaği, Özge; Kösekli, Mehmet AliAim: Differentiation of thyroid nodules, either as benign or malignant, is a real diagnostic challenge.Inflammation has an important role in development of the malignancy. Therefore, inflammatory markers areassociated with malignant thyroid nodules. Platelet /lymphocyte ratio (PLR) is also one of the novelinflammatory indices derived from hemogram tests. We hypothesized whether PLR was associated withmalignant thyroid nodules. For this purpose, we compared PLR levels of the patients with benign thyroidnodules to the PLR of the subjects with malignant nodules.Methods: The subjects who visited outpatient internal medicine clinics of our institution with a diagnosis ofthyroid nodule were enrolled to the present retrospective study. According to the examination of the fine needleaspiration cytology (FNAC) specimen of the nodules, patients grouped into benign or malignant nodule groups.PLR of groups were compared.Results: Median PLR values of the benign and malignant thyroid nodule groups were 106 (48-432) % and 119(48-365) %, respectively (p=0.001). PLR value higher than 106% has 69% sensitivity and 51% specificity indetecting malignant nodules (AUC: 0.59, p=0.001, 95% CI: 0.54-0.65). PLR was positively correlated withTSH level (r=0.10, p=0.34).Conclusion: We suggest that elevated PLR could be an additional tool to differentiate malignant thyroidnodules from benign ones in supportive of sonography, scintigraphy and cytology.Öğe Poorly controlled hypertension is associated with elevated serum uric acid to HDL-cholesterol ratio: A cross-sectional cohort study(Taylor & Francis Ltd, 2022) Aktaş, Gülali; Khalid, Atiqa; Kurtkulağı, Özge; Duman, Tuba Taslamacıoğlu; Bilgin, Satılmış; Kahveci, Gizem; Tel, Burçin Meryem Atak; Sincer, İsa; Güneş, YılmazObjectives The diagnosis and follow-up of hypertension (HT) depend on the blood pressure measurements, which can be affected by several factors. In the present work, we aimed to explore the role of uric acid/HDL-cholesterol ratio (UHR) in HT and whether/or not it was associated with poor blood pressure control. Methods In this retrospective cross-sectional cohort study, all the participants treated for hypertension and then followed up in the internal medicine clinics of our institution were enrolled. Hypertensive patients were grouped as either poorly or well-controlled hypertension groups, according to the suggestions of Joint National Committee VIII criteria and healthy volunteers were enrolled as control group. UHR of the study groups was compared. Results Our study cohort consisted of 535 subjects; 258 in the well-controlled HT group, 186 in the poorly controlled HT group, and 91 in the control group. Median UHR levels of the poorly controlled HT group (13 (4-43) %) were significantly higher than well-controlled HT group 11 (4-22) %) and control group (8 (4-19) %) (p < 0.001). UHR was correlated with systolic (r = 0.33, p < 0.001) and diastolic (r = 0.28, p < 0.001) BP. UHR level greater than 11% has 70% sensitivity and 60% specificity in predicting poor BP control (AUC: 0.73, p < 0.001, 95%CI: 0.68-0.77). UHR was an independent risk factor for poor BP control in HT subjects and a unit elevation in UHR increased the risk of poorer BP control by 7.3 times (p < 0.001, 95%CI: 3.9-13.63). Conclusion Assessment of UHR may be useful in HT patients since elevated UHR levels could be associated with poor blood pressure control in this population.Öğe Red cell distribution width-to-platelet count ratio is a promising predictor of functional bowel disease(Termedia Publishing House Ltd, 2022) Kahveci, Gizem; Aktaş, Gülali; Tel, Burçin Meryem Atak; Bilgin, Satılmış; Kurtkulağı, Özge; Balcı, Buse; Ertürk, Aslı; Duman, Tuba TaslamacıoğluBackground. Hemogram parameters are not only diagnostic tools in haematological diseases, but their role in inflamma-tory conditions is also important. One of these haematological markers is a derived index, the so-called red cell distribution width-to -platelet count ratio (RPR). The role of RPR has been well established in various inflammatory conditions. Objectives. In the present study, we aimed to observe the RPR levels of patients with functional bowel disease (FBD), which is also considered as an inflammatory process, and to compare this to the healthy population. Material and methods. Patients diagnosed with FBD according to Rome IV criteria were included as the study group. Healthy vol-unteers were enrolled as control subjects. Patients with any form of anaemia or haematological disorders or inflammatory diseases were excluded. Age, gender and hemogram parameters were obtained from institutional databases. The data of the study and control groups was compared. Results. 158 subjects were enrolled in the study; 87 in the FBD group and 71 in the control group. The RPR of the FBD and control groups were 7% (2%) and 5% (1%), respectively. The difference in RPR between the FBD and control groups was statistically significant (p = 0.008). A RPR value higher than 6% has a 70% sensitivity and 52% specificity in detecting FBD. There was a significant and positive correlation between RPR levels and the presence of FBD (r = 0.22, p = 0.007). Conclusions. We suggest that elevated RPR levels could yield potential diagnostic benefits in the diagnosis of FBD. However, prospec-tive studies with a larger population are needed to confirm our results.Öğe A relapsing immune thrombocytopenia case in a patient following COVID-19 vaccination(Thieme Medical Publishers Inc, 2022) Tel, Burçin Meryem Atak; Kahveci, Gizem; Duman, Tuba Taslamacıoğlu; Kurtkulağı, Özge; Şentürk, Hilal; Akın, Havva; Aktaş, GülaliThere are several vaccines developed against COVID-19 infection. Inactivated viral vaccines are usually well tolerated. We aimed to present a relapsing immune thrombocytopenia case following inactive COVID-19 vaccine. Here we report a case of relapsing immune thrombocytopenia following inactivated viral vaccine against COVID-19 in a 60-year-old woman with a history of immune thrombocytopenia. The patient responded well to dexamethasone treatment and was discharged from the hospital with full recovery. We suggest that physicians seek the history of a recent inactivate COVID-19 vaccine shot in patients with immune thrombocytopenia.Öğe Sodium glucose co-transporter-2 inhibitor, Empagliflozin, is associated with significant reduction in weight, body mass index, fasting glucose, and A1c levels in Type 2 diabetic patients with established coronary heart disease: The SUPER GATE study(Springer London Ltd, 2022) Bilgin, Satılmış; Kurtkulağı, Özge; Duman, Tuba Taslamacıoğlu; Tel, Burçin Meryem Atak; Kahveci, Gizem; Kıran, Murat; Erge, Eray; Aktaş, GülaliBackground Empagliflozin, a sodium-glucose co-transporter-2 (SGLT-2) inhibitor, yielded significant beneficiaries in the treatment of type 2 diabetes mellitus (T2DM). It is particularly benefited the diabetic subjects with heart conditions. Aims We aimed to obtain a real-world data about the effects of empagliflozin add-on treatment on metabolic parameters, cardiovascular risk factors, and anthropometric measures in patients with T2DM. Methods Type 2 diabetic patients with established coronary heart disease whom empagliflozin added to their treatment were enrolled in the study. Anthropometric measures, clinical and laboratory data, were obtained before and at the 6th month of the empagliflozin treatment. All data before and at the 6th month were compared. Results Body weight (p < 0.001), body mass index (p < 0.001), waist (p < 0.001) and hip (p < 0.001) circumferences, systolic blood pressure (p = 0.006), heart rate (p = 0.01), LDL cholesterol (p = 0.01), fasting plasma glucose (p < 0.001), and HbA1c (p < 0.001) levels were significantly reduced on 6th month of empagliflozin treatment compared to the baseline values. Estimated GFR (p = 0.66), serum creatinine (p = 0.8), uric acid (p = 0.40), total cholesterol (p = 0.053), triglyceride (p = 0.057), and HDL (p = 0.09) levels were not significantly changed. Conclusions We suggest that empagliflozin treatment may improve anthropometric measures, metabolic parameters, and blood pressure and does not cause deterioration in kidney functions in type 2 diabetic patients with established coronary heart disease.Öğe Triglyceride to high density lipoprotein cholesterol ratio is elevated in patients with complicated type 2 diabetes mellitus(University of Nis, Faculty of Medicine, 2022) Bilgin, Satılmış; Aktaş, Gülali; Tel, Burçin Meryem Atak; Kurtkulağı, Özge; Kahveci, Gizem; Duman, Tuba Taslamacıoğlu; Ertürk, AslıIntroduction/Aims: Microvascular and macrovascular complications lead to recurrent hospital admissions, hospitalizations, disability, and death in the course of type 2 diabetes mellitus (T2DM). Triglyceride to HDL cholesterol ratio (THR) is associated with insulin resistance. We aimed to find out whether there is a relationship between THR and diabetic complications in patients with T2DM. Methods: Patients with T2DM were enrolled in the study. The study population was divided into two groups according to the presence or absence of diabetic complications. Characteristics and laboratory data of the patients with (group A) and without (group B) diabetic complications were compared. Results: Median THR values of the groups A and B were 3.86 (0.33 - 53.38) and 2.86 (0.63 - 17.88), respectively (p = 0.006). THR level was significantly and positively correlated with glycated hemoglobin (HbA1c) (r = 0.12, p = 0.04) and fasting glucose levels (r = 0.14, p = 0.02). Conclusion: We suggest that THR should be monitored in patients with type 2 diabetes mellitus in order to detect diabetic microvascular complications earlier. Increased THR levels should prompt further investigation of diabetic complications in this population.
