Browsing by Author "Bayram, F"

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    Impact of Obesity on the Metabolic Control of Type 2 Diabetes: Results of the Turkish Nationwide Survey of Glycemic and Other Metabolic Parameters of Patients with Diabetes Mellitus (TEMD Obesity Study)
    Sonmez, A; Yumuk, V; Haymana, C; Demirci, I; Barcin, C; Kiyici, S; Güldiken, S; Örük, G; Saydam, BO; Baldane, S; Kutlutürk, F; Küçükler, FK; Deyneli, O; Çetinarslan, B; Sabuncu, T; Bayram, F; Satman, I; Ayturk, S; Yilmaz, M; Asik, M; Dinccag, N; Cakmak, R; Turker, F; Idiz, C; Hacisahinogullari, H; Bagdemir, E; Yildiz, B; Haliloglu, O; Sancak, S; Ozsari, L; Cagiltay, E; Imre, E; Sait Gonen; Boysan, SN; Altuntas, Y; Ozturk, FY; Mert, M; Piskinpasa, H; Aydin, H; Imamoglu, S; Ersoy, C; Oz Gul, O; Selek, A; Dogru, T; Kirik, A; Kebapci, N; Efe, B; Kaya, A; Cordan, I; Kirac, CO; Capa, Z; Cesur, M; Yetkin, I; Corapcioglu, D; Canlar, S; Yildiz, OB; Sendur, SN; Cakir, B; Ozdemir, D; Corakci, A; Kutlu, M; Bascil Tutuncu, N; Bozkus, Y; Cakal, E; Demirbas, B; Ertek, S; Altay, M; Dagdeviren, M; Abedi, AH; Cetinkalp, S; Ozisik, H; Yener, S; Guney, E; Unubol, M; Yaylali, GF; Topsakal, S; Hekimsoy, Z; Akbaba, G; Aslan, I; Balci, MK; Dalkiran, S; Akbay, E; Gul, K; Agbaht, K; Yilmaz, MO; Bozkirli, E; Tetiker, BT; Cetinkaya Altuntas, S; Atmaca, A; Durmus, ET; Mete, T; Dikbas, O; Akin, S; Nuhoglu, I; Ersoz, HO; Bayraktaroglu, T; Sisman, P; Sahin, I; Cetin, S; Capoglu, I; Akbas, EM; Ucler, R; Eren, MA; Tuzcu, AK; Pekkolay, Z; Ozkaya, M; Araz, M; Salman, S; Dizdar, OS; Gurkan, E; Kargili Carlioglu, A
    Background: Obesity is the main obstacle for metabolic control in patients with type 2 diabetes. Turkey has the highest prevalence of obesity and type 2 diabetes in Europe. The effect of obesity on the metabolic control, and the macro-and microvascular complications of patients are not apparent. Objectives: This nationwide survey aimed to investigate the prevalence of overweight and obesity among patients with type 2 diabetes and to search for the impact of obesity on the metabolic control of these patients. We also investigated the independent associates of obesity in patients with type 2 diabetes. Methods: We consecutively enrolled patients who were under follow-up for at least 1 year in 69 tertiary healthcare units in 37 cities. The demographic, anthropometric, and clinical data including medications were recorded. Patients were excluded if they were pregnant, younger than 18 years, had decompensated liver disease, psychiatric disorders interfering with cognition or compliance, had bariatric surgery, or were undergoing renal replacement therapy. Results: Only 10% of patients with type 2 diabetes (n = 4,648) had normal body mass indexes (BMI), while the others were affected by overweight (31%) or obesity (59%). Women had a significantly higher prevalence of obesity (53.4 vs. 40%) and severe obesity (16.6 vs. 3.3%). Significant associations were present between high BMI levels and lower education levels, intake of insulin, antihypertensives and statins, poor metabolic control, or the presence of microvascular complications. Age, gender, level of education, smoking, and physical inactivity were the independent associates of obesity in patients with type 2 diabetes. Conclusion: The TEMD Obesity Study shows that obesity is a major determinant of the poor metabolic control in patients with type 2 diabetes. These results underline the importance of prevention and management of obesity to improve health care in patients with type 2 diabetes. Also, the results point out the independent sociodemographic and clinical associates of obesity, which should be the prior targets to overcome, in the national fight with obesity. (c) 2019 The Author(s) Published by S. Karger AG, Basel
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    Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study)
    Sonmez, A; Haymana, C; Bayram, F; Salman, S; Dizdar, OS; Gurkan, E; Carlioglu, AK; Barcin, C; Sabuncu, T; Satman, I; Guldiken, S; Ayturk, S; Yilmaz, M; Asik, M; Dinccag, N; Cakmak, R; Turker, F; Idiz, C; Hacisahinogullari, H; Bagdemir, E; Yildiz, B; Yumuk, VD; Haliloglu, O; Sancak, S; Ozsari, L; Cagiltay, E; Deyneli, O; Imre, E; Gonen, S; Boysan, SN; Altuntas, Y; Ozturk, FY; Mert, M; Piskinpasa, H; Aydin, H; Imamoglu, S; Ersoy, C; Ozgul, O; Kiyici, SK; Cetinarslan, B; Selek, A; Dogru, T; Kirik, A; Kebapci, N; Efe, B; Kaya, A; Cordan, I; Baldane, S; Kirac, CO; Demirci, I; Capa, Z; Cesur, M; Yetkin, I; Corapcioglu, D; Canlar, S; Yildiz, OB; Sendur, SN; Cakir, B; Ozdemir, D; Corakci, A; Kutlu, M; Tutuncu, NB; Bozkus, Y; Cakal, E; Demirbas, B; Ertek, S; Altay, M; Dagdeviren, M; Abedi, AH; Cetinkalp, S; Ozisik, H; Oruk, GG; Yener, S; Saydam, BO; Guney, E; Unubol, M; Yaylali, GF; Topsakal, S; Hekimsoy, Z; Akbaba, G; Aslan, I; Balci, MK; Dalkiran, S; Akbay, E; Gul, K; Agbaht, K; Yilmaz, MO; Bozkirli, E; Tetiker, BT; Altuntas, SC; Atmaca, A; Durmus, ET; Mete, T; Kutluturk, F; Kucukler, FK; Dikbas, O; Akin, S; Nuhoglu, I; Ersoz, HO; Bayraktaroglu, T; Sisman, P; Sahin, I; Cetin, S; Capoglu, I; Akbas, EM; Ucler, R; Eren, MA; Tuzcu, AK; Pekkolay, Z; Ozkaya, M; Araz, M
    Aims: Turkey has the highest prevalence of diabetes in Europe. It is therefore essential to know the overall cardiovascular risk and reveal the predictors of metabolic control in Turkish adults with diabetes mellitus. Methods: A nationwide, multicenter survey consecutively enrolled patients who were under follow up for at least a year. Optimal control was defined as HbA1c <7%, home arterial blood pressure (ABP) <135/85 mmHg, or LDL-C <100 mg/dL. Achieving all parameters indicated triple metabolic control. Results: HbA1c levels of patients (n = 5211) were 8.6 +/- 1.9% (71 +/- 22 mmol/mol) and 7.7 +/- 1.7% (61 +/- 19 mmol/mol), in Type 1 and Type 2 diabetes, respectively. Glycemic control was achieved in 15.3% and 40.2%, and triple metabolic control was achieved in 5.5% and 10.1%, respectively. Only 1.5% of patients met all the criteria of being non-obese, nonsmoker, exercising, and under triple metabolic control. Low education level was a significant predictor of poor glycemic control in both groups. Conclusions: Few patients with Type 2, and even fewer with Type 1 diabetes have optimal metabolic control in Turkey. TEMD study will provide evidence-based information to policy makers to focus more on the quality and sustainability of diabetes care in order to reduce the national burden of the disease. (C) 2018 Elsevier B.V. All rights reserved.
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    Dopamine Agonist-Induced Impulse Control Disorders in Patients With Prolactinoma: A Cross-Sectional Multicenter Study
    Dogansen, SC; Cikrikcili, U; Oruk, G; Kutbay, NO; Tanrikulu, S; Hekimsoy, Z; Hadzalic, A; Gorar, S; Omma, T; Mert, M; Akbaba, G; Yalin, GY; Bayram, F; Ozkan, M; Yarman, S
    Context: Dopamine agonist (DA)-induced impulse control disorder (ICD) in patients with prolactinomas is not sufficiently known. Objective: To evaluate the prevalence of DA-induced ICDs and possible risk factors related to these disorders in patients with prolactinoma. Design, Setting, and Participants: This is a cross-sectional multicenter study involving 308 patients with prolactinoma followed up in tertiary referral centers who received at least three months of DA therapy. DA-induced ICDs (pathological gambling, hypersexuality, compulsive shopping, and compulsive eating) and impulsivity were assessed using the Questionnaire for ImpulsiveCompulsive Disorders in Parkinson Disease and the Barratt Impulsiveness Scale-11, respectively. Patients were evaluated in terms of parameters related to ICD development. Results: Any ICD prevalence was 17% (n = 51). Hypersexuality was most common (6.5%). Although any ICD and hypersexuality were more common in male patients (P = 0.009, P < 0.001, respectively), compulsive eating was more common in female patients (P = 0.046). Current smoking, alcohol use, and gambling history were more frequent (P = 0.033, P = 0.002, P = 0.008, respectively) in patients with any ICD. In Barratt Impulsiveness Scale-11 total, attentional, motor, and nonplanning scores were higher in patients with any ICD (P < 0.001). Current smoking and alcohol use were more frequent (P = 0.007, P = 0.003, respectively) and percentage increase of testosterone levels at last visit was higher (P = 0.021) in male patients with prolactinomas with hypersexuality. Conclusion: Any ICD may be seen in one of six patients with prolactinoma who are receiving DA therapy. Endocrinology specialists should be aware of this side effect, particularly in male patients with a history of gambling, smoking, or alcohol use.
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    33 Questions about Triglycerides and Cardiovascular Effects: Expert Answers
    Çetinkalp, S; Koylan, N; Özer, N; Onat, A; Özgen, AG; Koldas, ZL; Güven, GS; Özdogan, Ö; Karsidag, K; Yigit, Z; Kayikçioglu, M; Tokgözoglu, L; Can, LH; Tartan, Z; Kültürsay, H; Karpuz, B; Kirilmaz, B; Ersanli, M; Ural, D; Erbakan, AN; Oguz, A; Kayikçioglu, ÖR; Temizhan, A; Sansoy, V; Ceyhan, C; Öngen, Z; Bayram, F; Örem, C; Sönmez, A; Beyaz, S; Ükinç, K; Yürekli, BS; Çoker, M; Canda, E; Simsir, IY
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    Etiology of hypopituitarism in tertiary care institutions in Turkish population: analysis of 773 patients from pituitary study group database
    Tanriverdi, F; Dokmetas, HS; Kebapci, N; Kilicli, F; Atmaca, H; Yarman, S; Ertorer, ME; Erturk, E; Bayram, F; Tugrul, A; Culha, C; Cakir, M; Mert, M; Aydin, H; Taskale, M; Ersoz, N; Canturk, Z; Anaforoglu, I; Ozkaya, M; Oruk, G; Hekimsoy, Z; Kelestimur, F; Erbas, T
    Hypopituitarism in adult life is commonly acquired and the main causes are known as pituitary tumors and/or their treatments. Since there are new insights into the etiology of hypopituitarism and presence of differences in various populations, more studies regarding causes of hypopituitarism are needed to be done in different ethnic groups with sufficient number of patients. Therefore, we performed a multi-center database study in Turkish population investigating the etiology of hypopituitarism in 773 patients in tertiary care institutions. The study was designed and coordinated by the Pituitary Study Group of SEMT (The Society of Endocrinology and Metabolism of Turkey). Nineteen tertiary reference centers (14 university hospitals and 5 training hospitals) from the different regions of Turkey participated in the study. It is a cross-sectional database study, and the data were recorded for 18 months. We mainly classified the causes of hypopituitarism as pituitary tumors (due to direct effects of the pituitary tumors and/or their treatments), extra-pituitary tumors and non-tumoral causes. Mean age of 773 patients (49.8 % male, 50.2 % female) was 43.9 +/- 16.1 years (range 16-84 years). The most common etiology of pituitary dysfunction was due to non-tumoral causes (49.2 %) among all patients. However, when we analyze the causes according to gender, the most common etiology in males was pituitary tumors, but the most common etiology in females was non-tumoral causes. According to the subgroup analysis of the causes of hypopituitarism in all patients, the most common four causes of hypopituitarism which have frequencies over 10 % were as follows: nonsecretory pituitary adenomas, Sheehan's syndrome, lactotroph adenomas and idiopathic. With regard to the type of hormonal deficiencies; FSH/LH deficiency was the most common hormonal deficit (84.9 % of the patients). In 33.8 % of the patients, 4 anterior pituitary hormone deficiencies (FSH/LH, ACTH, TSH, and GH) were present. Among all patients, the most frequent cause of hypopituitarism was non-secretory pituitary adenomas. However, in female patients, present study clearly demonstrates that Sheehan's syndromeis still one of the most important causes of hypopituitarism in Turkish population. Further, population-based prospective studies need to be done to understand the prevalence and incidence of the causes of hypopituitarism in different countries.
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    Evaluation and follow-up of patients diagnosed with hypophysitis: a cohort study
    Hacioglu, A; Karaca, Z; Uysal, S; Ozkaya, HM; Kadioglu, P; Selcukbiricik, OS; Gul, N; Yarman, S; Koksalan, D; Selek, A; Canturk, Z; Cetinarslan, B; Corapcioglu, D; Sahin, M; Unal, FTS; Babayeva, A; Akturk, M; Ciftci, S; Piskinpasa, H; Dokmetas, HS; Dokmetas, M; Sahin, O; Eraydin, A; Fenkci, S; Ozturk, S; Akarsu, E; Omma, T; Erkan, B; Burhan, S; Koroglu, EP; Saygili, F; Kan, EK; Atmaca, A; Elbuken, G; Uc, ZA; Gorar, S; Hekimsoy, Z; Pekkolay, Z; Bostan, H; Bayram, F; Yorulmaz, G; Sener, SY; Turan, K; Celik, O; Dogruel, H; Ertorer, E; Iyidir, OT; Topaloglu, O; Cansu, GB; Unluhizarci, K; Kelestimur, F
    Objective Primary hypophysitis might be challenging to diagnose, and there is a lack of evidence regarding optimal treatment strategies due to rarity of the disease. We aim to investigate the clinical features and compare the outcomes of different management strategies of primary hypophysitis in a large group of patients recruited on a nationwide basis.Design A retrospective observational study.Methods The demographic, clinical, and radiologic features and follow-up data were collected in study protocol templates and analyzed.Results One hundred and thirteen patients (78.8% female, median age: 36 years) were included. Lymphocytic (46.7%) and granulomatous hypophysitis (35.6%) were the prevailing subtypes out of 45 patients diagnosed after pathologic investigations. Headache (75.8%) was the most common symptom, and central hypogonadism (49.5%) was the most common hormone insufficiency. Of the patients, 52.2% were clinically observed without interventions, 18.6% were started on glucocorticoid therapy, and 29.2% underwent surgery at presentation. Headache, suprasellar extension, and chiasmal compression were more common among glucocorticoid-treated patients than who were observed. Cox regression analysis revealed higher hormonal and radiologic improvement rates in the glucocorticoid-treated group than observation group (hazard ratio, 4.60; 95% CI, 1.62-12.84 and HR, 3.1; 95% CI, 1.40-6.68, respectively). The main indication for surgery was the inability to exclude a pituitary adenoma in the presence of compression symptoms, with a recurrence rate of 9%.Conclusion The rate of spontaneous improvement might justify observation in mild cases. Glucocorticoids proved superior to observation in terms of hormonal and radiologic improvements. Surgery may not be curative and might be considered in indeterminate, treatment-resistant, or severe cases.