Browsing by Author "Kizilay, DÖ"
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Item Associations Between Serum Uric Acid Concentrations and Cardiometabolic Risk and Renal Injury in Obese and Overweight ChildrenKizilay, DÖ; Sen, S; Ersoy, BObjective: The aim of this study was to assess the association between serum uric acid concentration (SUAC) and the parameters of the metabolic syndrome (MetS) and insulin resistance (IR). The secondary aim was to evaluate whether hyperuricemia is associated with renal injury and cardiovascular risk in obese (OB) and overweight (OW) children. Methods: The subjects of this study consisted of OB/OW children and adolescents (ages: 8-18 years). Sex and age specific serum uric acid (SUA) olarak degistirilecek percentiles were used and a SUA > 75th percentile was accepted as hyperuricemia. Anthropometric data, blood pressure (BP) measurements and biochemical parameters, including fasting blood glucose, insulin, total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglycerides (TG), aspartate aminotransferase, alanine aminotransferase, homeostatic model assessments of IR (HOMA-IR) and SUAC were recorded. Oral glucose tolerance tests (OGTT) were performed in all patients. MetS was defined according to the International Diabetes Federation criteria. Total cholesterol/HDL-c ratio > 4 and TG/HDL-c ratio >2.2 were used as the atherogenic index (Al) indicating cardiovascular risk. Urinary albumin excretion in a 24-hour and also in a first-morning urine sample were measured. Renal injury was assessed by microalbuminuria according to the National Kidney Foundation criteria. Results: There were 128 participants; 52 (40 %) had elevated (SUA > 75th percentile) and 76 had (60%) normal SUAC. The mean +/- SD age was 13.1 +/- 2.6 years and 87 (67.4 %) were female. The mean +/- SD weight was 73 +/- 18.97 kg and mean +/- SD height was 155.4 +/- 12.11 cm. There was no statistical difference between the groups with and without hyperuricemia in terms of age, sex, puberty stage and degree of obesity. Increased SUAC were significantly associated with higher waist-to-hip ratio (WHR), fasting insulin levels and insulin at 30 and 60 minutes during OGTT, HOMA-IR, lower HDL-c and presence of hypertriglyceridemia as well as with decreased HDL-c, increased AI, presence of IR and MetS. BP and microalbuminuria were not associated with SUAC. SUAC showed significant positive correlations with waist circumference, WHR, post-challenge glucose level at 60 minutes, with fasting insulin, post-challenge insulin levels at 30, 60, 90 and 120 minutes and also with HOMA-IR, total cholesterol/HDL-c ratio, TG/HDL-c ratio and a number of other criteria related to MetS. Also, an inverse correlation with HDL-c was noted. Conclusion: In OB/OW children frequency of MetS, IR and dislipidemia increases with increased SUAC, a finding independent of age, puberty, gender and body mass index. Patients meeting all of the MetS criteria had the highest SUAC. These results demonstrate that the association between UA and metabolic and cardiovascular risk factors can be detected early in childhood. Thus, we recommend monitoring SUAC in OB children and we believe that prevention of SUAC elevation in early life has a potential protective effect on metabolic impairment and subsequent comorbidities.Item Mental health of both child and parents plays a larger role in the health-related quality of life of obese and overweight childrenKizilay, DÖ; Sapmaz, SY; Sen, S; Özkan, Y; Özyurt, BC; Ersoy, BAims: A decrease in health-related quality of life (HRQOL) measures among obese (OB) and overweight (OW) children has been shown in several studies, but knowledge about the variables affecting HRQOL impairments is missing. The aim of this study was to evaluate the relationship between HRQOL and sociodemographic characteristics, anthropometric measurements, metabolic parameters, mental symptoms and parental attitudes in a sample of OB/OW children. Methods: Eighty-six OB/OW children, aged between 9 and 17 years, participated in the study. We performed sociodemographic questioning, anthropometric examinations and laboratory evaluations of the participants. HRQOL was assessed using the Pediatric Quality-of-Life Inventory (PedsQL), and levels of anxiety and depressive symptoms were measured using the Screen for Child Anxiety-Related Disorders (SCARED) questionnaire and the Children's Depression Inventory (CDI), respectively. Parental attitudes were assessed with the Parental Attitude Research Instrument (PARI) questionnaire. Results: A statistically significant relationship was found between total scores of CDI and SCARED answered by children and the total and subscale scores of PedsQL. Scores of total quality of life subscale, physical functionality and emotional functionality subscales were significantly lower in children with a family history of mental illness. No relationship was found between PedsQL subscales, anthropometric and metabolic parameters. Conclusions: Emotional problems and parental psychological distress are important factors in models of HRQOL in the OB/OW pediatric population.Item Mental health of both child and parents play a larger role in health related quality of life of obese and overweight childrenKizilay, DÖ; Sapmaz, SY; Sen, S; Özkan, Y; Özyurt, BC; Ersoy, BItem Reliability and Validity of the Turkish Version of Impact of Weight on Quality of Life for KidsKizilay, DÖ; Sapmaz, SY; Tepe, D; Ersoy, BObjective: The Impact of Weight on Quality of Life-Kids is a self-reported weight-related quality of life measure that has been validated for children and adolescents aged between 11 and 19. Impact of Weight on Quality of Life-Kids does not have a Turkish version. The aim of this study was to explore the reliability and validity of the Impact of Weight on Quality of Life-Kids in Turkish. Materials and Methods: The Impact of Weight on Quality of Life-Kids was translated into Turkish using Mapi Research Institute's suggested international translation technique. The psychometric evaluation included test-retest reliability, internal consistency, discriminant validity, concurrent validity, exploratory factor analysis, and confirmatory factor analysis. Results: For the total score, the internal consistency of the scale (Cronbach's alpha coefficient) was 0.93. The item-total score correlation coefficients ranged from 0.178 to 0.785. The testretest coefficients were found to be 0.94 for the total score and the subscales ranged from 0.66 to 0.89 after 2 weeks. Discriminant validity analysis demonstrated that the instrument differentiated well between the obese and non-obese samples. Five variables were discovered via factor analysis that explained 66.9% of the total variation. The chi-square/degree of freedom ratio value was 3.535, the comparative fit index value was 0.834, and the value of root mean square error of approximation was 0.10, as determined by confirmatory factor analysis. Conclusion: Our results demonstrated the adequate reliability and validity of the Impact of Weight on Quality of Life-Kids, suggesting that this scale is a useful tool for screening Turkish children and adolescents for weight-related quality of life.Item Information is Power: An Interventional Study on Parents of Children with Febrile SeizuresKizilay, DÖ; Kirdök, AA; Ertan, P; Ayça, S; Demet, MM; Polat, MAim: Febrile seizures (FS) cause great fear and panic in the families. The majority of parents think that they may lose their child during a seizure, and feel anxious about the possibility of seizures recurring in the future. We believe that educating the families with high levels of anxiety due to FS may help to reduce the level of anxiety. In this study, we aimed to determine the needs of parents regarding FS, and the effect of education on FS on the approach and anxiety of the parents. Materials and Methods: In our study, we interviewed the parents of 113 children who suffered from FS. We conducted a survey aiming at detailed detection of knowledge, attitudes, thoughts and concerns of the families about FS, and their approaches to fever and FS. We also performed Hospital Anxiety and Depression Scale and State-Trait Anxiety Inventory to determine the levels of anxiety and depression of the parents. Results: In this study, we found that parents were misinformed and had misbeliefs suggesting that FS damage the brain and cause epilepsy, that they are life-threatening and electroencephalography, magnetic resonance imaging and computed tomography scans of the brain are required. We also determined a significant lack of information about interventions during a seizure and thus, a high level of anxiety. Conclusion: We concluded that parents provided with sufficient information and given psychosocial support have their anxiety levels significantly reduced, making them better in first aid practices and reducing their requests for unnecessary preventive interventions.Item Biallelic variant at 5' UTR DMRT1: A novel 46,XY DSD syndrome?Solmaz, AE; Ersoy, B; Özen, S; Kilimci, DD; Kizilay, DÖ; Akin, HItem Insulin Resistance as Related to Psychiatric Disorders in Obese ChildrenKizilay, DÖ; Sapmaz, SY; Sen, S; Özkan, Y; Ersoy, BObjective: The current study aimed to investigate psychiatric consequences of obesity and the relationship between componenets of the metabolic syndrome and psychiatric disorders in children. Our second aim was to elucidate which of the anthropometric parameters or metabolic components were most strongly associated with psychiatric disorders. Methods: The study included 88 obese and overweight children with a body mass index (BMI) greater than 85th percentile. The patients were evaluated for psychiatric disorders by a single child and adolescent psychiatrist. Forty patients diagnosed with psychiatric disorders and 48 patients with normal psychiatric evaluation were compared in terms of anthropometric and metabolic parameters. BMI, BMI-standard deviation score and BMI percentile, waist circumference, waist to hip ratio, blood pressure and pubertal stage of all patients were recorded. Fasting serum glucose, insulin, lipid profile and homeostatic model assessments of insulin resistance (HOMA-IR) were measured to evaluate the metabolic parameters. Serum and 24 hour urine cortisol levels were measured. Results: HOMA-IR in the group with psychiatric disorders was found to be significantly higher than in the group without psychiatric disorders (6.59 +/- 3.36 vs 5.21 +/- 2.67; p = 0.035). Other anthropometric measurements and metabolic parameters were not significantly different between the two groups. Conclusion: An understanding of the relationships between obesity related medical comorbidities and psychiatric pathologies is important to encourage patients and their families to make successful healthy lifestyle changes and for weight management in terms of appropriate treatment.Item Urinary NGAL is a Potential Biomarker for Early Renal Injury in Insulin Resistant Obese Non-diabetic ChildrenSen, S; Kizilay, DÖ; Taneli, F; Özen, Ç; Ertan, P; Özunan, I; Yildiz, R; Ersoy, BObjective: Neutrophil gelatinase-associated lipocalin (NGAL) is one of the new biomarkers for detecting acute renal injury. There are studies showing the relationship between NGAL and renal injury in obese children. The aim of this study was to investigate whether urinary levels of NGAL, kidney injury molecule-1, and serum cystatin C are increased in insulin resistance (IR) patients before the development of diabetes. Methods: Cross-sectional, case-controlled study that included non-diabetic obese children and adolescent patients with IR and a non diabetic obese control group with no IR, who attended a tertiary center pediatric endocrinology outpatient clinic between 2016-2018. Those with diabetes mellitus and/or known renal disease were excluded. NGAL and creatinine (Cr) levels were evaluated in the morning spot urine from all participants. Serum renal function was evaluated. Results: Thirty-six control and 63 IR patients were included in the study, of whom 68 (68.7%) were girls. The mean age of all participants was 13.12 +/- 2.64 years and no statistically significant difference was found between the two groups in terms of age or gender distribution. Median (range) spot urinary NGAL (u-NGAL) values in the IR group were significantly higher at 26.35 (7.01-108.7) ng/mL than in the control group at 19.5 (3.45-88.14) ng/mL (p=0.018). NGAL/Cr ratio was also significantly higher in the IR group compared to the control group (p=0.018). Conclusion: Obese pediatric patients with IR were shown to have elevated levels of u-NGAL, a marker of renal injury. u-NGAL examination show renal before of diabetes.Item Bone mineral density, vitamin D status, and calcium intake in healthy female university students from different socioeconomic groups in TurkeyErsoy, B; Kizilay, DÖ; Yilmaz, SK; Taneli, F; Gümüser, GPeak bone mass is reached in late adolescence. Low peak bone mass is a well recognized risk factor for osteoporosis later in life. Our data do not support a link between vitamin D status, bone mineral density (BMD), and socioeconomic status (SES). However, there was a marked inadequacy of daily calcium intake and a high presence of osteopenia in females with low SES.PurposeOur aims were to (1) examine the effects of different SES on BMD, vitamin D status, and daily calcium intake and (2) investigate any association between vitamin D status and BMD in female university students.Subjects and methodsA questionnaire was used to obtain information about SES, daily calcium intake, and physical activity in 138 healthy, female university students (age range 18-22years). Subjects were stratified into lower, middle, and higher SES according to the educational and occupational levels of their parents. All serum samples were collected in spring for 25-hydroxyvitamin D concentration (25OHD). Lumbar spine and total body BMD was obtained by dual-energy X-ray absorptiometry (DXA) scan (Lunar DPX series). Osteopenia was defined as a BMD between -1.0 and -2.5 standard deviations (SDs) below the mean for healthy young adults on lumbar spine DXA.ResultsNo significant difference was found between the three socioeconomic groups in terms of serum 25OHD concentration, BMD levels, or BMD Z scores (p>0.05). Both the daily intake of calcium was significantly lower (p=0.02), and the frequency of osteopenia was significantly higher in girls with low SES (p=0.02). There was no correlation between serum 25OHD concentration and calcium intake and BMD values and BMD Z scores (p>0.05). The most important factor affecting BMD was weight (=0.38, p<0.001).ConclusionsLow SES may be associated with sub-optimal bone health and predispose to osteopenia in later life, even in female university students.