Browsing by Author "Mert, M"
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Item 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, ABackground: 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, BaselItem 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, MAims: 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.Item Prevalence and predictors of gestational diabetes mellitus: a nationwide multicentre prospective studyAydin, H; Çelik, Ö; Yazici, D; Altunok, Ç; Tarçin, Ö; Deyneli, O; Sancak, S; Kiyici, S; Aydin, K; Yildiz, BO; Çakiroglu, AY; Özer, A; Tuzcu, AK; Kan, A; Çelik, A; Uysal, A; Atmaca, A; Evren, B; Taskiran, B; Bilir, BE; Duran, C; Arpaci, D; Tüzün, D; Kavak, EÇ; Aydeniz, E; Akbas, EM; Üstünyurt, E; Bil, E; Güney, E; Akbaba, E; Gürkan, E; Çagliyan, E; Karakiliç, E; Karakas, E; Kilinç, F; Söylemez, F; Küçükler, FK; Yorulmaz, G; Akbaba, G; Uysal, G; Kurt, G; Yaylali, GF; Selimoglu, H; Sari, H; Piskinpasa, H; Çelik, H; Peynirci, H; Bilal, I; Sahin, I; Gözükara, I; Anaforoglu, I; Senyuva, I; Ugur, K; Dogan, K; Keskin, L; Mert, M; Adas, M; Tonguç, M; Eroglu, M; Kulaksizoglu, M; Özcan, M; Çinar, N; Kutbay, NÖ; Dikbas, O; Bakiner, O; Turhan, ÖT; Tütüncüoglu, P; Sari, R; Melekoglu, R; Ayaz, R; Emral, R; Mumusoglu, S; Görar, S; Keskek, SÖ; Tosun, SA; Çetinkaya, SE; Temizkan, S; Ünsal, S; Demir, T; Yüce, T; Aksoy, Ü; Çinkir, Ü; Simsek, Y; Uyar, Y; Türk, Y; Pekkolay, Z; Hekimsoy, Z; Cantürk, Z; Üç, ZAAim Prevalence rates of gestational diabetes mellitus (GDM) show considerable variation among different countries and regions of the world. The primary aim of this study was to determine the nationwide prevalence and predictors of GDM in Turkey. Methods We conducted prospective nationwide screening among pregnant women. Between August 2016 and November 2017, a total of 2643 pregnant women from 51 centres in 12 different regions were enrolled. A two-step screening method and Carpenter and Coustan criteria were used in the diagnosis of GDM. Clinical and biochemical data were obtained using electronic database software. Results The national prevalence of GDM was found to be 16.2% [95% confidence intervals (CI) 15.0% to 17.4%] without a significant difference between urban and rural regions. Women with GDM were older (mean age: 32 +/- 5 vs. 28 +/- 5 years, P < 0.001) and heavier (mean BMI: 27.2 +/- 5.1 vs. 24.7 +/- 4.7 kg/m(2), P < 0.001) than their counterparts without GDM. The prevalence of GDM tended to increase with age (< 25 years, 6.9%; 26-35 years, 15.6%; and 36-45 years, 32.7%; P < 0.001). Maternal age, maternal BMI, history of previous GDM and family history of diabetes mellitus were independent predictors of developing GDM (P < 0.05 for all). Low-risk women (age < 25 years, BMI < 25 kg/m(2), no family history of diabetes) comprised 10.7% of the total population and the prevalence of GDM in these women was 4.5% (95% CI 2.4% to 7.8%). Conclusion The results of this nationwide study indicate that GDM is very common, affecting one in seven pregnancies in Turkey. Implementation of international guidelines on screening and management of this public health problem is required.Item The Importance of DHEA-S Levels in Cushing's Syndrome; Is There a Cut-off Value in the Differential Diagnosis?Ciftci, S; Soyluk, O; Selek, A; Erol, S; Hekimsoy, Z; Esen, A; Dursun, H; Sahin, S; Oruk, G; Mert, M; Soylu, H; Yurekli, BS; Ertorer, ME; Omma, T; Evran, M; Adas, M; Tanrikulu, S; Aydin, K; Pekkolay, Z; Can, B; Karakilic, E; Karaca, Z; Bilen, H; Canturk, Z; Cetinarslan, B; Kadioglu, P; Yarman, SThe purpose of this study was to determine possible cut-off levels of basal DHEA-S percentile rank in the differential diagnosis of patients with Cushing's syndrome (CS) with ACTH levels in the gray zone and normal DHEA-S levels. In this retrospective study including 623 pathologically confirmed CS, the DHEA-S percentile rank was calculated in 389 patients with DHEA-S levels within reference interval. The patients were classified as group 1 (n=265 Cushing's disease; CD), group 2 (n=104 adrenal CS) and group 3 (n=20 ectopic ACTH syndrome).ROC-curve analyses were used to calculate the optimal cut-off level of DHEA-S percentile rank in the reference interval in the differential diagnosis of CS, and the effectiveness of this cut-off level in the identification of the accurate etiology of CS was assessed in patients who were in gray zone according to their ACTH levels. The DHEA-S percentile rank in the reference interval were significantly lower in group 2 compared to the other two groups (p<0.001), while group 1 and group 3 had similar levels. The optimal cut-off level of DHEA-S percentile rank in the reference interval providing differential diagnosis between group 1 and group 2 was calculated as 19.5th percentile (80.8% sensitivity, 81.5% specificity) and the level demonstrated the accurate etiology in 100% of CD and 76% of adrenal CS patients who were in the gray zone. This study showed that the cut-off value of DHEA-S level less than 20% of the reference interval could be used for differential diagnosis of CD and adrenal CS with high sensitivity and specificity, and it should be taken into the initial evaluation.Item Assesment of attainment of recommended TSH levels and levothyroxine compliance in differentiated thyroid cancer patientsYavuz, DG; Yazan, CD; Hekimsoy, Z; Aydin, K; Gokkaya, N; Ersoy, C; Akalin, A; Topaloglu, O; Aydogan, BI; Dilekci, ENA; Uc, ZA; Cansu, GB; Ozsari, L; Iyidir, OT; Olgun, ME; Keskin, L; Mert, M; Can, B; Gungor, K; Galip, T; Cantürk, Z; Elbuken, G; Pekkolay, Z; Kutbay, NO; Yorulmaz, G; Kalkan, AT; Unsal, YA; Yay, A; Karagun, B; Bozkur, EObjective Thyroid-stimulating hormone (TSH) suppression treatment can induce signs and symptoms of hyperthyroidism and hypothyroidism due to inappropriate treatment or poor compliance to the treatment. The current study aimed to investigate TSH levels, frequency of being on target TSH, adherence to levothyroxine (LT4) suppression treatment in differentiated thyroid cancer (DTC) patients after surgery in a multicentric setting. Design and Patients This multicentric cross-sectional study was conducted at 21 medical centres from 12 cities in Turkey. DTC patients followed at least one year in the same center included in the study. Clinical data, serum TSH, free thyroxine (FT4), thyroglobulin (Tg) and anti-Tg levels were recorded during the most recent visit. Body mass index, systolic and diastolic blood pressures, pulse rate were measured. LT4 doses were recorded and doses per kilogram of bodyweight were calculated. Pill ingestion habits recorded and adherence to the therapy were evaluated using the Morisky Medication Adherence Scale and categorized as good, moderate or poor compliant based on their scores. Risk stratification forpredicting the disease persistance and/or reccurence was assessed using the American Joint Committee on Cancer-7th edition thyroid cancer staging calculator. TSH serum concentrations were classified as severe suppression (TSH < 0.01 mU/L), moderate suppression (TSH: 0.01-0.1 mU/L), mild suppression (TSHL 0.1-0.5 mU/L), euthyroid (TSH: 0.5-4 mU/L) and hypothyroid (TSH > 4 mU/L). TSH levels can also be classified as on being on target, under the target, or beyond over the target, according to the American Thyroid Association recommendations. Results A group of 1125 patients (F/M: 941/184, 50.7 +/- 11.7 years) were included in the study. The mean LT4 daily dosage was 132.4 +/- 39.6 mcg/day. TSH levels showed severe suppression in 99 (%8.8) patients, moderate suppression in 277 (%24.6) patients and mild suppression in 315 (%28) patients and euthyroid range in 332 (%29.5) patients and hypothyroid range in 97 (8.6%). TSH levels were in target in 29.2% of the patients 20.4% of the patients were undertreated, 50.4% overtreated. The daily LT4 dose and LT4 dose/kg were significantly higher in the severe suppression group (p < .001, p < .001). According to the Morisky scale, 564 patients (50.1%) were good compliant, 368 patients (32.7%) were moderate compliant, and 193 patients (17.1%) were noncompliant. Patients with poor compliance need a higher dose of LT4 compared to the good compliance group (p < .001). TSH levels of patients with good compliance were 0.67 +/- 1.96 mU/L and TSH with poor compliance was 2.74 +/- 7.47 mU/L (p < .001). TSH levels were similar in patients on fixed and alternating dosages. Conclusion In 29.2% of the DTC patients, serum TSH levels were at target levels. Remaining of the study group have TSH levels under or over treatment range, exposing the patient to medication side effects. Majorty of the study group 82.8% have good or moderate adherence to LT4 therapy. Reaching TSH targets requires simplified and applicable guidelines and following the guideline recommendations.Item Dopamine Agonist-Induced Impulse Control Disorders in Patients With Prolactinoma: A Cross-Sectional Multicenter StudyDogansen, 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, SContext: 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.Item Etiology of hypopituitarism in tertiary care institutions in Turkish population: analysis of 773 patients from pituitary study group databaseTanriverdi, 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, THypopituitarism 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.Item Clinical and demographic aspects of Paget disease of bone: A multicentric study from TurkeyYavuz, DG; Aytürk, S; Çetinkalp, S; Bayraktar, F; Kulaksizoglu, M; Hekimsoy, Z; Aydin, H; Uygur, M; Deniz, F; Ipekçi, S; Atmaca, A; Saraç, F; Özdemir, N; Cantürk, Z; Mert, M; Sancak, S; Ertörer, E; Duran, C; Akarsu, E; Deyneli, O; Selek, A; Gürlek, AObjective: Paget disease of bone (PDB) is a metabolic bone disease that has been rarely reported in the Eastern countries. This study aimed to evaluate the clinical and demographic characteristics of patients with PDB followed up at endocrinology clinics in Turkey. Methods: An invitation was sent to tertiary endocrinology clinics to complete a survey on the dernc:graphic, clinical, radiological, and laboratory parameters, as well as treatment modalities of patients with PDB. This study enrolled clinically and radiologically proven 185 patients with PDB from 18 endocrinology centers based in 10 cities of Turkey. Results: This cohort of PDB had female preponderance (women/men: 105/80) with a mean age, during diagnosis, of 57 +/- 10 years. Most of the patients (59.6%) were symptomatic at diagnosis. Bone pain and headache were the predominant clinical symptoms. Polyostotic disease was observed in 67.5% (n=125) of patients. Frequently affected bones were skull (41.6%), pelvis (53.5%), spine (41%), and femur (25.4%). Moreover, 17 patients with skull involvement had hearing loss. Mean serum alkaline phosphatase (ALP) level (552 +/- 652 IU/L; range: 280-5762 IU/L) was over the normal reference cutoff with normal serum calcium levels. Intravenous bisphosphonates (zoledronic acid, 5 mg; pamidronate, 60-90 mg) were the most used drugs (75%) for the treatment of PDB. Most of the patients (87.1%) treated with intravenous bisphosphonates responded well, with a decrease in serum ALP level (117 +/- 114 IU/L) in the 12th month of therapy. Furthermore, 16 patients relapsed after the second year of therapy; 3 patients did not respond to the initial intravenous bisphosphonate treatment. Conclusion: The patients with PDB followed up by endocrinology clinics of Turkey exhibited polyostotic disease with classical clinical, radiological, and biochemical features and women's predominance with good response to intravenous bisphosphonate therapy.Item Prevalence of Vitamin D Deficiency and Hypervitaminosis D Among Adult Patients Admitted to the Tertiary Care Hospitals in TurkeyYavuz, DG; Ersoy, R; Altuntas, Y; Bilen, H; Pamuk, B; Apaydin, T; Temizkan, S; Altuntas, H; Mert, M; Akalin, A; Sert, M; Simsri, IY; Hekimsoy, Z; Cantürk, Z; Üç, ZA; Iplikci, S; Yasar, M; Unubol, M; Sezer, K; Toplaoglu, Ö; Iyidir, ÖT; Pekkolay, Z; Atmaca, A; Dikbas, O; Özdemir, N; Gül, K; Deniz, F; Ertörer, E; Karaca, Z; Elbüken, G; Arpaci, D; Agbaht, K; Turan, E; Anaforoglu, I; Bayraktaroglu, T; Haklar, G; Daglioglu, G; Tuzcu, A; Sahin, I; Çetinkalp, SObjective: Vitamin D deficiency is a common health problem around the world. This study aimed to evaluate the nationwide prevalence of vitamin D status in tertiary care hospitals in Turkey. Methods: Retrospectively, the data on vitamin D levels from 33 tertiary care hospitals' clinical bio-chemistry laboratories around Turkey between January and December were collected. Results: In total, 706 434 serum samples from adult subjects (female/male: 469 028/237 406; 66.4%/33.6%) were included. While vitamin D levels were sufficient in 20.3% (n = 14 222), they were insufficient in 21.9% (n = 154 360) and deficient in 57.8% (n = 408 882). We observed the highest rates of deficiency in those aged between 18 and 29 years (62.9%, n = 70 235) and lowest rates between 60 and 69 years (52.3%, n = 61 121) and between 70 and 79 years (52.3%, n = 32 397). Hypervitaminosis D was detected in 5.5% of adult subjects; highest rates of hypervitaminosis D were observed in those who were over 80 years (6.6%) and 70-79 years (6.5%) and the lowest in 18-29 years (2.8%). Discussion: In this cohort, over half of the subjects admitted to the tertiary care hospitals in Turkey had vitamin D deficiency and required vitamin D supplementation. The elderly population had the lowest prevalence of vitamin D insufficiency and the highest prevalence of hypervitaminosis D.