Browsing by Author "Ugur, K"

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    Prevalence and predictors of gestational diabetes mellitus: a nationwide multicentre prospective study
    Aydin, 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, ZA
    Aim 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.
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    Biochemical characteristics and calcium and PTH levels of patients with high normal and elevated serum 25(OH)D levels in Turkey: DeVIT-TOX survey
    Pekkolay, Z; Yavuz, DG; Saygili, ES; Degertekin, CK; Topaloglu, O; Önder, ÇE; Soylu, H; Taskaldiran, I; Pazir, AE; Ugur, K; Tanrikulu, S; Firat, SN; Atak, BM; Batman, A; Omma, T; Cagiltay, E; Özdemir, N; Altuntas, SÇ; Imga, NN; Karakiliç, E; Hekimsoy, Z; Kilinç, F; Yay, A; Eroglu, M; Tuzcu, AK
    A Summary Vitamin D intake over the recommended dose is usually associated with high serum 25(OH)D levels and generally not associated with symptoms of hypercalcemia. High doses of cholecalciferol need to be avoided to protect against vitamin D toxicity and related complications. Strict adherence to the clinical guidelines for treating vitamin D deficiency can ensure safe and effective treatment. Purpose We observed a tendency to use high doses of cholecalciferol for vitamin D deficiency treatment or vitamin D supplementation. We aimed to determine the biochemical characteristics of patients with high normal and elevated serum 25(OH)D levels. Methods An online invitation was sent to all tertiary endocrinology clinics in Turkey to complete an online retrospective survey (DeVIT-TOX Survey) for patients diagnosed with high serum 25(OH)D levels (> 88 ng/mL) between January 2019 and December 2019. The patients were evaluated according to the presence of signs and symptoms of hypercalcemia and doses of vitamin D intake, evaluated into the following three groups according to their 25(OH)D levels: group 1, > 150 ng/mL; group 2, 149-100 ng/mL; and group 3, 99-88 ng/mL. Results A total of 253 patients were included in the final analysis (female/male: 215/38; mean age, 51.5 +/- 15.6 years). The average serum 25(OH)D level was 119.9 +/- 33 (range, 88-455) ng/mL, and the average serum calcium level was 9.8 +/- 0.7 (range, 8.1-13.1) mg/dL. Most (n = 201; 75.4%) patients were asymptomatic despite having high serum 25(OH)D and calcium levels. The serum 25(OH)D level was significantly higher in the symptomatic groups than in the asymptomatic groups (138.6 +/- 64 ng/mL vs. 117.7 +/- 31 ng/mL, p < 0.05). The most common cause (73.5%) associated with high serum 25(OH) D levels was the inappropriate prescription of a high dose of oral vitamin D (600.000-1.500.000 IU) for treating vitamin D deficiency/insufficiency in a short time (1-3 months). The cut-off value of 25 (OH) D level in patients with hypercalcemia was found to be 89 ng/mL [median 116.5 (89-216)]. Conclusions High dose of vitamin D intake is associated with a high serum 25 OH D level, without symptoms of hypercalcemia. Inappropriate prescription of vitamin D is the primary cause for elevated 25(OH) D levels and related hypercalcemia. Hypercalcemia may not be observed in every patient at very high 25(OH) D levels. Adherence to the recommendation of guidelines is essential to ensure safe and effective treatment of vitamin D deficiency.
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    Identifying Clinical Characteristics of Hypoparathyroidism in Turkey: HIPOPARATURK-NET Study
    Degertekin, CK; Yavuz, DG; Pekkolay, Z; Saygili, E; Ugur, K; Koca, AO; Unubol, M; Topaloglu, O; Aydogan, BI; Kutbay, NO; Hekimsoy, Z; Yilmaz, N; Balci, MK; Tanrikulu, S; Unsal, YA; Ersoy, C; Omma, T; Keskin, M; Yalcin, MM; Yetkin, I; Soylu, H; Karakose, M; Yilmaz, M; Karakilic, E; Piskinpasa, H; Batman, A; Akbaba, G; Elbuken, G; Bahadir, CT; Kilinc, F; Bilginer, MC; Iyidir, OT; Canturk, Z; Yilmaz, BA; Sayiner, ZA; Eroglu, M
    Hypoparathyroidism is an orphan disease with ill-defined epidemiology that is subject to geographic variability. We conducted this study to assess the demographics, etiologic distribution, treatment patterns and complication frequency of patients with chronic hypoparathyroidism in Turkey. This is a retrospective, cross-sectional database study, with collaboration of 30 endocrinology centers located in 20 cities across seven geographical regions of Turkey. A total of 830 adults (mean age 49.6 +/- 13.5 years; female 81.2%) with hypoparathyroidism (mean duration 9.7 +/- 9.0 years) were included in the final analysis. Hypoparathyroidism was predominantly surgery-induced (n = 686, 82.6%). The insulting surgeries was carried out mostly due to benign causes in postsurgical group (SG) (n = 504, 73.5%) while patients in nonsurgical group (NSG) was most frequently classified as idiopathic (n = 103, 71.5%). The treatment was highly dependent on calcium salts (n = 771, 92.9%), calcitriol (n = 786, 94.7%) and to a lower extent cholecalciferol use (n = 635, 76.5%) while the rate of parathyroid hormone (n = 2, 0.2%) use was low. Serum calcium levels were most frequently kept in the normal range (sCa 8.5-10.5 mg/dL, n = 383, 46.1%) which might be higher than desired for this patient group. NSG had a lower mean plasma PTH concentration (6.42 +/- 5.53 vs. 9.09 +/- 7.08 ng/l, p < 0.0001), higher daily intake of elementary calcium (2038 +/- 1214 vs. 1846 +/- 1355 mg/day, p = 0.0193) and calcitriol (0.78 +/- 0.39 vs. 0.69 +/- 0.38 mcg/day, p = 0.0057), a higher rate of chronic renal disease (9.7% vs. 3.6%, p = 0.0017), epilepsy (6.3% vs. 1.6%, p = 0.0009), intracranial calcifications (11.8% vs. 7.3%, p < 0.0001) and cataracts (22.2% vs. 13.7%, p = 0.0096) compared to SG. In conclusion, postsurgical hypoparathyroidism is the dominant etiology of hypoparathyroidism in Turkey while the nonsurgical patients have a higher disease burden with greater need for medications and increased risk of complications than the postsurgical patients.