Slide Session : OS-END-44 ; Endocrinology : The Relationship Between Vitamin D and Testosterone Levels in Overweight Patients

( Ozlem Soyluk ),( Meral Mert ),( Yildiz Okuturlar ),( Samet Sayilan ),( Pinar Karakaya ),( Farid Babashov ),( Ozlem Harmankaya ),( Abaki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: There are studies showing the relationship between vitamin D deficiency and obesity in the literature. Also it is known that testosterone levels decrese in obesity. So it is hypothesized that testosterone levels can increase with vitamin D replacement. We aimed to investigate this relationship between vitamin D and testosterone level in patients with BMI over 25 kg/m2. Methods: The data of 3110 patients with BMI > 25 kg /m2 are evaluated retrospectively. The relation between 25 OH vitamin D3, tetsoterone, parathormone (PTH), A1c, fasting insulin, fasting glucose, HOMA values, age, sex were examined. We compared the data of 265 women and 38 men whose records included all these parameters. Results: Mean ages are found to be 46,38±12,82 yeasr and 40,42±12,60 years in female and male patients respectively. There are no significant differences between vitamin D, PTH, B12 and HOMA levels in female and male patients. In the female group there was a negative correlation between age and 25 (OH)D3 level and in the male group there was a negative correlation between 25(OH)D3 and HOMA value. In both groups no correlation was found between 25(OH)D3 and total testosterone levels (Table-1). Conclusions: There are several studies with different results about the realtionship between vitamin D and parameters like obesity, testosterone level. In our study we could not find any relationship between Vitamin-D and testosterone levels.

Slide Session : OS-END-23 ; Endocrinology : The Relationship Between Testosterone and Homa-R Levels in Overweight Patients

( Yildiz Okuturlar ),( Meral Mert ),( Ozlem Soyluk ),( Ozlem Harmankaya ),( Pinar Karakaya ),( Samet Sayilan ),( Didem Acarer ),( A Baki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: It was shown that there is a correlation between low testosterone level and insulin resistance. Insulin resistance is related with metabolic syndrome and type 2 diabetes which represent a risk factor for cardiovascular disease. Obesity has become an important public health problem and it is known that it has an adverse effect on reproductive system and fertility. In our study it was aimed to investigate the relation between testosterone level and insulin resistance in overweight male and female patients. Methods: In our study total number of 2699 female and 377 male patients who admitted to our hospital because of weight problem and had BMI>25 were evaluated retrospectively. Correlation analyses between total testosterone level and parameters like fasting blood glucose, insulin level, Alc and HOMA values were performed. Results: While average age was 41.38±12.50 years in female patients it was detected 39.15±13.73 years for male patients. While negative correlations were found between testosterone level and age, testosterone level and glucose, testosterone level and Alc in the female group there were no correlations between testosterone level and HOMA, testosterone level and insulin in the same group. Whereas in the male group negative correlations were found between testosterone level and glucose, testosterone level and insulin, testosterone level and Alc and testosterone level and HOMA in the male group (Table 1). Conclusions: The correlation between testosterone level and insulin was reported in female patients with polycystic ovary syndrome. In our study glucose and A1c levels may increase while testosterone level decreases in both male and female groups. In addition to this finding insulin level and HOMA also increases with the decrease of testosterone in male patients. This may be explaned by the metabolic effect of testosterone.

Slide Session : OS-NEP-06 ; Nephrology : Paraoxonase-1 Activity in Patients with Anemia with or Without Chronic Renal Failure

( Yildiz Okuturlar ),( Nilgul Akalin ),( Ozlem Harmankaya ),( Nurten Turan Guner ),( Deniz Yilmaz ),( Asuman Gedikbasi ),( Ozlem Soyluk ),( Meral Mert ),( Abaki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Paraoxonase (PON)-1 is an antioxidant enzyme. It has three known activities, paraoxonase, arylesterase and diazoxonase. It has been reported that PON-1 defi ciency is related to increased susceptibility to development of atherosclerosis and cardiovascular disease. The aim of this study is to evaluate antioxidative status and carotid intima-media thickness (CIMT) in patients with anemia with/without chronic renal failure. Methods: 42 patients with anemia and a control group of 47 patients were enrolled in to the study. Patients were divided into two groups as Group 1 with iron defi ciency anemia and Group 2 with chronic renal failure and anemia of chronic disease and Group 3 as the healthy control group. In all three groups antioxidative status was evaluated by measuring free sulfhydryl groups (-SH = total thiol), paraoxonase and arylesterase levels. CIMT measurements were also performed at the same time. Results: In all three groups, age, weight, average height, gender, presence of diabetes and smoking habit were not signifi cantly different (p>0.05). Hemoglobin levels were 7.85 ± 1.25 in Group 1, 8.62 ± 1.09 in Group 2 and 13.45±1.63 in Group 3. We have found that Arylesterase and -SH levels were decreased both in Group 1 and 2 according to Group 3. Bilateral CIMT was increased only in Group 2. Between group 1 and group 2 the only difference was the the more signifi cant decrease in Arylesterase levels in group 2 (Table 1-2). Conclusion: PON-1 activity and -SH levels may be independently associated with the presence of atherosclerosis.

Slide Session : OS-END-26 ; Endocrinology : Vitamin D Levels in Patients with Autoimmune Thyroid Disease

( Esref Erturk ),( Meral Mert ),( Yildiz Okuturlar ),( Ozlem Soyluk ),( Pinar Karakaya ),( Ozlem Harmankaya ),( Abaki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: It is known that vitamin D has effects on the immune system. Vitamin D is an important immune system regulator. Several observational studies show that, vitamin D inhibits proinflammatory processes by suppressing the enhanced activity of immune cells that take part in the autoimmune reaction. It has been suggested that vitamin D may play a role in the pathogenesis of several endocrine diseases, such as autoimmune thyroid diseases, hyperparathyroidism, diabetes mellitus, Addison`s disease. In this study it is aimed to find a correlation between autoimmune thyroid disease and vitamin D. Methods: Thyroid function test result, calcium, PTH and vitamin D levels were compared between a control group of 35 healthy people and 35 patients with a cross-sectional thyroid autoimmune disease. Results: Mean ages are found to be 41.8±14.08 years and 45.6±13.46 years in patients and controls respectively. Mean vitamin D, calcium and parathormone (PTH) levels in patients and control group are found to be 18.6±9.5 vs 39.13 ±14.6 ng/ml, 7.9±0.16 vs 8.67±0.80 mg/dl, 50.7±25.86 vs 56.21±18.17 pg/ml, respectively. Vitamin D levels were found to be significantly lower than the control group in patients with autoimmune thyroid disease. There was no difference between the levels of PTH. Conclusions: Analyzing of vitamin D, PTH and calcium parameters should be considered in patients with autoimmune thyroid diseases. Treatment of vitamin D deficiency may help increase the quality of life in tyroid patients.

Slide Session : OS-END-46 ; Endocrinology : A Rare Cause of Secondary Hypertension: An Unusual Case of Conn`s Syndrome

( Samet Sayilan ),( Yildiz Okuturlar ),( Meral Mert ),( Ozlem Soyluk ),( Serkan Enki ),( Yesim Ozden Inan ),( Ozlem Harmankaya ),( A Baki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Primary hyperaldosteronism (PHA) is a syndrome arising from autonomous aldosterone secretion from the adrenal gland and suppression of plasma renin activity. PHA is usually seen due to unilateral adenoma or bilateral hyperplasia. We present a case of Conn`s syndrome with bilateral adrenal lesions but unilateral functioning adenoma. Methods: A 43 years old female admitted to the emergency service due to inability to walk for 3 days, fatigue and generalised pain. She had a history of diabetes mellitus and hypertension for 15 years. She was receiving angiotensin receptor blocker with thiazide, calcium channel blocker, beta-blocker and insulin treatment. Her blood tests revealed alkalosis and severe hypokalemia with normal renal function. In the examinations for the causes of secondary hypertension; 24-hour urinary cortisol, metanephrine, normetanephrine and VMA levels were normal. Results: After cessation of diuretic treatment plasma renin activity (PRA) was measured 0.17 ng / mL/ h while plasma aldosterone level (PAL) was measured 71 ng / dl. The ratio of PAL / PRA was very high. Her abdominal MRI revealed bilateral adrenal lesions with 23x14 mm and 12x8 mm in diameters in the right and left adrenal gland respectively compatible with adenoma. On the other hand adrenal venous sampling (AVS) showed lateralisation for the right side. Conclusions: Most common causes of PHA are unilateral aldosterone secreting adenoma and bilateral adrenal hyperplasia. Although the appearance of bilateral adrenal lesions in MRI in our case, results of AVS were compatible with autonomous aldosteron production on the right side. According to these findings we accepted the case as a unilateral functioning adenoma with an incidentaloma on the other side.

Slide Session : OS-END-45 ; Endocrinology : Effect of Business Life on Obesity in Women

( Yildiz Okuturlar ),( Gulseren Gunduz ),( Nilgul Akalin ),( Meral Mert ),( Didem Acarer ),( Ozlem Soyluk ),( Ozlem Harmankaya ),( Abaki Kumbasar ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: The most important factor in the fight against obesity is thought to be change in lifestyle. Business life can effect weight and body fat distribution through its effects on levels of eating, sleeping, exercise and stress. In our study the relation between BMI, body fat distribution, 25-hydroxycholecalciferol (25-OH-D3), homeostasis model assessment (HOMA-R) and A1c levels were evaluated in working and non-working obese patients having a BMI of 30. Methods: Total number of 122 patients (62 of working and 60 of non-working) were enrolled in to the study. Medical history, weight-height-BMI- body fat ratio measurements and A1c- insulin- glucose- cortisol- 25-OH-D3- HOMA-R levels of all patients were recorded. Results: Between the working and non-working groups there were significant differences in average age (35.30±11.96 and 44.51±11.84 respectively, p=0.0001), weight (89.18±11.90 kg and 94.34±13.45 kg respectively, p=0.029), BMI (34.47±4.167 kg/ m2 and 37.39±5.65 kg/m2 respectively, p=0.002), body fat ratio (41.23±5.447% and 43.53±6.077% respectively, p= 0.029) and cortisol level (11.66±4.441 μg/dL and 14.12±5.402 μg/dL, respectively, p=0.029). Unlikely there were no significant differences in insulin, A1c, glucose, 25-OH-D3 and HOMA-R values. There were positive correlations between age and Alc and between BMI and age. Conclusions: Business life may lead to increase in weight and BMI. But in our study weight and BMI was significantly lower in the working group. This finding may be related to certain meal times, sleeping regime and physical activity of the working life which are effective on fat distribution and weight management.