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    Alteration in choroidal microvasculature determined by optical coherence tomography angiography in patients with acromegaly
    (Elsevier B.V., 2021) Selvinaz, Erol R.; Tiryaki, Semra; Çil Şen, Esra; Yener, Öztürk F.; Masum, Canat M.; Yıldız, Duygu; Batman, Adnan; Güven, Dilek; Altuntaş, Yüksel; Süren, Elçin; Kazım, Erol M.
    We aimed to investigate the retinal layers and macular capillary structure using optical coherence tomography angiography (OCTA) with acromegaly patients and determine the relationship between OCTA parameters and disease duration, Growth hormone (GH) and Insuline growth factor (IGF - 1) levels. Patients and Method: Twenty-two patients with acromegaly who were followed up in the endocrinology outpatient clinic of Sisli Hamidiye Etfal Health Training and Research Hospital, were recruited into the study. Healthy control group was consisted of 22 age and gender matched subjects. Complete opthalmological examination including best visual acuity (BCVA), axial lenght, intraocular pressure (IOP) measurement, anterior segment and fundus examination, central corneal thickness with pachymetry and OCTA measurement were performed in the patients and healthy control group. Foveal avascular zone (FAZ), foveal vascular density (FVD), parafoveal vascular density (PFVD), choroidal flow (CF), foveal thickness (FT) and choroidal thickness (CT) were compared beetwen groups. Correlation between disease duration, GH and IGF-1 levels and OCTA parameters were evaluated. Results: There was no statistically significant difference between the groups in terms of BCVA, axial length, IOP, FT, FAZ, FD and PFVD. Choroidal thickness and CF was significantly high in the patients group compared to healthy controls (respectively, p = 0.003, p = 0.022). The mean follow-up period in patients with acromegaly was 90±50.2 months. There was a significant correlation between GH and subfoveal choroidal thickness in the patient group (p < 0.001, r = 0.52), a significant correlation was determined between disease duration and corneal thickness (p = 0.01, r = 0.41). In addition, an inverse correlation was detected between the IGF-1 level and the FAZ domain (p = 0.022, r= -0.34). Conclusion: In patients with acromegaly, choroidal vasculature seems to be more affected than the retinal vasculature.
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    Öğe
    Effect of Exenatide on Nonalcoholic Steatohepatitis and Inflammation-Related Indices in Diabetic Patients with Non-Alcoholic Fatty Liver Disease
    (Larchmont, 2023) Menekşe, Burak; Batman, Adnan
    Diabetes mellitus is a chronic disease often associated with nonalcoholic steatohepatitis (NASH) and obesity. Both obesity and NASH are closely related to inflammation. In this study, we examined how exenatide, a glucagon-like peptide 1 analog, affects inflammatory and NASH-related markers in patients with diabetes. Methods: This retrospective study was conducted on 100 patients who visited our hospital with a diagnosis of type 2 diabetes mellitus. NASH-related indices and inflammatory indices were calculated from data obtained at baseline and at the third month of exenatide treatment. All data were analyzed first in all patients, and then the patients were grouped according to glycosylated hemoglobin A1c (HbA1c) levels of <8% or ?8% and body mass index (BMI) of <40 or ?40 kg/m2 and their data were reanalyzed. Results: A highly significant improvement was found in the conventional lipid profile. Among NASH-related indices, the nonalcoholic fatty liver disease (NAFLD) fibrosis score and aspartate aminotransferase-platelet ratio index (APRI) showed statistically significant decreases (P < 0.001 and P = 0.016, respectively). In particular, these significant decreases were independent of BMI and glycemic parameters. No statistically significant change was found in inflammatory indices. The decreases in NAFLD fibrosis score and APRI were statistically more significant in the group with HbA1c ?8% (P = 0.021 and P = 0.002, respectively) and the group with BMI ?40 kg/m2 (P = 0.002 and P = 0.029, respectively). Conclusions: Besides its established effects, such as lowering fasting plasma glucose levels and weight loss, exenatide exerts positive effects on the conventional lipid profile and NASH-associated indexes.
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    The effect of hypervitaminosis D and intoxication on hematological parameters
    (Edizioni Minerva Medica, 2022) Batman, Adnan; Çiftçiler, Rafiye
    This study aimed to compare the hematological parameters of patients with very high and normal 25-hydroxyvitamin-D3 (25(OH)D3) levels. METHODS: This study was designed as a retrospective cross-sectional study. The patients were divided into three groups according to their 25(OH)D3 levels: groups 1, 2 and 3 consists of patients with normal 25(OH)D3 levels (30-88 ng/mL), hypervitaminosis D (89-149 ng/mL) and vitamin D intoxication (>150 ng/mL), respectively. According to vitamin D levels, statistical analysis was performed by comparing the biochemical and hematological data between the groups. RESULTS: This study evaluated 120 patients (40 patients) in three equal groups. A statistically significant difference was found between the three groups in hemoglobin (P=0.03), hematocrit (P=0.01), red blood cell levels (P=0.03), leukocyte count (P<0.001), neutrophil count (P<0.001), lymphocyte count (P=0.006), mean platelet volume (P=0.04), and neutrophil/lymphocyte ratio (P=0.03). In post-hoc analysis, hemoglobin, hematocrit and RBC were significantly higher in group 1 than in group 3 (post-hoc Tukey, P<0.05). A statistically significant negative correlation was noted between 25(OH)D3 level and hemoglobin (r=-0.236), hematocrit (r=-0.230), and red blood cell (r=-0.265) levels. CONCLUSIONS: Vitamin D intoxication has been observed to affect hemoglobin, hematocrit, and RBC levels negatively. However, more studies are needed to clarify the effects and mechanisms of high vitamin D levels on the hematopoietic system.