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    25 - Hydroxyvitamin D Status in Type 1 Diabetic Adults and its Relationship with Glycemic Control
    (2024) Andac, Burak; Bulbul, Buket Yılmaz; Tezel, Mehmet Ogulcan; Okur, Mine; Colak, Serpil Yanık; Ekıcı, Buse; Celık, Mehmet
    Objective: To assess the vitamin D levels between adults with type 1 diabetes mellitus and the healthy control group and evaluate the relationship between HbA1c levels and vitamin D status in the diabetic group. Material and Methods: Our cross-sectional, descriptive study included 98 type 1 diabetic patients over 18 years old who applied to the Endocrinology Outpatient Clinic and 95 age- and sex-matched individuals without chronic disease. Patients with advanced renal or liver disorders, primary hyperparathyroidism, metabolic bone disorders, or using medications that might change vitamin D concentrations were excluded from the study. HbA1c and 25(OH) Vitamin-D3 levels were measured three times in nine months, and the average of the measurements was used. Diabetic patients and control individuals were separated into three groups according to their vitamin D levels as follows: deficiency (<12 ng/ml), insufficiency (12-20 ng/ml), and sufficiency (> 20 ng/ml). Results: Serum 25 (OH) vitamin D levels of diabetic patients were significantly lower than in healthy individuals (p=0.024). However, when diabetic adults were separated into three groups according to 25(OH) vitamin D levels, there was no significant difference regarding HbA1c levels (p=0.905). Conclusion: Although preclinical data support the role of low serum vitamin D levels in the etiopathogenesis of type 1 diabetes mellitus, studies examining the connection between low serum vitamin D levels and the prevalence of type 1 diabetes or glycemic control are not sufficient to reach a clear conclusion, including our study.
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    Association of MG53 with presence of type 2 diabetes mellitus, glycemic control, and diabetic complications
    (Public Library Science, 2023) Andac, Burak; Ozgun, Eray; Bulbul, Buket Yilmaz; Colak, Serpil Yanik; Okur, Mine; Yekdes, Ali Cem; Ocal, Eftal
    ObjectivesMitsugumin 53 (MG53) is a myokine that acts as a membrane repair protein in tissues. Data on the effect of MG53 on insulin signaling and type 2 diabetes mellitus (T2 DM) are still unknown; most are from preclinical studies. Nevertheless, some researchers have argued that it may be a new pathogenic factor, and therapies targeting MG53 may be a new avenue for T2 DM. Our study aims to evaluate the relationship of circulating MG53 levels with the presence of diabetes, diabetic complications, and glycemic control.MethodsWe conducted a case-control study with 107 patients with T2 DM and 105 subjects without insulin resistance-related disease. Concurrent blood samples were used for serum MG53 levels and other biochemical laboratory data. MG53 concentration was measured using Human-MG53, an enzyme-linked immunosorbent assay kit (Cat# CSB-EL024511HU).ResultsWe found no difference in MG53 levels between the diabetic and control groups (p = 0.914). Furthermore, when the subjects were divided into tertiles according to their MG53 levels, we did not find any difference between the groups in terms of the presence of diabetes (p = 0.981). Additionally, no correlation was observed between weight, BMI, waist circumference, systolic and diastolic blood pressure, fasting blood glucose, HbA1c, albumin excretion in the urine, e-GFR levels, and MG53. Finally, MG53 levels were similar between the groups with and without microvascular and macrovascular complications of diabetes.ConclusionOur research finding provides insightful clinical evidence of lack of association between the levels of MG53 and T2 DM or glycemic control, at least in the studied population of Turkeys ethnicity. However, further clinical studies are warranted to establish solid evidence of the link between MG53, insulin resistance and glycemic control in a wider population elsewhere in the world.
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    Falsely Elevated Thyroid Stimulating Hormone in Two Cases Requiring Special Follow-up
    (Galenos Publ House, 2023) Colak, Serpil Yanik; Ozgun, Eray; Andac, Burak; Okur, Mine; Bulbul, Buket Yilmaz; Celik, Mehmet
    Inappropriate thyroid stimulating hormone (TSH) refers to an elevation in TSH levels that does not match the clinical findings and free T3 and free T4 levels. Several conditions can cause this, such as pituitary tumors that produce TSH, resistance to thyroid hormones, macro-TSH, and antibody interference. Macro-TSH is a condition that causes TSH to be measured high in the blood for a long time by forming a complex with immunoglobulins, mostly IgG. However, patients are clinically euthyroid because macro-TSH is not a bioactive complex. It is essential to exclude the diagnosis of falsely elevated TSH to protect patients from unnecessary or high -dose levothyroxine therapy. In our first case, we presented a patient in whom subclinical hypothyroidism was detected during in vitro fertilization treatment, and levothyroxine was started. The other case was an operated papillary thyroid cancer patient. In both cases, although the dose of levothyroxine was increased, insufficient TSH response to increased fT4/fT3 levels suggested inappropriate TSH elevation. The polyethylene glycol (PEG) precipitation method was used to detect the assay variability. TSH recovery after PEG was 0.96016 and 21016, respectively, supporting the diagnosis of macro-TSH. In both cases, detecting Macro-TSH was crucial in preventing thyrotoxicosis caused by excessive levothyroxine dosage. In addition, delay in treatment for infertility was prevented in the first case.