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Öğe Effect of vildagliptin add-on treatment to metformin on plasma asymmetric dimethylarginine in type 2 diabetes mellitus patients(Dove Medical Press, 2014) Çakırca, Mustafa; Karatoprak, Cumali; Zorlu, Mehmet; Kıskaç, Muharrem; Kanat, Mustafa; Çıkrıkçıoğlu, Mehmet Ali; Soysal, Pınar; Hurşitoğlu, Mehmet; Çamlı, Ahmet Adil; Erkoç, Reha; Abdul-Ghani, MuhammadAims: A close association has been demonstrated between increased cardiovascular risk and high asymmetric dimethylarginine (ADMA) levels in type 2 diabetes mellitus (DM) patients. We planned to measure serum ADMA levels in type 2 DM patients using vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor. Materials and methods: A total of 68 type 2 DM patients who were on metformin were enrolled in the study. Based on the glycemic levels of patients, vildagliptin was added on to treatment in 33 patients. Patients were followed for 6 months. Serum ADMA, C-reactive protein, and fibrinogen levels were compared in groups of patients using metformin or metformin + vildagliptin, after 6 months. Results: Serum ADMA levels were found to be significantly lower in the group using vildagliptin compared to the group using metformin + vildagliptin (P<0.001). However, serum C-reactive protein and fibrinogen levels were statistically similar in the two study groups (P=0.34 and P=0.23, respectively). Conclusion: Metformin + vildagliptin treatment was observed to lower serum ADMA levels in type 2 DM patients. Our findings notwithstanding, large-scale prospective randomized controlled studies are warranted to conclude that vildagliptin provides cardiovascular protection along with diabetes regulation.Öğe Effects of 18-month vildagliptin treatment on portal vein pressure and hepatosteatosis(Bezmialem Vakif University, 2019) Karatoprak, Cumali; Kılıçarslan, Rukiye; Çakırca, Mustafa; Aydın, Sinem; Özkan, Tuba; Zorlu, Mehmet; Kıskaç, MuhammetObjective: Patients with type 2 diabetes have an increased tendency to develop hepatosteatosis. The effects of drugs used to treat diabetes on the liver, regardless of the disease, are unknown.The aim of this study was to investigate the effects of vildagliptin, a dipeptidyl peptidase-4 inhibitor, on the portal vein pressure and hepatosteatosis in patients with type 2 diabetes in the 18 months of follow-up. Methods: Patients to whose treatment vildagliptin was added while they were on therapy with metformin and gliclazide for type 2 DM the vildagliptin group were included. As the control group, 49 patients with type 2 DM treated with metformin and gliclazide were included. These patients were followed up for 18 months. These patients were followed for 18 months and their pre-treatment and post-treatment examinations were repeated. Portal vein diameter, portal vein flow and portal vein velocity were calculated to evaluate portal vein pressure with the same Doppler ultrasonography (US) by the same radiologist. In the same session, the liver steatosis stage of all patients was evaluated with US and recorded. The data before treatment and the data 18 months after treatment were compared. Results: Nineteen patients completed the study in the study group, while 10 patients completed the study in the control group. A significant increase in portal vein flow velocity and vein diameter was found in the study group when portal vein parameters were compared before and after treatment (p=<0.001, p=0.035, respectively). There was no significant difference in portal vein flow volume. In the control group, no significant changes in flow velocity and flow volume were detected, although there was a significant increase in portal vein diameter (p=0.04, p=0.07, p=0.14, respectively). There were no significant changes in vildagliptin group before and after treatment in terms of hepatosteatosis (p=0.41). There were no significant changes between control and study groups in terms of hepatosteatosis after 18 months of treatment. Conclusion: As a result, we did not find any significant changes in the parameters of portal vein pressure with vildagliptin use. We think that vildagliptin has no effect on hepatosteatosis.Öğe Evaluation of the relationship between vitamin D level and adropin, IL-1?, IL-6, and oxidative status in women(Turkiye Klinikleri, 2022) Zorlu, Mehmet; Şekerci, Abdüsselam; Tunç, Muhammed; Güler, Eray Metin; Gülen, Bedia; Karatoprak, Cumali; Kıskaç, Muharrem; Çakırca, MustafaBackground/aim: Vitamin D, adropin, proinflammatory cytokines, and oxidative stress closely related with metabolic homeostasis and endothelial dysfunction. The aim of the present study is to investigate how vitamin D levels affect serum adropin, IL-1ß, IL-6, and oxidative stress. Materials and methods: A total of 77 female subjects were divided into 3 groups according to vitamin D levels. Biochemical parameters, adropin, IL-1ß, IL-6, oxidative stress markers were studied in these groups, and the results were compared statistically. Results: Serum adropin, IL-1ß, IL-6, total oxidant status (TOS) and total antioxidant status (TAS) and oxidative stress index (OSI) levels differed significantly between the vitamin D groups (p < 0.05). A significant positive correlation was detected between vitamin D, and adropin and TAS (r = 0.807; p < 0.001, r = 0.814; p < 0.001, respectively). A significant negative correlation was detected between vitamin D, and IL-1ß, IL-6, TOS, OSI (r = –0.725; p < 0.001, r = –0.720; p < 0.001, r = –0.238; p = 0.037, r = –0.705; p < 0.001, respectively). Conclusions: Vitamin D could show its effects through vitamin D receptors on tissues or on the ENHO gene in adropin secreting tissues via direct or indirect mechanisms. Proinflammatory cytokines, oxidative stress, and adropin targeted studies could contribute to the prevention and treatment of diseases associated with vitamin D deficiency in future.Öğe GAS6 intron 8 c.834+7G > A gene polymorphism in diabetic nephropathy(Taylor and Francis, 2015) Erkoç, Reha; Çıkrıkçıoğlu, Mehmet Ali; Aintab, Emre; Erek-Toprak, Aybala; Kılıç, Ülkan; Gök, Özlem; Yasin Çetin, Ayşe İrem; Zorlu, Mehmet; Kıskaç, Muharrem; Çakırca, Mustafa; Erkal, Sena Nur; İsen, Hayati Can; Karatoprak, CumaliBackground - Aim: In animal experiments, growth arrest-specific 6 (Gas6) protein plays a key role in the development of mesangial cell and glomerular hypertrophy in the early phase of diabetic nephropathy, and diabetic nephropathy is prevented by warfarin-induced inhibition of GAS6 protein. It was shown that GAS6 intron 8 c.834+7G>A polymorphism is protective against type 2 diabetes mellitus, and AA genotype is associated with higher blood levels of GAS6 protein. Our aim is to investigate whether this polymorphism is a risk factor for diabetic nephropathy in type 2 diabetes mellitus. Method: Eighty-seven patients with diabetic nephropathy were compared with 66 non-diabetic controls in terms of GAS6 intron 8 c.834+7G>A polymorphism. Patients with history of stroke, ischemic heart disease were excluded. Each patient was examined by the ophthalmologist to determine diabetic retinopathy. Results: Frequency of GG, GA and AA genotypes are similar in diabetic nephropathy and control groups according to GAS6 intron 8 c.834+7G>A polymorphism (p = 0.837). Rate of diabetic retinopathy was 54.02%. In the subgroup analysis, GA genotype was significantly more frequent than GG genotype in patients with diabetic retinopathy when compared to without diabetic retinopathy (p = 0.010). Conclusion: In our study, GAS6 intron 8 c.834+7G>A polymorphism was not associated with diabetic nephropathy in type 2 diabetes mellitus. However, heterozygous state of this polymorphism may be a risk factor for diabetic retinopathy in patients with diabetic nephropathy.Öğe Markers predicting critical illness and mortality in COVID-19 patients: A multi-centre retrospective study(Bayrakol Medical Publisher, 2021) Karaaslan, Tahsin; Karatoprak, Cumali; Karaaslan, Esra; Şaşak Kuzgun, Gülşah; Gündüz, Mehmet; Şekerci, Abdüsselam; Büyükaydın, Banu; Alışır Ecder, SabahatAim: In this study, we aimed to investigate early predictors of critical illness and mortality in patients with coronavirus disease 2019 (COVID-19) based on clinical, biochemical, radiological, and epidemiological findings. Materials and Methods: This mufti-center, retrospective study was conducted in three centers and included a total of 206 confirmed COVID-19 cases using reverse transcription-polymerase chain reaction (RT-PCR). Data of survivors and non-survivors were compared, and predictors of mortality were examined. Results: Among the patients, 103 (50%) were mates with a mean age of 52.8 +/- 16.7 years; 88.3% of the patients were discharged in a healthy condition, white 11.7% died. The mean age was significantly higher in non-survivors. Dyspnea occurred in 32.5% of patients, and a significant correlation was found between dyspnea and mortality (p<0.001). Thoracic computed tomography (CT) findings were positive in 88.8% of patients. The most frequent imaging findings were ground-glass opacities in 86.4% and consolidation in 33% of patients. The mortality rate was significantly higher in patients with comorbidities (p<0.001). There was also a significant correlation between lymphocytopenia and mortality (p<0.001). A positive correlation was found between mortality risk and platelet-to-lymphocyte, neutrophil-to-lymphocyte, and red cell distribution width indices. The mortality risk was significantly higher in patients with acute kidney injury (10.7%) (p<0.001). Discussion: These results suggest that advanced age, coexisting diabetes, hypertension, heart failure, chronic kidney disease, or acute kidney injury are associated with an increased mortality risk. The presence of dyspnoea or consolidation on thoracic CT can predict an increased mortality risk In COVID-19 patients.Öğe Vildagliptin treatment on the portal venous pressure and hepatosteatosis in patients with type 2 diabetes mellitus(AVES, 2018) Karatoprak, Cumali; Kılıçarslan, Rukiye; Çakırca, Mustafa; Aydın, Sinem; Özkan, Tuba; Kocaman, Orhan; Yolbaş, Servet; Zorlu, Mehmet; Kıskaç, Muharrem; Çıkrıkçıoğlu, Mehmet Ali; Erkoç, RehaObjective: ftis study investigated how vildagliptin (a di-pepti- dyl peptidase 4 inhibitor) affects portal vein pressure and hepat- osteatosis in patients with type 2 diabetes mellitus. Methods: ftis cross-sectional study evaluated the use of specific drugs for at least 3 months on two groups of type 2 diabetes mellitus cases. Group 1 used metformin and gliclazide, Group 2 used the same amounts of metformin and gliclazide, with the addition of vildagliptin. Using Doppler ultrasound, all cases were measured for portal vein flow velocity, portal vein flow and portal vein diameter. Degree of hepatosteatosis was also recorded. Results: A total of 97 patients completed the study. fte study finished with 49 type 2 DM patients in Group1 (20 men, 29 women) and 48 patients in Group2 (20 men, 28 women. No significant difference was found in term of age, gender, BMI, HbA1c, mean arterial pressure, LDL-C, HDL-C or triglyceride levels in two groups.Portal vein flow velocity, portal vein flow volume, and portal vein diameter of all cases were measured by Doppler ultrasound in both groups. No significant difference was found between the groups (respectively p=0.92, p=0.60, p=0.92). ftere was no significant difference between groups re- garding to ultrasonographic grading of hepatosteatosis Conclusion: Treating type 2 diabetes mellitus patients with vildagliptin for had no effect on portal vein hemodynamics and hepatosteatosis as assessed with Doppler ultrasound. Further long-term studies with better evaluation methods are needed to demonstrate any expected beneficial effect of vildagliptin on por- tal hemodynamics and hepatosteatosis.
