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    Assessment of retinal thickness as a marker of brain masculinization in children with congenital adrenal hyperplasia: A pilot study
    (De Gruyter, 2019) Önal, Hasan; Kutlu, Esra; Aydın, Banu; Ersen, Atilla; Topal, Neval; Adal, Erdal; Güneş, Hatice; Doktur, Hilal; Tanıdır, Canan; Pirhan, Dilara; Sayın, Nihat
    To investigate the relationship between brain masculinization and retinal thickness in children with congenital adrenal hyperplasia (CAH). Forty-five patients with CAH aged between 4 and 18 years and 30 age-matched healthy controls were included in this prospective study. Macular area was examined with optical coherence tomography (OCT); central subfield thickness (CST), cube volume (CV) and macular retinal thickness (MT) were measured in each subject. A gender identity questionnaire (GIQ) was used for the evaluation of gender happiness index. Girls with CAH had a higher CV (p = 0.002) and MT (p = 0.003) than healthy girls. No significant difference was found between boys with CAH and healthy boys regarding the retinal thickness measurements. Mean CST, CV and MT were significantly higher in boys than in girls in the control group (p = 0.013, p < 0.001, respectively), but there was no significant difference in those parameters between girls and boys with CAH. The gender happiness index was not different between healthy boys and boys with CAH, but was significantly lower in girls with CAH than healthy girls (p = 0.01). As retina is part of the brain, our finding appears to be a morphological evidence of the excess androgen exposure on brain structures in girls with CAH. In addition, we suggest using retinal thickness measurements as a marker of prenatal excess androgen exposure in future studies.
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    Children with hashimoto's thyroiditis have increased intestinal permeability: Results of a pilot study
    (Galenos Yayıncılık, 2020) Küçükemre Aydın, Banu; Yıldız, Melek; Akgün, Abdurrahman; Topal, Neval; Adal, Erdal; Önal, Hasan
    Increased intestinal permeability (IIP) precedes several autoimmune disorders. Although Hashimoto's thyroiditis (HT) is the most common autoimmune disorder, the role of HP in its pathogenesis had received little attention. Zonulin plays a critical role in IIP by modulating intracellular tight junctions. Rise of serum zonulin levels were shown to indicate HP in human subjects. In this case-control study, we examined the hypothesis that patients with HT have IIP. We studied 30 children and adolescents with HT, and 30 patients with congenital hypothyroidism (CH) matched for age, gender and body mass index (BMI). Serum zonulin levels, free thyroxine (fT4), thyroid stimulating hormone (TSH), anti-thyroglobulin antibody and anti-thyroid peroxidase antibody were measured. Zonulin levels were significantly higher in patients with HT than patients with CH (59.1 +/- 22.9 ng/mL vs. 43.3 +/- 32.9 ng/mL, p = 0.035). In patients with HT, zonulin levels were positively correlated with weight (r = 0.406, p= 0.03), BMI (r = 0.486, p = 0.006) and levothyroxine dose (r = 0.463, p = 0.02). In patients with CH, zonulin levels were positively correlated with age (r = 0.475, p = 0.008), weight (r = 0.707, p< 0.001), BMI (r =0.872, p <0.001) and levothyroxine dose (r =0.485, p = 0.007). After adjusting for age, weight, TSH and fT4 levels, serum zonulin was only associated with levothyroxine dose in patients with HT (R-2 =0.36, p =0.05). In patients with CH, only weight was associated with zonulin levels (R-2 =0.62, p <0.001). In conclusion, higher zonulin levels in children and adolescents with HT suggested IIP in these patients. Additionally, the association between zonulin levels and levothyroxine dose might imply a relationship between serum zonulin and disease severity.