The International Journal of Romanian Society of Endocrinology / Registered in 1938

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  • Case Series

    Kardelen Al AD, Gencay G, Bayramoglu Z, Aliyev B, Karakilic-Ozturan E, Poyrazoglu S, Nisli K, Bas F, Darendeliler F

    Heart and Aorta Anomalies in Turner Syndrome and Relation with Karyotype

    Acta Endo (Buc) 2021 17(1): 124-130 doi: 10.4183/aeb.2021.124

    Objectives. Turner Syndrome (TS) is associated with a high risk of cardiac anomalies and cardiovascular disease. We aimed to evaluate patients with TS (n=33) for cardiac and aortic pathology using thorax magnetic resonance angiography (MRA). Subjects and methods. Clinical findings, karyotypes, echocardiogram (ECHO) findings and thorax MRA results were evaluated. Aortic dimensions were measured and standard Z scores of aortic diameters along with aortic size index (ASI) were calculated. Results. Mean age of the patients was 13.7±3.4 years. MRA revealed cardiovascular pathology in 10 patients (30%). CoA (n=4), aberrant right subclavian artery (n=3), dilatation of the ascending aorta (n=1), tortuosity of the descending aorta (n=1) and fusiform dilatation of the left subclavian artery (n=1) were found. Two of the four patients with CoA found on MRA were detected with ECHO. Mean diameter of the sinotubular junction was found to be elevated [mean±SD: 2.4±1.5]. Z scores for the diameters of the isthmus, ascending aorta and descending aorta were in normal ranges. 45,X patients were found to have significantly higher ASI values than non 45,X patients (p=0.036). Conclusion. Our findings indicate that patients with TS should be evaluated with MR imaging studies in addition to ECHO to reveal additional subtle cardiac and vascular anomalies. CoA which is very distally located or which has mild nature may not be seen by ECHO. The increase in ASI observed in 45,X patients may herald the development of life-threatening complications. Therefore, frequent followup is warranted in these patients.
  • Endocrine Care

    Yilmaz Oztekin GM, Genc A, Arslan S

    Vitamin D Deficiency is a Predictor of Mortality in Elderly with Chronic Heart Failure

    Acta Endo (Buc) 2021 17(3): 358-364 doi: 10.4183/aeb.2021.358

    Context. The prevalence of both heart failure and vitamin D deficiency increases with age and is associated with poor outcome in the elderly. Objectives. We aimed to investigate the relationship between all-cause mortality and vitamin D deficiency in elderly patients with chronic heart failure. Design. It is a retrospective, observational crosssectional study. Median follow-up time was 497 days. Subjects and Methods. 302 patients aged ≥65 years heart failure patients was categorized into tertiles based on the 25-hydroxy-vitamin D levels. Clinical and laboratory parameters were evaluated according to tertiles. Hospitalization rates and overall survival were compared between tertiles. Independent predictors of all cause mortality were defined. Results. Patients with low vitamin D tertile were mostly women (p=0.001), and had a worse NYHA functional class (p=0.005). During follow-up, deaths were more frequent in the first tertile (p = 0.001). All-cause mortality increased significantly with decreasing vitamin D tertiles (from third tertile 7.9%, to 11.9%, to 26%; log rank test p=0.003). No significant difference was observed at the composite endpoint of mortality or HF hospitalizations (P=0.451). Multivariate analysis supported that low vitamin D concentration was an independent predictor of all causes of mortality (HR 0.93; 95% CI 0.89-0.97; p=0.004). Conclusions. Low vitamin D levels were independent predictors of all-cause mortality in the elderly population with chronic heart failure.
  • General Endocrinology

    Fenkci SM, Karagenc N, Fenkci V

    An Open Pilot Atudy to Evaluate the Effects of Metformin and Life Style Changes on Serum Paraoxonase Activity and Oxidative Stress Markers in Premenopausal, Obese, Insulin Resistant Women

    Acta Endo (Buc) 2012 8(3): 403-412 doi: 10.4183/aeb.2012.403

    Background. The prevention of type 2 diabetes has great clinical importance. Many pharmacologic and nonpharmacologic\r\nmethods are used to prevent type 2 DM. Metformin reduces the risk of developing diabetes in insulin resistant subjects. Oxidative stress plays pivotal roles in the pathogenesis and complications of diabetes mellitus. Paraoxonase 1 has\r\nantioxidant capacity.\r\nObjective. This study was planned to assess the effects of metformin and life style changes on paraoxonase activity and\r\noxidative stress markers in premenopausal, obese, insulin resistant women.\r\nDesign.Open-pilot clinical study.\r\nSubjects and methods. Thirty-two insulin resistant, premenopausal, obese women were enrolled into this clinical\r\nstudy. These women were treated by diet + exercise + metformin (1700 mg/d) for 6-month interval. All anthropometric characteristics, serum fasting and\r\npostprandial glucose, fasting insulin, paraoxonase, arylesterase, and malondialdehyde (MDA) levels and lipid\r\nsub-fractions were measured at the commencement and the finish of the study. Homeostasis model assessment (HOMAIR)\r\nwas used to estimate insulin resistance.\r\nResults. Significantly reduced body weight, body mass index, waist circumference measurements, HOMA-IR and serum fasting\r\ninsulin, postprandial glucose, triglyceride, MDA levels and paraoxonase/high density lipoprotein cholesterol (HDL-C) ratio were observed at the end of the study compared\r\nwith initial evaluations. Conversely, there were considerable increases in serum arylesterase and HDL-C levels following the treatment. Nevertheless, the increase in serum PON-1 level was statistically insignificant.\r\nArylesterase was inversely correlated with TC, LDL-C levels and HOMA-IR.\r\nConclusions. Metformin treatment with intensive life-style modification may be appropriate management in premenopausal,\r\nobese, insulin resistant women who have increased propensity for the development of type 2 diabetes, although long-term,\r\ncontrolled studies are needed for evaluation in greater detail.
  • Case Report

    Genc S, Evren B, Bozbay A, Aydin ES, Genc O, Sahin I

    Could Covid-19 Trigger Type 1 Diabetes? Presentation of Covid-19 Case Presented with Diabetic Ketoacidosis

    Acta Endo (Buc) 2021 17(4): 532-536 doi: 10.4183/aeb.2021.532

    COVID-19 is a viral disease that is recognized now as a pandemic by the World Health Organization. It is known that some viral infections may trigger autoimmune diseases. It has been revealed that COVID-19 may also lead to the pathogenesis of some autoimmune diseases, including Type 1 DM (T1DM) and autoimmune thyroid diseases. Here, we aimed to present a young female patient with COVID-19, who we followed up in our clinic, who presented with diabetic ketoacidosis (DKA), and developed Hashimoto’s disease during the treatment process. In order to emphasize that COVID-19 may trigger the emergence of T1DM, that it may mask nonspecific DKA symptoms like nausea and vomiting, that it may cause delay in diagnosis of DKA, and also to emphasize the importance of evaluating other autoimmune diseases accompanying COVID-19, we found it appropriate to present this case.