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Introduction: Nonalcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome (MetS), insulin resistance (IR) and chronic inflammation. Although familial Mediterranean fever (FMF) patients have no symptoms in the periods between attacks, their subclinical inflammation continues. The aim of the present study was to determine the NAFLD frequency in FMF patients and to evaluate their MetS, IR and lipid profiles. Methods: The study included 54 FMF patients and 54 control subjects. The clinical and demographic characteristics of the subjects were recorded, and the patients’ Pras disease severity score was calculated. IR was determined using the homeostasis model assessment (HOMA) index. MetS was diagnosed using the revised National Cholesterol Education Program Adult Treatment Panel III criteria (NCEP ATP III). Hepatic ultrasonography was used to diagnose NAFLD. Results: NAFLD was observed in 15 FMF patients (27.8%) and 14 controls (25.9%). The difference between the groups was not significant (p=0.828). Similarly, no significant difference was found between the two groups for MetS frequency and HOMA index levels. Fasting plasma glucose was significantly higher in FMF patients, whereas differences between the two groups were not significant for lipid levels and other parameters. When FMF patients with and without NAFLD were compared, no significant difference was found in Pras disease severity score, duration of the disease and daily colchicine dose. Conclusion: The present study showed that NAFLD frequency was not increased in FMF patients, and that patients’ MetS frequency, IR and lipid profiles were not different from control subjects.

Ankylosing spondylitis is the most common form of the chronic inflammatory disease group known as spondyloarthritides. Recent discoveries of the CD4+ Th17 cells and IL-23/IL-17 axis have changed the paradigms in many autoimmune diseases. In this study, we aimed to evaluate the importance of IL-23/IL-17 pathway and IL-23 receptor polymorphism in the pathogenesis of ankylosing spondylitis. Blood samples for this study were obtained from 109 ankylosing spondylitis patients and 40 healthy control subjects. Serum levels of TNF-alpha, IL-6, IL-17, and IL-23 were measured by the ELISA method. The IL-23R gene polymorphisms rs11209026 (Arg381Gln) and rs4131362 (Val362Ile) were performed by the Sanger Sequence method. IL-6 levels were higher in the active and inactive ankylosing spondylitis groups than in the control group. However, levels of IL-17 and IL-23 were lower in the patient group. The frequency of IL-23R gene rs11209026 and rs4131362 polymorphism were 3.7% and 8.3% in the patient, respectively. As a result, dysregulation of the IL-23 / IL-17 pathway, which is caused by reduced levels of IL-17 and IL-23 in systemic circulation in patients with ankylosing spondylitis, may contribute to the pathogenesis of the disease by systemically producing chronic autoimmune inflammation. WOS:000517818400012 2-s2.0-85082200711 PubMed: 32140056

Background: Insulin resistance (IR) is one of the most important etiological risk factors in the development of diabetes. How- ever, there is no clear data regarding the prevalence of IR in the country. Objective: This study evaluates the prevalence of IR and identifies the optimal threshold values for the HOMA indexes in Turkey. Methods: This cross-sectional, population-based survey includes 2013 participants aged 20–84 years. The values of the anthro- pometric measurements and laboratory analysis were recorded. The 90th percentile in the non-obese and non-diabetic population was accepted as cut-off values for IR. Results: The optimal threshold values for IR were 2.46 in HOMA1-IR and 1.40 in HOMA2-IR. Using the HOMA2-IR method, the overall prevalence of IR was 33.2%. The IR prevalence was higher in women (35.6%) compared to men (30.1%) [p=0.008]. There was a higher IR prevalence in men living in urban areas (p=0.001), not in women. The multivariate logistic regression analysis showed that gender, serum glucose level, serum levels of triglycerides and high-density lipoprotein cholesterol, body- mass index and income status were associated with insulin resistance. Conclusion: The cut-off values of HOMA1-IR and HOMA2-IR were determined in this study and we believe that these find- ings will be helpful to clinicians in the fight against health problems such as diabetes. Keywords: Insulin resistance; HOMA; diabetes mellitus.

Introduction: Osteoporosis is a common disease, and several factors contribute to its development. Recently, there has been increasing evidence that vitamin K (VK) plays a critical role in maintaining bone strength. Vitamin K serves as a co-factor for the γ-carboxylation of particular proteins to convert specific glutamic acid residues to γ-carboxyglutamic acid residues. This process involves two enzymes, γ-glutamyl carboxylase and vitamin K epoxide reductase (VKORC1). The number of studies investigating the effects of VKORC1 gene mutations on bone mineral density in postmenopausal osteoporosis patients is limited. The aim of this study was to investigate the relationship between the VKORC1 -1639G>A polymorphism and osteoporosis in postmenopausal Turkish women. Methods The study group consisted of 176 postmenopausal women with osteoporosis and 140 healthy postmenopausal women. The selection criteria for the healthy controls included non-osteoporotic bone mineral density (BMD) and similar demographic characteristics to the osteoporosis group. The genotyping of the VKORC1 -1639G>A polymorphism was conducted using the restriction fragment-length polymorphism method. Results We found that the genotype frequencies of the GG, GA and AA genotypes were 25.6, 64.2 and 10.2% in the patients and 33.6, 55.8 and 10.7% in the controls, respectively. In the patient and control groups, the genotype distribution of the studied locus was found to be non-compatible with Hardy-Weinberg equilibrium. We found a nonsignificant association between the -1639G>A polymorphism in the VKORC1 gene and osteoporosis in postmenopausal Turkish women. Conclusion We have shown that the VKORC1 -1639G>A polymorphism is not a risk factor for postmenopausal osteoporosis.

It is well known that arterial stiffness is associated with hypertension. Recent studies have shown that adiponectin +276 G/T, ACE I/D, AGTR1 A1166C, and eNOS E298D polymorphisms are likely to be risk factors for arterial stiffness. In this study, we aimed to investigate possible associations between these single-nucleotide polymorphisms (SNPs) and essential hypertension in a Turkish population.The study population consisted of 170 patients who were diagnosed with essential hypertension and 170 sex- and age-matched controls. Genotyping of adiponectin +276 G/T, ACE I/D, AGTR1 A1166C, and eNOS E298D SNPs were performed using real-time polymerase chain reaction and commercially produced kits.The percentage of the adiponectin +276 T allele carriers was significantly higher in the patients with hypertension (33%) than in the controls (25%, p0.011). Through multiple logistic regression analysis, the adiponectin +276 T allele carrier was found to be associated with an increased risk of hypertension (TT vs. GG and TG: odds ratio = 3.318, p = 0.014, 95% confidence interval: 1.269-8.678). The genotype distributions or allelic frequencies of ACE I/D, AGTR1 A1166C, and eNOS E298D SNPs did not significantly differ between the patients with hypertension and the controls.The present study demonstrated that the adiponectin +276 G/T SNP is likely to be a risk factor for essential hypertension in a Turkish population.

Aim: To investigate the prevalence of uveitis in ankylosing spondylitis (AS) patients and its relationship with HLA B27. Methods: The data of 95 patients with AS who admitted to Tokat Gaziosmanpasa University Internal Medicine and Rehabilitation Outpatient Clinics between 2010 and 2019 were analyzed retrospectively. Demographic characteristics, HLA B27 positivity and detailed eye consultation notes of the patients were recorded. Results: Of the 95 patients, 65 (68%) were male and 30 (32%) were female. The mean age of the patients was 38.3 ± 11.6 years. The HLA B27 results of 10 patients could not be reached. 22% of the patients had at least one episode of uveitis attack. While 82% (70/85) of patients had HLA B27 positivity, this rate was 86% in (18/21) patients with uveitis. Conclusion: Uveitis is a disease that can cause permanent loss of vision. In our study, no significant difference was found between the presence of uveitis and the presence of HLA B27 in patients with AS and this finding needs to be supported by randomized studies.

The purpose of the present study was to evaluate the thickness of the peripapillary retinal nerve fiber layer (RNFL) and retinal ganglion cell–inner plexiform layer (GCIPL) in adult-onset familial Mediterranean fever (FMF). Forty two adult-onset FMF patients and forty two healthy controls were included in the present study. Detailed ocular examination was performed, and then the thickness of the peripapillary RNFL and GCIPL was measured by Spectral domain optical coherence tomography. The patients were divided into two groups according to their disease severity score, M694V gene mutation, colchicine dosage used per day, colchicine usage time period and number of FMF attacks per year. There were no statistically significant differences in peripapillary RNFL and retinal GCIPL thickness in patients with adult-onset FMF and controls. According to our study, it looks like that neither adult-onset FMF nor colchicine has any effect on the RNFL and GCIPL thicknesses. Further studies with a large sample size are needed.

WOS:000370271100010 PubMed: 27511489 Backgroud/aim: We aimed to determine the prevalence of psoriasis (PS) and seborrheic dermatitis (SD) (erythematous-squamous diseases) in our region and reveal the frequently encountered associated factors to aid in planning appropriate healthcare. Materials and methods: A community-based study was conducted with 85 sample groups that reflected the population rate and demography of Tokat Province in northern Anatolia. Results: In this community, the prevalence of PS in people older than 20 years of age was 1.2% and the prevalence of SD was 5.2%. SD rates were higher in patients who used tobacco and especially alcohol. SD prevalence was also higher in patients treated for depression and epilepsy. Furthermore, as education levels increased, SD prevalence increased proportionally. Conclusion: In general, PS prevalence in this region was higher than in Asia and Africa but lower than in Europe and the United States. Whereas SD prevalence varies between 2% and 12% throughout the world, the average SD prevalence was 5.2% in this study.

WOS: 000366553200006, PubMed ID: 26678939, Preliminary evidence suggests that a higher neutrophil-lymphocyte ratio (NLR) may be an indicator of active ulcerative colitis (UC). However, it is not clear whether the NLR is a useful and simple indicator of clinical activity in UC after adjusting for the other inflammatory markers. We designed a retrospective study to evaluate the role of the NLR in estimating disease severity in UC patients. The study consisted of 71 patients with UC and 140 age- and sex-matched healthy individuals (control group). The NLR, erythrocyte sedimentation rate, C-reactive protein, and white blood cell count were measured. The NLR values of the active UC group were elevated compared with those of the patients with inactive UC and the controls (2.59 + 1.47, 2.03 + 1.07, and 1.98 + 0.85, respectively; p = 0.005). The receiver operating characteristic revealed that the optimum NLR cut-off point for active UC was 2.39. A multivariable logistic analysis showed that of the parameters studied, C-reactive protein was the only parameter able to significantly discriminate active from inactive UC (B: 0.222; p = 0.017; odds ratio: 1.248; 95% confidence interval: 1.041-1.497). Copyright (C) 2015, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. All rights reserved.

Diabetes mellitus is a disease that affects entire the world and its prevalence is increasing. Most patients with diabetes mellitus will have developed diabetic retinopathy which can cause blindness in time. The treatment of retinopathy, a microvascular complication of diabetes mellitus, needs a multifaceted approach. For the follow up of diabetic retinopathy, beside ophthalmologist and endocrinologist, family physician and dietician as well should be aware of the disease. Delaying the formation of diabetic retinopathy or to have low intensity can be controlled by systemic factors. In patients with poor regulation of blood sugar, blood pressure and blood lipid profil, retinopathy is seen earlier and its progress is increasing. Therefore, regulation of systemic factors associated with the formation of diabetic retinopathy is very important in the fight against this complication. In this study, systemic risk factors of diabetic retinopathy were discussed with the review of recent literature.

This study investigated the role of plasma adropin levels to show endothelial dysfunction in individuals with type 2 diabetes mellitus and to compare these with flow-mediated dilatation.A total of 92 individuals with diagnosed type 2 diabetes mellitus were included and divided into 2 groups according to their brachial flow-mediated dilatation. The endothelial dysfunction group consisted of 46 participants with flow-mediated dilatation change of less than 7%, whereas 46 participants with flow-mediated dilatation change of more than 7% were accepted as the nonendothelial dysfunction group. Venous blood samples were taken from all study participants, and plasma adropin levels were measured using an enzyme-linked immunosorbent assay kit.The mean flow-mediated dilatation values were 13.2% ± 4.9% in the nonendothelial dysfunction group, and 3.5% ± 3.4% in the endothelial dysfunction group. Mean hemoglobin A1c levels were significantly higher in the endothelial dysfunction group than in the nonendothelial dysfunction group (8.7% ± 1.9% vs 7.9% ± 1.6%, respectively; P0.038). Mean plasma adropin levels were 3.04 ± 0.79 ng/mL in the endothelial dysfunction group and 4.67 ± 1.43 ng/mL in the nonendothelial dysfunction group; P0.001. Plasma adropin levels showed no correlation with body mass index (r = -0.072, P = 0.497) but were positively correlated with flow-mediated dilatation values (r = 0.537, P0.001). In the linear regression analysis, adropin and hemoglobin A1c were independent risk factors for endothelial dysfunction in individuals with type 2 diabetes mellitus.Adropin is a new marker for use in demonstrating endothelial dysfunction.

Central corneal thickness and dry eye tests were evaluated in a study population consisting of 68 ankylosing spondylitis patients diagnosed according to the modified New York criteria, and 61 age-matched controls without ankylosing spondylitis. A full ophthalmological evaluation was performed on each subject. All subjects were screened for age, gender, HLA-B27, tear break-up time test, Schirmer test, and duration of disease. Central corneal thickness was measured under topical anesthesia with an ultrasonic pachymeter. The mean central corneal thickness was 537.3 ± 30.6 μm, range 462–600 μm, in ankylosing spondylitis patients, whereas it was 551.7 ± 25.2 μm, range 510–620 μm, in controls (p = 0.005). The Schirmer test result was 7.3 ± 5.9 mm for the ankylosing spondylitis patients and 11.7 ± 5.8 mm for the control group (p = 0.002). Tear break-up time was 7.3 ± 3.2 s for the ankylosing spondylitis patients and 14.0 ± 4.5 s for the control group (p