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Objective To assess the frequency of sarcopenia in type 2 diabetes mellitus (DM) patients using different formulas of bioimpedance analysis (BIA). Study design Cross-sectional study. Place and duration of study Obesity Clinic, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey, between March and June 2015. Methodology The present study included DM patients at >18 years of age with BMI >30 kg/m2. BIA measurements consisted of body weight, height, total muscle mass and sum of the muscle masses of the four limbs (ALM). Skeletal muscle index, total muscle index, skeletal muscle percentage, total muscle percentage, and ALM/BMI were used for muscle-related analyses. The data were presented as frequency, mean ± standard deviation, and percentage. Student t-test was used to compare differences between two independent groups. Results A total of 295 DM patients were enrolled in the study, of whom 176 (59.66%) were females, 119 (40.34%) were males, 47 (15.93%) were over the age of 65 years, and the mean age was 53.39 +10.39 years. Sarcopenia was determined in 40 males (33.61%) by body muscle ratio, in 15 males (12.60%) by ALM/BMI ratio, and in one male participant (0.84%) by skeletal muscle index. Among female participants, while sarcopenia was determined in 61 (34.65%) by body muscle ratio and in 1 (0.56%) by ALM/BMI ratio, no sarcopenia case was detected using skeletal muscle index. Conclusion The frequency of sarcopenia in obese diabetic patients is found to be lower when skeletal muscle index and ALM/BMI ratio is used, but higher with body muscle ratio.

The cardiovascular effect of liraglutide, a glucagon-like peptide 1 analogue, when added to standard care in patients with type 2 diabetes, remains unknown. METHODS In this double-blind trial, we randomly assigned patients with type 2 diabetes and high cardiovascular risk to receive liraglutide or placebo. The primary composite outcome in the time-to-event analysis was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The primary hypothesis was that liraglutide would be noninferior to placebo with regard to the primary outcome, with a margin of 1.30 for the upper boundary of the 95% confidence interval of the hazard ratio. No adjustments for multiplicity were performed for the prespecified exploratory outcomes. RESULTS A total of 9340 patients underwent randomization. The median follow-up was 3.8 years. The primary outcome occurred in significantly fewer patients in the liraglutide group (608 of 4668 patients [13.0%]) than in the placebo group (694 of 4672 [14.9%]) (hazard ratio, 0.87; 95% confidence interval [CI], 0.78 to 0.97; P, Novo Nordisk; National Institutes of Health; LEADER ClinicalTrials.gov

Vitamin D has been determined to have some effects on b cell function and insulin sensitivity, and it is known that type 2 diabetes mellitus and hyperparathyroidism can cause obesity. The aim of our study was to investigate if vitamin D deficiency without diabetes mellitus and metabolic syndrome is associated with obesity and abdominal obesity.The study included 276 healthy premenopausal women. To exclude other causes of obesity, postmenopausal women and subjects with diabetes mellitus and metabolic syndrome were excluded. Women were divided into two groups depending on their 25-hydroxyvitaminD(3) [25(OH)D(3)] levels: subjects with vitamin D deficiency (Group 1) and subjects without vitamin D deficiency (Group 2). Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) were compared between the two groups.BMI, WC, WHR, rates of obesity, and abdominal obesity according to WC and WHR of Group 2 were lower than those of Group 1 (p = 0.0005, p = 0.0001, p = 0.0045, p = 0.032, p = 0.002, p = 0.011, respectively). 25(OH)D(3) levels negatively correlated with BMIs (r = -0.480, p0.0001), WCs (r = -0.480, p0.0001) and WHRs (r = -0.312, p0.05). There were no differences between serum parathormone, calcium and phosphorus levels of Group 1 and 2 (p = 0.239, p = 0.354, p = 0.95, respectively).Vitamin D deficiency without diabetes mellitus and hyperparathyroidism may be associated with obesity and abdominal obesity.

Thyroid autoimmunity has been suggested as a risk factor for atherosclerosis independent of thyroid function in several studies. The aim of this study was to investigate whether thyroid autoimmunity had any effect on hyperlipidaemia, obesity and abdominal obesity independent of thyroid function.184 premenopausal female patients with Hashimoto's thyroiditis (HT) and 150 healthy premenopausal female volunteers as control group (CG) were included in the study. According to thyroid function status, the patients were divided into three subgroups: overt hypothyroid patients (ohp), subclinical hypothyroid patients (shp) and euthyroid patients (ep). Body mass index (BMI), waist to hip ratios, waist circumference (WC), and serum lipid levels of all the participants were determined. These parameters of ep were compared with those of ohp, shp and CG. Relationships among thyroid stimulating hormone (TSH), thyroid autoantibodies and lipid levels were investigated.There were no significant differences between serum total cholesterol and low density lipoprotein cholesterol (LDL-C) levels of ohp and ep with HT (P = 0.18, P = 0.07 respectively) and LDL-C levels of ep were higher than those of CG (P = 0.03, P = 0.042, respectively). Although TSH levels did not correlate with serum lipid levels, levels of anti-thyroid peroxidase antibody correlated with triglyceride levels and WCs (r = 0.158; P = 0.013, r = 0.128; P = 0.048 respectively) and negatively correlated with high density lipoprotein cholesterol (HDL-C) levels (r = -0.137; P = 0.031). Levels of anti-thyroglobulin antibody also correlated with triglyceride and nonHDL-C levels (r = 0.208; P = 0.007, r = 0.158; P = 0.043 respectively).Thyroid autoimmunity may have some effects on hyperlipidaemia and abdominal obesity independent of thyroid function.

Most of the previous studies have shown a significant inverse relationship between smoking during pregnancy and weight, height and head circumference of infants at birth, but there is limited literature that assesses the head circumference measures of infants of smoker mothers in postnatal follow-up. The aim of this study was to assess the effects of maternal smoking and passive smoking during pregnancy on postnatal anthropometric measures of infants. Infants were divided into 3 groups: infants of smokers (n = 48), passive smokers (n = 57) and nonsmokers (n = 54), and were evaluated for their weight, height and head circumference at birth, 3 months and 6 months of age. Infants of smokers showed significant weight and head circumference deficits at birth compared to nonsmokers' infants (p < 0.05 and p < 0.001, respectively). At 6 months of age, infants of smokers continued to show significant deficits in all 3 measures compared to nonsmokers' infants (p < 0.001 for each), and infants of passive smokers showed only marginal decreases. Moreover, the weight and height growth velocities of the smokers' infants remained deficient, whereas their growth velocity of the head circumferences increased from birth up to 6 months and reached the growth velocity of the nonsmokers' infants. Infants of passive smokers showed a complete catch-up growth at 6 months. This study indicates that smoking during pregnancy results in serious deficits in infants' growth even after birth. Therefore, it is essential to inform smoker women before pregnancy the possible growth retardation of infants. © 2009 Tohoku University Medical Press.

The value of genetic sonogram is controversial in low-risk population. The aim of our study was to compare the anxiety levels among women with high risk and low risk for fetal chromosomal/structural defects.A total of 115 consecutive pregnant women were included. The anxiety levels were assessed by the use of Turkish version of the standardized state-trait-anxiety-inventory. Before and after genetic sonogram, state and trait-anxiety was measured.The mean state anxiety score before genetic sonogram was statistically, significantly higher than the mean score after the examination. Before genetic sonogram, the mean state-anxiety score of the women with high risk for fetal chromosomal/structural defects was significantly higher than the mean score of women with low risk. Following genetic sonogram, although the anxiety scores decreased, the scores of women with high risk still remained significantly higher than the scores of women with low risk and the anxiety scores significantly further increased among women with a positive minor or major ultrasound finding.Genetic sonogram presents an anxiety-inducing situation for the parents-to-be. The level of experienced anxiety was found to be proportional to the level of the perceived risk. Women with low risk for chromosomal/structural defects experienced lower anxiety than women with high risk. Following the examination, women with a negative result were found to have a significant reduction of anxiety and emotional relief whereas a positive test result led to a further increase in anxiety scores.

The aim of this prospective cross-sectional study was to investigate the hypertrophic effects of endogenous subclinical hyperthyroidism on myocardium and early development of left ventricular hypertrophy (LVH) in essential hypertensive patients accompanied by endogenous subclinical hyperthyroidism. A total of 31 consecutive patients with stage I hypertension were included in the study. Sixteen of them also had endogenous subclinical hyperthyroidism that they were unaware before. The patients and the controls formed out of ten healthy subjects all underwent an investigation of thyroid functions and cardiologic evaluation. The mean wall thickness of the left ventricle in the stage I hypertensive group with endogenous subclinical hyperthyroidism (group I) was significantly increased as compared with both hypertensive patients without thyroid disease (group II) and the control subjects. The mean left ventricle mass was also significantly higher in group I than group II. Both of the patients' groups had an increased prevalence of LVH as compared with the controls. In this study, hypertensive patients with subclinical hyperthyroidism presented more increase in left ventricular mass, suggesting that subclinical hyperthyroidism may contribute to left ventricular hypertrophy forming a natural progression to hypertension. The hypertensive population should always be screened for endogenous subclinical hyperthyroidism, and should be examined for the criteria of left ventricular hypertrophy by echocardiography in early stages.

Objectives: Gastrointestinal symptoms (GIS) are more common in individuals with type 2 diabetes mellitus (DM) in comparison to normal population. This study aimed to evaluate the effects of the pancreatin therapy on the GIS in patients with type 2 DM. Methods: This study included patients with type 2 DM admitted to the Gastroenterology Department between February to July 2017. Age, HbA1c, level of C-peptide, triglyceride, antidiabetic treatments, fecal elastase levels were evaluated in the files of all patients. The GIS of the patients, who were considered to suffer from the exocrine pancreatic insufficiency, including abdominal pain, bloating, constipation and diarrhea were evaluated before and after the 25000 IU pancreatin therapy. Results: The study included 35 patients with type 2 DM, the mean age was 59.1±7.6 years, and 24 (68.6%) of the patients were female. The exocrine pancreatic insufficiency was detected in 1 (2.9%) of the patients. Prior to the pancreatin therapy, 33 (94.3%) of the patients were determined to have abdominal pain, 34 (97.1%) had bloating, 33 (94.3%) had constipation and 32 (91.4%) had diarrhea. After the therapy, 29 (82.9%) of the patients were found to have abdominal pain, 31 (88.6%) had bloating, 31 (88.6%) had constipation and 29 (82.9%) had diarrhea. GIS including abdominal pain, bloating, constipation and diarrhea were decreased after pancreatin treatment (p=0.015, p