Researcher: Batman, Adnan
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Batman, Adnan
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Publication Metadata only Predictive value of nutrition and inflammation-related indices on prognosis in type 2 diabetes mellitus patients with Coronavirus Disease-2019(KARE PUBL, 2023) Ekici, Mustafa; Menekse, Tugba Sanalp; Ciftciler, Rafiye; Batman, Adnan; Dereli, Dilek Yazıcı; School of Medicine; Koç University HospitalObjectives: This study aimed to demonstrate how the prognostic nutritional index (PNI) and systemic immune -inflammatory index (SII) help predict the severity and prognosis of patients with type 2 diabetes (T2DM) and coronavirus disease (Covid-19). Methods: This retrospective cohort study included 501 T2DM patients (male, 42.1%; female, 57.9%) who were hospitalized due to Covid-19 between April 2020 and December 2020. The patients were divided into survivors and non -survivors. After comparing demographic and laboratory data between the groups, the correlation of PNI and SII with clinical and laboratory data was evaluated. Results: The median (interquartile) ages of the non -survivor and survivor groups were 74 (15) and 69 (14) years, respectively, and the difference was significant (p<0.001). The PNI was significantly lower in the non -survivor group than in the survivor group (p<0.001). The SII was significantly higher in the non-survivor group than in the survivor group (p<0.001). PNI was negatively correlated with glucose levels (r=-0.115, p=0.011). If the cut-off PNI value of 29.1 was used, it had a sensitivity and specificity of 76.2% and 76.3%, respectively, in predicting the severity of the illness and the risk of death in T2DM patients. Conclusion: Consequently, the PNI and SII levels are effective in predicting survival and disease severity in patients with Covid-19 and T2DM.Publication Open Access Choroidal thickness in mild autonomous cortisol secretion(KARE PUBL, 2024) Cakir, Sezin Dogan; Cakir, Akin; Ozturk, Feyza Yener; Basmaz, Seda Erem; Saygili, Emre Sedar; Erol, Rumeysa Selvinaz; Sen, Esra Cil; Canat, Muhammed Masum; Altuntas, Yuksel; Batman, Adnan; Koç University HospitalObjectives: To evaluate the patients with mild autonomous cortisol secretion (MACS) by means of choroidal thickness (CT) and also investigate whether CT may be a diagnostic tool in the management of MACS or not. Methods: Twenty-seven patients with MACS and 25 age -sex -matched healthy controls were enrolled in this cross-sectional comparative study. All the participants underwent CT measurement by using Spectralis optical coherence tomography (Heidelberg Engineering, Heidelberg, Germany) with enhanced deep imaging mode at the subfoveal, 500-1000-1500 mu m nasal and 500-10001500 mu m temporal to the foveola. Results: The groups were similar in terms of spherical equivalence, age and axial lengths. The mean CT was significantly thicker in patients with MACS than controls in all measurement quadrants (p<0.001). There was no significant correlation between CT, size of the adenoma, basal cortisol, 1mg dexamethasone suppression test, salivary cortisol, 24 -hour total urine -free cortisol, ACTH and DHEAS levels. However, 2 mg dexamethasone suppression test results were found to be significantly correlated with CT in temporal 500-1000 and 1500 m quadrants (r=0.436, p=0.023, r=0.443, p=0.021 and r=0.488, p=0.010, respectively). Five (18.5%) eyes had pachychoroid pigment epitheliopathy in the MACS group. Conclusion: CT increases in patients with MACS and those tend to have pachychoroid pigment epitheliopathy more frequent than healthy individuals. A thicker choroid in the patients with MACS may be a novel biomarker both as a diagnostic tool for the degree of hypercortisolemia and cortisol-related comorbidity.Publication Metadata only Risk factors for acute kidney injury associated with severe hypothyroidism(EDITURA ACAD ROMANE, 2023) Canat, Muhammed Masum; Saygili, Emre S.; Besler, E.; Yildiz, D.; Ozturk, Feyza Yener; Altuntas, Yuksel; Batman, Adnan; Koç University HospitalObjective. This study aims to investigate the factors affecting development of acute kidney injury (AKI) in patients with severe hypothyroidism. Methods. This retrospective observational study involved patients with primary hypothyroidism and thyroid stimulating hormone (TSH) levels of more than 50 mIU/L at their review in the endocrinology outpatient clinic, between January 2015 and April 2021. Factors affecting the development of AKI were examined by logistic regression analysis. Results. A total of 100 patients, 20 (11 male (M), 9 female (F)) in the AKI (case) group and 80 (23 M, 57 F) patients in control group, were included in our study. The median age of the case group (56 years, interquartile range (IQR) 44.3-68.5) was significantly higher than the control group (49 years, IQR 32.3-60;p = 0.027), and the ratio of males to females was significantly higher in the case group (p = 0.001). Multivariate logistic regression analyses showed that hypothyroidism diagnosed after the age of 60 years (odds ratio (OR) 59.674, 95% confidence intervals (CI) 5.955-598.031;p = 0.001), free triiodothyronine (FT3) < 1.3 pg/mL (OR 17.151, 95% CI 2.491-118.089;p = 0.004) and creatine kinase (CK) > 1000 U/L (OR 1.522, 95% CI 1.602- 82.848;p = 0.015) were predictors for the development of AKI in patients with severe hypothyroidism. Conclusion. We recommend close follow-up and monitoring of patients with AKI caused by severe hypothyroidism if patients who are diagnosed at age > 60 years, CK > 1000 U/L or FT3 < 1.3 pg/mL.Publication Metadata only Risk of hypercalcemia in elderly patients with hypervitaminosis D and intoxication(Editura Acad Romane, 2021) Altuntaş, Yüksel; Batman, Adnan; Doctor; Koç University Hospital; N/AObjective: We aimed to determine the risk of hypercalcemia in a geriatric population with very high dose levels of 25-hydroxy-vitamin D (25(OH)D). Patients and Method. This study was designed as a retrospective, cross-sectional two-center study for examining the elderly patients with very high 25(OH)D levels (>88ng/mL) between January 2014 and December 2019. After recruitment, subgroup analyses of the patients were performed based on their calcium and vitamin D levels. Results: A total of 81.101 elderly patients, who had been evaluated for their vitamin D levels, were screened. of the 458 (0.6%) elderly patients with 25(OH)D>88 ng/mL according to our criteria, 217 patients with complete data were accepted into our study. The median 25(OH)D level was 103.7ng/mL (min-max:88.2-275.9). Most of the elderly patients (86.6%) with very high 25(OH)D levels were normocalcemic. When patients with hypercalcemia were compared with normocalcemic group, no difference was observed in the levels of 25(OH)D, intact parathormone (iPTH), phosphorus, alkaline phosphatase (ALP), and their age. However, the PTH suppression rate was significantly higher in hypercalcemic group (0.005). Conclusion: The elderly patients with very high 25(OH)D levels would appear to be mostly normocalcemic whereas life-threatening hypercalcemia would also occur. Treatment and follow-up planning should be done according to the clinical guideline recommendations.Publication Metadata only The effect of hypervitaminosis d and intoxication on hematological parameters(Edizioni Minerva Medica, 2022) Ciftciler, Rafiye; N/A; Batman, Adnan; Doctor; Koç University Hospital; N/ABackground: This study aimed to compare the hematological parameters of patients with very high and normal 25-hydroxyvitamin-D3 (25(OH)D3) levels.Methods: This study was designed as a retrospective cross-sectional study. The patients were divided into three groups according to their 25(OH)D3 levels: groups 1, 2 and 3 consists of patients with normal 25(OH)D3 levels (30-88 ng/ mL), hypervitaminosis D (89-149 ng/mL) and vitamin D intoxication (>150 ng/mL), respectively. According to vitamin D levels, statistical analysis was performed by comparing the biochemical and hematological data between the groups.Results: This study evaluated 120 patients (40 patients) in three equal groups. A statistically significant difference was found between the three groups in hemoglobin (P=0.03), hematocrit (P=0.01), red blood cell levels (P=0.03), leukocyte count (P<0.001), neutrophil count (P<0.001), lymphocyte count (P=0.006), mean platelet volume (P=0.04), and neutro-phil/lymphocyte ratio (P=0.03). In post-hoc analysis, hemoglobin, hematocrit and RBC were significantly higher in group 1 than in group 3 (post-hoc Tukey, P<0.05). A statistically significant negative correlation was noted between 25(OH)D3 level and hemoglobin (r=-0.236), hematocrit (r=-0.230), and red blood cell (r=-0.265) levels.Conclusions: Vitamin D intoxication has been observed to affect hemoglobin, hematocrit, and RBC levels nega-tively. However, more studies are needed to clarify the effects and mechanisms of high vitamin D levels on the hemato-poietic system.Publication Metadata only Effect of exenatide on nonalcoholic steatohepatitis and inflammation-related indices in diabetic patients with non-alcoholic fatty liver disease(Mary Ann Liebert, Inc., 2023) Menekse, Burak; N/A; Batman, Adnan; Doctor; N/A; Koç University Hospital; N/APurpose: Diabetes mellitus is a chronic disease often associated with nonalcoholic steatohepatitis (NASH) and obesity. Both obesity and NASH are closely related to inflammation. In this study, we examined how exenatide, a glucagon-like peptide 1 analog, affects inflammatory and NASH-related markers in patients with diabetes.Methods: This retrospective study was conducted on 100 patients who visited our hospital with a diagnosis of type 2 diabetes mellitus. NASH-related indices and inflammatory indices were calculated from data obtained at baseline and at the third month of exenatide treatment. All data were analyzed first in all patients, and then the patients were grouped according to glycosylated hemoglobin A1c (HbA1c) levels of <8% or >= 8% and body mass index (BMI) of Results: A highly significant improvement was found in the conventional lipid profile. Among NASH-related indices, the nonalcoholic fatty liver disease (NAFLD) fibrosis score and aspartate aminotransferase-platelet ratio index (APRI) showed statistically significant decreases (P < 0.001 and P = 0.016, respectively). In particular, these significant decreases were independent of BMI and glycemic parameters. No statistically significant change was found in inflammatory indices. The decreases in NAFLD fibrosis score and APRI were statistically more significant in the group with HbA1c >= 8% (P = 0.021 and P = 0.002, respectively) and the group with BMI >= 40 kg/m(2) (P = 0.002 and P = 0.029, respectively).Conclusions: Besides its established effects, such as lowering fasting plasma glucose levels and weight loss, exenatide exerts positive effects on the conventional lipid profile and NASH-associated indexes.Publication Open Access Antioxidant effect of thioredoxin and vitamin D3 in peritoneal dialysis patients(Hindawi, 2022) İleri, S.Y.; Eraldemir, C.; Bakırdöğen S.; Dervişoğlu E.; Batman, Adnan; Doctor; Koç University HospitalBackground: among the chronic diseases, chronic kidney failure is one of diseases that have the most difficulty in coping with oxidative stress due to the deterioration of the antioxidant system balance in the body. Beyond being a vitamin, 1 alpha,25-dihydroxycholecalciferol (vitamin D3) is a molecule that positively or negatively affects many enzymes which are in protein structures. Thioredoxin (TRX), which has an important role in the antioxidant system, is one of these proteins. By conducting this study, we wanted to emphasize the role of vitamin D3 in reducing the oxidative stress load on patients undergoing peritoneal dialysis (PD) via serum TRX level measurement. Methods: in this study, we evaluated the medical treatments of 69 PD patients who were followed up routinely. The patients were divided into 2 groups according to whether they used vitamin D3 or not. 49 of our patients were using vitamin D3. While requesting routine laboratory tests, we reserved a separate serum sample to measure serum TRX levels by double-antibody sandwich enzyme-linked immunosorbent assay for all patients. Results: only one parameter has a significant statistical relationship with serum TRX level and the treatment protocol. The serum TRX level was significantly higher (211,62 U/l +/- 314,46) in the group receiving vitamin D3 compared to the group which is not using Vitamin D3 (101,63 U/l +/- 215,03) (p < 0,006). Conclusion: this study highlights the importance of appropriate dose of vitamin D3 replacement especially in PD patients who are under intense oxidative stress compared to healthy individuals