Serum α-Klotho and fibroblast growth factor 23 levels are not associated with non-proliferative diabetic retinopathy in type 1 diabetes mellitus.

Diabetic retinopathy is a commonly observed cause of blindness and is a common problem in individuals with diabetes. Recent investigations have showed the capability of serum α-Klotho and FGF 23 in mitigating the effects of diabetic retinopathy. This study aimed to discover the correlation between FGF 23, α-Klotho, and diabetic retinopathy in type 1 diabetics. This case-control study included 63 diabetic patients and 66 healthy controls. Following an overnight duration of fasting, morning blood samples were taken from both the patient and the control groups. The serum concentrations of α-Klotho and FGF 23 were quantified. An experienced ophthalmologist inspected the retinopathy. All participants in this study have moderate non-proliferative retinopathy. A p value under 0.05 was considered statistically significant. The mean α-Klotho level for retinopathic diabetic patients was 501.7 ± 172.2 pg/mL and 579.6 ± 312.1 pg/mL for non-retinopathic diabetic patients. In comparison, α-Klotho level of the control group was 523.2 ± 265.4 pg/mL (p = 0.531). The mean of FGF 23 level did not demonstrate a significant difference (p = 0.259). The mean FGF 23 level were 75.7 ± 14.0 pg/mL, 74.0 ± 14.8 pg/mL and 79.3 ± 14.4 pg/mL in groups, respectively. In conclusion, there was no significant difference in FGF 23 and α-Klotho levels between type 1 diabetics with and without retinopathy when compared to the control group.

Change of pulmonary function tests in hospitalized COVID-19 patients at third and sixth month follow-up.

BACKGROUND: The effect of COVID-19 infection on pulmonary function is unknown. OBJECTIVE: This study aimed to evaluate pulmonary function tests (PFTs) of patients hospitalized with the diagnosis of COVID-19 pneumonia at 3 and 6 months post-discharge. METHODS: Patients aged 18 years and over who had positive COVID-19 PCR test results and were hospitalized in the pandemic service between 1 May 2020 and 31 October 2020, were included in the study. All patients were evaluated with PFTs FVC, FEV1, FEV1/FVC, and FEF25-75 at 3 and 6 months after discharge. RESULTS: The mean age of 34 patients included in the study was 47.7 ± 12.7 years. The FVC, FEV1, FEV1/FVC, and FEF25-75 measurements at 3 and 6 months post-discharge showed no significant difference (P = 0.765, P = 0.907, P = 0.707, and P = 0.674, respectively). There was no significant difference in any PFT measurements at the third month follow-up, regardless of the pharmacological treatment protocols applied during hospitalization (P > 0.05). However, FEV1/FVC and FEF25-75 levels were 83.1 [3.4]% and 91.0 [10.0]%, respectively, in those who received systemic steroid treatment, and 78.3 ± 8.5% and 72.5 ± 25.7% in those who did not (P = 0.019 and P = 0.048, respectively). In addition, FVC and FEV1 levels increased significantly from the third to the sixth month follow-up in patients who received systemic steroid therapy (P = 0.035 and P = 0.018, respectively). CONCLUSION: Although there is no significant difference in PFT measurements from 3 to 6 months in COVID-19 patients, systemic steroid therapy may have a beneficial effect on respiratory function in COVID-19 patients.

Night Eating Syndrome According to Obesity Groups and the Related Factors.

OBJECTIVE: To find the frequency of night eating syndrome (NES) in different obesity groups and to determine related factors. STUDY DESIGN: Descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Department of Family Medicine, Outpatient Clinics, University of Health Sciences, Kartal Dr. Lutfi Kirdar Training and Research Hospital from December 2018 to January 2019. METHODOLOGY: Participants were divided into class I, class II, and class III obesity groups according to their BMI levels and administered a survey evaluating their sociodemographic features and a NES questionnaire. RESULTS: NES was detected in 92 (21.85%) of all participants; whereas, 28 participants (18.67%) of class I obesity group, 32 participants (22.70%) of class II obesity group and 32 participants (24.62%) of class III obesity group had NES (p=0.465). There was no significant difference between individuals with and without NES in terms of age, gender, marital status, income level, occupational status, presence of children, living-together subjects, cigarette consumption, BMI, waist-hip ratio, and waist-height ratio. However, within the class I obesity group, the likelihood of weight loss was significantly lower among participants with NES (p=0.026). There was no relationship between NES and the duration of obesity, dieting, and the number of main meals per day. However, the relationship between NES and the number of snacks per day was significant in class I and III obesity groups (p=0.040 and p=0.034, respectively).   Conclusion: The frequency of NES was found to be high in all obesity groups with no significant difference across groups. Therefore, all obese patients should be evaluated in terms of NES, and nutritional recommendations should be provided in the treatment of obesity. Key Words: Morbid obesity, Night eating syndrome, Obesity.

Evaluation of muscle mass in obesity, prediabetes and diabetes mellitus by different equations used for the measurement of muscle mass.

OBJECTIVE: Insulin resistance is one of risk factors for sarcopenia and there is no specific equation for the measurement of muscle mass. The present study aimed to evaluate muscle mass in the patients with obesity, prediabetes (PDM) and type 2 diabetes mellitus (DM) by different equations for the measurement of muscle mass. METHODS: Obese patients aged 18-65 years old, who presented between 2013 and 2015 were reviewed and they were separated into three groups as obese, prediabetes (PDM) and diabetes mellitus (DM). Height, body weight, body mass index (BMI), sum of the appendicular lean masses (ALM) were measured in all participants. Body muscle mass ratio was calculated as the total muscle mass divided by the body weight, and skeletal muscle index was calculated as the total muscle mass divided by the square of the height. In addition, ALM/weight, ALM/height2 and ALM/BMI ratios were also evaluated. RESULTS: A total of 1107 participants, of whom 666 (60.2%) were female, were enrolled into the study. Of the participants, 288 (%26.02) had obesity, 524 (%47.33) had PDM and 295 (26.65%) had DM. There was a significant difference in ALM/BMI ratio between the three groups for both genders (p = 0.003 for female and p = 0.003 for male). ALM/weight ratio and body muscle mass ratio were decreased between groups in female, whereas it was no difference in male (p = 0.003, p < 0.001 for females, respectively; p = 0.802, p = 0.840 for males, respectively). CONCLUSIONS: ALM/BMI may be more accurate for the evaluation of muscle mass in middle-aged obese, PDM and DM subjects.

Relationship between irritable bowel syndrome and plasma and tissue ghrelin levels.

BACKGROUND/AIMS: This study aimed to evaluate the relationship between irritable bowel syndrome (IBS) and plasma and tissue ghrelin levels. MATERIALS AND METHODS: Patients who had undergone gastroscopy procedure for any reason previously were enrolled in the study. Among these, patients with IBS symptoms were evaluated according to the Roma III criteria. The healthy control group comprised patients with no IBS symptom and had undergone gastroscopy procedure for another reason. The plasma ghrelin level and tissue ghrelin level obtained by immunohistochemical examination of biopsy specimens taken from the gastric antrum and corpus were evaluated in all participants. RESULTS: The mean age of 90 participants was 43.64}12.64 years. The median value of the plasma ghrelin level was 3.29 (1.2-12.7) in the diarrhea group (IBS-D), 1.49 (0.82-7.08) in the constipation group (IBS-C), and 1.5 (0.2-3.7) in the control group. The plasma ghrelin levels between the groups were found to be significantly higher in IBS-D than in IBS-C and the control groups (p=0.001 and p=0.001, respectively). On comparing antral mucosal gland biopsy outcomes among the groups, staining intensity score was found to be significantly high in IBS-C as compared with the control group, whereas no significant difference was observed between IBS-D and the control groups (p=0.020 and p=0.429, respectively). CONCLUSION: The plasma ghrelin level in IBS-D and the staining intensity in the antral mucosal gland in IBS-C were found to be significantly higher. In addition, there was no difference between the groups in terms of ghrelin staining intensity in the gastric corpus.

Sarcopenia among Genders in Type 2 Diabetes Mellitus Patients Using Different Formulas of Bioimpedance Analysis.

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.

Relation of Muscle Indices with Metabolic Parameters and C-Peptide in Type 2 Diabetes Mellitus.

OBJECTIVE: To assess the relation between bioimpedance measurements and metabolic parameters and C-peptide in patient with type 2 diabetes mellitus (DM). STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Kartal Dr Lutfi Kirdar Training and Research Hospital, Pendik Kaynarca Diabetes Center, Exercise and Metabolism Unit, between January and March 2015. METHODOLOGY: Patients with DM, aged less than 65 years, were assessed for bioimpedance analysis, fasting plasma glucose (FPG), HbA1c, C-peptide levels, triglyceride levels, LDL-cholesterol, and HDL-cholesterol levels. Skeletal muscle index, total muscle index, skeletal muscle percentage, and total muscle percentage were used for muscle-related analyses. Mann-Whitney U-test or independent t-test were used to compare differences between two independent groups. Pearson correlation test or Spearman correlation test were used to find out correlation between variables. RESULTS: Atotal of 359 DM patients were enrolled in the study. Mean age was 51.6 ±8.0 years, and 278 (77.7%) of the participants were females. After adjusting age and gender variables, there was no relation between muscle-related measurements and FPG, triglyceride, LDL-cholesterol (p>0.05). However, there was muscle-related indexes (MRI) positively correlation with C-peptide and inversely associated with HDL-cholesterol (p<0.05). CONCLUSION: Muscle-related indices positively correlated with C-peptide, which showed endogenous insulin reserve.