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1.
J Clin Ultrasound ; 52(5): 608-618, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38600828

ABSTRACT

BACKGROUND AND AIMS: There are limited data on the comparison of body compositions between diabetic and non-diabetic patients. We aimed to compare the muscle mass and fat parameters measured by ultrasonography (USG) and dual-energy x-ray absorptiometry (DXA) between older palliative care patients with and without type 2 diabetes mellitus (DM). METHODS: We conducted a prospective, cross-sectional study. We recorded the demographics, comorbidities, blood pressures, microvascular complications, pressure injuries, ambulation and nutritional status, and laboratory parameters. We measured the handgrip strength with a hand dynamometer and anthropometric parameters. We analyzed the subcutaneous fat thickness, muscle thickness (MT), and cross-sectional area (CSA) of the rectus femoris (RF) and biceps brachii muscles by USG and the total and regional muscle mass and fat parameters by DXA. We performed a regression analysis to examine the independently associated factors of DM. RESULTS: We included 55 patients (mean age: 79.0 ± 8.0 years, 56.4%: female). 43.6% had type 2 DM. The patients with DM had significantly higher glucose and HbA1c levels and lower RFMT and RFCSA values than the patients without DM (p < 0.01, for all). The RFMT was independently associated with DM after adjusting age, sex, and body mass index (Odds ratio = 0.735, 95% confidence interval = 0.565-0.956, p = 0.022). CONCLUSION: Our study demonstrated that the RFMT might be associated with type 2 DM. This was the first study comparing the body compositions measured by USG and DXA between older diabetic and non-diabetic palliative patients with a wide range of laboratory evaluations. Longitudinal, multi-center studies are warranted to understand the underlying mechanisms.


Subject(s)
Absorptiometry, Photon , Diabetes Mellitus, Type 2 , Muscle, Skeletal , Palliative Care , Ultrasonography , Humans , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/physiopathology , Female , Male , Absorptiometry, Photon/methods , Cross-Sectional Studies , Aged , Ultrasonography/methods , Prospective Studies , Muscle, Skeletal/diagnostic imaging , Palliative Care/methods , Aged, 80 and over , Body Composition , Adipose Tissue/diagnostic imaging
2.
Curr Med Imaging ; 2024 Mar 19.
Article in English | MEDLINE | ID: mdl-38676518

ABSTRACT

AIM: We have aimed to investigate the role of ultrasonographic muscle parameters (UMP) in predicting osteosarcopenia in bedridden patients in a palliative care center. BACKGROUND: The role of ultrasound has not been evaluated in predicting osteosarcopenia. OBJECTIVE: Reduced muscle thickness (MT) and cross-sectional area (CSA) have often been observed in individuals with sarcopenia, reflecting muscle loss and atrophy. Meanwhile, the potential role of muscle ultrasound has not been evaluated in predicting osteosarcopenia. METHODS: We have conducted a prospective, observational study between January 2021 and 2022. We have recorded the demographics, comorbidities, and nutritional status by using the mini nutritional assessment-short form. We measured handgrip strength with a hand dynamometer and the muscle mass with dual X-ray absorptiometry. Sarcopenia was defined by the European Working Group on Sarcopenia in Older People 2 criteria. Osteoporosis was diagnosed according to the World Health Organization criteria. We have categorized the body phenotypes into four groups: "non-sarcopenic non-osteoporotic," "sarcopenic alone," "osteoporotic alone," and "sarcopenic osteoporotic." We have measured the subcutaneous fat thickness (SFT), MT, and CSA of the rectus femoris (RF) and biceps brachii (BB) via ultrasonography. A multivariate regression analysis was performed and area under curve (AUC) values were used to evaluate the accuracy of UMPs. RESULTS: We included 31 patients (mean age: 74.6±12.1 years, 54.8%: male). The prevalences of sarcopenia, osteoporosis, and sarcopenic osteoporosis were 71%, 48.4%, and 41.9%, respectively. Only the "sarcopenic osteoporotic" phenotype was negatively correlated with all UMPs. In the regression analysis, only the "sarcopenic osteoporotic" phenotype was independently associated with RFCSA (ß=-0.456, p= 0.024). The AUC for all patients was >0.700. CONCLUSION: RFCSA measurement might be useful in the screening for osteosarcopenia. This has been the first study investigating the relationship between UMPs and body phenotypes. Multi-center and large-scale studies are, however, needed.

3.
Turk J Med Sci ; 52(3): 605-612, 2022 Jun.
Article in English | MEDLINE | ID: mdl-36326320

ABSTRACT

BACKGROUND: Hashimoto thyroiditis (HT) is one of the most prevalent autoimmune diseases. The intestine microbiota is strongly associated with autoimmune diseases. Zonulin, a modulator of tight junctions that controls the selective permeability of the intestine can induce an elevation in gut permeability. We aimed to investigate the association of plasma zonulin levels with HT. METHODS: We compared 77 HT patients with 66 age-gender and BMI-matched healthy individuals in the case of plasma zonulin levels. Plasma zonulin levels were measured by ELISA. The statistical analyses were performed using Student's t-test and chi-square tests. The predictive power was investigated using univariate and multivariate logistic regression analysis. RESULTS: We found that the increase in plasma zonulin levels in the HT group was statistically significant compared to the control group (p < 0.001). The regression analysis showed that urea, anti-thyroid peroxidase, aspartate aminotransferase, thyroid-stimulating hormone, free T3, and serum zonulin levels were found to be associated with HT in both univariate and multivariate models (p < 0.05). DISCUSSION: Zonulin is a possible biomarker candidate that may link intestinal permeability with the etiology of autoimmune diseases.


Subject(s)
Autoimmune Diseases , Gastrointestinal Microbiome , Hashimoto Disease , Humans , Protein Precursors , Autoimmune Diseases/complications
4.
J Gastrointestin Liver Dis ; 31(3): 309-316, 2022 09 15.
Article in English | MEDLINE | ID: mdl-36112712

ABSTRACT

AIM: We aimed to evaluate the circulating thrombospondin-1 (TSP-1) and nuclear factor kappa B (NF-κB) in nonalcoholic fatty liver disease (NAFLD) in order to integrate these signaling pathways in the inflammatory and fibrogenic processes of this liver disorder. METHODS: Ninety-five NAFLD patients were recruited in the study. The study also included 83 age-sex matched healthy controls. RESULTS: The number of patients with metabolic syndrome (MetS) criteria was 57 (60%). TSP-1 level was found to be statistically significantly lower in the NAFLD group compared to the control group (p=0.037). However, NF-κB level was found to be significantly higher in the NAFLD group compared to the control group (p=0.004). There was a significant negative correlation between plasma TSP-1 levels with glucose (r=-0.235, p=0.022), alanine aminotransferase (r=-0.261, p=0.011) and aspartate transaminase (r=-0.328, p=0.001) levels. In addition, a significant negative correlation was found between plasma TSP-1 and NF-κB levels (r=-0.729, p<0.001). CONCLUSIONS: Our results suggest a close relationship between increased NF-κB and reduced TSP-1 in NAFLD. TSP-1 and NF-κB signaling pathways might have a role in the inflammatory and fibrogenic processes. Furthermore, they may be used as a noninvasive marker and could assist as a therapeutic target for NAFLD.


Subject(s)
NF-kappa B , Non-alcoholic Fatty Liver Disease , Thrombospondin 1 , Alanine Transaminase , Aspartate Aminotransferases , Glucose , Humans , NF-kappa B/metabolism , Non-alcoholic Fatty Liver Disease/metabolism , Signal Transduction , Thrombospondin 1/metabolism
5.
Int J Vitam Nutr Res ; 92(1): 4-12, 2022 Jan.
Article in English | MEDLINE | ID: mdl-34538066

ABSTRACT

Purpose: This study aimed to investigate the effect of the nutritional status, as assessed by the prognostic nutritional index (PNI) on the disease prognosis of patients with COVID-19. Methods: This retrospective study included 282 patients with COVID-19. The PNI score of all patients, 147 of whom were male, with a mean age of 56.4±15.3 years, was calculated. According to the PNI score, the patients with normal and mild malnutrition constituted group-1 (n=159) and the patients with moderate-to-severe and serious malnutrition constituted group-2 (n=123). Results: The PNI score was correlated with age (r=-0.146, p=0.014); oxygen saturation (r=0.190, p=0.001); heart rate (r=-0.117, p=0.05); hospitalization duration (r=-0.266, p<0.001); white blood cells (r=0.156, p=0.009); hemoglobin (r=0.307, p<0.001); C-reactive protein (CRP) (r=-0.346, p<0.001); creatinine (r=-0.184, p=0.002); D-dimer (r=-0.304, p<0.001); ferritin (r=-0.283, p<0.001); procalcitonin (r=-0.287, p<0.001); the confusion, urea, respiratory rate, blood pressure, and age ≥65 years score (r=-0.217, p<0.001); and the quick sequential organ failure assessment score (r=-0.261, p<0.001) in patients with COVID-19. Mortality was significantly higher in Group 2 (p<0.001). Survival was significantly higher if PNI score was >41.2 (p<0.001, sensitivity: 78.7% and specificity: 84.2%). In multivariate regression analysis, among various other parameters, only PNI score and oxygen saturation had a significant effect on the disease course (p=0.02 and p=0.045, respectively). Conclusion: PNI, calculated from the serum albumin concentration and total lymphocyte count, is a simple and objective indicator that assesses the immune nutritional status of patients with COVID-19. The presence of malnutrition has a high predictive value in predicting the severity of COVID-19. Our data suggest that the PNI might be useful for risk stratification of patients with COVID-19 in clinical practice.


Subject(s)
COVID-19 , Nutrition Assessment , Adult , Aged , Humans , Male , Middle Aged , Nutritional Status , Oxygen Saturation , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2
6.
Int J Endocrinol ; 2014: 954045, 2014.
Article in English | MEDLINE | ID: mdl-25530760

ABSTRACT

The risk for cardiovascular diseases and type 2 diabetes mellitus significantly increases in the patient population with metabolic syndrome (MeS). The present study aimed to investigate the association between the epicardial adipose tissue thickness (EATT) and the oxidative stress parameters in MeS patients. The study included 181 patients as a patient group of 92 consecutive patients with MeS and a control group of 89 consecutive patients with similar age and gender. EATT was evaluated by transthoracic echocardiography. Serum levels of total oxidant status (TOS), total antioxidative capacity (TAS), paraoxonase-1 (PON-1), and arylesterase activities were measured. EATT was higher in the MeS group compared to the control group (6.0 ± 2.0 mm and 4.0 ± 1.0 mm, resp.; P < 0.001). The level of TOS was higher in the MeS group compared to the control group (P < 0.001). Additionally, the TAS level was higher in the MeS group compared to the control group (P < 0.001). Furthermore, the serum levels of PON-1 and arylesterase were lower in the MeS group compared to the control group (P < 0.001). EAT may cause an increased risk of cardiovascular diseases by leading to increased oxidative stress in patients with MeS.

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