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    Postload hyperglycemia is associated with increased subclinical inflammation in patients with prediabetes
    (Taylor & Francis Ltd, 2013) Colak, Ayfer; Akinci, Baris; Diniz, Gulden; Turkon, Hakan; Ergonen, Faruk; Yalcin, Hulya; Coker, Isil
    Background/aims. In this present study, we aimed: (i) To clarify if prediabetes is associated with subclinical inflammation independent of underlying obesity, and (ii) to evaluate the effect of postload glucose concentration on subclinical inflammation markers in a group of patients with elevated fasting glucose. Material and methods. In a cohort of 165 patients with newly detected fasting hyperglycemia, according to 75 g oral glucose tolerance test (OGTT), subjects were classified either as newly diagnosed type 2 diabetes (diabetes group, n = 40), impaired fasting glucose (IFG) plus impaired glucose tolerance (IGT) (IFG/IGT group, n = 42) or IFG only (IFG group, n = 83). A control group (n = 47) consisted of age-and body mass index (BMI)-matched healthy subjects with a normal OGTT. Circulating concentrations of lipids, insulin, interleukin-6 (IL-6), interleukin-8 (IL-8) and high sensitive C-reactive protein (hsCRP) were measured. HOMA index was calculated. Results. Subclinical inflammation markers were elevated in patients with diabetes and IFG/IGT compared to healthy controls and also IFG patients (diabetes vs. control: p < 0.05 for hsCRP, IL-8, and IL-6; IFG/IGT vs. control: p < 0.05 for hsCRP, and IL-6; diabetes vs. IFG: p < 0.05 for hsCRP, and IL-6; IFG/IGT vs. IFG: p < 0.05 for hsCRP, and IL-6). In multiple regression analysis, postload glucose concentration was independently associated with circulating hsCRP and IL-6 concentrations when the data was controlled for age, gender, BMI and lipid concentrations (p < 0.05 for hsCRP, and IL-6). Conclusion. Our results suggest that patients with prediabetes, independent of underlying obesity, have increased concentrations of subclinical inflammation which is mostly driven by postload glucose concentrations.
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    The effect of sleeve gastrectomy on serum irisin levels in patients with morbid obesity
    (Via Medica, 2016) Demirpence, Mustafa; Yilmaz, Hamiyet; Colak, Ayfer; Yalcin, Hulya; Toprak, Burak; Turkon, Hakan; Ugurlu, Levent
    Introduction: Irisin, a recently identified myokine, is associated with increased energy expenditure and has a potential role in obesity. Therefore, we investigated circulating irisin levels in morbidly obese patients undergoing sleeve gastrectomy (SG). Materials and methods: Thirty morbidly obese patients undergoing SG and 30 healthy subjects were included. All participants were evaluated at baseline and again at three months post-SG. Body weight and height, the lipid profile, and plasma glucose, HbA1c, insulin, and irisin levels were measured at each visit. Results: The two groups had similar mean age and sex distribution. Serum irisin was significantly lower in the morbidly obese subjects compared with the controls (p - 0.003) and negatively correlated with BMI, body weight, insulin levels, and HOMA-IR (p - 0.006, p = 0.011, p = 0.046, p = 0.048, respectively). When the morbidly obese patients were re-evaluated three months post-SG, their weight and BMI had significantly decreased (both p = 0.001). Similarly, the insulin, HbA1c, HDL-cholesterol, and HOMA-IR values significantly decreased (p - 0.001, p - 0.028, p - 0.006, and p - 0.001, respectively). However, irisin levels remained unchanged (p = 0,267). Conclusion: Although the irisin levels were significantly lower in the morbidly obese subjects, they did not change after SG-induced weight loss.
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    The Effectiveness of Temperature Versus Aprotinin in Maintaining the Preanalytical Stability of Adrenocorticotrophin
    (Oxford Univ Press, 2016) Turkon, Hakan; Toprak, Burak; Yalcin, Hulya; Colak, Ayfer; Ozturk, Nurinnisa
    Objective: To investigate the effect of temperature and protease inhibitor on adrenocorticotrophin (ACTH) stability. Methods: We collected blood specimens from 10 donors into K3 EDTA (ethylenediaminetetraacetic acid) and K3 EDTA + aprotinin tubes. Plasma specimens were held at room temperature and at 2 degrees C to 8 degrees C for 0, 2, 4, 8, 24, and 72 hours. ACTH concentrations in 4 storage conditions were compared with repeated-measures analysis of variance (ANOVA) at each time point. Results: ACTH concentrations substantially decreased after a 72-hour time period. At the 72nd hour, standard EDTA tubes and EDTA + aprotinin tubes stored at 4 degrees C showed the optimal stability. EDTA + aprotinin tubes stored at room temperature performed more strongly than standard EDTA tubes stored at room temperature. Conclusion: Our results show that refrigerated storage is more effective than protease inhibitor addition to maintain ACTH stability. We recommend using aprotinin tubes, especially for specimens standing at room temperature.