Person: İLHAN, MAHMUT MUZAFFER
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Publication Open Access Investigation of the Vitamin D Receptor Polymorphisms in Acromegaly Patients(2015-01-01) Ilhan, MAHMUT MUZAFFER; TOPTAS-HEKIMOGLU, Bahar; YAYLIM, Ilhan; Turgut, SEDA; TURAN, Saime; Karaman, Ozcan; Tasan, ERTUĞRUL; İLHAN, MAHMUT MUZAFFER; TURGUT, SEDA; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRULObjective. The genetic structural alterations in the majority of somatotroph adenomas are not clarified and the search for novel candidate genes is still a challenge.We aimed to investigate possible associations between vitamin D receptor (VDR) polymorphisms and acromegaly. Design, Patients, and Methods. 52 acromegaly patients (mean age 45.7 ± 1.9 years) and 83 controls (mean age 43.1 ± 2.6 years) were recruited to the study. VDR polymorphism was determined by polymerase chain reaction-based restriction fragment length polymorphism methods. Results. The distribution of VDR genotypes showed a significant difference in the frequencies of VDR FokI genotypes between patients and controls (𝑃 = 0.034). VDR FokI ff genotype was significantly decreased in acromegaly patients (𝑃 = 0.035) and carriers of FokI Ff genotype had a 1.5-fold increased risk for acromegaly (OR: 1.5, 95% CI: 1.07–2.1; 𝑃 = 0.020). IGF1 levels after treatment were significantly higher in patients carrying the Ff genotype compared to carrying ff genotype (𝑃 = 0.0049). 25(OH)D3 levels were significantly lower in acromegaly patients (𝑃 < 0.001). Conclusions. Our study suggests that VDR FokI genotypes might affect the development of acromegaly and VDR polymorphisms may play a role in the course of acromegaly as a consequence of altering hormonal status.Publication Open Access The use of complementary medicine in patients with diabetes(2016-05-01) İLHAN, MAHMUT MUZAFFER; DEMİR, BÜŞRA; YÜKSEL, SENA; AYDIN ÇATAKLI, SERRA; YILDIZ, RABİA SEVDA; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRUL; İLHAN, MAHMUT MUZAFFER; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRULOBJECTIVE: Diabetes mellitus (DM) is a growing health problem with serious complications. The chronic and progressive nature of the disease often leads patients to use complementary and integrative medicine. The present study aimed to investigate the frequency of use of alternative medicine by patients with DM and the products used. METHODS: Between September 2014 and May 2015, 301 patients with DM were selected from Bezmialem Foundation University Hospital Diabetes Clinic to participate in the study. RESULTS: The results of the study indicate that 81 (26.9%) patients had tried alternative medicine, and 50 (16.6%) patients continued to use some form of alternative medicine product. A total of 43 (14.3%) patients used such products every day and 24 (8%) patients had used alternative medicine products for up to 6 months. Glycated hemoglobin (HbA1c) levels were significantly decreased in patients using alternative medicine products compared to the remainder of patients in the study (p=0.017). No other significant difference was found between the two groups. It was observed that among patients using alternative medicine products, only 10 (12%) had informed their physicians. CONCLUSION: This study indicated that patients with diabetes are very likely to use alternative medicine products. Additional studies are needed to further determine the efficacy of these products. Patients as well as health providers must be educated about complementary medicine and alternative products.Publication Open Access Radiation field size and dose determine oncologic outcome in esophageal cancer.(2016-10-13T00:00:00Z) GEMICI, C; YAPRAK, G; BATIREL, HF; ILHAN, MAHMUT MUZAFFER; Mayadagli, ALPASLAN; İLHAN, MAHMUT MUZAFFER; MAYADAĞLI, ALPASLANPublication Open Access The Role of p16 and MDM2 Gene Polymorphisms in Prolactinoma: MDM2 Gene Polymorphisms May Be Associated with Tumor Shrinkage(2017-05-01) Turgut, SEDA; Ilhan, Muzaffer; Turan, Saime; Karaman, Ozcan; Yaylim, Ilhan; Kucukhuseyin, Ozlem; Tasan, ERTUĞRUL; TURGUT, SEDA; İLHAN, MAHMUT MUZAFFER; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRULAim: Prolactinomas are thought to arise from clonal expansion of a single mutated cell which is subjected to growth stimuli of several permissive factors, although the pathogenetic mechanisms underlying tumorigenesis remain unclear. The present study aimed to investigate the role of p16 (540C→G and 580C→T) and mouse double minute 2 (MDM2) (SNP309T→G) gene polymorphisms in tumorigenesis and characteristics of prolactinoma. Patients and methods: A total of 74 patients with prolactinoma and 100 age- and gender-matched healthy individuals were enrolled in the study. Serum prolactin levels were measured by enzyme-linked immunosorbent assay (ELISA). p16 and MDM2 polymorphisms were determined by polymerase chain reaction-restriction fragment polymorphism and agarose gel electrophoresis. Results: p16 540C→G genotype distribution was found to be: CC: 66.2%, CG: 28.4%, GG: 5.4%; p16 580C→T genotype distribution was found to be: CC: 82.4%, CT: 17.6%, TT: 0% and MDM2 genotype distribution was found to be: TT: 31.1%, TG: 47.3%, GG: 21.6% in patients with prolactinoma. Tumor diameter before treatment was correlated with prolactin levels before treatment and percentage of prolactin decrease with treatment (r=0.719, p<0.001, p=0.034 r=0.256, respectively). The number of patients with tumor size decrease of more than 50% in those with homozygous genotype (TT+GG) of MDM2 SNP309T→G was significantly higher than in heterozygous genotype (TG) carriers (odds ratio(OR)=0.18, 95% confidence interval(CI)=0.06-0.58; p=0.003). Conclusion: This study showed that p16 and MDM2 polymorphisms do not play a decisive role in tumorigenesis, but some genotypes of these polymorphisms might be associated with follow-up characteristics of prolactinoma.Publication Open Access The Correlation of Increased CRP Levels with NFKB1 and TLR2 Polymorphisms in the Case of Morbid Obesity(2016-11-01) Soydas, T.; Karaman, O.; Arkan, H.; Yenmis, G.; ILHAN, M. M.; Tombulturk, K.; TASAN, ERTUĞRUL; Sultuybek, G. Kanigur; KARAMAN, ÖZCAN; İLHAN, MAHMUT MUZAFFER; TAŞAN, ERTUĞRULMorbid obesity (MO) is associated with an increase in circulating levels of systemic acute phase proteins such as C-reactive protein (CRP). Toll-like receptor is possible candidate for inflammatory responses which is mainly mediated by NFKB1. The aim of this study was to investigate the relationship between NFKB1 and Toll-like receptor (TLR) 2 polymorphisms and the risk of MO in a Turkish population in the context of CRP serum levels which may contribute to susceptibility to the disease. We analysed the distribution of NFKB1-94 ins/del ATTG rs28362491 and TLR2 Arg753Gln rs5743708 polymorphisms using PCR-RFLP method and CRP serum levels using ELISA method in 213 MO and 200 healthy controls. The frequency of the ins/ins genotype and ins allele of rs28362491 was significantly higher in the patients compared to control group (P: 0.0309; P: 0.0421, respectively). Additionally, the frequency of GG genotype and G allele of rs5743708 was found to be statistically higher in the patient group (P: 0.0421; P < 0.0001, respectively). In addition, serum CRP levels (>20 mg/l) in MO patients with ins/ins genotype were significantly higher than in patients with del/ins genotype (P: 0.0309). Serum CRP levels were also higher in MO patients with GG genotype and G allele (P: 0.0001). According to combined analysis, the wild type of rs28362491 and rs5743708 polymorphisms (ins/ins/GG genotype) was also significantly higher in the patient group versus the control group when compared with the combined ins/ins/GA and del/ins/GA genotype (P < 0.0001). Therefore, our findings suggest that rs28362491 and rs5743708 polymorphisms were significantly associated with MO disease through acting by modulating serum CRP levels.Publication Open Access Microstructural brain changes in acromegaly: quantitative analysis by diffusion tensor imaging(2014-06-01) KILICARSLAN, R.; ILHAN, M. M.; Alkan, ALPAY; ARALASMAK, AYŞE; AKKOYUNLU, M. E.; KART, L.; TASAN, ERTUĞRUL; İLHAN, MAHMUT MUZAFFER; ALKAN, ALPAY; ARALAŞMAK, AYŞE; TAŞAN, ERTUĞRULObjective: We examined brain diffusion changes of patients with acromegaly. We searched whether there are differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values between remission and nonremission patients with acromegaly and investigated any effect of time of hormone exposure on diffusion metrics. Methods: The values of FA and ADC were calculated in a total of 35 patients with acromegaly and 28 control subjects. Patients were subdivided into remission and non-remission groups. We looked at brain FA and ADC differences among the groups and looked for any relation between the diffusion changes and time of hormone exposure among the patients with acromegaly. Results: We found decreased FA and increased ADC values in some of the growth hormone responsive areas. There were no significant brain diffusion changes between remission and non-remission groups. The most affected areas were the hypothalamus, parietal white matter and pre-motor cortex in patients with acromegaly. In terms of hormone exposure time among the patients with acromegaly, there was no effect of disease duration on brain microstructural changes. Conclusion: All patients with acromegaly showed increased brain diffusion with no relation to disease duration and treatment status. We suggested that in patients with acromegaly, brain damage had already occurred in the subclinical period before symptom onset. Advances in knowledge: This study contributes to the understanding of the mechanisms in acromegaly.Publication Open Access Does hormonal control obviate positive airway pressure therapy in acromegaly with sleep-disordered breathing?(2013-11-01) Akkoyunlu, MUHAMMED EMİN; Ilhan, MAHMUT MUZAFFER; Bayram, MEHMET; Tasan, ERTUĞRUL; YAKAR, Fatih; OZCELIK, Hatice Kutbay; KARAKOSE, Fatmanur; Kart, Levent; AKKOYUNLU, MUHAMMED EMİN; İLHAN, MAHMUT MUZAFFER; BAYRAM, MEHMET; TAŞAN, ERTUĞRUL; OKYALTIRIK, FATMANURAcromegaly is a disease in which uncontrolled release of growth hormone occurs after closure of epiphyseal plates, causing changes in the body that can lead to sleep disordered breathing (SDB). No definite guidelines regarding the treatment of SDB in acromegaly are available. In this study, we aimed to investigate the prevalence of SDB in acromegaly and whether hormonal control alters the necessity of positive airway pressure (PAP) therapy in acromegaly patients with SDB. Methods: Forty-two acromegaly patients were included in the study and divided into two groups according to disease status, i.e., active or well controlled. All patients underwent polysomnography. Fourteen patients with active acromegaly were diagnosed with SDB and were evaluated for PAP therapy with polysomnography both before and 6 months after disease control was achieved. Results: Sleep-disorder breathing was diagnosed in 22 of 42 patients, 7 of 20 patients with controlled-disease and 15 of 20 patients with active diseases. There were significant reductions in respiratory disturbance index (RDI), apnea index, desaturation index, central apnea number, and rapid eye movement-phase RDI at the control polysomnography. Initially, PAP therapy was indicated in 12 of 14 patients and PAP therapy indication held in 11 patients after acromegaly control was achieved. Conclusion: Our study revealed that over half of patients with acromegaly had SDB. Furthermore, SDB severity decreases with acromegaly treatment; however, this decrease does notPublication Open Access The assessment of total antioxidant capacity and superoxide dismutase levels, and the possible role of manganese superoxide dismutase polymorphism in acromegaly.(2018-01-30) ILHAN, MAHMUT MUZAFFER; Turgut, SEDA; TURAN, S; Demirci, Cekic; ERGEN, HA; Korkmaz, Dursun; MEZANI, B; KARAMAN, O; YAYLIM, I; APAK, MR; TASAN, ERTUĞRUL; İLHAN, MAHMUT MUZAFFER; TURGUT, SEDA; KARAMAN, ÖZCAN; TAŞAN, ERTUĞRULOxidative status is attributed to endothelial dysfunction and might be one of the key mechanisms of endothelial dysfunction in acromegaly. In this study, we aimed to investigate the effect of acromegaly on superoxide dismutase (SOD) and total antioxidant capacity (TAC) levels, and the possible influence of human manganese superoxide dismutase (MnSOD) polymorphism on these levels. 51 acromegaly patients and 57 age and sex matched healthy subjects were recruited to the study in Bezmialem Vakif University Hospital between 2011 and 2014. The median SOD and TAC levels were 42.7 (33-60) pg/mL and 1,313.7 (155-1,902) μM in acromegaly; and 46.3 (38-95) pg/mL and 1,607.3 (195-1,981) μM in healthy subjects (p < 0.001, p < 0.001). SOD levels were decreased in controlled and uncontrolled patients compared to healthy subjects (p = 0.05 and p = 0.002, respectively). Controlled and uncontrolled acromegaly displayed significantly decreased levels of TAC compared to healthy subjects (p < 0.05 and p < 0.001, respectively). SOD levels were not associated with MnSOD polymorphisms in acromegaly. In conclusion, this study showed that acromegaly was associated with decreased levels of SOD and TAC, and controlling the disease activity could not adequately improve these levels.Publication Open Access Microstructural effects of Ramadan fasting on the brain: a diffusion tensor imaging study(2015-05-01) BAKAN, Ayse Ahsen; Yildiz, Seyma; Alkan, ALPAY; YETIS, Huseyin; Kurtcan, SERPİL; Ilhan, MAHMUT MUZAFFER; YILDIZ, ŞEYMA; ALKAN, ALPAY; KURTCAN, SERPİL; İLHAN, MAHMUT MUZAFFERPurpose: We aimed to examine whether the brain displays any microstructural changes after a three-week Ramadan fasting period using diffusion tenson imaging. Methods: This study included a study and a control group of 25 volunteers each. In the study group, we examined and compared apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of the participants during (phase 1) and after (phase 2) a period of fasting. The control group included individuals who did not fast. ADC and FA values obtained in phase 1 and phase 2 were compared between the study and control groups. Results: In the study group, ADC values of hypothalamus and, to a lesser extent, of insula were lower in phase 1 compared with phase 2 and the control group. The FA values of amygdala, middle temporal cortex, thalamus and, to a lesser extent, of medial prefrontal cortex were lower in phase 1 compared with phase 2 and the control group. Phase 2 ADC and FA values of the study group were not significantly different compared with the control group at any brain location. Conclusion: A three-week Ramadan fasting period can cause microstructural changes in the brain, and diffusion tensor imaging enables the visualization of these changes. The identification of brain locations where changes occurred in ADC and FA values during fasting can be helpful in diagnostic imaging and understanding the pathophysiology of eating disorders.Publication Open Access Acromegaly can be associated with impairment of LES relaxation in the oesophagus(2015-09-01) Ilhan, MAHMUT MUZAFFER; DANALIOGLU, Ahmet; Turgut, SEDA; Karaman, Ozcan; Arabaci, ELİF; Tasan, ERTUĞRUL; İLHAN, MAHMUT MUZAFFER; TURGUT, SEDA; KARAMAN, ÖZCAN; ARABACI, ELİF; TAŞAN, ERTUĞRULIntroduction: Although prolonged small intestine and colonic transit time has been demonstrated in acromegaly patients, the influence of acromegaly on oesophagus motility and the pathological mechanisms involved are still not clarified. We aimed to investigate manometric measurements to ascertain whether oesophagus motility is affected in active acromegaly patients. Material and methods: The study was performed in an institutional referral centre at a tertiary care hospital. Twenty-three acromegaly patients (mean age 43.2 ± 13.2 years) and 25 sex- and age-matched healthy control subjects (mean age 48.6 ± 7.9 years) were recruited to a case-control study. Oesophageal manometry was performed using MMS (Medical Measurement Systems, Netherlands) Solar GI — Air Charged Intelligent Gastrointestinal Conventional Manometry. Results: In manometric measurements the lower oesophageal sphincter pressure was 18 ± 7 mmHg in acromegaly patients and 15.6 ± 4.4 mm Hg in controls, and there was no significant difference (p = 0.17). The percentage of relaxation was 64.8% and 81.8%, respectively, and it was significantly lower in acromegaly patients than in controls (p < 0.001). Additionally, the duration of relaxation was found to be 4 ± 1.9 seconds and 5 ± 1.7 seconds in patients and controls, respectively (p = 0.049). Conclusions: Our study has demonstrated a significant reduction in the percentage and duration of lower oesophageal sphincter relaxation in oesophagus motility even in acromegaly patients without any gastrointestinal symptoms. Further clinical and pathophysiological studies are required to clarify the underlying mechanisms of gastrointestinal motility disorders in acromegaly