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 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 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