Browsing by Author "Ertugrul, Derun Taner"

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Does Isotretinoin Therapy Have Any Effects on Electrocardiography, Heart Rate and Blood Pressure
(Taylor & Francis Ltd, 2012) Karadag, Ayse Serap; Gumrukcuoglu, Hasan Ali; Bilgili, Serap Gunes; Ozkol, Hatice Uce; Ertugrul, Derun Taner; Simsek, Hakki; Calka, Omer
Background: Isotretinoin therapy is associated with numerous adverse effects of various systems. Although some cases have been reported, cardiac side effects are rare following isotretinoin treatment. Objective: To investigate the effects of isotretinoin on the cardiovascular system. Methods: Seventy patients with acne vulgaris were enrolled in the study. The patients were treated with a dose of 0.5-1.0 mg/kg per day of isotretinoin. Screening for biochemical and hematologic parameters, heart rate, blood pressure and electrocardiographic parameters were done before treatment and after 3 months of isotretinoin treatment. Results: Heart rate, systolic/diastolic tension and electrocardiographic parameters (P-wave duration and QTc duration) were not statistically different before compared with after treatment. Conclusion: As far as we know, there is no study researching the effect of isotretinoin on P- and QT-wave measurements in the literature. We found that isotretinoin did not affect P- and QT-wave measurement. Further studies with longer periods of follow-up are needed to understand the effect of isotretinoin on the cardiovascular system.
The Effect of Acitretin Treatment on Insulin Resistance, Retinol-Binding Protein-4, Leptin, and Adiponectin in Psoriasis Vulgaris: a Noncontrolled Study
(Karger, 2013) Karadag, Ayse Serap; Ertugrul, Derun Taner; Kalkan, Goknur; Bilgili, Serap Gunes; Celik, Huseyin Tugrul; Takci, Zennure; Calka, Omer
Background/Aim: To investigate the effects of acitretin treatment on insulin resistance (IR) and adipokines, particularly retinol-binding protein (RBP)-4. Methods: Thirty-four patients with chronic plaque psoriasis and a control group of 34 healthy volunteers were recruited in the study. Screening for the parameters was performed before starting and after 3 months of acitretin treatment in the psoriasis group. The control group was only evaluated at the beginning of the study and did not receive placebo. We could not compare our results with a placebo control group because of ethical reasons. Results: Basal adiponectin (p = 0.01), insulin (p < 0.0001) levels and homeostasis model assessment (HOMA) IR (p < 0.0001) were significantly higher in psoriasis patients. After the treatment, insulin (p = 0.014), C peptide (p = 0.011), RBP-4 (p < 0.0001) levels and HOMA-IR (p = 0.008) decreased significantly. Posttreatment leptin (p = 0.036)levels were significantly lower than those of the controls. Posttreatment adiponectin (p = 0.005) and insulin (p = 0.048) levels were higher than those of the controls. Conclusions:This study showed for the first time that RBP-4 levels and IR are decreased significantly with acitretin treatment. This finding is very important in psoriasis patients because psoriasis may cause insulin resistance and diabetes. Further experimental and clinical studies are needed to clarify the effect of acitretin on adipocyte structure and behavior. (C) 2013 S. Karger AG, Basel
The Effect of Different Doses of Isotretinoin on Pituitary Hormones
(Karger, 2015) Karadag, Ayse Serap; Takci, Zennure; Ertugrul, Derun Taner; Bilgili, Serap Gunes; Balahoroglu, Ragip; Takir, Mumtaz
Background: There are a limited number of studies investigating the side effects and effectiveness of various doses of isotretinoin (ISO). We have previously shown that high-dose ISO affects pituitary hormones. Objectives: To our knowledge, there is no study in the literature looking into the effects of various doses of ISO on pituitary hormones. We searched pituitary hormones in three groups of different doses in acne patients. Methods: We included 105 acne vulgaris patients from two different centers. We divided the patients into three groups; the first group received 0.5-1 mg/kg/day, the second 0.2-0.5 mg/kg/day and the third intermittent 0.5-1 mg/kg/day (only 1 week in 1 month) ISO treatment. Blood samples were collected for biochemistry and hormone analysis, before the treatment and after 3 months. Results: After 3 months of treatment with ISO, luteinizing hormone (LH) (p < 0.001), prolactin (p < 0.001), total testosterone (p < 0.001), adrenocorticotropic hormone (ACTH) (p < 0.001), cortisol (p < 0.001), insulin-like growth factor-binding protein 3 (p < 0.001), insulin-like growth factor 1 (IGF-1) (p = 0.002), growth hormone (GH) (p = 0.002) and free T3 (fT3) (p < 0.001) levels had decreased significantly. Furthermore, we split data into three different groups. Among the patients receiving intermittent-dose ISO, LH, ACTH, IGF-1, GH and fT3 measurements lost significance. Most of the significant measurements observed in the whole group were also significant among the patients receiving high-dose ISO. Additionally, dehydroepiandrosterone sulfate (p = 0.003) levels increased, and free T4 levels decreased significantly. Conclusions: ISO affects pituitary hormones at all of these three doses. The differences in pituitary hormones are more pronounced in high-dose treatment. The weakest effect was observed in the intermittent-dose group. Choosing lower doses of ISO may decrease side effects, however the effectiveness of the treatment may also be diminished. ISO, by affecting the PPAR gamma/RXR system, may affecting hormone systems. These changes in various hormone systems may be related to the effectiveness of ISO. (C) 2015 S. Karger AG, Basel
The Effect of Isotretinoin on Retinol-Binding Protein 4, Leptin, Adiponectin and Insulin Resistance in Acne Vulgaris Patients
(Karger, 2015) Karadag, Ayse Serap; Ertugrul, Derun Taner; Takci, Zennure; Bilgili, Serap Gunes; Namuslu, Mehmet; Ata, Naim; Sekeroglu, Ramazan
Background: The effect of isotretinoin (ISO) on adipokines and insulin resistance has been investigated in a few studies, and the results are conflicting. Objective: The aim of this study was to investigate the effect of ISO treatment on insulin resistance and adipokines. Methods: Thirty-three patients with acne vulgaris and a control group of 30 healthy volunteers were included in our study. Screening for the biochemical parameters was performed just before the initiation and after 3 months of ISO treatment. Results: In the acne group, basal leptin levels were significantly lower (p = 0.003) and basal adiponectin levels significantly higher (p = 0.008) compared with the control group. After ISO treatment, leptin levels (p = 0.0005) decreased and adiponectin levels (p = 0.003) increased significantly. However, measurements of fasting blood glucose, insulin, C peptide, retinol-binding protein 4 (RBP4), homeostasis model assessment insulin re-sistance and BMI did not differ after ISO treatment. Conclusion: ISO may affect leptin and adiponectin levels. It does not, however, affect insulin resistance and RBP4 levels. (C) 20155. Karger AG, Basel
Effect of Isotretinoin Treatment on Plasma Holotranscobalamin, Vitamin B12, Folic Acid, and Homocysteine Levels: Non-Controlled Study
(Wiley, 2011) Karadag, Ayse Serap; Tutal, Emre; Ertugrul, Derun Taner; Akin, Kadir Okhan
Isotretinoin (Iso) has been used for the treatment of acne. Some previous studies reported elevated homocysteine (Hcy) levels after treatment with Iso. Some side effects have clinical presentations similar to vitamin B12, folic acid deficiencies, and hyperhomocysteinemia. In the present study we evaluated the plasma Hcy levels, the vitamins involved in its metabolism (vitamin B12 and folic acid), and holotranscobalamin (HoloTC), a transport system for vitamin B12 absorption in patients receiving Iso treatment for acne vulgaris. A total of 66 patients with acne vulgaris between the ages of 18 and 40 years were included. Screening for hemoglobin, creatinine, SGOT, SGPT, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein cholesterol (VLDL-C), folic acid, vitamin B12, Hcy, and HoloTC were done just before initiation (pretreatment) and after four months of Iso treatment (posttreatment). Posttreatment vitamin B12, folic acid, and HoloTC levels were significantly lower while Hcy levels were significantly higher compared with initial values. Posttreatment total cholesterol, LDL-C, triglycerides, VLDL-C, SGPT, and SGOT levels were also higher, and HDL-C levels were lower compared with initial values while there was no change in hemoglobin levels during Iso treatment. We found that Iso usage might cause decreased vitamin B12, folic acid, and HoloTC. These Iso side effects might contribute to the missing link between Iso usage, hyperhomocysteinemia, and neuropsychiatric disorders. Trials may be made with the aim of demonstrating (clearly) if starting vitamin B12 and folic acid replacement therapies with Iso treatment initialization could be useful for preventing hyperhomocysteinemia and possibly related disorders.
Effect of Low-Dose Acitretin Treatment on Pituitary Hormones in Psoriasis Vulgaris: a Retrospective Study
(Wolters Kluwer Medknow Publications, 2019) Karadag, Ayse Serap; Ozlu, Emin; Kostek, Osman; Bilgili, Serap Gunes; Balaharoglu, Ragip; Ertugrul, Derun Taner
Background: It has been reported that retinoids may lead to hormonal alterations. Aim: In this retrospective study, we aimed to study the effect of acitretin on pituitary hormones in psoriasis patients. Methods: Out of 50 patients intended to be studied, blood samples of 43 patients could be tested before and after 3 months of acitretin therapy (0.2 to 0.5 mg/kg/day). Results: Patients mean +/- standard deviation ages and female/male ratio were 46 +/- 17 years and 19/24, respectively. After treatment with acitretin, gamma-glutamyltransferase, alkaline phosphatase, total cholesterol and triglyceride levels increased significantly (P < 0.05). After treatment, total protein, free thyroxine (T4) levels decreased significantly (P < 0.05). No significant differences were observed between before-after acitretin treatment regarding pituitary hormone levels in psoriasis patients (P > 0.05). Limitations: The retrospective nature of the study, inability to retest blood samples of 7 patients at 3 months post treatment, low dose and short duration of acitretin treatment were limitations of this study. Conclusion: This study showed that pituitary hormones were not affected except free T4 (thyroid hormone) by acitretin treatment. Further experimental and clinical studies are needed to clarify the effect of acitretin on pituitary hormones.
Insulin Resistance Is Increased in Alopecia Areata Patients
(Taylor & Francis Ltd, 2013) Karadag, Ayse Serap; Ertugrul, Derun Taner; Bilgili, Serap Gunes; Takci, Zennure; Tutal, Emre; Yilmaz, Hamiyet
Increased insulin resistance (IR) has been found in androgenetic alopecia in several studies. However, IR has not been investigated in alopecia areata (AA). We aimed to investigate IR in AA patients and the controls. Anthropometric and demographic data were obtained from 51 AA patients and 36 controls. We measured insulin, c-peptide and blood glucose and HOMA-IR. Demographic characteristics of the two groups were similar. AA group had higher insulin [12.5 +/- 7.01 vs. 8.3 +/- 3.9 mu IU/mL, p = 0.001], c-peptide [2.7 +/- 1.07 vs. 2.1 +/- 0.6 ng/mL, p = 0.007] and HOMA-IR levels [2.8 +/- 1.6 vs. 1.9 +/- 0.9, p = .004] than the controls. Patient and control groups were also similar regarding lipid profiles. In this study, we found increased IR in AA patients for the first time in literature. Increased inflammatory cytokines and hypothalamic-pituitary-adrenal axis activation may be responsible for this finding. Further studies with larger sample sizes may give additional information for IR in AA.
Insulin Resistance Is Increased in Patients With Vitiligo
(Acta dermato-venereologica, 2011) Karadag, Ayse Serap; Tutal, Emre; Ertugrul, Derun Taner
The aim of this study was to evaluate the relationship between vitiligo and insulin resistance (IR). A total of 96 subjects were included in the study; 57 patients with vitiligo and 39 subjects in an age and a body mass index-matched control group. In fasting blood samples, insulin, C-peptide, glucose, total cholesterol, triglyceride, low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) were measured. IR was calculated with the homeostasis model assessment-IR (HOMA-IR) method. Comparison of the vitiligo and the control groups revealed that patients with vitiligo had higher IR (2.3 vs. 2.0,p<0.01), higher insulin and C-peptide levels (p<0.001, p<0.001, respectively), higher LDL/HDL ratio and lower HDL-C levels (p<0.01, p<0.0001, respectively). Systolic blood pressures of patients with vitiligo were also higher compared with control subjects (p<0.01). Further experimental and clinical studies are needed to elucidate the molecular mechanisms underlying this association.
Isotretinoin Influences Pituitary Hormone Levels in Acne Patients
(Acta dermato-venereologica, 2011) Karadag, Ayse Serap; Ertugrul, Derun Taner; Tutal, Emre; Akin, Kadir Okhan
Besides suppressing sebum production, the exact mechanism of action of isotretinoin in acne vulgaris is not known. Several hormones have been linked to the pathogenesis of acne. In this study, we investigated the effects of isotretinoin on the pituitary-adrenal axis, whose activity may be increased in acne. Various hormone systems were evaluated before and after 3 months of isotretinoin treatment in 47 acne patients. Free triiodothyronine (T3), thyroid-stimulating hormone and thyroid-stimulating hormone receptor antibody levels decreased significantly during isotretinoin treatment (p<0.001, p<0.02 and p<0.02, respectively), as did those of luteinising hormone, prolactin and total testosterone (p<0.005), as well as morning cortisol and adrenocorticotropic hormone (p<0.005 and p<0.05, respectively). We conclude that isotretinoin causes mild suppression of pituitary hormone levels, which may be beneficial for tackling the pathogenesis of acne.
Isotretinoin Modestly Increases Platelet Count in Acne Patients
(informa Healthcare, 2013) Karadag, Ayse Serap; Ertugrul, Derun Taner; Takci, Zennure
The Role of Anemia and Vitamin D Levels in Acute and Chronic Telogen Effluvium
(Tubitak Scientific & Technological Research Council Turkey, 2011) Karadag, Ayse Serap; Ertugrul, Derun Taner; Tutal, Emre; Akin, Kadir Okhan
Aim: Telogen effluvium (TE) is an abnormality of hair cycling. Vitamin D promotes hair follicle differentiation. The importance of vitamin D in hair growth is evident in patients with hereditary vitamin D receptor deficiency. The role of vitamin D in the pathogenesis of TE has not been investigated before. We investigated the role of vitamin D, ferritin, and zinc in the pathogenesis of TE. Materials and methods: We measured serum hemoglobin, ferritin, zinc, calcium, phosphate, parathormone, magnesium, 25 and 1,25-hydroxyvitamin D3, and bone alkaline phosphatase and thyroid stimulating hormone levels in 63 female patients and 50 control subjects. Twenty-nine of the TE patients were classified in the acute TE group and 34 were classified in the chronic TE groups. Results: Ferritin (acute TE; 17.0 +/- 12.8, chronic TE; 19.6 +/- 15.2, control; 35.5 +/- 31.8, P < 0.001) and hemoglobin (acute TE; 12.7 +/- 1.7, chronic TE; 13.3 +/- 1.0, control; 14.2 +/- 1.2, P < 0.0001) levels were significantly lower in the TE group than in the control group. However, 25-hydroxyvitamin D3 levels were significantly higher in the TE group than in the control group (acute TE; 18.5 +/- 9.2, chronic TE; 24.4 +/- 11.2, control; 15.6 +/- 15.8, P < 0.01). Vitamin D levels increased gradually from control groups to acute and chronic TE groups. However, active D vitamin levels (1,25-hydroxyvitamin D3) were similar. Conclusion: Iron deficiency anemia seems to be the main triggering factor for the development of TE and the increase in serum 25-hydroxyvitamin D3 levels may be related to increased exposure to UV light due to TE.
Serum Holotranscobalamine, Vitamin B12, Folic Acid and Homocysteine Levels in Alopecia Areata Patients
(informa Healthcare, 2013) Ertugrul, Derun Taner; Karadag, Ayse Serap; Takci, Zennure; Bilgili, Serap Gunes; Ozkol, Hatice Uce; Tutal, Emre; Akin, Kadir Okhan
Alopecia areata has been associated with many autoimmune diseases. There is a common belief that the prevalance of pernicious anemia is increased in patients with alopecia areata. In this study, we sought to investigate vitamin B12, folate and homocysteine metabolism in alopecia areata. We measured holotranscobalamine (holoTC), vitamin B12, folate and homocysteine levels in 75 patients with alopecia areata and 54 controls. We did not find any significant differences in these parameters between these groups. We think that alopecia areata may not be associated with vitamin B12 deficiency. The co-occurence of pernicious anemia and alopecia areata in rare autoimmune syndromes, may not justify routine measurements of these parameters in alopecia areata patients.