Browsing by Author "Tutal, Emre"

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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.
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.
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.