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    Chronic obstructive pulmonary disease may be one of the terminal end points of metabolic syndrome
    (Professional Medical Publications, 2012) Helvaci, Mehmet Rami; Aydin, Leyla Yilmaz; Aydin, Yusuf
    Objective: We tried to understand presence of any effect of excess weight on respiratory system by means of excessive adipose tissue functioning as an endocrine organ and causing a pulmonary inflammation. Methodology: Mild (stage 1), moderate (stage 2), and severe (stage 3 and 4) chronic obstructive pulmonary disease (COPD) patients were detected, and compared according to the metabolic parameters in between. Results: There were 145, 56, and 34 patients in the mild, moderate, and severe COPD groups, respectively. The mean age increased gradually (52.4, 56.4, and 60.0 years) from the mild towards the severe COPD groups, respectively (p<0.05 nearly in all steps). Similarly, the mean pack-years increased gradually and significantly (26.7, 34.8, and 36.8 pack-years) in the same direction (p<0.05 nearly in all steps). Parallel to them, the mean body mass index increased up to the moderate COPD cases (28.2 versus 29.6 kg/m2, p=0.039), and then decreased significantly (29.6 versus 26.8 kg/m2, p=0.006). Conclusion: The metabolic syndrome includes some reversible indicators such as overweight, hyperbetalipoproteinemia, hypertriglyceridemia, dyslipidemia, impaired fasting glucose, impaired glucose tolerance, and white coat hypertension for the development of terminal diseases including obesity, hypertension, diabetes mellitus, peripheral artery disease, coronary heart disease, and stroke. In our opinion, COPD may be one of the terminal end points of the syndrome.
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    Digital clubbing and metabolic syndrome
    (Medi+World Int, 2011) Helvaci, Mehmet Rami; Aydin, Leyla Yilmaz; Maden, Emin; Aydin, Yusuf
    Background: Any relationship between clubbing and metabolic syndrome was studied. Methods: The study was performed in the Internal Medicine Polyclinic. Results: The study included 224 cases (104 with clubbing), in total. The mean age of clubbing cases was 49.2 years, and there was a male predominance (81.7%). There were significantly higher prevalences of smoking and chronic obstructive pulmonary disease (COPD) in the clubbing group (69.2 vs 41.6% and 27.8 vs 10.8%, respectively, p<0.001 for both). Although the body mass index (BMI), weight, and fasting plasma glucose (FPG) were lower in the clubbing group, the differences were nonsignificant probably due to the small sample size, although the negative effect of small sample size, and prevalence of type 2 diabetes mellitus (DM) was significantly lower in the clubbing group (12.5 vs 21.6%, p<0.05). Mean low density lipoprotein cholesterol and triglyceride values were higher in the clubbing group, non-significantly. Although both the systolic and diastolic blood pressures (BP) were lower in the clubbing group, the difference was only significant for systolic BP (127.6 vs 136.9 mmHg, p=0.011). On the other hand, prevalence of coronary heart disease (CHD) and/or peripheric artery disease (PAD) were significantly higher in the clubbing group (7.6 vs 0.0%, p<0.01). Conclusion: There are direct relationships between clubbing and prevalence of smoking, COPD, CHD and PAD, probably due to the atherosclerotic effects of smoking, whereas BMI, weight, FPG, systolic and diastolic BPs and prevalence of DM are inversely related with clubbing, probably due to suppressor effects of smoking on appetite.
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    Digital clubbing may be an indicator of systemic atherosclerosis even at microvascular level
    (Drunpp-Sarajevo, 2012) Helvaci, Mehmet Rami; Aydin, Leyla Yilmaz; Aydin, Yusuf
    Background: Presence of any relationship between digital clubbing and microvascular atherosclerosis was tried to be understood. Methods: Cases with digital clubbing and controls were studied. Results: The study included 104 cases with clubbing and 120 controls. Mean age of clubbing cases was 49.2 years, and there was a male predominance (81.7%) among them. There were significantly higher prevalences of smoking and chronic obstructive pulmonary disease (COPD) in the clubbing group (69.2 versus 41.6% and 27.8 versus 10.8%, respectively, p<0.001 for both). Although body mass index (BMI), weight, and fasting plasma glucose (FPG) were lower in the clubbing group, the differences were nonsignificant probably due to the small sample sizes. Although the negative effect of small sample sizes, prevalence of type 2 diabetes mellitus (DM) and mean value of systolic blood pressure (BP) were significanlty lower in the clubbing group (12.5 versus 21.6% and 127.6 versus 136.9 mmHg, respectively, p<0.05 for both). On the other hand, prevalence of coronary heart disease (CHD) and/or peripheric artery disease (PAD) were significantly higher in the clubbing group (7.6 versus 0.0%, p<0.01). Conclusions: There are significant relationships between digital clubbing and smoking, COPD, and CHD and/or PAD probably due to strong atherosclerotic effects of smoking with highly suspected atherosclerotic background of COPD. Whereas the BMI, weight, FPG, systolic BP, and prevalence of DM are inversely related with digital clubbing probably due to suppressor effects of smoking on appetite. So clubbing may be a significant indicator of systemic atherosclerosis even at microvascular level.
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    Effects of season-induced hormonal changes on mortality
    (Medi+World Int, 2012) Helvaci, Mehmet Rami; Ari, Mustafa; Maden, Emin; Aydin, Leyla Yilmaz; Aydin, Yusuf; Ozer, Cahit
    Background: We tried to understand whether or not there are some seasonal differences in human mortality rates in the present study. Methods: The study was performed in the General Internal Medicine and Hematology Clinics between March 2007 and December 2010. All hospitalized cases in these units during the 45-month period were included into the study. The total number of deaths in each season were detected and compared. Results: There were 68 deaths during the period, with various causes. Although there were only three deaths in July, there were nine in October. In other words, the total number of deaths was the highest in autumn with 22 deaths (32.3% of all) in the 45-month period, totally. It was 13 (25.4%) in winter, 16 (23.5%) in spring, and 17 (25.0%) in the summer. Although there is obvious difference in the number of deaths between autumn and the other seasons, the difference was statistically nonsignificant probably due to the small number of death cases (p= 0.481). Conclusion: Although seasonal differences of human mortality rates were statistically nonsignificant, this was probably due to the small number of death cases of the present study; there may actually be a significant increase in autumn with unexplained reasons yet. Relative hormonal insufficiencies during the passage from a summer-like relaxed, to an autumn-like stressful season may be one of the causes. If so, it can be prevented by some hormonal replacement therapies, thus this theory should be searched with a higher number of cases in a more detailed approach.