Polat, Seher; Şimşek, Yasin

Objective: Polycystic ovary syndrome (PCOS) is one of the most common endocrine-reproductive-metabolic disorders of women at reproductive age, affecting 5-15% of the women worldwide. Although the pathogenesis of PCOS is not well defi-ned, it is associated with an increased risk of premature coronary artery disease (CAD). Hyperhomocysteinemia (HHcy) is associated with hyperlipidemia and is an independent risk factor for CAD. The most common cause of HHcy is related to the deficiency of methylenetetrahydrofolate reductase (MTHFR). This study aimed to investigate the relationship between different genotypes of MTHFR C677T and the risk of PCOS. Material and Methods: Two hundred twenty voluntary premenopausal women (110 healthy controls and 110 PCOS patients) were in-cluded in the study. All the volunteers underwent a physical examination along with biochemical hormonal evaluation and genetic analysis. Results: The genotyping analyses and genetic model of inheritance analyses revealed that the frequencies of CC, CT, and TT genotypes in the control and PCOS group to be 51.8%, 45.5%, and 2.7% and 51.8%, 48.2%, and 0%, respectively. The frequency of C and T alleles in the control and PCOS group was determined to be 74% (C: 0.74/155) and 26% (T: 0.26/53), and 75% (C: 0.75/167) and 25% (T: 0.25/53), respectively. The “T” additive, “T” dominant, and “C” recessive models it found that the CT vs. CC (OR:1.06 Cl:0.62-1.83), CC vs. TC+TT (OR: 0.99 Cl: 0.58-1.72), and TC+TT vs. CC (OR: 0.99 Cl: 0.58-1.70), respectively, did not show an increase in the PCOS risk. Conclusion: Our findings indicated that the different genotypes of MTHFR C677T were not associated with the risk of PCOS in Turkish women from Central Anatolia.

Akbas, Emin Murat; Güngör, Adem; Arslan, Volkan

Metformin-associated lactic acidosis in a diabetic patient is a rare and severe complication. The severity of the condition is associated with the underlying disease. The diagnosis may be delayed due to its rarity and the fact that its symptoms and signs are frequently confused with other pathologies. In such cases, generally, the underlying renal disease helps to establish the diagnosis. In this paper, we present the case of lactic acidosis in a patient without a serious underlying disease who was using metformin, ramipril and spironolacton for diabetes and hypertension. The level of blood creatinine was found to be 1.4 mg/dL. It should be kept in mind that metformin can cause life-threatening lactic acidosis, especially in patients using renin-angiotensin-aldosterone system blockers, even without a serious deterioration in renal functions.

Akbaş, Emin Murat; Bilen, Habib; Güngör, Adem; Çapoǧlu, Ilyas; Başçi, Hümeyra

The occurrence of metastatic insulinoma in a patient with pre-existing diabetes is extremely rare. We report the case of a diabetic patient who had frequent hypoglycemic episodes, apparently related to metastatic insulinoma. A 47-year-old woman with type 2 diabetes mellitus who had been treated with a sulfonylurea for 10 years began experiencing frequent episodes of hypoglycemia even after complete withdrawal of the hypoglycemic agent. Endogenous hyperinsulinism was found using a prolonged fasting test. Computed tomography identified a pancreatic tumor with metastatic liver lesions and peripancreatic lymphadenopathies. Ultrasound-guided hepatic mass biopsy was performed and the pathology examination of the tumor demonstrated a neuroendocrine tumor. The patient refused surgery; octreotide (10 mg) was administered. A few days later, the patient had no further episodes of hypoglycemia. Although the coincidence of insulinoma and diabetes is extremely rare, after excluding common reasons for hypoglycemia in diabetic patients, insulinoma must be considered.