ACTA ENDOCRINOLOGICA (BUC)

Objective. We aimed to determine the risk of hypercalcemia in a geriatric population with very high dose levels of 25-hydroxy-vitamin D (25(OH)D). Patients and Method. This study was designed as a retrospective, cross-sectional two-center study for examining the elderly patients with very high 25(OH)D levels (>88ng/mL) between January 2014 and December 2019. After recruitment, subgroup analyses of the patients were performed based on their calcium and vitamin D levels. Results. A total of 81.101 elderly patients, who had been evaluated for their vitamin D levels, were screened. Of the 458 (0.6%) elderly patients with 25(OH)D>88 ng/ mL according to our criteria, 217 patients with complete data were accepted into our study. The median 25(OH)D level was 103.7ng/mL (min-max:88.2-275.9). Most of the elderly patients (86.6%) with very high 25(OH)D levels were normocalcemic. When patients with hypercalcemia were compared with normocalcemic group, no difference was observed in the levels of 25(OH)D, intact parathormone (iPTH), phosphorus, alkaline phosphatase (ALP), and their age. However, the PTH suppression rate was significantly higher in hypercalcemic group (p=0.005). Conclusion. The elderly patients with very high 25(OH)D levels would appear to be mostly normocalcemic whereas life-threatening hypercalcemia would also occur. Treatment and follow-up planning should be done according to the clinical guideline recommendations.

Objective. This study aims to investigate the factors affecting development of acute kidney injury (AKI) in patients with severe hypothyroidism. Methods. This retrospective observational study involved patients with primary hypothyroidism and thyroid stimulating hormone (TSH) levels of more than 50 mIU/L at their review in the endocrinology outpatient clinic, between January 2015 and April 2021. Factors affecting the development of AKI were examined by logistic regression analysis. Results. A total of 100 patients, 20 (11 male (M), 9 female (F)) in the AKI (case) group and 80 (23 M, 57 F) patients in control group, were included in our study. The median age of the case group (56 years, interquartile range (IQR) 44.3–68.5) was significantly higher than the control group (49 years, IQR 32.3–60; p = 0.027), and the ratio of males to females was significantly higher in the case group (p = 0.001). Multivariate logistic regression analyses showed that hypothyroidism diagnosed after the age of 60 years (odds ratio (OR) 59.674, 95% confidence intervals (CI) 5.955–598.031; p = 0.001), free triiodothyronine (FT3) < 1.3 pg/mL (OR 17.151, 95% CI 2.491–118.089; p = 0.004) and creatine kinase (CK) > 1000 U/L (OR 1.522, 95% CI 1.602– 82.848; p = 0.015) were predictors for the development of AKI in patients with severe hypothyroidism. Conclusion. We recommend close follow-up and monitoring of patients with AKI caused by severe hypothyroidism if patients who are diagnosed at age > 60 years, CK > 1000 U/L or FT3 < 1.3 pg/mL.

Objective. Obesity is a metabolic condition characterized by increased body fat mass. Increased prevalence of nonalcoholic steatohepatitis (NASH) and increased atherogenicity are closely associated with morbidity and mortality in obesity patients. In this study, we investigated the effect of orlistat, a gastrointestinal lipase inhibitor, on atherogenicity-related and NASH-related indexes in obese patients. Material and Methods. This retrospective study was completed with a total of 139 class III obesity patients with NASH who were admitted to our hospital, creating an orlistat treatment group and a control group. NASH-related indices and atherogenicity indices were calculated at the beginning of the study. These parameters were repeated in the 12th week of the study. Statistical analyzes were performed on the entire patient population and in groups classified according to body mass index (BMI) (BMI <40 kg/m2 and BMI ≥40 kg/m2). Results. As a result of our 12-week study, in addition to the improvement in glycemic parameters and lipid profile, atherogenic indexes (Triglyceride-Glucose index and Triglyceride-Glucose-BMI index) and NASH-related indices (Nonalcoholic Fatty Liver Disease Fibrosis Score, Fibrosis-4 Index, Aspartate aminotransferase-Platelet Ratio Index) superior improvements were achieved compared to the control group (p<0.001). These improvements were similar in groups separated by BMI (p>0.05). Conclusion. In addition to its proven body weight loss effect, Orlistat may be beneficial in the treatment of atherogenicity and steatohepatitis.