Bağdagül Yüksel Güler

Objective: Dynapenia is increasingly recognized as a distinct clinical phenotype. However, its clinical significance in adults living with obesity, including its associations with psychological symptoms, cognitive function, and comorbidity burden, remains insufficiently characterized. This study aimed to evaluate the prevalence of dynapenia and its metabolic, psychological, and clinical correlates in adults living with obesity. Methods: This cross-sectional study included 140 adults living with obesity recruited from a tertiary endocrinology clinic. Handgrip strength was measured using a digital dynamometer and categorized as weak (dynapenic), normal, or strong according to age- and sex-adjusted reference values. Body composition was assessed using bioelectrical impedance analysis. Cognitive function, depressive symptoms, comorbidity burden, and physical activity levels were evaluated using the AD8 Dementia Screening Interview, Beck Depression Inventory (BDI), Charlson Comorbidity Index (CCI), and International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. Group comparisons were performed using non-parametric tests, and correlations were assessed using Spearman coefficients. Results: Dynapenia was present in 20.0% of participants. Compared with strong individuals, those with dynapenia had higher body fat percentage, lower appendicular skeletal muscle mass index, and lower hemoglobin and creatinine levels (all P < .01). Dynapenia was also associated with a higher prevalence of hypothyroidism and a greater depressive symptom burden. Handgrip strength correlated positively with ASMI (ρ = 0.320, P < .001), creatinine (ρ = 0.245, P = .004), and hemoglobin (ρ = 0.249, P = 0.004), and negatively with body fat percentage (ρ = −0.374, P < .001) and BDI scores (ρ = −0.181, P = .036). No significant correlation was observed with AD8 scores. Higher CCI scores were associated with lower muscle strength. Conclusion: Dynapenia is common among adults living with obesity and is associated with adverse body composition, reduced biochemical markers of muscle integrity, greater depressive symptom burden, and higher comorbidity burden. Handgrip strength represents a simple, rapid, and integrative clinical marker that may support early risk stratification in obesity care. Cite this article as: Erdem M, Yıldırım S, Yılmaz SK, Doğan ŞE, Yüksel B. Handgrip strength as a multidimensional marker in adults living with obesity. Endocrinol Res Pract. Published online September 1, 2026. doi: 10.5152/erp.2026.26934.

Aims: Subacute thyroiditis (SAT) is a self-limiting inflammatory thyroid disorder that frequently presents with neck pain, systemic symptoms, and biochemical thyrotoxicosis. Delayed recognition of SAT may lead to repeated healthcare visits, inappropriate antibiotic use, and postponement of appropriate treatment. This study aimed to evaluate healthcare-seeking behavior, referral patterns, antibiotic use, and treatment approaches among patients diagnosed with SAT at a tertiary referral center. Additionally, demographic characteristics of patients diagnosed during the study period were assessed. Methods: In this retrospective cross-sectional study, medical records of patients evaluated for SAT in the Endocrinology Department of Sincan Training and Research Hospital between June 2023 and March 2025 were reviewed. Among 117 identified cases, 100 patients with confirmed SAT and complete clinical data were included in the analysis. Demographic characteristics, departments visited before endocrinology referral, time from symptom onset to endocrinology evaluation, antibiotic use, laboratory findings, thyroid ultrasonography results, and treatment methods were analyzed. Results: The study population consisted predominantly of female (74%), with a mean age of 45.4±9.9 years. The mean interval between symptom onset and endocrinology referral was 23.7±17.3 days. Prior to endocrinology evaluation, patients most frequently presented to internal medicine (45.6%) and otorhinolaryngology (14.4%) clinics. Notably, some patients sought care from multiple specialties, including emergency departments. Elevated inflammatory markers were observed at presentation, with mean erythrocyte sedimentation rate and C-reactive protein levels of 52.7±30.8 mm/h and 7.9±18.0 mg/dl, respectively. Before receiving a diagnosis of SAT, 42% of patients had been prescribed antibiotics, most commonly cephalosporins and amoxicillinclavulanate. Typical ultrasonographic findings of SAT were present in 80% of patients. Following diagnosis, the most frequently prescribed treatment regimen was a combination of nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids (42%), followed by NSAID monotherapy (27%) and corticosteroid monotherapy (26%). Conclusion: A substantial proportion of patients with SAT underwent evaluation by multiple healthcare providers and received unnecessary antibiotic treatment before referral to endocrinology services. These findings underscore the continuing challenges in early recognition of SAT and the importance of increasing clinical awareness, particularly among first-contact healthcare providers. Earlier identification of SAT may reduce diagnostic delays, minimize inappropriate antibiotic use, and facilitate timely initiation of appropriate therapy.

Aims: Our study aimed to investigate the impact of metabolic parameters, specifically insulin level and body-mass index (BMI), on the thyroid gland, considering both morphological and functional aspects. For this purpose, we performed a cross-sectional analysis with euthyroid participants.Methods: One hundred euthyroid adults without thyroid autoimmunity or nodules were included. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), fasting insulin levels (FPI), and glucose/insulin values from a 2-hour OGTT were recorded. Anthropometric measures, including BMI and waist circumference (WC), were obtained, and thyroid volume (TV) was measured by ultrasound. The relationship between TV, hormone levels, and metabolic parameters was analyzed.Results: A significant positive relationship was observed between TV and multiple parameters, including BMI, HOMA-IR, HbA1c, FPG, and FPI. Regression modeling identified OGTT 2nd-hour insulin and WC as significant predictors of thyroid volume. Furthermore, FT3 concentrations correlated positively with BMI, WC, HOMA-IR, and FPI measurements.Conclusion: Increased TV appears to be associated with obesity and higher HOMA-IR, whereas FT3 levels show a positive correlation with both. These findings imply a significant interplay between insulin level, adiposity, thyroid gland morphology, and thyroid hormone metabolism.

Objective: To investigate the clinical characteristics of patients with gestational transient thyrotoxicosis and its possible impacts on pregnancy. Methods: This retrospective study included pregnant women with gestational transient thyrotoxicosis who were admitted to our endocrinology outpatient clinic from June 2020 to March 2023. Patients with other causes of thyrotoxicosis, such as Graves’ disease, toxic nodular goiter, and subacute thyroiditis, were excluded. Results: The study included 50 pregnant women who met the inclusion criteria and whose data could be accessed. [...] Abstract Objective: To investigate the clinical characteristics of patients with gestational transient thyrotoxicosis and its possible impacts on pregnancy. Methods: This retrospective study included pregnant women with gestational transient thyrotoxicosis who were admitted to our endocrinology outpatient clinic from June 2020 to March 2023. Patients with other causes of thyrotoxicosis, such as Graves’ disease, toxic nodular goiter, and subacute thyroiditis, were excluded. Results: The study included 50 pregnant women who met the inclusion criteria and whose data could be accessed.

It is known that the use of inhaled corticosteroids increases the incidence of pneumonia in patients followed up with the diagnosis of chronic asthma and chronic obstructive pulmonary disease (COPD). This study aimed to investigate the contribution of inhaled steroid use to pneumonia severity and mortality in cases with COVID-19 pneumonia. The study is a retrospective, observational study. Among the cases admitted to the pandemic clinic, patients diagnosed with COVID-19 pneumonia were included. The plan was to compare cases who received and did not receive inhaled corticosteroids in terms of pneumonia severity and mortality. In order to define risk factors for mortality, univariate and multivariable negative binomial regression analyses were performed. In our study, it was observed that n= 540 (75%) cases did not receive inhaled corticosteroids (group 1), and 180 (25%) cases used inhaled corti costeroids (group 2). Group 1 and group 2 cases were compared in terms of pneumonia severity with no significant difference between the two groups (p= 0.11). Then, risk factors affecting mortality in all cases were examined with univariate analyses. Increasing age, applying mechanical ventilation, having severe pneumonia, having interstitial lung disease, and applying prone position were found to be statistically significant factors in mortality (p < 0.05). In conclusion, in our study, it was observed that the use of inhaled corticosteroids did not increase the severity of pneumonia and mortality. It was thought that the treatment they received could be continued when the patients treated with inhaled corticosteroids due to asthma and COPD had COVID-19 pneumonia.

Objective Artificial intelligence (AI) has significant potential in healthcare, particularly in providing decision-support in specialized domains like thyroid nodule management. This study assesses the effectiveness of ChatGPT-v4, an advanced AI model, in aligning with the European Thyroid Association (ETA) - 2023 guidelines. Methods The study utilized a structured questionnaire comprising 100 questions, divided into true/false and multiple-choice formats, reflecting real-world clinical scenarios in thyroid nodule management. These questions encompassed diagnostic criteria, treatment options, follow-up protocols, and patient counseling. ChatGPT response was evaluated for accuracy, consistency, and comprehensiveness using a six-point Likert scale. The assessment occurred initially and was repeated after 14 days. Results In the binary queries, the AI model showed an ability to correct some initially incorrect responses. However, there was a noticeable regression in certain responses. 8 of the 11 previously non-compliant responses remained unchanged, while 3 non-compliant responses were rectified. Conversely, 6 initially compliant answers transitioned to non-compliance after 14 days. In multiple-choice queries, the AI’s performance was more consistent. A majority of the responses, 43 (86% of the total), were initially correct and maintained their correctness upon re-assessment. However, 4 responses that were initially incorrect remained unchanged, and 3 correct responses shifted to non-compliance over time. Conclusion ChatGPT exhibited improving potential as a clinical support tool in thyroid nodule management altgouh it showed varied performance for binary and multiple-choice questions. Clinical trial registration N/A

Context: The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. Methods: This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19–related SAT (Cov-SAT), SARS-CoV-2 vaccine–related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. Results: Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. Conclusion: Since there is no difference in terms of follow-up parameters and outcomes, COVID-19– and SARS-CoV-2 vaccine–related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism.

Objectives: This study aimed to investigate the triglyceride-glucose (TyG) index, which is a simple surrogate marker of insulin resistance that is associated with various cardiometabolic diseases, in patients with Klinefelter syndrome (KS). Subjects and methods: A total of 30 patients with KS (mean age: 21.53 ± 1.66 years) and 32 healthy controls (mean age: 22.07 ± 1.01 years) were included in the study.The clinical and laboratory parameters,TyG index, asymmetric dimethylarginine (ADMA) level, homeostatic model assessment of insulin resistance (HOMA-IR) [...] ABSTRACT Objectives: This study aimed to investigate the triglyceride-glucose (TyG) index, which is a simple surrogate marker of insulin resistance that is associated with various cardiometabolic diseases, in patients with Klinefelter syndrome (KS). Subjects and methods: A total of 30 patients with KS (mean age: 21.53 ± 1.66 years) and 32 healthy controls (mean age: 22.07 ± 1.01 years) were included in the study.The clinical and laboratory parameters,TyG index, asymmetric dimethylarginine (ADMA) level, homeostatic model assessment of insulin resistance (HOMA-IR)