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Öğe Adaptation of the Problem Areas in Diabetes-Teen Scale into Turkish and examination of its psychometric properties: a validity and reliability study(Turkish J Pediatrics, 2024) Sari, Seda Aybuke; Agadayi, Ezgi; Celik, Nurullah; Karahan, Seher; Komurluoglu, Ayca; Doger, EsraObjective. Management of type 1 diabetes (T1DM) is quite challenging for both adolescents and their families. In this study, we aimed to translate the 14-item Problem Areas in Diabetes-Teen (PAID-T) scale, which measures variables that influence diabetes distress, to Turkish and investigate the Turkish version's reliability and validity. Methods. One hundred and ninety-four adolescents with T1DM participated in the study. PAID-T and forms for sociodemographic and diabetes characteristics were used for data collection. The scale's content validity was checked using the Davis technique. Cronbach's alpha was used to analyze the scale's internal reliability and the testretest for the scale's reliability. Exploratory factor analysis (EFA) was utilized to examine the factor structure. The fit of the scale was assessed using confirmatory factor analysis (CFA). Results. Of the participants, 54.6% (n=106) were girls. The content validity index values of the scale items ranged between 0.86 and 1.0. The PAID-T scores of girls and boys were similar. No significant difference was found between PAID-T scores with sociodemographic data and diabetes characteristics (p>0.05). The test-retest correlation coefficient of the scale was found to be 0.952. The three-factor (emotional burden, family and friend distress, and regimen-specific distress) model identified in EFA explained 61.8% of the common variance. Fit analysis was performed using CFA for the three-factor model, which did not show adequate fit (x2/df = 2.402, GFI = 0.822, CFI = 0.815, NFI = 0.727, NNFI = 0.772, RMSEA = 0.118). The Cronbach alpha value of the scale was 0.864. Conclusion. The Turkish version of the 14-item PAID-T showed moderate validity and strong reliability. Accordingly, it can be used as a reliable measurement tool to assess diabetes stress in adolescents with T1DM.Öğe Body Perception, Self-Esteem, and Comorbid Psychiatric Disorders in Adolescents Diagnosed with Polycystic Ovary Syndrome(Elsevier Science Inc, 2020) Sari, Seda Aybuke; Celik, Nurullah; Cicek, Ayla UzunStudy Objective: To investigate adolescents with polycystic ovary syndrome (PCOS) in terms of body perception, self-esteem, and comorbid psychiatric diseases by comparing them with their healthy peers. Design: Cross-sectional design. Setting: The Department of Child and Adolescent Psychiatry and the Department of Pediatric Endocrinology outpatient clinic of Cumhuriyet University in Sivas, Turkey. Participants: Fifty female adolescents aged 12-18 years who were diagnosed as having PCOS and 37 healthy adolescents aged 12-18 years. Interventions and Main Outcome Measures: All adolescents were evaluated by a child and adolescent psychiatrist using a semistructured interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children) and asked to complete the Rosenberg Self-Esteem Scale, Children's Depression Inventory, and Body Image Scale. Results: The rate of psychiatric disorders in the PCOS group was significantly higher than in the control participants (16/50 (32%) vs 5/37 (13.5%), respectively; P = .046). The most common disorder was major depressive disorder. The Rosenberg Self-Esteem Scale and Body Image Scale scores of the PCOS group were lower (P = .03; P ! .001, respectively), and Children's Depression Inventory scores were higher (P = .03) than in the control group. There was no significant relationship between obesity, hirsutism, and insulin resistance with any psychiatric disorders in the PCOS group. Conclusion: Adolescents with PCOS had more psychopathology than their peers. Moreover, their self-esteem was lower and their body perceptions were more dissatisfied compared with their peers.Öğe Clinical and genetic characteristics of patients with monocarboxylate transporter-8 deficiency: a multicentre retrospective study(Springer, 2024) Celik, Nurullah; Demir, Korcan; Dibeklioglu, Saime Ergen; Dundar, Bumin Nuri; Hatipoglu, Nihal; Mutlu, Gul Yesiltepe; Arslan, EmrullahAllan- Herndon-Dudley syndrome is a neurodevelopmental disorder characterized by motor and intellectual disabilities. Despite its rarity, there has been a rise in interest due to ongoing research and emerging therapy suggestions. In this multicenter, retrospective, cross-sectional study, the genetic characteristics and clinical data of twenty-one cases of genetically confirmed MCT8 deficiency were evaluated. The median age at the diagnosis was 2.4 ( 1.29; 5.9) years, which ranged from 0.5 to 14.0 years. The median follow-up period was 2.34 years, ranging from four months to 7.9 years. In 21 patients, 17 different variants were detected in the SLC16A2 gene. Eleven of these variants (c. 1456delC, c.439G > T, c.949C > A, c.1392dupC, c.1612C > T, c. 407dup, c. 781del, c.589C > A, c.712G > A, c. 311 T > A, c.1461del) have not been previously reported. In this study, with the exception of three cases with fT3/fT4 ratios of 4.95, 3.58, and 4.52, all cases exhibited fT3/fT4 ratios higher than five (9.9 (7.9; 12.0)). Conclusion: MCT8 deficiency is a rare and devastating disorder characterized by central hypothyroidism and peripheral thyrotoxicosis. The fT3/fT4 ratio can be used as a useful diagnostic indicator of MCT8 deficiency in males with mental and motor retardation. There is a need to raise clinicians' awareness of this potentially treatable condition with the emergence of new and promising treatments.Öğe Cognitive disengagement syndrome in children with type 1 diabetes: important implications for clinical outcomes(Springer-Verlag Italia Srl, 2024) Cicek, Ayla Uzun; Celik, NurullahAims Children with type 1 diabetes (T1D) are prone to a variety of psychiatric disorders, however, to date, no study has examined cognitive disengagement syndrome (CDS) in children with T1D. The present study aimed to evaluate the frequency of CDS symptoms in children with T1D and whether it is related to glycemic control. Methods This cross-sectional study included 74 children with T1D and 88 healthy (control) children, aged 8-14 years. All children were evaluated through a semi-structured psychiatric interview, the Kent-EGY test, porteus maze test, stroop test TBAG form, Barkley child attention scale, and Conners' parent rating scale-revised-short form. Result Children with T1D had considerably higher rates of elevated CDS symptoms than control children (35.1% vs. 10.2%, p < 0.001). Children with T1D performed poorly on attention and cognitive tests. High levels of CDS symptomatology were strongly associated with earlier diabetes onset age, longer disease duration, a higher percentage of diabetic ketoacidosis at diagnosis, higher HbA1c levels, and higher daily insulin dosages. Also, T1D patients with elevated CDS symptoms had lower IQ and attention scores and worse cognitive function performance compared to participants with low levels of CDS symptomatology. Conclusions Elevated CDS symptoms are significantly higher in children with T1D and are associated with poorer diabetes control. The routine psychiatric examination of children with T1D should also include a screening for CDS, particularly in patients with poor glycemic control.Öğe Diagnostic value of urinary luteinizing hormone levels in the monitoring of precocious puberty treatment(Sbem-Soc Brasil Endocrinologia & Metabologia, 2020) Yuce, Ozge; Bideci, Aysun; Celik, Nurullah; Camurdan, Orhun; Cinaz, PeyamiObjective: To determine whether first-voided urinary LH (FV-ULH) - level measurement can adequately assess pubertal suppression as much as standard tests can. Subjects and methods: The study group included patients with central precocious puberty and rapidly progressing early puberty who received up to 3 - 4 doses of GnRHa therapy monthly and did not have adequate hormonal suppression after GnRH stimulation (90-minute LH level > 4 IU/L). Design: All of the participants underwent an LHRH test just after admission to the study. According to the stimulated peak LH levels, the patients were divided into 2 groups and followed until the end of the first year of treatment.The concordance between FV-ULH and stimulated LH levels was assessed. Results: The FV-ULH levels in patients with inadequate hormonal suppression were significantly high compared to patients with adequate hormonal suppression. FV-ULH levels were very strongly correlated with stimulated LH levels (r = 0.91). Its correlation with basal LH levels was significant (r = 0.65). However, this positive correlation was modestly weakened after the first year of treatment.The cutoff value for FV-ULH of 1.01 mlU/mL had the highest sensitivity (92.3%) and specificity (100%). Conclusion: FV-ULH levels, using more reliable and sensitive assay methods, can be used to monitor the adequacy of GnRHa therapy.Öğe Evaluation of Serum Adipokine Levels in Girls With Central Precocious Puberty(Wiley, 2024) Caglayan, Ilkin Seda Can; Celik, Nurullah; Bolat, SerkanPurpose: Adipose tissue has an important endocrine function by secreting a variety of hormones known as adipokines, such as Visfatin, Omentin-1 and Chemerin. On the other hand, these hormones are also secreted from places other than fatty tissues in the girl's genital system. The goal of this study was to demonstrate the secretory status of adipokines in patients with central precocious puberty (CPP) and their utility in the diagnosis of precocious puberty. Method: A total of 105 patients were included in the study (53 in the CPP group and 52 in the control group). The following were used as the CPP diagnostic criteria; breast development, basal LH measurement higher than 0.3 IU/L, peak LH level >= 5 IU/L, peak LH/FSH ratio >= 0.66 (after 0.1 mg GnRH stimulation test) and a difference of at least 1 year between bone and chronological age. Results: A statistically significant difference was detected between the groups in serum Omentin-1 and Chemerin levels, and no significant differences were detected between the groups in Visfatin values. The cut-off values for the diagnosis of CPP were calculated as <= 48.9 with 81% sensitivity and 54% specificity for Omentin-1, and as >= 417 with 85% sensitivity and 60% specificity for Chemerin. Conclusion: In our study, we found that Omentin-1 level decreased and Chemerin level increased in lean girls with CPP. More studies are needed to elucidate how adipokines play roles in explaining the onset of CPP, and whether they may be used as a reliable marker for the diagnosis of CPP.Öğe Evaluation of Subclinical Inflammation in Children with Premature Adrenarche(Erciyes Univ Sch Medicine, 2022) Koylu, Gozde; Celik, Nurullah; Dogan, Halef OkanObjective: The objectives of this study were to compare the serum inflammatory markers, interleukin-6 (IL-6), highly sensi-tive C-reactive protein (hs-CRP), and fetuin-A, in patients with premature adrenarche (PA) and the control group.Materials and Methods: This single-center cross-sectional study included 85 non-obese and pre-pubertal children. After 8-12 h of fasting, blood glucose, HDL, LDL, triglyceride, cholesterol, insulin, dehydroepiandrosterone sulfate, total testos-terone, 17-OH PG, IL-6, hs-CRP, and Fetuin-A levels were measured and compared in a convenience sample of PA (n=35) and a healthy volunteers of control (n=50) group.Results: The mean age (7.34 +/- 0.62 years vs. 7.09 +/- 0.77 years, respectively) and sex (82% girl vs. 80% girl, respectively) of the PA and control groups were similar (p>0.05). Fasting insulin levels (10.9 +/- 6.21 Uu/mL vs. 7.4 +/- 5.9 Uu/mL; p<0.001), HOMA-IR (2.06 +/- 0.63 vs. 1.36 +/- 1.00; p=0.017), FGIR (11.31 +/- 5.60 vs. 16.46 +/- 8.52; p=0.004), and QUICKI (0.35 +/- 0.02 vs. 0.37 +/- 0.03; p<0.001) levels were different in PA and control groups. IL-6 level higher in PA group than controls [2.7 (3.30) pg/mL vs. 3.02 (1.31) pg/mL, p=0.035], while plasma Fetuin-A [522.02 (715.86) mg/L; 519.4 (945.97) mg/L, p=0.434] and hs-CRP [0.73 (1.02) mg/dL; 1.0 (1.12) mg/dL, p=0.439] levels were similar. IL-6 cutoff value for PA was calculated as 2.06 with 72.7% sensitivity and 48.8% specificity for all study groups (AUC=0.641, p=0.036). Conclusion: The high IL-6 levels may be an indicator of chronic subclinical inflammation in PA cases. These children should be followed closely in terms of metabolic disorders.Öğe Predictive markers of metabolically healthy obesity in children and adolescents: can AST/ALT ratio serve as a simple and reliable diagnostic indicator?(Springer, 2024) Celik, Nurullah; Unsal, Gulsah; Tastanoglu, HuseyinThis study aimed to estimate the prevalence of metabolically healthy obesity (MHO) according to two different consensus-based criteria and to investigate simple, measurable predictive markers for the diagnosis of MHO. Five hundred and ninety-three obese children and adolescents aged 6-18 years were included in the study. The frequency of MHO was calculated. ROC analysis was used to estimate the predictive value of AST/ALT ratio, waist/hip ratio, MPV, TSH, and Ft4 cut-off value for the diagnosis of MHO. The prevalence of MHO was 21.9% and 10.2% according to 2018 and 2023 consensus-based MHO criteria, respectively. AST/ALT ratio cut-off value for the diagnosis of MHO was calculated as >= 1 with 77% sensitivity and 52% specificity using Damanhoury et al.'s criteria (AUC = 0.61, p = 0.02), and 90% sensitivity and 51% specificity using Abiri et al.'s criteria (AUC = 0.70, p = 0.01). Additionally, using binomial regression analysis, only the AST/ALT ratio is independently and significantly associated with the diagnosis of MHO (p = 0.03 for 2018 criteria and p = 0.04 for 2023 criteria).Conclusion: The ALT/AST ratio may be a useful indicator of MHO in children and adolescents.What is Known:center dot Metabolically healthy obesity refers to people who are obese but do not have any of the standard cardio-metabolic risk factors.center dot Metabolically healthy obesity is not entirely harmless; the metabolic characteristics of individuals with this phenotype are less favorable than those of healthy lean groups. Moreover, it is not a constant state, and there may be a transition to metabolically unhealthy phenotypes over time.What is New:center dot The prevalence of MHO is 21.9% and 10.2% according to 2018 and 2023 consensus-based metabolically healthy obesity criteria, respectively.center dot The ALT/AST ratio may be a useful indicator of metabolically healthy obesity in children and adolescents.Öğe Psychometric Properties of the Turkish Validity and Reliability of the Parent Diabetes Distress Scale(Galenos Publ House, 2023) Karahan, Seher; Agadayi, Ezgi; Sari, Seda Aybuke; Celik, Nurullah; Tan, Ayca Komurluoglu; Doger, EsraObjective: The aim of this study was to evaluate the validity and reliability of the Turkish translation of the Parent Diabetes Distress Scale (PDDS). Methods: The PDDS is a 5-point Likert-type scale with 20 items. After obtaining permission from the scale developers, the study commenced. First, a systematic adaptation of the scale into the Turkish language was performed including translation, expert panel review, back translation, and pilot study. Test-retest was applied to 35 participants. After these procedures, data collection was undertaken using the adapted PDDS and a demographic data collection form. The collected data were analyzed for reliability, including stability of the scale with test-retest and internal consistency of the scale (Cronbach's alpha), and validity including construct validity of the scale with confirmatory factor analysis (CFA). Results: The parents of 210 teenagers, aged >11 and <18 years, who had been diagnosed with type 1 diabetes mellitus for at least one year were included. Of these parents, 71.9% (n=151) were mothers and 53.3% (n=112) of the children were girls. The Cronbach's a value was 0.906. The results of the CFA were.2/df=4.406, p<0.001, comparative fit test 0.704, and goodness of fit tests 0.749. The mean total PDDS score was 2.2 +/- 0.7. These results indicate that scores of 1.6 points or less was evaluated as little or no distress 1.7-2.4 as moderate distress, and >2.4 points as high distress. This showed that the majority of the parents in the study experienced moderate or severe diabetes-related distress. Conclusion: The Turkish version of the PDDS fulfilled the validity and reliability tests at an acceptable level.Öğe Sleep quality and glycemic control in children and adolescents with type 1 diabetes mellitus(2023) Berk, Erhan; Celik, NurullahAbstract. – OBJECTIVE: This study aimed to investigate the frequency of sleep disorders, and the relationship between glycemic control and sleep characteristics in diabetic children and adolescents. PATIENTS AND METHODS: Sixty-one pa tients followed for at least one year for type 1 diabetes mellitus (T1DM) aged 6-16 years old, and eighty-three group-matched healthy con trols were included in the study. Time in range (TIR) and hypoglycemia episode numbers were recorded using the freestyle libre sensor data. The sleep characteristics were evaluated using the Sleep Disturbance Scale for Children (SDSC) validated survey. The diabetic patients were tri chotomized according to SDSC scores, as low, medium, and high score groups. RESULTS: Sleep duration, SDSC total score, and subgroup scores except for sleep hyperhi drosis (3.11±1.53 vs. 2.16±0.85, p<0.001, respec tively) were similar (p>0.05) between the dia betic and control group. According to the sur vey, 1.6% of diabetic cases and 6.1% of the con trol group had clinically significant sleep distur bances (p>0.05). Duration of diabetes (DD) was lower (p=0.01), and the level of HbA1C was high er (p=0.02) in the high-score group than the oth ers. Regression analysis revealed that TIR was the only independent determinant for the SDSC score (β=-1.27, t=-1.90; p=0.012). CONCLUSIONS: Sleep habits and problems should be routinely evaluated in diabetic chil dren and adolescents.Öğe The Turkish version of the problem areas in diabetes-parents of teens (P-PAID-T): Cross-cultural adaptation, reliability, and validity(Elsevier Science Inc, 2023) Sari, Seda Aybuke; Agadayi, Ezgi; Celik, Nurullah; Karahan, Seher; Tan, Ayca Komurluoglu; Doger, EsraObjective: To examine the Turkish validity and reliability of the Problem Areas in Diabetes-Parents of Teens (P PAID-T) scale and its psychometric properties for determining the parents' diabetes-related distress.Methods: The study included the parents of 200 adolescents with T1DM for at least a year. P-PAID-T and a demographic data form were used for data collection. Davis technique was used for the content validity of the scale. The scale's reliability was tested using test-retest, and its internal reliability was analyzed with Cronbach's alpha test. Exploratory Factor Analysis (EFA) was used to analyze the factor structure. Confirmatory Factor Analysis (CFA) was used to evaluate the fit of the scale.Results: 69.5% (n = 139) of the participants were mothers. Compared to the fathers, the mothers' mean P-PAID-T score was significantly higher. Parents of sons, who used insulin injections for their children, and had a college degree or higher education level had higher P-PAID-T scores. The test-retest correlation coefficient of the scale was 0.977. The Cronbach alpha value of the scale was 0.901. The results of confirmatory factor analysis were x2/df = 2.931, GFI = 0.736, CFI = 0.711, NFI = 0.628, NNFI = 0.660, RMSEA = 0.141.Conclusion: The Turkish version of P-PAID-T was a valid and reliable screening tool for measuring diabetes stress in parents of adolescents with T1DM. Practice implications: Nurses could use the Turkish version of P-PAID-T to monitor parental diabetes distress and organize interventions; also Turkish P-PAID-T could facilitate research on diabetes distress for parents of adolescents with T1DM.Öğe Turkish Validity and Reliability of the Sleep Disturbance Scale for Children(Galenos Publ House, 2020) Agadayi, Ezgi; Celik, Nurullah; Baser, Duygu AyhanObjective: This study evaluates the validity and reliability of the Turkish version of the Sleep Disturbance scale for Children (SDSC). Materials and Methods: SDSC is a Likert-type scale with 26 items and 6 subscales used to investigate sleep disturbances in school-age children. The SDSC is completed by the parent based on the preceding 6 months. The study was started after obtaining permission from the scale owner. First, an orderly adaptation of the scale to the Turkish language was performed (translation, expert panel, back translation, pilot study). Test-retest was applied to 30 participants. After these procedures, data collection was started with SDSC and demographic data form. The collected data were analyzed for reliability (stability of the scale with test-retest; internal consistency of the scale with Cronbach's alpha) and validity (construct validity of the scale with confirmatory factor analysis). T-score table was created for SDSC and its subscales. Results: Overall, 328 participants attended the study. Of these, 51.5% were females and 48.5% were males. The mean age was 10.3 +/- 2.8 years (min: 6; max: 16 years). The Cronbach alpha value, which tested the scale's internal consistency, was 0.79. Confirmatory factor analysis revealed X-2/df=2.003, p<0.001, CFI =0.845, GFI =0.875, and RMSEA =0.055. The mean of the SDSC total score was 40.6 +/- 10.1 (min: 26; max: 86). The total SDSC score of 13 children (4%) were clinically significant in terms of sleep disturbance (T-score >70). Conclusion: The Turkish version of SDSC fulfilled the validity and reliability tests at an acceptable level.
