ÖZET Amaç: Adiposit kaynaklı hormon olarak bilinen Leptin, beslenme ve enerji homeostazinda önemli rol oynamaktadır. Leptin, reseptörleri aracılığıyla merkezi veya periferik kompleks biyolojik etkileri düzenler. Obezite ve ilişkili Leptin direncini bağlayan mekanizmalar büyük ölçüde belirsizliğini korumaktadır. Ayrıca vitamin D'nin kalsemik olmayan etkileri, glikoz metabolizmasının hormonal regülasyonu ve adipokinlerin yağ dokusu ile sentezi üzerinde perspektif rol oynar. Çalışmamızın amacı, vitamin D düzeylerinin obezite üzerindeki rolünü ve obez hastalarda D vitamini farklılaşması sırasındaki Leptin düzeylerinin aktivitesini göstermektir. Gereç ve Yöntemler: Vitamin D düzeylerini analiz etmek için 40 obez ve sağlıklı hasta bu çalışmaya dâhil edildi. Düşük vitamin D düzeyi görülen bireylerde, 4 hafta vitamin D tedavisi uygulandı. Leptin ölçümü için tüm deney gruplarından kan alındı. Bulgular: D vitamini düzeyi düşük olan hasta grubunda, Leptin ekspresyonunun azaldığı görülürken; D vitamini takviyesi sırasında, obez hastalarda Leptin seviyeleri anlamli duzeyde artmıştır. Bu, Leptinin, vitamin D düzeyi ile doğrudan ilişkisi olan obeziteyi tespit etmek için önemli bir belirleyici olduğu anlamına gelir. Sonuç: Bu sonuçlar serum vitamin D seviyelerinin arttırılmasının Leptin duyarlılığında iyileşme sağladığını göstermektedir. Gelecekteki klinik denemeler test edilmelidir. Vitamin D değişikliği, Leptin salgılanmasına bağlı obezite için tanısal bir faktör olabilir. Anahtar Kelimeler: Beden Kitle Indeksi; Leptin Ekspresyonu; Obezite; Vitamin D ABSTRACT Objective: Adipocyte-induced hormone Leptin, nutrition and energy play an important role in homeostasis. Leptin regulates central or peripheral complex biological effects through its receptors. The mechanisms linking obesity and associated Leptin resistance remain largely unclear. Also noncalcaemic effects of vitamin D, perspective role is played on hormonal regulation of glucose metabolism and synthesis of adipokines by fat tissue. The aim of our study is to show the role of vitamin D levels on obesity and the activity of Leptin levels during vitamin D differentiation on obese patients. Material and Methods: Fourty obese and healthy patients were included this research to analyze vitamin D levels. While seen low-vitamin D level in individuals, 4 weeks vitamin D treatment has been completed. Whole experimental groups were taken blood for Leptin measurement. Results: Our findings were indicated that Leptin expression was decreased when vitamin D level in low. However, during vitamin D uptake, Leptin levels in obese patients were increased correlated to deficiency. That means, Leptin is known significant marker to detect obesity which has direct relation with vitamin D level. Conclusion: These results highlight that reduction serum vitamin D levels leads to improved Leptin sensitivity. Future clinical trials should be tested vitamin D alteration might be diagnostic factor for obesity treatment to Leptin secretion. Keywords: Body Mass Index; Leptin Expression; Obesity; Vitamin D Level

Objective: The aim of this study was investigate whether or not lumbar spinal stenosis (LSS) had effect onpain, daily living activities and muscular activation.Material and Methods: Individuals diagnosed as lumbar spinal stenosis with average of 55,19 ± 10,41 yearsold was included to the study. Individuals were divided into three groups as mild, moderate and severe bydural pouch magnetic resonance imaging inspection. Resting and activity pain assessment was made withvisual analog scale (VAS), muscular activity of the rectus femoris, biceps femoris, tibialis anterior and medialpart of the gastrocnemius was measured with surface electromyography (sEMG), and daily living activitieswas assessed with Oswestry lower back disability index.Results: Significant difference was found in VAS and ODI values according to the LSS severity (p<0,05). Painin resting and during activities were different from each other (p<0,05). It was found that individuals withsevere LSS had more lower limb muscular activity compared to moderate and mild individuals, and individuals with moderate LSS had more muscular activity compared to the mild ones (p<0,05).Conclusion: It was determined that disability and pain increases as the LSS severity increases. It was observed that more pain occurs while patients are active. It was concluded that early diagnosis of LSS is importantand necessary preventions should be taken to prevent further increase in severity.