Diyabetin Kas Sistemi Üzerindeki Etkileri ve Vitamin E’nin Olası Faydaları: Deneysel Bir Sıçan Modeli
Abstract
Amaç: Diyabet, çok sayıda komplikasyonu ile önemli bir halk sağlığı sorunudur. Bu çalışmada, diyabetik miyopatide E vitamininin olası koruyucu etkilerinin değerlendirilmesi amaçlanmıştır.
Yöntem: Çalışmada 24 erkek Wistar albino sıçan kontrol, diyabet ve diyabet + E vitamini (DE) olmak üzere üç gruba ayrıldı. Diyabet, tek doz 45 mg/kg streptozotosin (STZ) enjeksiyonu ile oluşturuldu ve kan glukozu ≥250 mg/dL olan sıçanlar diyabetik kabul edildi. STZ uygulamasından 3 gün sonra kan glukoz düzeyleri ölçüldü. DE grubuna, diyabet oluşturulduktan sonra 3 hafta boyunca 250 mg/kg/gün oral E vitamini verildi. Kas fonksiyonları ters ekran testi ve in-situ kas kasılma analizi ile değerlendirildi.
Bulgular: Çalışmanın başlangıcında gruplar arasında vücut ağırlığı ve kan glukoz düzeyleri açısından anlamlı fark yoktu. Deney sonunda, DE grubunda kontrol grubuna kıyasla vücut ağırlığında anlamlı azalma gözlendi (p=0.005). Diyabet grubunda kan glukoz düzeyleri kontrol grubuna göre anlamlı olarak artarken (p<0.001), E vitamini uygulanan grupta da yüksek seyretmeye devam etti (p<0.001). Ters ekran testinde diyabet grubunda kas dayanıklılığı azalırken (p<0.001), E vitamini uygulaması bu azalmayı anlamlı düzeyde iyileştirdi (p=0.001). Diyabet grubunda artan kas kasılma eşiği (p=0.002), E vitamini ile anlamlı şekilde azaldı (p=0.003). Tetani ölçümlerinde kontrol ve diyabet grupları arasında fark saptanmazken (p=0.072), E vitamini uygulaması diyabet grubuna kıyasla kas dayanıklılığını artırdı (p=0.026).
Sonuç: Diyabetin kas gücü ve nöromüsküler iletim üzerinde olumsuz etkiler oluşturduğu, E vitamini tedavisinin ise bu bozulmaları kısmen düzelttiği görülmüştür. Bu bulgular, E vitamininin diyabete bağlı kas fonksiyon bozukluklarının önlenmesinde destekleyici olabileceğini düşündürmektedir.
Keywords
Ethical Statement
Bu çalışma için Başkent Üniversitesi Hayvan Deneyleri Yerel Etik Kurulu tarafından onay almıştır (23.12.2024- 24/31).
Supporting Institution
Çalışma Başkent Üniversitesi tarafından desteklenmiştir (DA 24/27).
Project Number
DA 24/27
References
- International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels: International Diabetes Federation; 2021 [cited 2024 Jan 28]. Available from: https://diabetesatlas.org/resources/previous-editions/
- Hernández-Ochoa EO, Vanegas C. Diabetic myopathy and mechanisms of disease. Biochem Pharmacol. 2015;4(5):1-5. doi:10.4172/2167-0501.1000e179
- Finsterer J, Löscher WN, Wanschitz J, Quasthoff S, Grisold W. Secondary myopathy due to systemic diseases. Acta Neurol Scand. 2016;134(6):388-402. doi:10.1111/ane.12576
- Tan S, Gunendi Z, Meray J, Yetkin İ. The evaluation of muscle strength and architecture in type 1 diabetes mellitus: a cross-sectional study. BMC Endocr Disord. 2022;22(1):1-9. doi:10.1186/s12902-022-01062-y
- Roy S. Muscle cramps - a mini review of possible causes and treatment options available with a special emphasis on diabetics - A narrative review. Clinical Diabetology. 2019;8(6):310-317. doi:10.5603/DK.2019.0029
- Basiri R, Seidu B, Cheskin LJ. Key nutrients for optimal blood glucose control and mental health in individuals with diabetes: a review of the evidence. Nutrients. 2023;15(18). doi:10.3390/nu15183929
- Darenskaya MA, Kolesnikova LI, Kolesnikov SI. Oxidative stress: pathogenetic role in diabetes mellitus and its complications and therapeutic approaches to correction. Bull Exp Biol Med. 2021;171(2):179-189. doi:10.1007/s10517-021-05191-7
- Chung E, Mo H, Wang S, et al. Potential roles of vitamin E in age-related changes in skeletal muscle health. Nutrition Research. 2018;49:23-36. doi:10.1016/J.NUTRES.2017.09.005
- Dinić S, Arambašić Jovanović J, Uskoković A, et al. Oxidative stress-mediated beta cell death and dysfunction as a target for diabetes management. Front Endocrinol (Lausanne). 2022;13(September):1-20. doi:10.3389/fendo.2022.1006376
- Ghasemi A, Jeddi S. Streptozotocin as a tool for induction of rat models of diabetes: a practical guide. EXCLI J. 2023;22:274-294. doi:10.17179/excli2022-5720
- Ramadan E, Hassanin A, El-salkh I, Farrag EAE. Protective effect of carvedilol versus vitamin E against MSG-induced ataxia model in rats through NRF2 modulation, Antioxidant and Antiapoptotic Effects. J Neonatal Surg. 2025 Jun;14(30S):379-391. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/6970
- Afify H, Abdel-Aziz AA, El-Din M, Balah A, Akool ES. Molecular mechanisms of the modulatory effect of vitamin E on tacrolimus (FK506)-induced renal injury in rats. Br J Pharm Res. 2016;9(1):1-9. doi:10.9734/bjpr/2016/21684
- Sadek KM, Lebda MA, Nasr SM, Shoukry M. Spirulina platensis prevents hyperglycemia in rats by modulating gluconeogenesis and apoptosis via modification of oxidative stress and MAPK-pathways. Biomedicine and Pharmacotherapy. 2017;92:1085-1094. doi:10.1016/j.biopha.2017.06.023
- Yoon SH, Kim ME, Kim HY, Lee JS, Jang CH. Inflammatory cytokines and mononuclear cells in sudden sensorineural hearing loss. Journal of Laryngology and Otology. 2019;133(2):95-101. doi:10.1017/S0022215119000100
- Muramatsu K. Diabetes mellitus-related dysfunction of the motor system. Int J Mol Sci. 2020;21(20):1-26. doi:10.3390/ijms21207485
- Haider S, Madiha S, Batool Z. Amelioration of motor and non-motor deficits and increased striatal APoE levels highlight the beneficial role of pistachio supplementation in rotenone-induced rat model of PD. doi:10.1007/s11011-020-00584-5
- Prince N, Rajendran E, Sidharthan A, et al. Rat skeletal muscle-nerve preparation to teach skeletal muscle physiology. Adv Physiol Educ. 2021;45(4):869-879. doi:10.1152/ADVAN.00143.2020
- BIOPAC Systems, Inc. BSL PRO Lesson A02: Contractility of Skeletal Muscle Using Frog Gastrocnemius. Goleta (CA): BIOPAC Systems, Inc.; [year]. Available from: https://www.biopac.com/curriculum/a02-frog-gastrocnemius/
- Cheng K, Niu Y, Zheng XC, et al. A comparison of natural (D-α-tocopherol) and synthetic (DL-α-tocopherol acetate) Vitamin E supplementation on the growth performance, meat quality and oxidative status of broilers. Asian-Australas J Anim Sci. 2016;29(5):681-688. doi:10.5713/ajas.15.0819
- Wong WY, Ward LC, Fong CW, Yap WN, Brown L. Anti-inflammatory γ- and δ-tocotrienols improve cardiovascular, liver and metabolic function in diet-induced obese rats. Eur J Nutr. 2017;56(1):133-150. doi:10.1007/s00394-015-1064-1
- Asbaghi O, Nazarian B, Yousefi M, Anjom-Shoae J, Rasekhi H, Sadeghi O. Effect of vitamin E intake on glycemic control and insulin resistance in diabetic patients: an updated systematic review and meta-analysis of randomized controlled trials. Nutr J. 2023;22(1):10. doi:10.1186/s12937-023-00840-1
- Luna RCP, Dos Santos Nunes MK, Monteiro MGCA, et al. α-Tocopherol influences glycaemic control and miR-9-3 DNA methylation in overweight and obese women under an energy-restricted diet: A randomized, double-blind, exploratory, controlled clinical trial. Nutr Metab (Lond). 2018;15(1). doi:10.1186/s12986-018-0286-7
- Wang X, Yang X liang, Liu K chun, et al. Effects of streptozotocin on pancreatic islet β-cell apoptosis and glucose metabolism in zebrafish larvae. Fish Physiol Biochem. 2020;46(3):1025-1038. doi:10.1007/s10695-020-00769-w
- Si Q, Guo J, Yang X, et al. Systematic assessment of streptozotocin-induced diabetic metabolic alterations in rats using metabolomics. Front Endocrinol (Lausanne). 2023;14. doi:10.3389/fendo.2023.1107162
- Reno-Bernstein CM, Oxspring M, Bayles J, Huang EY, Holiday I, Fisher SJ. Vitamin E treatment in insulin-deficient diabetic rats reduces cardiac arrhythmias and mortality during severe hypoglycemia. Am J Physiol Endocrinol Metab. 2022;323(5):E428-E434. doi:10.1152/ajpendo.00188.2022
- Jin Y, Yoon HJ, Park KW, et al. Effects of Vitamin E intake and voluntary wheel running on whole-body and skeletal muscle metabolism in ovariectomized mice. Nutrients. 2025;17(6):991. doi:10.3390/nu17060991
- Emami MR, Jamshidi S, Zarezadeh M, et al. Can vitamin E supplementation affect obesity indices? A systematic review and meta-analysis of twenty-four randomized controlled trials. Clinical Nutrition. 2021;40(5):3201-3209. doi:10.1016/j.clnu.2021.02.002
- Sundram K, Sambanthamurthi R, Tan YA. Palm fruit chemistry and nutrition. Asia Pac J Clin Nutr. 2003;12(3):355-362.
- Zabielski P, Blachnio-Zabielska A, Lanza IR, et al. Impact of insulin deprivation and treatment on sphingolipid distribution in different muscle subcellular compartments of streptozotocin-diabetic C57Bl/6 mice. Am J Physiol Endocrinol Metab. 2014;306(5). doi:10.1152/ajpendo.00610.2012
- Moulin M, Ferreiro A. Muscle redox disturbances and oxidative stress as pathomechanisms and therapeutic targets in early-onset myopathies. Semin Cell Dev Biol. 2017;64:213-223. doi:10.1016/j.semcdb.2016.08.003
- Campero M, Ezquer M, Ezquer F. Nerve excitability and structural changes in myelinated axons from diabetic mice. Experimental and Clinical Endocrinology & Diabetes. 2015;123(08):485-491. doi:10.1055/s-0035-1559606
- LIU X, CHENG C, DENG B, LIU M. ellagic acid attenuates muscle atrophy in STZ-induced diabetic mice. Physiol Res. October 31, 2022:631-641. doi:10.33549/physiolres.934918
- Ryan MJ, Dudash HJ, Docherty M, et al. Vitamin E and C supplementation reduces oxidative stress, improves antioxidant enzymes and positive muscle work in chronically loaded muscles of aged rats. Exp Gerontol. 2010;45(11):882-895. doi:10.1016/J.EXGER.2010.08.002
- Chang CK, Huang HY, Tseng HF, Hsuuw Y Der, Tso TK. Interaction of vitamin E and exercise training on oxidative stress and antioxidant enzyme activities in rat skeletal muscles. Journal of Nutritional Biochemistry. 2007;18(1):39-45. doi:10.1016/j.jnutbio.2006.02.007
- Meacci E, Chirco A, Garcia-Gil M. Potential vitamin E signaling mediators in skeletal muscle. Antioxidants (Basel). 2024;13(11). doi:10.3390/antiox13111383
- Sztretye M, Singlár Z, Szabó L, et al. Improved tetanic force and mitochondrial calcium homeostasis by astaxanthin treatment in mouse skeletal muscle. Antioxidants. 2020;9(2):98. doi:10.3390/antiox9020098
- Takanami Y, Iwane H, Kawai Y, Shimomitsu T. Vitamin E supplementation and endurance exercise: are there benefits? Sports Medicine. 2000;29(2):73-83. doi:10.2165/00007256-200029020-00001
The Effects of Diabetes on the Muscular System and Potential Benefits of Vitamin E: An Experimental Rat Model
Abstract
Objective: Diabetes mellitus is a major public health problem associated with numerous complications. The aim of this study was to evaluate the potential protective effects of vitamin E in diabetic myopathy.
Methods: Twenty-four male Wistar albino rats were divided into three groups: control, diabetes, and diabetes + vitamin E (DE). Diabetes was induced by a single intraperitoneal injection of streptozotocin (STZ, 45 mg/kg), and rats with blood glucose levels ≥250 mg/dL were considered diabetic. Blood glucose levels were measured three days after STZ administration. Following the induction of diabetes, the DE group received oral vitamin E at a dose of 250 mg/kg/day for three weeks. Muscle function was assessed using the inverted screen test and in situ muscle contraction analysis.
Results: At baseline, there were no significant differences among the groups in terms of body weight or blood glucose levels. At the end of the experiment, a significant decrease in body weight was observed in the DE group compared with the control group (p = 0.005). Blood glucose levels were significantly elevated in the diabetes group compared with the control group (p < 0.001) and remained significantly high in the vitamin E–treated group (p < 0.001). In the inverted screen test, muscle endurance was significantly reduced in the diabetes group (p < 0.001), whereas vitamin E treatment significantly improved this reduction (p = 0.001). The increased muscle contraction threshold observed in the diabetes group (p = 0.002) was significantly reduced by vitamin E administration (p = 0.003). Although no significant difference in tetanic contractions was found between the control and diabetes groups (p = 0.072), vitamin E treatment significantly increased muscle endurance compared with the diabetes group (p = 0.026).
Conclusion: Diabetes adversely affects muscle strength and neuromuscular transmission, while vitamin E treatment partially ameliorates these impairments. These findings suggest that vitamin E may have a supportive role in preventing diabetes-induced muscle dysfunction.
Keywords
Ethical Statement
This study was approved by the Başkent University Animal Experiments Local Ethics Committee (23.12.2024- 24/31).
Supporting Institution
The study was supported by Başkent University (DA 24/27).
Project Number
DA 24/27
References
- International Diabetes Federation. IDF Diabetes Atlas. 10th ed. Brussels: International Diabetes Federation; 2021 [cited 2024 Jan 28]. Available from: https://diabetesatlas.org/resources/previous-editions/
- Hernández-Ochoa EO, Vanegas C. Diabetic myopathy and mechanisms of disease. Biochem Pharmacol. 2015;4(5):1-5. doi:10.4172/2167-0501.1000e179
- Finsterer J, Löscher WN, Wanschitz J, Quasthoff S, Grisold W. Secondary myopathy due to systemic diseases. Acta Neurol Scand. 2016;134(6):388-402. doi:10.1111/ane.12576
- Tan S, Gunendi Z, Meray J, Yetkin İ. The evaluation of muscle strength and architecture in type 1 diabetes mellitus: a cross-sectional study. BMC Endocr Disord. 2022;22(1):1-9. doi:10.1186/s12902-022-01062-y
- Roy S. Muscle cramps - a mini review of possible causes and treatment options available with a special emphasis on diabetics - A narrative review. Clinical Diabetology. 2019;8(6):310-317. doi:10.5603/DK.2019.0029
- Basiri R, Seidu B, Cheskin LJ. Key nutrients for optimal blood glucose control and mental health in individuals with diabetes: a review of the evidence. Nutrients. 2023;15(18). doi:10.3390/nu15183929
- Darenskaya MA, Kolesnikova LI, Kolesnikov SI. Oxidative stress: pathogenetic role in diabetes mellitus and its complications and therapeutic approaches to correction. Bull Exp Biol Med. 2021;171(2):179-189. doi:10.1007/s10517-021-05191-7
- Chung E, Mo H, Wang S, et al. Potential roles of vitamin E in age-related changes in skeletal muscle health. Nutrition Research. 2018;49:23-36. doi:10.1016/J.NUTRES.2017.09.005
- Dinić S, Arambašić Jovanović J, Uskoković A, et al. Oxidative stress-mediated beta cell death and dysfunction as a target for diabetes management. Front Endocrinol (Lausanne). 2022;13(September):1-20. doi:10.3389/fendo.2022.1006376
- Ghasemi A, Jeddi S. Streptozotocin as a tool for induction of rat models of diabetes: a practical guide. EXCLI J. 2023;22:274-294. doi:10.17179/excli2022-5720
- Ramadan E, Hassanin A, El-salkh I, Farrag EAE. Protective effect of carvedilol versus vitamin E against MSG-induced ataxia model in rats through NRF2 modulation, Antioxidant and Antiapoptotic Effects. J Neonatal Surg. 2025 Jun;14(30S):379-391. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/6970
- Afify H, Abdel-Aziz AA, El-Din M, Balah A, Akool ES. Molecular mechanisms of the modulatory effect of vitamin E on tacrolimus (FK506)-induced renal injury in rats. Br J Pharm Res. 2016;9(1):1-9. doi:10.9734/bjpr/2016/21684
- Sadek KM, Lebda MA, Nasr SM, Shoukry M. Spirulina platensis prevents hyperglycemia in rats by modulating gluconeogenesis and apoptosis via modification of oxidative stress and MAPK-pathways. Biomedicine and Pharmacotherapy. 2017;92:1085-1094. doi:10.1016/j.biopha.2017.06.023
- Yoon SH, Kim ME, Kim HY, Lee JS, Jang CH. Inflammatory cytokines and mononuclear cells in sudden sensorineural hearing loss. Journal of Laryngology and Otology. 2019;133(2):95-101. doi:10.1017/S0022215119000100
- Muramatsu K. Diabetes mellitus-related dysfunction of the motor system. Int J Mol Sci. 2020;21(20):1-26. doi:10.3390/ijms21207485
- Haider S, Madiha S, Batool Z. Amelioration of motor and non-motor deficits and increased striatal APoE levels highlight the beneficial role of pistachio supplementation in rotenone-induced rat model of PD. doi:10.1007/s11011-020-00584-5
- Prince N, Rajendran E, Sidharthan A, et al. Rat skeletal muscle-nerve preparation to teach skeletal muscle physiology. Adv Physiol Educ. 2021;45(4):869-879. doi:10.1152/ADVAN.00143.2020
- BIOPAC Systems, Inc. BSL PRO Lesson A02: Contractility of Skeletal Muscle Using Frog Gastrocnemius. Goleta (CA): BIOPAC Systems, Inc.; [year]. Available from: https://www.biopac.com/curriculum/a02-frog-gastrocnemius/
- Cheng K, Niu Y, Zheng XC, et al. A comparison of natural (D-α-tocopherol) and synthetic (DL-α-tocopherol acetate) Vitamin E supplementation on the growth performance, meat quality and oxidative status of broilers. Asian-Australas J Anim Sci. 2016;29(5):681-688. doi:10.5713/ajas.15.0819
- Wong WY, Ward LC, Fong CW, Yap WN, Brown L. Anti-inflammatory γ- and δ-tocotrienols improve cardiovascular, liver and metabolic function in diet-induced obese rats. Eur J Nutr. 2017;56(1):133-150. doi:10.1007/s00394-015-1064-1
- Asbaghi O, Nazarian B, Yousefi M, Anjom-Shoae J, Rasekhi H, Sadeghi O. Effect of vitamin E intake on glycemic control and insulin resistance in diabetic patients: an updated systematic review and meta-analysis of randomized controlled trials. Nutr J. 2023;22(1):10. doi:10.1186/s12937-023-00840-1
- Luna RCP, Dos Santos Nunes MK, Monteiro MGCA, et al. α-Tocopherol influences glycaemic control and miR-9-3 DNA methylation in overweight and obese women under an energy-restricted diet: A randomized, double-blind, exploratory, controlled clinical trial. Nutr Metab (Lond). 2018;15(1). doi:10.1186/s12986-018-0286-7
- Wang X, Yang X liang, Liu K chun, et al. Effects of streptozotocin on pancreatic islet β-cell apoptosis and glucose metabolism in zebrafish larvae. Fish Physiol Biochem. 2020;46(3):1025-1038. doi:10.1007/s10695-020-00769-w
- Si Q, Guo J, Yang X, et al. Systematic assessment of streptozotocin-induced diabetic metabolic alterations in rats using metabolomics. Front Endocrinol (Lausanne). 2023;14. doi:10.3389/fendo.2023.1107162
- Reno-Bernstein CM, Oxspring M, Bayles J, Huang EY, Holiday I, Fisher SJ. Vitamin E treatment in insulin-deficient diabetic rats reduces cardiac arrhythmias and mortality during severe hypoglycemia. Am J Physiol Endocrinol Metab. 2022;323(5):E428-E434. doi:10.1152/ajpendo.00188.2022
- Jin Y, Yoon HJ, Park KW, et al. Effects of Vitamin E intake and voluntary wheel running on whole-body and skeletal muscle metabolism in ovariectomized mice. Nutrients. 2025;17(6):991. doi:10.3390/nu17060991
- Emami MR, Jamshidi S, Zarezadeh M, et al. Can vitamin E supplementation affect obesity indices? A systematic review and meta-analysis of twenty-four randomized controlled trials. Clinical Nutrition. 2021;40(5):3201-3209. doi:10.1016/j.clnu.2021.02.002
- Sundram K, Sambanthamurthi R, Tan YA. Palm fruit chemistry and nutrition. Asia Pac J Clin Nutr. 2003;12(3):355-362.
- Zabielski P, Blachnio-Zabielska A, Lanza IR, et al. Impact of insulin deprivation and treatment on sphingolipid distribution in different muscle subcellular compartments of streptozotocin-diabetic C57Bl/6 mice. Am J Physiol Endocrinol Metab. 2014;306(5). doi:10.1152/ajpendo.00610.2012
- Moulin M, Ferreiro A. Muscle redox disturbances and oxidative stress as pathomechanisms and therapeutic targets in early-onset myopathies. Semin Cell Dev Biol. 2017;64:213-223. doi:10.1016/j.semcdb.2016.08.003
- Campero M, Ezquer M, Ezquer F. Nerve excitability and structural changes in myelinated axons from diabetic mice. Experimental and Clinical Endocrinology & Diabetes. 2015;123(08):485-491. doi:10.1055/s-0035-1559606
- LIU X, CHENG C, DENG B, LIU M. ellagic acid attenuates muscle atrophy in STZ-induced diabetic mice. Physiol Res. October 31, 2022:631-641. doi:10.33549/physiolres.934918
- Ryan MJ, Dudash HJ, Docherty M, et al. Vitamin E and C supplementation reduces oxidative stress, improves antioxidant enzymes and positive muscle work in chronically loaded muscles of aged rats. Exp Gerontol. 2010;45(11):882-895. doi:10.1016/J.EXGER.2010.08.002
- Chang CK, Huang HY, Tseng HF, Hsuuw Y Der, Tso TK. Interaction of vitamin E and exercise training on oxidative stress and antioxidant enzyme activities in rat skeletal muscles. Journal of Nutritional Biochemistry. 2007;18(1):39-45. doi:10.1016/j.jnutbio.2006.02.007
- Meacci E, Chirco A, Garcia-Gil M. Potential vitamin E signaling mediators in skeletal muscle. Antioxidants (Basel). 2024;13(11). doi:10.3390/antiox13111383
- Sztretye M, Singlár Z, Szabó L, et al. Improved tetanic force and mitochondrial calcium homeostasis by astaxanthin treatment in mouse skeletal muscle. Antioxidants. 2020;9(2):98. doi:10.3390/antiox9020098
- Takanami Y, Iwane H, Kawai Y, Shimomitsu T. Vitamin E supplementation and endurance exercise: are there benefits? Sports Medicine. 2000;29(2):73-83. doi:10.2165/00007256-200029020-00001
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Research Article |
| Authors | |
| Project Number | DA 24/27 |
| Submission Date | August 28, 2025 |
| Acceptance Date | January 8, 2026 |
| Early Pub Date | February 6, 2026 |
| Publication Date | February 6, 2026 |
| Published in Issue | Year 2026 Issue: Advanced Online Publication |
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- For scientific studies of the review type, the number of authors should not exceed three.
- For case reports, the number of authors should not exceed six.
- Abbreviations should be given in parentheses at the first occurrence of the word in the abstract and main text, and that abbreviation should be used throughout the text. The suffixes added to the abbreviations made in lowercase letters are based on the pronunciation of the word: cm'yi, kg'dan, mm'den, kr. un. In addition to abbreviations made in capital letters, the pronunciation of the last letter of the abbreviation is taken as basis: BDT'ye, TDK'den, THY'de, TRT'den, TL'den, etc. However, the pronunciation of the abbreviation is based on the suffixes added to abbreviations that read like a word even though the abbreviation is written in capital letters: ASELSAN, BOTAŞ, NATO, UNESCO, etc. • The presentation page should be sent to the editor as a separate Word file. On the presentation page to the editor, the category of the work submitted, whether it has not been simultaneously submitted to another journal, whether it has not been previously published in another journal, the people and organizations that financially support the work, if any, and the relationships of these organizations with the authors, if any, should be stated.
Statistical Information Note
• The statistical method used should be stated in such detail that a knowledgeable reader with access to the original data can confirm the reported results. Statistical terms, abbreviations and symbols should be defined. An explanation of the computer program and statistical method used should be given. Sources regarding the study design and statistical method should be stated if possible.
• In presenting the results, especially when giving averages and percentages, 2 decimal places should be used after the decimal point (instead of 112.2, such as 112.20 or 112.21). p, t, Z values are exceptions, and 3 digits should be given after the comma (full value p=0.001 instead of p<0.05). Presenting two digits after the comma in representations other than integers, presenting statistical values (such as p, t, z, F, Chi-Square) with three digits after the comma, and presenting p values with test statistics instead of p<0.05 or p>0.05. However, the exact p-value (in case this value is less than one thousandth, p<0.001) must be shown.
Keywords
- At least 3 keywords must be listed.
- Words must be separated from each other with a comma (,).
- English keywords should be given in accordance with “Medical Subject Headings (MESH)”.
References
- Authors can only cite sources they directly used in their articles.
- References should be written in the order they appear in the text and should be specified as "Superscript" at the end of the sentence, immediately after the punctuation marks.
- If the number of authors in the study is 6 or less, all authors should be stated; if there are 7 or more, the first 3 names should be written, and “et al.” should be added.
- The format used for writing references must be as specified in Index Medicus (www.icmje.org).
- Only studies that have been published or accepted for publication or have a DOI number should be included in the reference list.
- If possible, references should be from the last 5 years. Except in special cases, sources older than 10 years should not be included.
The arrangement of the sources and punctuation must comply with the following examples (Please pay attention to punctuation): For the article, The surname(s) and initial(s) of the author(s), article name, journal name, year, volume, issue, page number must be stated. Example: Dilek ON, Yilmaz S, Degirmenci B, Ali Sahin D, Akbulut G, Dilek FH. The use of a vessel sealing system in thyroid surgery. Acta Chir Belg 2005;105:369-372. For the book, The surname(s) of the author(s) and initial(s) of their name(s), chapter title, name(s) of the editor(s), book title, edition number, city, publishing house, year and pages should be stated. Example: • For books published in foreign languages; Vissers RJ, Abu-Laban RB. Acute and Chronic Pancreatitis. In: Tintinalli JE, Kelen GD, Stapczynski JS (eds.), Emergency Medicine: A Comprehensive Study Guide. 6st ed. New York: McGraw-Hill Co.; 2005. p.573-577. • For Turkish books: Gokce O. Peptic ulcer. Dilek ON, editor. Stomach and Duedon. 1st Edition. Ankara: Anit Printing House; 2001. pp:265- 276. • Format for online publications: DOI is the only acceptable online reference.
Figures, Pictures, Tables, and Graphs
- The places where figures, pictures, tables, and graphs appear in the text should be stated at the end of the relevant sentence.
- Explanations of figures, pictures, tables, and graphs should be added to the end of the main text.
- Tables should be included in the file to which the article is sent, one table per page, but each of the figures, graphics, and photographs belonging to the article should be sent as a separate image file (jpeg or gif).
- Abbreviations used should be stated in the explanations below the figures, pictures, tables, and graphs.
- If previously published figures, pictures, tables, and graphics are used, written permission must be obtained, and this permission must be stated as an explanation in the description of the figure, picture, table, and graphic.
- Pictures/photographs must be colorful, contrasting, and clear enough to see details.
Conflict of interest: If the authors have any conflict of interest, this should be disclosed.
Acknowledgments: This section should include people or institutions that are not mentioned as authors but need to be thanked.
Contribution Rate Statement: In this section, what each researcher contributed to the research should be stated.
Ethical Principles and Publication Policy
Sakarya Medical Journal adheres to national and international standards in research and publication ethics. It complies with the Press Law, the Law on Intellectual and Artistic Works, and the Higher Education Institutions Scientific Research and Publication Ethics Directive. Sakarya Medical Journal has adopted the International Ethical Publishing Principles published by the Committee on Publication Ethics (COPE), Directory of Open Access Journals (DOAJ), Open Access Scholarly Publishers Association (OASPA), and World Association of Medical Editors (WAME).
The Sakarya University Sakarya Medical Journal expects all its parties to take on the following ethical responsibilities as part of the publication ethics.
The ethical duties and responsibilities listed below are based on the guidelines and policies published as open access by the Committee on Publication Ethics (COPE).
The publication of an article in a peer-reviewed journal is essential for the development of a coherent and respected knowledge network. Peer-reviewed articles support and develop scientific methods. Therefore, it is important for all relevant parties involved in the publishing process, including authors, journal editors, reviewers, and publishing agencies, to agree on the expected ethical behaviors and standards.
1. Ethical Principles
1. Authorship of the Paper:
Authorship should be limited to those who have made a significant contribution to the conception, design, execution, or interpretation of the reported study. All those who have made significant contributions should be listed as co-authors. Where there are others who have participated in certain substantive aspects of the research project, they should be acknowledged or listed as contributors. The corresponding author should ensure that all appropriate co-authors and no inappropriate co-authors are included in the paper and that all co-authors have seen and approved the final version of the paper and have agreed to its submission for publication.
2. Conflicts of Interest:
Authors: All authors should disclose in their manuscript any financial or other substantive conflict of interest that might be construed to influence the results or interpretation of their manuscript. All sources of financial support for the project should be disclosed.
Reviewers: Referees should inform the journal editor about the evaluation process if they suspect any conflict of interest in the article they are evaluating, and refuse article evaluation if necessary. In order to prevent conflict of interest, people in the institutions where the article authors are working cannot referee the article.
Editors: Editors should not have personal or financial conflicts of interest with articles.
3. Data Access and Retention:
Authors are asked to provide the raw data in connection with a paper for editorial review, and should be prepared to provide public access to such data, if practicable, and should in any event be prepared to retain such data for a reasonable time after publication.
4. Data Fabrication and Falsification:
Fabrication and/or falsified experimental results, including the manipulation of images.
5. Duplicate / Multiple Submission(s):
Manuscripts that are either found to have been submitted elsewhere or published elsewhere. If authors have used their own work, either previously submitted or published, as the basis for a submitted manuscript, they are required to cite the previous work. They also need to indicate how novel contributions are offered in their submitted manuscript, over and above those of the previous work.
6. Intellectual Property
• Authors certify that their submitted manuscript (and any supporting items) are their own intellectual property, and the copyright has not been transferred to others.
• Authors certify that the manuscript contains no plagiarism, no fabrication, no falsification, no manipulated citations and that the manuscript conforms to JSS authorship policies.
• All manuscripts, revisions, drafts, and galleys remain the intellectual property of the author(s). Except as stated in the agreed license, the author(s) retain the copyright to their work.
• Authors, reviewers, and editors agree to keep all communications, comments, or reports from reviewers or editors confidential.
• Reviewers and editors agree to keep all manuscripts, revisions, and drafts confidential, with the exception of the final published galley(s).
7. Correction, Retraction, Expression of Concern
• Editors may make corrections if they detect minor errors in the published article that do not affect the findings, interpretations, or results.
• Editors may retract the article in case of major errors/violations that invalidate the findings and results.
• Editors may issue a statement of concern if there is a possibility of abusive research or publication by the authors, if there is evidence that the findings are unreliable and the authors' institutions have not investigated the incident, or if the potential investigation seems unfair or inconclusive. The COPE guideline is taken into account with regard to the correction, retraction, and expression of concern.
Aiming to establish ethical assurance in scientific periodicals, Sakarya Medical Journal adopts the principles of the "Code of Conduct and Best Practice Guidelines for Journal Editors" and the "Code of Conduct for Journal Publishers" published by the Committee on Publication Ethics (COPE). In this scope, the following aspects should be adhered to in the studies submitted to the journal:
• Ethics committee approval should be obtained for research conducted in all the disciplines that require ethics committee approval, and this approval should be stated and documented in the article.
• In studies that require ethics committee approval, information about the approval (committee name, date, and issue number) may be included in the method section of the study. However, in the case of reports, information about the informed consent and the signed consent form should be included in the Article Information Form at the end of the article.
The studies that require ethics committee approval are as follows:
• All kinds of research conducted with qualitative or quantitative approaches that require data collection from participants through surveys, interviews, focus group works, observations, experiments, and other interview techniques.
• Use of humans and animals (including material/data) for experimental or other scientific purposes,
• Clinical studies conducted on humans,
• Studies conducted on animals,
• Retrospective studies in accordance with the law on the protection of personal data,
Also;
• A statement confirming that an "informed consent form" has been received in case reports,
• Obtaining permission from the owners for the use of scales, surveys or photographs belonging to others,
• A statement confirming that copyright regulations are met for the intellectual and artistic works used.
9. Policy of Publishing Additional or Special Issues
A special issue can be published in our journal once a year upon the request of the Editorial Board. The publication processes of the articles sent to be included in the special issue are the same as the standard processes.
1. Additional or Special issue: An issue published in addition to the regular issues of a periodically published journal. It may consist of conference papers or a series of articles focusing on a specific topic.
2. Page numbering in the additional or special issue is different from the regular issues.
3. The print run of the additional or special issue cannot be more than one-third of the regular issue. The special issues containing conference paper abstracts are not included in this scope.
4. Ratios of case reports, compilations, and research articles (excluding conference paper abstracts) published in the additional or special issue will be included in the ratios of articles published in other issues.
5. The issues published as a tribute are not accepted as additional or special issues. Their page numbering and organization are the same as the regular issues.
10. Journal Policies on Data Sharing and Reproducibility
Sakarya University Sakarya Medical Journal strongly recommends author(s) submit supplementary material and data sets that illustrate the results shown in their papers. If any restrictions exist on the side of the author(s), these concerns should be shared with the editorial team during the submission of scientific papers.
Sakarya Medical Journal encourages author(s) to share data and make them publicly available if they do not violate human rights or other privacy issues. Cited data sets, apart from whether they are created by the author(s) or not, should be written in the reference lists of papers. Authors are also recommended to include a data availability statement.
Sakarya Medical Journal encourages all authors to make their data available to share publicly.
Actions that violate scientific research and publication ethics are as follows:
Plagiarism: Showing others' original ideas, methods, data, or works as their own work, partially or completely, without reference to scientific rules,
Forgery: Using data that does not actually exist or has been falsified in scientific research,
Distortion: Falsifying the research records or data obtained, displaying the equipment or materials not used in the research as if used, distorting or shaping the results of the research in the interests of the people and organizations that provide support,
Republishing: Presenting repetitive publications as separate publications in academic appointments and promotions,
Slicing: Dividing the results of research into pieces in an improper way or in a way that disrupts the integrity of the research and publishing each one separately to increase the total publication count for academic appointments and promotions,
Unfair Authorship: Including non-contributors in the author list or not including those who have contributed, changing the author's order in an unjustified and inappropriate manner, removing the names of contributors from the work in subsequent editions, using influence to include names among the authors despite not being contributors,
Other ethical violations include:
a) Not specifying the supporting individuals, institutions or organizations and their contributions in the publications made as a result of research conducted with support.
b) Using theses or studies that have not yet been submitted or have not been accepted as a source without the permission of the owner,
c) Not complying with ethical rules in research on humans and animals, not respecting patients' rights in publications,
ç) Violating the provisions of the relevant legislation in biomedical research and other clinical research related to humans,
d) Sharing the information in a work that has been assigned for review with others before it is published without the explicit consent of the author,
e) Misusing resources, spaces, facilities and equipment provided or allocated for scientific research,
f) Deliberately making a false and ungrounded allegation about ethical violation,
g) Publishing the data obtained from surveys conducted as part of a scientific study without the explicit consent of the participants, or without the permission of the relevant institution if the study is conducted in an institution,
h) Harming animal health and ecological balance in research and experiments,
ı) Failing to obtain written permissions from authorities that are required for starting research activities or experiments,
i) Conducting research activities or experiments in violation of the related legislation or the provisions on research and experiments in the international conventions to which Turkey is a party,
j) Disregarding the obligation to inform and warn the relevant authorities about possible harmful practices related to the scientific research.
k) Not using the data and information obtained from other individuals or institutions in scientific studies to the extent and as permitted, not respecting the confidentiality of this information and not ensuring its protection,
l) Making false or misleading statements regarding scientific research and publications in academic appointments and promotions.
Ethical Guidelines for Authors
• Studies must be original and based on research.
• It must be ensured that all the persons mentioned as authors/co-authors have contributed to the article. It is against scientific ethics to show persons who have not made any academic contribution as additional authors or to rank the authors by non-scientific criteria such as title, age, and gender, regardless of the order of contribution.
• In the articles with multiple authors, it should be clearly stated to what extent the authors have contributed to which stage of the article.
• The article should not be sent to different journals at the same time and should not have been sent to another journal before. If it is found to have been sent to another journal, the publication process will be canceled.
• It is assumed that the authors who submit articles to the journal have read and accepted the publication and writing principles of the journal, and the authors are deemed to have committed to these principles.
• The citations and bibliography should be complete.
• Plagiarism and fake data should be avoided.
• The similarity rate obtained as a result of the similarity checks should not exceed 30% in order to initiate the peer review process.
• An article may be included in a maximum of 2 PRE-REVIEW processes. The article will be rejected if the feedback conveyed to the author is not revised.
• The corresponding author must inform the journal editor in case of any conflict of interest.
This issue can be referred to WAME.
Ethical Guidelines for Peer Reviewers
• Peer reviewers should be aware that they play a critical role in the academic quality of the article to be published in the journal, and they should engage in the peer review process with the responsibility of improving academic quality.
• Peer reviewers should only accept to review articles for which they have the expertise to make an appropriate assessment. They should also respect the confidentiality of the blind peer review process and keep the details of the article confidential at all costs.
• After the review process, any information about the reviewed article should not be shared with others under any circumstances.
• Peer reviewers should only evaluate the accuracy of the content of the articles and their compliance with academic criteria. Any difference of opinions between the article's argument and the peer reviewer should not affect the review process.
• Peer review reports should be objective and measurable. Libelous, derogatory, or accusatory expressions should definitely be avoided.
• Peer reviewers should avoid superficial or inaccurate statements in their peer review reports. In reviews with negative results, a complete justification should be presented on the aspects that led to the negative result.
• Peer reviewers should review the articles within the time period allotted to them. If they are not going to review the article, they should notify the journal within a reasonable time.
• Peer reviewers should identify relevant published work that has not been cited by the authors. Any statement that an observation, derivation, or argument had been previously reported should be accompanied by the relevant citation. A reviewer should also call to the editor's attention any substantial similarity or overlap between the manuscript under consideration and any other published paper of which they have personal knowledge.
Ethical Guidelines for Editors
• Editors should accept articles that will contribute to the relevant areas specified in the journal policy.
• Editors should not have any conflict of interest with accepted or rejected articles.
• Editors have full responsibility and authority to accept or reject an article.
• It is editors' responsibility to keep the names of peer reviewers and authors mutually confidential.
• Only the articles that will contribute to the relevant field should be accepted.
• If an error is detected, editors should support the correction or retraction of the error.
• It is the duty of editors to complete the pre-review, peer review, editing and publishing processes of the articles submitted to the journal in a timely and appropriate manner.
• Editors should not assign people who do not contribute to the journal as editorial board members or associate editors.
2. Publication Policy
Any manuscript that is considered to be published in Sakarya Medical Journal must meet the following criteria:
• Originality
• Not containing ethical violations
• Having clear messages for the scientific community
• Expressing the extent of the article's contributions to researchers in the field and its relevance to social sciences
• Current fields and topics drawing the interest of researchers in the field of health sciences
• Having structural and logical integrity
• Research results that are based on scientific evidence
• Coherence of the scientific method
Review of the Articles
Articles can be submitted to the Sakarya Medical Journal by registering in the "Article Management System" on https://dergipark.org.tr/en/journal/630/submission/step/manuscript/new
Articles sent by e-mail will not be taken into consideration.
Pre-Review and Plagiarism Checking
The journal's compliance with the writing rules is examined and a similarity check is made to prevent plagiarism. Similarity software is used in the checking process. The overall similarity rate should be less than 30%. If the similarity rate is more than 30%, the study is either rejected or sent back to the author to reduce the similarity rate. The pre-review is completed within a maximum of 30 days.
Editor/Field Editor Review
After the study passes the stages of pre-review and similarity checking, it is reviewed by the relevant editor/field editor in terms of subject, scope, language use, and academic competence. This review is completed within a maximum of 30 days.
Peer Review Process (Double-Blind Peer Review)
Studies that pass the pre-review and editorial review undergo a confidential double-blind peer review process. Within the double-blind strategy, the identity of the peer reviewer is concealed from the author submitting publications to the journal. Similarly, the peer reviewers do not know who wrote the article they are reviewing. In other words, the peer review process is conducted by keeping both authors and peer reviewers anonymous to each other. The reports are also stored in the Article Management System.
Author's Revision
Authors take into account the feedback, criticisms, and recommendations of the reviewer and the Editorial Board. In case of any disagreement, they have the right to appeal with their justifications. Authors edit the article as per the reports and upload the final version of the article to the system.
Field Editor Review
The field editor checks whether the author has made the requested corrections in the text. If there is a “Major Revision” requirement in the peer review reports, they send the article to the relevant peer reviewer. If there is an "Acceptance" or "Minor Revision" requirement and the revisions are completed, they can submit the article for language checks (The checking process is completed within a maximum of 7 days.). If they detect that the corrections have not been made, they re-send the article to the author. They may reject the article if the author does not make the corrections again. Articles that are not accepted for publication are not deleted from the system. Their processes and files are stored in the system.
English Language Checks
The checking process is completed within 15 days at the latest.
Editorial Board Review
The articles that pass technical, academic, and linguistic reviews are examined by the Editorial Board, and the final publication status is determined. In case of any objection from the members, the Board decides by a majority of votes.
Typesetting and Layout Process
The journal undertakes the typesetting and layout processes of the studies decided to be published by the Editorial Board.
Language
Sakarya Medical Journal publishes articles written in English.
Change of Authorship
Sakarya Medical Journal accepts article authors according to the statement on the Title Page of the article. Therefore, it is the responsibility of the authors to submit the final version of the full author list. Requests for any change of authorship after the submission of the article (e.g removal/addition of authors, change of order, etc.) are subject to editorial approval. The Editorial Board will investigate such cases and act according to the COPE flowcharts.
Requests for a change of authorship should be conveyed to the Editor with an official letter stating the reasons for the change. The letter should be signed by all the authors and include their confirmation of the change of authorship. If the request is approved by the Editorial Board, the authors are required to submit a new Copyright Agreement Form according to the final author list.
Disclaimer
The opinions expressed in the articles published in the journal are those of the author(s). They do not purport to reflect the opinions or views of the Sakarya Medical Journal and its Editor-In-Chief, Editorial Board or Publisher. The Editor-in-Chief, Editorial Board, and Publisher assume no responsibility or liability for such cases. The sole responsibility for the published content lies with the authors.
Complaints and Appeals
Sakarya Medical Journal handles complaints and appeals by following the below procedure. Complaints, including but not limited to the long delays in handling studies and publication ethics, are initially handled by the Editor-in-Chief of Sakarya Medical Journal. The Editor-in-Chief examines complaints and appeals together with Area Editors and Editorial Board if applicable. If anything occurs about complaints and appeals please contact sakaryatipdergisi@sakarya.edu.tr.
Complaints about the Content of a Paper
The Editor-in-Chief examines the complaints of the author(s) and the reports of reviewers and make a decision about:
• A fresh opinion from an independent reviewer is needed.
Complaints about Processes
The complaints about processes are handled by the Editor-in-Chief. Long delays in handling studies are examined by editors of Sakarya Medical Journal, and any necessary issues are shared with the Editor-in-Chief. The Editor-in-Chief evaluates the complaints, and when necessary, information is shared with the authors.
Complaints about Ethics
The Editor-in-Chief considers complaints about publication ethics of the author’s or reviewer’s conduct. The editor-in-chief follows the publication ethics on the Sakarya Medical Journal website. The editorial board of Sakarya Medical Journal examines the concerns of complainants or reviewers. The details and progress of the examination are clearly shared with the complainant(s). The Editor-in-Chief or Assistant Editors provide feedback to the complainant(s) on the manner of action and the final decision.
Price Policy
• Sakarya Medical Journal does not request any fees for article submission, reviewing and editing processes, page layout, and publication (page or color fees).
• Sakarya Medical Journal does not pay any fees to authors, reviewers, editors, and editorial board members.
• All papers in Sakarya Medical Journal are free to read and download.
• Sakarya Medical Journal signed on to the Budapest Open Access Initiative (BOAI), which promotes free access to research literature and has adopted the Open Access Principles that are clarified in this initiative.
• All papers in Sakarya Medical Journal are archived with the LOCKSS (Lots Of Copies Keep Stuff Safe) system through TUBITAK ULAKBİM DergiPark.
• Sakarya Medical Journal does not accept announcements, advertisements, sponsorships, etc. due to its publication policy.
• All expenses of Sakarya Medical Journal are covered by Sakarya University.
Indexes
Citation Indexes
Other Indexes
Journal Boards
Baş Editör
Editör Kurulu
Mizanpaj Editörü
Yazım ve Dil Editörü
Ingilizce Dil Editörü
Biyoistatistik Editörü
INDEXING & ABSTRACTING & ARCHIVING
The published articles in SMJ are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.