Sağlıklı kişilerde ve koroner kalp hastalarında bitki sterolleri, total antioksidan kapasite (tas), okside ldl (ox-ldl) ve homosistein düzeylerinin araştırılması
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Dosyalar
Tarih
2007
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Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma 28-87 (60,9 ± 11,8) yaşları arasında KKH ön tanısıyla koroner anjiografisi yapılan toplam 166 kişi (46 kadın, 120 erkek) üzerinde gerçekleştirildi. Vakalar anjiografi sonuçlarına göre aşağıdaki şekilde gruplandırıldı. 1. Kontrol grubu (n=60): 59.8±12.9 yaşları arasında anjiografisi tamamen normal olan ve üç majör epikardiyal koroner arterinde %50'den az stenozu olanlar. 2. Hasta grubu (n=106): 62.8±11.0 yaşları arasında ve üç majör koroner arterlerinin en az birinde ?% 50 stenozu olanlar. Vakalardan, 12-14 saat açlıktan sonra sabah saatlerinde 8-10 ml antikoagülansız tam kan örnekleri alınarak bekletilmeden serumları ayrıldı ve bitki sterolleri (stigmasterol, ß- sitosterol), kolesterol, TAS, Ox-LDL ve homosistein düzeyleri ölçüldü Bitki sterolleri, kolesterol ve homosistein düzeyleri HPLC (High performance Liquid Chromatography) yöntemiyle, Ox-LDL düzeyleri ticari kit kullanılarak eliza yöntemiyle, TAS düzeyi ise spektrofotometrik yöntemle ölçüldü. Kontrol grubuna ait stigmasterol, ß-sitosterol, kolesterol, homosistein, Ox-LDL ve TAS düzeyleri sırasıyla 2.86±0.48 ?g/ml, 3.22±0.37 ?g/ml, 101,2±4,3 mg/dl, 16.61±0.60 ?mol/L, 114.5±4.1 U/L, ve 1.16±0.01 mmol/L olarak, hasta grubuna ait aynı parametreler sırasıyla 5.02±1.21 ?g/ml, 5.59±1.39 ?g/ml, 106,1±4,6 mg/dl, 17.62±0.78 ?mol/L, 119.7±4.7 U/L, ve 1.09±0.01mmol/L olarak bulundu. Çalışmamızda her iki gruba ait sitosterol düzeyleri arasında istatistiki açıdan önemli bir fark bulunmazken, hasta grubuna ait Ox-LDL ve homosistein düzeyleri kontrol grubuna göre biraz yüksek (istatistiksel açıdan önemsiz), TAS düzeyleri ise önemli düzeyde (p<0.01) düşük bulunmuştur. Ayrıca, hastalarımızda kan sitosterol düzeyleri ile kolesterol düzeyleri arasında pozitif bir korelasyon bulunması bu hastalarda bitki sterollerinin ateroskleroz oluşumuna pozitif katkı yaptığını göstermektedir. Yaptığımız çalışmada üç hastanın sterol seviyeleri diğerlerine göre çok yüksek bulunmuştur. Bu hastaların serum kolesterol düzeyleri normal olduğu halde sitosterol düzeylerinin yüksek olması, bu kişilerde genetik sitosterolemi bulunabileceğini düşündürmektedir. Sonuç olarak bulgularımız, KKH'nda kan sitosterol düzeylerinin sağlıklı kişilerden istatistiksel açıdan farklı olmadığını göstermektedir. Ancak, çalıştığımız hastaların üç tanesinde normal sınırların çok üzerinde sitosterol düzeylerinin bulunmuş olması bu hastalarda genetik sitosterolemi olabileceğini, dolayısı ile KKH'nda kan sitosterol düzeylerinin ölçülmesinin bu tip hastalarda sitosteroleminin teşhis ve tedavisi bakımından önemli olduğunu göstermektedir. Ayrıca, hastalarımızda TAS düzeylerinin düşük olması da önemli bir bulgu olup, tedavide dikkate alınması gerektiği kanaatindeyiz.
This study was performed on angiographicly documented 166 CAD patients (46 F, 120 M) aged 28-87 years. Subjects were classified according to coronary angiographic results as follows: angiographic documentation. Control group: 60 subjects aged 59.8±12.9 years with normal coronary angiograms (no vessel disease) and with less than 50% stenosis in any of the three major coronary arteries. Patients group: 106 subjects aged 62.8±11.0 years and with ?50% stenosis in at least one of the three major coronary arteries 8-10 ml of non-anticoagulated whole blood samples were drawn after a 12-14 hours of fasting at morning. Sera of the samples were immediately seperated and plant sterols (stigmasterol, ß-sitosterol), cholesterol, Ox-LDL, TAS and homocysteine levels were measured. Plant sterols, cholesterol and homocysteine levels were determined by HPLC (High performance Liquid Chromatography), Ox-LDL levels were determined by using a commercially available elisa kit and TAS levels were determined spectrophotometrically. Serum stigmasterol, ß-sitosterol, cholesterol, homocysteine, Ox-LDL and TAS levels of the control group were found as 2.86±0.48?g/ml, 3.22±0.37?g/ml, 101,2±4,3mg/dl, 16.61±0.60?mol/L, 114.5±4.1U/L, and 1.16±0.01mmol/L respectively. The same parameters of the patients group were found as 5.02±1.21?g/ml, 5.59±1.39?g/ml, 106,1±4,6 mg/dl, 17.62±0.78?mol/L, 119.7±4.7U/L, and 1.09±0.01mmol/L respectively. There was no significant difference between serum sitosterols levels of the groups. However, Ox-LDL and homocysteine levels of the patients group were slightly, but not significantly, higher than those of the control group whereas TAS level of the patients group was significantly (p<0.01) lower than that of the control group. We have found a significant positive correlation between cholesterol and sitosterol levels in the patients group. This shows that plant sterols contributes to the development and the progression of atherosclerosis in patients with CAD. In our study, plant sterols levels of three patiens were found to be significantly higher while cholesterol levels were not different compaired to those of the other patients. That finding suggested that those three patients might have genetic sitosterolemia. In conclusion, our results show that there was no significant difference between sitosterol levels of patients with CAD and controls. However, sitosterol levels of 3 patients were significantly higher than that of control subjects. This finding shows that these patients may have sitosterolemia disease. Therefore, we believe that it is important to measure blood sitosterol levels in these patients in respect to the diagnosis and treatment of sitosterolemia in patients with CAD. In addition, significantly low level of TAS in our patients is another important finding which might be considered in the treatment of these patients.
This study was performed on angiographicly documented 166 CAD patients (46 F, 120 M) aged 28-87 years. Subjects were classified according to coronary angiographic results as follows: angiographic documentation. Control group: 60 subjects aged 59.8±12.9 years with normal coronary angiograms (no vessel disease) and with less than 50% stenosis in any of the three major coronary arteries. Patients group: 106 subjects aged 62.8±11.0 years and with ?50% stenosis in at least one of the three major coronary arteries 8-10 ml of non-anticoagulated whole blood samples were drawn after a 12-14 hours of fasting at morning. Sera of the samples were immediately seperated and plant sterols (stigmasterol, ß-sitosterol), cholesterol, Ox-LDL, TAS and homocysteine levels were measured. Plant sterols, cholesterol and homocysteine levels were determined by HPLC (High performance Liquid Chromatography), Ox-LDL levels were determined by using a commercially available elisa kit and TAS levels were determined spectrophotometrically. Serum stigmasterol, ß-sitosterol, cholesterol, homocysteine, Ox-LDL and TAS levels of the control group were found as 2.86±0.48?g/ml, 3.22±0.37?g/ml, 101,2±4,3mg/dl, 16.61±0.60?mol/L, 114.5±4.1U/L, and 1.16±0.01mmol/L respectively. The same parameters of the patients group were found as 5.02±1.21?g/ml, 5.59±1.39?g/ml, 106,1±4,6 mg/dl, 17.62±0.78?mol/L, 119.7±4.7U/L, and 1.09±0.01mmol/L respectively. There was no significant difference between serum sitosterols levels of the groups. However, Ox-LDL and homocysteine levels of the patients group were slightly, but not significantly, higher than those of the control group whereas TAS level of the patients group was significantly (p<0.01) lower than that of the control group. We have found a significant positive correlation between cholesterol and sitosterol levels in the patients group. This shows that plant sterols contributes to the development and the progression of atherosclerosis in patients with CAD. In our study, plant sterols levels of three patiens were found to be significantly higher while cholesterol levels were not different compaired to those of the other patients. That finding suggested that those three patients might have genetic sitosterolemia. In conclusion, our results show that there was no significant difference between sitosterol levels of patients with CAD and controls. However, sitosterol levels of 3 patients were significantly higher than that of control subjects. This finding shows that these patients may have sitosterolemia disease. Therefore, we believe that it is important to measure blood sitosterol levels in these patients in respect to the diagnosis and treatment of sitosterolemia in patients with CAD. In addition, significantly low level of TAS in our patients is another important finding which might be considered in the treatment of these patients.
Açıklama
Anahtar Kelimeler
Koroner kalp hastaları, Coronary heart disease, Bitki sterolü, Plant sterol, Total antioksidan kapasite, Total antioxidant capacity
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Sivrikaya, A. (2007). Sağlıklı kişilerde ve koroner kalp hastalarında bitki sterolleri, total antioksidan kapasite (tas), okside ldl (ox-ldl) ve homosistein düzeylerinin araştırılması. Selçuk Üniversitesi, Yayımlanmış doktora tezi, Konya.
