Diyabeti olmayan ve tip 2 diyabet tanısını yeni almış olan hastalarda H-CRP ve fraktalkine düzeylerinin değerlendirilmesi
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Dosyalar
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Diabetes mellitus, pankreastan insülin sekresyonu, insülinin etkisi ya da her ikisindeki bozukluklardan kaynaklı, hiperglisemi ile karakterize, kronik, karbonhidrat, lipid ve protein metabolizması bozuklukları ile seyreden, metabolik bir hastalıktır. Düşük düzeyli inflamasyonun diabet patofizyolojisinde önemli bir belirteç olduğu yönünde yoğun çalışmalar yapılmaktadır. C-Reaktif protein (CRP) önemli akut faz reaktanlarından biridir. Son dönem çalışmalarında obezite, insülin direnci, hipertrigliseridemi, diyabet, LDL kolesterol gibi parametrelerle arasında belirgin korelasyon bulunmuştur. Fraktalkine proinflamatuar sitokin olarak düşünülür ve TNF-alfa converting enzim varlığında dolaşıma katılması artar. Tip 2 diyabet, obezite ve adipoz doku inflamasyonu ile yakından ilişkilidir. Bu süreçte yağ dokusundan monositlerin toplanması, anahtar rolü oynar ve sitokinlerin lokal üretimini başlatır. Bu süreç sonrasında sistemik inflamasyon ve insülin direncine yol açar. Kemokinlerin obezite ve inflamasyon arasındaki ilişkiyi sağladığı düşünülür. Ateroskleroz, kardiyovasküler hastalıklar, romatoid artrit, HİV ve kanser gibi inflamatuar faktörlerin aktivitesinin önemli olduğu bazı hastalıkların patogenizinde fractalkinin rolü bazı çalışmalarla gösterilmiştir. Diyabetin patogenezindeki kronik inflamasyon, hsCRP ve yeni çalışılan kemokinlerden fractalkine düzeyinin yeni tanı diyabette nasıl değişim gösterdiğini amaçladık. Gereç ve Yöntem: Selçuk Üniversitesi Tıp Fakültesi İç Hastalıkları Endokrinoloji, Metabolizma ve Beslenme Ana Bilim Dalında, Ocak 2016 – Temmuz 2016 arasında prospektif olarak yapıldı. Çalışmaya OGTT sonucunda ADA kriterlerine göre yeni diyabet tanısı konulan 33 hasta ve OGTT sonucunda diyabeti ve prediyabet saptanmayan 34 kontrol hasta grubu alındı. Katılanların sosyodemografik özellikleri yüz yüze görüşme yöntemi ile formlara kaydedildi. Hastaların laboratuvar değerleri hastane sistem kayıtları ve hasta dosyasındaki raporlardan retrospektif olarak incelenerek kaydedildi. Tüm veriler SPSS 23.0 istatistik paket programı kullanılarak değerlendirildi. Bulgular: Çalışmaya dahil edilen hastaların ve sağlıklı kontrollerin yaş, cinsiyet, sigara kullanımı ve aile öyküleri benzerdi. HsCRP düzeyleri açısından; diyabetik hasta grubunda 0. Saat (3,78±1,27) ve 2.saat (4,27±1,13) değerleri, kontrol grubu 0. Saat(3,19±1,79) ve 2. Saatinden (2,92±1,79) yüksekti (p<0,01). Fractalkine düzeyleri 0. Saat(0,37±0,03) ve 2. Saat düzeyleri(0,36±0,03), kontrol grubu 0. Saat(0,26±0,25) ve 2. Saat (0,23±0,21) düzeylerinden yüksek bulundu (p<0,01). OGTT öncesi ve sonrası bakılan değerlerde, hiperglisemi ile HsCRP düzeyi anlamlı olarak artmıştır(r:0,33 p<0,01). Fractalkine düzeyleri hiperglisemi ile değişim göstermemiştir. HsCRP düzeyleri VKİ, sistolik kan basıncı, trigliserid düzeyleri ile anlamlı pozitif korelasyon göstermekteydi. Fractalkine düzeyleri ile herhangi br korelasyon izlenmedi. Glukoz değerleri ile VKİ, sistolik kan basıncı, diyastolik kan basıncı, trigliserid düzeyleri pozitif korelasyon göstermekteyken, HDL kolesterol düzeyleri negatif anlamlı korelasyon gösterdiği görüldü. Sonuç: Çalışmamızda hs-CRP ve fractalkine seviyelerinin diabet grubunda kontrol grubuna göre anlamlı yüksek bulunmasını; diabet ve kronik inflmasyon ilişkisini desteklediği şeklinde yorumladık.Yüksek glukoz düzeyleri sonucunda yan ürün olarak oluşan ileri glikolizasyon ürünleri, hatta glikozun kendisi de inflamatuar sitokin üretimini uyarabilir. İnflamatuar belirteçlerden biri olan hsCRP, diyabet gelişimini de öngörebilir. İnflamasyon, diyabet oluşumunun önlenmesi ve tedavisinde yeni bir hedef olarak değerlendirilmelidir.Fractalkine inflamsyon çalışmaları diabet grubunda tanıda, patogenezde, tedavi düzenlenmesinde ve yeni ajanlar bulunmasında yol gösterici olabilir. Bu açıdan daha geniş tabanlı klinik çalışmalara ihtiyaç vardır.
Diabetes mellitus is a chronic metabolic disease resulting from insulin secretion from pancreas, from the effect of insulin or from disorders in both of them, characterized by hyperglycemia and showing disorders in carbohydrate, lipid and protein metabolisms. Extensive research is conducted as to the fact that low-level inflammation is an important indicator in the pathophysiology of diabetes. C-reactive protein is one of the important acute phase reactants. A noticeable correlation has been found in recent studies between factors such as obesity, insulin resistance, hypertriglyceridemia, diabetes, LDL and cholesterol. Fractalkine is thought of as a proinflammatory cytokine, and there is an increase in its inclusion into circulation in the presence of TNT-alpha converting enzyme. Type II diabetes is closely associated with obesity and adipose tissue inflammation. The collection of monocytes from the fatty tissue plays a key role in this process and starts the local production of cytokines. It leads to systemic inflammation and insulin resistance after this process. Chemokines are thought to mediate in the relation ship between obesity and inflammation. Several studies have revealed the role of fractalkine in the pathogenesis of certain diseases in which the activity of such inflammatory factors as aterosiklerosis, cardiovascular diseases, rheumatoid arthritis, HIV and cancer is important. We have aimed to show how chronic inflammation in diabetic pathogenesis, hsCRP and fractaline level, one of the newly studied chemokines, change in just diagnosed diabetes. Method: The study was conducted retrospectively in the Department of Internal Diseases Endocrinology, Metabolism and Nourishment in the Medical Faculty at Seljuk University between January 2016 and July 2016. 33 patients who had just been diagnosed with diabetes based on the results of OGTT according to ADA criteria and 34 control patients that hadn't been diagnosed with diabetes or pre-diabetes as a result of OGTT were included in the study. The socio-demographic characteristics of the participants were recorded in forms through face to face interview. The laboratory values of the patients were recorded by retrospectively examining the hospital system records and from the reports in the files of the patients. All the data were evaluated using SPSS 23.0 statistics package program. Results: The history of the patients and of the healthy controls as regards the age, the gender, smoking cigarettes and familial backgrounds were similar. As for their HsCRP levels, the zero hour (3,78±1,27) and the second hour values (4,27±1,13) in the patient group were higher than the zero (3,19±1,79) and second hour values (2,92±1,79) in the control group (p<0,01). Their fractalkine levels at the zero hour (0,37±0,03) and at the second hour (0,36±0,03) were found to be higher than those at the zero hour (0,26±0,25) and at the second hour (0,23±0,21) in the control group (p<0,01). Hyperglycemia and HsCRP level significantly increased in the values examined before and after OGTT (r:0,33 p<0,01). Fractalkine levels didn't change with hyperglycemia. HsCRP levels showed a significantly positive correlation with VKI, systolic blood pressure and triglyceride levels. No correlation was observed with fractalkine levels. While a positive correlation was seen between glucose values and VKI, systolic blood pressure, diastolic blood pressure and triglyceride levels, HDL cholesterol levels were observed to show a significantly negative correlation. Conclusion: We interpret the significantly high levels of hs-CRP and fractalkine in the diabetic group compared with those in the control group as supporting the relationship between diabetes and chronic inflammation. Further glucolization products that form as by-products as a result of high glucose levels, even the glucose itself can stimulate the production of inflammatory cytokine. One of the indicators of inflammation, hsCRP can also foresee the development of diabetes. Inflammation should be regarded as a new target in the prevention and treatment of the development of diabetes. Studies of fractalkine inflammation can be a guide in the diagnosis of diabetes, pathogenesis and arrangement of the treatment as well as identifying new agents. In this regard, clinical studies with a wider population are required.
Diabetes mellitus is a chronic metabolic disease resulting from insulin secretion from pancreas, from the effect of insulin or from disorders in both of them, characterized by hyperglycemia and showing disorders in carbohydrate, lipid and protein metabolisms. Extensive research is conducted as to the fact that low-level inflammation is an important indicator in the pathophysiology of diabetes. C-reactive protein is one of the important acute phase reactants. A noticeable correlation has been found in recent studies between factors such as obesity, insulin resistance, hypertriglyceridemia, diabetes, LDL and cholesterol. Fractalkine is thought of as a proinflammatory cytokine, and there is an increase in its inclusion into circulation in the presence of TNT-alpha converting enzyme. Type II diabetes is closely associated with obesity and adipose tissue inflammation. The collection of monocytes from the fatty tissue plays a key role in this process and starts the local production of cytokines. It leads to systemic inflammation and insulin resistance after this process. Chemokines are thought to mediate in the relation ship between obesity and inflammation. Several studies have revealed the role of fractalkine in the pathogenesis of certain diseases in which the activity of such inflammatory factors as aterosiklerosis, cardiovascular diseases, rheumatoid arthritis, HIV and cancer is important. We have aimed to show how chronic inflammation in diabetic pathogenesis, hsCRP and fractaline level, one of the newly studied chemokines, change in just diagnosed diabetes. Method: The study was conducted retrospectively in the Department of Internal Diseases Endocrinology, Metabolism and Nourishment in the Medical Faculty at Seljuk University between January 2016 and July 2016. 33 patients who had just been diagnosed with diabetes based on the results of OGTT according to ADA criteria and 34 control patients that hadn't been diagnosed with diabetes or pre-diabetes as a result of OGTT were included in the study. The socio-demographic characteristics of the participants were recorded in forms through face to face interview. The laboratory values of the patients were recorded by retrospectively examining the hospital system records and from the reports in the files of the patients. All the data were evaluated using SPSS 23.0 statistics package program. Results: The history of the patients and of the healthy controls as regards the age, the gender, smoking cigarettes and familial backgrounds were similar. As for their HsCRP levels, the zero hour (3,78±1,27) and the second hour values (4,27±1,13) in the patient group were higher than the zero (3,19±1,79) and second hour values (2,92±1,79) in the control group (p<0,01). Their fractalkine levels at the zero hour (0,37±0,03) and at the second hour (0,36±0,03) were found to be higher than those at the zero hour (0,26±0,25) and at the second hour (0,23±0,21) in the control group (p<0,01). Hyperglycemia and HsCRP level significantly increased in the values examined before and after OGTT (r:0,33 p<0,01). Fractalkine levels didn't change with hyperglycemia. HsCRP levels showed a significantly positive correlation with VKI, systolic blood pressure and triglyceride levels. No correlation was observed with fractalkine levels. While a positive correlation was seen between glucose values and VKI, systolic blood pressure, diastolic blood pressure and triglyceride levels, HDL cholesterol levels were observed to show a significantly negative correlation. Conclusion: We interpret the significantly high levels of hs-CRP and fractalkine in the diabetic group compared with those in the control group as supporting the relationship between diabetes and chronic inflammation. Further glucolization products that form as by-products as a result of high glucose levels, even the glucose itself can stimulate the production of inflammatory cytokine. One of the indicators of inflammation, hsCRP can also foresee the development of diabetes. Inflammation should be regarded as a new target in the prevention and treatment of the development of diabetes. Studies of fractalkine inflammation can be a guide in the diagnosis of diabetes, pathogenesis and arrangement of the treatment as well as identifying new agents. In this regard, clinical studies with a wider population are required.
Açıklama
Anahtar Kelimeler
Diabetes mellitus, Fractalkine, İnflamasyon, Inflammation
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kendir, İ. C. (2016). Diyabeti olmayan ve tip 2 diyabet tanısını yeni almış olan hastalarda H-CRP ve fraktalkine düzeylerinin değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
