Turner sendromlu çocuk ve adölesanlarda subklinik aterosklerozun değerlendirilmesi
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Dosyalar
Tarih
2006
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kardiyovasküler risk faktörlerinin varlığı dikkate alındığında Turner sendromlu hastalarda aterosklerozun erken yaşlarda başlama olasılığı artmaktadır. AMAÇ Bu çalışmanın amacı, Turner sendromlu hastalarda subklinik aterosklerozun varlığını karotis arter intima media kalınlığını ölçerek değerlendirmek. MATERYAL VE METOD SÜMTF Çocuk Sağlığı ve Hastalıkları Anabilim dalı Endokrin Polikliniğinde takip ve tedavisi sürdürülen 5-20 yaş arası 24 Turner sendromlu hasta çalışma grubu olarak alındı. Kontrol grubu ise yaş dağılımı yönünden uyumlu 24 sağlıklı kız olgudan oluştu. Her iki grupta, karotis arter intima media kalınlık ölçümleri, boy, vucut ağırlığı, vucut kitle indeksi, kulaç mesafesi, bel-boy oranları hesaplandı, sistolik ve diastolik kan basınçları ölçüldü. Hastalarda açlık kan şekeri, HOMA-IR, insülin, lipidler, homosistein, vitamin B12, folat, düzeylerine bakıldı. BULGULAR Turner sendromlu hastaların yaş ortalaması 11,5±3,6 yıl, kontrol grubunun yaş ortalaması 10,5±3,6 yıl olarak saptandı. Karotis arter intima media kalınlık ölçümleri, Turner sendromlu hasta grubun da 0,3±0,06 mm, kontrol grubunda ise 0,3±0,1 mm olup aradaki fark istatistiki olarak anlamlı değildi. Kontrol grubu olgularında intima media kalınlığı ile vucut ağırlığı ( p = 0,045 r=0,413) ve vucut kitle indeksi arasında (p =0,007 r = 0,535) pozitif korelasyon saptandı. Turner sendromlu hastalarda karotis arter intima- media kalınlığı ile LDL kolesterol ( p = 0,034 r = 0,435 ) arasında pozitif korelasyon saptanırken, HDL kolesterol ( p = 0,01 r = -0,518 ) ile negatif korelasyon saptandı. Multiple regresyon analizinde, Turner sendromlu hasta gurubunda HDL kolesterol düzeylerinin karotis arter intima media kalınlık değerlerindeki değişime negatif yönde anlamlı katkıda bulunduğu ve bu değişimi %26.8 oranında açıkladığı tespit edildi (p< 0,05; R²=0,268). Turner sendromlu hastalarda boy, kulaç mesafesi anlamlı düşük iken vucut kitle indeksi ve bel boy oranı anlamlı yüksek bulundu (p<0,05). Turner sendromlu hastalarda trigliserid, VLDL, HDL kolesterol ve total kolesterol değerleri anlamlı olarak yüksek tespit edildi (p<0,05). Kontrol grubunda, plazma homosistein düzeyleri karşılaştırıldığında sınırda anlamlı yüksek değerler bulundu (p=0,047). SONUÇ Bulgularımız Turner sendromlu çocuk ve adölesanlarda subklinik aterosklerozun başlamadığını göstermektedir.
In the aspect of cardiovascular risk factors, the possibility of premature atherosclerosis in patients with Turner syndrome seems to be increased. AIM The aim of this study is to determine subclinic atherosclerosis in patients with Turner syndrome by measuring intima-media thickness of carotid artery MATERIAL AND METHOD This study was conducted in the out-patient clinic of Pediatric Endocrinology of Meram Medical Faculty. The study group consisted of 24 patients with Turner syndrome (ages varied 5 to 20-years) and the control group comprised 24 healthy, age matched girls. Measurements of intima media thickness of carotid artery, height, weight, body mass index, distance of crawl, waist-height ratio, systolic and diastolic blood pressures were obtained for all the participants. Serum levels of fasting glucose, insulin, lipids, homocysteine, vitamin B-12, folate and HOMA-IR were also investigated. RESULTS The mean age of patient in study group and control group were 11.5 ± 3.6 years, 10.5 ±3.6 years, respectively. Intima media thickness of carotid artery in study group and control group were 0.3 ± 0.06 mm, 0.3 ±0.1 mm, respectively but this difference was not significant. Positive correlation between intima media thickness of carotid artery and weight (p=0.045, r= 4.413) and body mass index (p=0.007, r=0.535) was determined. While, a positive correlation between intima media thickness of carotid artery and LDL- cholesterol (p=0.034, r=0.435) was determined, a negative correlation between intima media thickness of carotid artery and HDL-cholesterol (p=0.01, r= -0.518) were determined at patients with Turner syndrome. Values of height, distance of crawl were significantly lower, whereas values of body mass index, waist-height ratio, were higher at study group than controls (p<0.05). Serum levels of triglyceride, VLDL, HDL and total cholesterol were significantly higher at patients with Turner syndrome (p<0.05). Plasma levels of homoscyteine were slightly higher at control group than the study group (p=0.047). CONCLUSION Our results showed that subclinic atherosclerosis had not been determined in children and adolescents with Turner syndrome.
In the aspect of cardiovascular risk factors, the possibility of premature atherosclerosis in patients with Turner syndrome seems to be increased. AIM The aim of this study is to determine subclinic atherosclerosis in patients with Turner syndrome by measuring intima-media thickness of carotid artery MATERIAL AND METHOD This study was conducted in the out-patient clinic of Pediatric Endocrinology of Meram Medical Faculty. The study group consisted of 24 patients with Turner syndrome (ages varied 5 to 20-years) and the control group comprised 24 healthy, age matched girls. Measurements of intima media thickness of carotid artery, height, weight, body mass index, distance of crawl, waist-height ratio, systolic and diastolic blood pressures were obtained for all the participants. Serum levels of fasting glucose, insulin, lipids, homocysteine, vitamin B-12, folate and HOMA-IR were also investigated. RESULTS The mean age of patient in study group and control group were 11.5 ± 3.6 years, 10.5 ±3.6 years, respectively. Intima media thickness of carotid artery in study group and control group were 0.3 ± 0.06 mm, 0.3 ±0.1 mm, respectively but this difference was not significant. Positive correlation between intima media thickness of carotid artery and weight (p=0.045, r= 4.413) and body mass index (p=0.007, r=0.535) was determined. While, a positive correlation between intima media thickness of carotid artery and LDL- cholesterol (p=0.034, r=0.435) was determined, a negative correlation between intima media thickness of carotid artery and HDL-cholesterol (p=0.01, r= -0.518) were determined at patients with Turner syndrome. Values of height, distance of crawl were significantly lower, whereas values of body mass index, waist-height ratio, were higher at study group than controls (p<0.05). Serum levels of triglyceride, VLDL, HDL and total cholesterol were significantly higher at patients with Turner syndrome (p<0.05). Plasma levels of homoscyteine were slightly higher at control group than the study group (p=0.047). CONCLUSION Our results showed that subclinic atherosclerosis had not been determined in children and adolescents with Turner syndrome.
Açıklama
Anahtar Kelimeler
Turner sendromu, Turner syndrome, Subklinik ateroskleroz, Subclinic atherosclerosis
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Güçlü, R. (2006). Turner sendromlu çocuk ve adölesanlarda subklinik aterosklerozun değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
