Gestasyonel Diyabetin Trimetilamin-N-Oksit ve Ayrıştırıcı Protein-1 ile İlişkisi
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Dosyalar
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Gestasyonel Diabetes Mellitus (GDM); gebelik esnasında başlayan veya ilk kez gebelikte tespit
edilen, anne ve bebekte ciddi komplikasyonlara yol açan ve prevalansı oldukça yüksek olan herhangi
bir düzeydeki glukoz tolerans bozukluğudur. GDM patogenezinde genetik ve çevresel faktörlerin yer
aldığı bilinse de altta yatan mekanizmalar henüz tam olarak aydınlatılabilmiş değildir. Trimetilamin-Noksit (TMAO); diyetle hazır olarak alınabildiği gibi başta kolin olmak üzere çeşitli diyet öncüllerinden
bağırsak mikrobiyotasının etkisi ile sentezlenen Trimetilamin’in (TMA) karaciğerde okside edilmesi ile
elde edilen kısa zincirli bir amindir. Yüksek TMAO seviyeleri ile başta kardiyovasküler hastalıklar ve
diyabet olmak üzere birçok hastalık gelişim riski arasında pozitif bir ilişki olduğu bildirilse de bu
ilişkinin neden-sonuç ilişkisi olup olmadığı belirsizliğini korumaktadır. Ayrıştırıcı Protein-1 (UCP-1),
kahverengi ve bej yağ dokularının termojenik aktiviteleri için işaret olarak kabul edilen bir proteindir.
Kahverengi adipositlerin aktivasyonu ile UCP-1 miktarı artar ve kahverengi yağ dokusuna glukoz alımı
uyarılır. Böylece insülin duyarlılığında artış, kan glukozunda ise azalma meydana gelir. İnsanlarda
kahverengi yağ dokusunun aktifliği ile GDM riski arasındaki ilişki ortaya konmalıdır. Bu bilgiler
doğrultusunda çalışmamız, TMAO ve UCP-1 ile GDM gelişimi arasında bir ilişki olup olmadığını
belirlemek amacıyla yapılmıştır. Buna göre Selçuk Üniversitesi Tıp Fakültesi Hastanesi Kadın
Hastalıkları ve Doğum Polikliniği’ne başvuran ve gönüllü olmayı kabul eden 6-12 haftalık gebeler, 24-
28. haftalarda yapılan oral glukoz tolerans testine (OGTT) kadar takip edilmiş ve bu iki aşamadaki
serumlarından TMAO ve UCP-1 analizleri yapılmış, elde edilen değerler karşılaştırılmıştır. 30 GDM’li
birey ve benzer yaş ve beden kitle indeksine (BKİ) sahip 30 sağlıklı gebe kontrol olarak seçilmiştir.
Gruplar kendi aralarında ve kendi içlerinde gebelik dönemine göre kıyaslanmıştır. Serum TMAO
düzeyleri bakımından hem gruplar arasında hem de grup içlerinde anlamlı farklılıklar gözlenmiştir.
GDM grubu hem 6-12. haftalarda hem de 24-28. haftalarda kontrol grubuna göre daha yüksek serum
TMAO düzeyleri göstermiştir. 24-28. haftalarda GDM grubunda kontrol grubuna göre daha düşük
serum UCP-1 düzeyleri bulunmuştur. Hem hasta hem de kontrol grubunda 24-28. haftalarda, 6-12.
haftalara göre daha yüksek UCP-1 seviyeleri gözlenmiştir. Yapılan analizlerde ilk trimesterde serum
TMAO ölçümünün ilerde GDM geliştirme riski için bir biyobelirteç olarak kullanılabileceği ancak
UCP-1’in bu amaçla kullanılamayacağı sonucuna varılmıştır. GDM ile TMAO ve UCP-1 ilişkisinin
aydınlatılabilmesi için daha fazla çalışmaya ihtiyaç vardır.
Gestational Diabetes Mellitus (GDM) is characterized as any level of glucose tolerance disorder that starts during pregnancy or is detected for the first-time during pregnancy, causes serious complications in the mother and baby, and has a very high prevalence. Although it is known that genetic and environmental factors are involved in the pathogenesis of GDM, the underlying mechanisms have not yet been fully elucidated. Trimethylamine-N-oxide (TMAO); is a short-chain amine obtained by oxidizing Trimethylamine (TMA), which is synthesized by the effect of intestinal microbiota from various dietary precursors, especially choline, as it can be supplied with the diet. Although it has been reported that there exists a positive relationship between high TMAO levels and the risk of developing many diseases, especially cardiovascular diseases and diabetes, it remains unclear whether this relationship is a cause-effect relationship. Uncoupling Protein-1 (UCP-1) is a protein accepted as a marker for thermogenic activities of brown and beige adipose tissues. Activation of brown adipocytes increases the amount of UCP-1 and stimulates glucose uptake into brown adipose tissue in addition an increase in insulin sensitivity and a decrease in blood glucose occurs. The relationship between the activity of brown adipose tissue and the risk of GDM in humans should be clarified. In line with this information, our study was conducted to determine whether there is a relationship between TMAO and GDM and between UCP-1 and GDM. For this purpose, 6-12 weeks pregnant women who applied to Selcuk University Medical Faculty Hospital Gynecology and Obstetrics Polyclinic and agreed to volunteer were followed up to the oral glucose tolerance test (OGTT) performed at 24-28 weeks and TMAO and UCP-1 analysis were examined in the serum and the obtained values were compared. 30 individuals with GDM and 30 healthy pregnant women with similar age and body mass index (BMI) values were selected as controls. The groups were compared among themselves, and each group was compared according to their gestational period. Significant differences were observed in serum TMAO levels both between groups and by gestational age within the groups. GDM group showed both weeks 6-12 and 24-28 higher serum TMAO levels compared to the control group. In weeks 24-28, lower serum UCP-1 levels were found-observed in the GDM group compared to the control group. Higher UCP-1 levels were observed in both the patient and control groups, at weeks 24-28 compared to weeks 6-12. According to analyzes, it was concluded that serum TMAO measurement in the first trimester can be used as a prediagnostic biomarker for the determination of the risk of developing GDM in the future, but UCP-1 cannot be used for this purpose. More studies are needed to elucidate the relationship between TMAO and GDM and UCP-1 and GDM.
Gestational Diabetes Mellitus (GDM) is characterized as any level of glucose tolerance disorder that starts during pregnancy or is detected for the first-time during pregnancy, causes serious complications in the mother and baby, and has a very high prevalence. Although it is known that genetic and environmental factors are involved in the pathogenesis of GDM, the underlying mechanisms have not yet been fully elucidated. Trimethylamine-N-oxide (TMAO); is a short-chain amine obtained by oxidizing Trimethylamine (TMA), which is synthesized by the effect of intestinal microbiota from various dietary precursors, especially choline, as it can be supplied with the diet. Although it has been reported that there exists a positive relationship between high TMAO levels and the risk of developing many diseases, especially cardiovascular diseases and diabetes, it remains unclear whether this relationship is a cause-effect relationship. Uncoupling Protein-1 (UCP-1) is a protein accepted as a marker for thermogenic activities of brown and beige adipose tissues. Activation of brown adipocytes increases the amount of UCP-1 and stimulates glucose uptake into brown adipose tissue in addition an increase in insulin sensitivity and a decrease in blood glucose occurs. The relationship between the activity of brown adipose tissue and the risk of GDM in humans should be clarified. In line with this information, our study was conducted to determine whether there is a relationship between TMAO and GDM and between UCP-1 and GDM. For this purpose, 6-12 weeks pregnant women who applied to Selcuk University Medical Faculty Hospital Gynecology and Obstetrics Polyclinic and agreed to volunteer were followed up to the oral glucose tolerance test (OGTT) performed at 24-28 weeks and TMAO and UCP-1 analysis were examined in the serum and the obtained values were compared. 30 individuals with GDM and 30 healthy pregnant women with similar age and body mass index (BMI) values were selected as controls. The groups were compared among themselves, and each group was compared according to their gestational period. Significant differences were observed in serum TMAO levels both between groups and by gestational age within the groups. GDM group showed both weeks 6-12 and 24-28 higher serum TMAO levels compared to the control group. In weeks 24-28, lower serum UCP-1 levels were found-observed in the GDM group compared to the control group. Higher UCP-1 levels were observed in both the patient and control groups, at weeks 24-28 compared to weeks 6-12. According to analyzes, it was concluded that serum TMAO measurement in the first trimester can be used as a prediagnostic biomarker for the determination of the risk of developing GDM in the future, but UCP-1 cannot be used for this purpose. More studies are needed to elucidate the relationship between TMAO and GDM and UCP-1 and GDM.
Açıklama
Anahtar Kelimeler
Ayrıştırıcı Protein-1, Gestasyonel Diabetes Mellitus, Kahverengi Yağ Dokusu, Trimetilamin-N-Oksit, Brown Adipose Tissue, Gestational Diabetes Mellitus, Trimethylamine-N-Oxide, Uncoupling Protein-1
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Çıbık, S., (2023). Gestasyonel Diyabetin Trimetilamin-N-Oksit ve Ayrıştırıcı Protein-1 ile İlişkisi. (Yüksek Lisans Tezi). Selçuk Üniversitesi, Sağlık Bilimler Enstitüsü Konya.
