Tip 1 diabetes mellitus tanılı çocuklarda epikardiyal yağ dokusu kalınlığı ile P/QT/QTc dispersiyonu ve Tp-e arasındaki ilişkinin değerlendirilmesi / Evaluation of the association between epicardial adipose tissue thickness, and P/QT/QTc dispersion and Tp-e in children with type-1 diabetes mellitus
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Dosyalar
Tarih
2018
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Tip 1 Diabetes Mellitus (T1DM) insülin eksikliğiyle seyreden ve ciddi kardiyovasküler komplikasyonlara neden olabilen çocukluk ve ergenlik çağının en yaygın görülen endokrin-metabolik hastalığıdır. Bu çalışmada T1DM tanılı çocuklarda epikardiyal yağ dokusu kalınlığı (EYDK) ile P dispersiyonu (Pd), QT dispersiyonu (QTd), QTc dispersiyonu (QTcd) ve Tp-e intervali arasındaki ilişkinin araştırılması amaçlandı. Yöntem: Çalışmaya Şubat 2018 – Temmuz 2018 tarihleri arasında T1DM tanılı 41 çocuk olgu ve 41 sağlıklı çocuk dahil edildi. Tüm olguların demografik özellikleri incelendi, elektrokardiyografik olarak Pd, QTd, QTcd, Tp-e intervali süreleri ve ekokardiyografik sağ ventrikül serbest duvarından sistol sonunda EYDK ölçümleri yapıldı. Bulgular: Hasta grubun (n:41) yaş ortalaması 12,43±3,04 yıl, kontrol grubunun (n:41) ise 12,08±2,56 yıl bulundu. Gruplar arasında yaş, cinsiyet, vücut ağırlığı, boy ve vücut kitle indeksi açısından anlamlı fark yoktu (p>0,05). Hasta grubunda EYDK, Pd, QTd, QTcd ve Tp-e intervali kontrol grubuna göre anlamlı derecede yüksek saptandı (p<0,05). Hasta grubunda EYDK ile Pd, QTd, QTcd ve Tp-e arasında anlamlı korelasyon saptanmadı (p>0,05). Ancak hasta ve kontrol grubu birlikte değerlendirildiğinde (n:82) EYDK ile Pd,QTd,QTcd ve Tp-e arasında istatistiksel olarak anlamlı pozitif korelasyon tespit edildi (p<0,05). Sonuç: Çalışmamızda; visseral yağlanmanın bir göstergesi olan EYDK'nın T1DM tanılı çocuklarda artmış olması ve elektrokardiyografide; atriyal (Pd) ve ventriküler (QTd, QTcd ve Tp-e) aritmi risklerinde de artış gözlenmesi hastalığın erken dönemlerinde bir takım yapısal ve fonksiyonel değişikliklerin başladığını düşündürmektedir. Bu nedenle diyabete bağlı gelişebilecek kardiyovasküler komplikasyonları minimuma indirebilmek için kardiyolojik takiplerde detaylı ekokardiyografi ve elektrokardiyografi parametrelerinin kullanılmasının önemli olduğunu düşünmekteyiz.
Type 1 Diabetes Mellitus (T1DM) is the most common endocrine-metabolic disease of childhood and adolescence which is characterized by insulin deficiency and may lead to severe cardiovascular complications. In this study, evaluation of the association between epicardial adipose tissue thickness (EATT), and P dispersion (Pd), QT dispersion (QTd), QTc dispersion (QTcd) and Tp-e interval in children diagnosed with T1DM was aimed. Method: Forty-one children diagnosed with T1DM and 41 healthy children who admitted between February 2018 and July 2018 were included in the study. Demographical characteristics of all patients were examined, measurements of Pd, QTd, QTcd and Tp-e interval on electrocardiogram, as well as end-systolic epicardial EATT from the right ventricular free wall on echocardiography were performed. Results: Mean age was determined to be 12.43±3.04 years in the patient group (n:41) and 12.08±2.56 years in the control group (n:41). There was no significant difference between the groups in terms of age, gender, body weight, height, and body mass index (p>0,05). EATT, as well as Pd, QTd, QTcd and Tp-e interval were found to be significantly higher in the patient group compared to the control group (p<0,05). No significant correlation was found between EATT and Pd, QTd, QTcd and Tp-e in the patient group (p>0,05). However, when the patient and control groups were evaluated together (n:82), a statistically significant positive correlation was determined between EATT, and Pd, QTd, QTcd and Tp-e (p<0,05). Conclusion: In our study, an increase in EATT, which is an indicator of visceral adiposity in children with T1DM, and in the electrocardiographic parameters showing the risk of atrial (Pd) and ventricular (QTd, QTcd and Tp-e) arrhythmias suggest that some structural and functional changes have already started in the early stages of the disease. Therefore, we think that it is important to use detailed echocardiographic and electrocardiographic parameters in cardiological follow-up in order to minimize cardiovascular complications due to diabetes. Keywords: Epicardial Adipose Tissue, Type 1 Diabetes Mellitus, P dispersion, QT dispersion, Tp-e interval.
Type 1 Diabetes Mellitus (T1DM) is the most common endocrine-metabolic disease of childhood and adolescence which is characterized by insulin deficiency and may lead to severe cardiovascular complications. In this study, evaluation of the association between epicardial adipose tissue thickness (EATT), and P dispersion (Pd), QT dispersion (QTd), QTc dispersion (QTcd) and Tp-e interval in children diagnosed with T1DM was aimed. Method: Forty-one children diagnosed with T1DM and 41 healthy children who admitted between February 2018 and July 2018 were included in the study. Demographical characteristics of all patients were examined, measurements of Pd, QTd, QTcd and Tp-e interval on electrocardiogram, as well as end-systolic epicardial EATT from the right ventricular free wall on echocardiography were performed. Results: Mean age was determined to be 12.43±3.04 years in the patient group (n:41) and 12.08±2.56 years in the control group (n:41). There was no significant difference between the groups in terms of age, gender, body weight, height, and body mass index (p>0,05). EATT, as well as Pd, QTd, QTcd and Tp-e interval were found to be significantly higher in the patient group compared to the control group (p<0,05). No significant correlation was found between EATT and Pd, QTd, QTcd and Tp-e in the patient group (p>0,05). However, when the patient and control groups were evaluated together (n:82), a statistically significant positive correlation was determined between EATT, and Pd, QTd, QTcd and Tp-e (p<0,05). Conclusion: In our study, an increase in EATT, which is an indicator of visceral adiposity in children with T1DM, and in the electrocardiographic parameters showing the risk of atrial (Pd) and ventricular (QTd, QTcd and Tp-e) arrhythmias suggest that some structural and functional changes have already started in the early stages of the disease. Therefore, we think that it is important to use detailed echocardiographic and electrocardiographic parameters in cardiological follow-up in order to minimize cardiovascular complications due to diabetes. Keywords: Epicardial Adipose Tissue, Type 1 Diabetes Mellitus, P dispersion, QT dispersion, Tp-e interval.
Açıklama
Anahtar Kelimeler
Epikardiyal Yağ Dokusu, Epicardial Adipose Tissue, Tip 1 Diabetes Melitus, Type 1 Diabetes Mellitus, P dispersiyonu, P dispersion, QT dispersiyonu, QT dispersion, Tp-e intervali, Tp-e interva
Kaynak
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Künye
Güney, A. Y. (2018). Tip 1 diabetes mellitus tanılı çocuklarda epikardiyal yağ dokusu kalınlığı ile P/QT/QTc dispersiyonu ve Tp-e arasındaki ilişkinin değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Konya.
