Metabolik sendromlu hastalarda aterojenik plazma indeksi ve nabız dalga hızının (pulse wave velocity) arteriyel sertlik ile ilişkisinin değerlendirilmesi
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Tarih
2023
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info:eu-repo/semantics/openAccess
Özet
Amaç: Metabolik sendrom (MetS), insülin direnciyle başlayan abdominal
obezite, glukoz intoleransı veya tip 2 diyabet, dislipidemi, hipertansiyon ve koroner
arter hastalığı (KAH) gibi sistemik bozuklukların birbirine eklendiği ölümcül bir
endokrinopatidir. Arteriyel sertlik yaşlanma, çevresel ve genetik faktörler sonucunda
damarlarda oluşan fonksiyonel ve yapısal değişiklikler olarak tanımlanır. Arteriyel
sertliğin kardiyovasküler hastalık ilişkili mortalitenin bağımsız belirleyicisi olduğu
bilinmektedir. Kardiyovasküler hastalık risk kümelenmesi olan metabolik sendromda
da arteriyel sertlik artışı gözlenmektedir. Aterojenik plazma indeksi (API); aterojenik
ve anti-aterojenik faktörler arasındaki dengeyi kapsamlı bir şekilde yansıtır ve KAH
riskini tahmin etmede güçlü bir belirteçtir. Çalışmamızda metabolik sendromlu
hastalarda; metabolik sendrom bileşenleri ile aterojenik plazma indeksi ve nabız
dalga hızının ilişkisini incelemeyi amaçladık.
Gereç ve yöntem: Çalışmamız için Mart 2023 – Ağustos 2023 tarihleri
arasında Necmettin Erbakan Üniversitesi Hastanesi Endokrinoloji Polikliniğine
ayaktan başvuran 18- 65 yaş arasındaki bireylerden; daha önceden belirlenmiş
çalışmaya dahil edilme kriterlerine uyan 55 olgu ve kontrol grubu için; hasta grubuna
benzer yaş ve cinsiyette vücut kütle indeksi (VKİ) 30’un altında olan ve aynı
polikliniğe başvuran sağlıklı bireylerden 26 olgu seçildi. Hasta ve kontrol grubu
nabız dalga hızı (NDH), API ve biyokimyasal parametre sonucuna göre
değerlendirildi ve elde edilen verilerin istatistiksel analizi yapıldı.
Bulgular: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Hastanesi
Endokrin ve Metabolizma Hastalıkları Kliniği’nde yapılan bu çalışmaya 55 hasta ve
26 sağlıklı birey dahil edildi. Hasta grubunun %50,9’u (n=28), kontrol grubunun
%55,0’ı (n=13) kadındı. Hastaların yaş ortalaması 54,96±8,16 yıl, kontrol grubunun
ise 51,31±10,72 yıldı. Hasta grubunda kontrol grubuna göre sistolik kan basıncı
(SKB), diastolik kan basıncı (DKB), ortalama arteriyel kan basıncı (OAB), nabız
basıncı (NB) ve aortta ölçülen sistolik kan basıncı, merkezi nabız basıncı (CPP),
nabız dalga hızı (NDH) ve aterojenik plazma indeksi (API) değerleri istatistiki olarak
daha yüksek bulundu (p değerleri sırasıyla; p<0,001; p=0,036; p<0,001; p<0,001;
p<0,001; p=0,001; p<0,001; p<0,001).
API ile TyG indeksi arasında pozitif yönlü iyi derecede anlamlı korelasyon
tespit edildi. NDH düzeyi ile yaş arasında pozitif yönlü çok iyi derecede; sistolik kan
basıncı, aort sistolik kan basıncı düzeyleri arasında pozitif yönlü orta derecede;
ortalama arteriyel kan basıncı, glikozillenmiş hemoglobin (HbA1c) ve üre ile pozitif
yönde; total kolesterol düzeyi arasında negatif yönlü düşük-orta derecede; nabız
basıncı düzeyi arasında iyi derecede pozitif yönde; glukoz arasında pozitif yönlü,
LDL ve GFR arasında negatif yönlü düşük anlamlı korelasyon tespit edildi.
Sonuç: Çalışmamızda, MetS bireylerde nabız dalga hızının arttığı ve
metabolik sendrom mevcudiyetinin arteriyel sertliğin bağımsız belirleyicisi olduğu
gösterilmiştir. MetS bireylerde SKB, OAB, HbA1c, glukoz ve eGFR düzeyleri
arteriyel sertlik ile ilişkili bulunmuştur. Arteriyel sertliğin bir göstergeleri olan API
ve NDH arasında anlamlı korelasyon saptanmamıştır. Ancak çalışmamızda hasta
sayısı sınırlı olup daha geniş hasta popülasyonunun yer aldığı çalışmalara ihtiyaç
vardır.
Objective: Metabolic syndrome (MetS) is a fatal endocrinopathy characterized by the combination of systemic disorders such as insulin resistance, abdominal obesity, glucose intolerance or type 2 diabetes, dyslipidemia, hypertension, and coronary artery disease (CAD). Arterial stiffness is defined as functional and structural changes in the arteries that occur as a result of aging, environmental, and genetic factors. Arterial stiffness is known to be an independent determinant of cardiovascular disease-related mortality. Metabolic syndrome, characterized by the clustering of cardiovascular disease risk factors, is also associated with increased arterial stiffness. Atherogenic Plasma Index (API) comprehensively reflects the balance between atherogenic and anti-atherogenic factors and is a powerful marker for predicting CAD risk. In our study, we aimed to investigate the relationship between the components of metabolic syndrome and atherogenic plasma index and pulse wave velocity in patients with metabolic syndrome. Materials and Methods: For our study, 55 cases meeting the pre-defined inclusion criteria and a control group of 26 individuals with a body mass index (BMI) below 30, similar in age and gender to the patient group, were selected from individuals aged 18-65 who presented to the Endocrinology Outpatient Clinic of Necmettin Erbakan University Hospital between March 2023 and August 2023. The patient and control groups were evaluated based on pulse wave velocity (PWV), API, and biochemical parameters, and the statistical analysis of the obtained data was performed. Results: This study, conducted at Necmettin Erbakan University Meram Faculty of Medicine Hospital Endocrinology and Metabolism Diseases Clinic, included 55 patients and 26 healthy individuals. Of the patient group, 50.9% (n=28) were female, while 55.0% (n=13) of the control group were female. The mean age of the patients was 54.96±8.16 years, and that of the control group was 51.31±10.72 years. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), pulse pressure (PP), systolic blood pressure measured in the aorta, central pulse pressure (CPP), pulse wave velocity (PWV), and atherogenic plasma index (API) values were statistically higher in the patient group compared to the control group (p values, respectively; p<0.001; p=0.036; p<0.001; p<0.001; p<0.001; p=0.001; p<0.001; p<0.001). A positive and significantly strong correlation was found between API and TyG index. PWV showed a significantly strong positive correlation with age, a moderately positive correlation with systolic blood pressure and aortic systolic blood pressure, a positive correlation with mean arterial blood pressure, glycated hemoglobin (HbA1c), and urea, a low to moderate negative correlation with total cholesterol level, a significantly positive correlation with pulse pressure, a positive correlation with glucose, and a low significant negative correlation with LDL and GFR. Conclusion: In our study, it was demonstrated that pulse wave velocity increases in individuals with MetS, and the presence of metabolic syndrome is an independent determinant of arterial stiffness. In MetS individuals, SBP, MAP, HbA1c, glucose, and eGFR levels were found to be associated with arterial stiffness. No significant correlation was found between API and PWV, which are indicators of arterial stiffness. However, our study has a limited number of participants, and further studies with a larger patient population are needed.
Objective: Metabolic syndrome (MetS) is a fatal endocrinopathy characterized by the combination of systemic disorders such as insulin resistance, abdominal obesity, glucose intolerance or type 2 diabetes, dyslipidemia, hypertension, and coronary artery disease (CAD). Arterial stiffness is defined as functional and structural changes in the arteries that occur as a result of aging, environmental, and genetic factors. Arterial stiffness is known to be an independent determinant of cardiovascular disease-related mortality. Metabolic syndrome, characterized by the clustering of cardiovascular disease risk factors, is also associated with increased arterial stiffness. Atherogenic Plasma Index (API) comprehensively reflects the balance between atherogenic and anti-atherogenic factors and is a powerful marker for predicting CAD risk. In our study, we aimed to investigate the relationship between the components of metabolic syndrome and atherogenic plasma index and pulse wave velocity in patients with metabolic syndrome. Materials and Methods: For our study, 55 cases meeting the pre-defined inclusion criteria and a control group of 26 individuals with a body mass index (BMI) below 30, similar in age and gender to the patient group, were selected from individuals aged 18-65 who presented to the Endocrinology Outpatient Clinic of Necmettin Erbakan University Hospital between March 2023 and August 2023. The patient and control groups were evaluated based on pulse wave velocity (PWV), API, and biochemical parameters, and the statistical analysis of the obtained data was performed. Results: This study, conducted at Necmettin Erbakan University Meram Faculty of Medicine Hospital Endocrinology and Metabolism Diseases Clinic, included 55 patients and 26 healthy individuals. Of the patient group, 50.9% (n=28) were female, while 55.0% (n=13) of the control group were female. The mean age of the patients was 54.96±8.16 years, and that of the control group was 51.31±10.72 years. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), pulse pressure (PP), systolic blood pressure measured in the aorta, central pulse pressure (CPP), pulse wave velocity (PWV), and atherogenic plasma index (API) values were statistically higher in the patient group compared to the control group (p values, respectively; p<0.001; p=0.036; p<0.001; p<0.001; p<0.001; p=0.001; p<0.001; p<0.001). A positive and significantly strong correlation was found between API and TyG index. PWV showed a significantly strong positive correlation with age, a moderately positive correlation with systolic blood pressure and aortic systolic blood pressure, a positive correlation with mean arterial blood pressure, glycated hemoglobin (HbA1c), and urea, a low to moderate negative correlation with total cholesterol level, a significantly positive correlation with pulse pressure, a positive correlation with glucose, and a low significant negative correlation with LDL and GFR. Conclusion: In our study, it was demonstrated that pulse wave velocity increases in individuals with MetS, and the presence of metabolic syndrome is an independent determinant of arterial stiffness. In MetS individuals, SBP, MAP, HbA1c, glucose, and eGFR levels were found to be associated with arterial stiffness. No significant correlation was found between API and PWV, which are indicators of arterial stiffness. However, our study has a limited number of participants, and further studies with a larger patient population are needed.
Açıklama
Anahtar Kelimeler
Metabolik sendrom, Arteriyel sertlik, Aterojenik plazma indeksi, Metabolic syndrome, Arterial stiffness, Atherogenic plasma index
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Duru, H. B. İ. (2023). Metabolik sendromlu hastalarda aterojenik plazma indeksi ve nabız dalga hızının (pulse wave velocity) arteriyel sertlik ile ilişkisinin değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
