Tip 2 diyabetes mellituslu hastalarda kardiyovasküler otonom nöropati sıklığı ve bununla ilişkili risk faktörlerinin belirlenmesi
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Dosyalar
Tarih
2011
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Tip 2 DM?li hastalarda KVONP sıklığını, KVONP risk faktörlerini ve bu risk faktörlerinin KVONP?un progresyonu ile ilişkisini araştırmayı amaçladık.Materyal ve Metod: Çalışmamız normotansif tip 2 DM tanısı olan, yaşları 32 ile 64 arasında değişen (ort. 49.20 ± 7.44 yıl), 38?i (%63.3) kadın, 22?si (%36.7) erkek olmak üzere toplam 60 hastanın dahil edildiği gözlemsel bir çalışmadır. Tüm hastalara başvuruda ve birinci yıl sonunda standart Ewing Battery testleri (derin solunum, Valsalva manevrası, 30:15 oranı, ayağa kalkmaya ve handgribe kan basıncı yanıtı) uygulandı. Test sonuçları bir skorlama sistemi kullanılarak ifade edildi. Test sonuçlarına göre KVONP yok (0-0.5 skor) ve KVONP var (1-5 skor) olarak sınıflandırıldı.Bulgular: Çalışmamızda başlangıçta KVONP prevalansı % 78.3 iken, birinci yılın sonunda % 70?e gerilerken (P=0.245), Ewing skoru toplamı 1.50 (1.00-2.50)?dan 1.00 (0.50-2.00)?e geriledi (P=0.035). KVONP grubunda başvuruda hastaların yaşı daha ileriydi ve 12.ayın sonunda sistolik kan basıncı (SKB) daha yüksekti (sırasıyla P=0.037, P=0.039). KVONP, yaş ve SKB?dan, anlamlılığa yakın olarak da statin kullanımının azlığından etkilenmekteydi (sırasıyla B=0.12, P=0.015; B=0.09, P=0.007; B= -1.83, P=0.052). Ewing skoru SKB ile anlamlı (r=0.38, P=0.034), yaş, diyabet süresi ve HbA1c ile anlamlılığa yakın koreleydi (sırasıyla r=0.25, P=0.062; r=0.24, P=0.063; r=0.24, P=0.071). Ewing skorundaki değişimle sadece total kolesteroldeki azalmanın anlamlı olduğu görüldü (B=0.26, P=0.047).Sonuç: Yaş, SKB ve total kolesterol seviyeleri tip 2 DM hastalarında KVONP ile ilişkili olabilir. Statinler KVONP tedavisinde umut vaat edebilir. Bu konuda farklı şekilde dizayn edilmiş ileri çalışmalara ihtiyaç vardır
We aimed to evaluate the prevelance of cardiovascular autonomic neuropathy (CVONP), associated risk factors and the relationship between these risk factors and progression of CVONP in patients with type 2 diabetes.Material and Methods: Our study is an observational study that included a total of 60 patients between the ages of 32 and 64 (mean 49.20 ± 7.44), 38 women (63.3%) and 22 men (36.7%). All patients are evaluated with standart Ewing Battery tests (deep inspiration, Valsalva manuever, 30;15 ratio, standing and blood pressure response to handgrip) at the beginning and at the end of the study. Test results are expressed by a scoring system and patients with a score between 0-0.5 are classified as having no CVONP and patients with a score between 1-5 are classified as having CVONP.Results: CVONP prevelance regressed from 78.3% at the beginning to 70% at the end of the first year (P=0.245), and Ewing score regressed from 1.50 (1.00-2.50) to 1.00 (0.50-2.00) (P= 0.035). CVONP group patients were older and had higher systolic blood pressures (SBP) at the end of the 12th month (P=0.037 and P=0.039, respectively). CVONP was associated with age, SBP and more significantly with the lower percentage use of statins (B= 0.12, P= 0.015; B=0.09, P= 0.007; B= -1.83, P=0.052 respectively). Ewing score was significantly correlated with SBP (r=0.38, P=0.034), and was correlated near significantly with age, the duration of diabetes and HbA1c (r=0.25, P=0.062; r=0.24, P=0.063; r= 0.24, P=0.071). Changes in Ewing score was associated only with the reduction of total cholesterol (B=0.26, P=0.047).Conclusions: Age, SBP and total cholesterol level may be associated with CVONP in patients with type 2 diabetes. There is a need for further studies with different designs.
We aimed to evaluate the prevelance of cardiovascular autonomic neuropathy (CVONP), associated risk factors and the relationship between these risk factors and progression of CVONP in patients with type 2 diabetes.Material and Methods: Our study is an observational study that included a total of 60 patients between the ages of 32 and 64 (mean 49.20 ± 7.44), 38 women (63.3%) and 22 men (36.7%). All patients are evaluated with standart Ewing Battery tests (deep inspiration, Valsalva manuever, 30;15 ratio, standing and blood pressure response to handgrip) at the beginning and at the end of the study. Test results are expressed by a scoring system and patients with a score between 0-0.5 are classified as having no CVONP and patients with a score between 1-5 are classified as having CVONP.Results: CVONP prevelance regressed from 78.3% at the beginning to 70% at the end of the first year (P=0.245), and Ewing score regressed from 1.50 (1.00-2.50) to 1.00 (0.50-2.00) (P= 0.035). CVONP group patients were older and had higher systolic blood pressures (SBP) at the end of the 12th month (P=0.037 and P=0.039, respectively). CVONP was associated with age, SBP and more significantly with the lower percentage use of statins (B= 0.12, P= 0.015; B=0.09, P= 0.007; B= -1.83, P=0.052 respectively). Ewing score was significantly correlated with SBP (r=0.38, P=0.034), and was correlated near significantly with age, the duration of diabetes and HbA1c (r=0.25, P=0.062; r=0.24, P=0.063; r= 0.24, P=0.071). Changes in Ewing score was associated only with the reduction of total cholesterol (B=0.26, P=0.047).Conclusions: Age, SBP and total cholesterol level may be associated with CVONP in patients with type 2 diabetes. There is a need for further studies with different designs.
Açıklama
Anahtar Kelimeler
Diabetes mellitus-tip 2, Diabetes mellitus-type 2, Nöropatiler, Neuropathies, Nöropatiler-herediter-sensoryel ve otonom, Neuropathies-hereditary-sensory and autonomic
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Künye
Tekinalp, M. (2011). Tip 2 diyabetes mellituslu hastalarda kardiyovasküler otonom nöropati sıklığı ve bununla ilişkili risk faktörlerinin belirlenmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Kardiyoloji Anabilim Dalı, Konya.
