Hemodiyaliz hastalarında aterojenik plazma indeksinin (logtrigliserid/HDL) kardiyovasküler hastalıklarla ilişkisi
Yükleniyor...
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: D islipidemi ve kardiyovasküler hastalıklar arasındaki ilişki genel popülasyonda
oldukça iyi bilinmesine rağmen, diyaliz hastalarında kanıtlar tartışmalıdır .Bu çalışma da
amacımız hemodiyaliz hastalarında aterojenik plazma indeksinin [log (TG/HDL-K) oranı] kardiyovasküler hastalıklarla ilişkisini değerlendirmektir.
Yöntem: Necmettin Erbakan Üniversitesi Tıp Fakültesi ve Konya Şehir Hastanesi Hemodiyaliz Ünitesi’nde rutin hemodiyalize giren 18 yaş üstü toplam 150 hastada retrospektif çalışma yapıldı. Antihiperlipidemik ajan kullanan hastalar çalışmanın dışında bırakıldı. Hastane otomasyon sistemleri ve hasta dosyaları taranarak veriler elde edildi.
Bulgular: Çalışmamıza dahil edilen hastaların %57,30’i (n=86) erkek idi. Tüm hastaların yaş ortalaması 51,84±17,48, VKİ ortalaması 24,28 ±4,56 kg/m2, hemodiyaliz süresi ortalaması 56,61 ± 49,62 ay olarak tespit edildi. Hastaların %48,7’si (n=73) sigara kullandığını belirtti. Hastaların %74,7’sinde (n=112) hipertansiyon, %27,3’ünde (n=41) diyabetes mellitus, %13,3’ünde (n=20) koroner arter hastalığı mevcuttu. Kardiyovasküler hastalık görülme oranı %25,3 (n=38) olarak tespit edildi. Hastaların HDL ortalaması 40,16 ± 13,07 mg/dl, TG ortalaması 147,92 ± 75,22 mg/dl, AIP index ortalaması ise 0,17 ± 0,30 olarak belirlendi. Hastaların cinsiyete göre vücut kitle indeksi gruplarının dağılımında istatistiki olarak anlamlı düzeyde fark tespit edildi (p=0,035). Bu fark erkeklerde kilolu (VKİ=≥25,0-29,9 kg/m 2) hasta oranının kadınlara göre daha düşük olmasından kaynaklanmaktaydı. Kadınlarda sigara kullanım oranı erkek hastalara göre istatistiki olarak anlamlı düzeyde düşük belirlendi(p<0,001). HDL ve total kolesterol düzeyleri kadın hastalarda erkeklere göre istatistiksel olarak anlamlı düzeyde yüksek tespit edildi (p değerleri sırasıyla; p=0,012; p=0,025). Hastaların AIP index düzeylerinin VKİ gruplarına göre dağılımında istatistiksel olarak anlamlı düzeyde fark bulundu (p=0,046). Bu fark vücut kitle indeksi <18,5 kg/m2 olan hasta grubunda, vücut kitle indeksi ≥30,0 kg/m 2 olan hasta grubuna göre düşük olmasından kaynaklanmaktaydı (p<0,05). Sigara kullanan hastalarda sigara kullanmayan hastalara göre AIP düzeyi istatistiki olarak anlamlı düzeyde yüksek tespit edildi(p<0,001). Kan lipit parametrelerinden HDL ve trigliserit düzeyi kardiyovasküler hastalık bulunan hastalarda kardiyovasküler hastalık bulunmayan hastalara kıyasla daha yüksek kaydedildi. Fakat istatistiksel olarak anlamlı düzeyde farklılık tespit edilmedi (p>0,05). Çalışmamızda hastalar AIP index düzeylerine göre üç gruba ayrıldı. (AIP <0,11; düşük risk, 0,11-0,21; orta risk, >0,21 yüksek risk) Hastaların 60’ının AIP indeks düzeyi <0,11; 23’ünün AIP index düzeyi 0,11-0,21 aralığında; 67’sinin AIP index düzeyi ise >0,21 olarak kaydedildi. 38 hasta kardiyovasküler hastalık geçirmiş olarak tespit edildi ve bunların 17’i AIP indeksine göre düşük riskli grupta, 4’ü orta riskli grupta ve 17’ü yüksek riskli gruptaydı. Yani AIP indeksine göre kardiyovasküler hastalık geçirmiş olan hemodiyaliz hastaları U şeklinde bir dağılım göstermekteydi. Fakat bu istatistiksel olarak anlamlı değildi.
Sonuç: AIP, kardiyovasküler hastalıkların göstergesi olabilecek basit, tekrarlanabilir ve düşük maliyetli bir parametre olmasına karşın HD hastalarında bu biyobelirtecin kullanılabilmesi için daha fazla çalışmaya ihtiyaç vardır. Bu nedenle, gelecekteki çalışmaların HD hastalarına özgü risk faktörlerini belirlemeye odaklanması ve bu hastalarda kötü sonuçlardan sorumlu olan altta yatan mekanizmaları deşifre etmesi hayati önem taşımaktadır.
Objective: Although the association between dyslipidaemia and cardiovascular events is well established in the general population, the evidence is controversial in dialysis patients. In this study, we aimed to evaluate the association of atherogenic plasma index [log (TG/HDL-C) ratio] with cardiovascular diseases in hemodialysis patients. Methods: A retrospective study was performed in a total of 150 patients aged ≥18 years undergoing routine haemodialysis at Necmettin Erbakan University Faculty of Medicine and Konya City Hospital Haemodialysis Unit. Patients using antihyperlipidaemic agents were excluded from the study. Data were obtained by scanning hospital automation systems and patient files. Results: Among the patients included in our study, 57.30% (n=86) were male. The mean age of all patients was 51.84±17.48 years, mean BMI was 24.28 ± 4.56 kg/m2, and mean haemodialysis duration was 56.61 ± 49.62 months. Smoking was reported by 48.7% (n=73) of the patients. Hypertension was present in 74.7% (n=112), diabetes mellitus in 27.3% (n=41), and coronary artery disease in 13.3% (n=20). The rate of cardiovascular disease was 25.3% (n=38). The mean HDL was 40.16 ± 13.07 mg/dl, mean TG was 147.92 ± 75.22 mg/dl, and mean AIP index was 0.17 ± 0.30. A statistically significant difference was found in the distribution of body mass index groups according to sex (p=0.035). This difference was due to the fact that the rate of overweight patients (BMI=≥25.0-29.9 kg/m 2) was lower in males than in females. The rate of smoking was significantly lower in women than in men (p<0.001). HDL and total cholesterol levels were found to be statistically significantly higher in female patients than in male patients (p values; p=0,012; p=0,025, respectively). A statistically significant difference was found in the distribution of AIP index levels according to BMI groups (p=0,046). This difference was due to the fact that AIP index levels were lower in the patient group with a BMI <18.5 kg/m2 than in the patient group with a BMI ≥30.0 kg/m2 (p<0.05). AIP level was found to be statistically significantly higher in smoking patients than in non-smoking patients (p<0.001). Among the blood lipid parameters, HDL and triglyceride levels were higher in patients with cardiovascular disease compared to patients without cardiovascular disease. However, no statistically significant difference was found (p>0.05). In our study, patients were divided into three groups according to AIP index levels (AIP <0.11; low risk, 0.11-0.21; moderate risk,>0.21; high risk). 60 patients had AIP index level <0.11, 23 patients had AIP index level between 0.11-0.21 and 67 patients had AIP index level>0.21. 38 patients were found to have had a cardiovascular disease and 17 of them were in the low-risk group, 4 in the intermediate-risk group and 17 in the high-risk group according to the AIP index. In other words, haemodialysis patients who had cardiovascular disease according to the AIP index showed a U-shaped distribution. However, this was not statistically significant. Conclusion: Although AIP is a simple, reproducible and low-cost parameter that may be an indicator of cardiovascular diseases, further studies are needed to utilise this biomarker in HD patients. Therefore, it is vital that future studies focus on identifying risk factors specific to HD patients and decipher the underlying mechanisms responsible for poor outcomes in these patients.
Objective: Although the association between dyslipidaemia and cardiovascular events is well established in the general population, the evidence is controversial in dialysis patients. In this study, we aimed to evaluate the association of atherogenic plasma index [log (TG/HDL-C) ratio] with cardiovascular diseases in hemodialysis patients. Methods: A retrospective study was performed in a total of 150 patients aged ≥18 years undergoing routine haemodialysis at Necmettin Erbakan University Faculty of Medicine and Konya City Hospital Haemodialysis Unit. Patients using antihyperlipidaemic agents were excluded from the study. Data were obtained by scanning hospital automation systems and patient files. Results: Among the patients included in our study, 57.30% (n=86) were male. The mean age of all patients was 51.84±17.48 years, mean BMI was 24.28 ± 4.56 kg/m2, and mean haemodialysis duration was 56.61 ± 49.62 months. Smoking was reported by 48.7% (n=73) of the patients. Hypertension was present in 74.7% (n=112), diabetes mellitus in 27.3% (n=41), and coronary artery disease in 13.3% (n=20). The rate of cardiovascular disease was 25.3% (n=38). The mean HDL was 40.16 ± 13.07 mg/dl, mean TG was 147.92 ± 75.22 mg/dl, and mean AIP index was 0.17 ± 0.30. A statistically significant difference was found in the distribution of body mass index groups according to sex (p=0.035). This difference was due to the fact that the rate of overweight patients (BMI=≥25.0-29.9 kg/m 2) was lower in males than in females. The rate of smoking was significantly lower in women than in men (p<0.001). HDL and total cholesterol levels were found to be statistically significantly higher in female patients than in male patients (p values; p=0,012; p=0,025, respectively). A statistically significant difference was found in the distribution of AIP index levels according to BMI groups (p=0,046). This difference was due to the fact that AIP index levels were lower in the patient group with a BMI <18.5 kg/m2 than in the patient group with a BMI ≥30.0 kg/m2 (p<0.05). AIP level was found to be statistically significantly higher in smoking patients than in non-smoking patients (p<0.001). Among the blood lipid parameters, HDL and triglyceride levels were higher in patients with cardiovascular disease compared to patients without cardiovascular disease. However, no statistically significant difference was found (p>0.05). In our study, patients were divided into three groups according to AIP index levels (AIP <0.11; low risk, 0.11-0.21; moderate risk,>0.21; high risk). 60 patients had AIP index level <0.11, 23 patients had AIP index level between 0.11-0.21 and 67 patients had AIP index level>0.21. 38 patients were found to have had a cardiovascular disease and 17 of them were in the low-risk group, 4 in the intermediate-risk group and 17 in the high-risk group according to the AIP index. In other words, haemodialysis patients who had cardiovascular disease according to the AIP index showed a U-shaped distribution. However, this was not statistically significant. Conclusion: Although AIP is a simple, reproducible and low-cost parameter that may be an indicator of cardiovascular diseases, further studies are needed to utilise this biomarker in HD patients. Therefore, it is vital that future studies focus on identifying risk factors specific to HD patients and decipher the underlying mechanisms responsible for poor outcomes in these patients.
Açıklama
Anahtar Kelimeler
Trigliserid / HDL kolesterol oranı, Kardiyovasküler hastalıklar, Böbrek yetmezliği, Dislipidemi, Triglyceride / HDL cholesterol ratio, Cardiovascular diseases, Renal failure, Dyslipidemia
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kıllıbaş, A. (2023). Hemodiyaliz hastalarında aterojenik plazma indeksinin (logtrigliserid/HDL) kardiyovasküler hastalıklarla ilişkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
