Nonfonksiyonel surrenal insidentalomalı hastalarda serum visfatin düzeyi ile kardiyometabolik risk faktörleri arasındaki ilişki

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dc.contributor.advisorKarakurt, Feridun
dc.contributor.authorAltın, Ebru
dc.date.accessioned2022-04-05T08:12:02Z
dc.date.available2022-04-05T08:12:02Z
dc.date.issued2021en_US
dc.date.submitted2021
dc.departmentNEÜ, Meram Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Anabilim Dalıen_US
dc.description.abstractGörüntüleme tekniklerin ilerlemesi ve kullanımın yaygınlaşması ile nonfonksiyonel adrenal insidenteloma (NFAİ) saptanma sıklığı artmıştır. Hormonal olarak inaktif olarak değerlendirilmesine rağmen son çalışmalarda NFAİ hastalarında metabolik ve kardiyovasküler hastalık riskinin arttığı gösterilmiştir. Altta yatan etiyopatogenezin ve risk faktörlerin tanımlanması bu hasta grubunda kardiyovasküler hastalıkların önlenmesinde oldukça önemlidir. Bu çalışmanın amacı, NFAİ hastalarında özellikle yağ dokusundan salınan; glukoz metabolizması ve inflamasyon ile yakından ilişkili olan visfatinin bilinen kardiyometabolik risk faktörleri ile ilişkisine ışık tutmaktır. Gereç ve yöntem Çalışmamıza Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Endokrinoloji ve Metabolizma Hastalıkları Bölümüne başvuran 18-65 yaş arası NFAİ tanısı alan 45 hasta ve adrenal bezde kitlesi olmayan 45 sağlıklı gönüllü çalışmaya dahil edildi. Katılımcıların demografik bilgileri kaydedilerek, fizik muayene bulguları, antropometrik ölçümleri not alındı. Hastaların biyokimyasal değerlerine ek olarak serum visfatin düzeyleri ölçüldü. Ekokardiyografi ile karotis intima media kalınlığı (KIMK) ve epikardiyal yağ doku kalınlığı (EYDK) ölçümleri yapıldı. Veriler SPSS (Statistical Package for Social Sciences) 18.0 paket programı ile analiz edildi. Kategorik verilerin karşılaştırılmasında Ki-kare (ꭕ 2 ), KolmogorovSmirnov, Mann Whitney U testi ile, Kruskal-Wallis testi kullanılarak incelendi. Ayrıca Dunn Bonferoni düzeltmesi, Post Hoc ve Spearman Korelasyon analizi ve ANOVA testi kullanıldı.en_US
dc.description.abstractWith the advancement of imaging techniques and widespread use, the frequency of detection of nonfunctional adrenal incidenteloma (NFAI) has increased. Although it is considered to be hormonally inactive, recent studies have shown an increased risk of metabolic and cardiovascular disease in NFAI patients. Identifying the underlying etiopathogenesis and risk factors is very important in the prevention of cardiovascular diseases in this patient group. The aim of this study; evaluate the relationship between known cardiometabolic risk factors and visfatin which is closely related to glucose metabolism , inflammation and especially released from adipose tissue in NFAI patients. Methods 45 patients diagnosed with NFAI and 45 healthy volunteers without adrenal mass were included in the study. Participants were between the ages of 16 and 65 who applied to the Department of Endocrinology and Metabolism Diseases of Necmettin Erbakan University Meram Medical Faculty. The demographic information of the participants was recorded, and their physical examination findings and anthropometric measurements were noted. In addition to the biochemical values of the patients, serum visfatin levels were measured. Carotid intimamedia thickness (CIMT) and epicardial adipose tissue thickness (EYDT) were measured by echocardiography. Data were analyzed with SPSS (Statistical Package for Social Sciences) 18.0 package program. Chi-square (ꭕ2), Kolmogorov-Smirnov, Mann Whitney U test and KruskalWallis test were used to compare categorical data. In addition, Dunn Bonferoni correction, Post Hoc and Spearman Correlation analysis and ANOVA test were used. vii Results Our study included 90 participants, 53 females and 37 males. While the median age was 51 in the group with adenoma, it was 44 in the group without adenoma. Age, gender distribution, height, waist circumference, and blood pressure values were similar between the groups. While the weight, body mass index (BMI), hip circumference values were higher in the group with adenoma, the incidence of insulin resistance and metabolic syndrome was higher in this group, which was statistically significant (p <0.05). While the median value of visfatin was 7.8 in the group with adenoma, this value was 6.94 in the group without adenoma, and this difference was not statistically significant (p >0.05). CIMT and EYDT values were similar in both groups, no significant difference was found between the two groups (p >0.05). When the relationship between serum visfatin value and cardiometabolic risk factors is examined; In the group with adenoma, there was a positive low-moderate significant correlation between visfatin level and total cholesterol and LDL-cholesterol (r values were respectively; r=0.362, r=0.338, p values were p=0.014, p=0.023, respectively), whereas in the group without adenoma, a positive low-moderate significant relationship was found between insulin and HOMA-IR (r values were r=0.351, r=0.312, p values were p=0.018, p=0.037, respectively). Conclusion The effectiveness of visfatin on cells and tissues, its functions, and its relationship with cardiometabolic diseases are not clearly known. There are conflicting data in the studies. The findings of our study, in which we investigated the relationship between serum visfatin level and cardiometabolic risk factors in NFAI patients, suggest that visfatin cannot be used as an indicator of cardiovascular disease in this patient group. There is a need for detailed studies involving more patient groups on this subject.en_US
dc.identifier.citationAltın, E. (2021). Nonfonksiyonel surrenal insidentalomalı hastalarda serum visfatin düzeyi ile kardiyometabolik risk faktörleri arasındaki ilişki. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12452/8200
dc.language.isotren_US
dc.publisherNecmettin Erbakan Üniversitesi Meram Tıp Fakültesien_US
dc.relation.publicationcategoryTezen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAdrenal insidentalomaen_US
dc.subjectVisfatinen_US
dc.subjectKardiyometabolik risk faktörlerien_US
dc.subjectAdrenal incidentalomaen_US
dc.subjectVisfatinen_US
dc.subjectCardiometabolic risk factorsen_US
dc.titleNonfonksiyonel surrenal insidentalomalı hastalarda serum visfatin düzeyi ile kardiyometabolik risk faktörleri arasındaki ilişkien_US
dc.title.alternativeThe relationship between serum visfatin level andcardiometabolic risk factors in patients with nonfunctionalsurrenal incidentalomaen_US
dc.typeSpecialist Thesisen_US

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