Koroner anjiografi yapılan hastalarda aterosklerotik lezyonun şiddeti ile ultrasonografik karaciğer yağlanması ve ast ve ggt düzeyleri arasındaki ilişki
Küçük Resim Yok
Tarih
2013
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Non alkolik yağlı karaciğer hastalığı ve koroner arter hastalığının birçok ortak risk faktörü olmakla birlikte bu iki durum arasındaki direk ilişki sadece birkaç çalışma ile sınırlı kalmıştır. Çalışmamızda anjiografik yöntem ile kanıtlanmış ve gensini skoru ile değerlendirilen koroner arter hastalığı yaygınlığı ve şiddeti ile non alkolik karaciğer yağlanması ve serum aspartat aminotransferaz ve gama glutamil transferaz seviyeleri arasındaki ilişkileri araştırmak ve klasik koroner ateroskleroz risk faktörleri ile non alkolik karaciğer yağlanması arasındaki olası ilişkileri gözden geçirmek amaçlanmıştır. Kliniğimizde herhangi bir nedenle koroner anjiografi yapılan; batın ultrasonografi ve/veya hepatobilier ultrasonografi yapılmış olan ve eş zamanlı serum aspartat aminotransferaz ve gama glutamil transferaz düzeylerine bakılmış olan hastaların geriye dönük olarak koroner anjiografi görüntüleri, ultrasonografi raporları ve labaratuar parametreleri incelendi. Koroner anjiografi görüntüleri incelenerek hastaların gensini skoru hesaplandı. Hepatosteatoz derecesine göre hastalar grade 0, grade 1, grade 2-3 şeklinde guplandı. Daha sonra hastalar hepatosteatoz derecesine göre grade 0-1 ve grade 2-3; gensini skoruna göre ise kabul edilebilir cut off değeri alınarak gensini skoru ?36 (koroner ateroskleroz yok veya hafif) ve gensini skoru >36 (orta ve ciddi düzeyde koroner ateroskleroz) şeklinde ayrıca gruplara ayrıldı. Geleneksel risk faktörleri açısından hasta dosyaları tarandı. Hepatosteatoz derecesi arttıkça gruplar arasında gensini skoru anlamlı olarak daha yüksek saptandı; hepateastoz grade 2-3 olan grupta gensini skor ortalaması ve gensini skor >36 saptanan hasta oranı hepasteastoz grade 0-1 olan gruptan anlamlı olarak daha yüksek saptandı (p < 0,05). Koroner arter hastalığı olanlarda aspartat aminotransferaz düzeyi koroner arter hastalığı olmayanlara göre anlamlı olarak daha yüksek saptandı, gensini skoru ile aspartat aminotransferaz düzeyi arasında anlamlı korelasyon saptandı(p < 0,05). Koroner arter hastalığı olanlarda gama glutamil transferaz düzeyi koroner arter hastalığı olmayanlar ile kıyaslandığında anlamlı fark saptanmadı. Gensini skoru ile gama glutamil transferaz düzeyi arasında anlamlı olma eğilimde olan p değeri saptandı ( p değeri 0,051). Hepatosteatoz varlığı ve şiddetindeki ultrasonografik artışın KAH yaygınlığı ve şiddeti ile direk ilişkili olduğunu ve non alkolik yağlı karaciğer hastalığının mevcut bulgularla koroner arter hastalığı için bağımsız bir risk faktörü olabileceğini düşünüyoruz. Anahtar kelimeler: Koroner ateroskleroz yaygınlığı ve şiddeti, non alkolik yağlı karaciğer hastalığı, aspartat aminotransferaz, gama glutamil transferaz
Non-alcoholic fatty liver disease and coroner artery disease have many common risk factors as well as the relationship between these two diseases has remained limited with a few studies. In the study we have been aimed to research the relationships between the prevalence and the intensity of coroner artery disease that has been proved with angiographic methods and evaluated with gensini score and non-alcoholic fatty liver disease and serum aspartate aminotransferase and gamma glutamiltransferase levels; and to review the possible relationships between classic coroner artery risk factors and non-alcoholic fatty liver disease. In our clinic retrospectively coroner angiography views, ultrasonography reports and laboratory parameters of patients were examined whose coroner angiography has been performed in any reason; abdomen ultrasonography and/or hepatobiliary ultrasonography has been performed and comorbid serum aspartate aminotransferase and gamma glutamiltransferase levels have been checked. Gensini score of the patients have been assessed by checking the angiographic views. The patients have been grouped as grade 0, grade 1, grade 2-3 according to hepatosteatosis grade. Afterwards, patients have been divided according to hepatosteatosis grade as grade 0-1 and grade 2-3 ; and according to gensini score an appropriate cut-off value was chosen and patients were divided into groups those with a gensini score ?36 (absent or mild coronary atherosclerosis) and >36 (medium to severe coronary atherosclerosis). Patient files have been scanned in terms of traditional risk factors. As the degree hepatosteatosis, the higher gensini score between groups has been meaningfully determined; in hepatosteatosis grade 2-3 group the average gensini score and the patient rate whose gensini score has been determined >36 has been significantly higher than hepatosteatoz grade 0-1 group (p < 0,05). Aspartate aminotransferase level was significantly higher in patients have coronary artery disease to compared patients without coronary artery disease and there was significantly correlation between aspartate aminotransferase and gensini score levels (p < 0,05). There was no significant difference on gamma glutamiltransferase levels between patient groups with and without coronary artery disease. P value was found which tend to be statistically significant between gensini score and gamma glutamiltransferase level ( p value 0,051). We think there is direct link between the presence and severity of ultrasonographic hepatosteatosis level and the extensity and severity of coronary artery disease; and because of the current findings we think that non-alcoholic fatty liver disease could be an independent risk factor for coronary artery disease. Key words: Coronary atherosclerosis extensity and severity, non alcoholic fatty liver disease, aspartate aminotransferase, gamma glutamiltransferase
Non-alcoholic fatty liver disease and coroner artery disease have many common risk factors as well as the relationship between these two diseases has remained limited with a few studies. In the study we have been aimed to research the relationships between the prevalence and the intensity of coroner artery disease that has been proved with angiographic methods and evaluated with gensini score and non-alcoholic fatty liver disease and serum aspartate aminotransferase and gamma glutamiltransferase levels; and to review the possible relationships between classic coroner artery risk factors and non-alcoholic fatty liver disease. In our clinic retrospectively coroner angiography views, ultrasonography reports and laboratory parameters of patients were examined whose coroner angiography has been performed in any reason; abdomen ultrasonography and/or hepatobiliary ultrasonography has been performed and comorbid serum aspartate aminotransferase and gamma glutamiltransferase levels have been checked. Gensini score of the patients have been assessed by checking the angiographic views. The patients have been grouped as grade 0, grade 1, grade 2-3 according to hepatosteatosis grade. Afterwards, patients have been divided according to hepatosteatosis grade as grade 0-1 and grade 2-3 ; and according to gensini score an appropriate cut-off value was chosen and patients were divided into groups those with a gensini score ?36 (absent or mild coronary atherosclerosis) and >36 (medium to severe coronary atherosclerosis). Patient files have been scanned in terms of traditional risk factors. As the degree hepatosteatosis, the higher gensini score between groups has been meaningfully determined; in hepatosteatosis grade 2-3 group the average gensini score and the patient rate whose gensini score has been determined >36 has been significantly higher than hepatosteatoz grade 0-1 group (p < 0,05). Aspartate aminotransferase level was significantly higher in patients have coronary artery disease to compared patients without coronary artery disease and there was significantly correlation between aspartate aminotransferase and gensini score levels (p < 0,05). There was no significant difference on gamma glutamiltransferase levels between patient groups with and without coronary artery disease. P value was found which tend to be statistically significant between gensini score and gamma glutamiltransferase level ( p value 0,051). We think there is direct link between the presence and severity of ultrasonographic hepatosteatosis level and the extensity and severity of coronary artery disease; and because of the current findings we think that non-alcoholic fatty liver disease could be an independent risk factor for coronary artery disease. Key words: Coronary atherosclerosis extensity and severity, non alcoholic fatty liver disease, aspartate aminotransferase, gamma glutamiltransferase
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Kardiyoloji, Cardiology
