Diyabetik nefropatide ateroskleroz; etkileyen faktörler ve irisinin yeri
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Date
2022
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Trakya Üniversitesi Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Abstract
İrisin, esas olarak iskelet kasında u?retilen ve egzersiz ile konsantrasyonu artan yeni kes?fedilmis? bir hormondur. Beyaz yag? dokusu hu?crelerini kahverengi yag? dokusuna do?nu?s?tu?rerek enerji harcanmasını artırmakta ve lipid ve enerji metabolizmasını etkilemektedir. Glukoz homeostazisine katkıda bulunan irisinin, aynı zamanda orta derecede ancak o?nemli bir kilo kaybı sag?ladıg?ı go?sterilmis?tir. İrisin, enerji harcanmasını artırıp kilo kaybına neden oldug?u için metabolik hastalıkların tedavisinde umut verici olmus?tur İrisin, metabolik hastalıklar için terapo?tik bir protein olabilir veya metabolik hastalıkların bir biyomarkerı olarak tanıda kullanılabilir. Bu amaçla yapılan çalıs?malar devam etmektedir. Bu çalıs?manın amacı, bilinen aterosklerotik hastalıg?ı olmayan sag?lıklı bireyler, diyabetik nefropati gelis?memis? diyabetikler ve diyabetik nefropati gelis?mis? diyabetikler arasında serum irisin du?zeyleri açısından bir fark olup olmadıg?ını ve diyabetik nefropati gelis?en ve bilinen aterosklerotik hastalıg?ı olmayan hastalarda irisin düzeyi ile aterosklerozun bir ilis?kisi olup olmadıg?ını, irisin du?zeyi ile aterosklerozun erken ve noninvaziv bir go?stergesi olan CIMT ile ilis?kisini deg?erlendirmek ve bunun yanında serum irisin seviyesi ve karotis intima-media kalınlıg?ı ile ilis?kili olabilecek dig?er parametrelerin go?zden geçirilmesidir. Çalıs?mada Trakya Üniversitesi Tıp Faku?ltesi Hastanesine Ag?ustos 2020- Ag?ustos 2021 tarihlerinde bas?vuran 93 Tip 2 Diabetes Mellitus tanılı hasta ve bilinen kronik hastalıg?ı olmayan sag?lıklı 41 go?nu?llu?de irisin du?zeyi ve karotis intima media kalınlıg?ı ölçümleri yapılarak, etkileyen fakto?rler aras?tırılmıs?tır. Hastaların verileri rutin kontrol sırasındaki muayenelerinde toplanmıs?tır. Serum irisin seviyesi tayini hastaların rutin kontrolleri sırasında alınan serumlarda ELISA yo?ntemi ile test edilmis?tir. Yapılan analizler sonucunda irisin du?zeylerinin Tip 2 Diyabetes Mellitus tanısı olan hastalarda daha du?s?u?k oldug?u ve hipertansiyon varlıg?ı, diyabet süresi, diyabet aile öyküsü varlıg?ı, diyabetik retinopati varlıg?ı, yas?, vu?cut kitle indeksi, sistolik kan basıncı, açlık kan s?ekeri, albu?minu?ri ve karotis intima-media kalınlıg?ı ile negatif korelasyon go?sterdig?i tespit edilmis?tir. Karotis intima-media kalınlıg?ının Tip 2 diyabetes mellitus tanılı grupta daha kalın oldug?u ve karotis intima media kalınlıg?ının yas?, diyabet su?resi, hipertansiyon varlıg?ı, diyabetik ve hipertansif retinopati varlıg?ı, vu?cut kitle indeksi, bel çevresi, sistolik ve diyastolik kan basıncı ve ortalama arter basıncı, albu?minu?ri du?zeyi ile pozitif; tahmini glomeru?ler filtrasyon hızı ve irisin du?zeyi ile negatif korelasyon go?sterdig?i saptanmıs?tır. Mevcut bulgular irisin ve karotis intima-media kalınlıg?ının ateroskleroz erken bir belirteci oldug?u, ateroskleroz risk fakto?rleri ile anlamlı ilis?kileri dolayısıyla uygun bir biyobelirteç olma konusunda umut vaat etmektedir.
Irisin is a newly discovered hormone produced mainly in skeletal muscle and whose concentration is increased by exercise. It increases energy expenditure by transforming white adipose tissue cells into brown adipose tissue and affects lipid and energy metabolism. Contributing to glucose homeostasis, irisin has also been shown to provide moderate but significant weight loss. Since irisin increases energy expenditure and causes weight loss, it has been promising in the treatment of metabolic diseases. Studies for this purpose continue. The aim of this study is to determine whether there is a difference in serum irisin levels between healthy individuals without known atherosclerotic disease, diabetics without diabetic nephropathy and diabetics with diabetic nephropathy, and whether there is a relationship between irisin level and atherosclerosis in patients with diabetic nephropathy and no known atherosclerotic disease, irisin level and early atherosclerosis and to evaluate its relationship with carotid intima-media thickness, a noninvasive indicator, as well as to review the serum irisin level and other parameters that may be associated with carotid intima-media thickness. In the study, irisin level and carotid intima-media thickness measurements were made in 93 patients with Type 2 Diabetes Mellitus and 41 healthy volunteers without known chronic diseases who applied to Trakya University Faculty of Medicine Hospital between August 2020 and August 2021, and the affecting factors were investigated. The data of the patients were collected during their routine control examinations. Determination of serum irisin level was tested by ELISA method in the serums taken during routine controls of the patients. As a result of the analysis, irisin levels were lower in patients diagnosed with Type 2 Diabetes Mellitus, and it was found that there was a negative correlation with presence of hypertension, duration of diabetes, family history of diabetes, presence of diabetic retinopathy, age, body mass index, systolic blood pressure, fasting blood glucose, albuminuria and carotid intimamedia thickness. Carotid intima-media thickness was found thicker in the group diagnosed with Type 2 diabetes mellitus. Carotid intima-media thickness was positively correlated with age, duration of diabetes, presence of hypertension, presence of diabetic and hypertensive retinopathy, body mass index, waist circumference, systolic and diastolic blood pressure, and mean arterial blood pressure, albuminuria. It was found there was a negative correlation with the estimated glomerular filtration rate and irisin level. Current findings show promise as an appropriate biomarker because of the fact that the irisin and carotid intima-media thickness are an early marker of atherosclerosis and are significantly associated with atherosclerosis risk factors.
Irisin is a newly discovered hormone produced mainly in skeletal muscle and whose concentration is increased by exercise. It increases energy expenditure by transforming white adipose tissue cells into brown adipose tissue and affects lipid and energy metabolism. Contributing to glucose homeostasis, irisin has also been shown to provide moderate but significant weight loss. Since irisin increases energy expenditure and causes weight loss, it has been promising in the treatment of metabolic diseases. Studies for this purpose continue. The aim of this study is to determine whether there is a difference in serum irisin levels between healthy individuals without known atherosclerotic disease, diabetics without diabetic nephropathy and diabetics with diabetic nephropathy, and whether there is a relationship between irisin level and atherosclerosis in patients with diabetic nephropathy and no known atherosclerotic disease, irisin level and early atherosclerosis and to evaluate its relationship with carotid intima-media thickness, a noninvasive indicator, as well as to review the serum irisin level and other parameters that may be associated with carotid intima-media thickness. In the study, irisin level and carotid intima-media thickness measurements were made in 93 patients with Type 2 Diabetes Mellitus and 41 healthy volunteers without known chronic diseases who applied to Trakya University Faculty of Medicine Hospital between August 2020 and August 2021, and the affecting factors were investigated. The data of the patients were collected during their routine control examinations. Determination of serum irisin level was tested by ELISA method in the serums taken during routine controls of the patients. As a result of the analysis, irisin levels were lower in patients diagnosed with Type 2 Diabetes Mellitus, and it was found that there was a negative correlation with presence of hypertension, duration of diabetes, family history of diabetes, presence of diabetic retinopathy, age, body mass index, systolic blood pressure, fasting blood glucose, albuminuria and carotid intimamedia thickness. Carotid intima-media thickness was found thicker in the group diagnosed with Type 2 diabetes mellitus. Carotid intima-media thickness was positively correlated with age, duration of diabetes, presence of hypertension, presence of diabetic and hypertensive retinopathy, body mass index, waist circumference, systolic and diastolic blood pressure, and mean arterial blood pressure, albuminuria. It was found there was a negative correlation with the estimated glomerular filtration rate and irisin level. Current findings show promise as an appropriate biomarker because of the fact that the irisin and carotid intima-media thickness are an early marker of atherosclerosis and are significantly associated with atherosclerosis risk factors.
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Keywords
Tip 2 diabetes mellitus, Diyabetik nefropati, İrisin, Karotis intima-media kalınlığı, Type 2 diabetes mellitus, Diabetic nephropathy, Irisin, Carotid intima-media thickness
