Metabolik sendromlu hastalarda serum total sialik asid, hassas C-reaktif protein ve prokalsitonin düzeylerinin incelenmesi
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Date
2008
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Abstract
Metabolik sendrom, inflamatuvar sürecin rol oynadığı bir hastalık olup, akut faz yanıtını oluşturan bazı markerler bu hastalığın tanısında değerli olabilir. Bu çalışmanın amacı, metabolik sendromlu hastalarda serum prokalsitonin, total sialik asid ve hassas C-reaktif protein düzeylerini birlikte inceleyerek metabolik sendromun tanısında biyokimyasal belirteç olarak rollerini değerlendirmektir. Çalışmamıza yeni metabolik sendrom tanısı alan 30-60 yaş arası 45 metabolik sendromlu olgu ve 31 sağlıklı gönüllü dahil edildi. Metabolik sendrom tanısı 'The İnternational Diabetes Federation' kriterlerine göre konuldu. Serum total sialik asid düzeyleri metabolik sendromlu hasta grubunda kontrol grubundan anlamlı olarak yüksekti (p<0.001). Serum hassas C-reaktif protein metabolik sendromlu hasta grubunda kontrol grubundan anlamlı olarak yüksekti (p=0.001). Serum prokalsitonin düzeyleri açısından metabolik sendromlu hasta grubu ile kontrol grubu arasında istatistiksel açıdan anlamlı farklılık yoktu (p>0.05). Hasta grubunda total sialik asid ile vücut kitle indeksi (p=0.009), insülin (p=0.001) ve 'Homeostasis Model Assesment' indeksi (p=0.014) arasında pozitif korelasyon saptandı. Ayrıca hassas C-reaktif protein ile bel çevresi (p=0.044), vücut kitle indeksi (p<0.001), insülin (p=0.012) ve 'Homeostasis Model Assesment' indeksi (p=0.031) arasında da pozitif bir korelasyon mevcuttu. Serum total sialik asid ve hassas C-reaktif protein üzerinde etkili olabilecek değişkenlerin belirlenmesi için yapılan aşamalı regresyon analizi sonucunda ise total sialik asid düzeyleri üzerinde vücut kitle indeksi ve insülinin birlikte, hassas C-reaktif protein düzeyleri üzerinde ise vücut kitle indeksinin tek başına belirleyici faktör olduğu saptandı. 'Receiver Operation Characteristics' analizi sonuçları hem total sialik asidin hem de hassas C-reaktif proteinin metabolik sendromlu hastaları sağlıklılardan ayırmada prognostik gücü olan biyokimyasal belirteçler olduğunu gösterirken, daha önceki çalışmaları destekler biçimde total sialik asidin hassas C-reaktif proteinden daha duyarlı bir belirteç olduğunu da ortaya koydu. Sonuç olarak çalışmamız, metabolik sendromlu hastaların serum total sialik asid ve hassas C-reaktif protein düzeylerinde önemli bir artış olduğunu, oysa prokalsitonin düzeylerinin değişmediğini, dolayısıyla metabolik sendrom tanısı koymada serum total sialik asid ve hassas C-reaktif protein düzeylerinin biyokimyasal belirteç olarak kullanılabileceğini göstermiştir.
Metabolic syndrome is a disease which occurs as part of an inflammatory process. Some biochemical markers that form the acute phase response may be valuable for the diagnosis of the syndrome. The aim of the study is to evaluate the levels of serum procalcitonin, serum total sialic asid and high sentitive C-rective protein in patients with metabolic syndrome and to determine their roles as biochemical markers for the diagnosis of metabolic syndrome. In this study, 45 cases aged between 30-60 years old who were recently diagnosed as having metabolic syndrome and 31 healthy control cases were included. Metabolic syndrome was diagnosed according to The International Diabetes Federation criteria. Serum total sialic acid levels in patients with metabolic syndrome were significantly higher than those in control group (p<0.001). Serum high sensitive C-reactive protein levels in metabolic syndrome patients were found to be significantly higher than control group (p<0.001). Serum procalcitonin levels were not significantly different between metabolic syndrome and control group (p>0.05). In the patient group, there was a positive correlation between total sialic acid levels and body mass index (p=0.009), insulin (p=0.001) and Homeostasis Model Assesment index (p=0.014). In addition, there was also a positive correlation between high sensitive C-reactive protein and waist circumference (p=0.044), body mass index (p<0.001), insulin (p=0.012) and Homeostasis Model Assesment index (p=0.031). In the regression analysis that was performed to investigate the variables that could have effects on serum total sialic acid and high sensitive C-reactive protein, it was found that on the total sialic acid levels, both of body mass index and insulin and on the CRP levels just the body mass index were determinant factors. According to 'Receiver Operation Characteristics' analysis; it was found that both total sialic acid and high sensitive C-reactive protein were good biochemical markers which have some prognostic power to differentiate patients with metabolic syndrome from healty individuals. In addition, it was exposed that total sialic acid had higher sensitivity than high sensitive C-reactive protein in parallel with previous studies. In conclusion, in our study, it was observed that the levels of serum high sensitive C reactive protein and total sialic acid were significantly increased in metabolic syndrome. However, serum procalcitonin level was unchanged. Therefore, serum high sensitive C reactive protein and total sialic acid levels may be used as biochemical markers for the diagnosis of metabolic syndrome.
Metabolic syndrome is a disease which occurs as part of an inflammatory process. Some biochemical markers that form the acute phase response may be valuable for the diagnosis of the syndrome. The aim of the study is to evaluate the levels of serum procalcitonin, serum total sialic asid and high sentitive C-rective protein in patients with metabolic syndrome and to determine their roles as biochemical markers for the diagnosis of metabolic syndrome. In this study, 45 cases aged between 30-60 years old who were recently diagnosed as having metabolic syndrome and 31 healthy control cases were included. Metabolic syndrome was diagnosed according to The International Diabetes Federation criteria. Serum total sialic acid levels in patients with metabolic syndrome were significantly higher than those in control group (p<0.001). Serum high sensitive C-reactive protein levels in metabolic syndrome patients were found to be significantly higher than control group (p<0.001). Serum procalcitonin levels were not significantly different between metabolic syndrome and control group (p>0.05). In the patient group, there was a positive correlation between total sialic acid levels and body mass index (p=0.009), insulin (p=0.001) and Homeostasis Model Assesment index (p=0.014). In addition, there was also a positive correlation between high sensitive C-reactive protein and waist circumference (p=0.044), body mass index (p<0.001), insulin (p=0.012) and Homeostasis Model Assesment index (p=0.031). In the regression analysis that was performed to investigate the variables that could have effects on serum total sialic acid and high sensitive C-reactive protein, it was found that on the total sialic acid levels, both of body mass index and insulin and on the CRP levels just the body mass index were determinant factors. According to 'Receiver Operation Characteristics' analysis; it was found that both total sialic acid and high sensitive C-reactive protein were good biochemical markers which have some prognostic power to differentiate patients with metabolic syndrome from healty individuals. In addition, it was exposed that total sialic acid had higher sensitivity than high sensitive C-reactive protein in parallel with previous studies. In conclusion, in our study, it was observed that the levels of serum high sensitive C reactive protein and total sialic acid were significantly increased in metabolic syndrome. However, serum procalcitonin level was unchanged. Therefore, serum high sensitive C reactive protein and total sialic acid levels may be used as biochemical markers for the diagnosis of metabolic syndrome.
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Keywords
Biyokimya, Biochemistry, Sendrom X, Sendrom X, Sialik Asit, Sialic Acid
