Primer hiperparatiroidili hastalarda metabolik sendrom sıklığı
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Date
2015
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Trakya Üniversitesi Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Abstract
Amaç: Çalışmamızda, primer hiperparatiroidizm olgularında artan morbidite ve mortaliteye neden olduğu iddia edilen metabolik sendromun sıklığının tespiti, metabolik sendrom parametrelerinin incelenmesi ve primer hiperparatiroidizmde metabolik sendrom belirleyicilerinin tayinini yaparak, bu hastaların uzun dönem takibine ve yönetimine katkıda bulunmayı hedefledik. Materyal ve Metod: Trakya Üniversitesi Tıp Fakültesi İç Hastalıkları Anabilim Dalı Endokrinoloji ve Metabolizma Bilim Dalı tarafından ocak 2005 ile aralık 2014 tarihleri arasında takip edilen, primer hiperparatioidizm olarak tanımlanan, 18 yaşını doldurmuş, gebe olmayan, böbrek ve karaciğer yetmezliği ve diğer sistemik hastalıkları olmayan 78 hasta çalışmaya dahil edildi. Bulgular: Hastaların 62'si (%79,5) kadın, 16'sı (%20,5) erkek, K/E: 3,875, yaş ortalamaları 55,3±12,6 yıl (minimum: 27, maksimum: 78) olarak saptandı. Hastalardan 58 tanesinin primer hiperparatiroidizme ait semptom taşıdığı, 20 tanesinin semptomatik olmadığı tespit edildi. Hastalar "National Cholesterol Education Program-Adult Treatment Panel III" metabolik sendrom tanı kriterlerine göre değerlendirildiğinde, 32 hastada (%41) metabolik sendrom tespit edilip, 37 hastanın da (%47,5) metabolik sendrom tespit edilmese de bir veya iki sendrom kriteri taşıdığı görüldü. Metabolik sendrom tespit edilen primer hiperparatirodili hastalar ile metabolik sendrom tespit edilmeyen primer hiperparatiroidi hastalarının asemptomik, semptomatik hasta dağılımları arasında istatistiksel olarak anlamlı farklılık görülmedi (p=0,710). Metabolik sendromlu primer hiperparatiroidi hastalarında üriner sisteme ait taş hastalığı sıklığı, metabolik sendrom olmayanlara göre istatiksel olarak anlamlı düzeyde yüksek tespit edildi (p=0,018). Primer hiperparatiroidizmde metabolik sendrom belirleyicilerinin tespiti için oluşturulan 12 basamaklı lojistik regresyon modelinde; yüksek açlık kan şekeri düzeyi, düşük HDL kolesterol düzeyi, yüksek trigliserid düzeyi, eşlik eden hipertansiyon tanısı ve üriner sisteme ait taş hastalığı varlığının istatistiksel önemini tespit ettik. Sonuç: Primer hiperparatiroidizmli hastalarda metabolik sendrom sıklığının genel topluma göre artmamasına rağmen bu hastalarda kardiyovasküler morbidite ve mortalite artışına neden olabilecek hipertansiyon, artmış bel çevresi, lipid profili bozukluğu gibi sendrom anormalliklerin sıklıklarında artış olduğu saptandı.
Abstract
Introduction: In this study, we wanted to evaluate prevalence of metabolic syndrome, metabolic abnormalities and independent predictors of metabolic syndrome in primary hyperparathyroidism and contribute to long term follow up and management of these patients. Materials and Methods: Seventy eight patients diagnosed primary hyperparathyroidism, over 18 years, non-pregnant , non- renal and hepatic failure and other systemic diseases,between january 2005 and december 2014 at Trakya University Medical Faculty Endocrinology and Metabolism Department were evaluated. Results: Sixty two (%79,5) patients were female, sixteen patients (%20,5) were male. The mean age was 55,3±12,6 year (minimal:27, maximal:78), female/male ratio was 3,875. Fifty eight patients were classified symptomatic and twenty patient were classified asymptomtic. Prevalence of metabolic syndrome defined with the modified "National Cholesterol Educational Program-Adult Treatment Panel III" criteria within this study of primary hyperparathyroidism were thirty two patients (%41). Thirty seven patients were presence one or two abnormalities of the metabolic syndrome. The symptomatic /asemptomatic rate was similiar in primary hyperparathiroidism with metabolic syndrom group and primary hyperparathyroidism without metabolic syndrome group (p=0,710). Hyperparathiroidism with metabolic syndrom group showed significantly higher prevalence of urinary tract stone disease than primary hyperparathyroidism without metabolic syndrome group (p=0,018). In our twelve stepwise logistic regression model of independent predictors of metabolic syndrome in primary hyperparathyroidism; we observed a significant independent relationship between metabolic syndrome and high fasting blood glucose levels, low HDL cholesterol levels, high triglycerides levels, hypertension and urinary tract stone disease. Conclusion: The prevalence of metabolic syndrome in primary hyperparathyroidism is not increased in comparison to that found in the general population. Although in these patients showed higher prevalence of hypertension, increased waist circumference, lipid disorders such as some syndrome abnormalities that may lead to the increased cardiovascular morbidity and mortality.
Abstract
Introduction: In this study, we wanted to evaluate prevalence of metabolic syndrome, metabolic abnormalities and independent predictors of metabolic syndrome in primary hyperparathyroidism and contribute to long term follow up and management of these patients. Materials and Methods: Seventy eight patients diagnosed primary hyperparathyroidism, over 18 years, non-pregnant , non- renal and hepatic failure and other systemic diseases,between january 2005 and december 2014 at Trakya University Medical Faculty Endocrinology and Metabolism Department were evaluated. Results: Sixty two (%79,5) patients were female, sixteen patients (%20,5) were male. The mean age was 55,3±12,6 year (minimal:27, maximal:78), female/male ratio was 3,875. Fifty eight patients were classified symptomatic and twenty patient were classified asymptomtic. Prevalence of metabolic syndrome defined with the modified "National Cholesterol Educational Program-Adult Treatment Panel III" criteria within this study of primary hyperparathyroidism were thirty two patients (%41). Thirty seven patients were presence one or two abnormalities of the metabolic syndrome. The symptomatic /asemptomatic rate was similiar in primary hyperparathiroidism with metabolic syndrom group and primary hyperparathyroidism without metabolic syndrome group (p=0,710). Hyperparathiroidism with metabolic syndrom group showed significantly higher prevalence of urinary tract stone disease than primary hyperparathyroidism without metabolic syndrome group (p=0,018). In our twelve stepwise logistic regression model of independent predictors of metabolic syndrome in primary hyperparathyroidism; we observed a significant independent relationship between metabolic syndrome and high fasting blood glucose levels, low HDL cholesterol levels, high triglycerides levels, hypertension and urinary tract stone disease. Conclusion: The prevalence of metabolic syndrome in primary hyperparathyroidism is not increased in comparison to that found in the general population. Although in these patients showed higher prevalence of hypertension, increased waist circumference, lipid disorders such as some syndrome abnormalities that may lead to the increased cardiovascular morbidity and mortality.
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Tıpta Uzmanlık Tezi
Keywords
Metabolik Sendrom, Metabolik Anormallik, Primer Hiperparatiroidizm, Primary Hyperparathyroidism, Metabolic Abnormalities, Metabolic Syndrome
