OBEZ HASTALARDA BEDEN KİTLE İNDEKSİ VE ATEROJENİK İNDEKSİN RETINAL MİKROVASKÜLER YAPI ÜZERİNE ETKİLERİ

Year 2023, Volume: 13 Issue: 2, 287 - 294, 30.06.2023

Erel İçel Nergis Akbaş Emin Murat Akbaş Aykut İçel Yusuf Kemal Arslan

https://doi.org/10.31832/smj.1260292

Abstract

Amaç: Bu çalışmada, obez hastalarda retinal mikrovasküler yapısında meydana gelen değişiklikleri değerlendirmeyi ve bu değişikliklerin klinik özelliklerle ilişkisini belirlemeyi amaçladık.
Gereç ve Yöntemler: Tüm katılımcılarda kolesterol, açlık kan şekeri, açlık insülini,CRP ve HbA1C düzeylerini içeren biyokimyasal incelemeler yapıldı. Plazma aterojenik indeksi(AI) plazma trigliserid (TG) düzeyinin yüksek yoğunluklu lipoprotein (HDL) düzeyine oranının logaritması [log (TG/HDL-K)] olarak hesaplandı. Vücut Kitle İndeksi (VKİ) ≤25 kg/m2 olan hastalar kontrol grubuna dahil edildi. Obez hastalar VKİ'lerine göre üç gruba ayrıldı: grup 1 (VKİ: 30-34,99 kg/m2), grup 2 (VKİ: 35-39.99 kg/m2) ve grup 3 (VKİ ≥ 40 kg/m2) . Optik koherens tomografi anjiografi (OKT-A) ile foveal avasküler zon (FAZ), makulada yüzeyel ve derin kapiller pleksusun damar dansitesi (VD) ile radial peripapiller kapiller pleksus VD ölçüldü.
Bulgular: Çalışmaya 27 kontrol ve 83 obez hasta olmak üzere toplam 110 hasta dahil edildi. Kontrol vakalarına kıyasla obez hastalarda HbA1C, açlık insülini, HOMA-IR, C-reaktif protein ve AI seviyeleri anlamlı derecede yüksekti. Obez hastalarda retinanın yüzeyel (p=0,003) ve derin (p=0,001)VD'leri anlamlı olarak azaldı ve FAZ anlamlı olarak arttı (p=0,032). Klinik özellikler ile OKT-A bulguları arasında yapılan korelasyon analizinde yüzeyel ve derin VD'ler yaş, VKİ, HbA1C ve AI ile ters orantılıydı.
Sonuç: Obez hastalarda retina yüzeyel ve derin VD'leri azalmıştı ve retinal VD'ler ile yaş, VKI, HbA1C ve AI arasında ters bir ilişki vardı.

Keywords

obezite, vücut kitle indeksi, optik koherens tomografi anjiografi, retina, aterojenik indeks

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