OBEZ ADOLESANLARDA SERUM N-TERMİNAL PRO B-TİPİ NATRİÜRETİK PEPTİT (NT-PROBNP) DÜZEYLERİ, ERKEN KARDİYOVASKÜLER RİSK FAKTÖRLERİ VE EKOKARDİYOGRAFİK PARAMETRELER ARASINDAKİ İLİŞKİLER

Yıl 2019, Cilt: 52 Sayı: 1, 20 - 27, 14.03.2019

Mehmet Boyraz Atilla Çifci

Öz

AMAÇ: 

Bu çalışmada; adolesan obezitesinde N-terminal pro B- tipi natriüretik peptit (NT-proBNP) düzeyleri ile metabolik, ekokardiyografik parametreler, karotis intima media ölçümü (IMT) ve epikardiyal yağ dokusu (EATT) düzeyleri arasındaki ilişki incelenmiştir.

 

MATERYAL-METOD:

Çalışma grubuna 138 obez ergen ve kontrol grubuna ise 63 obez olmayan ergen kabul edildi. VKİ’ye göre; 33,90± 9,30 olan hastaların 95’i hafif-orta obez, 39,40± 4,00 olan hastaların 43’ü ise şiddetli obez olacak şekilde alt gruplara ayrıldı. Tüm hastalara sol ventrikül (SV) sistolik fonksiyonu ve kitle indeksi, miyokardiyal duvar kalınlığı ve miyokardiyal performans indeksi (MPI) saptanması için transtorasik ekokardiyografik inceleme yapıldı. Ekokardiyografide epikardiyal yağ dokusu ve karotis IMT ölçüldü. Eş zamanlı serum NT-proBNP değerleri ölçüldü.

 

BULGULAR:

NT-proBNP değerleri; şiddetli obez grupta 76,00± 49,70 pg / ml, hafif-orta derece obez grupta 67,20 ± 64,40 pg / ml (p= 0,007) ve kontrol grubunda ise 44,30 ± 23,30 pg / ml (p= 0,002) olarak bulundu (p= 0,007, p= 0,002).

Ortalama karotis IMT ölçümleri sırasıyla obez gruplarda 0,91± 0,23 ve 0,88  ± 0,18 mm kontrol grubunda ise 0,52 ± 0.08 mm idi (p= 0,0001). Obez alt gruplar arasında istatistiksel anlamlı farklılık yoktu. EATT ölçümleri obez alt grupları ortalaması, 7,42  ± 1,55 mm ve 7,38± 1,76, kontrol grubunda ise 4,28 ± 0,79 mm olarak ölçüldü (p= 0,0001).

NT-proBNP seviyesi, şiddetli obezitede sol ventrikül sistolik ve diyastolik fonksiyonları ile karotis IMT veya EATT oranları fonksiyonel olarak belirgin pozitif korelasyon göstermiştir.

 

SONUÇLAR:

Çalışmamızda,
hafif-orta ve şiddetli obez ergenlerde serum
NT- proBNP düzeylerinin kontrol grubuna göre daha yüksek olduğunu ve
NT- proBNP'nin obez ergenlerde ateroskleroz ve kardiyak
disfonksiyonu öngörmede yararlı bir belirteç olabileceğini gösterdi.

Anahtar Kelimeler

Ergen obezite, ekokardiyografi, N-terminal pro B-tipi natriüretik peptid, ateroskleroz, erken kardiyovasküler risk

INTERRELATIONS BETWEEN SERUM N-TERMINAL PRO B-TYPE NATRIURETIC PEPTIDE (NT-PROBNP) LEVELS AND EARLY CARDIOVASCULAR RISK FACTORS AND ECHOCARDIOGRAPHIC PARAMETERS IN OBESE ADOLESCENTS

Öz

Purpose:
This study aimed to evaluate the associations between the N-terminal pro-B-type
natriuretic peptide (NT-proBNP) levels and the metabolic, echocardiographic
parameters, carotid intima-media thickness (IMT) and epicardial adipose tissue
thickness (EATT) in adolescent obesity.

Material
and Method: The study participants consisted of 138 obese
adolescents in the study group and 63 non-obese adolescents as control
subjects. All the subjects underwent transthoracic echocardiographic
examination for determination of left ventricular (LV) systolic function and
mass index, myocardial tissue rates, and myocardial performance index (MPI).
Epicardial adipose tissue thickness and carotid IMT were also measured during
echocardiography. Serum NT-proBNP levels were measured at the time of the
evaluation.

Results:
The NT-proBNP values averaged 67.20 ± 64.40 pg/ml in mildly-moderately obese,
76.00 ± 49.70 pg/ml in the severely obese group and 44.30 ± 23.30 pg/ml in the
control group (p = 0.007, p = 0.002, respectively). The average carotid IMT was
0.91 ± 0.23 and 0.88 ± 0.18 mm in the obesity groups and 0.52 ± 0.08 mm in the
control group (p= 0.0001), but differences were not observed between obesity
groups and the EATT which averaged 7.38 ± 1.76 and 7.42 ± 1.55 mm in the
obesity groups and 4.28 ± 0.79 mm in the control group (p = 0.0001). The
NT-proBNP levels showed statistically significant positive correlations with
left ventricular systolic and diastolic functions, carotid IMT, or EATT values,
especially in severe obesity.

Conclusion:
The study showed higher measurements of serum NT-proBNP levels in
mildly-moderately and severely obese adolescents than control and NT-proBNP
might be a useful marker for predicting atherosclerosis and cardiac dysfunction
in the obese adolescent. 

Anahtar Kelimeler

Adolescent obesity, echocardiography, N-terminal pro-B-type natriuretic peptide, atherosclerosis, early cardiovasculer risk

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