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ÜRİNER SİSTEM ENFEKSİYONU OLAN TİP 2 DİABETES MELLİTUS HASTALARINDA SİSTEMİK İMMÜN-İNFLAMASYON İNDEKSİNİN DEĞERLENDİRİLMESİ

Year 2024, Volume: 38 Issue: 3, 132 - 137, 31.12.2024
https://doi.org/10.54962/ankemderg.1604144

Abstract

Üriner sistem enfeksiyonları diyabetik hastalarda sıklıkla görülmekte ve anormal böbrek fonksiyonlarına neden olabilmektedir. İnflamasyon ve immün yanıt bu hastalığın patofizyolojisinde rol oynamaktadır. Diyabette enfeksiyonu ve inflamasyonu tetikleyen birçok mekanizma aydınlatılmıştır. Ancak yeni bir inflamasyon belirteci olan sistemik immün-inflamasyon indeksi (SII) ile idrar kültürü pozitif olan diyabetik hastalar arasındaki ilişki henüz değerlendirilmemiştir. Çalışmamızda SII ve tip 2 diyabetes mellitus (T2DM) ile kültür pozitif üriner enfeksiyonlar (ÜSE) arasındaki tahmini ilişkinin araştırılması amaçlanmıştır. Bu çalışmaya ÜSE olan 48 diyabetik hasta ve ÜSE olmayan 42 diyabetik hasta dahil edildi. Tam kan sayımı parametreleri ve hsCRP düzeyleri kaydedildi ve SII hesaplandı. Yüksek duyarlı C-reaktif protein (hsCRP) ve SII, ÜSE olan DM'de ÜSE olmayan DM'ye göre istatistiksel olarak anlamlı derecede yüksek bulundu (her ikisi için p<0.01). İlaveten SII, hasta grubunda hsCRP ile istatistiksel olarak anlamlı ve pozitif korelasyon gösterdi (p=0.001). Ardından, "receiver operating characteristic" (ROC) eğrisi analizi yapıldı ve SII'nin %63 duyarlılık ve %78 özgüllük ile 746.25'lik bir kesim seviyesi kullanarak T2DM grubunda ÜSE varlığını tahmin ettiği gösterildi. Bu çalışmada, ÜSE'li T2DM hastalarında ÜSE varlığının tahmin edilmesi için SII'nin kullanımı değerlendirilmiş ve değerli bir enfeksiyon ve inflamasyon biyobelirteci olan hsCRP ile karşılaştırılmıştır. Çalışma sonuşlarımıza göre T2DM hastalarında yüksek SII kabulünün ÜSE saptamada faydalı olabileceği düşünülmüştür.

Ethical Statement

Bu çalışma Erciyes Üniversitesi Bilimsel Araştırmalar Etik Kurulu tarafından onaylanmıştır (11.12.2019-2019/839). Çalışmamız Helsinki Deklarasyonuna uygun olarak tasarlandı.

Supporting Institution

Araştırma için herhangi bir finansman alınmamıştır.

References

  • 1. Carey IM, Critchley JA, DeWilde S, Harris T, Hosking FJ, Cook DG. Risk of Infection in Type 1 and Type 2 Diabetes Compared With the General Population: A Matched Cohort Study. Diabetes Care. 2018;41(3):513-21.
  • 2. Carrillo-Larco RM, Anza-Ramírez C, Saal-Zapata G, et al. Type 2 diabetes mellitus and antibiotic-resistant infections: a systematic review and meta-analysis. J Epidemiol Community Health. 2022;76(1):75-84.
  • 3. Chen JH, Zhai ET, Yuan YJ, et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol. 2017;23(34):6261-72.
  • 4. Geerlings S, Fonseca V, Castro-Diaz D, List J, Parikh S. Genital and urinary tract infections in diabetes: impact of pharmacologically-induced glucosuria. Diabetes Res Clin Pract. 2014;103(3):373-81.
  • 5. Guo W, Song Y, Sun Y, et al. Systemic immune-inflammation index is associated with diabetic kidney disease in Type 2 diabetes mellitus patients: Evidence from NHANES 2011- 2018. Front Endocrinol. 2022;13:1071465.
  • 6. Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-22.
  • 7. Huang H, Liu Q, Zhu L, et al. Prognostic Value of Preoperative Systemic Immune- Inflammation Index in Patients with Cervical Cancer. Sci Rep. 2019;9(1):3284.
  • 8. Mnif MF, Kamoun M, Kacem FH, et al. Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management. Indian J Endocrinol Metab. 2013;17(3):442-5.
  • 9. Moutachakkir M, Lamrani Hanchi A, Baraou A, Boukhira A, Chellak S. Immunoanalytical characteristics of C-reactive protein and high sensitivity C-reactive protein. Ann Biol Clin. 2017;75(2):225-29.
  • 10. Orna N, Mazen E, Bibiana C, Walid S. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management. Diabetes Metab Syndr Obes. 2015;8:129-36.
  • 11. Sun H, Saeedi P, Karuranga S, et al. Idf diabetes atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.
  • 12. Tang M, Cao H, Wei XH, et al. Association between high-sensitivity c-reactive protein and diabetic kidney disease in patients with type 2 diabetes mellitus. Front Endocrinol. 2022;13:885516.
  • 13. Vinken JEM, Mol HE, Verheij TJM, et al. Antimicrobial resistance in women with urinary tract infection in primary care: no relation with type 2 diabetes mellitus. Prim Care Diabetes. 2018;12(1):80-6.
  • 14. Wilke T, Boettger B, Berg B, et al. Diabetes Complications. Epidemiology of urinary tract infections in type 2 diabetes mellitus patients: An analysis based on a large sample of 456,586 German T2DM patients. J Diabetes Complications. 2015;29(8):1015-23.

Evaluation of Systemic Immune-Inflammation Index in Type 2 Diabetes Mellitus Patients with Urinary Tract Infections

Year 2024, Volume: 38 Issue: 3, 132 - 137, 31.12.2024
https://doi.org/10.54962/ankemderg.1604144

Abstract

Urinary system infections are frequently seen and may cause abnormal renal functions in diabetic patients. Inflammation and the immune response may have the role in the pathophysiology of this disease. Many mechanisms that trigger infections and inflammation in diabetes have been elucidated. But the relation between a novel inflammation marker, systemic immune-inflammation index (SII) ,and diabetic patients with positive urinary culture hasn’t been evaluated yet. Our study aimed to investigate the estimated relation with SII and type 2 diabetes mellitus (T2DM) with culture positive urinary infections (UTI). Fourty-eight diabetic patients with UTI and fourty-two diabetic patients without UTI were included. Complete blood count analysis was done and hsCRP levels were recorded. SII was calculated. High sensitive C-reactive protein (hsCRP) and SII were statistically significantly higher in DM with UTI group than DM without UTI (p<0.01, for both). Additionally, SII statistically significantly and positively correlated with hsCRP in patients group (p=0.001).
Then, receiver operating characteristic (ROC) curve analysis was performed and presented that SII predicted UTI in T2DM group using a cut-off level of 746.25 with 63% sensitivity and 78% specificity. In this study, we evaluated the use of SII to predict the presence of UTI in T2DM patients with UTI and compared it with hsCRP, a valuable biomarker of infection and inflammation. Our results suggest that high SII acceptance may be useful in detecting UTI in T2DM patients.

Ethical Statement

Ethical approval for the study was obtained from the Ethics Committee of Erciyes University (11.12.2019-2019/839). Our study was designed to be compatible with the Declaration of Helsinki.

Supporting Institution

There was no funding for the study.

References

  • 1. Carey IM, Critchley JA, DeWilde S, Harris T, Hosking FJ, Cook DG. Risk of Infection in Type 1 and Type 2 Diabetes Compared With the General Population: A Matched Cohort Study. Diabetes Care. 2018;41(3):513-21.
  • 2. Carrillo-Larco RM, Anza-Ramírez C, Saal-Zapata G, et al. Type 2 diabetes mellitus and antibiotic-resistant infections: a systematic review and meta-analysis. J Epidemiol Community Health. 2022;76(1):75-84.
  • 3. Chen JH, Zhai ET, Yuan YJ, et al. Systemic immune-inflammation index for predicting prognosis of colorectal cancer. World J Gastroenterol. 2017;23(34):6261-72.
  • 4. Geerlings S, Fonseca V, Castro-Diaz D, List J, Parikh S. Genital and urinary tract infections in diabetes: impact of pharmacologically-induced glucosuria. Diabetes Res Clin Pract. 2014;103(3):373-81.
  • 5. Guo W, Song Y, Sun Y, et al. Systemic immune-inflammation index is associated with diabetic kidney disease in Type 2 diabetes mellitus patients: Evidence from NHANES 2011- 2018. Front Endocrinol. 2022;13:1071465.
  • 6. Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-22.
  • 7. Huang H, Liu Q, Zhu L, et al. Prognostic Value of Preoperative Systemic Immune- Inflammation Index in Patients with Cervical Cancer. Sci Rep. 2019;9(1):3284.
  • 8. Mnif MF, Kamoun M, Kacem FH, et al. Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management. Indian J Endocrinol Metab. 2013;17(3):442-5.
  • 9. Moutachakkir M, Lamrani Hanchi A, Baraou A, Boukhira A, Chellak S. Immunoanalytical characteristics of C-reactive protein and high sensitivity C-reactive protein. Ann Biol Clin. 2017;75(2):225-29.
  • 10. Orna N, Mazen E, Bibiana C, Walid S. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and management. Diabetes Metab Syndr Obes. 2015;8:129-36.
  • 11. Sun H, Saeedi P, Karuranga S, et al. Idf diabetes atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.
  • 12. Tang M, Cao H, Wei XH, et al. Association between high-sensitivity c-reactive protein and diabetic kidney disease in patients with type 2 diabetes mellitus. Front Endocrinol. 2022;13:885516.
  • 13. Vinken JEM, Mol HE, Verheij TJM, et al. Antimicrobial resistance in women with urinary tract infection in primary care: no relation with type 2 diabetes mellitus. Prim Care Diabetes. 2018;12(1):80-6.
  • 14. Wilke T, Boettger B, Berg B, et al. Diabetes Complications. Epidemiology of urinary tract infections in type 2 diabetes mellitus patients: An analysis based on a large sample of 456,586 German T2DM patients. J Diabetes Complications. 2015;29(8):1015-23.
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Bacteriology, Microbiology (Other)
Journal Section Research Articles
Authors

Nuri Çakır 0000-0002-9935-7397

Işıl Çakır 0000-0001-5728-4671

Publication Date December 31, 2024
Submission Date December 19, 2024
Acceptance Date December 24, 2024
Published in Issue Year 2024 Volume: 38 Issue: 3

Cite

Vancouver Çakır N, Çakır I. ÜRİNER SİSTEM ENFEKSİYONU OLAN TİP 2 DİABETES MELLİTUS HASTALARINDA SİSTEMİK İMMÜN-İNFLAMASYON İNDEKSİNİN DEĞERLENDİRİLMESİ. ANKEM Derg. 2024;38(3):132-7.

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