The relationship between nephropathy, retinopathy, obesity and arterial stiffness in type 2 diabetes mellitus

Year 2015, Volume: 1 Issue: 2, 59 - 67, 17.09.2015

Bilgin Demir Sibel Demiral Sezer Ömercan Topaloğlu Emin Taşkıran Burcu Işık Utku Soyaltın Harun Akar

https://doi.org/10.5606/fng.btd.2015.012

Abstract

Objectives: In this trial, we aimed to define arterial stiffness (AS) parameters in patients with type 2 diabetes mellitus (DM) without any known coronary heart disease and compare our results with the incidence of complications of type 2 DM like abdominal obesity, nephropathy and retinopathy in our study population.

Patients and methods: We included 110 type 2 DM patients between the ages of 30-80, without any coronary heart disease with estimated glomerular filtration rate (eGFR) value of above 30 m/min/1.73 m2 to our study. We recorded patients’, body weight, body mass indexes (BMI), conicity indexes (CI), waist circumferences, onset of diabetes, smoking habits, fundus evaluation, hypertension and hyperlipidemia background. Moderately increased albuminuria was used as a marker to identify the diabetic nephropathy. We measured the pulse wave velocity (PWV), augmentation index (AIx), arterial blood pressure of patients by using Mobil-O-Graph® ARC solver algorithm” device.

Results: PWV values were positively associated with CI, onset of type 2 DM, and systolic blood pressure. PWV values were negatively associated with eGFR. AIx values were positively associated with BMI, systolic blood pressure and heart rate. AIx values were negatively associated with hemoglobin level. Hypertension was positively associated with PWV. Smoking habits was negatively associated with AIx. There were no statistically association among complications of diabetes such as nephropathy, retinopathy and PWV, AIx values.

Conclusion: There were associations between AS and CI, eGFR, hemoglobin level, onset of diabetes, arterial blood pressure values of type 2 DM patients. There were no association between AS and nephropathy, retinopathy rates of type 2 DM patients. We assume that AS is an independent novel cardiovascular risk factor for patients diagnosed with obesity, anemia, hypertension and type 2 DM.

Keywords: Arterial stiffness; diabetes mellitus; nephropathy; obesity; retinopathy.

Keywords

Arterial stiffness, diabetes mellitus, nephropathy, obesity, retinopathy

Tip 2 diabetes mellitus tanılı hastalarda nefropati, retinopati, obezite ve arteriyel sertlik arasındaki ilişki

Abstract

Amaç: Bu çalışmada, bilinen koroner arter hastalık öyküsü olmayan tip 2 diyabetes mellitus (DM) tanılı hastalarda arteriyel sertlik parametrelerinin belirlenmesi ve arteriyel sertliğin abdominal obezite, nöropati, nefropati gibi diyabetes mellitus komplikasyonları ile karşılaştırılmasını amaçladık.Hastalar ve yöntemler: Çalışmamıza; tip 2 DM tanılı, koroner arter hastalık öyküsü olmayan, tahmini glomerüler filtrasyon hızı (eGFR): 30 mL/min/1.73 m2’nin üzerinde olan, 30-80 yaş arasında bulunan 110 hasta dahil edildi. Hastaların vücut ağırlığı, vücut kütle indeksi (VKİ), konisite indeksi (Kİ), bel çevresi, laboratuvar tetkikleri, diyabet süresi, sigara kullanımı, göz dibi bakısı, hipertansiyon ve hiperlipidemi öyküsü kaydedildi. Diyabetik nefropatiyi tanımlamak için belirteç olarak orta derecede artmış albuminüri kullanıldı. Hastaların nabız dalga hızı (NDH), augmentasyon indeksi (AIx) ve arteriyel kan basıncı, ”Mobil-O-Graph® ARC solver algorithm” cihazı ile tek koldan ölçüldü.Bulgular: NDH değerleri ile CI, tip 2 DM süresi ve arteriyel kan basıncı arasında pozitif yönlü ilişki saptandı. NDH ve eGFR değeri arasında ise negatif yönlü bir ilişki vardı. Alx değerleri ile VKİ , sistolik kan basıncı ve kalp hızı arasında pozitif yönlü Ilişki vardı. AIx değerleri ile hemoglobin düzeyi arasında ise negatif yönlü bir ilişki vardı. Hipertansiyon ile NDH pozitif ilişkili idi. Sigara içimi ile AIx negatif yönlü ilişkili idi. Hastaların diyabet komplikasyonları (nefropati ve retinopati) ile NDH ve Alx arasında istatistiksel olarak anlamlı bir fark saptanmadı.Sonuç: Tip 2 DM'li hastaların Kİ, eGFR, hemoglobin düzeyleri , tip 2 DM süresi ve arteriyel kan basıncı; arteriyel sertlik ile ilişkili idi. Nefropati ve retinopati ile arteriyel sertlik arasında ilişki saptanmadı. Arteriyel sertliğin obezite, anemi, esansiyel hipertansiyon ve tip 2 DM tanılı hastalarda kardiyovasküler olaylar için bağımsız bir risk faktörü olduğunu düşünüyoruz

Keywords

Arteriyel sertlik, diyabetes mellitus, nefropati, obezite, retinopati

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