BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER

Abstract

Amaç: Kalp ve damar hastalıklarının büyüme hormonu (BH) replasmanı almayan erişkin hipopitüiter (HP) hastalarda mortaliteye ek katkıda bulunduğu bildirilmektedir. BH eksikliği proaterojenik bir duruma neden olmaktadır. Bu çalışmada BH eksikliği olan HP hastalarda endotel fonksiyonu ve erken aterosklerotik değişiklikleri incelemeyi amaçladık. Gereç ve yöntem: Endotel fonksiyonu brakiyal arterin akıma bağlı dilatasyonu (FMD) ile değerlendirildi. Demografik, antropometrik, endokrin ve biyokimyasal bulgular ile brakiyal arter FMD ve karotis intima-media kalınlığı (ĠMK) ölçümleri kaydedildi. Bulgular: Çalışmaya 19 BH almayan HP hasta (9 kadın, 42±16 yaş) ile 19 sağlıklı kontrol (6 kadın, 39±16 yaş) alındı. HP hastalarda kontrollere göre kalça çevresi (94,5±13,2 cm vs. 86,8±8,7 cm, p=0,04), vücut yağ kütlesi (%) daha yüksek bulundu (30,9±9,1 vs. 23,8±8,6, p=0,02). HP hastalarda yağsız vücut kütlesi (%) daha düşüktü (69,0±9,1 vs. 76,1±8,6, p=0,01). Karotis İMK‟sı hastalarda kontrollere oranla daha yüksek (0,80±0,22 vs. 0,56±0,25, p=0,01), brakiyal arter FMD‟si ise daha düşüktü (8,8±6,06 vs. 13,5±4,6, p=0,02). Her iki gruptada hasta yaşı ile karotis İMK‟sı arasında anlamlı bir korelasyon mevcuttu ancak ilişki hasta grubunda daha belirgindi (hastalar için r=0,8624 p < 0,001, kontroller için r=0,7859 p=0,001). Sonuç: BH eksikliği olan HP hastalardaki düşük FMD endotel disfonksiyonunu ortaya koymuştur. Hipopitüiter grupta karotis İMK‟sı ile yaş arasındaki ilişki daha belirgindi. Bulgularımız HP hastalarda endotel fonksiyonunun bozulduğuna ve yaşlanmanın ateroskleroz üzerine etkilerinin daha belirgin hal aldığına işaret etmektedir.

Keywords

• Hipopitüitarizm, büyüme hormonu yetersizliği, endotel fonksiyonu

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