BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER

Year 2011, Volume: 74 Issue: 1, 1 - 6, 10.11.2011

Hüseyin Oflaz Alper Yurci Burak Pamukçu Binnur Pınarbaşı Sami Uzun Neşe Özbey

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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