Diyabet Aşikar Olmasa da Komplikasyonları Aşikar Olabilir, Prediyabet Hastalarında Nefropatinin Sıklığı

Abstract

GİRİŞ/AMAÇ: Prediyabet, diabetes mellitus (DM) ve kardiyovasküler hastalıklar için bir risk faktörü kabul edilmektedir. Tip 2 DM tanısı konduğu anda hastaların %10-40’ında komplikasyonlar vardır. Diyabetik nefropati diyabetin önemli mikrovasküler komplikasyonlarından biridir. Yapılan çalışmalar prediyabetin de diyabetin erken dönemlerinde olduğu gibi, glomerüler hiperfiltrasyon ve albüminüri gelişimi ile ilişkili olduğunu göstermiştir. Aşikar DM ortaya çıkmadan önce hastaların tespit edilmesi nefropatinin ve DM’ün erken tanı ve tedavisi için önemlidir. Çalışmamızın amacı prediyabet hastalarında nefropatinin varlığını ve sıklığını araştırmaktır. METOD: Ayaktan iç hastalıkları ve endokrinoloji polikliniğine başvuran, rastgele bakılan açlık kan şekeri ≥100 mg/dl olan hastalar değerlendirmeye alındı. Oral glukoz tolerans testi (OGTT) yapıldı ve HbA1C değerleri ölçüldü. Çalışmaya prediyabet tanısı konulan ve nefropati değerlendirmesi yapılan 280 hasta dahil edildi. BULGULAR: Hastaların 81’sinde (%28,9) nefropati saptandı. Nefropatisi olan grubun ortalama HbA1C değeri %6,28 (ss:0,52) nefropatisi olmayan grubun ortalama HbA1C değeri %6,05 (ss:0,29) düzeyinde saptandı. Nefropatisi olan grupta ortalama HbA1C değerinin anlamlı olarak daha yüksek olduğu görüldü (p=0,000). SONUÇ: Hastaların %28,9’unda nefropati saptanmış olması prediyabetin ciddiyetini bir kez daha göstermiş oldu. Bundan dolayı prediyabeti olan, özellikle de HbA1C değeri yüksek olan hastalarda nefropati ve KBY açısından daha dikkatli olunmalıdır.

Keywords

• diyabet
• prediyabet
• nefropati

Although Diabetes is Not Obvious, Its Complications May Be Obvious, Frequency of Nephropathy in Prediabetic Patients

Abstract

BACKGROUND/AIMS: Prediabetes is considered a risk factor for diabetes mellitus (DM) and cardiovascular diseases. Complications are also detected during diagnosis in 10-40% of diabetes patients. Diabetic nephropathy is one of the critical microvascular complications of diabetes. Studies have shown that prediabetes is associated with the development of glomerular hyperfiltration and albuminuria, as in the early stages of diabetes. Identifying patients before overt DM occurs is important for early diagnosis and treatment of nephropathy and DM. The aim of our study is to investigate the presence and frequency of nephropathy in prediabetes patients. METHODS: Patients who applied to the outpatient internal medicine and endocrinology outpatient clinics and whose random fasting blood sugar was ≥100 mg/dl were evaluated. Oral glucose tolerance test (OGTT) was performed and HbA1C values were measured. 280 patients diagnosed with prediabetes and evaluated for nephropathy were included in the study. RESULTS: Nephropathy was detected in 81 (28.9%) of the patients. The average HbA1C value of the group with nephropathy was 6.28% (sd: 0.52) and the average HbA1C value of the group without nephropathy was 6.05% (sd: 0.29). The average HbA1C value was found to be significantly higher in the group with nephropathy (p=0.000). CONCLUSIONS: The fact that nephropathy was detected in 28.9% of the patients showed once again the seriousness of prediabetes. Therefore, patients with prediabetes, especially those with higher HbA1C values, need to be evaluated more carefully in terms of nephropathy and CKD.

Keywords

• diabetes
• prediabetes
• nephropathy

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