Tip 2 diyabetli hastalar arasında hepatosteatoz, safra taşı ve tiroid hastalıkları insidansı

Year 2019, Volume: 11 Issue: 3, 71 - 76, 30.12.2019

Yasemin Gül Aydemir , Mehmet Yamak

Abstract

ÖZET
GİRİŞ VE AMAÇ
Tip 2 diyabetli hastalarda hemoglobin A1C düzeyi, lipid profili, serum ALT, GGT ve hemoglobin düzeyinin ultrasound bulguları eşliğinde inceleyerek hepatosteatoz, safra taşı ve tiroid hastalıkları sıklığını incelemeyi amaçladık.

GEREÇ VE YÖNTEM
Tekirdağ Malkara devlet hastanesi iç hastalıkları polikliniğine 01.08.2016-01.09.2017 tarihleri arasında gelen 136 tip 2 diyabetik hasta çalışmaya dahil edildi. Tip 2 diyabetli hastalarda hemoglobin A1C düzeyi, lipid profili, serum ALT, GGT ve hemoglobin düzeyinin ultrasound bulguları eşliğinde inceleyerek hepatosteatoz, safra taşı ve tiroid hastalıkları taşı sıklığı değerlendirildi.
BULGULAR
Safra taşı olan olgularda hepatosteatoz görülme oranı (%87.9), safra taşı olmayan olgulardan (%69.4) daha yüksek olmakla birlikte bu farklılık anlamlılığa yakın ancak istatistiksel olarak anlamlı bulunmamıştır (p>0.05).

SONUÇ
Ultrasound ve laboratuar bulguları eşliğinde metabolik sendromlu hastalarda safra taşı, hepatosteatoz, lipid profilinde hdl düşüklüğü, trigliserit yüksekliği ve tiroid hastalıklarının (tiroidit ve tiroid nodülü) birlikte sık tespiti ile birbirleri arasında bir ilişki olduğunu ortaya koymuştur.

ABSTRACT
AİM: The aim of this study was to investigate the frequency of hepatosteatosis, gallstones and thyroid disorders in patients with type 2 diabetes by examining lipid profile, hemoglobin a1c, serum ALT, GGT and hemoglobin levels together with findings in ultrasound.

METHODS: 136 type 2 diabetic patients who were admitted to Ministry of Health, Malkara State Hospital internal medicine outpatient clinic between 01.08.2016-01.09.2017 were included. The incidence of nonalcoholic fatty liver disease (NAFLD), renal cyst, and gallstones were evaluated in all patients with type 2 diabetes by examining lipid profile, hemoglobin A1C, serum ALT, GGT and hemoglobin levels together with ultrasound findings.


RESULTS: Although the rate of hepatosteatosis was higher in patients with gallstones (87.9%) than the cases without gallstones (69.4%), this difference was close to significance but not statistically significant (p> 0.05).

CONCLUSION:
In the presence of ultrasound and laboratory findings, it was found that there was a correlation between gallstones, hepatosteatosis, decrease in hdl,increase in triglyceride and thyroid diseases (thyroiditis and thyroid nodule) in patients with metabolic syndrome

Keywords

Tip 2 diyabet, hepatosteatoz, safra kesesi taşı

References

• 1. Mezey E, Shiff ER, Sorrell MF, et al. Ed: Diseases of the Liver. 8.th ed Philadelphia; Lippincott-Raven: 1999; 185: 1204-1326.
• 2. Sonsuz A. Karaciğer Yağlanmas›, 3. Ulusal İç Hastalıkları Kongresi Kongre Kitab›: 2001; 21-23.
• 3. Nervi F, Arrese M. Cholecystectomy and NAFLD: does gallbladder removal have metabolic consequences? Am J Gastroenterol 2013;108:959-61.
• 4. Nahm AM, Ritz E. The simple renal cyst. Nephrol Dial Transplant 2000 ;15(10):1702-4.
• 5. Thompson D, Edelsberg J, Colditz GA. Lifetime health and economic consequence of obesity. Arch Intern Med 1999; 159: 2177-813.
• 6. Kültürsay H, Yavuzgil O. Obezite ve Kardiyovasküler Risk. Türk Kardiyoloji Seminerleri 2003; 3: 129-35.
• 7. American Diabetes Association. Dyslipidemia Management in Adults With Diabetes. Diabetes Care 2004 27: S68-71.
• 8. NCEP Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001, 285:2486–2497.
• 9. American Diabetes Association: Detection and management of lipid disorders in diabetes (Consensus Statement). Diabetes Care 1993,16:828–834
• 10. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013; 28: 169-80.
• 11. Addisu Y Mengesha. Lipid profile among diabetes patients in Gaborone Botswana. S Afr Med J 2006; 96: 147–148.
• 12. Lawrence JM, Bennett P, Young A, Robinson AM. Primary care screening for diabetes in general practice: cross sectional population study. BMJ 2001; 323: 548–551.
• 13. David L. Rainwater, Jean W. Mac Cluer, Michael P. Stern, John L. Vandeberg, Steven M. Haffner. Department of Medicine, University of Texas Health Science Center, San Antonio, Texas. Effects of NIDDM on lipoprotein (a) concentration and apoprotein (a) size. Diabetes,1994;43: 942–946.
• 14. Addisu Y Mengesha. Lipid profile among diabetes patients in Gaborone Botswana. S Afr Med J 2006; 96: 147–148. 15. Sonsuz A, Uraz S. Karaciger yaglanması ve nonalkolik steatohepatit. Göksoy E (ed) Aktuel gastroenteroloji ve hepatoloji-1. 2. baskı, İstanbul, Bilimsel Medikal yayıncılık, 2003:131-46 16. Younossi ZM, Matteoni CA, Gramlich T, et . Patient characteristics cirrhosis and death in nonalcoholic steatohepatitis. Hepatolology 1998;28:303A
• 17. Manton ND, Lipsett J, Moore DJ, Davidson GP, Bourne AJ, Couper RTL. Nonalcoholic steatohepatitis in children and adolescents. Med J Aust 2000;173:476-479
• 18. Arthur J, McCullough. Update on nonalcoholic fatty liver diseases. Journal Of Clinical Gastroenterology 2002; 34(3): 255-262.
• 19. Scragg RKT.,Calvert GD.,Oliver RJ. Plasma Lipids and insülin in gall stone disease: a case control study.B Med J 1984;289:521-525.
• 20. Scragg RKT , et al. Diet, alchol and relative weight in gall stone disease; a case control study.B Med J 1984 ; 288(14): 1113-1119.
• 21. Stinton LM, Myers RP, Shaffer EA. Epidomiology of gallstones. Gasroenterol Clin North Am 2010;39:157-69.
• 22. Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Prospective study of abdominal adiposity and gallstone disease in US men. Am J Clin Nutr 2004;80:38-44.
• 23. Gurusamy KS, Davidson BR. Surgical treatment of gallstones. Gastroenterol Clin North Am 2010;39:229-44.
• 24. Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet 2006;368:230-9.
• 25. Xie Y, Newberry EP, Kennedy SM, Luo J, Davidson NO. Increased susceptibility to diet-induced gallstones in liver fatty acid binding protein knockout mice. J Lipid Res 2009;50:977-87.
• 26. Özveren B, Onganer E, Türkeri LN. Simple Renal Cysts: Prevalence, Associated Risk Factors and Follow-Up in a Health Screening Cohort. Vol 13; No 01; January-February 2016; 2569-2575.