TİP 2 DİABETES MELLİTUSLU HASTALARDA VÜCUT DEMİR DEPOLARININ METABOLİK KONTROL, İNSÜLİN REZİSTANSI ve MİKROALBUMİNÜRİ ÜZERİNE ETKİSİ

Year 2008, Volume: 9 Issue: 1, 23 - 30, 01.04.2008

Sadi Kerem Okutur Cemal Bes Ayla Yıldız Erkal Gülçagrı Erol Fatih Borlu

Abstract

Amaç:Serbest demirin oksidatif stres, inflamasyon ve insülin direnci gibi diyabet gelişiminde anahtar roloynayan proçeslerde yer aldığı gösterilmiştir. Bu çalışmanın amacı tip 2 diyabette vücut demir depolarınınmetabolik kontrol, insülin direnci ve mikroalbuminüri açısından önemini ortaya koymaktır.Gereç ve Yöntem:Çalışmamız, 50 yeni tanı konmuş tip 2 diyabetli hasta ile 50 sağlıklı kişiden oluşan kontrolgrubunu kapsamaktadır. Her 2 grup cinsiyet, yaş, vücut kitle indeksi, biokimyasal ve metabolik parametreleraçısından karşılaştırıldı. Ayrıca hasta grubundaki bireylerin ortalama ferritin düzeyleriyle bu parametrelerarasında anlamlı bir ilişki olup olmadığı incelendi. Diyabetli hastalar metabolik kontrol, insülin direnci vemikroalbuminüri açısından gruplandırılarak bu parametrelerle ferritin düzeyleri arasındaki ilişki değerlendirildi.Bulgular:İki grup arasında ferritin düzeyleri açısından fark bulunmadı. Hasta grubunda ortalama ferritindüzeyiyle açlık kan şekeri, hemoglobin A1c, C-peptid, insülin ve HOMA skoru arasında anlamlı ve pozitifkorelasyon tespit edildi. Kötü metabolik kontrollü diyabetik hastalarla iyi metabolik kontrollü diyabetik hastalararasında ferritin düzeyleri açısından farklılık saptanmadı. İnsülin direnci olan diyabetik hasta grubunun ferritindüzeyi insülin direnci bulunmayan gruba göre anlamlı olarak yüksekti. Mikroalbuminürisi olan hasta grubununferritin düzeyi mikroalbuminürisi olmayan gruba göre anlamlı olarak yüksek bulundu.Sonuç:Bulgularımız, tip 2 diyabette vücut demir depolarının hastalığın patogenezinde yer aldığınıdesteklemektedir. Tip 2 diabetes mellitus' ta artmış serum ferritininin hastalığın seyri ve komplikasyonlarıylailişkisini ortaya koymak için daha kapsamlı preklinik ve klinik çalışmalara ihtiyaç vardır

Keywords

Tip 2 Diabetes mellitus, demir depoları, metabolik kontrol, insülin rezistansı, mikroalbuminüri

The Effects of Body Iron Stores on Metabolic Control, Insulin Resistance and Microalbuminuria in Patients with Type 2 Diabetes Mellitus

Abstract

Objective: Free iron is involved in processes including oxidative stress, inflammation and insulin resistance which play key roles in the development of type 2 diabetes. The aim of this study is to investigate the role of body iron stores in metabolic control, insulin resistance and microalbuminuria. Materials and Methods: Our study included 50 patients with newly diagnosed type 2 diabetes mellitus and 50 healthy subjects as controls. Groups were compared for sex, age, body mass index, various biochemical and metabolic parameters. Correlation between these parameters with mean ferritin levels of patients was also calculated. Diabetic patients were grouped according to metabolic control, insulin resistance and microalbuminuria and the correlation between these paremeters and ferritin level was analyzed. Results: There was no difference in mean ferritin levels between two groups In the patient group, significant correlation was determined between mean ferritin level and fasting blood glucose, hemoglobin A1c, C-peptide, insulin andHOMAscore. There was no difference in mean ferritin levels between diabetic patients with good or bad metabolic control. The mean ferritin level was significantly higher in diabetic patients with insulin resistance than non-insulin resistant diabetics. Mean ferritin level was significantly higher in microalbuminuric patients. Conclusion: Our findings support that body iron stores are involved in the pathogenesis of type 2 diabetes.

Keywords

Diabetes mellitus type 2, iron stores, metabolic control, insulin resistance, microalbuminuria

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