Diyabetik Nöropatili Hastalarda Plazma Speksin, Visfatin Ve Leptin Düzeylerinin İncelenmesi

Abstract

Amaç: Diyabetik nöropati (DN), Diabetes Mellitus’un (DM) en sık görülen kronik komplikasyonlarından biridir. Bu çalışmada, Tip 2 DM’li olup komplikasyon olarak DN gelişen hastalar ile DN gelişmeyen hastaların plazma speksin, visfatin ve leptin değerlerinin incelenmesi ve gruplar arasında farklılık olup olmadığının araştırılması amaçlanmıştır. Yöntem: Çalışmaya Tip 2 DM tanısı almış olan 93 yetişkin hasta dahil edildi. Elektrofizyolojik sinir ileti çalışması olarak elektromiyografi (EMG) yapıldı. EMG bulgularına göre hastalar DN olan (n = 55) ve DN olmayanlar (n = 38) olarak iki gruba ayrıldı. Her hastadan, biri 5 ml olacak şekilde iki tüp venöz kan örneği alındı. İlk kan örneğinde hastaların HbA1c düzeyleri kontrol edildi. HbA1c düzeylerine göre gruplar kendi aralarında, HbA1c 6,5-8,4 arası ve ≥8,5 olmak üzere iki alt gruba ayrılarak toplam dört çalışma grubu oluşturuldu. Diğer kan örneği plazmaya ayrıldıktan sonra ELISA yöntemi ile speksin, visfatin ve leptin düzeyleri belirlendi. Sonuçlar gruplar arasında karşılaştırıldı.Bulgular: Katılımcılardan DN olanların 31’i kadın, 24’ü erkektir. DN olmayanların ise 29 kadın, 9’u erkektir. DN olan hastaların, olmayan hastalara göre glikoz ve HbA1c değerlerinin anlamlı derecede daha yüksek değerlere sahip olduğu görüldü (p<0,05). Lipid profilleri karşılaştırıldığında, her iki grupta da total kolesterol ve trigliserid seviyeleri yüksek olmasına rağmen, aralarındaki fark istatistiksel olarak anlamlı değildi (p>0,05). Yüksek Yoğunluklu Lipoprotein (HDL) düzeyleri açısından gruplar arasında net bir farklılık tespit edilemedi. Düşük Yoğunluklu Lipoprotein (LDL) seviyeleri genel olarak DN olmayan grupta daha yüksek bulundu ancak anlamlı değildi (p>0,05). HbA1c düzeyleri 6,5-8,4 arasında yer alan DN olan ve olmayan hastaların beden kitle indeksi (BKİ), glikoz, trigliserid, total kolesterol, HDL, LDL, speksin, visfatin ve leptin değerleri, nöropati tanısı alma durumuna göre istatistiksel olarak anlamlı bir farklılık göstermedi (p>0,05). HbA1c düzeyi ≥8,5 olan hastalardan, DN olan ve olmayanların BKİ, glikoz, trigliserid, HDL, speksin, visfatin ve leptin düzeyleri arasında istatistiksel olarak anlamlı bir fark bulunmazken (p>0.05), aynı gruptaki hastaların total kolesterol ve LDL düzeyleri arasında istatistiksel olarak anlamlı bir fark bulundu (p<0.05). LDL düzeyleri DN olan hastalarda daha yüksekti. DN olan ve olmayan hastaların speksin, visfatin ve leptin düzeyleri arasındaki korelasyon incelendiğinde ise, aralarında yüksek pozitif ve anlamlı bir ilişki tespit edildi (p<0,01). Sonuç: Speksin, visfatin ve leptinin plazma düzeyleri, DN olan ve olmayan hasta grupları arasında anlamlı farklılık göstermemiştir. Ancak, hastaların plazma speksin, visfatin ve leptin düzeyleri arasında anlamlı düzeyde pozitif korelasyon tespit edilmiştir. Bu sonuç, speksin, visfatin ve leptinin plazma düzeylerinin birlikte hareket ettiğini ve klinik olarak önemli olabileceğini düşündürmektedir.

Keywords

• Diyabetik nöropati
• Speksin
• Visfatin
• Leptin
• Diyabetes Mellitus

Investigation of Plasma Spexin, Visfatin and Leptin Levels in Patients with Diabetic Neuropathy

Abstract

Aim: Diabetic neuropathy (DN) is one of the most common chronic complications of diabetes mellitus (DM). The aim of this study was to investigate plasma spexin, visfatin and leptin levels of patients with Type 2 DM who developed DN as a complication and patients who did not develop DN and to determine whether any significant differences existed between the groups. Method: The study included 93 patients diagnosed with type 2 DM. Electromyography (EMG) was performed as an electrophysiologic nerve conduction study. According to EMG results, patients were divided into two groups: those with DN (n=55) and those without (n=38). Two tubes of venous blood samples (5 ml each) were collected from each patient. HbA1c levels of patients were checked in the first blood sample. According to HbA1c levels, the groups were divided into two subgroups as HbA1c between 6.5-8.4 and ≥8.5, and a total of four study groups were formed. The second blood sample was separated into plasma, spexin, visfatin and leptin levels were determined by ELISA method. The results were compared between the groups. Results: Of the participants with DN, 31 were female and 24 were male. Of those without DN, 29 were female and 9 were male. DN patients had significantly higher glucose and HbA1c values than those without (p<0.05). When lipid profiles were compared, although total cholesterol and triglyceride levels were high in both groups, the difference was not statistically significant (p>0.05). There was no significant difference between groups in terms of High Density Lipoprotein (HDL) levels. Low Density Lipoprotein (LDL) levels were higher in the non-DN group, but not significantly (p>0.05). Body mass index (BMI), glucose, triglycerides, total cholesterol, HDL, LDL, spexin, visfatin and leptin values of patients with and without DN with HbA1c levels between 6.5-8.4 did not show statistically significant difference according to the diagnosis of neuropathy (p>0.05). Among patients with HbA1c level ≥8.5, there was no statistically significant difference between BMI, glucose, triglyceride, HDL, spexin, visfatin and leptin levels of patients with and without DN (p>0.05), whereas there was a statistically significant difference between total cholesterol and LDL levels of the same group (p<0.05). LDL levels were higher in patients with DN. When the correlation between spexin, visfatin, and leptin levels of patients with and without DN was examined, a strong and statistically significant positive correlation was found between them (p<0.01).Conclusion: Plasma levels of spexin, visfatin and leptin did not differ significantly between the groups of patients with and without DN. However, a significant positive correlation was found between plasma spexin, visfatin and leptin levels of the patients. This result suggests that plasma levels of spexin, visfatin and leptin act together and may be clinically important.

Keywords

• Diabetic Neuropathy
• Spexin
• Visfatin
• Leptin
• Diabetes Meliitus

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