Tip 2 Diyabetli Hastalarda Serum Resistin Düzeyleri İle Obezite ve İnsülin Direnci Arasındaki İlişki

Year 2017, Volume: 5 Issue: 3, 109 - 117, 27.12.2017

Ebru Yorulmaz Ertuğ , Mürvet Algemi

Abstract

 Amaç: Tip 2 diyabetes
mellitus (DM) hedef dokunun insüline dirençli olması ile karakterize olup
obezite ile yakın ilişkilidir. Resistin yağ dokusundan türeyen bir hormon olup
Tip 2 DM, obezite, insülin direnci ve inflamasyonla ilişkilendirilmektedir. Bu
çalışmamızın amacı Tip 2 DM , bozulmuş glukoz toleransı olan (IGT) ve normal
glukoz toleransı (NGT) olan gruplar arasındaki serum resistin seviyelerini
karşılaştırmak ve bu seviyelerin obezite ve insülin direnciyle ilişkisini
araştırmaktır.

Mateyal ve Metod:  Çalışma
gruplarımız  toplam 72 kişiden oluşmaktadır. Serum resistin
konsantrasyonlarını NGT(n=25), IGT(n=23) ve Tip 2 DM’lu grupların(n=24) glukoz,
insülin, HbA1c, BMI, HOMA ve bel/kalça oranı ile karşılaştırdık. Daha sonra 72
vaka beden kütle indeksine(BMI) ve HOMA-IR  skoruna göre alt gruplara
bölündü; obez olmayan BMI<25 kg/²(43 vaka), obez BMI>25kg/²(29 vaka),
HOMA-IR(+)(23 vaka) ve HOMA-IR(-)(49 vaka). Açlık serum resistin seviyesi ELISA
yöntemi ile ölçüldü. İnsülin direnci HOMA-IR formülüne göre hesaplandı. 

Bulgular: NGT, IGT
ve Tip 2 DM grupları arasında serum resistin seviyeleri bakımından istatistiksel
anlamlı farklılık yoktu(p>0,05). Obez olmayan gruba göre obez grupta daha
yüksek serum resistin seviyeleri görüldü(p<0,01). HOMA skoru NGT grubuna
göre IGT ve Tip 2 DM gruplarında daha yüksek bulundu(p<0,01). HOMA-IR(-)
grup ve HOMA-IR(+) grupları arasında resistin seviyeleri bakımından istatistiksel
anlamlı fark gözlenmedi(p>0,05). NGT grubunda resistin ile bel/kalça oranı
arasında , IGT grubunda serum resistini ile açlık kan glukozu, sistolik kan
basıncı, yaş arasında negatif korelasyon bulundu. (Sırasıyla; r=-0,45,p<0,05;
r=-0,59,p<0,05; r=-0,53,p<0,01; r=0,46; r=0,45, p<0,05).

Sonuç: Resistinin glukoz metabolizmasını
etkileyebileceğini, obezite ile ilişkili olabileceğini ancak insülin direnci ve
diyabeti dolaylı yollardan etkileyebileceğini düşünmekteyiz. 

Anahtar Kelimeler:  Diyabetes
Mellitus, HOMA, obezite, resistin

Aim: Type 2
diabetes mellitus (DM) characterized by target-tissue resistance to insülin and
it is strongly linked to obesity. The adipocytes derived hormone resistin is
involved in tip 2 DM, obesity, insülin resistance and iflammation. The aim of
this study is to compare serum resistin levels between in normal glucose
tolerance group (NGT), impaired glucose tolerance group (IGT) and Type 2 DM
group and investigate correlations with obesity and insulin resistance.

Materials ve Methods: Firstly,
we compared serum concentrations of resistin with glucose,insülin,HbA1C, BMI,HOMA
and waist-to-hip ratio in subject with NGT(n=25), IGT(n=23) and type 2
DM(n=24).Later, according to the body mass index(BMI) and homeostasis model
assesment of insulin resistance(HOMA-IR) score 72 cases were divided into subgroups;
nonobese with BMI<25 kg/²(43 cases), the obese with BMI>25kg/²(29 cases),
HOMA-IR(+)(23 cases) and HOMA-IR(-)(49 cases). Fasting serum resistin level was
measured by ELISA. Insulin resistance was measured by the(HOMA-IR) formula.

Results: There was no statisfically difference in resistin levels
between NGT, IGT and Type 2 DM gorups(p>0,05). Compared with non obese
group, obese group showed higher serum resistin levels(p<0,01). HOMA score
was found significantly higher in the IGT and Type 2 DM groups than NGT
group(p<0,01). Between HOMA-IR(-) group and HOMA-IR(+) group no significant
difference was observed between in the levels of resistin(p>0,05). A
significant negative correlation observed between resistin and blood glucose
waist-to-hip ratio (r=0,45,p<0,05) in NGT group, between resistin and fasting
blood glucose, systolic blood pressure, age in IGT group
(respectively;r=-0,45,p<05;r=-0,59,p<05;r=-0,53,p<0,01;r=0,46;r=0,45,p<0,05). 

Conclusion: We concluded
that resistin may effect glucose metabolism, linked with obesity but indirectly
effect insülin resistance and diabetes.

Key Words: Diabetes
Mellitus, HOMA, obesity, resistin

Keywords

Diyabetes Mellitus, HOMA, obezite, resistin

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