Tip 2 diyabette kardiyometabolik kontrol ve malnütrisyonun diyabetik retinopati prevalansı ve prognozuna etkisi

Abstract

Amaç: Bu çalışmanın amacı kardiyometabolik kontrol, gama glutamil transferaz (GGT) ve malnütrisyonla ilişkili inflamasyon belirteçlerinin diyabetik retinopati (DR) prevalansı ve prognozunu öngörmedeki değerini araştırmaktır. Gereç ve yöntem: Bu çalışmaya Dahiliye ve Göz Hastalıkları polikliniklerine ardışık olarak başvuran Tip 2 Diabetes Mellitus hastaları dahil edilmiştir. Klinik, hematolojik ve biyokimyasal veriler kaydedildi. Alıcı operatör karakteristik eğri analizi ile GGT, hemoglobin, albümin, lenfosit ve trombosit (HALP) skoru, nutrisyonel risk indeksi (NRI) ve prognostik nutrisyonel indeks (PNI) skorlarının cut-off değerleri belirlendi. Tüm değişkenlerin DR ile ilişkisini belirlemek için tek değişkenli ve çok değişkenli analizler yapıldı. Bu testlerden hangilerinin DR gelişimi için öngörücü ve prognostik olduğu değerlendirilmiştir. Bulgular: Bu çalışmaya 166 Tip 2 Diyabetes Mellitus hastası dahil edildi. Retinopati olanlarda; açlık kan glukozu (p<0,001), kreatinin (p=0,01), HbA1c (p<0,001) ve mikroalbüminüri (p=0,01) yüksek bulundu. Hastaların GGT düzeyi arttıkça ortalama arteriyel basınç (p=0,01), açlık kan glukoz (p=0,03), trigliserit (p=0,008), vücut kütle indeksi (BMI) (p=0,02) ve HbA1c (p=0,04) değerlerinin anlamlı arttığı bulundu. Literatürün aksine HALP, PNI ve NRI skorun DR ile anlamlı ilişki saptanmadı. Sonuç: Diyabet süresi, kardiyometabolik kontrol ve GGT düzeyi diyabetik retinopati prognozu için prediktif değeri olan değişkenlerdir. Malnütrisyonla ilişkili inflamasyon belirteçleri ile DR gelişimi ve evresi arasında anlamlı bir ilişki bulunmamıştır.

Keywords

• Diyabetik retinopati
• kardiyometabolik kontrol
• GGT
• malnutrisyon ilişkili inflamasyon belirteçleri

Project Number

1

The effect of cardiometabolic control and malnutrition on the prevalence and prognosis of diabetic retinopathy in type 2 diabetes

Abstract

Purpose: This study aims to investigate the predictive value of cardiometabolic control, gamma glutamyl transferase (GGT) and malnutrition-related inflammation markers for predicting diabetic retinopathy (DR) prevalence and prognosis. Materials and methods: Type 2 Diabetes Mellitus patients who were consecutively admitted to Internal and Ophthalmology outpatient clinics were included in this study. Clinical, haematological and biochemical data were recorded. Cut-off values of GGT, hemoglobin, albumin, lymphocyte and platelet (HALP) score, nutritional risk index (NRI) and prognostic nutritional index (PNI) scores were determined by receiver operator characteristic curve analysis. Univariate and multivariate analyses were performed to determine the association of all variables with DR. We evaluated which of these tests were predictive and prognostic for the development of DR. Results: This study included 166 patients. Fasting blood glucose (p<0.001), creatinine (p=0.01), HbA1c (p<0.001) and microalbuminuria (p=0.01) were higher in patients with retinopathy. Mean arterial pressure (p=0.01), fasting blood glucose (p=0.03), triglyceride (p=0.008), body mass index (BMI) (p=0.02) and HbA1c (p=0.04) increased significantly as GGT level increased. Contrary to the literature, HALP, PNI and NRI scores were not associated with DR. Conclusion: Duration of diabetes, cardiometabolic control and GGT level are variables with predictive value for the prognosis of DR. No significant

Keywords

• Diabetic retinopathy
• cardiometabolic control
• GGT
• malnutrition releated inflamation markers

Supporting Institution

yok

Project Number

1

Ethical Statement

Bu çalışmayla ilgili gerekli izin, İstanbul Medeniyet Üniversitesi Göztepe Eğitim ve Araştırma Hastanesi Etik Komisyonu tarafından verildi (Tarih:01.08.2013, Karar No:2013/0036).

Thanks

TEZ danışmanım Mehmet Uzunlulu ve çalışmada emeği geçen hocalarıma çok teşekkür ediyorum

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