Tip 1 Diabetes Mellitus Tanılı Hastalarda Poliglandüler Otoimmün Sendrom Sıklığının Tespiti ve Diyabetin Prognoz ve Komplikasyonları ile İlişkisinin Araştırılması

Abstract

Amaç: Tip 1 diabetes mellitus (T1DM) tanılı hastaların üçte birinde otoimmün poliglandüler sendrom (OPS) bulunmaktadır. Çalışmada T1DM’ye eşlik eden OPS sıklığı ve diyabetin prognoz, komplikasyonları ile ilişkisinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya Endokrinoloji polikliniğine başvuran ve T1DM tanısı ile takipli 99 hasta dahil edildi. Verilerin analizinde Ki-Kare analizi (Pearson Chi-kare), Kolmogorov-Smirnov testi, Student t-testi, Mann Whitney-U testi, Spearman Korelasyon testi ve Kruskal Wallis testi kulanılmıştır. Verilerin analizinde SPSS 22 paket programı kullanıldı. Anlamlılık değeri p≤ 0,05 olarak alındı. Bulgular: Çalışmaya alınan hastaların 25’inde (%25,3) hipotiroidi ve 8’inde (%8,1) çölyak hastalığı saptandı. Hastaların 9’unda (%9,1) anti endomisyum antikor, 50’sinde (%50,5) adacık antikoru, 22’sinde (%22,2) anti insülin antikor, 26’sında (%26,3) anti parietal antikor, 8’inde (%8,1) doku transglutaminaz IG A, 43’ünde (%43,4) ANA, 4’ünde (%4,0) ASMA pozitifliği ve 25’inde (%25,3) OPS varlığı tespit edildi. T1DM tanılı hastalarda retinopati, nöropati ve nefropati gelişen hastaların hastalık süresi gelişmeyenlerin hastalık süresinden anlamlı şekilde yüksek olduğu tespit edildi. Hastaların hastalık yılı ile VKİ ve bel çevresi arasında pozitif yönde, hastalık yılı ile HbA1c ve c peptit arasında ise negatif yönde anlamlı bir korelasyon saptandı. OPS varlığı arasında retinopati varlığı, nöropati varlığı ve nefropati varlığı açısından anlamlı farklılık olmadığı saptandı. Bunun yanında OPS varlığı arasında HbA1c değeri açısından da anlamlı farklılık görülmedi. Sonuç: T1DM tanılı hastalarda diğer otoimmün hastalıkların sıklığında yıllar geçtikçe ciddi bir artış gelişmekte olup, diyabetik hastaların takiplerinde komplikasyon risklerinin azaltılması, iyi bir prognoz, iyi klinik gelişim ve erken tanı açısından otoimmün hastalıkların diyabetin hem tanı anında hem de ilerleyen yıllarında dikkate alınması gerekmektedir

Keywords

• Tip 1 diabetes mellitus,
• Otoimmün poliglandüler sendrom,
• Prognoz

Investigation of the Frequency of Polyglandular Autoimmune Syndrome in Patients with Type 1 Diabetes Mellitus and Its Relationship with the Prognosis and Complications of Diabetes

Abstract

Aim: One third of patients with type 1 diabetes mellitus (T1DM) have an autoimmune polyglandular syndrome (OPS). In this study, it was aimed to investigate the frequency of OPS accompanying T1DM and the relationship of diabetes with prognosis and complications. Material and Methods: Our study included 99 patients who applied to the endocrine outpatient clinic and were followed up with the diagnosis of T1DM. Chi-square analysis (Pearson Chi-square), Kolmogorov-Smirnov test, Student’s t-test, Mann Whitney-U test, Spearman Correlation test and Kruskal Wallis test were used in the analysis of the data. SPSS 22 package program was used in the analysis of the data. The significance value was taken as p≤ 0.05. Results: Of the patients included in the study, 25 (25.3%) had hypothyroidism and 8 (8.1%) had celiac disease. Anti-endomysium antibodies in 9 (9.1%), islet antibodies in 50 (50.5%), anti-insulin antibodies in 22 (22.2%) patients, and anti-parietal antibodies in 26 (26.3%) patients’ antibody, tissue transglutaminase IG A in 8 (8.1%), ANA in 43 (43.4%), ASMA positivity in 4 (4.0%) and OPS in 25 (25.3%) detected. It was determined that the duration of the disease of the patients with retinopathy, neuropathy and nephropathy in T1DM patients was significantly higher than the duration of the disease in those who did not. It was found that there was a positive correlation between the patients’ disease year and BMI and waist circumference, and a negative correlation between the disease year and HbA1c and C peptide. It was determined that there was no significant difference between the presence of OPS in terms of presence of retinopathy, presence of neuropathy) and presence of nephropathy. In addition, there was no significant difference between the presence of OPS in terms of HbA1c value. Conclusion: The incidence of other autoimmune diseases has increased significantly over the years in patients with T1DM, and autoimmune diseases should be considered both at the time of diagnosis and in the following years in terms of reducing the risk of complications in the follow-up of diabetic patients, a good prognosis, good clinical development and early diagnosis.

Keywords

• Type 1 diabetes mellitus,
• polyglandular syndrome,
• prognosis

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