Aterojenik Plazma İndeksi ile Demir Metabolizması Arasındaki İlişkinin Araştırılması

Yıl 2024, Cilt: 4 Sayı: 1, 661 - 670, 25.04.2024

Seda Çelik , Oğuzhan Tuğrul

Öz

Amaç: Demir, vücudumuz için oldukça önemli bir elementtir; ancak hücre içi kararsız demir yükü, reaktif oksijen türlerinin oluşmasına ve hücresel hasara yol açabilmektedir. Çalışmamız ile kardiyovasküler hastalıklar için önemli bir risk faktörü olan plazma lipid düzeyi ile demir metabolizması arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntem: Çalışmamızda 2015-2023 yılları arası Kardiyoloji Polikliniği’nde takip edilen 559 hastadan alınan veriler retrospektif olarak incelenmiştir. Hastaların yaş, cinsiyet ve kan tetkiklerinin sonuçları hastane veri tabanından alınarak SPSS 26.0 ile analiz edilmiştir. Aterojenik Plazma İndeksi (AIP) log (trigliserit /yüksek dansiteli lipoprotein kolesterol) hesabı ile elde edilmiştir. Bulgular: Çalışmamızda hastaların yaş ortalaması 36,73±13,92 yıl olup kadın erkek cinsiyet dağılımı ise 452/107 kişi şeklinde idi. Hastalar AIP düzeylerine göre -0,3 ile 0,1 arası düşük risk, 0,1 ile 0,24 arası orta risk ve 0,24'ün üzeri yüksek risk olmak üzere 3 gruba ayrıldı. Gruplar arasında AIP düzeyi arttıkça yaş ortalamasının ve erkek cinsiyet dağılım yüzdesinin arttığı izlendi ve istatistiksel olarak anlamlı farklılık saptandı (p<0,001). Gruplar arasında demir düzeyi istatistiksel olarak anlamlı farklılık göstermemiş iken (p=0,056) demir bağlama kapasitesi, total demir bağlama kapasitesi, transferrin, transferrin saturasyonu ve ferritin düzeyi istatistiksel olarak anlamlı farklılık göstermişti; p değerleri sırasıyla 0,005; 0,029;0,023; 0,014 ve <0,001 şeklinde idi. Sonuç: Demir metabolizması parametreleri kardiyovasküler hastalıkların tanı ve takibinde oldukça önemli bir yol gösterici olabilir.

Anahtar Kelimeler

Demir, Metabolizma, Lipid

Investigation of the Relationship Between Atherogenic Plasma Index and Iron Metabolism

Öz

Objective: Iron is a very important element for our body; however, intracellular unstable iron load may lead to the formation of reactive oxygen species and cellular damage. We aimed to investigate the relationship between iron metabolism and plasma lipid levels, which is an important risk factor for cardiovascular diseases. Methods: In our study, the data obtained from 559 patients who were followed up in the Cardiology Outpatient Clinic between 2015 and 2023 were analysed retrospectively. Age, gender and blood test results of the patients were obtained from the hospital database and analysed with SPSS 26.0. Atherogenic Plasma Index (AIP) was obtained by log (triglyceride/high density lipoprotein cholesterol) calculation. Results: The mean age of the patients in our study was 36.73±13.92 years and the gender distribution was 452/107. Patients were divided into 3 groups according to AIP levels: low risk between -0.3 and 0.1, intermediate risk between 0.1 and 0.24 and high risk above 0.24. It was observed that the mean age and the percentage of male sex distribution increased as the AIP level increased between the groups and a statistically significant difference was found (p<0.001). While iron level did not show statistically significant difference between the groups (p=0.056), iron binding capacity, total iron binding capacity, transferrin, transferrin saturation and ferritin level showed statistically significant difference; p values were 0.005, 0.029, 0.023, 0.014 and <0.001, respectively. Conclusion: Iron metabolism parameters may be an important guide in the diagnosis and follow-up of cardiovascular diseases.

Anahtar Kelimeler

Iron, Metabolism, Lipid

Kaynakça

• Bo, M. S., Cheah, W. L., Lwin, S., Moe Nwe, T., Win, T. T., & Aung, M. (2018). Understanding the Relationship between Atherogenic Index of Plasma and Cardiovascular Disease Risk Factors among Staff of an University in Malaysia. J Nutr Metab, 2018, 7027624. https://doi.org/10.1155/2018/7027624
• Cho, S. K., Kim, J. W., Huh, J. H., & Lee, K. J. (2020). Atherogenic Index of Plasma Is a Potential Biomarker for Severe Acute Pancreatitis: A Prospective Observational Study. J Clin Med, 9(9), 2982. https://doi.org/10.3390/jcm9092982
• Dobiásová M. (2006). API--aterogenní index plazmy jako významný prediktor kardiovaskulárního rizika: od výzkumu do praxe [API--atherogenic index of plasma as a significant predictor of cardiovascular risk: from research to practice]. Vnitrni lekarstvi, 52(1), 64–71.
• Frey, P. A., & Reed, G. H. (2012). The ubiquity of iron. ACS Chem Biol, 7(9), 1477–1481. https://doi.org/10.1021/cb300323q
• Guo, S., Mao, X., Li, X., & Ouyang, H. (2022). Association between iron status and incident coronary artery disease: a population based-cohort study. Sci Rep, 12(1), 17490. https://doi.org/10.1038/s41598-022-22275-0
• Hu, X., Cai, X., Ma, R., Fu, W., Zhang, C., & Du, X. (2019). Iron-load exacerbates the severity of atherosclerosis via inducing inflammation and enhancing the glycolysis in macrophages. J Cell Physiol, 234(10), 18792–18800. https://doi.org/10.1002/jcp.28518
• Kiechl, S., Willeit, J., Egger, G., Poewe, W., & Oberhollenzer, F. (1997). Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study. Circulation, 96(10), 3300–3307. https://doi.org/10.1161/01.cir.96.10.3300
• Kirk, E. A., Heinecke, J. W., & LeBoeuf, R. C. (2001). Iron overload diminishes atherosclerosis in apoE-deficient mice. Clin Invest, 107(12), 1545–1553. https://doi.org/10.1172/JCI7664
• Lee, T. S., Shiao, M. S., Pan, C. C., & Chau, L. Y. (1999). Iron-deficient diet reduces atherosclerotic lesions in apoE-deficient mice. Circulation, 99(9), 1222–1229. https://doi.org/10.1161/01.cir.99.9.1222
• Niroumand, S., Khajedaluee, M., Khadem-Rezaiyan, M., Abrishami, M., Juya, M., Khodaee, G., & Dadgarmoghaddam, M. (2015). Atherogenic Index of Plasma (API): A marker of cardiovascular disease. Medical journal of the Islamic Republic of Iran, 29, 240. Erişim: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715400/
• Petersen, K. S., Bowen, K. J., Tindall, A. M., Sullivan, V. K., Johnston, E. A., Fleming, J. A., & Kris-Etherton, P. M. (2020). The Effect of Inflammation and Insulin Resistance on Lipid and Lipoprotein Responsiveness to Dietary Intervention. Curr Dev Nutr, 4(11), 160. https://doi.org/10.1093/cdn/nzaa160
• Phillips M. C. (2014). Molecular mechanisms of cellular cholesterol efflux. J Biol Chem, 289(35), 24020–24029. https://doi.org/10.1074/jbc.R114.583658
• Salonen, J. T., Nyyssönen, K., Korpela, H., Tuomilehto, J., Seppänen, R., & Salonen, R. (1992). High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men. Circulation, 86(3), 803–811. https://doi.org/10.1161/01.cir.86.3.803
• Sawada, H., Hao, H., Naito, Y., Oboshi, M., Hirotani, S., Mitsuno, M., … Masuyama, T. (2015). Aortic iron overload with oxidative stress and inflammation in human and murine abdominal aortic aneurysm. Arterioscler Thromb Vasc Biol, 35(6), 1507–1514. https://doi.org/10.1161/ATVBAHA.115.305586
• Sawicki, K. T., De Jesus, A., & Ardehali, H. (2023). Iron Metabolism in Cardiovascular Disease: Physiology, Mechanisms, and Therapeutic Targets. Circ Res, 132(3), 379–396. https://doi.org/10.1161/CIRCRESAHA.122.321667
• Shi, Y., & Wen, M. (2023). Sex-specific differences in the effect of the atherogenic index of plasma on prediabetes and diabetes in the NHANES 2011-2018 population. Cardiovasc Diabetol, 22(1), 19. https://doi.org/10.1186/s12933-023-01740-8
• Shin, H. R., Song, S., Cho, J. A., & Ly, S. Y. (2022). Atherogenic Index of Plasma and Its Association with Risk Factors of Coronary Artery Disease and Nutrient Intake in Korean Adult Men: The 2013-2014 KNHANES. Nutrients, 14(5), 1071. https://doi.org/10.3390/nu14051071
• Sniderman, A. D., Williams, K., Contois, J. H., Monroe, H. M., McQueen, M. J., de Graaf, J., & Furberg, C. D. (2011). A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes, 4(3), 337–345. https://doi.org/10.1161/CIRCOUTCOMES.110.959247
• Wang, W., Knovich, M. A., Coffman, L. G., Torti, F. M., & Torti, S. V. (2010). Serum ferritin: Past, present and future. Biochim Biophys Acta, 1800(8), 760–769. https://doi.org/10.1016/j.bbagen.2010.03.011
• Xia, Y., Xia, C., Wu, L., Li, Z., Li, H., & Zhang, J. (2023). Systemic Immune Inflammation Index (SII), System Inflammation Response Index (SIRI) and Risk of All-Cause Mortality and Cardiovascular Mortality: A 20-Year Follow-Up Cohort Study of 42,875 US Adults. J Clin Med, 12(3), 1128. https://doi.org/10.3390/jcm12031128
• Yin, B., Wu, Z., Xia, Y., Xiao, S., Chen, L., & Li, Y. (2023). Non-linear association of atherogenic index of plasma with insulin resistance and type 2 diabetes: a cross-sectional study. Cardiovasc Diabetol, 22(1), 157. https://doi.org/10.1186/s12933-023-01886-5
• Zhu, L., Lu, Z., Zhu, L., Ouyang, X., Yang, Y, Song, Y. (2015). Lipoprotein ratios are better than conventional lipid parameters in predicting coronary heart disease in Chinese Han people. Kardiol Pol, 73(10), 931–938. https://doi.org/10.5603/KP.a2015.0086
• Zhu, X., Yu, L., Zhou, H., Ma, Q., Zhou, X., Lei, S. (2018). Atherogenic index of plasma is a novel and better biomarker associated with obesity: a population-based cross-sectional study in China. Lipids Health Dis, 17(1), 37. https://doi.org/10.1186/s12944-018-0686-8