OBEZ ADOLESANLARDA SERUM N-TERMİNAL PRO B-TİPİ NATRİÜRETİK PEPTİT (NT-PROBNP) DÜZEYLERİ, ERKEN KARDİYOVASKÜLER RİSK FAKTÖRLERİ VE EKOKARDİYOGRAFİK PARAMETRELER ARASINDAKİ İLİŞKİLER

Öz

AMAÇ: 

Bu çalışmada; adolesan obezitesinde N-terminal pro B- tipi natriüretik peptit (NT-proBNP) düzeyleri ile metabolik, ekokardiyografik parametreler, karotis intima media ölçümü (IMT) ve epikardiyal yağ dokusu (EATT) düzeyleri arasındaki ilişki incelenmiştir.

 

MATERYAL-METOD:

Çalışma grubuna 138 obez ergen ve kontrol grubuna ise 63 obez olmayan ergen kabul edildi. VKİ’ye göre; 33,90± 9,30 olan hastaların 95’i hafif-orta obez, 39,40± 4,00 olan hastaların 43’ü ise şiddetli obez olacak şekilde alt gruplara ayrıldı. Tüm hastalara sol ventrikül (SV) sistolik fonksiyonu ve kitle indeksi, miyokardiyal duvar kalınlığı ve miyokardiyal performans indeksi (MPI) saptanması için transtorasik ekokardiyografik inceleme yapıldı. Ekokardiyografide epikardiyal yağ dokusu ve karotis IMT ölçüldü. Eş zamanlı serum NT-proBNP değerleri ölçüldü.

 

BULGULAR:

NT-proBNP değerleri; şiddetli obez grupta 76,00± 49,70 pg / ml, hafif-orta derece obez grupta 67,20 ± 64,40 pg / ml (p= 0,007) ve kontrol grubunda ise 44,30 ± 23,30 pg / ml (p= 0,002) olarak bulundu (p= 0,007, p= 0,002).

Ortalama karotis IMT ölçümleri sırasıyla obez gruplarda 0,91± 0,23 ve 0,88  ± 0,18 mm kontrol grubunda ise 0,52 ± 0.08 mm idi (p= 0,0001). Obez alt gruplar arasında istatistiksel anlamlı farklılık yoktu. EATT ölçümleri obez alt grupları ortalaması, 7,42  ± 1,55 mm ve 7,38± 1,76, kontrol grubunda ise 4,28 ± 0,79 mm olarak ölçüldü (p= 0,0001).

NT-proBNP seviyesi, şiddetli obezitede sol ventrikül sistolik ve diyastolik fonksiyonları ile karotis IMT veya EATT oranları fonksiyonel olarak belirgin pozitif korelasyon göstermiştir.

 

SONUÇLAR:

Çalışmamızda, hafif-orta ve şiddetli obez ergenlerde serum NT- proBNP düzeylerinin kontrol grubuna göre daha yüksek olduğunu ve NT- proBNP'nin obez ergenlerde ateroskleroz ve kardiyak disfonksiyonu öngörmede yararlı bir belirteç olabileceğini gösterdi.

Anahtar Kelimeler

• Ergen obezite,ekokardiyografi,N-terminal pro B-tipi natriüretik peptid,ateroskleroz,erken kardiyovasküler risk

INTERRELATIONS BETWEEN SERUM N-TERMINAL PRO B-TYPE NATRIURETIC PEPTIDE (NT-PROBNP) LEVELS AND EARLY CARDIOVASCULAR RISK FACTORS AND ECHOCARDIOGRAPHIC PARAMETERS IN OBESE ADOLESCENTS

Öz

Purpose: This study aimed to evaluate the associations between the N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and the metabolic, echocardiographic parameters, carotid intima-media thickness (IMT) and epicardial adipose tissue thickness (EATT) in adolescent obesity.

Material and Method: The study participants consisted of 138 obese adolescents in the study group and 63 non-obese adolescents as control subjects. All the subjects underwent transthoracic echocardiographic examination for determination of left ventricular (LV) systolic function and mass index, myocardial tissue rates, and myocardial performance index (MPI). Epicardial adipose tissue thickness and carotid IMT were also measured during echocardiography. Serum NT-proBNP levels were measured at the time of the evaluation.

Results: The NT-proBNP values averaged 67.20 ± 64.40 pg/ml in mildly-moderately obese, 76.00 ± 49.70 pg/ml in the severely obese group and 44.30 ± 23.30 pg/ml in the control group (p = 0.007, p = 0.002, respectively). The average carotid IMT was 0.91 ± 0.23 and 0.88 ± 0.18 mm in the obesity groups and 0.52 ± 0.08 mm in the control group (p= 0.0001), but differences were not observed between obesity groups and the EATT which averaged 7.38 ± 1.76 and 7.42 ± 1.55 mm in the obesity groups and 4.28 ± 0.79 mm in the control group (p = 0.0001). The NT-proBNP levels showed statistically significant positive correlations with left ventricular systolic and diastolic functions, carotid IMT, or EATT values, especially in severe obesity.

Conclusion: The study showed higher measurements of serum NT-proBNP levels in mildly-moderately and severely obese adolescents than control and NT-proBNP might be a useful marker for predicting atherosclerosis and cardiac dysfunction in the obese adolescent. 

Anahtar Kelimeler

• Adolescent obesity,echocardiography,N-terminal pro-B-type natriuretic peptide,atherosclerosis,early cardiovasculer risk

Kaynakça

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