Obez Türk çocuklarında plazma adiponektin ve plazminojen aktivatör inhibitor-1 düzeyleri

Öz

Giriş: Obezitenin tek başına ateroskleroz için bir risk faktörü olduğu bilinmektedir. Obezite ve ateroskleroz ilişkisi ile ilgili bilinen başlıca faktörler dislipidemi, insülin rezistansı ve insülin duyarlılığını artırıcı bir adipositokin olan adiponektin (ADPN) eksikliğidir. Bu çalışmada, obez çocuklarda adiponektin düzeylerinin araştırılması ve adiponektin düzeyleri ile ateroskleroza yatkınlık oluşturduğu bilinen başka faktörlerin ilişkilerinin değerlendirilmesi amaçlanmıştır.

Gereçler ve yöntem: 30 obez çocuk hastanın ve 28 sağlıklı çocuğun plazma örneklerinden ADPN, plazminojen aktivatör inhbitor-1 (PAI-1), lipid profili, insülin ve tam kan örneklerinden hemoglobin A1c (HbA1c) düzeyleri belirlendi ve bu faktörlerin birbirleri ile ilişkileri araştırıldı. Obez hasta grubunda oral glukoz tolerans testi (OGTT) uygulandı ve OGTT’nin 2. saatinde ADPN ve PAI-1 düzeyleri tekrar değerlendirildi.

Sonuçlar: Obez hasta grubunda, bazal ADPN ve PAI-1 düzeyleri, OGTT’nin 2. saatinde elde edilen değerlere göre daha düşük tesbit edildi. Bazal ADPN düzeyleri, vücut kitle indeksi, trigliserid düzeyleri, çok düşük dansiteli lipoprotein (VLDL) ve insulin düzeyleri ile negatif korelasyon göstermekteydi. Postprandial elde edilen ADPN ve PAI-1 bazal değerlere göre anlamlı olarak yüksek tespit edildi. Postprandial PAI-1 ve yüksek dansiteli lipoprotein (HDL) arasında ve postprandial ADPN ile insulin ve trigliserid düzeyleri arasında negatif korelasyon tesbit edildi. Trigliserid ve insulin düzeylerindeki değişiklikler ADPN’i negatif yönde etkilerken, HbA1c’deki değişiklikler pozitif yönde etkilemekteydi.

Sonuç: Çalışmamız plazma ADPN düzeylerinin atheroskleroz yatkınlığını gösteren bir belirteç olarak kullanılabileceğini ortaya koymaktadır.

Anahtar Kelimeler

• Çocukluk çağı obezitesi,adiponectin,plazminojen aktivatör inhibitör-1

Plasma levels of adiponectin and plasminogen activator inhibitor-1 in Turkish obese children

Öz

Introduction: It is known that obesity itself is a risk factor for atherosclerosis. Dyslipidemia, insulin resistance and the deficiency of the adiponectin (ADPN), which is an adipocytokine increasing the insulin sensitivity, are the main factors known for their relations with the obesity and atherosclerosis. This study aimed to determine the levels of plasma ADPN in obese children and its relationship with several other factors associated with atherosclerosis.

Materials and Method: Plasma levels of ADPN, plasminogen activator inhbitor-1 (PAI-1), lipids and insulin and blood hemoglobin A1c (HbA1c) levels were measured and their relations with each other were determined in 30 obese and 28 healthy children. Oral glucose tolerance test (OGTT) was performed to obese children and ADPN and PAI-1 levels were rechecked at the second hour of OGTT.

Results: In obese children, the basal ADPN and PAI-1 levels were lower, than their levels obtained 2 hours after the OGTT. Basal ADPN levels showed negative correlation with the body mass index, and triglyceride, very low density lipoprotein (VLDL) and insulin levels. Negative correlation was also detected between the postprandial PAI-1 and high density lipoprotein (HDL), and between plasma ADPN and insulin and triglyceride levels. While the changes in triglyceride and insulin levels negatively affected the ADPN, the changes in HbA1c affected ADPN positively.

Conclusion: Our study indicates that, plasma ADPN level can be used as a follow up marker for atherosclerosis.

Anahtar Kelimeler

• Childhood obesity,adiponectin,plasminogen activator inhibitor-1

Kaynakça

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