Araştırma Makalesi
İnflamatuar Barsak Hastalığı İle İlişkili Belirteçlerin Düzeylerinin Diyabet Hastalarında İncelenmesi
Öz
AMAÇ:
Öncelikli amaç inflamatuar barsak hastalıkları oluşum ve gelişiminde önemli
olabileceği düşünülen adipoz doku ve inflamasyon belirteçlerinin tip 2 diyabet
vakalarında panel olarak ve ilk defa bir arada çalışmaktır. Ayrıca elde
edilecek leptin, ghrelin, resistin, EGF ve TNF-α belirteçlerine ait analiz verilerinden
yararlanarak tip 2 diyabet ile ilgili tanı yöntemlerinin geliştirilebilmesine
katkıda bulunmayı planlamaktayız
MATERYAL
METOD: Çalışmada kullanılan örnekler gönüllülerden kuru tüplerde kan alınarak,
3000 rpm 5 dakika soğutmalı santrifüjden sonra alınan serum olarak
aligotlanmıştır. ELISA çalışması ise Leptin, Ghrelin, Resistin, EGF ve TNF-α belirteçlerine
ait uygun protokoller eşliğinde gerçekleştirilmiştir.
BULGULAR:
Elde edilen veriler SPSS-8 paket programı ile istatistiksel olarak
belirlenmiştir. Denek sayısı<50 olduğundan Leptin,EGF,Ghrelin için gruplarda
Shapiro-Wilk testi sonuçlarına bakıldı. P< 0.05 olduğundan veriler normal
dağılım göstermemektedir. Ghrelinin sonuçları Mann-WhitneyU testi ile değerlendirildi.
Kontrol grubunda veriler normal dağılım göstermiş(p:0.544) ama hasta grubunda
normal dağılım göstermediği için nonparametrik test olan Mann-Whitney U testi kullanıldı.
EGF sonuçları Mann-Whitney U testi ile değerlendirildi. TNF Alfa için;p= 0.0001
gibi yüksek skorda ilişki saptanmıştır. Leptin için Mann-Whitney U testinde
p=0.001 olarak anlamlı sonuçlar kaydedilmiştir. Rezistinde serum düzeyleri de
benzer sebeplerden Mann-Whitney U testinde p=0.003 olarak belirlenmiştir
SONUÇ:
Epiteliyal gelişimini, gastrik asid salınımını ve anjiyogenezi teşvik eden
multipotent bir protein olan EGF, β hücrelerinin yenilenmesinde ve sayılarının
artırımında önemli rol oynadığı anlaşılmış,β hücrelerinin sayısının artmasıyla
kana insülin salınımında artış ve diyabette etkisi gösterilmiştir. EGF verilerine
göre hasta serum düzeyleri kontrol grupları düzeylerine göre yüksek düzeydedir
ve ciddi fark/anlamlılık görülmüştür. TNF-α ile ilgili elde ettiğimiz sonuçlar
diğer çalışmalarla beraber sitokin/diyabet ilişkisini daha iyi anlamamızı
sağlayacaktır.
Anahtar Kelimeler
Kaynakça
- 1.Jahanshahi G, Motavasel V, Rezaie A, Hashtroudi AA, Daryani NE, Abdollahi M. Alterations in antioxidant power and levels of epidermal growth factor and nitric oxide in saliva of patients with inflammatory bowel diseases. Dig Dis Sci. 2004 Nov-Dec;49(11- 12):1752-7. 2.Oikonomou KA, Kapsoritakis AN, Kapsoritaki AI, Manolakis AC, Tsiopoulos FD, Germenis AE, Potamianos SP. Downregulation of serum epidermal growth factor in patients with inflammatory bowel disease. Is there a link with mucosal damage? Growth Factors. 2010 Dec;28(6):461-6. 3.Karmiris K, Koutroubakis IE, Xidakis C, Polychronaki M, Voudouri T, Kouroumalis EA. Circulating levels of leptin, adiponectin, resistin, and ghrelin in inflammatory bowel disease. Swiss Med Wkly. 2009 May 16;139(19-20):278-87. 4.Lakso M. Epidemiology and diagnosis of type 2 diabetes. In: Goldstein BJ, Müller-Wieland D, eds. Textbook of Type 2 Diabetes. New York: Martin Dunitz Taylor&Francis Group; 2003, p 1-12 5.Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998 Jul;15(7):539-53. 6.Satman İ. Diabetes mellitus’un epidemiyolojisi. In: Yenigün M, Altuntaş Y, eds. Her Yönüyle Diabetes Mellitus. İstanbul: Nobel Tıp Kitapevi; 2001. P. 69-83. 7.Müller-Wieland D, Kotzka J, Goldstein BJ. Pathogenesis of type 2 diabetes. In: : Goldstein BJ, Müller-Wieland D, eds. Textbook of Type 2 Diabetes. New York: Martin Dunitz Taylor&Francis Group; 2003, p. 13-28. 8.Nagaya N, Uematsu M, Kojima M, Date Y, Nakazato M, Okumura H, Hosoda H, Shimizu W, Yamagishi M, Oya H, Koh H, Yutani C, Kangawa K: Elevated circulating level of ghrelin in cachexia associated with chronic heart failure: relationships between ghrelin and anabolic/catabolic factors. Circulation 104:2034 –2038, 2001. 9.Otto B, Cuntz U, Fruehauf E, Wawarta R, Folwaczny C, Riepl RL, Heiman ML, Lehnert P, Fichter M, Tschop M: Weight gain decreases elevated plasma ghrelin concentrations of patients with anorexia nervosa. Eur J Endocrinol 145:669–673, 2001. 10. Tolle V, Kadem M, Bluet-Pajot MT, Frere D, Foulon C, Bossu C, Dardennes R, Mounier C, Zizzari P, Lang F, Epelbaum J, Estour B: Balance in ghrelin and leptin plasma levels in anorexia nervosa patients and constitutionally thin women. J Clin Endocrinol Metab 88:109 –116, 2003. 11.Tschop M, Weyer C, Tataranni PA, Devanarayan V, Ravussin E, Heiman ML: Circulating ghrelin levels are decreased in human obesity. Diabetes 50:707–709, 2001. 12. Shiiya T, Nakazato M, Mizuta M, Date Y, Mondal MS, Tanaka M, Nozoe S, Hosoda H, Kangawa K, Matsukura S: Plasma ghrelin levels in lean and obese humans and the effect of glucose on ghrelin secretion. J Clin Endocrinol Metab 87:240 – 244, 2002. 13. Weigle DS, Cummings DE, Newby PD, Breen PA, Frayo RS, Matthys CC, Callahan HS, Purnell JQ: Roles of leptin and ghrelin in the loss of body weight caused by a low fat, high carbohydrate diet. J Clin Endocrinol Metab 88:1577–1586, 2003. 14. Haqq AM, Farooqi IS, O‘Rahilly S, Stadler DD, Rosenfeld RG, Pratt KL, LaFranchi SH, Purnell JQ: Serum ghrelin levels are inversely correlated with body mass index, age, and insulin concentrations in normal children and are markedly increased in Prader-Willi syndrome. J Clin Endocrinol Metab 88:174 –178, 2003. 15. Hansen TK, Dall R, Hosoda H, Kojima M, Kangawa K, Christiansen JS, Jorgensen JO: Weight loss increases circulating levels of ghrelin in human obesity. Clin Endocrinol (Oxf) 56:203– 206, 2002. 16. Lippl F, Kircher F, Erdmann J, Allescher HD, Schusdziarra V: Effect of GIP, GLP-1, insulin and gastrin on ghrelin release in the isolated rat stomach. Regul Pept 119:93–98, 2004. 17. Masaoka T, Suzuki H, Hosoda H, Ota T, Minegishi Y, Nagata H, Kangawa K, Ishii H: Enhanced plasma ghrelin levels in rats with streptozotocin-induced diabetes. FEBS Lett 541:64–68, 2003. 18. Ueno H, Dube MG, Inui A, Kalra PS, Kalra SP: Leptin modulates orexigenic effects of ghrelin and attenuates adiponectin and insulin levels and selectively the dark-phase feeding as revealed by central leptin gene therapy. Endocrinology 145:4176– 4184, 2004. 19. Barazzoni R, Zanetti M, Stebel M, Biolo G, Cattin L, Guarnieri G: Hyperleptinemia prevents increased plasma ghrelin concentration during shortterm moderate caloric restriction in rats. Gastroenterology 124:1188 –1192, 2003. 20. Flier JS. Diabetes: the missing link with obesity? Nature 2001; 409:292–3. 21. Meier U, Gressner AM. Endocrine regulation of energy metabolism: review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clin Chem. 2004 Sep;50(9):1511-25. Epub 2004 Jul 20. 22. G. Andrisani, L. Guidi, A. Papa, A. Armuzzi, Anti-TNF alpha therapy in the management of extraintestinal manifestation of inflammatory bowel disease European Review for Medical and Pharmacological Sciences, 2012; 16: 890-901.A. Ballinger, Paul Kelly, Elizabeth Hallyburton, Rachel Besser, Michael Farthing, Plasma leptin in chronic inflammatory bowel disease and HIV: implications for the pathogenesis of anorexia and weight loss Clinical Science (1998) 94, 479-483. 23. Baggio LL, Drucker DJ. Therapeutic approaches to preserve islet mass in type 2 diabetes. Annu Rev Med. 2006;57:265-81.
Yıl 2016,
Cilt: 6 Sayı: 11, 90 - 93, 01.06.2016
Öz
Kaynakça
- 1.Jahanshahi G, Motavasel V, Rezaie A, Hashtroudi AA, Daryani NE, Abdollahi M. Alterations in antioxidant power and levels of epidermal growth factor and nitric oxide in saliva of patients with inflammatory bowel diseases. Dig Dis Sci. 2004 Nov-Dec;49(11- 12):1752-7. 2.Oikonomou KA, Kapsoritakis AN, Kapsoritaki AI, Manolakis AC, Tsiopoulos FD, Germenis AE, Potamianos SP. Downregulation of serum epidermal growth factor in patients with inflammatory bowel disease. Is there a link with mucosal damage? Growth Factors. 2010 Dec;28(6):461-6. 3.Karmiris K, Koutroubakis IE, Xidakis C, Polychronaki M, Voudouri T, Kouroumalis EA. Circulating levels of leptin, adiponectin, resistin, and ghrelin in inflammatory bowel disease. Swiss Med Wkly. 2009 May 16;139(19-20):278-87. 4.Lakso M. Epidemiology and diagnosis of type 2 diabetes. In: Goldstein BJ, Müller-Wieland D, eds. Textbook of Type 2 Diabetes. New York: Martin Dunitz Taylor&Francis Group; 2003, p 1-12 5.Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998 Jul;15(7):539-53. 6.Satman İ. Diabetes mellitus’un epidemiyolojisi. In: Yenigün M, Altuntaş Y, eds. Her Yönüyle Diabetes Mellitus. İstanbul: Nobel Tıp Kitapevi; 2001. P. 69-83. 7.Müller-Wieland D, Kotzka J, Goldstein BJ. Pathogenesis of type 2 diabetes. In: : Goldstein BJ, Müller-Wieland D, eds. Textbook of Type 2 Diabetes. New York: Martin Dunitz Taylor&Francis Group; 2003, p. 13-28. 8.Nagaya N, Uematsu M, Kojima M, Date Y, Nakazato M, Okumura H, Hosoda H, Shimizu W, Yamagishi M, Oya H, Koh H, Yutani C, Kangawa K: Elevated circulating level of ghrelin in cachexia associated with chronic heart failure: relationships between ghrelin and anabolic/catabolic factors. Circulation 104:2034 –2038, 2001. 9.Otto B, Cuntz U, Fruehauf E, Wawarta R, Folwaczny C, Riepl RL, Heiman ML, Lehnert P, Fichter M, Tschop M: Weight gain decreases elevated plasma ghrelin concentrations of patients with anorexia nervosa. Eur J Endocrinol 145:669–673, 2001. 10. Tolle V, Kadem M, Bluet-Pajot MT, Frere D, Foulon C, Bossu C, Dardennes R, Mounier C, Zizzari P, Lang F, Epelbaum J, Estour B: Balance in ghrelin and leptin plasma levels in anorexia nervosa patients and constitutionally thin women. J Clin Endocrinol Metab 88:109 –116, 2003. 11.Tschop M, Weyer C, Tataranni PA, Devanarayan V, Ravussin E, Heiman ML: Circulating ghrelin levels are decreased in human obesity. Diabetes 50:707–709, 2001. 12. Shiiya T, Nakazato M, Mizuta M, Date Y, Mondal MS, Tanaka M, Nozoe S, Hosoda H, Kangawa K, Matsukura S: Plasma ghrelin levels in lean and obese humans and the effect of glucose on ghrelin secretion. J Clin Endocrinol Metab 87:240 – 244, 2002. 13. Weigle DS, Cummings DE, Newby PD, Breen PA, Frayo RS, Matthys CC, Callahan HS, Purnell JQ: Roles of leptin and ghrelin in the loss of body weight caused by a low fat, high carbohydrate diet. J Clin Endocrinol Metab 88:1577–1586, 2003. 14. Haqq AM, Farooqi IS, O‘Rahilly S, Stadler DD, Rosenfeld RG, Pratt KL, LaFranchi SH, Purnell JQ: Serum ghrelin levels are inversely correlated with body mass index, age, and insulin concentrations in normal children and are markedly increased in Prader-Willi syndrome. J Clin Endocrinol Metab 88:174 –178, 2003. 15. Hansen TK, Dall R, Hosoda H, Kojima M, Kangawa K, Christiansen JS, Jorgensen JO: Weight loss increases circulating levels of ghrelin in human obesity. Clin Endocrinol (Oxf) 56:203– 206, 2002. 16. Lippl F, Kircher F, Erdmann J, Allescher HD, Schusdziarra V: Effect of GIP, GLP-1, insulin and gastrin on ghrelin release in the isolated rat stomach. Regul Pept 119:93–98, 2004. 17. Masaoka T, Suzuki H, Hosoda H, Ota T, Minegishi Y, Nagata H, Kangawa K, Ishii H: Enhanced plasma ghrelin levels in rats with streptozotocin-induced diabetes. FEBS Lett 541:64–68, 2003. 18. Ueno H, Dube MG, Inui A, Kalra PS, Kalra SP: Leptin modulates orexigenic effects of ghrelin and attenuates adiponectin and insulin levels and selectively the dark-phase feeding as revealed by central leptin gene therapy. Endocrinology 145:4176– 4184, 2004. 19. Barazzoni R, Zanetti M, Stebel M, Biolo G, Cattin L, Guarnieri G: Hyperleptinemia prevents increased plasma ghrelin concentration during shortterm moderate caloric restriction in rats. Gastroenterology 124:1188 –1192, 2003. 20. Flier JS. Diabetes: the missing link with obesity? Nature 2001; 409:292–3. 21. Meier U, Gressner AM. Endocrine regulation of energy metabolism: review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clin Chem. 2004 Sep;50(9):1511-25. Epub 2004 Jul 20. 22. G. Andrisani, L. Guidi, A. Papa, A. Armuzzi, Anti-TNF alpha therapy in the management of extraintestinal manifestation of inflammatory bowel disease European Review for Medical and Pharmacological Sciences, 2012; 16: 890-901.A. Ballinger, Paul Kelly, Elizabeth Hallyburton, Rachel Besser, Michael Farthing, Plasma leptin in chronic inflammatory bowel disease and HIV: implications for the pathogenesis of anorexia and weight loss Clinical Science (1998) 94, 479-483. 23. Baggio LL, Drucker DJ. Therapeutic approaches to preserve islet mass in type 2 diabetes. Annu Rev Med. 2006;57:265-81.
Toplam 1 adet kaynakça vardır.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Makale |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2016 |
| Yayımlandığı Sayı | Yıl 2016 Cilt: 6 Sayı: 11 |
