Diyabetik retinopatide subklinik aterosklerozun bir göstergesi olarak monosit /HDL oranı

Yıl 2020, Cilt: 3 Sayı: 2, 109 - 114, 19.03.2020

Seyfullah Kan , Adnan Karaibrahimoğlu

https://doi.org/10.32322/jhsm.640710

Öz

Amaç:
Diyabetik
retinopatisi olan hastalarda kardiyovasküler hastalıkların artan sıklığı
bilinmektedir. MHO (Monosit/HDL oranı), kardiyovasküler ve serebrovasküler
hastalıklarla ilişkisi yeni saptanmış bir belirteçtir. Bu çalışmanın amacı
aşikar kardiyovasküler hastalık bulgusu olmayan diyabetik retinopatisi olan
hastalarda subklinik ateroskleroz risk göstergesi karotis intima media
kalınlığı (KİMK) ile MHO ilşkisini araştırmaktır.

Gereç
ve Yöntem: Aşikar kardiyovasküler hastalığı olmayan 106 diyabetik
hasta ve 35 yaş, cinsiyet ve BMI (Body mass index) ile uyumlu sağlıklı kontrol
alındı. Hastalar proliferatif diyabetik retinopati (PDR , n=30),
nonproliferatif diyabetik retinopati ( NPDR, n=35), retinopati olmayan diyabet
hastaları (n=41) ve kontrol grubu (n=35) olmak üzere dört gruba ayrıldı.
Anthropometric, biyokimyasal parametreler ve KİMK ölçüldü. MHO ile KİMK
arasındaki ilşkiyi değerlendirmek için korelasyon ve regresyon analizi yapıldı.

Bulgular:
MHO değerleri
gruplar arasında anlamlı farklılığa sahip ve PDR grubunda anlamlı düzeyde daha
yüksekti ( p < ,001). Ateroskleroz
göstergesi olan KİMK gruplar arasında anlamlı farklılık gösterdi ( p < ,001). KİMK değeri PDR grubunda
anlamlı düzeyde yüksek iken diğer gruplarda birbirine yakın değerler ölçüldü
(Tablo 1). PDR grubunda MHO ile KİMK arasında önemli düzeyde anlamlı korelasyon
bulundu ( r=0,96; p < ,001). Binary logistic regression analizinde MHO’nin KİMK
üzerine anlamlı etkisi bulunmaktaydı [ β=0,206, (%95 CI : 1,004-1,505), P=0,046
] (Table 3).

Sonuç: Bu çalışma, yüksek MHO’nın diyabetik
retinopatisi olan hastalarda subklinik kardiyovasküler riski belirlemede
non-invaziv, basit ve maliyeti düşük bir marker olarak kullanılabileceğini
göstermektedir. Diabetik retinopatide MHO ve KİMK arasındaki ilişkiyi inceleyen
literatürdeki ilk çalışma olan bu çalışma, aşikar kardiyovasküler hastalık
bulgusu olmayan diyabetik hastalardaki kardiak riski erken belirlemede fayda
sağlayabilir.

Anahtar Kelimeler

Diyabetik retinopati, subklinik ateroskleroz, monosit /HDL oranı

Monocyte to HDL ratio as an indicator of subclinical atherosclerosis in diabetic retinopathy

Öz

ABSTRACT

Aim: Incidence of cardiovascular
diseases is gradually increasing in patients with diabetic retinopathy (DR).
MHR (Monocyte/HDL ratio), is a novel marker related with cardiovascular and
cerebrovascular diseases. The aim of this study was to investigate the
relationship between a subclinical atherosclerosis marker, carotid intima media
thickness (CIMT), and MHR in diabetic retinopathy patients without an apparent
cardiovascular disease. 

Material
and Method: 106 diabetic patients without an apparent
cardiovascular disease and 35 healthy controls matched for age, gender and body
mass index (BMI) were included in this study. 
The patients were separeted into four groups which were proliferative
diabetic retinopahy (PDR , n=30), nonproliferative diabetic retinopathy (NPDR,
n=35), diabetic patients without retinopathy (n=41) and control group (n=35).
Anthropometric, biochemical parameteres and CIMT were measured. Correlation and
regression analysis were done to assess the relation between MHR and CIMT.

Results:
MHR was
significantly different between
groups and significantly higher in PDR group (p < .001). CIMT, a marker for atherosclerosis, significantly
differed between groups (p <
.001). CIMT levels were significantly higher in PDR while similar values were
found in other than groups. In PDR group, a significant correlation was found
between MHR and CIMT ( r=0.96; p < .001). According to binary logistic regression analysis,
MHR had a significant effect on CIMT [ β=0.206, (%95 CI : 1.004-1.505), P=0.046
].

Conclusion: This study showed that  in patients with diabetic retinopathy, high
levels of MHR which is a non-invasive, simple and inexpensive marker, might be
useful for determination of subclinical cardiovascular risk. This study which
is the first in literature that investigated the relation between MHR and CIMT
in diabetic retinopathy might have a benefit on early detection of cardiac risk
in diabetic patients without an apparent cardiovascular disease.

Anahtar Kelimeler

Diabetic retinopathy, subclinical atherosclerosis, monocyte to HDL ratio

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