Gestasyonel Diyabet, Metabolik Sendrom ile İlişkili midir?

Yıl 2019, Cilt: 9 Sayı: 2, 110 - 116, 01.08.2019

Emel Arslan Yıldırım Mehmet Bülbül Kemal Özerkan Osman Haldun Develioğlu

Öz

Amaç: Gestasyonel Diabetes Mellitus (GDM) gebeliklerin %1-14’ünü görülür. Polikistik over sendromu (PCOS) ve metabolik sendromda (MS) olduğu gibi patofizyolojisinde insülin direnci (IR) rol alır. Bundan dolayı bu üç klinik durumun birbiriyle ilişkili olduğu düşünülmektedir. Materyal ve Metot: Bu çalışmada GDM tanısı almış 27 kadın ve sağlıklı 30 kadın PCOS, MS ve IR açısından karşılaştırılmıştır. Bulgular: GDM grubunda kilo ve vücut kitle indeksi (BMI), bel ve kalça çevreleri kontrol grubundan daha yüksekti (sırasıyla 69.0±11,5 kg vs 62.0±10,3 kg, p:0,01; 27.0±4,7 kg/m2 vs 23.0±3,5 kg/m2, p:0,001; 82.0±8,5 cm vs 74.0±7,5 cm, p<0,001; 103.0±8,1 cm vs 98.0±8,7 cm, p:0,02). MS sıklığı GDM grubunda kontrol grubuna göre istatistiksel anlamlı olarak daha yüksekti. Bel çevresi, kan basıncı, açlık kan şekeri ve trigliserid düzeyleri yüksek olan hasta sayısı kontrol grubuna göre daha fazlaydı (sırasıyla %55,6 vs %20, p:0,006; %18,5 vs %0, p:0,01; %29,6 vs %6,7, p:0,02; %48,1 vs %10, p: 0,002). HDL kolesterol düzeyi açısından ise gruplar arasında istatistiksel olarak fark saptanmadı (p>0,05). HOMA için eşik değer 2.24 olarak alındığında GDM grubunda kontrol grubundan daha fazla insülin direnci saptandı sırasıyla (sırasıyla %48,1 vs %20,0, p: 0,02). Sonuç: GDM’de olduğu gibi MS ve PCOS’ta ortak problem IR’dır. Birçok çalışmada gösterildiği gibi bizim çalışmamızda da MS, GDM grubunda daha yüksek saptandı. Bundan dolayı GDM öyküsü olan hastalarda metabolik sendrom taranmalıdır

Anahtar Kelimeler

gestasyonel diyabet; insulin direnci; metabolik sendrom; polikistik over sendromu

Kaynakça

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