Sakarya Eğitim ve Araştırma Hastanesine Başvuran Hastaların HOMA-IR Değerlerinin Yaş ve Cinsiyet Faktörü Açısından Değerlendirilmesi

Öz

Amaç: Bu çalışmada, farklı rahatsızlıklar sebebiyle hastanemizin farklı polikliniklerine başvuran bireylerin HOMA-IR değerlerini tespit etmek amaçlanmıştır. Bu çalışma, bireylerin insülin direncini belirlemek için yapılmıştır. Materyal Metot: Çalışmamızda, hastanemizin farklı polikliniklerine başvuran 7815 hastaya ait veriler incelenerek insülin direnci parametreleri kaydedildi. Materyal olarak 7815 hasta (1740 erkek, 6075 kadın) değerlendirildi. Bu çalışmada insülin direnci; homeostatic model değerlendirme (HOMA) metoduyla ölçüldü. Homeostatic model assessment insulin resistance (HOMA-IR) skoru ≥ 2.7 değerlere sahip olan bireylerin insülin direnci olduğu kabul edildi. Bulgular: Hastanemizin farklı polikliniklerine müracaat eden hastaların yaş ortalaması 40.89±0.16 yıl olarak hesaplandı. Bu hastaların 4681’i (%59.90) insülin dirençli olduğu hesaplandı. İnsülin direnci olan ve olmayan grup arasında yaş ve cinsiyet açısından istatistik olarak anlamlı bir farklılık (p<0.001) bulundu. Sonuç: Toplamda 7815 kişi değerlendirildi. Hastaneye başvuran bireylerin %59.90’ı (4681 kişi) diabetes mellitusa yakalanma riskinin daha yüksek olduğu sonucuna varıldı. Diyabet hastalarında rutin olarak HOMA-IR testinin yapılması önerildi. Bu bulguların diyabetik olmayan hastalarda da bulunması kardiyovasküler mortalite riskini artıracağından daha yakın takip edilmesi gerektiği kanaatine varıldı.

Anahtar Kelimeler

• Diyabet
• Hastalık riski
• İnsülin direnci

Evaluation of HOMA-IR Values of Patients Applying to Sakarya Training and Research Hospital in Terms of Age and Gender Factor

Öz

Aim: In this study, it was aimed to determine the HOMA-IR values of individuals who applied to different polyclinics of our hospital due to different ailments. This study was conducted to determine the insulin resistance of individuals. Material and Method: In our study, insulin resistance parameters were recorded by analyzing the data of 7815 patients who applied to different polyclinics of our hospital. 7815 patients (1740 men, 6075 women) were evaluated as material. In this study, insulin resistance; it was measured by the homeostatic model evaluation (HOMA) method. Individuals with HOMA-IR scores ≥ 2.7 were considered to have insulin resistance. Findings: The average age of patients who applied to different polyclinics of our hospital was calculated as 40.89 ± 0.16 years. 4681 (59.90%) of the patients were calculated to be insulin resistant. A statistically significant difference was found between the groups with and without insulin resistance in terms of age and gender (p <0.001). Results: In total, 7815 people were evaluated. It was concluded that 59.90% (4681 people) of individuals who applied to the hospital had a higher risk of developing diabetes mellitus. Routine HOMA-IR testing was recommended for patients with diabetes. It was concluded that these findings should be followed up more closely since the presence of these findings in non-diabetic patients would increase the risk of cardiovascular mortality.

Anahtar Kelimeler

• Diabetes
• Disease risk
• Insulin resistance

Kaynakça

1. Sheu WH, Jeng CY, Young MS, et al. Coronary artery disease risk predicted by insulin resistance, plasma lipids, and hypertension in people without diabetes. Am J Med Sci. 2000;319(2):84-8. https://doi.org/10.1097/00000441-200002000-00003
2. Despres JP, Lamarche B, Mauriege P, et al. Hyperinsulinemia as an independent risk factor for ischemic heart disease. N Engl J Med. 1996;334(15):952-7. https://doi.org/10.1056/NEJM199604113341504
3. DeFronzo RA, Bonadonna RC, Ferrannini E. Et al. A balanced overview. Diabetes Care 1992;15: 318-68. https://doi.org/10.2337/diacare.15.3.318
4. Bakris GL. Pathogenesis of hypertension in diabetes. Diabetes Reviews 1995;3:460-76.
5. Reaven GM. Role of insulin resistance in human disease. Diabetes 1988;37:1595-607. https://doi.org/10.2337/diab.37.12.1595
6. Topsakal S, Yerlikaya E, Akin F, ve ark. Relation with HOMA-IR and thyroid hormones in obese Turkish women with metabolic syndrome. Eat Weight Disord 2012;17(1):e57-61. https://doi.org/10.1007/BF03325329
7. Song YS, Hwang YC, Ahn HY, et al. Comparison of the Usefulness of the Updated Homeostasis Model Assessment (HOMA2) with the Original HOMA1 in the Prediction of Type 2 Diabetes Mellitus in Koreans, Diabetes Metab J 2016;40:318-325. https://doi.org/10.4093/dmj.2016.40.4.318
8. Bilge U, Gültekin G, Bilgin M, Ünlüoğlu İ. Bir Aile Hekimliği polikliniğine başvuran kırk yaş altı populasyonda obezite ve insülin direnci oranları, Türk Aile Hek Derg 2016; 20 (2): 50-53. https://doi.org/10.15511/tahd.16.21650

9. Türkiye Endokrinoloji ve Metabolizma Derneği. Metabolik Sendrom Kılavuzu. Ankara 2009 s:8.
10. Gupta D, Krueger CB, Lastra G. Over-nutrition, obesity and insulin resistance in the development of βcell dysfunction. Curr Diabetes Rev 2012;8(2):76-83. https://doi.org/10.2174/157339912799424564
11. Moller DE, Flier JS. Insulin resistance mechanisms, syndromes, and implications.N Engl J Med 1991;325(13):938-48. https://doi.org/10.1056/NEJM199109263251307
12. Esteghamati A, Ashraf H, Khalilzadeh O etal. Optimal cutoff of homeostasis model assessment of insulin resistance (HOMA-IR) for the diagnosis of metabolicsyndrome: third national surveillance of risk factors of noncommunicable diseases in Iran (SuRFNCD-2007). NutrMetab (Lond) 2010;7:26. https://doi.org/10.1186/1743-7075-7-26
13. CDC. Prevalance of diabetes and impaired fasting glucose in adults United States 1999-2000. MMWR 2003; 52: 833-837.
14. Bilge U, Gültekin G, Bilgin M, Ünlüoğlu İ (2015). Homeostatic Model Assessment Insulin Resistance (HOMA-IR) Değerleri ile Glomerüler Filtrasyon Hızları Arasındaki İlişki: Retrospektif Bir Çalışma, Ankara Med J, 2015, 15(4):220-225, https://doi.org/10.17098/amj.18395
15. Satman I, Omer B, Tutuncu Y etal. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013; 28(2): 169-80 https://doi.org/10.1007/s10654-013-9771-5