Diyabetik ve Prediyabetik Hastalarda Osteoprotegerin RANKL ve Karotis İntima Media Kalınlığı

Öz

Anahtar Kelimeler

• -

Diyabetik ve Prediyabetik Hastalarda Osteoprotegerin RANKL ve Karotis İntima Media Kalınlığı

Öz

Amaç: Osteoprotegerin ve RANKL’ın (receptor activator of nuclear factor ĸB) osteoporozdaki rolleri iyi bilinmektedir fakat yakın zamanda ateroskleroz üzerine etkileri araştırılmaya başlanmıştır. Bu çalışma komplikasyonsuz diyabetik ve prediyabetik hastalarda ateroskleroz ile osteoprotegerin RANKL düzeyleri arasında bir ilişki olup olmadığını araştırmaya yöneliktir. Yöntem: Olgular tip 2 diyabet (n:20), bozulmuş glukoz toleransı (BGT) (n:16), bozulmuş açlık glukozu (BAG) (n: 19) ve kontrol grubu (n:23) olarak gruplandı. Osteoprotegerin ve çözünebilir RANKL, ELISA yöntemiyle ölçüldü ve sağ ve sol tarafta karotis intima media kalınlığı (KİMK) ölçülerek ortalama hesaplandı. Bulgular: Diğer gruplarla karşılaştırıldığında diyabetiklerde KİMK daha fazlaydı fakat bu fark istatistiksel olarak anlamlı değildi. Gruplar arasında osteprotegerin ve RANKL düzeyleri açısından fark yoktu. Korelasyon analizi sadece BAG grubunda osteoprotegerin ve KİMK arasında bir pozitif korelasyon (r 0,47) ve kontrol grubunda RANKL ve KİMK arasında bir negatif korelasyon (r -0,45) olduğunu gösterdi. Diyabetik hastalarda osteoprotegerin ve insulin düzeyleri arasında bir pozitif korelasyon (p

Anahtar Kelimeler

• osteoprotegerin, RANKL, ateroskleroz, diyabet, insülin

Kaynakça

1. Lacey DL, Timms E, Tan HL, et al. Osteoprotegerin ligand is a cytokine that regulates osteoclast differentiation and activation. Cell. 1998; 93 (2):165-76
2. Yasuda H, Shima N, Nakagawa N, et al. Identity of osteoclastogenesis osteoprotegerin (OPG): a mechanism by which OPG/OCIF Endocrinology. 1998;139(3):1329-37. (OCIF) and inhibits
3. osteoclastogenesis in vitro.
4. Haynes DR, Barg E, Crotti TN, et al. Osteoprotegerin expression in synovial tissue from patients with rheumatoid arthritis, spondyloarthropathies and osteoarthritis and normal controls. Rheumatology (Oxford). 2003; 42(1): 123- 34
5. Shin V, Zebboudj AF, Boström K. Endothelial cells modulate osteogenesis in calcifying vascular cells. J Vasc Res. 2004; 41(2): 193-201
6. Browner WS, Lui LY, Cummings SR. Associations of serum osteoprotegerin levels with diabetes, stroke, bone density, fractures, and mortality in elderly women. J Clin Endocrinol Metab. 2001; 86(2):631-7.
7. Kiechl S, Schett G, Wenning G, et al. Osteoprotegerin is a risk factor for progressive atherosclerosis and cardiovascular disease. Circulation. 2004; 109(18):2175-80.
8. Jono S, Ikari Y, Shioi A, et al. Serum osteoprotegerin levels are associated with the presence and severity of coronary artery disease. Circulation. 2002;106(10):1192-4.

9. Schoppet M, Sattler AM, Schaefer JR, Herzum M, Maisch B, Hofbauer LC. Increased osteoprotegerin serum levels in men with coronary artery disease.J Clin Endocrinol Metab. 2003;88(3):1024-8.
10. Abedin M, Omland T, Ueland T, et al. Relation of osteoprotegerin to coronary calcium and aortic plaque (from the Dallas Heart Study). Am J Cardiol. 2007; 99(4):513-8.
11. Fox CS, Pencina MJ, Wilson PW, Paynter NP, Vasan RS, D'Agostino RB Sr. Lifetime risk of cardiovascular disease among individuals with and without diabetes stratified by obesity status in the Framingham heart study. Diabetes Care. 2008 ;31(8):1582-4.
12. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329(14):977-86.
13. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. N Engl J Med. 2000; 342(6):381-9.
14. Hanefeld M, Fischer S, et al. Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Diabetologia. 1996;39(12):1577-83 Study, 11-year follow-up.
15. Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe. Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Lancet. 1999;354(9179):617-21
16. Diagnosis and Classification of Diabetes Mellitus. American Diabetes Association. Diabetes Care 2008; 31:S55-S60,
17. Anand DV, Lahiri A, Lim E, Hopkins D, Corder R. The relationship between plasma osteoprotegerin levels and coronary artery calcification in uncomplicated type 2 diabetic subjects.J Am Coll Cardiol. 2006;47(9):1850-7
18. Shin JY, Shin YG, Chung CH. Elevated serum osteoprotegerin levels are associated with vascular endothelial dysfunction in type 2 diabetes. Diabetes Care. 2006; 29(7):1664-6.
19. Xiang GD, Xu L, Zhao LS, Yue L, Hou J. The relationship between plasma osteoprotegerin and endothelium- dependent arterial dilation in type 2 diabetes. Diabetes. 2006;55(7):2126-31
20. Kaden JJ, Bickelhaupt S, Grobholz R, et al. Receptor activator of nuclear factor kappaB ligand and osteoprotegerin regulate aortic valve calcification. J Mol Cell Cardiol. 2004;36(1):57-66.
21. Collin-Osdoby P, Rothe L, Anderson F, Nelson M, Maloney W, Osdoby P .Receptor activator of NF-kappa B and osteoprotegerin expression by human microvascular endothelial cells, regulation by inflammatory cytokines, and role in human osteoclastogenesis. J Biol Chem. 2001;276(23):20659-72.
22. Schoppet M, Al-Fakhri N, Franke FE, et al. Localization of osteoprotegerin, tumor necrosis factor-related apoptosis- inducing ligand, and receptor activator of nuclear factor- kappaB atherosclerosis. J Clin Endocrinol Metab. 2004; 89(8):4104- 12. sclerosis and