İnsülin Direnci ve Ektopik Yağ Birikiminin HOMA İndeksleri ile İlişkisi: Tek Merkezli Bir Gözlem Çalışması

Yıl 2024, , 97 - 106, 30.08.2024

Sevde Nur Emir , Servet Emir

https://doi.org/10.25048/tudod.1461623

Öz

Amaç: Bu çalışmanın amacı, diyabet mellitus tanısı olmayan obez hastalarda, rutin muayeneler sırasında yaygın bir non-invaziv tanı aracı olan ultrason (US) kullanılarak, non alkolik yağlı karaciğer hastalığı (NAFLD), non alkolik yağlı pankreas (veya pankreatik) hastalığı (NAFPD) ve HOMA indeksleri arasındaki ilişkiyi araştırmaktır.
Yöntemler: Bu tek merkezli, retrospektif çalışmada, 2023 yılında obezite polikliniğine başvuran hastaların kayıtları gözden geçirilmiştir. Dijital kayıtlar taranmış ve yaş, cinsiyet, vücut kitle indeksi (VKİ), açlık plazma glikozu, açlık plazma glikozu, C-peptid seviyesi ve pankreatik ve hepatik steatoz derecesini belirten abdominal ultrason raporlarına sahip hastalar çalışmaya dahil edilmiştir. Bilinen kronik hastalığı veya diyabet mellitusu olan ve belirli ilaçları kullanan hastalar çalışma dışı bırakılmıştır. Homa indeksleri, açlık plazma glikozu ve C-peptid seviyeleri kullanılarak hesaplanmıştır.
Sonuçlar: Toplam 62 hasta dahil edilmiştir. Ortalama vücut kitle indeksi 39.1, %91’inde NAFLD ve %82’sinde NAFPD bulunmuştur. VKİ ile NAFLD ve NAFPD arasında anlamlı pozitif bir korelasyon saptanmıştır. HOMA skorları, NAFLD'nin insülin direnci (HOMA-IR) ve insülin hassasiyeti (HOMA-S) üzerinde istatistiksel olarak anlamlı bir etkisi olduğunu, ancak beta-hücre fonksiyonu (HOMA-B) üzerinde anlamlı bir etkisinin olmadığını ortaya koymuştur. NAFPD'nin HOMA skorları üzerinde anlamlı bir etkisi gözlenmemiştir.
Sonuç: Bulgular, NAFLD ile insülin direnci arasındaki ilişkiyi vurgulamakta ve obez hastalarda ektopik yağ birikiminin metabolik yükünü ön plana çıkarmaktadır. Buna karşın, NAFPD ile insülin direnci veya beta-hücre fonksiyonu arasında anlamlı bir korelasyon bulunmamıştır, bu da pankreatik steatozun metabolik etkisinin farklı olabileceğini öne sürmektedir. Bu bulgular, obezitede metabolik bozuklukların tespiti ve tedavisi için klinik stratejileri yönlendirmede yardımcı olabilir.

Anahtar Kelimeler

İnsülin Direnci, Obezite, HOMA İndeksi, Ultrason Görüntüleme, Non alkolik Yağlı Pankreas Hastalığı, Non alkolik Yağlı Karaciğer Hastalığı

Association of Insulin Resistance and Ectopic Fat Accumulation with HOMA Indices: A Single-Centre Observational Study

Öz

Purpose: The aim of this study was to investigate the relationship between non-alcoholic fatty liver disease (NAFLD), non-alcoholic fatty pancreas (or pancreatic) disease (NAFPD) and HOMA indices in obese patients without a diagnosis of diabetes mellitus, using ultrasound (US) as a common non-invasive diagnostic tool during routine examinations.
Methods: In this single-centre, retrospective study, the records of patients who applied to the obesity outpatient clinic in 2023 were reviewed. Digital records were scanned and patients with abdominal ultrasound reports indicating age, gender, body mass index(BMI), fasting plasma glucose, fasting plasma glucose, C-peptide level and degree of pancreatic and hepatic steatosis were included in the study. Patients with known chronic disease or diabetes mellitus and patients with specific drug use were excluded from the study. Homa indices were calculated using fasting plasma glucose and C-peptide levels.
Results: A total of 62 patients were included. Body mass index was 39.1, 91% had NAFLD and 82% had NAFPD. There was a significant positive correlation between BMI and NAFLD and NAFPD. HOMA scores revealed a statistically significant impact of NAFLD on insulin resistance (HOMA-IR) and insulin sensitivity (HOMA-S) but not on beta-cell function (HOMA-B). No significant effect of NAFPD on HOMA scores was observed.
Conclusion: The findings underline the association between NAFLD and insulin resistance and highlight the metabolic burden of ectopic fat deposition in obese patients. In contrast, there was no significant correlation between NAFPD and either insulin resistance or beta-cell function, suggesting that the metabolic impact of pancreatic steatosis may be different. These findings may help to guide clinical strategies for detecting and treating metabolic disorders in obesity.

Anahtar Kelimeler

Non-Alcoholic Fatty Liver Disease, Non-Alcoholic Fatty Pancreas Disease, Insulin Resistance, Obesity, HOMA Index, Ultrasound Imaging

Etik Beyan

Ethics committee approval was obtained from University of Health Sciences, Umraniye Training and Research Hospital Clinical Research Ethics Committee on 01/04/2024.

Destekleyen Kurum

University of Health Sciences, Umraniye Training and Research Hospital Clinical Research Ethics Committee on 01/04/2024.

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