Hipertansiyon Tanılı Hastalarda Trigliserit/Glukoz İndeksinin İnsülin Direncini Belirlemede Rolü

Yıl 2024, Cilt: 4 Sayı: 1, 652 - 660, 25.04.2024

Muhammet Yıldız , Habibe İnci , Burcu Korkut , Pınar Kalem , Aysegul Ertınmaz Ozkan , Didem Adahan

Öz

Amaç: Bu çalışmada; kan insülin düzeyine bakılamayan merkezlerde özellikle birinci basamakta takip edilen hipertansiyon (HT) hastalarında insülin direncini tespit etmede Trigliserit-Glukoz İndeksinin (TyG) rolünün belirlenmesi amaçlandı. Gereç ve Yöntem: Bu çalışma kesitsel özelliktedir. Ocak 2020-Ocak 2022 tarihleri arasında üniversite hastanesi iç hastalıkları polikliniklerine başvurmuş, 18-65 yaş arasındaki 458 kişi ile çalışma yapıldı. Bireylerin 285’ i hasta grubunu, 173’ ü kontrol grubunu oluşturdu. Hipertansiyon dışında kronik hastalık tanısı alan ve insülin direnci nedeniyle medikal tedavi alan katılımcılar çalışma dışı bırakıldı. Bireylerin sosyodemografik özellikleri, açlık kan şekeri, trigliserit (TG), alanin aminotransferaz testi (ALT), aspartat aminotransferaz testi (AST), kreatinin, glikozillenmiş hemoglobin (HbA1c), insülin ve tiroit stimülan hormon (TSH) değerleri ile antropometrik ölçümleri hastane otomasyon sisteminden alındı. Bulgular: Çalışmada 285/kişi HT hastasının yaş ortalaması; 52,82±12,60, 173/kişi kontrol grubunun 50,65±13,04’tü. HT hasta grubunun %60,4’ü, kontrol grubunun %59,5’i kadındı. HOMA-IR değeri ≥2,5 olan HT hastalarında TyG değeri için kesim noktası ≥4,78 olarak saptanmış olup duyarlılık %69,1, özgüllük %74,7, ROC eğrisi altındaki alan ± standart hata (AUC±SE)= 0,759±0,030 (p<0,001) olarak bulundu. Yapılan tek değişkenli regresyon analizlerinde TyG değerindeki 1 birimlik artışın hipertansiyon riskini 7,21 kat arttırdığı ve bu artışın istatistiksel olarak anlamlı olduğu tespit edildi (p<0,001). Sonuç: Bu çalışmada TyG indeksinin hipertansiyon tanısı almış hastalarda prognozu etkileyecek bir parametre olarak insülin direncini hesaplamada kullanılabileceği saptandı. Çalışma TyG’nin özellikle aile sağlığı merkezlerinde HOMA-IR’ye alternatif olarak kullanılabileceğine dikkat çeken önemli bir araştırmadır.

Anahtar Kelimeler

Hipertansiyon, İnsülin Direnci, Trigliserit/Glukoz İndeksi

Etik Beyan

Çalışma için Karabük Üniversitesi Girişimsel Olmayan Çalışmalar Etik Kurulu’ndan onay alındı (Karar No: 2022/915, Karar tarihi:13/04/2022). Bu çalışma Helsinki Bildirgesine uygun olarak hazırlanmıştır.

The Role of Triglyceride/Glucose Index in Determining Insulin Resistance in Patients Diagnosed with Hypertension

Öz

Objective: In this study, we aimed to determine the role of Triglyceride-Glucose Index (TyG) in detecting insulin resistance in hypertension (HT) patients followed up in primary care, especially in centers where blood insulin levels cannot be checked. Methods: This study is cross-sectional. The study was conducted with 458 people aged 18-65 who applied to the internal medicine outpatient clinics of the university hospital between January 2020 and January 2022. 285 of the individuals formed the patient group and 173 constituted the control group. Participants diagnosed with chronic diseases other than hypertension and receiving medical treatment due to insulin resistance were excluded from the study. Sociodemographic characteristics of the individuals, fasting blood sugar, triglyceride (TG), alanine aminotransferase test (ALT), aspartate aminotransferase test (AST), creatinine, glycated hemoglobin (HbA1c), insulin and thyroid stimulating hormone (TSH) values and anthropometric measurements were taken from the hospital automation system. Results: The mean age of 285/person HT patients and 173/person control group was 52.82±12.60 and 50.65±13.04, respectively. 60.4% of the HT patient group and 59.5% of the control group were female. In HT patients with a HOMA-IR value of ≥2.5, the cut-off point for TyG value was found to be ≥4.78, with a sensitivity of 69.1%, specificity of 74.7%, area under the ROC curve ± standard error under the ROC curve (AUC±SE)= 0.759±0.030 (p<0.001). Univariate regression analysis showed that a 1-unit increase in TyG increased the risk of hypertension 7.21-fold and this increase was statistically significant (p<0.001). Conclusion: In this study, it was determined that the TyG index can be used to calculate insulin resistance as a parameter that will affect the prognosis in patients diagnosed with hypertension. The study is important research that points out that TyG can be used as an alternative to HOMA-IR, especially in family health centers.

Anahtar Kelimeler

Hypertension, Insulin Resistance, Triglyceride/Glucose Index

Kaynakça

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