Buradasınız

Diyabette Glisemik Kontrolün Serum Biyokimyasal Parametreleri İle İlişkisi

The Relationship Between Serum Biochemical Parameters And Glycaemic Control In Diabetes

Journal Name:

Publication Year:

DOI: 
http://dx.doi.org/10.5505/abantmedj.2012.36854
Abstract (2. Language): 
Background: We aimed this study to evaluate the relationship between some biochemical parameters and glycaemic control in diabetic patients categorized by HbA1c levels. Method: This study includes 24 good glycaemic control (HbA1c<6.5) and 58 poorly glycaemic control (HbA1c>6.5) patients with diabetes mellitus and 29 healthy subjects. Plasma levels of HbA1c were measured by HPLC. Serum fasting and post-prandial glucose, creatinin, triglyceride, total cholesterol, HDL cholesterol concentrations were analyzed by photometric method. Urine protein and microalbumin levels were studied by turbidimetric method. Serum TSH, sT3, sT4, vitamin B12 and folic acid concentrations were measured by electrochemiluminescent assay. Results: Serum triglyceride levels of poorly glycaemic control group were higher than healthy subjects (p=0,003). Urine microalbumin/creatinine ratio was increased in patients with poorly glycaemic control when compared good glycaemic control group (p=0,05). There was no significant difference between groups and other biochemical parameters. Conclusion: The triglyceride and microalbumin levels were associated with glycemic control in diabetic patients. These data suggested that good glycemic control may affect development of nephropathy and coronary artery disease in patients with diabetes mellitus.
Abstract (Original Language): 
Amaç: Bu çalışmanın amacı diyabetes mellitus hastalarını HbA1c düzeylerine göre iyi ve kötü kontrollü diyabet olarak sınıflandırarak glisemik kontrol ile bazı biyokimyasal parametrelerin ilişkisini araştırmaktır. Yöntem: Çalışmaya 24 iyi kontrollü diyabet (HbA1c<6,5) hastası, 58 kötü kontrollü diyabet (HbA1c>6,5) ve diyabeti olmayan 29 sağlıklı birey katıldı. HbA1c seviyeleri HPLC yöntemiyle, açlık ve tokluk kan glukozu, kreatinin, trigliserid, total kolesterol ve HDL kolesterol seviyeleri fotometrik, idrar protein ve mikroalbumin düzeyleri türbidimetrik, TSH, sT3, sT4, B12 vitamini ve folik asit seviyeleri elektrokemilüminesans yöntemle ölçüldü. Bulgular: Kötü kontrollü diyabet hastalarının trigliserid düzeyleri kontrol gurubuna göre anlamlı derecede yüksek bulundu (p=0,003). İdrar mikroalbumin/kreatinin düzeyleri, kötü kontrollü diyabet hastalarında iyi kontrollü diyabet hastalarına göre anlamlı şekilde yüksek bulundu (p=0,05). Diğer parametreler açısından, gruplar arasında anlamlı bir farklılık tespit edilemedi. Sonuç: Diyabetik hastalarda glisemik kontrol, trigliserid ve mikroalbumin düzeyi ile ilişkili bulunmuştur. Bu veriler, diyabetli hastalarda glisemik kontrolün nefropati ve koroner kalp hastalığı gelişimini etkileyebileceğini düşündürmektedir.
51-54

REFERENCES

References: 

1. de Zeeuw D, Ramjit D, Zhang Z, Ribeiro AB, Kurokawa K,
Lash JP, Chan J, Remuzzi G, Brenner BM, Shahinfar S.
Renal risk and renoprotection among ethnic groups with
type 2 diabetic nephropathy: a post hoc analysis of RENAAL.
Kidney Int. 2006; 69: 1675-82.
2. Mogensen CE. Microalbuminuria predicts clinical proteinuria
and early mortality in non-insulin-dependent
diabetes. N Eng J Med. 1984; 310: 356-360.
3. Rutledge JC, Ng KF, Aung HH, Wilson DW. Role of triglyceride-
rich lipoproteins in diabetic nephropathy. Nat
Rev Nephrol. 2010; 6: 361-370.
4. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE,
Cull CA, Hadden D, Turner RC, Holman RR. Association
of glycaemie with macrovascular and microvascular
complications type 2 diabetes (UKPDS 35): prospective
observational study. BMJ. 2000; 321: 405-12.
5. Khaw KT, Wareham N. Glycated hemoglobin as a marker
of cardiovascular risk. Curr opin Lipidol. 2006; 17: 637-
43.
6. Selvin E, Ning Y, Steffes MW, Bash LD, Klein R, Wong TY,
Astor BC, Sharrett AR, Brancati FL, Coresh J. Glycated
hemoglobin and the risk of kidney disease and retinopathy
in adults with and without diabetes. Diabetes. 2011;
60: 298-305.
7. Hemmingsen B, Lund SS, Gluud C, Vaag A, Almdal T,
Hemmingsen C, Wetterslev J. Intensive glycaemic control
for patients with type 2 diabetes: systematic review
with meta-analysis and trial sequential analysis of randomised
clinical trials. BMJ. 2011;343:d6898.
8. Koenig RJ, Peterson CM, Kilo C, Cerami A, Williamson JR.
Hemoglobin A1c as an indicator of the degree of glucose
intolerance in diabetes. Diabetes. 1976; 25: 230-232.
9. Herman WH, Fajans SS. Hemoglobin A1c for the diagnosis
of diabetes: practical considerations. Pol Arch Med
Wewn. 2010; 120: 37-40.
10. True MW. Circulating biomarkers of glycemia in diabetes
management and implications for personalized medicine.
J Diabetes Sci Technol. 2009 1; 3: 743-747.
11. American Diabetes Association. Standarts of medical
care in diabetes-2009. Diabetes Care. 2009; 32(Suppl
1):S13-61.
12. Rodbard HW, Blonde L, Braithwaite SS, Brett EM, Cobin
RH, Handelsman Y, Hellman R, Jellinger PS, Jovanovic
LG, Levy P, Mechanick JI, Zangeneh F. American Association
of Clinical Endocrinologists medical guidelines for
clinical practice for the management of diabetes mellitus.
AACE Diabetes Mellitus Clinical Practice Guidelines
Task Force. Endocr Pract. 2007; 13 Suppl 1: 1-68.
13. Niskanen L, Uusitupa M, Sarlund H, Siitonen O, Voutilainen
E, Penttile I, Pyorala K. Microalbuminuria predicts
the development of serum lipoprotein abnormalities favouring
atherogenesis in newly diagnosed type 2 (noninsulin-
dependent) diabetic patiens. Diabetologia. 1990;
33: 237-43.
14. Witte EC, Lambers Heerspink HJ, de Zeeuw D, Bakker SJ,
de Jong PE, Gansevoort R. First morning voids are more
reliable than spot urine samples to assess microalbuminuria.
J Am Soc Nephrol. 2009; 20: 436-443.
15. Ravid M, Brosh D, Ravid-Safran D, Levy Z, Rachmani R.
Main risk factors for nephropathy in type 2 diabetes
mellitus are plasma cholesterol levels, mean blood pressure,
and hyperglycemia. Arch Intern Med. 1998 11;
158: 998-1004.
16. Zarini GG, Exebio JC, Gundupalli D, Nath S, Huffman FG.
Hypertension, poor glycemic control, and microalbuminuria
in Cuban Americans with type 2 diabetes. Int J
Nephrol Renovasc Dis. 2011; 4: 35-40.
17. AlAdsani A, Memon A, Suresh A. Pattern and Determinants
of Dyslipedemia in Type 2 Diabetes Mellitus patients
in Kuwait. Acta Diabetol. 2004; 41:1295.
18. Naheed T, Khan A, Masood G, Yunus BB, Chaudry MA.
Dyslipedemias in type II diabetes mellitus patients in a
teaching hospital of Lahore, Pakistan. Pak J Sci. 2003;
19: 2836.
19. Thomas RM. Oxidative stress and lipid in diabetes. A
role in endothelium vasodilator dysfunction. Vasc Med.
2002; 1: 195–204.
20. Ginsberg HN. Identification and treatment of hypertriglyceridemia
as a risk factor for coronary heart disease.
Curr Cardiol Rep. 1999; 1: 2337.
21. Agbola Abu CF, Ohwovoriole AE, Akinlade KS. The effect
of glycaemic control on the prevalence and pattern of
dyslipedemia in Nigerian patients with newly diagnosed
noninsulin dependent diabetes. West Afr J Med. 2000;
19: 275.

Thank you for copying data from http://www.arastirmax.com