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Kardiyovasküler Perspektiften Tip 2 Diabetes Mellitus

TYPE 2 DIABETES MELLITUS FROM CARDIOVASCULAR PERSPECTIVE

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Abstract (2. Language): 
Objective: Type 2 diabetes mellitus is an important health problem for both the world and our country. Cardiovascular diseases are the major causes of mortality and morbidity in diabetic patients. Normotensive and hypertensive type 2 diabetic patients attending Adana Numune Hospital Internal Medicine Outpatient Clinic were investigated for left ventricle diastolic dysfunction prevalence and its relationship with the duration of diabetes and HbA1c levels. Materials and Methods: The cardiac function of the cases was analyzed with echocardiography. Results: The rate of diastolic dysfunction was 46.4% in the nor-motensive group and 75% in the hypertensive group (p=0.03). The mean age of the patients with diastolic dysfunction (56.20±4.37 years) was higher than that of patients with normal diastolic function (50.10±3.66 years) (p=0.004). The duration of diabetes was 8.56±6.98 years for the patients with diastolic dys¬function and 5.55±6.24 years for the patients with normal dias-tolic function (p=0.05). There was no correlation between dias-tolic dysfunction and serum HbA1c levels (p>0.05). All patients were dyslipidemic and had bad metabolic control. Conclusion: Left ventricular diastolic dysfunction may be present in type 2 diabetic patients with no symptoms of cardiac dysfunc¬tion. Ventricular dysfunction rates are higher if hypertension is concurrent with diabetes mellitus. Periodical echocardiography evaluation is appropriate for early detection of cardiac dysfunc¬tion.
Abstract (Original Language): 
Amaç: Diabetes mellitus tüm dünyada olduğu gibi ülkemizde de görülme sıklığı artan önemli bir sağlık sorunudur. Diabetik hasta-lardaki en önemli mortalite ve morbidite nedeni kardiyovasküler hastalıklardır. Bu çalışmada, Adana Nümune Eğitim ve Araştırma Hastanesi Dahiliye Polikliniği'ne başvuran normotansif ve hiper-tansif tip 2 diyabetiklerde sol ventrikül diyastolik disfonksiyon pre-valansı araştırılmış, diyabet süresi ve HbAlc düzeyi ile ilişkisi incelenmiştir. Gereç ve Yöntem: Olguların kalp fonksiyonları ekokardiyografi ile değerlendirildi. Bulgular: Normotansif diyabetik hastaların % 46.4'ünde diyasto-lik disfonksiyon saptanırken, bu oran, hipertansif diyabetiklerde %75.0'e ulaşıyordu (p=0.03). Normotansif ve hipertansif diyabetik hasta grupları arasında yaş bakımından fark yokken (p>0.05), diyastolik disfonksiyon saptanan hastaların yaş ortalamaları (56.2 yıl), diyastolik fonksiyonu normal olan hastalara göre (50.1 yıl) daha yüksek idi (p=0.004). Diyabet süresi, diyastolik disfonksiyon saptanan hastalarda ortalama 8.56 yıl iken, diyastolik fonksiyonu normal olan hastalarda ortalama 5.55 yıl idi (p=0.05). Diyastolik fonksiyon bozukluğu ile HbA1c arasında ilişki bulunamadı (p>0.05). Hastaların çoğunun metabolik kontrollerinin kötü oldu¬ğu ve hepsinin dislipidemik olduğu gözlendi. Sonuç: Hiçbir kalp yakınması olmayan tip 2 diyabetik hastalarda sol ventrikül fonksiyon bozukluğu olabileceği; hipertansiyonun diyabete eşlik ettiği durumlarda bu bozukluğun daha yüksek oran¬da görüldüğü ve diyabetik hastalarda erken dönemde kalp fonk¬siyonlarını değerlendirmek için periyodik ekokardiyografinin uy¬gun olacağı söylenebilir.
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