Jihat BALI, Umut KARABULUT, Ahmet BÜYÜK, Cengiz ÇELİKER

Diyabetik olmayan ST yükselmesiz miyokard enfarktüsü hastalarında serum vaspin düzeyi ile koroner arter hastalığının şiddeti arasındaki ilişki

Giriş ve Amaç: Vaspin bir adipositokin, serin proteaz inhibitörüdür ve obezite, insülin duyarlılığı, diabetes mellitus ve koroner arter hastalığı ile ilişkilidir. Vaspin ve koroner arter hastalığı arasındaki ilişki çeşitli çalışmalarda gösterilmiştir. Koroner arter hastalığı olan hastalarda bu değerin diyabetten bağımsız olup olmadığı ise bilinmemektedir. Ayrıca ST elevasyonsuz miyokard enfarktüslü (NONSTEMI) hastalarda vaspinin önemini gösteren bir çalışma yapılmamıştır. Bu çalışmada, diyabetik olmayan NONSTEMI hastalarında serum vaspin düzeyleri ile SYNTAX skoru ile belirlenen koroner arter hastalığı şiddeti arasındaki ilişkinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: NONSTEMI'li toplam 165 diyabetik olmayan hasta, kesitsel olarak çalışmaya dahil edildi. Serum vaspin seviyeleri ELISA yöntemi ile ölçüldü. SYNTAX skorları, anjiyografi sonuçlarına (çift kör) iki uzman operatör tarafından değerlendirildi. Hastalar çeyrekler arası aralık yöntemi ile SYNTAX skoruna göre üç gruba ayrıldı (Grup 1 SS <10, grup 2 10 ≤ SS≤22, grup 3 SS> 22). Bulgular: Serum vaspin düzeyleri üç grup arasında anlamlı olarak farklı (p = 0,03) ve grup 1'de grup 3'e göre anlamlı olarak yüksek bulundu (p = 0,01). Grup 1 ve 2 ile grup 2 ve grup 3 arasında anlamlı fark bulunmadı. (p = 0, 52, p = 0.06). SYNTAX skoru ile serum vaspin seviyeleri arasında anlamlı ancak zayıf bir negatif korelasyon olduğu bulundu (r = -0.207, p = 0.008). Sonuç: Vaspin, SYNTAX skoru ile negatif korelasyon göstermektedir ve diyabetik olmayan NONSTEMI hastalarında koroner hastalığın şiddetini göstermek için yararlı bir belirteç olabilir.

Anahtar Kelimeler:

Vaspin, NONSTEMI, diyabetik olmayan, SYNTAX

Relationship between serum vaspin levels and the severity of coronary disease in non-diabetic patients with non-ST elevation myocardial infarction

Objectives: Vaspin is an adipocytokine, serine protease inhibitor, correlated to obesity, insülin sensitivity, diabetes mellitus, and coronary artery disease. The association between vaspin and coronary artery disease was shown in several studies. Whether this value is independent of diabetes in coronary artery disease patients is not known. Also, a study that shows the importance of vaspin in patients with Non-ST elevation myocardial infarction (NONSTEMI) is not conducted. This study aimed to investigate the relationship between serum vaspin levels and the severity of coronary artery disease, which is determined by the SYNTAX score, in nondiabetic patients with NONSTEMI Materials and Methods: A total of 165 nondiabetic patients with NONSTEMI were included in this cross-sectional study. Serum vaspin levels were measured by the ELISA method.SYNTAX scores were evaluated by two expert operators blinded to the angiography results. Patients were divided into three groups according to the SYNTAX score by the interquartile range method (group 1 with SS <10, group 2 with 10 ≤ SS≤22, group 3 with SS> 22). Results: Serum vaspin levels were found significantly different between three groups (p = 0,03) and significantly higher in group 1 than group 3 (p = 0,01).No significant difference was found between group 1 and 2 also group 2 and 3 (p = 0, 52, p = 0.06 ).It was found to be a significant but weak negative correlation between the SYNTAX score and serum vaspin levels (r = -0,207, p = 0.008). Conclusion: Vaspin negatively correlates to SYNTAX score and maybe a useful marker to show the severity of coronary disease in nondiabetic patients with NONSTEMI

Keywords:

Vaspin, NONSTEMI, nondiabetic, SYNTAX,

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